Medical experts discuss: what we make a medical treatment fault?

health

Benban published "the medical treatment, how patients with a sword into harm?" After the discussion topics, the attention. Will now several famous medical expert opinion on this problem to its readers. Next will have made special disease problem launch misdiagnosis discuss, welcome to participate.

Iatrogenic damage occur frequently

Respondents expert: the Chinese medical doctor association, vice President of anesthesiology branch of wuhan xiehe hospital deputy dean YaoShangLong

Core ideas

Inadequate is hurt patients first cause

Strict management in doctor-patient are protected

Patients are always vulnerable groups, in the face of uncertainty and science and technology condition when the inscrutable always appears individual effort is less preferable; Doctors may prescribe, surgery in patients with unconsciously hurt the interests, as our country's physician training system flaw, without formal training unqualified doctor patient harm is not uncommon. Damage the interests of cure source sex patients in the global occur frequently. A

Various hurt patients' medical events in clinical quite common, if not the rational use of drugs (antibiotic abuse), not qualified technical means, excessive examination, etc. These inappropriate medical behavior investigate its reason is training does not reach the designated position, know not deeply, the knowledge is not comprehensive creates. If the doctor on disease have a profound understanding of, can completely avoid excessive unnecessary check; If the doctor to know medical ethics GanCheng, the heart has not seeking business interests, and can completely for patients less money, cure ill. These are all doctors in ideological and technical business, need reasonable blind regular training to solve and to know.

Use "live and learn" this sentence to generalize the practicing the most appropriate way peers. Learning process is a kind of sublimate to self knowledge system to improve the process again and recognition, so, even qualified doctors, facing daedal their condition still skating on thin ice; Reasonable, strict and humanized training system, can make a qualified doctor, who can make the most of the interests of patients with the protection, is harmonious doctor-patient relationship of lubricant.

Of course training cannot be written on-but, we need to have strict standard procedures, from system on regulating residency training system, doing after graduation education, let a continued builds full credits, qualified doctors examinations, posts; And when the doctors practicing remote supervision, still with strict quality-control training, medical procedures and clinical pathway guide to discipline the doctor's behavior; While strengthening the doctor's examination management.

Such rules may harsh, but this kind of regulating the procedures can be set up to enable doctors to active passively, build patients and doctors in the double protection, tracing the process of the accident responsibility identification can clear responsibility, avoid adverse events.

Experience more mistakes "confidence" more feet

Respondents expert: southern medical university hospital director had its imperial pearl river

Core ideas

Wrong idea of therapy, jeopardize patients

Medical knowledge blank let doctors to make mistakes

At present, the patient to use antibiotic, the damage must solve moment has arrived. For this problem, general patients and doctors are terrified in result of antibiotic drug-resistant strains. But in fact, the emergence of drug-resistant strains or small problems, greater danger is that many lives are during the course of treatment for antibiotic caused by excessive use of multiple organ damage. In our hospitals have a rule that many cases of emergency and severe cases, the choice must be discontinued antibiotics during SARS outbreak in 2003, it proves its correctness. We retrospectively, 86 SARS patients in accordance with commonly used guide without the use of hormone therapy, circumstance, mortality control is zero.

In fact, for infectious diseases of the body, the main harm neither bacteria also not toxins, using the traditional antibacterial antitoxin therapy and not heal, but only a sterilization sterilization, real cause airframe damage is autoimmunity damage, called the host autoimmune damage. Use antibiotic therapy, aggravate the host's own immune response, allowing patients to illness. Even some symptoms improved, but also lead to antibiotic use early symptoms of hyperthyroidism, immune suppression occur will cover () to live; Interim is immune disorder; Late immune attack, low is immune. So, in the mid-late process using hormone treatment is quicken illness development. However, unfortunately, is currently in the domestic not most doctors know the truth.

Fashioning sex bronchitis (once the professor is domestic first react-driven naming the disease. - editor's note) is one of the critical pediatrics. Its clinical characteristics is endogenous caused extensive bronchial foreign airway blockage within, killing lung ventilation transaired function obstacle, happen respiratory failure life-threatening, international fatality rate of 50% ~ 70%. Because the disease within the formation of endogenous for airway foreign jelly-like, serious when along the bronchi jams, remove widely filling a bronchial tree when shape, is called fashioning sex bronchitis. Due to the foreign law of time not clear form, so it is difficult to treatment by bronchoscopy remove self-generating foreign bodies is the only effective treatment methods. Because the disease's obstruction is extensive jams, foreign bodies clamp out relatively fine, so easily broken part by flushing, cleared eyewinker and stimulation cough to larger deep eyewinker row will airway obstruction, relieving from airway state. In the absence of oxygen cases, trachea cut a long working time, may delay rescue, and operation easy exciting vagus nerve reflection respiratory cardiac arrest, so do trachea cut should belong to taboo.

Because of this disease cognitive, many doctors blank delayed treatment. If during the SARS during treatment, a critically ill patients with our recommendations, the symptoms improved obviously. But, as its authority to model group, inadequate understanding of bronchitis, later changed treatments, eventually the 10-month-old patients heal invalid died. Therefore, the blank of medical knowledge will also affect treatment of patients.

Sometimes, the experience was instead make mistakes "motivation". With experience of mistake increases, the doctor "faith" more and more feet.

Pursue interests excessive medical injury patients

Respondents expert: Chinese society of cardiovascular diseases branch b the chairman of the committee

Core ideas

Doctors and pharmaceutical factory reach interests chain

Proper treatment to be implemented

Right now, most doctors in technology driven by supreme concept indiscriminately seek high technology and new technology, coronary artery balloon expansion and coronary ZhiJiaShu in each big hospital heart medicine has serious flooding. Together with the medical information asymmetry, many patients in large persuasion did the clatter of shady drug-eluting stents (this can do bare metal stents). What's more, no good doctors in patients without narrow vessel segment still, stent placement in the United States it yue is to protect patients...

In fact, with bare metal stents drug-eluting stents compared to proper use. High prices (foreign 2 thousand yuan, domestic 1.1 million) of drug-eluting stents (des) and cost as only 9450 yuan for half (foreign 4,000 to 5,000 yuan, domestic) bare-metal stents (hereinafter referred to as bare metal stents compared with immediate success) there were no significant differences between long-term outcomes.

Our 2009 24 million stents implanted, bare metal stents in insufficient 4%. This means that 23 million stents are drug-eluting stents, only less than one million is bare metal stents, became the world's an exception. America's ratio for bare metal stents use 20% ~ 30%, many countries in Europe the use ratio for bare metal stents 50%. A scientific data proof, the largest intervention value in st-elevation myocardial infarction opened infarction related to save a life, use the blood vessels of the low price bare metal stents and price high des recent success rate with long-dated end no significant difference between the prognosis. For large blood vessels and short lesions, bare metal stents restenosis rate is not higher than drug-eluting stents. For patients with bleeding risks large elderly patients, or has especially recent surgery patients, plans to accept for prevention des thrombosis risk after long-term use of aspirin and clopidogrel patients, apparently should choose bare metal stents.

Why innocent patients were so excessive medical? Why get hurt of always patients? Investigate its deep-seated reasons, one is the doctor in the treatment of patients, and not willing to deep analysis patients should use what treatment and choose which implant tools, but to escape risk, free dispute, blindly to choose your, imported. If doctors heal patients like us to choose furniture appliances that comparison shop, the selection of the most appropriate, so patients and the public health benefits can be maximized protection. Second, our country currently has no regular supply channel bare metal stents. Doctors and enterprise both in the pursuit of interests, both sides have reached a silent interests chain. The doctor to explain their condition with drug-eluting stents, recommend preferred bare metal stents makers believe that low prices, profits, nor production and sales of thin enthusiasm. The doctor party didn't order, manufacturer of the other party and ready to not not produce supply. So, both the eye to glance the imported drugs stents. Little imagine this on doctors and enterprise eyes BoBo, became the incense on the economic inedible canteen patients to dump.

In recently held in anhui taihe county hospital "evidence-based love engineering" yizhen activities, I advocate in the lecture to break the doctors thought einstellung "cheap goods is not good" idea, hope in the face of patients with primary doctor economic stimulus factors, let slam the appropriate and reasonable treatment every doctor heart deeply.

Technology not hard to guarantee safe patients

The Chinese academy of medical sciences interviewed experts: fortune recourse international YangYueJin hospital professor cardiovascular disease

Core ideas

The hospital that is the core of management and technology

Improve the medical technology must rely on ChuanBangDai

Medical technology and management is the core of hospital work two aspects. At present, the health administrative departments under the management of the very hard, put forward many policy, standard, the hospital is also true that in improving service ability and optimize medical process, improve work efficiency, reduce mistakes made a lot of work, and achieved significant results. But, should realize that management itself cannot improve the medical technology level. To improve medical and technical level by? Should rely on training, study and practice, summarize and improve, must rely on old experts preach, help, belt.

In fact, our country generations of masterful medical experts are to rely on continuous learning and training, practice, review and improve, and preach, help, take out, don't tube out. Because the doctor first is a person, not mechanical screws. Medical management can reduce medical errors, make quality resources can be fully used, gears, but management itself does not improve the medical technology level. Especially with after 80, 90 Cenozoic entering society, these medical jobs, hope to rely solely on management put their "tube" into experts must not, might even be "more tube more die", will make doctors more dogma, lack of innovation, may also keep people.

Want to know, clinical medicine based on clinical medical practice and subject, theory and practice in the combination of science, medical talents growth and medical technology level and ability the enhancement also has its inherent regularity. Doctor training, to contemporary theoretical training and practice must be given a chance, help them quickly to improve medical and technical level and ability, still cannot leave the old experts preach, help, to bring this a traditional classical method. I particularly want to emphasize that: the core is technology, medical establishment of doctor-patient trust relationship were relying on medical technology level and ability to support. Patients with simple requirement is bullish on disease, and we even though there are still many face medical mysteries confusion, but should also ask yourself don't put patients to see "bad", namely, it must ensure the safety of patients. This will rebuild the doctor-patient trust harmonious relationship.

Therefore, I often reminded colleagues: I don't doubt your technology, but must have risk and safety consciousness, is how to prevent and emergency treatment in case of problem, to which we must advance do preventative measures and emergency plan. Because the modern medical technology is a double-edged sword, any experts are difficult to assure absolutely not wrong. I also constantly remind yourself: for percutaneous coronary intervention, technical difficulties can challenge, risk, because there is no difficulty may give patients life-threatening; The medical quality after all, only one, is safety first.