我国急诊科晶体液应用情况分析(1)
摘要：目的 了解國内急诊科晶体液应用情况，分析我国急诊科医生针对不同疾病选用晶体液进行液体治疗的现状。方法 于2018年11～12月在全国范围内对急诊科医生进行调查，分析急诊患者处方中晶体液占比、晶体液应用的疾病种类、不同晶体液应用的比例、晶体液选择参照因素情况。结果 共收集20个省市自治区的241家医院720份问卷，其中三级医院回收问卷554份(76.90%)，二级医院158份(21.90%)，以副主任医师职称占比最多，为21.11%。241家医院急诊科年急诊量及年急诊输液量均主要以2～5万人次为主，分别占39.00%、65.15%。急诊输液患者处方中晶体液比例以20%～30%为主，占31.54%;处方频率最高的晶体液是生理盐水(96.10%)，其次是林格液(59.30%)、乳酸钠林格液(46.40%)、钠钾镁钙葡萄糖注射液(33.20%)、复方电解质注射液(18.10%)及醋酸钠林格注射液(11.40%)。处方晶体液对应的主要急症包括脓毒血症、脓毒症休克、腹泻、失血性休克，以脓毒症休克占比最高为92.95%。选择晶体液时医生考虑的主要因素包括pH值及渗透压(73.30%)、缓冲体系(45.60%)、乳酸含量(40.00%)及氯/钠的含量(39.40%)。结论 我国各级别医院急诊科医师对于不同晶体液有一定的了解，但对于不同疾病选用不同晶体液治疗的能力有待提高，需加强这方面的学习和培训。
Abstract：Objective To understand the application of crystal fluids in domestic emergency departments and analyze the current status of emergency fluid surgeons in my country choosing crystal fluids for different diseases.Methods Surveyed emergency doctors nationwide from November to December 2018， analyze the proportion of crystal fluid in the prescriptions of emergency patients， the types of diseases used in crystal fluid， the proportion of different crystal fluid applications， and the reference factors of crystal fluid selection.Results A total of 720 questionnaires were collected from 241 hospitals in 20 provinces， municipalities， and autonomous regions. Among them， 554 questionnaires (76.90%) were recovered from tertiary hospitals， and 158 (21.90%) were from secondary hospitals. The proportion of deputy chief physicians accounted for the most21.11%.The annual emergency volume and annual emergency infusion volume of the emergency department of 241 hospitals are mainly 20，000 to 50，000， accounting for 39.00% and 65.15%， respectively. The proportion of crystal fluid in the prescription of emergency infusion patients is mainly 20%～30%， accounting for 31.54%; the crystal fluid with the highest prescription frequency is physiological saline (96.10%)， followed by Ringer's solution (59.30%)， sodium lactate Ringer's solution (46.40%)， sodium potassium magnesium calcium injection (33.20%)， compound electrolyte injection (18.10%) and sodium acetate ringer injection (11.40%). The main emergencies corresponding to prescription crystal fluids include sepsis， septic shock， diarrhea， and hemorrhagic shock. The highest proportion of septic shock is 92.95%. The main factors considered by doctors when choosing crystal fluids include pH and osmotic pressure (73.30%)， buffer system (45.60%)， lactic acid content (40.00%) and chlorine/sodium content (39.40%).Conclusion The emergency department physicians at all levels of hospitals in my country have a certain understanding of different crystal fluids， but the ability to choose different crystal fluids for different diseases needs to be improved. It is necessary to strengthen learning and training in this area., 百拇医药(李建国 张玉真 王玉红)
Abstract：Objective To understand the application of crystal fluids in domestic emergency departments and analyze the current status of emergency fluid surgeons in my country choosing crystal fluids for different diseases.Methods Surveyed emergency doctors nationwide from November to December 2018， analyze the proportion of crystal fluid in the prescriptions of emergency patients， the types of diseases used in crystal fluid， the proportion of different crystal fluid applications， and the reference factors of crystal fluid selection.Results A total of 720 questionnaires were collected from 241 hospitals in 20 provinces， municipalities， and autonomous regions. Among them， 554 questionnaires (76.90%) were recovered from tertiary hospitals， and 158 (21.90%) were from secondary hospitals. The proportion of deputy chief physicians accounted for the most21.11%.The annual emergency volume and annual emergency infusion volume of the emergency department of 241 hospitals are mainly 20，000 to 50，000， accounting for 39.00% and 65.15%， respectively. The proportion of crystal fluid in the prescription of emergency infusion patients is mainly 20%～30%， accounting for 31.54%; the crystal fluid with the highest prescription frequency is physiological saline (96.10%)， followed by Ringer's solution (59.30%)， sodium lactate Ringer's solution (46.40%)， sodium potassium magnesium calcium injection (33.20%)， compound electrolyte injection (18.10%) and sodium acetate ringer injection (11.40%). The main emergencies corresponding to prescription crystal fluids include sepsis， septic shock， diarrhea， and hemorrhagic shock. The highest proportion of septic shock is 92.95%. The main factors considered by doctors when choosing crystal fluids include pH and osmotic pressure (73.30%)， buffer system (45.60%)， lactic acid content (40.00%) and chlorine/sodium content (39.40%).Conclusion The emergency department physicians at all levels of hospitals in my country have a certain understanding of different crystal fluids， but the ability to choose different crystal fluids for different diseases needs to be improved. It is necessary to strengthen learning and training in this area., 百拇医药(李建国 张玉真 王玉红)