论著

2018~2022 年某三甲眼科专科医院临床诊疗非手术常规血液检验项目分析

Analysis of non-surgical routine blood test items in clinical diagnosis and treatment at a tertiary ophthalmic specialist hospital from 2018 to 2022

:99-106
 
目的:分析某三甲眼科专科医院近5年临床诊疗涉及非手术常规血液检验项目的申请检测情况,为眼科医师了解检验辅助诊断概况、专科医院的实验室项目管理和开展新项目提供依据。方法:从中山大学中山眼科中心医学检验信息管理系统导出2018年1月1日至2022年12月31日期间到院申请进行血液检测的12 866例门诊患者的22 453份样本(共94 081项检验项目)相关检验记录。将申请检测科室及专科医师按照中华医学会眼科学分会推荐分为10个亚专科,对疾病诊断和检测项目等资料进行统计分析,采用文字、柱状图及折线图的形式进行描述。结果:5年间申请进行血液检测的12 866例门诊患者,男性患者6 356例(49.4%),女性患者6 510例(50.6%)。基于首诊眼病诊断分类,排名前三位的眼病分别为眼整形/眼肿瘤病5 214例 (40.5%)、眼底病 3 487例(27.1%)、角膜病1 711例(13.3%)。申请检测样本量从2018年的3 163份增至2022年的5 903份,总体呈上升趋势。从申请的专科医师分析,眼整形/眼眶病专科医师申请单最多,有6 751份(占30.1%),其中自身免疫性疾病检测所占比例最高,为49.1%,甲状腺疾病相关检测占41.9%;眼免疫专科医师申请检测量为4 214份(占18.8%),以自身免疫性疾病检测为主占55.7%,感染性项目检测占32.5%;眼底病专科医师申请检测量为3 629份(16.2%),其中自身免疫性疾病检测和感染性项目检测分别占47.8%和39.6%;角膜病专科医师申请数为1 436份(占6.4%),其中过敏性疾病检测比例为41.2%。基于一份申请单可同时检测多个项目,眼整形/眼眶专科申请检测总项最多,有33 513项,甲
状腺疾病检测占65.0%;角膜病专科申请16 482项,过敏性疾病检测占83.4%,眼底病专科和眼免疫专科分别为8 794项和8 047项,均以自身免疫性疾病检测为主,分别占42.5%和40.4%。结论:眼科专科医院中非手术常规检验项目在各亚专科的申请数量明显分布不均,项目构成受亚专科疾病特点的影响。眼科实验室应针对性加强非手术常规检测项目的宣传和管理。
Objective: To analyze the application and testing of non-surgical routine blood test items in clinical diagnosis and treatment in a top-tier ophthalmic hospital over the past five years, providing ophthalmologists with insights into the overview of laboratory-assisted diagnosis, laboratory project management in specialized hospitals, and the basis for launching new projects. Methods: Relevant test records of 22,453 samples (totaling 94,081 test items) from 12,866 outpatient patients who applied for blood tests at the Zhongshan Ophthalmic Center of Sun Yat-sen University from January 1, 2018, to December 31, 2022, were retrieved from the medical laboratory information management system. The departments applying for tests and specialist physicians were divided into 10 subspecialties according to the recommendations of the Ophthalmology Branch of the Chinese Medical Association. Statistical analysis was performed on disease diagnosis and test items, and the results were described in the form of text, bar graphs, and line graphs. Results: Among the 12,866 outpatient patients who applied for blood tests over the five-year period, 6,356 (49.4%) were male and 6,510 (50.6%) were female. Based on the classification of first-visit ophthalmic diseases, the top three were ophthalmic plastic surgery/ocular tumor diseases (5,214 cases, 40.5%), fundus diseases (3,487 cases, 27.1%), and corneal diseases (1,711 cases, 13.3%). The number of samples applied for testing increased from 3,163 in 2018 to 5,903 in 2022, showing an overall upward trend. From the perspective of specialist physicians applying for tests, ophthalmic plastic surgery/orbital disease specialists had the highest number of applications, with 6,751 (30.1%), among which autoimmune disease testing accounted for the highest proportion, at 49.1%, and thyroid disease-related testing accounted for 41.9%. The number of applications from ophthalmic immunology specialists was 4,214 (18.8%), with autoimmune disease testing accounting for 55.7% and infectious disease testing accounting for 32.5%. The number of applications from fundus disease specialists was 3,629 (16.2%), with autoimmune disease testing and infectious disease testing accounting for 47.8% and 39.6%, respectively. The number of applications from corneal disease specialists was 1,436 (6.4%), with allergic disease testing accounting for 41.2%. Since multiple tests could be performed on a single application, the ophthalmic plastic surgery/orbital disease subspecialty had the highest total number of tests applied for, with 33,513 tests, of which thyroid disease testing accounted for 65.0%. The corneal disease subspecialty applied for 16,482 tests, with allergic disease testing accounting for 83.4%. The fundus disease subspecialty and ophthalmic immunology subspecialty respectively applied for 8,794 and 8,047 tests, both primarily focused on autoimmune disease testing, accounting for 42.5% and 40.4%, respectively. Conclusions: The number of applications for non-surgical routine test items in ophthalmic specialized hospitals is significantly unevenly distributed among various subspecialties, and the composition of the items is influenced by the characteristics of diseases in each subspecialty. Ophthalmic laboratories should strengthen the promotion and management of non-surgical routine test items in a targeted manner.
经验交流

眼科专科医院住院医师规范化培训实践与思考

Practice and reflection on standardized training for ophthalmology residents in eye hospitals

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眼科住院医师规范化培训(以下简称“规培”)是培养眼科医师的必要环节。我国规培模式日臻成熟,但眼科规培过程管理中仍存在诸多问题,包括专科医院和综合医院的规培协调问题、师资激励、规培学员类型多样、研究生和规培“双轨制”、如何开展显微手术技能培训等,很多具体方案和措施仍在摸索中。眼科专科医院学科体系建设相对完善,配备更充足的教学资源,有一定的规培经验,是眼科规培的主力军。汕头国际眼科中心结合国家要求创建了一套规培模式,注重规范化、标准化和个性化相结合,并通过借鉴香港及海外住院医师培训经验,丰富理论培训形式,优化操作培训环境,突出外语和科研能力训练,强调系统性临床思维。本文基于汕头国际眼科中心五年来开展眼科规培的实践经验与思考,总结当前眼科专科医院规培现状,并提出对策和建议。
Standardized training for ophthalmology residents is an essential stage during the development of ophthalmologists. The standardized training system has become more and more mature, while problems still exist in the aspects of coordination between specialized hospitals and general hospitals, teacher resources, unevenness of trainees, combination of postgraduate education and residency standardized training, microsurgical skills training, and so on. Therefore, programs and strategies of standardized training are still under exploration. Eye hospitals, with the excellent disciplinary system, adequate resources, and advanced experience, play a key role in standardized training for ophthalmology residents. Joint Shantou International Eye Center has set up a training model in accordance with national requirements, focusing on the combination of standardization, normalization, and individuation. Besides, by learning from the oversea experience of residents training, Joint Shantou International Eye Center has enriched the training forms, optimized the skill training environment, and highlighted the training of foreign language, scientific research, and systematic clinical thinking. This paper, based on the 5-year experience and reflection on standardized training for ophthalmology residents in Joint Shantou International Eye Center, summarizes the current status of standardized training and put forward some measures and suggestions.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
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