CN114049954A - Novel coronavirus pneumonia clinical diagnosis and treatment support method and system - Google Patents
Novel coronavirus pneumonia clinical diagnosis and treatment support method and system Download PDFInfo
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Abstract
The invention relates to a novel coronavirus pneumonia clinical diagnosis and treatment support method and a system, belonging to the technical field of medical support systems; since the new coronary pneumonia epidemic situation occurs, difficult epidemic prevention experience is reviewed, and the local and hospital practice is combined, so that the diagnosis and treatment process is gradually standardized, the medical environment is improved, a novel clinical treatment mode is explored, the clinical treatment effect is effectively improved, the infection source is well controlled, the cure rate of patients is obviously improved, the incidence rate of converting the common cases into severe cases and severe cases into critical cases is reduced, and the epidemic situation is effectively controlled.
Description
Technical Field
The invention belongs to the technical field of medical support systems, and particularly relates to a novel coronavirus pneumonia clinical diagnosis and treatment support method and system.
Background
In 20 days 1 month 2020, the disease is taken into class B infectious disease by the health care committee and managed as class A infectious disease. In 30 days 1 month, the WHO names the virus as 2019 type coronavirus (2019-nCov), the disease caused by the virus is novel coronavirus pneumonia (Corona virus disease, COVID-19, which is called novel coronavirus pneumonia for short, the novel coronavirus is a newly discovered pathogen, people generally lack immunity, and the novel coronavirus has huge transmission power, high pathogenicity and high lethality rate to cause outbreak and prevalence in the world, and is identified as 'international Public Health Emergency (PHEIC)' by the WHO, since epidemic situation occurs, people in the whole country show unprecedented courage and fate, has concentric force and resists epidemic, and all medical personnel show responsibility and act of cherub, carry out the first in a reverse way, and carry burden forward.
Through a series of joint defense joint control measures, the epidemic situation of China is basically restrained, but the number of the overseas input disease cases is gradually increased, and the prevention and control situation faces new challenges and new requirements. In the face of the new situation of the global epidemic situation of the new coronary pneumonia, people need to have work preparation for lasting battles, and each medical and health institution needs to combine with actual conditions, deeply explore and research clinical diagnosis and treatment processes, continuously innovate a treatment mode, and practically improve the prevention and treatment efficiency.
Under the new situation, the necessity and the urgency of perfecting the major infectious disease treatment system are more and more remarkable. Therefore, the design of the standardized, scientific and refined diagnosis and treatment process and the construction of the clinical diagnosis and treatment mode are of great importance, the clinical diagnosis and treatment process and the mode are retrospectively analyzed, and the details which can be improved are discussed so as to optimize the diagnosis and treatment process and improve the prevention and control efficiency.
Therefore, a new method and system for supporting clinical diagnosis and treatment of coronavirus pneumonia are needed to solve the above problems.
Disclosure of Invention
The invention aims to provide a novel coronavirus pneumonia clinical diagnosis and treatment support device, which is used for solving the technical problems in the prior art, such as: through a series of joint defense joint control measures, the epidemic situation of China is basically restrained, but the number of the overseas input disease cases is gradually increased, and the prevention and control situation faces new challenges and new requirements. Under the new situation, the necessity and the urgency of perfecting a major infectious disease treatment system are increasingly remarkable; therefore, the design of the standardized, scientific and refined diagnosis and treatment process and the construction of the clinical diagnosis and treatment mode are of great importance.
In order to achieve the purpose, the technical scheme of the invention is as follows:
a novel support method for clinical diagnosis and treatment of coronavirus pneumonia comprises the following steps:
s1 specifies the work flow before admission; objective data before patient admission is obtained by fully utilizing an informatization means, assessment before patient admission is completed, and basic preparation work for patient admission is well done;
s2, standardizing diagnosis and treatment processes after hospital admission; after the patient is admitted, basic care is firstly ensured, and the health propaganda and education of the new coronary pneumonia are completed;
s3, standardizing a core medical operation flow; completely standardizing, programming and institutionalizing the core medical operation;
s4 promoting cooperation and division of labor among doctors in the affected area;
s5 promoting the medical document full-process electronization and paperless office mode;
s6 proposes doctor-patient communication strategy and doctor-patient relationship processing in special period;
s7, standardizing the disease transition and coping strategies;
s8 specifies discharge and follow-up management.
Further, step S1 is specifically as follows:
1-2h before the patient is admitted into the hospital, the patient personal history, the past history, the family history, the epidemiological history and the observation record are communicated with a fixed-point treatment mechanism by fully utilizing an informatization means, and after medical staff of the fixed-point treatment medical mechanism receives the information, the evaluation before the patient is admitted into the hospital is completed at the first time, the preparation of a ward, consumables, equipment, medicines, oxygen sources and personal living articles is well made, and the basic work of hospitalization procedure handling and bed allocation is completed; for some special patients, the medical institution performs personnel allocation and tissue division in advance, and performs preoperative preparation for the operation patient.
Further, step S2 is specifically as follows:
after the patient is admitted, performing basic nursing and intensive nursing to finish the propaganda and education of new coronary lung health; informing the patient of each detail of disease prevention and control during hospitalization by paper data, signing various informed consent forms, and uploading an electronic version through a picture acquisition terminal;
the doctor in charge finishes necessary physical examination, inquiry and equipment debugging at one time, informs the treatment principle and possible complications and conducts necessary psychological dispersion;
there are three basic principles for the initial disease management and treatment regimen;
firstly, comprehensively collecting case data, scientifically evaluating, accurately typing, managing in a partition way, and treating according to different treatment methods; the critical type treats the symptoms first, the light type and the common type treat the root causes first, and the heavy type treats both the symptoms and root causes;
secondly, an individualized treatment scheme is formulated by following the latest diagnosis and treatment guide of the new coronary pneumonia, considering complications and objective symptoms and combining medical history;
thirdly, hospital medical resources are utilized, expert consultation is organized, multidisciplinary cooperation is developed, and the expert opinions are referred to, so that the experience medication and the individual opinions of a core treatment scheme are avoided.
Further, step S3 is specifically as follows:
the method comprises the steps of setting up detailed operation flows and setting up an emergency plan for hand hygiene, putting on and taking off of isolation clothes, throat swab collection, artery and vein blood sampling, atomization operation, noninvasive ventilator management, ward disinfection, ward external examination and transportation, artificial airway establishment, deep vein puncture and tracheotomy.
Further, step S4 is specifically as follows:
for the shift, the consultation of the ward, the case discussion and the writing of the medical document, the cooperation and the division of labor are carried out; the doctor in charge is responsible, the doctor of white class enters ward round and relevant medical operation, the change of state of an illness is recorded in the cooperation of two-line doctor's office, the doctor of taking group guides and closes the work, the cooperation mode that the chief of the department focuses on the key attention is accomplished through information-based system, intelligent terminal, intercom, visual equipment and is looked into, a series of work of ward round, consultation, equipment debugging, case history record, treatment scheme adjustment.
Further, step S5 is specifically as follows:
the whole process of electronic medical record management is realized, various paper medical record data are cancelled in a ward, an electronic signature system is implemented, an electronic medical record auditing program is added, and the electronic medical record is archived after being checked and qualified through three network audits;
after a patient is discharged from a hospital, a clean area is selected for centralized printing, non-close contact persons are designated for unified binding, a computer, a printer and a mobile terminal are used for operating a working area for periodic disinfection, reports and medical record documents in a PDF format are produced by various medical technology systems, nursing systems and electronic medical record systems, and the PDF reports and the electronic documents are uploaded to a clinical data center through an integrated platform interface, so that the PDF reports and the electronic documents of the lower limbs of the patient at corresponding addresses are obtained.
Further, step S6 is specifically as follows:
the risk factors of the PICS are recognized and intervened in the early stage of the patient receiving the treatment process, the prevention and treatment are repeated, and the multidisciplinary team construction aiming at the ICU rear service is strengthened after the patient leaves the ICU.
Further, step S7 is specifically as follows:
four types of outcome appear in patients with new coronary pneumonia, which are respectively: healing, aggravation, recurrence and death;
patients who reach the discharge index: for patients reaching clinical recovery, a discharge process is designed in advance according to the infectious disease management principle; before leaving the hospital, the personal articles are disinfected comprehensively, the personal articles brought out of the ward are strictly screened and controlled, the personal articles are well handed over with the community hospital, the next medical isolation is carried out, and public opinion propaganda and management are well carried out;
patients with increased disease: the weight is changed from light to heavy or from heavy to dangerous; for patients with confirmed diagnosis, accurately evaluating the disease degree when the patients are admitted, identifying independent risk factors, evaluating the probability of disease aggravation by combining the complications of the patients and the current disease degree, grading the risk factors of the diseases, and performing classification management according to the grades; wherein, management is divided into four aspects: firstly, the method comprises the following steps: dynamically carrying out grading evaluation on the current disease situation and the risk factors; secondly, according to the treatment strategy of the next step of the latest clinical diagnosis guidance, the treatment and nursing scheme is adjusted in time, the sensory management is upgraded, and different professional medical care teams are established according to the condition of the equipment required by organ support; thirdly, the method comprises the following steps: scientifically evaluating the curative effect and the disease process, accurately identifying various complications and adverse reactions, and fourthly: actively carrying out remote consultation and on-line consultation, collecting opinions of experts group and optimizing a treatment scheme;
patients with nucleic acid restoring yang: the median time of virus turning negative in the surviving patients is 20 days, the phenomenon of restoring positive exists in part of patients, the psychological health assessment is carried out on the part of the patients comprehensively, a psychotherapist team is established for psychological dispersion, the medicine is fully utilized for restoring positive intervention, the reason of restoring positive and the infectivity thereof are scientifically assessed, and the nucleic acid turning negative time is shortened;
patients who died: according to the law of infectious diseases prevention and treatment, the infection sources of remains, personal articles and the like are treated at the end, and the disease area is disinfected at the end.
Further, step S8 is specifically as follows:
after the patient reaches the discharge standard, the patient finishes the household isolation for 14 days, and is uniformly brought into the standard management by the CDC and the health organization of the residential foundation layer; reexamining chest CT from 2 nd week and 4 th week to the fixed-point rescue hospital after the medical observation is finished, and reexamining nucleic acid detection of respiratory pharynx swabs; the system is responsible and obligated to participate in follow-up work as a fixed-point treatment hospital, guides the primary medical and health institution to complete the rest observation tasks, informs the focus of attention and shares medical record data; the basic health institution needs to take full advantage of the area and dynamically manage the discharged patients by using an informatization means.
A novel coronavirus pneumonia clinical diagnosis and treatment support system adopts the novel coronavirus pneumonia clinical diagnosis and treatment support method to carry out novel coronavirus pneumonia clinical diagnosis and treatment support.
Compared with the prior art, the invention has the beneficial effects that:
the scheme has the advantages that since the new coronary pneumonia epidemic situation occurs, the difficult epidemic prevention experience is reviewed, local and hospital reality is combined, through the scheme, diagnosis and treatment processes are gradually standardized, the medical environment is improved, a novel clinical treatment mode is explored, the clinical treatment effect is effectively improved, the infection source is well controlled, the cure rate of patients is obviously improved, the incidence rate of converting from common to severe cases and severe cases into severe cases is reduced, and the epidemic situation is effectively controlled.
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Fig. 1 is a schematic flow chart illustrating steps according to an embodiment of the present application.
Detailed Description
The technical solutions in the embodiments of the present invention are clearly and completely described below with reference to fig. 1 of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
Example (b):
as shown in fig. 1, a novel method for supporting clinical diagnosis and treatment of coronavirus pneumonia is proposed.
Standardizing the work flow before admission
The confirmed patients mostly come from channels such as a medical centralized isolation area, an isolation ward, a suspected patient observation area, a fixed-point treatment hospital referral and the like, the epidemiological history is clear, the past history, the personal history and the family history are clear, and the main symptoms and physical signs can be traced in advance. The information means is fully utilized, objective data such as personal history, past history, family history, epidemiological history, observation records and the like of the patient are communicated with the fixed-point treatment mechanism 1-2 hours before the patient is admitted, and after medical staff of the fixed-point treatment medical mechanism receives the information, the evaluation before the patient is admitted can be completed at the first time, sickrooms, consumables, equipment, medicines, oxygen sources, personal living articles and the like are prepared, and basic work such as hospitalization procedure handling, bed allocation and the like is completed; for some special patients, the medical institution can carry out personnel allocation and organization division in advance, can shorten the rescue time for critically ill patients, can complete preoperative preparation for the patients with the operation, and can be busy without disorder and spare for use.
Standardizing diagnosis and treatment process after hospital admission
After the patient is admitted, in addition to basic care, intensive care requirements of patients with the novel coronavirus pneumonia are complex [6], and the completion of new coronary lung health promotion and education is an important ring. If necessary, the paper data is used to inform the patient of the details of disease prevention and control during the hospitalization, such as: the system comprises a plurality of details such as personal hygiene, personal protection, secretion management, food hygiene, going-out examination attention, sleeping and health care, mental health, doctor-patient communication modes and the like, various informed consent is signed, an electronic edition is uploaded through a picture acquisition terminal, and a paper edition is not reserved in principle.
The physician in charge needs to complete necessary physical examination, inquiry and equipment debugging as soon as possible, inform the treatment principle and the possible complications, and perform necessary psychological dispersion is also part of the standard treatment. Conditional medical institutions attempt video interrogation, utilize 5G networks, AI, etc. to reduce exposure time and opportunities. There are three basic principles for the initial disease management and treatment regimen; first, the overall collection of the case data, scientific evaluation, accurate typing, partition management, and treatment of different diseases. The critical type treats the symptoms first, the light type and the common type treat the root causes first, and the heavy type treats both the symptoms and root causes. Secondly, the latest diagnosis and treatment guidelines of the new coronary pneumonia are strictly followed, complications and objective symptoms are fully considered, and an individual treatment scheme is formulated by combining the medical history. Thirdly, the method comprises the following steps: medical resources of hospitals are fully utilized, expert consultation is actively organized, multidisciplinary cooperation is developed, special opinions are paid attention, and experience medication and personal opinions of core treatment schemes are reduced.
Normalizing core medical procedures
In the new coronary lung diagnosis and treatment process, in order to reduce hospital infection, medical care personnel are effectively protected, the diagnosis and treatment level is improved, and the important medical operation needs to be completely standardized, programmed and institutionalized, such as: the medical personnel organization team has the advantages that the operation process is detailed, an emergency plan is established, business learning and training are enhanced, the medical personnel organization team with rich drawing and adjusting work experience and strong personal quality is reduced to the minimum, and various risks are reduced.
Promoting cooperation and division of labor among doctors in the affected area
In the special period of epidemic situation prevention and control, medical treatment teams are mostly constructed by different departments, different specialties and different hospitals, so that the work progress is ensured, the medical safety is concerned, and the reasonable division of labor and the effective cooperation are very important. The work modes of the system are innovated for shift, ward-round consultation, case discussion and medical writing. The doctor in charge of exploration is responsible, the doctor in white class enters ward round and related medical operations, the office of the second-line doctor collaborates to record the change of the state of an illness, the doctor in group is guided to check the customs, the doctor is in a collaboration mode of focusing on the key points, and a series of work such as ward round, consultation, equipment debugging, medical record, treatment scheme adjustment and the like is completed through an information system, an intelligent terminal, an interphone, visual equipment and the like. The gathering shift, ward visit and consultation frequency are reduced, the independent diagnosis and treatment range is expanded, the independent response capability is improved, the informatization means is fully utilized to carry out data transmission and work exchange, unnecessary medical operations are strictly controlled, and necessary personnel gathering opportunities are carefully balanced.
Full-course electronic and paperless office mode for propelling medical document
The main application value of AI in the prevention and control of new coronary pneumonia epidemic situation is as follows: reduce nosocomial infection and improve the diagnosis and treatment efficiency [7 ]. The whole process of electronic medical record management is advocated, various paper medical record data are cancelled in a ward, an electronic signature system is implemented, an electronic medical record auditing program is added, and the medical record is archived after being rechecked and qualified through three network audits (one audit: a doctor in charge, a nurse in charge, two audit: a group leader of a treatment group, an office nurse, and three audit: a principal department and a nurse leader) so as to avoid loopholes in writing of medical documents. After the patient is discharged, a clean area is selected for centralized printing, designated non-close contact persons are bound uniformly, the medical record printing, sorting, binding and uploading process is guaranteed not to be polluted, a computer, a printer and a mobile terminal are used for operating a working area for periodic disinfection, and the safety of different personnel and equipment operated at different periods is guaranteed. The medical technology systems, the nursing systems and the electronic medical record systems are used for producing reports and medical record documents in PDF format, the PDF reports and the electronic documents are uploaded to a clinical data center through an integrated platform interface, and the PDF reports and the electronic documents of the lower limbs corresponding to the PDF reports and the electronic documents are uploaded, so that the purpose of paperless medical records is achieved.
Doctor-patient communication strategy and doctor-patient relationship handling in special period
The treatment of the doctor-patient relationship in the new coronary infectious disease area is more complicated and difficult than that in the common disease area. The reason is that artificial barriers are formed between doctors and patients in the isolated disease area and are not known mutually, so that psychological abstinence and distrust are more easily caused by the patients; the doctor-patient communication time is limited, and psychological care often cannot be taken; the shout can not be followed, and the requirements of patients can not be met in time; without family companionship, the patient is easy to generate panic psychology and autism. Meanwhile, the confusion of disease treatment, the adverse reaction of the medicine, various symptoms of the disease, the situation of epidemic prevention and control, the long-time course of disease, isolation and the like all cause damage to the mind and body of the patient, and various contradictions are generated. Critical medicine also needs to identify and intervene risk factors of the PICS in an early stage in the process of receiving treatment of a patient, so that the prevention and treatment are repeated, and simultaneously, multidisciplinary team construction aiming at the ICU back service is strengthened after the patient leaves the ICU, so as to improve the life quality and the long-term prognosis of the severe new coronary lung patient. Therefore, necessary humanistic care, effective communication and scientific psychological dispersion are very important for relieving the contradiction between doctors and patients.
Disease diversion and coping strategies
Four types of outcome generally appear in patients with new coronary pneumonia, which are: recovery, aggravation, recurrence and death.
Patients who reach the discharge index: for patients to be cured clinically, a discharge process is designed in advance according to the infectious disease management principle. Before leaving the hospital, the personal articles are disinfected comprehensively, the personal articles brought out of the ward are strictly screened and controlled, the personal articles are well handed over with the community hospital, next medical isolation is carried out, and public opinion publicity and management are well done.
Patients with increased disease: generally, the weight of the vehicle is changed from light to heavy or from heavy to dangerous. The 2 th 29 th day "China-New CoV pneumonia (COVID-19) United investigation report" suggests: the incidence of severe illness is 13.8%, and the gross fatality rate is 3.8%. For patients with confirmed diagnosis, the disease degree is accurately evaluated when the patients are admitted, independent risk factors are identified, the probability of disease aggravation is evaluated by combining the complications of the patients and the current disease degree, the risk factors of the diseases are graded, and classified management is carried out according to the grades. Management is divided into four aspects: first, the assessment of the status of disease and risk factors is dynamically performed, such as: APACHE II score, catheter risk score, MEWS score, Glasgow score, pain and sedation score, infection risk assessment, etc., revised and completed clinical diagnosis; secondly, according to the treatment strategy of the next step of the latest clinical diagnosis guidance, the treatment and nursing scheme is adjusted in time, the sensory management is upgraded, and different professional medical care teams are established according to the condition of the equipment required by organ support; thirdly, the method comprises the following steps: scientifically evaluating the curative effect and the disease process, accurately identifying various complications and adverse reactions, and fourthly: actively conduct remote consultation and on-line consultation, collect the opinions of expert groups and optimize the treatment scheme. For critically ill and end-stage disease patients, a strategy of "please go to experts without letting the patient go" is in principle implemented, and cross-city transfer treatment is not recommended.
Patients with nucleic acid restoring yang: the median time of virus turning negative in the surviving patients is 20 days, the phenomenon of restoring positive exists in part of patients, the psychological health assessment is proposed to be carried out comprehensively for the part of patients, a psychotherapist team is established to carry out psychological dispersion, medical science is fully utilized to carry out restoring positive intervention, the reason of restoring positive and infectivity of the reason are scientifically assessed, and the time of nucleic acid turning negative is shortened as far as possible.
Patients who died: according to the law of infectious diseases prevention and treatment, the infection sources of remains, personal articles and the like are treated at the end, and the disease area is disinfected at the end.
Discharge and follow-up management
When patients meet discharge standards, home isolation needs to be completed for 14 days, which requires uniform inclusion of regulatory control by the CDC and the infrastructure of residence, under the direction of the relevant personnel. The chest CT was reviewed from 2 nd week, 4 th week to the point-of-care hospital after the medical observation was finished, and the nucleic acid detection by the respiratory pharynx swab was reviewed. The system is responsible and obligated to participate in follow-up work as a fixed-point treatment hospital, guides the primary medical and health institution to complete the rest observation tasks, informs the focus of attention and shares medical record data. The basic health organization needs to fully take regional advantages and dynamically manage discharged patients by utilizing an informatization means, so that a three-level medical health system realizes scientific division of labor, information sharing, efficient cooperation, seamless connection and closed-loop management.
The above are preferred embodiments of the present invention, and all changes made according to the technical scheme of the present invention that produce functional effects do not exceed the scope of the technical scheme of the present invention belong to the protection scope of the present invention.
Claims (10)
1. A novel support method for clinical diagnosis and treatment of coronavirus pneumonia is characterized by comprising the following steps:
s1 specifies the work flow before admission; objective data before patient admission is obtained by fully utilizing an informatization means, assessment before patient admission is completed, and basic preparation work for patient admission is well done;
s2, standardizing diagnosis and treatment processes after hospital admission; after the patient is admitted, basic care is firstly ensured, and the health propaganda and education of the new coronary pneumonia are completed;
s3, standardizing a core medical operation flow; completely standardizing, programming and institutionalizing the core medical operation;
s4 promoting cooperation and division of labor among doctors in the affected area;
s5 promoting the medical document full-process electronization and paperless office mode;
s6 proposes doctor-patient communication strategy and doctor-patient relationship processing in special period;
s7, standardizing the disease transition and coping strategies;
s8 specifies discharge and follow-up management.
2. The method of claim 1, wherein step S1 is as follows:
1-2h before the patient is admitted into the hospital, the patient personal history, the past history, the family history, the epidemiological history and the observation record are communicated with a fixed-point treatment mechanism by fully utilizing an informatization means, and after medical staff of the fixed-point treatment medical mechanism receives the information, the evaluation before the patient is admitted into the hospital is completed at the first time, the preparation of a ward, consumables, equipment, medicines, oxygen sources and personal living articles is well made, and the basic work of hospitalization procedure handling and bed allocation is completed; for some special patients, the medical institution performs personnel allocation and tissue division in advance, and performs preoperative preparation for the operation patient.
3. The method of claim 2, wherein step S2 is as follows:
after the patient is admitted, performing basic nursing and intensive nursing to finish the propaganda and education of new coronary lung health; informing the patient of each detail of disease prevention and control during hospitalization by paper data, signing various informed consent forms, and uploading an electronic version through a picture acquisition terminal;
the doctor in charge finishes necessary physical examination, inquiry and equipment debugging at one time, informs the treatment principle and possible complications and conducts necessary psychological dispersion;
there are three basic principles for the initial disease management and treatment regimen;
firstly, comprehensively collecting case data, scientifically evaluating, accurately typing, managing in a partition way, and treating according to different treatment methods; the critical type treats the symptoms first, the light type and the common type treat the root causes first, and the heavy type treats both the symptoms and root causes;
secondly, an individualized treatment scheme is formulated by following the latest diagnosis and treatment guide of the new coronary pneumonia, considering complications and objective symptoms and combining medical history;
thirdly, hospital medical resources are utilized, expert consultation is organized, multidisciplinary cooperation is developed, and the expert opinions are referred to, so that the experience medication and the individual opinions of a core treatment scheme are avoided.
4. The method of claim 3, wherein step S3 is as follows:
the method comprises the steps of setting up detailed operation flows and setting up an emergency plan for hand hygiene, putting on and taking off of isolation clothes, throat swab collection, artery and vein blood sampling, atomization operation, noninvasive ventilator management, ward disinfection, ward external examination and transportation, artificial airway establishment, deep vein puncture and tracheotomy.
5. The method of claim 4, wherein step S4 is as follows:
for the shift, the consultation of the ward, the case discussion and the writing of the medical document, the cooperation and the division of labor are carried out; the doctor in charge is responsible, the doctor of white class enters ward round and relevant medical operation, the change of state of an illness is recorded in the cooperation of two-line doctor's office, the doctor of taking group guides and closes the work, the cooperation mode that the chief of the department focuses on the key attention is accomplished through information-based system, intelligent terminal, intercom, visual equipment and is looked into, a series of work of ward round, consultation, equipment debugging, case history record, treatment scheme adjustment.
6. The method of claim 5, wherein step S5 is as follows:
the whole process of electronic medical record management is realized, various paper medical record data are cancelled in a ward, an electronic signature system is implemented, an electronic medical record auditing program is added, and the electronic medical record is archived after being checked and qualified through three network audits;
after a patient is discharged from a hospital, a clean area is selected for centralized printing, non-close contact persons are designated for unified binding, a computer, a printer and a mobile terminal are used for operating a working area for periodic disinfection, reports and medical record documents in a PDF format are produced by various medical technology systems, nursing systems and electronic medical record systems, and the PDF reports and the electronic documents are uploaded to a clinical data center through an integrated platform interface, so that the PDF reports and the electronic documents of the lower limbs of the patient at corresponding addresses are obtained.
7. The method of claim 6, wherein step S6 is as follows:
the risk factors of the PICS are recognized and intervened in the early stage of the patient receiving the treatment process, the prevention and treatment are repeated, and the multidisciplinary team construction aiming at the ICU rear service is strengthened after the patient leaves the ICU.
8. The method of claim 7, wherein step S7 is as follows:
four types of outcome appear in patients with new coronary pneumonia, which are respectively: healing, aggravation, recurrence and death;
patients who reach the discharge index: for patients reaching clinical recovery, a discharge process is designed in advance according to the infectious disease management principle; before leaving the hospital, the personal articles are disinfected comprehensively, the personal articles brought out of the ward are strictly screened and controlled, the personal articles are well handed over with the community hospital, the next medical isolation is carried out, and public opinion propaganda and management are well carried out;
patients with increased disease: the weight is changed from light to heavy or from heavy to dangerous; for patients with confirmed diagnosis, accurately evaluating the disease degree when the patients are admitted, identifying independent risk factors, evaluating the probability of disease aggravation by combining the complications of the patients and the current disease degree, grading the risk factors of the diseases, and performing classification management according to the grades; wherein, management is divided into four aspects: firstly, the method comprises the following steps: dynamically carrying out grading evaluation on the current disease situation and the risk factors; secondly, according to the treatment strategy of the next step of the latest clinical diagnosis guidance, the treatment and nursing scheme is adjusted in time, the sensory management is upgraded, and different professional medical care teams are established according to the condition of the equipment required by organ support; thirdly, the method comprises the following steps: scientifically evaluating the curative effect and the disease process, accurately identifying various complications and adverse reactions, and fourthly: actively carrying out remote consultation and on-line consultation, collecting opinions of experts group and optimizing a treatment scheme;
patients with nucleic acid restoring yang: the median time of virus turning negative in the surviving patients is 20 days, the phenomenon of restoring positive exists in part of patients, the psychological health assessment is carried out on the part of the patients comprehensively, a psychotherapist team is established for psychological dispersion, the medicine is utilized for restoring positive intervention, the reason of restoring positive and the infectivity thereof are scientifically assessed, and the nucleic acid turning negative time is shortened;
patients who died: according to the law of infectious diseases prevention and treatment, the infection sources of remains, personal articles and the like are treated at the end, and the disease area is disinfected at the end.
9. The method of claim 8, wherein step S8 is as follows:
after the patient reaches the discharge standard, the patient finishes the household isolation for 14 days, and is uniformly brought into the standard management by the CDC and the health organization of the residential foundation layer; reexamining chest CT from 2 nd week and 4 th week to the fixed-point rescue hospital after the medical observation is finished, and reexamining nucleic acid detection of respiratory pharynx swabs; the system is responsible and obligated to participate in follow-up work as a fixed-point treatment hospital, guides the primary medical and health institution to complete the rest observation tasks, informs the focus of attention and shares medical record data; the basic health institution needs to take full advantage of the area and dynamically manage the discharged patients by using an informatization means.
10. A novel system for supporting clinical diagnosis and treatment of coronavirus pneumonia, which is characterized in that the novel method for supporting clinical diagnosis and treatment of coronavirus pneumonia according to any one of claims 1 to 8 is adopted to support clinical diagnosis and treatment of coronavirus pneumonia.
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| CN202111250524.2A CN114049954A (en) | 2021-10-26 | 2021-10-26 | Novel coronavirus pneumonia clinical diagnosis and treatment support method and system |
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| CN114974565A (en) * | 2022-05-17 | 2022-08-30 | 上海市第四人民医院 | Refined management and control method and system for diagnosis and treatment stages of new coronary patients |
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