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.
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.
ObjectiveTo summarize the experience of microsurgery in primary hospital for the posterior communicating artery aneurysms (PCOAan). MethodsThe clinical data of 48 patients with PCOAan who underwent microsurgery from January 2008 to December 2012 were retrospectively analyzed. ResultsAll the necks of aneurysms of 48 cases were successfully clipped, Acording to the Glasgow outcome score (GOS), the early curative effects were good in 36 cases (75.0%, GOS 4-5) poor in 10 cases (20.8%, GOS 2-3) and death in 3 cases (2.1%, GOS 1). After the operation was carried out, the operation time was shorten, aneurysm intraoperative rupture rate was lower, postoperative complications were lower, and the average medical expense was reduced; the difference was significant in 24 cases before and after the operation (P<0.05). ConclusionMicrosurgery for PCOAan is an effective method which should be popularized in primary hospitals.
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 explore the effect of humanistic ideas applied for high quality nursing service in grass-root hospitals. MethodsIn the process of high quality nursing service between January 2011 and December 2013, humanistic philosophy was adopted. We provided humanistic nursing care for the patients, and humanistic management and care for doctors and nurses. Then, we used self-made questionnaire to do survey on the satisfaction degree in 1 200 patients, 500 nurses and 100 doctors in a third-grade class-A hospital. ResultsThrough the application of humanistic management idea, the satisfaction degree of all patients, nurses and doctors was significantly raised. ConclusionHumanistic concept applied in high quality nursing service inspires the enthusiasm and activity of nurses, promotes their nursing mode, and raise the nursing quality, which satisfies all the patients nurses and doctors.
目的 探讨局部麻醉（以下简称局麻）腹股沟疝无张力修补术在基层医院的应用价值。方法 分析内蒙古医学院附属人民医院2010年10月至2011年12月期间242例行局麻腹股沟疝修补手术患者的临床资料。结果 除1例因过度紧张而停止手术外，其余手术顺利。平均手术时间50min，所有患者术后0.5～4h （平均2h） 均能下床活动，切口疼痛时间0.5～1d。无一例发生尿潴留；12例患者术后阴囊轻-中度水肿，切口感染1例。全部病例术后观察1～2d出院。门诊随访2～15个月（平均8个月），复发2例。结论 局麻下腹股沟疝无张力修补术安全、疼痛轻微、禁忌证少、复发率及费用低，值得在基层医院推广。