摘要:目的: 探讨基层医院急诊“120”院前救治水平的影响。 方法 :分析301例死因,年龄及百分比。 结果 :急诊致死原因疾病病谱前9位分别是交通事故,猝死,溺水,意外伤害,自杀,电击伤,刀伤,一氧化碳中毒及呼吸道梗塞,“无名氏”群体86例占285%,这部分给临床和社会带来了新问题,这仍有待今后继续探讨。 结论 :完善基层医院“120”体系,提高救治水平。Abstract: Objective: To explore the factors relate to prehospital“120”Emergency Medical Services cases death. Methods : Analysis the cause for death, ages and percentage of the age in 301 cases. Results : Traffic accident, sudden death, drowns, accident, suicide, electric burn, knife trauma, anthracemia and respiratory tract obstruction were the leading cases in the diseases spectrum of the cause for death in emergency cases. 86 cases were anonym, which brought new problems to clinic treatment and provoked social issue, accounting for 285% in total cases. These remain us to study henceforth. Conclusion : Consummate the “120” Emergency MedicalServices system in grassroots hospital and enhance the level of cure.
ObjectiveTo know about equipment of pulmonary function tests (PFTs) in community health service centers and the knowledge of pulmonary function in general physicians.MethodsThis questionnaire survey was carried out sponsored by Shanghai Basic Alliance for Respiratory Diseases Prevention and Treatment from June to December in 2016. Most community health service centers in 16 districts of Shanghai participated the survey. The questionnaire included education background, professional qualification, PFTs equipment, and knowledge about PFTs.ResultsThere were 963 general physicians in 131 community health service centers completed the questionnaire. There were 27 (20.6%) community health service centers equipped with simplified pulmonary function test device and 910 (94.5%) physicians knowing PFTs. Out of these 910 physicians, 458 physicians (50.3%) gave the correct answer on question about the items of PFTs. The accuracy of question about the diagnosis of chronic obstructive pulmonary disease (COPD) was 24.0% (218/910).ConclusionsThe rate of community health service centers with equipment on PFTs is low and the knowledge on pulmonary function in general physicians is insufficentt in Shanghai. Training on pulmonary function is essential to adapt the stratified treatment of COPD.
【摘要】 目的 探讨在基层医院建立脑卒中单元模式的临床意义。 方法 将2006年1-3月和2007年同期共381例脑卒中患者分为脑卒中单元组和普通病房组。脑卒中单元组按照脑卒中单元模式进行治疗，普通病房组按照传统方法治疗，分别于治疗前、治疗后7、15、30 d时，对比分析两组患者神经功能缺损及疗效。 结果 脑卒中单元组和普通病房组治疗后，随时间两组的神经功能缺损评分（NIHSS）均逐渐降低，两组在治疗后15、30 d时差异有统计学意义（P=0.007），脑卒中单元组家属满意度明显高于普通病房组（P=0.002）。 结论 在基层医院脑卒中单元模式对脑卒中患者的治疗效果明显优于传统治疗。【Abstract】 Objective To investigate the clinical significance of setting up stroke unit model in basic hospital. Methods Three hundreds and eighty-one stroke patients were randomly divided into stroke unit group (n=186) and general ward group (n=189). The stroke unit group patients were treated with the stroke unit model designed by ourselves, while the control group patients were treated with traditional method, The clinical efficacy was compared before treatment, seven days, 15 days and 30 days after treatment. Results Improvement in neurological score was significantly better among patients treated in the SU than in the GW. NIHSS scores gradually reduce in the both groups after treatment, which were significantly lower than those in the control group on 15 days and 30 days after treatment(P=0.007,0.004). The satisfactory of relatives in the stroke unit group was better than that in the general ward group(P=0.002). Conclusion The efficacy of treatment with stroke unit model was better than that of treatment with traditional method in the stroke patients.
ObjectiveTo explore the current situation of nosocomial infection, sample test and use of antibiotics in the in-patients, so as to provide scientific evidence for control and prevention of nosocomial infection. MethodsBedside investigation and medical records checking were adapted to conduct cross-sectional survey among all the in-patients in 2013 and 2014. ResultsOn July 16 th, 2013 (00:00-24:00) and September 10 th, 2014 (00:00-24:00), a total of 1 400 in-patients were investigated in whom 68 with nosocomial infection were diagnosed, with a prevalence rate of 4.86%. No statistical difference were found between the two year's prevalence rate (χ2=1.341, P=0.264). The prevalence rate of Intensive Care Unit, Department of Neurosurgery (including Department of Thoracic Surgery) and Department General Surgery ranked the first three places, and the most common infection position was respiratory tract (61.76%). The usage rate of antibiotics was 48.00% in the two years, and no statistical difference was observed in the usage rate between the two years (χ2=1.309, P=0.261). Therapeutic use (67.86%) and onefold use (90.33%) accounted for most of antibiotics use. Test rate of therapeutic antibiotics use was 49.17% and no statistical difference was observed in the test rates between the two years (χ2=2.023, P=0.170). ConcluslonsThe nosocomial infection rate was stably high in the two years. To prevent and control nosocomial infection effectively, medical personnels knowledge and skills on nosocomial infection should be improved, surveillance and guidance towards key departments should be strengthened and clinicians' diagnosis and treatment behaviors should further be regulated.
ObjectiveTo design and use adverse nursing events information management system to improve the quality of nursing for high-risk patients and guarantee nursing quality and safety. MethodAdverse nursing events information management system was started from January 2014. Two hundred cases assessed to be nursing adverse events cases from September to December 2013 were chosen to form the control group, and another 200 from the same period in 2014 were designated to be the observation group. Then we compared the two groups in terms of the onset time of nursing assessment, incidence of adverse nursing events and rate of missing reports. ResultsThe onset time of nursing assessment, incidence of adverse events, and the rate of missing reports were significantly lower in the observation group than the control group (P<0.05). ConclusionsThe application of adverse nursing events information management system can improve the quality of nursing management and promote the nursing quality and safety.
ObjectiveTo explore the application of tracking method in intravenous treatment in primary hospitals, in order to improve the quality of nursing of intravenous therapy. MethodsFor the 22 events of venous transfusion adverse reactions between January and March 2013, we used tracking methodology for tracking and analyzing the reasons. Through this, we regulated and implemented specific improvement scheme, perfected rules and regulations to improve the work process. ResultsThrough reason analysis and improving regulations, the number of intravenous infusion adverse reactions was decreased from 22 in the first quarter to 0 in the fourth quarter of the year. ConclusionTracking methodology used for regulating the intravenous treatment behaviors of basic-level hospitals nurses can reduce the occurrence of adverse transfusion reaction
摘要:目的:探讨基层医院开展急诊经皮冠状动脉支架植入术(PCI)治疗急性心肌梗死(AMI)的可行性、安全性。方法:回顾分析2002年11月~2009年4月我院41例AMI患者的急诊PCI资料。结果:41例AMI患者,急诊开通梗死相关动脉(IRA)39例(即时成功率95.1%),开通IRA者中术后死亡2例(死亡率4.9%),总成功率90.2％。结论:在有条件的基层医院开展急诊PCI安全有效。Abstract: Objective: To explore the feasibility and safety of primary percutaneous coronary intervention in patients with acute myocardial infarction in elementary hospital. Methods: The clinical data of 41 AMI patients who underwent emergent PCI from November 2002 to April 2009 were retrospectively analyzed. Results: Among the 41 AMI patients referred to PCI, infarctrelated arteries were recanalized in 39 cases. The immediate success rate was 95.1%. 2 cases of them died. The total success rate was 90.2%.Conclusion: Emergent PCI is safe and effective in the hospitals which could carry out PCI.