摘要
目的比较北京和巴黎社区获得性肺炎的急诊治疗情况。方法收集2003年10月1日至2004年9月30日北京大学人民医院急诊科和巴黎市中心H(?)tel-Dieu 医院急诊科的社区获得性肺炎患者病情和治疗方面的信息,通过Fine危险分层评估两组患者,并对治疗进行比较。结果(1)两组患者在五个 Fine分级中的分布差异没有统计学意义(P＞0．05),因此两组患者病情有可比性。(2)北京组患者和巴黎组相比,三代头孢类、碳青霉烯类等高级抗生素的用药比例高(P＜0．01),而青霉素和大环内酯类用药等基础药物的比例低(P＜0．01)；静脉用药比例高,而口服药比例低(P＜0．01)。北京组病人抗生素治疗和指南的一致性(59．6%)显著低于巴黎组患者(88．6%,P＜0．01)。(3)北京组患者全部在4 h 内得到抗生素治疗,而巴黎组患者92例(52．2%)在4 h 内得到抗生素治疗。(4)急诊观察室停留时间北京组患者显著长于巴黎组患者。结论北京和巴黎社区获得性肺炎的急诊处理有很大的不同,我们应借鉴巴黎,以完善自己。
Objective To compare the management of CAP in Emergency Department between Paris and Beijing. Methods The data of CAP patients was collected from the Emergency Department of Hotel-Dieu hospital in the center of Paris and of People＇s Hospital Beijing University from October 1, 2003 to September 30, 2004. Severity of the patients was evaluated by Fine＇s stratification, and the treatments were compared. Results （1） There was no significant difference in patients distribution of five strata of Fine in two groups （ P 〉 0.05 ）, so we could compare the management. （2） The administration of third-generation cephalosporins and imipenem were more frequently used in Beijing group than in Paris group, while penicillin and macrolides were less used in Beijing group than in Paris group （ P 〈 0.01）. The most patients of Beijing group were intravenously administrated with antibiotics, whereas more patients in Paris group were treated by oral antibiotic （ P 〈 0.01 ）. The antibiotic treatment in Beijing group was less consistent with gnidlines than that in Paris group （59.6% vs. 88.6%, P 〈 0.01 ）. （3） Antibiotics were administrated within 4 hours in the all patients of Beijing group and 52.2 percent （92 patients） in Paris group. The difference was significant. （4） The emergency room stay was longer in Beijing group than in Paris group. Conclusion There were many differences in the CAP management of Emergency Department between Beijing and Paris. We should learn from each other and improve our strategy of treating patients suffering from CAP.
出处
《中华急诊医学杂志》
CAS
CSCD
2006年第12期1118-1121,共4页
Chinese Journal of Emergency Medicine
关键词
社区获得性肺炎
指南
急诊
比较
Community-acquired pneumonia
Guidelines
Emergency
Comparison
