关于慢性危重症及其管理的几点思考OA北大核心CSTPCD

Chronic critical illness(CCI)is difficult to define,which the author thinks should not limit the source of patients,but should pay attention to the features of disease prevention and treatment.It is suggested that all the disease states with the following five characteristics,namely,the severity of disease,the diversity of manifestations,the difficulty of treatment,the long-term course of disease and the recurrence of disease,should be collectively referred to as extended chronic critical illness(ECCI),which may have more clinical practical significance.Patients with CCI can be managed by a multi-disciplinary team,consisting of doctors and nurses with experience in critical care and general practice,respiratory therapists,physiotherapists,nutritional therapists,psychotherapists,occupational therapists and social workers,and among them,respiratory therapists are scarce and it is necessary to strengthen talent cultivation.CCI medical management center can provide comprehensive technical support to CCI patients and close-loop management from hospital to home to improve the quality of treatment and reduce the social burden.CCI medical management center should include ventilator evacuation center,CCI ward,CCI general out-patient clinic,long-term care ward,day care unit,CCI home guidance center,etc.CCI medical management center should be managed locally and hierarchically.The construction of CCI network and the support of medical insurance and charging policy are important guarantees.