刘君玲 鲍海华 吴有森 李伟霞 尹桂秀 张红迁

【摘要】目的：鑒于农牧地区基层医院医疗力量的薄弱，通过远程影像会诊平台，依托大医院的优质资源达到帮扶基层医院的目的。方法：通过东软公司的熙康远程影像会诊系统，使远程医疗平台与农牧地区基层医院影像平台实现互联互通，数据的传输及存储采用云计算、云存储、云管理等技术。帮扶基层医院进行远程影像会诊、线上讲座及培训、在线影像技术指导、线下及线上影像质量控制指导、线上多学科会诊（MDT）等工作。结果：在23家基层医院成功搭建远程影像会诊平台，自2017年7月至2021年2月完成远程影像病例会诊共1687例，其中包虫会诊并分型诊断179例，各类肿瘤的诊断及分期共349例，高原病（高原性心脏病、肺水肿、脑水肿等）198例，急症病例280例，其他病例354例，129例CT诊断不明，建议进一步增强或MRI检查。2019年12-2020年4月新冠疫情期间胸部CT会诊198例。线上讲座及培训12次，在线影像技术指导21次，线下及线上影像质量控制指导46次，远程线上多学科综合会诊（MDT）10次。结论：开展远程医学影像诊断会诊平台的优势显著，解决了基层医院诊断人才稀缺，诊断水平较低的问题，满足了群众的就医需求。期待远程影像会诊平台进一步改进及完善，赢得基层医疗单位的认可及信任，更好地服务于人民群众。

【关键词】远程影像;会诊平台;农牧地区;基层医院

【Abstract】Objective：In view of the weak medical power of grassroots hospitals in agricultural and pastoral areas， the purpose of helping grassroots hospitals is achieved through the remote imaging consultation platform and the high-quality resources of large hospitals. Methods： Through Neusoft's Xikang remote imaging consultation system， the telemedicine platform and the imaging platform of grassroots hospitals in agricultural and pastoral areas are interconnected， and data transmission and storage adopt cloud computing， cloud storage， cloud management and other technologies. Assist primary hospitals in remote imaging consultations， online lectures and training， online imaging technology guidance， offline and online imaging quality control guidance， and online multidisciplinary consultations （MDT）.Results：Successfully set up a remote imaging consultation platform in 23 primary hospitals. From July 2017 to February 2021， a total of 1687 remote imaging case consultations were completed， of which 179 were diagnosed with hydatid consultation and typed diagnosis. The diagnosis and staging of various tumors were total There were 349 cases of altitude sickness （high altitude heart disease， pulmonary edema， cerebral edema， etc.）， 198 cases， 280 emergency cases， 354 other cases， and 129 cases with unclear CT diagnosis. It is recommended to further enhance or MRI. During the period from December 2019 to April 2020， there were 198 chest CT consultations during the new crown epidemic. 12 online lectures and trainings， 21 online imaging technology guidance， 46 offline and online image quality control guidance， and remote online multidisciplinary comprehensive treatment （MDT） 10 times.Conclusion： The development of remote medical imaging diagnosis consultation platform has significant advantages， which solves the problem of the scarcity of diagnosis talents and low diagnosis level in primary hospitals， and meets the medical needs of the masses. It is expected that the remote imaging consultation platform will be further improved and perfected， win the recognition and trust of primary medical units， and better serve the people.

【Key words】Remote image; Consultation platform; Farming and pastoral areas; Grassroots hospital

青海省地处高海拔地区，部分农牧地区海拔可高达3600米以上，气候寒冷、干燥，高原病、地方病多发，但农牧地区医疗条件有限，医疗卫生专业人员稀缺，疑难病及危重病人需异地城市医院就医，加重了患者就医成本。……