在挪威治疗患有支气管炎住院的婴儿的区域差异和时间趋势
Maren Våland Øymar1,2, Joel Selvakumar3,4, Ingvild Dalen5
1Division of Paediatrics, Stavanger University Hospital, Stavanger, Norway.
Acta paediatrica (Oslo, Norway : 1992)
|October 13, 2025
概括
遵守支气管炎指南的情况有所改善,血液检测和上腺素使用减少. 然而,胸部X射线的过度使用仍然存在,并且仍然存在显著的医院变异,这表明儿科护理的进一步改进有空间.
科学领域:
- 儿科呼吸系统医学 儿科呼吸系统医学
- 坚持临床指南的遵守.
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 2018年,挪威更新了支气管炎评估和治疗的国家指南.
- 选择明智的建议旨在减少不必要的胸部X射线,重复血液测试和常规吸入.
- 评估这些指南的遵守对于优化儿科呼吸系统护理至关重要.
研究的目的:
- 评估遵守更新的挪威支气管炎指南.
- 分析诊断和治疗实践中的时间趋势.
- 为了识别医院间的护理交付差异.
主要方法:
- 一项多中心的回顾性研究,涉及1186名因支气管炎住院的12个月以下的婴儿.
- 从挪威五家医院收集的数据跨越了三个冬季:2017-2018,2018-2019和2021-2022.
- 对诊断测试和治疗的常规数据进行比较.
主要成果:
- 胸部X射线使用率保持稳定,约为29%,没有显著的季节性变化.
- 随着时间的推移,<1个血液检测的婴儿比例显著下降 (60.4%至43.5%).
- 抗生素 (4.5%),类固醇 (2.7%) 和吸入剂 (15.4%) 的使用率较低;上腺素的使用率显著下降 (18.1%至5.2%).
- 医院之间观察到诊断和治疗实践的显著差异.
结论:
- 虽然一些指导方针的遵守程度有所改善,特别是在减少重复血液检测和上腺素使用方面,但医院间仍然存在显著的差异.
- 在患有支气管炎的婴儿中,过度使用胸部X射线和重复血液检测仍然是令人担忧的.
- 需要进一步努力来规范护理,减少不必要的诊断程序.
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