图书名称：《远程医疗系统和网络》【作者】“世界医药学研究前沿丛书”编委会编【丛书名】世界医药学研究前沿丛书【页数】834【出版社】北京/西安：世界图书出版公司,2018.12【ISBN号】978-7-5192-5876-4【价格】598.00【分类】远程医学－医疗卫生服务－研究－英文【参考文献】“世界医药学研究前沿丛书”编委会编.远程医疗系统和网络.北京/西安：世界图书出版公司,2018.12.图书封面：图书目录：《远程医疗系统和网络》内容提要：远程医疗是指通过计算机技术、遥感、遥测、遥控技术为依托，充分发挥大医院或专科医疗中心的医疗技术和医疗设备优势，对医疗条件较差的边远地区、海岛或舰船上的伤病员进行远距离诊断、治疗和咨询。编委会根据目前国际研究水平选择30多个研究点对远程医疗系统和网络相关最新技术和研究成果进行详细论述，将研究分析和数据，以文字、图片、表格等形式清晰展现给读者，为便于内容统一全球各地区作者，全书采用英文写作。本书内容涉及KAIFU救护车急救医学系统、院前监护中的远程医疗、基于手机的远程医疗、多中心院前远程医疗支持系统、挪威医院常规远程医疗的应用、英国远程医疗、远程医疗系统评价体系对下肢和足部溃疡的影响等。本书为读者展现国际一线学者在相关细分领域的最新研究数据、科研思路、技术逻辑等，针对性及功能性均较强，适合相关领域专业读者阅读与参考。《远程医疗系统和网络》内容试读Chater1Chater1FractureDiagotic,UecearyTraveladTreatmet:AComarativeStudyeforeadaftertheItroductioofTeleradiologyiaRemoteGeeralPracticeJacJWMJaco'2",JaPAMJaco',EricvaSodere',ThyvaderMole,RoertSaderma25GeeralPracticeBallum,9162ET,BallumAmelad.TheNetherladHealthPychologySectio,UiverityMedicalCetreGroige,UiverityofGroige,9712CPGroige,TheNetherladFacultyofEcoomicadBuie,UiverityofGroige,9712CPGroige,TheNetherladDeartmetofPrimaryCare,UiverityMedicalCetreGroige,UiverityofGroige,9712CPGroige,TheNetherladPDeartmetofPychology,HealthadTechology,UiverityofTwete,7522,NBEchede,TheNetherladAtract:Backgroud:Teleradiologyetailattaimetofx-rayioelocatio,traferoveromeditaceadaemetataotherlocatiofordiagoiorcoultatio.Thitudydocumetfracturediagotic,uecearytritothe1TelemedicieSytemadNetworkhoital,treatmetadumerofx-rayfortheyear2006ad2009,eforeadaftertheitroductioofteleradiologyiageeralracticeotheiladofAmel-aditheorthoftheNetherlad.Method:Iaretroective,decritive,o-ervatioaleforeadaftertudyoftheitroductioofx-rayfacilitieiail-ad-aedgeeralractice,wecomaredtheumerofaccuratelydiagoedfracture,uecearytri,treatmetadumerofx-raytakei2006wheolyahoitalx-rayfacilitywaavailale5hourawaywiththoei2009afterax-rayfacilityecameavailaleatalocalgeeralractice.AllatietviitigageeralracticeotheiladofAmeladi2006ad2009withtraumaadcli-icaluicioofafracture,dilocatioorraiwereicludedithetudy.Theiitialcliicaldiagoe,icludigthoeaedotheoutcomeofx-ray,werecomaredforthetwoyearadalowhethertheatietweretreatedathomeorihoital.Reult:Atotalof316ad490atietwithtraumaviitedageeralracticei2006ad2009,reectively.Oftheeatiet,66ad116werefoudtohavefractureordilocatioithetwoyear,reectively.I2006,83x-raywereorderedi2009,thiwa284.I2006,9fractureweremiedi2009,thiwaoly2.I2006,15atietwithfractureordilocatioweretreatedatthegeeralracticei2009,thihadicreaedto77.Cocluio:Sicethei-troductioofteleradiologytheumerofmiedfractureiatietviitigthegeeralracticewithtraumaadtheumeroftheuecearytritoahoitalarereduced.Iadditiomoreatietwithfractureaddilocatiocaetreatedithegeeralracticeaooedtothehoital.Keyword:Teleradiology,FamilyPractice,GeeralPractice,Diagoi,Treatmet,TraumaFracture1.ItroductioTeleradiologyitheelectroictramiioofradiologicalimagefromoelocatiotoaotherfortheuroeofiterretatioad/orcoultatio.Thitech-iqueharoliferatedimaycoutrieutotyetitheNetherlad.ItheNetherlad,allx-rayareotaiedihoitalordiagoticcetreadue-quetlyaeedyradiologit.Imayothercoutrie,x-rayareotaiedithegeeralracticethemelveadreviewedythegeeralractitioer(GP).Whejudgedeceary,aradiologitmayometimeecoultedwiththeueof2Chater1teleradiologyItheNetherlad,aaverageof42-43er1000atietexerieceewtraumaadviitageeralracticeaually:27withtraioaverage13-14withfractureoaveragead2withdilocatiooaverage4).Fortraumaa-tietwithuectedfractureordilocatio,Dutchhealthcareguidelierequirex-raycofirmatioofthefractureordilocatioihoital,followedyeithercoervativeorurgicaltreatmetyaurgeo5.TheGPitheNetherladtodayormallyrefertheatiettothehoitalforx-ray.Traumaatietwithuectedtrai,icotrat,aretyicallytreatedolyotheaiofcliicaligygeeralractitioer.Iarelativelyremotelocatio,theiladofAmeladitheorthofthemallcoutryoftheNetherlad,teleradiologywarecetlyitroduced.Priorto2007,allatietwithuectedfracturereceivedlaterlitatthegeeralracticeforimmoilizatioorwheecearyfollowigdeformitycorrectio,adwereettothehoitalforfurtherx-rayexamiatio(whichiikeeigwiththeormalrocedureiTheNetherlad).Theeatietfrequetlyreturedwiththeamelaterlitfollowigx-raycofirmatioofthefractureoruccefulreoi-tioig.Ifact,atthattime,uchtraumaatietofteolytravelledtotheho-italtohavethex-raytake.Givethatthehoitaltakeaferrytritoereached,thethreholdforareferraltothehoitalwa(adi)veryhigh.Thehyicalexamiatioatthegeeralracticehadtotroglyuggetafractureordilocatioforreferraltothehoitalfractureofthehalax(i.e.,figerortoe)orhaitualhoulderdilocatiowereoftetreatedithegeeralracticewithoutx-rayackthe.Medicaldiagoialwayhatherikofmiigomethig,otheoehad,veruuecearyreferral,otheotherhad(i.e.,atiettravelligtohoitalforothigitheed).ThidilemmaadarticularlythehighthreholdfororderigulemetaldiagoticiarurallocatioaAmeladwaexectedtodiaearwheaGPotaiedaccetoax-rayfacilityaditroducedtelera-diologytocommuicatewithahoital(i.e.,radiologitadurgeo).TelemediciehareceivedcoideraleattetioithereearchliteratureutteleradiologymuchleIthereettudy,itwathereforedecidedtoi-3TelemedicieSytemadNetworkvetigatethefollowigquetio:whatitheiflueceoftheitroductioofax-rayfacilityiaremoteGPracticeoaccuratelydiagoedfracture,hoitalviit,umerofx-rayadtreatmet.Itwaexectedthattheumerofmiedfractureaduecearyhoitalreferral(tritothehoital)woulddecliewiththeitroductioofteleradiology.Wedidotexecthugechageitreatmetadumerofx-ray,i.e.thatcliicalidicatioforx-raywouldeuaffected.2.Method2.1.SettigadPrearatioAmeladiailadwith3500ihaitatad20timeamaytouritdurigtheuyeao(ummer).Medicalcareideliveredattwogeeralrac-tice,whichaloicaeofemergecieervethefuctioofemergecyroom.TheearethoitaliiDokkumothemailad,withatravelligtimeofa-roximatelyfivehour,icludigaferrytri.Theteleradiologyfacilityiitalledioeofthetwogeeralracticeutavailaleforuewithallatiet-icludigthoefromtheotherGPotheiladadtourit.Wheeeded,thex-rayaretakeyatraiedradiograherworkigithegeeralracticeaddigitallytramittedtothehoitaliDokkumwherethex-rayiformatioievaluatedaditerretedyatraiedradiologit.Thera-diologitareavailaledurigregularofficehouradforemergecyituatio24houraday,7dayaweek.Icoultatiowiththeurgeoithehoital,itidecidedwhethertheatietiquetiocaetreatedithegeeralracticeudertheuerviioofaurgeoorhouldetreatedihoital.Theradiograheriafull-timeemloyeeofthegeeralracticeadreoileolyforthetakigofx-rayadotfortheiterretatioofthee.Theradiologitalwayreoddigitallyotheamedayad,ifeceary,directlyyhoe.Theradiologitmayometimegivetheradiograherecialitructioforthex-rayyhoe.Thehoital'x-rayrotocolifollowed.Theradiograherreceiveogoigfeedackothequalityofthex-raytake.Adtheradiograherreceiveaualtraiigatthehoital.4Chater1Theidicatioforax-rayaretwofold,amely:(1)traumaitheformoffractureordilocatioad(2)o-traumarequirigx-rayformoitorigorur-gicaluroe(e.g.,x-rayicaeofhidegeeratio,keerolem,adlugcarcioma).Ithereetettig,theGPwatraiedaaradiatioexert.TogetherwiththeItituteofNuclearServiceforEergy,EvirometadHealthitheNetherlad,theGPialoreoileforallradiatiohygieeadafetywithithegeeralractice.Thecotofthex-rayadthehoorariumfortheradiologitarecoveredytheatiet'iurace.Thex-raymadeithegeeralracticearetoredtogetherwithayx-raymadeatthehoitalithePictureArchivigadCommuicatioSytem(PACS)ofthehoital.2.2.StudyDeigIaretroective,decritive,oervatioaleforeadaftertudy,wecomaredthehealthoutcomeforatietwhoviitedthegeeralracticewitharecettraumai2006-theyeareforetheitroductiooftheteleradiologyfa-cility-adatietwhoviitedtheGPwitharecettraumai2009-theecodyearaftertheitroductioofthefacilityadthemotrecetyearforwhichdatawaavailale.Olytraumarelatedtothemuculokeletalytem(i.e.,trai,fractureaddilocatio)wereivetigated.2.3.StudyPoulatio,DataCollectioadMaterialRetroective,alltheatietwhoviitedtheGPi2006ad2009withtheaovemetioedtraumawereelectedfromthePromedicodataaeytheGPhimelf.Otheaioftheiriitialcliicalig,theatietwerecategorizeditoixgrou:(1)cleardeformity,(2)aiduetoweightearigoraxialcom-reio,(3)localreureai,(4)haematoma,(5)tiffe,(6a)odiorderor(6)immoilized.Patietigrou1defiitelyhadafractureordilocatioadeededtreatmetaooaoile-referalyfollowigx-raycofirmatioofthecoditio.Patietigrou2haduectedfracturewhichhadotyeteecofirmedutcalledforax-ray.Patietigrou3hadtraiutalotheoiilityoffracture()adwereitructedtoreturforre-examiatioiftill5TelemedicieSytemadNetworkidoutaoutthediagoiaftertwodayPatietigrou4,5ad6ahowedmiimaltraumaadoaaretfracture.Theatietigrou6hadeeimmoilized(re-trauma),whichrecludedhyicalexamiatioithegeeralractice.Iformatiowaalogatheredfromtheaovemetioeddataaeothecliicaldiagoi,whetherax-raywaotaiedorot,udertaketreatmet,locatiooftreatmet(hoitalorgeeralractice),theracticewithwhichtheatietwaregiteredadthex-raywaordered(GPfromothgeeralracticeotheiladcouldorderx-ray)adfialdiagoi.Ahyiciaaitatcotactedthoeatietforwhomofialiformatioothemedicaloutcomewaavailaletootaithiiformatioytelehoe(i.e.,othtouritadiladerwhodidotreturtotheracticefollowigcoultatiofortherelevattraumawerecotactedtootairequiredfollow-uiformatio).Tale1litthequetioaire.SuequetlytheGPaoymizedtheelecteddata(icludigtheiforma-tiogatheredythehyiciaaitat)adamedicaltudetimortedtheedataitoaregitratioytemoftheUiverityMedicalCetreGroige.Itera-tioalClaificatioofPrimaryCare(ICPC)codewereaiged.TheiitialICPCdiagoe(diagoiatthemometoftreatmet)werethecomaredtothefialICPCdiagoe(diagoicollectedafteraeriodythehyiciaaitathoecallorfromthemedicaloutcome).Tale1.Quetioaireteleradiology.Whedidyouviitthegeeralracticei2006or2009?2Whatwathereaoforthecoultatio?3Whatwathediagoi?Wathediagoicorrect?5Howlogdidyouhavecomlait?6WaaX-raytake?7Quetioixifye,whewathatX-raytake?Adwhatwathediagoi?6···试读结束···...

2022-10-28