“和谐使命-2015”任务期间CT检查情况分析

“和谐使命-2015”任务共到访8国9港,任务期间对所有任务中官兵、8国的华侨以及墨西哥、巴巴多斯、格林纳达和秘鲁4国的部分民众进行医疗服务,开展CT检查.本文旨在分析“和谐使命-2015”任务期间医院船CT工作情况,了解任务期间不同人群尤其是美洲4国部分民众的CT检查数量以及疾病检出情况,为未来执行相关任务提供参考.     

“和谐使命-2015”任务医院船海外医疗服务的实践与思考

中国海军“和平方舟”号医院船于2015年9月7日从浙江舟山启航,执行“和谐使命-2015”任务。此次任务历时142 d,访问马来西亚并参加“和平友谊-2015”演习,访问澳大利亚、法属波利尼西亚、美国、墨西哥、巴巴多斯、格林纳达、秘鲁执行“和谐使命-2015”任务,并在后4个国家开展免费医疗与人道主义服务,医院船主平台共诊疗12589人次,派出29支医疗队前出诊疗4852人次,收治住院患者46人次,实施手术59例次,开展CT、DR等辅助检查7130人次,在各到访国还安排了学术交流、参观访问、文化联谊、动静态展示等系列活动。该文总结此次任务的做法与经验,为医院船建设及后续任务提供参考。     

医院船对外军事医学交流的经验与体会

医院船在执行“和平友谊-2015”中马军演及“和谐使命-2015”人道主义医疗服务任务的过程中,船上医务人员多次组织医学交流会、卫勤演练展示、现场医学展示、技能培训,并多次赴当地医学机构参观交流,内容涉及战创伤救治、海水浸泡伤、军事训练伤、常见病与多发病诊治、舰艇卫生、传染性疾病等多个专业,与到访国或地区军事医学专业人员进行了深入的探讨。该文详细介绍了此次出访期间对外军事医学交流的特点、具体做法,并归纳总结了这些机构中值得我方借鉴的经验与启示,为今后医院船出访中对外医学交流积累了宝贵的经验。     

"和谐使命-2010"任务前出分队护理突发事件的应对

"和谐使命-2010"任务到访亚非5国,分别派出前出医疗分队携药品器械,以协作、依托及独立3种医疗模式,在当地军方或政府机构提供的场地为各国民众展开医疗援助.海上医院护理质控小组评估前出医疗分队展开护理工作的不安全因素,制定了护理突发事件应急预案,以期成功规避风险,确保护理工作安全.     

“和谐使命-2010”医疗服务中儿科存在的问题与对策

历时近3个月的＂和谐使命-2010＂任务圆满结束了,此次人道主义医疗援助和服务很成功,也获得到访国各界的肯定和赞誉,但由于是首次对外医疗,无任何经验可借鉴,难免会存在一些问题。     

"和谐使命-2010"儿科医疗活动存在的问题和对策分析

历时近3个月的"和谐使命-2010"任务圆满结束了,此次任务中对亚非5国的医疗服务获得了到访国各界的肯定和赞誉,但因为是首次对外医疗,无任何经验可借鉴,仍存在一些问题和瑕疵.作为一名执行任务的儿科医师,笔者总结了此次任务中儿科医疗活动存在的问题,为今后更好地执行类似任务提供参考.     

"和谐使命-2010"医疗服务中神经外科临床工作分析

目的 分析"和谐使命-2010"医疗服务中神经外科工作,了解亚非5国的神经外科发病情况及治疗情况.方法 回顾性分析"和谐使命-2010"医疗服务中各服务点(吉布提的吉布提市、肯尼亚的蒙巴萨市、坦桑尼亚的达累斯萨拉姆市、塞舌尔的维多利亚和孟加拉国的吉大港)的门诊患者及开展手术的情况.结果 神经外科接诊门诊患者535例,专科手术6例.结论 当地神经外科技术及人才均很稀缺,神经外科工作在这5国医疗服务活动中均很重要.     

“和谐使命-2017”任务海上医院医疗工作组织实施与经验启示

对“和谐使命-2017”任务的前期准备与组织实施进行分析和思考,总结经验和不足,为今后执行类似海外医疗任务提出合理化建议,包括：合理配备全科医生是完成和谐使命任务的必备素质、及时根据医疗服务状况改变诊疗模式、强化军人服从意识及纪律意识等等。     

医院船执行＂和谐使命-2011＂任务中存在的问题与对策

目的确保“和平方舟”号医院船在以后执行和谐使命任务中能够准备充分、流程顺畅,灵活开展各项医疗任务。方法针对“和谐使命-2011”任务中存在的问题,如派出的先遣组与医院的沟通不够,多头指挥协同不顺畅,医务人员配置不尽合理,工作计划下达不及时,便携式仪器准备不齐全,医疗服务时间短、任务重,使领馆的作用发挥不足,工作任务、目标及工作内容量化不清等提出对策,包括：①充分发挥先遣组的作用;②指挥机构的设置要简洁高效;③合理编配海上医院医务人员;④尽早确定工作内容和目标;⑤适情加强便携式医疗诊断器材的准备;⑥可适当延长在到访国家的停留时间;⑦充分调动和依托使领馆作用;⑧合理预算、准备医疗耗材和物资及匹配电源设备。结果与结论出色地完成了国外医疗服务任务,得到了军委、总部、海军首长的充分肯定和鼓励。总结“和谐使命-2011”任务中的经验对于今后完成此类任务具有重要意义。     

"和谐使命-2010"前出医疗活动耳鼻咽喉专业经验总结

本次执行"和谐使命-2010"任务,为亚非5国服务期间,笔者有幸作为前出医疗队成员,全程参与了5次前出医疗服务工作,5国国情不同,医疗卫生状况各异,每个国家的前出形式均有不同.前出分队的主要任务是初步诊治患者,视情况后送患者至医院船进一步治疗.耳鼻喉科由于设备人员不足,不具备在船上开展手术的条件,因此在本次执行任务中,前出活动主要是为当地患者进行初步诊治,对于需要进行特殊检查患者,后送至医院船.     

医院船执行“和谐使命-2011”任务中存在的问题与对策

目的确保"和平方舟"号医院船在以后执行和谐使命任务中能够准备充分、流程顺畅,灵活开展各项医疗任务。方法针对"和谐使命-2011"任务中存在的问题,如派出的先遣组与医院的沟通不够,多头指挥协同不顺畅,医务人员配置不尽合理,工作计划下达不及时,便携式仪器准备不齐全,医疗服务时间短、任务重,使领馆的作用发挥不足,工作任务、目标及工作内容量化不清等提出对策,包括:①充分发挥先遣组的作用;②指挥机构的设置要简洁高效;③合理编配海上医院医务人员;④尽早确定工作内容和目标;⑤适情加强便携式医疗诊断器材的准备;⑥可适当延长在到访国家的停留时间;⑦充分调动和依托使领馆作用;⑧合理预算、准备医疗耗材和物资及匹配电源设备。结果与结论出色地完成了国外医疗服务任务,得到了军委、总部、海军首长的充分肯定和鼓励。总结"和谐使命-2011"任务中的经验对于今后完成此类任务具有重要意义。     

“和谐使命-2011”内科门诊特点分析和医师能力需求探讨

目的分析"和谐使命-2011"国外医疗服务内科门诊工作特点,探讨内科医师综合能力需求。方法回顾性分析门诊疾病总体分布情况;根据诊断结果分析内科疾病分布情况;分析内科门诊明确诊断的比率;对非明确诊断进行归类,统计各类症状或体征所占的比例;对专科医师接诊情况进行统计,分析专科医师接诊符合率。结果门诊内科患者最多,占总就诊量的28.82%;内科病种分布较广,心血管内科疾病最多,占35.95%;内科门诊诊断明确的占61.50%;非明确诊断患者中胸闷、胸痛类症状最多见,占31.03%;心血管内科和消化内科医师接诊本专科疾病符合率分别为28.46%和29.17%。结论内科门诊工作至少有两个特点:一是病种分布广;二是常以某一症状或体征为诊疗切入点。需要门诊内科医师具备一专多能的业务技能、较强的风险识别能力和风险应对能力。     

"和谐使命-2010"医疗服务中神经外科临床工作分析

目的 分析"和谐使命-2010"医疗服务中神经外科工作,了解亚非5国的神经外科发病情况及治疗情况.方法 回顾性分析"和谐使命-2010"医疗服务中各服务点(吉布提的吉布提市、肯尼亚的蒙巴萨市、坦桑尼亚的达累斯萨拉姆市、塞舌尔的维多利亚和孟加拉国的吉大港)的门诊患者及开展手术的情况.结果 神经外科接诊门诊患者535例,专科手术6例.结论 当地神经外科技术及人才均很稀缺,神经外科工作在这5国医疗服务活动中均很重要.

Abstract：

Objective To analyze the neurosurgical work in the medical service of "Operation Harmony -2010" , and find out categories of neurosurgical diseases and treatment delivered to the countries during the Operation. Methods A retrospective analysis was made on the patients and neurosurgery delivered at various service points (Djibouti City in Djibouti, Mombasa in Kenya, Dallas Salam in Tanzania, Victoria in Seychelles and Chittagong in Bangladesh) , in the medical service during "Mission Harmony -2010". Results Five hundred and thirty-five cases of neurosurgical out - patients were treated and neurosurgical procedures were performed in 6 cases. Conclusions Neurosurgical techniques and neurosurgical specialists were badly short of in these cities, and neurosurgical operations delivered were considered to be very important in the medical service in the five countries.     

EX SAIF SEREEA II--the field hospital clinical report

This paper places on record the clinical activity of the hospital facilities run by 22 Field Hospital on Exercise SAIF SEREEA II in Oman from August to November 2001. There were 1322 episodes of illness resulting in a hospital admission. The mean rate of admission was 1.96 patients per thousand per day (SD 13.62). The main causes of admission were gastrointestinal illness, conditions related to the heat and injuries. The reporting of health service utilisation data is an important duty of medical personnel during overseas deployments in order to add to the dataset available for the estimation of medical workload for future operations.     

A review of orthopedic injuries in three recent U.S. military conflicts

We conducted a retrospective review of all patients with orthopedic injuries evacuated to a single medical center to evaluate the treatment and outcome of these injuries in three recent U.S. military conflicts: Operation Urgent Fury (Grenada), Operation Desert Shield/Storm (southwest Asia), and Operation Restore Hope (Somalia). Sixteen orthopedic casualties were originally treated at the medical detachment in Grenada before evacuation to the medical center. Most of these injuries were gunshot wounds to the extremities (11), with three known open fractures. Two patients (three extremities) sustained traumatic amputation (19% amputation rate). One hundred eighty-one patients with orthopedic injuries were medically evacuated from southeast Asia to the medical center for definitive treatment. Of these injuries, there were 143 fractures in 69 patients. One hundred of these fractures were open fractures, and 60% of these injuries were blast injuries. Furthermore, there were 26 amputations (14%). Twenty-two patients with orthopedic injuries were treated in Somalia and evacuated to the medical center. Thirteen of the 22 patients (59%) sustained gunshot wounds, and 2 (9%) sustained blast injuries. There were eight open fractures (36%) and three amputations in two patients (14%). Three of the 22 patients underwent successful limb salvage when ablation was the only other surgical alternative. It appears that a large percentage of medical center evacuations from military conflicts are for orthopedic injuries. Many of these injuries are the result of high-velocity weapons or blast injuries. Regardless of the size and/or purpose of the intervention, similar injury patterns and severity can be expected, because 51% of orthopedic patients had open fractures. Similarly, the rate of amputation associated with extremity trauma has not varied significantly since the Vietnam War.     

我国首批女实习舰员长远航心理健康状况调查分析

目的 了解执行"和谐使命-2010"任务女实习舰员的心理健康状况及影响因素,为更好地维护女舰员心理健康及未来女舰员的选拔提供科学依据.方法 以参加此次任务的女实习舰员、女医务人员、男舰员为调查对象,以整群抽样和分层随机抽样相结合,采用症状自评量表(SCL-90)进行4次跟踪问卷调查,同时使用自制的一般资料问卷进行访谈.结果 女实习舰员长远航期间心理健康问题总体检出率为21.8%.长远航中期各因子分超出正常的人数明显增加,长远航后期各因子分超出正常的人数略有降低.女实习舰员长远航前、早期与中、后期比较,心理健康水平差异有统计学意义(P<0.05),躯体化、抑郁、恐怖、其他因子分均显著高于中国军人常模(P<0.05),人际敏感、焦虑、偏执因子分低于中国军人常模,但差异无统计学意义.女实习舰员在航行中、晚期较同期男舰员、女医务人员心理健康状况差(P<0.05).结论 长远航明显降低女实习舰员的心理健康水平,应及时对女实习舰员的心理健康进行必要的干预.

Abstract：

Objective To investigate the mental health status of the midshipwomen involved in Mission Harmony-2010 and its influencing factors, and also to provide scientific basis for the maintenance of mental health and selection of female ship crew.Methods With midshipwomen, female medical personnel, male shipcrew as study subjects, and with cluster sampling and stratified random sampling as study methods, questionnaires were conducted 4 times by using symptom checklist (SCL-90) and routine interviews were also made during our study.Results During the prolonged seagoing deployment, the rate of detection for mental health problems among the midshipwomen was 21.8%. Scores of various factors during the mid stage of deployment were obviously higher than those of the normal people. However, in the later stage, scores of various factors were slightly lower than those of the normal people. Statistical significance was shown in the mental health status of the midshipwomen, when a comparison was made between pre-deployment,early stage of deployment and the mid and later stages of deployment(P<0.05). Scores of somatization, depression, phobia and other factors were significantly higher than those of the norms of Chinese military personnel (P<0.05). Scores of interpersonal sensitivity, anxiety and paranoia were lower than those of the norms of Chinese military personnel, but without statistical significance. During the mid and later stage of the prolonged seagoing deployment, the mental health status of midshipwomen was worse than that of the male ship crew and female medical personnel(P<0.05).Conclusions Prolonged seagoing deployment could significantly worsen the mental health status of midshipwomen. It was necessary to give in-time psychological intervention so as to ensure the mental health of midshipwomen.