ObjectiveTo assess the feasibility and safety of percutaneous transcatheter closure of atrial septal defect (ASD) guided by transthoracic echocardiography (TTE) in outpatients.MethodsFrom December 2016 to June 2018, 50 simple ASD patients underwent TTE-guided transcatheter closure in the outpatient operating room of our hospital (a TTE group) including 22 males and 28 females at the age of 16-48 (27.40±6.95) years. Fifty patients with simple ASD treated with the guidance of conventional fluoroscopy during the same period were treated as a control group, including 22 males and 28 females at the age of 15-48 (28.58±6.96) years. Both groups were re-examined by TTE during follow-up at 1 month, 3 months, 6 months and 1 year.ResultsThe mean age, body weight, the size of ASD and occluder and success rate had no statistical difference between the two groups (P>0.05). Compared with the control group, the TTE group had significantly lower mean operation time (P<0.01) and less cost (P<0.01) since patients need not to be hospitalized. No related complications were found in the TTE group during follow-up.ConclusionPercutaneous transcatheter closure of ASD guided by TTE appears safe and effective for outpatients, and can significantly reduce the cost.
ObjectiveTo explore the disability of social function of gastrointestinal outpatients with depressive or anxiety disorders in general hospitals. MethodsA multicenter cross-sectional study was conducted from May to June in 2007. A total of 1 995 subjects from 13 general hospitals in China were screened by using the Hospital Anxiety and Depression Scale (HADS). The subjects scored≥8 on HADS were diagnosed via the Mini International Neuropsychiatric Interview by psychiatrists. The Sheehan Disability Scale (SDS) was used to assessed patients' disability of life, work, and social intercourse aspects. Then, compared the subjective quality of life, number of doctor visits, and monthly loss of working days between outpatients with and without depressive or anxiety disorders in last six months. Further, compared the social dysfunction between patients with depression/anxiety disorders (the case group) and without depression/anxiety disorders (the control group) in functional disorders group and organic disease group of gastroenterology respectively. ResultsIn comparison to the control group, the case group had much higher score of SDS, including life, work, and social intercourse (P<0.05) aspect and had more doctor visits and loss of more working days (P<0.05). In functional disorders group of gastroenterology, the case group had much higher score of SDS, including life, work, and social intercourse (P<0.05) aspect and had more doctor visits, loss of more working days (P<0.05) compared with those in the control group. In organic disease group of gastroenterology, the case group had much higher score of SDS, including life, work, and social intercourse (P<0.05) aspect and had loss of more working days (Z=-4.307, P<0.001) compared with those in the control group. ConclusionFor the patients with functional disorders or organic disease of gastroenterology, the depressive and anxiety disorders may lead to the disability of social function.
ObjectiveTo analyze the characteristics of outpatients in Neurological Department in different periods and to provide guidance on medical decision-making for Neurological Department. MethodOutpatients treated between August and September 1994 (group 1994) and between August and September 2012 (group 2012) in the Department of Neurology of a general hospital were included in our study. Group 1994 had 1 000 consecutive patients; while group 2012 had 18 995 patients excluding those repeat visitors, patients waiting to be treated (including dizziness), patients misdiagnosed to have severe mental diseases (such as schizophrenia), and patients with physical diseases. Then we compared the demographic and disease distribution of patients in the two groups, and performed statistical analysis. ResultsCompared with the year 1994, the year 2012 had more female, less young and more elderly patients (P<0.05). The constituent ratio of neurosis, cerebrovascular disease, internal medicine diseases with nerve damage, peripheral nerve disease, brain post-traumatic syndrome, intracranial space-occupying lesions reduced significantly while headache, epilepsy, extrapyramidal disease (such as Parkinson's disease) increased significantly (P<0.01) with no obvious change of constituent ratio of muscle disease, neuropathic muscular dystrophy, spinal cord, brain atrophy and dementia diseases. ConclusionsThere are significant changes in characteristics of neurology clinical patients between 1994 and 2012. Revelation of these differences can provide evidence for the optimization of outpatient resources allocation and the prevention policy.
Objective To provide baseline date for further research by retrospectively investigating the disease constitution of over-60-year old patients in the West China Hospital of Sichuan University in 2011. Methods The information of over-60-year old outpatients was extracted from HIS and their diagnoses were classified by ICD-10. The data of single disease among top 3 categories of diseases were rearranged and analyzed by Excel software. Results The total of over-60-year old outpatients was 895 123 person-time in 2011, accounting for 19.65%, including 716 826 person-time in specialist outpatient clinics. The specialist diagnoses of 683 491 person-time could be classified by ICD-10, accounting for 95.35% of specialist outpatients. The top 12 diseases were neoplasm, circulatory, digestive, factors influencing health status and contacting with health services, respiratory, musculoskeletal system and connective tissues, nervous, eyes, symptoms/signs and abnormal clinical and laboratory findings, non-classified, mental and behavioral disorders, endocrine, and genitourinary system diseases, and the cumulative constituent ratio was 92.96%. The main pathogenic sites of neoplasm were bronchus and lung (21.98%), esophagus (8.66%), stomach (8.10%), rectum (7.37%), prostate (5.86%), and liver and intrahepatic bile ducts (5.55%), with a cumulative constituent ratio of 57.72%. The main disease burden in circulatory system was hypertension (39.50%), chronic ischaemic heart disease (11.17%), and cerebral infarction (9.70%), and the cumulative constituent ratio was 60.38%. While the main disease burden in digestive system was gastritis and duodenitis (24.98%), other diseases of digestive system (9.26%), and other diseases of liver (8.90%), and the cumulative constituent ratio was 43.13%. There were more female than male among the over-60-year old outpatients (50.67% vs. 49.33%), and male was higher than female only in the incidence of neoplasm, respiratory, factors influencing health status and contacting with health services, and genitourinary system diseases. The disease constitution ratio of 60-69 years old patients was 58.21%. The top 3 neoplasm were the malignant tumors in digestive (38.20%), respiratory and intrathoracic organs (24.70%), and lymphoid, haematopoietic and related tissue (11.97%), with a cumulative constituent ratio of 74.87%. Conclusion The top 3 disease burden of over-60-year old outpatients in West China Hospital were neoplasm, circulatory and digestive diseases, which reflects the trend and law of treatment demands of old patients. It needs to deeply analyze the frequency and flow pattern of patients, and to provide evidence for preventing and treating geriatric diseases.
ObjectiveTo explore the epidemiological characteristics and analyze the related diagnosis and treatment information of wound outpatient cases in a tertiay hospital in Leshan City.MethodsThe data of cases admitted to the wound clinic in a tertiary hospital of Leshan City between January 1st, 2017 and December 31st, 2019 were retrospectively collected. The SPSS software was used for statistical analyses in terms of basic patient information, wound type and dressing use, number of visits and expenses.ResultsA total of 10 880 cases were enrolled. The average age of the patients treated was (45.23±13.45) years old. Patients from the Central District, where the hospital was located in, accounted for the highest proportion (38.63%). The proportion of acute skin and soft tissue injuries was higher than that of chronic skin and soft tissue injuries (62.51% vs. 37.49%). According to the proportions from high to low, the top three chronic skin and soft tissue injuries were postoperative refractory wounds (19.63%), skin and soft tissue infections (3.90%), and stoma complications (3.04%), respectively. A total of 22 937 functional wound dressings were used, of which non-woven outer dressings accounted for 47.52%. Patients with acute skin and soft tissue injuries had a higher healing rate compared with those with chronic skin and soft tissue injuries (96.65% vs. 43.03%, P<0.05). The type of skin and soft tissue injuries with the most visits was cancerous wound [the median (lower quartile, upper quartile) was 68 (35, 121) visits], and the one with the least visits was acute skin and soft tissue injuries [the median (lower quartile, upper quartile) was 2 (1, 7) visits].ConclusionsAs the distance between residence and hospital grows, the number of patients decreases, suggesting that the specialized nursing assistance has achieved initial results in remote areas, but the task of assistance in surrounding areas is still heavy. The type of skin and soft tissue injuries is changing under the concept of enhanced recovery after surgery, and wound care plays an important role in the recovery of patients after surgery. The concept of wet healing and new dressings to promote wound healing are widely used, but still need to be further popularized among patients and medical staff. For chronic wounds that are more expensive to treat, it is necessary to formulate comprehensive treatment plans such as wound treatment, psychological support, and systemic nutrition to promote healing.