目的   通过对压疮不同治疗方式的分析，探讨疾病诊断相关分组（DRG）组合的特征，提高核心疾病诊断相关组（ADRG）的入组率和提升相对权重值，从而提升医疗服务效率和水平。方法   使用医院DRGs分析评价系统以及EXCEL软件筛选出2023—2024年广州市第一人民医院主要诊断压疮疾病病例，分析ADRG组合的特征。结果   根据压疮疾病不同治疗方式，主要诊断为压疮（L89）的176病例进入相对的外科治疗组和内科治疗组，ADRG组分别为JD1组合、JJ1组合、JV1组合。JJ1组合治疗方案以创面封闭式负压引流为主；JD1组合的外科治疗方式均是以皮肤和皮下坏死组织的切除清创术+创面封闭式负压引流术（VSD）的手术治疗方案。JD13组、JD15组比JJ13组、JJ15组，相对权重分别高2.35和1.48。26例患者的住院时间均超过60 d，导致进入了QY组合。结论   利用好DRGs工具能有效地提高压疮的入组率，结合精细化的首页质量管理，提升DRGs的组合权重值及医疗服务效率和水平。

       Objective  To analyze  different treatment methods for  pressure  ulcers and explore the characteristics of Diagnosis-Related Groups（DRGs）to improve the admission rate of Adjacent DRGs（ADRGs）and enhance the  relative weight value，thereby improving the efficiency and level of medical services．Methods  Using the DRGs management system and EXCEL software，cases of pressure ulcer disease from Class A tertiary hospital in Guangzhou from 2023 to 2024 were selected，with pressure ulcers as the primary diagnosis，and analyzed the characteristics of ADRG combinations．Results  Based on different treatment methods for pressure ulcers，176 cases primarily diagnosed with pressure ulcers（L89）were categorized into  relative surgical and medical treatment groups，with ADRG groups being JD1，JJ1，and JV1 combinations．The JJ1 group’s treatment plan primarily focused on closed wound negative pressure drainage，the surgical treatment method for JD1 group involved skin and subcutaneous necrotic tissue excision and debridement surgery combined with closed wound negative pressure drainage（VSD）．The  relative weights of JD13 and JD15 groups were 2.35 and 1.48，higher than those of JJ13 and JJ15 groups．Twenty-six cases had an average hospital stay exceeding 60 days，leading to their categorization into the QY group．Conclusions  Utilizing the DRG tool effectively improves the admission rate for pressure ulcer diseases．By combining it with refined quality management on the first page of medical records，the combination weight value of DRGs and the efficiency and level of medical services can be enhanced．

目的 分析乳腺恶性肿瘤患者的诊断和治疗方法的动态变化,了解该疾病的患者诊治相关行为方式的变化。方法 抽取我院1999年—2014年收治的所有乳腺恶性肿瘤患者,比较不同初诊时间和初诊年龄分组间,患病部位、肿瘤大小、手术方式、治疗方式的差异。结果 比较1999年—2004年组、2005—2009年组,近年诊断的肿瘤最大直径有所下降,经过卡方比较,构成比有差异(χ²=14.2,P=0.007)。近年诊断的患者更愿意选择积极的改良根治术作为手术治疗方式(χ²=38.8,P<0.001)。就不同年龄而言,年轻的患者选择改良根治术和化疗的比例也较年老的患者高,而年龄大的患者则选择姑息治疗的比例较高(χ²=154.9,P<0.001)和(χ²=129.8,P<0.001)。结论 乳腺恶性肿瘤的认知的加强,诊治技术的提高,乳腺恶性肿瘤能够更早的被发现诊断,治疗方式的选择也更加积极。

Objective To analyze the dynamic changes of breast cancer diagnosis and treatment. and to understand the changes of related behaviors of the patients. Methods From 1999 to 2014, breast cancer patients were chosen, the differences of tumor size, operation and treatment were not compared. Results The results were compared within different groups of diagnosis years, such as 1999-2004,2005-2009, and 2010-2015. The maximum diameter of the tumor diagnosed in recent years was decreased, χ²=14.2,P= 0.007. At the same time, patients that were diagnosed in recent years were more likely to choose radical surgery as surgical treatment, χ²=38.8,P<0.001. Comparing within groups of different ages, more patients chose radical surgery and chemotherapy in younger patients than older ones, we found that the older patients chose a higher proportion of palliative care, χ²=154.9,P<0.001 and χ²=129.8,P<0.001. Conclusion Understan-ding of breast cancer malignancies was enhanced. Breast cancer may be diagnosed earlier and the choice of treatment is more positive with the development of technology.