又一家公立三甲医院全面禁止门诊输液!

2016-04-08 Jeffrey MedSci原创

输液安全问题一直备受关注。合理的输液可以挽救患者生命,而一次差错也可能让一个生命消逝。近段时间以来,全国各地纷纷叫停门诊输液。浙江省卫计委1月22日下发通知,要求逐步停止门诊患者静脉输注抗菌药物,除儿童医院和儿科外,三级医院率先全面停止。江苏省卫计委更是要求,2016年底前,江苏全省二级以上医院(除儿童医院外)全面停止门诊患者静脉输液。全国各地禁止门诊输液的势头越来越强劲,公立医院门诊输液或将成为

输液安全问题一直备受关注。合理的输液可以挽救患者生命,而一次差错也可能让一个生命消逝。近段时间以来,全国各地纷纷叫停门诊输液。浙江省卫计委1月22日下发通知,要求逐步停止门诊患者静脉输注抗菌药物,除儿童医院和儿科外,三级医院率先全面停止。江苏省卫计委更是要求,2016年底前,江苏全省二级以上医院(除儿童医院外)全面停止门诊患者静脉输液。全国各地禁止门诊输液的势头越来越强劲,公立医院门诊输液或将成为历史。

又一家公立医院停止门诊输液

据《深圳都市报》报道,4月1日起,深圳市宝安区人民医院停止门诊成人患者静脉输液。这是继港大深圳医院之后深圳市又一家停止“门诊输液”的公立医院。



据介绍,国家卫计委公布了“53种不需要输液”的疾病清单,对抗菌药物使用作出最新规定,要求对抗菌药物临床应用实行分级管理,同时倡导停止门诊患者静脉输液和静脉使用抗菌药物,三甲医院(除儿童医院和儿科)率先全面停止。按照要求,该院自4月1日起在全市率先停止成人门诊输液,并将严格控制急诊输液。

据医院有关负责人介绍,禁令在医院本部和下辖4家社康中心(海乐、海华、新乐、第五大道)门诊执行,涉及上呼吸道感染、普通感冒、病毒性咽喉炎、无并发症的水痘、流行性腮腺炎、风疹、慢性浅表性胃炎等病种。

宝安区人民医院表示,很多疾病根本不需要输液,口服药物3-7天可以达到同样的治疗效果。“对门诊输液说‘不’也许是个艰难的过程,但符合现代医学的基本原则,既能为病人减轻经济负担,也能为病人提供更为合理的治疗途径,应该会逐步被患者所理解与接受。”宝安区人民医院门诊部主任肖琳说。

为何要叫停门诊输液?

“能口服不肌注,能肌注不输液”,这是世卫组织很早就提出的用药原则。一般来说,输液是仅对急救患者、重症患者和不能进食的患者使用的“最后给药方式”。但在我国,长期以来,由于输液治疗能给医院和医生增加收入,加上不少患者治病求“速好”的心理等因素,导致输液治疗被普遍滥用。

首都医科大学附属北京天坛医院药学部赵志刚教授表示,目前,不少患者对输液治疗认知还存在一些误区,如普通发烧感冒、腹泻、肠胃炎等常见疾病均使用输液治疗,对输液的风险和不良反应认识不足,成为过度输液的重要原因之一,以上误区凸显我国过度输液及输液安全需引起重点关注。

根据2014年《国家药品不良反应监测年度报告》显示,静脉注射给药发生不良反应(ADR)占不良反应总数的57.8%。静脉输液常见的不良反应包括过敏反应、类过敏反应、热原反应、局部刺激、溶血反应、水电解质紊乱、容量负荷等,严重的还会出现过敏性休克危及生命等问题,长期使用静脉抗生素,还会诱发细菌耐药、二重感染等。因此,叫停静脉输液势在必行。

首部输液安全专家共识将出炉

近日,中国健康促进基金会、中华护理学会、中国医药包装协会、中国药师协会等六个组织共同编制的首部《守护针尖上的安全-中国输液安全与防范专家共识》(以下简称《专家共识》)在北京定稿。据悉,该共识将于5月份发布。

据悉,初步定稿的《专家共识》共分为六部分,包括中国输液使用现状、输液质量与安全评价、输液包装材料质量与安全性评价、各国输液的质量与安全性评价、不合理使用输液的危害及合理使用输液的政策建议。“共识”全面梳理了我国输液使用的现状与存在主要问题,从专业的角度介绍了输液质量与安全性问题的评价方法,介绍了国外相关输液合理使用的指南,同时提出了综合施治,解决我国目前存在的过度输液问题的策略和方法。

梅斯医学小编:

门诊输液,尤其是抗生素的滥用,不仅增加医疗费用,还会增加耐药细菌的产生,可能导致最后无药可用。全面禁止门诊输液,一方面是为加强抗菌药物的临床管理;另一方面也为规范医疗行为,减少不必要的医疗支出,改善医疗质量。滥用输液是一种粗放型医疗经济,潜在损害医疗安全和患者健康利益,叫停门诊输液反而是一种理性的回归。

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    2016-04-14 李继凯

    好好好好

    0

  3. 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    2016-04-14 李继凯

    学习吗?

    0

  4. 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    2016-04-10 1de00086m73(暂无匿称)

    还是太片面

    0

  5. 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  6. 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    2016-04-10 陈吴1239
  7. 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    2016-04-09 CAOJGSZ

    那就住院了。不过床位不足,医生又要倒霉了!

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1632736, encodeId=97ef1632e364e, content=<a href='/topic/show?id=7a3d9e143cf' target=_blank style='color:#2F92EE;'>#门诊输液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97143, encryptionId=7a3d9e143cf, topicName=门诊输液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a6921946992, createdName=cmsvly, createdTime=Thu Mar 16 01:27:00 CST 2017, time=2017-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78199, encodeId=4ff7e819928, content=好好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:42:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78200, encodeId=a3bde820056, content=学习吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:42:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76640, encodeId=7bdae664030, content=还是太片面, beContent=null, objectType=article, channel=null, level=null, likeNumber=182, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAbAss3ANsjUWZKUgN2n3JyJDHOJJAxibetNCiaEh70YckbPPTELyyStMZ8T3Q340icNSXgj72MowgTC/0, createdBy=188f1666747, createdName=1de00086m73(暂无匿称), createdTime=Sun Apr 10 07:53:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1365839, encodeId=2b49136583924, content=<a href='/topic/show?id=468119e04db' target=_blank style='color:#2F92EE;'>#三甲医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19704, encryptionId=468119e04db, topicName=三甲医院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Sun Apr 10 04:27:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552288, encodeId=0ec9155228846, content=<a href='/topic/show?id=a8d5196997c' target=_blank style='color:#2F92EE;'>#三甲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19699, encryptionId=a8d5196997c, topicName=三甲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88e914287502, createdName=陈吴1239, createdTime=Sun Apr 10 04:27:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76556, encodeId=00c4e65562b, content=那就住院了。不过床位不足,医生又要倒霉了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUEWmBkP7d4ib2OPTVSicoWCYiaXGfR6R78FNLwmPXO87NTiaZhgicuBaxhspKCXFmgAribspic0CZIrbca/0, createdBy=85341432978, createdName=CAOJGSZ, createdTime=Sat Apr 09 08:46:00 CST 2016, time=2016-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76537, encodeId=d329e653762, content=一刀切?, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Sat Apr 09 07:05:00 CST 2016, time=2016-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76512, encodeId=75c1e65121f, content=走中国特色社会主义建设道路,曲折中前进,最终还是要与国际接轨。, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=225a1697989, createdName=1de7460am01(暂无匿称), createdTime=Fri Apr 08 23:58:00 CST 2016, time=2016-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76408, encodeId=06b3e64087e, content=身在其中才能体会, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Fri Apr 08 18:50:00 CST 2016, time=2016-04-08, status=1, ipAttribution=)]
    2016-04-09 老段

    一刀切?

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1632736, encodeId=97ef1632e364e, content=<a href='/topic/show?id=7a3d9e143cf' target=_blank style='color:#2F92EE;'>#门诊输液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97143, encryptionId=7a3d9e143cf, topicName=门诊输液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a6921946992, createdName=cmsvly, createdTime=Thu Mar 16 01:27:00 CST 2017, time=2017-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78199, encodeId=4ff7e819928, content=好好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:42:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78200, encodeId=a3bde820056, content=学习吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:42:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76640, encodeId=7bdae664030, content=还是太片面, beContent=null, objectType=article, channel=null, level=null, likeNumber=182, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAbAss3ANsjUWZKUgN2n3JyJDHOJJAxibetNCiaEh70YckbPPTELyyStMZ8T3Q340icNSXgj72MowgTC/0, createdBy=188f1666747, createdName=1de00086m73(暂无匿称), createdTime=Sun Apr 10 07:53:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1365839, encodeId=2b49136583924, content=<a href='/topic/show?id=468119e04db' target=_blank style='color:#2F92EE;'>#三甲医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19704, encryptionId=468119e04db, topicName=三甲医院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Sun Apr 10 04:27:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552288, encodeId=0ec9155228846, content=<a href='/topic/show?id=a8d5196997c' target=_blank style='color:#2F92EE;'>#三甲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19699, encryptionId=a8d5196997c, topicName=三甲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88e914287502, createdName=陈吴1239, createdTime=Sun Apr 10 04:27:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76556, encodeId=00c4e65562b, content=那就住院了。不过床位不足,医生又要倒霉了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUEWmBkP7d4ib2OPTVSicoWCYiaXGfR6R78FNLwmPXO87NTiaZhgicuBaxhspKCXFmgAribspic0CZIrbca/0, createdBy=85341432978, createdName=CAOJGSZ, createdTime=Sat Apr 09 08:46:00 CST 2016, time=2016-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76537, encodeId=d329e653762, content=一刀切?, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Sat Apr 09 07:05:00 CST 2016, time=2016-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76512, encodeId=75c1e65121f, content=走中国特色社会主义建设道路,曲折中前进,最终还是要与国际接轨。, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=225a1697989, createdName=1de7460am01(暂无匿称), createdTime=Fri Apr 08 23:58:00 CST 2016, time=2016-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76408, encodeId=06b3e64087e, content=身在其中才能体会, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Fri Apr 08 18:50:00 CST 2016, time=2016-04-08, status=1, ipAttribution=)]
    2016-04-08 1de7460am01(暂无匿称)

    走中国特色社会主义建设道路,曲折中前进,最终还是要与国际接轨。

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1632736, encodeId=97ef1632e364e, content=<a href='/topic/show?id=7a3d9e143cf' target=_blank style='color:#2F92EE;'>#门诊输液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97143, encryptionId=7a3d9e143cf, topicName=门诊输液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a6921946992, createdName=cmsvly, createdTime=Thu Mar 16 01:27:00 CST 2017, time=2017-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78199, encodeId=4ff7e819928, content=好好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:42:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78200, encodeId=a3bde820056, content=学习吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:42:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76640, encodeId=7bdae664030, content=还是太片面, beContent=null, objectType=article, channel=null, level=null, likeNumber=182, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAbAss3ANsjUWZKUgN2n3JyJDHOJJAxibetNCiaEh70YckbPPTELyyStMZ8T3Q340icNSXgj72MowgTC/0, createdBy=188f1666747, createdName=1de00086m73(暂无匿称), createdTime=Sun Apr 10 07:53:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1365839, encodeId=2b49136583924, content=<a href='/topic/show?id=468119e04db' target=_blank style='color:#2F92EE;'>#三甲医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19704, encryptionId=468119e04db, topicName=三甲医院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5662228, createdName=mjldent, createdTime=Sun Apr 10 04:27:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552288, encodeId=0ec9155228846, content=<a href='/topic/show?id=a8d5196997c' target=_blank style='color:#2F92EE;'>#三甲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19699, encryptionId=a8d5196997c, topicName=三甲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88e914287502, createdName=陈吴1239, createdTime=Sun Apr 10 04:27:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76556, encodeId=00c4e65562b, content=那就住院了。不过床位不足,医生又要倒霉了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUEWmBkP7d4ib2OPTVSicoWCYiaXGfR6R78FNLwmPXO87NTiaZhgicuBaxhspKCXFmgAribspic0CZIrbca/0, createdBy=85341432978, createdName=CAOJGSZ, createdTime=Sat Apr 09 08:46:00 CST 2016, time=2016-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76537, encodeId=d329e653762, content=一刀切?, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Sat Apr 09 07:05:00 CST 2016, time=2016-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76512, encodeId=75c1e65121f, content=走中国特色社会主义建设道路,曲折中前进,最终还是要与国际接轨。, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=225a1697989, createdName=1de7460am01(暂无匿称), createdTime=Fri Apr 08 23:58:00 CST 2016, time=2016-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76408, encodeId=06b3e64087e, content=身在其中才能体会, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Fri Apr 08 18:50:00 CST 2016, time=2016-04-08, status=1, ipAttribution=)]
    2016-04-08 1de3b290m83(暂无匿称)

    身在其中才能体会

    0

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门诊输液为何只禁大医院?

近日,江苏省卫生计生委发布《转发关于进一步加强抗菌药物临床应用管理工作通知的通知》,宣布到2016年底前,除儿童医院外,江苏全省二级以上医院全面停止门诊患者静脉输液。“从医学上说,小病不需要输液治疗,需要输液治疗的属于急重症,一般都需要急诊甚至住院治疗。特别是作为有创治疗手段,输液需要作出全身评估,还时常会伴随着一些不良反应。”江苏省卫生计生委医管医政处工作人员坦言,新规出台的另一个初衷,就是帮助