国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2015, Vol. 34 ›› Issue (2): 109-111.

• 论著 • 上一篇    下一篇

江苏省不孕不育症双向转诊体系建设的初步总结

苏凤金，柴德春，冒韵东，王媁，丁卫，崔毓桂，许豪勤，刘嘉茵，胡志斌   

  1. 210029 南京医科大学第一附属医院生殖医学国家重点实验室（苏凤金，冒韵东，崔毓桂，刘嘉茵，胡志斌），生殖医学科（柴德春，冒韵东，王媁，丁卫，崔毓桂，刘嘉茵）；江苏省计划生育科学技术研究所（许豪勤）；南京市玄武医院（苏凤金）；南京医科大学公共卫生学院（胡志斌）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-03-15 发布日期:2015-03-15
  • 通讯作者: 胡志斌

Construction of Dual Referral System for Infertility Treatment in Jiangsu Province

SU Feng-jin，CHAI De-chun，MAO Yun-dong，WANG Wei，DING Wei，CUI Yu-gui，XU Hao-qin， LIU Jia-yin，HU Zhi-bin   

  1. State Key Laboratory of Reproductive Medicine（SU Feng-jin，MAO Yun-dong，CUI Yu-gui，LIU Jia-yin，HU Zhi-bin），Center of Clinical Reproductive Medicine（CHAI De-chun，MAO Yun-dong，WANG Wei，DING Wei，CUI Yu-gui，LIU Jia-yin），The First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China；Jiangsu Science and Technology Research Institute of Planned Parenthood，Nanjing 210029，China（XU Hao-qin）；Xuanwu Hospital of Nanjing，Nanjing 210029，China（SU Feng-jin）；School of Public Health，Nanjing Medical University， Nanjing 211166，China（HU Zhi-bin）
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-03-15 Online:2015-03-15
  • Contact: HU Zhi-bin

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摘要： 目的：对江苏省不孕不育双向转诊体系建设的工作进行总结，使得经培训的妇科内分泌医师能熟练应用不孕不育症临床初筛方案，诊治患者和进行必要的转诊。方法：建立不孕不育诊治规范流程；建立不孕不育病因初筛临床路径；电子化管理数据库系统的运用和升级；多次开展学习班培训以及为期3个月的临床进修学习；专家巡回讲座；专家定期出诊；设立绿色通道；设立不孕不育门诊示范点。结果：2005年1月—2013年10月完成临床病例病因初筛人数271 309例，初筛单位27家，转诊患者7 149例，转诊率2.6%，初筛平均费用1 176.4元，专家出诊74次，接诊1 785人次；实际参加为期3个月进修培训人员236人次；学习班举行28次，参加人员2 529人；设立不孕不育门诊点40家；参加数据库系统学习的单位56家。结论：不孕不育症双向转诊制度的建设取得了很好的效果，已经在江苏省内建立了不孕不育规范化诊治流程，建立了不孕不育病因初筛临床流程，对减少不孕不育症患者来回奔波、减少医疗开支有切实可行的意义。

关键词: 不育, 男（雄）性, 不育, 女（雌）性, 转诊和会诊, 卫生资源, 临床路径

Abstract: Objective：To retrospect the construction and application of the dual referral system for infertility treatment in Jiangsu Province, China. With the standard procedure to screen infertile pathogeny, those doctors of reproductive medicine with formal training can diagnose and treat patients step by step, and smoothly transfer treatment between superior and subordinate reproductive centers. Methods：The standardized diagnosis and treatment procedure of infertility and sterility and the clinical pathway of preliminary screening on the pathogeny were established. The database system, CCRM, was upgraded in the practice in our center. The advanced training course of 3 months was designed for doctors. The expert out-calls and lecture tours were scheduled in Jiangsu Province. The clinical shortcut service system, so called the Green Channel，and the demonstration clinics were well developed. Results：There were 271 309 patients undergone the preliminary screening system from January 2005 to October 2013 in our center. 27 hospitals joined the program. 7 149 patients underwent the transfer treatment, the referral rate is 2.6% （7 149/271 309）. The cost of the preliminary screening on pathogeny was 1 176.4 RMB. Times of the expert out-call were 74，and 1 785 patients were diagnosed in those expert out-calls. 236 trainees finished their three-months′ advanced training program; 2 529 participants finished training in 28 courses. 40 outpatient clinics of infertility were set up and 56 hospitals joined in the training of the database system. Conclusions：It is concluded from our practice that the infertility dual referral system was effectively developed in Jiangsu Province, China, and that the standardized infertility diagnosis and treatment procedure was also successfully developed. With above system and procedure and the clinical pathway of preliminary screening on the pathogeny of infertility，it is feasible to reduce the medical cost for patients, and to provide the high-quality medical service in the limited times of visiting doctors.

Key words: Infertility, male, Infertility, female, Referral and consultation, Health resources, Critical pathways