上海20家医院住院患者静脉血栓栓塞症防治效果回顾性研究

目的了解上海市级三级综合医院静脉血栓栓塞症（VTE）防治效果，为提高医院内VTE防治管理水平提供参考。方法回顾性分析2019年-2020年上海申康医院发展中心单病种数据库中20家市级三级综合医院VTE防治相关数据，同时实地调研其VTE防治能力。结果2020年，上海20家市级三级综合医院VTE发生率为1.00%，比2019年上升14.94%（χ2=115.26，P＜0.001）；住院患者VTE风险评估率和出血风险评估率分别为71.06%、25.96%，比2019年分别上升16.13%（χ2=28 754.00，P＜0.001）、53.25%（χ2=2 167.74，P＜0.001）；住院VTE风险患者所有预防措施实施率为34.12%，比2019年上升33.02%（χ2=22 790.00，P＜0.001）；医院相关性VTE死亡率为5.35%，比2019年下降21.55%（χ2=3.91，P<0.05）。超过2/3的医院建立了较完整的VTE管理体系，并开展了相关学科建设。结论上海市级三级综合医院住院患者VTE规范防治能力有一定提升，但也存在较大改进空间。延伸VTE防治关口，建立全周期风险评估流程；多学科协作，构建VTE综合防治体系；加强培训与宣教，提高VTE规范预防率；提高诊疗技术水平，降低VTE相关死亡率等，是医院提高VTE防治管理水平的工作重点。

Retrospective Study on the Prevention and Treatment Effect of Venous Thromboembolism among Inpatients in 20 Hospitals in Shanghai

ObjectiveTo investigate the prevention and treatment effect of Venous Thromboembolism（VTE） in Shanghai municipal tertiary general hospitals, and to provide reference for improving the prevention and management level of VTE in hospitals.MethodsThe data related to VTE prevention and treatment in 20 municipal tertiary general hospitals from the single disease database of Development Center of Shanghai Shenkang Hospital from 2019 to 2020 were retrospectively collected, and field research was performed on VTE prevention and control capacity.ResultsIn 2020, the incidence of VTE in 20 municipal tertiary general hospitals in Shanghai was 1.00%, which was 14.94% higher than that in 2019 (χ2=115.26, P<0.001). The VTE risk assessment rate and bleeding risk assessment rate of inpatients were 71.06% and 25.96%, respectively, which increased by 16.13% (χ2=28 754.00, P<0.001) and 53.25% (χ2=2 167.74, P<0.001) compared with those in 2019. The implementation rate of all preventive measures among inpatients at risk of VTE was 34.12%, which was 33.02% higher than that in 2019 (χ2=22 790.00, P<0.001). The mortality rate of hospital-associated VTE was 5.35%, which was 21.55% lower than that in 2019 (χ2=3.91, P<0.05). More than 2/3 of hospitals had established a relatively complete VTE management system and carried out the construction of related disciplines.Conclusion The standard prevention and treatment ability of VTE among inpatients in Shanghai tertiary general hospitals had been improved to a certain extent, but there was still a large room for improvement. Extending the VTE prevention and control gateways and establishing the full-cycle risk assessment process; multi-disciplinary cooperation to build an integrated VTE prevention and treatment system; strengthen training and education to improve the standard prevention rate of VTE; improve the technical level of diagnosis and treatment and reduce the mortality of VTE will be the focus of the hospital to improve the prevention and management level of VTE.