ObjectiveTo discuss the present situation of emergency physicians' communicational ability and the intervention measures. MethodsWe investigated 66 students who participated in continuing medical education of "emergency physicians' communication skills training course" from 2010 to 2013. All students accepted systematic training. After the training, we did the investigation again, and then made a comparison before and after the training. ResultsA major 78.8% of the students in this training had never taken part in the training of communication skills before; 51.5% of the students thought that the improvement of communication ability could be achieved mainly through long-term accumulation of clinical experiences. Students' self-evaluation showed that communication problem occurred 2 times a year in 10.6% of them, 3 times in 22.7%, 4 times in 24.2%, and five or more times in 34.8%. Students' role playing score in the scenario training rose from 5.374±0.686 to 6.717±0.517 after the training, and the difference was statistically significant (P=0.024). ConclusionEmergency physicians lack knowledge of communication skills which needs to be improved. Through training, the skills can be improved significantly.
目的 探討血清降鈣素原（PCT）、C反應蛋白（CRP）與急性生理及慢性健康評分標準Ⅱ（APACHE Ⅱ）評分在轉診肺炎合并膿毒癥患者診斷中的相關性，以尋找更為簡潔、快速判斷其病情嚴重程度的指標。 方法 2009年1月－2010年12月，選取178例轉診肺炎合并膿毒癥患者并進行膿毒癥分級，對其進行血清PCT和CRP測定，并與APACHE Ⅱ評分及預后進行相關性分析。 結果 嚴重膿毒癥組及膿毒性休克組患者血清PCT、CRP水平與APACHE Ⅱ評分較全身炎癥反應綜合征組及膿毒癥組高（P＜0.05）；30 d內死亡的患者其血清PCT、CRP水平及APACHEⅡ評分較存活組明顯增高（P＜0.05）；轉診肺炎合并膿毒癥患者血清PCT與APACHE Ⅱ評分呈正相關（r=0.683，P=0.023），與血清CRP水平呈較弱的正相關（r=0.272，P=0.037）。 結論 對轉院肺炎合并膿毒癥患者進行血清PCT和CRP測定，對病情評估具有一定臨床價值，特別是PCT可作為對轉診肺炎合并膿毒癥患者病情程度判斷的重要指標，為早期干預及治療提供依據，值得臨床推廣應用。