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1.
目的针对武汉地区医院信息化系统在新型冠状病毒肺炎(简称新冠肺炎)防疫救治过程中暴露出的问题,提出应对突发公共卫生事件时医院信息化的完善方法。方法充分分析医院信息化系统在新冠肺炎防疫救治中所暴露出的各个医院信息化系统结构不同、各个医院之间无法实施信息共享、门诊病房之间系统相互独立、数据信息更新不及时等九大问题,并提出医院信息化基础布局的建立、区域链及大数据临床中的应用等多项措施。结果医院信息化能力的提高有助于降低医护人员工作强度,提高患者的安全。结论新冠肺炎疫情的发生给我国医院信息化系统带来了严峻的挑战,但同时也给我们带来了更大的机遇。我国在未来针对突发公共卫生事件时,医院信息化将为医护人员、患者提供更有利的支持。 相似文献
2.
《The Foot》2020
PurposeOptimum management of displaced intra-articular calcaneal fractures (DIACF) still controversial. Open surgery carries the risk of wound complications, while non-operative management has a high incidence of arthrosis. To avoid these complications, minimally invasive and percutaneous fixation was introduced. The purpose of this study was to prospectively evaluate the short term clinical and radiological outcomes after closed reduction and percutaneous fixation of DIACF using K-wires.Patients and methodsOutcomes of twenty patients were evaluated at the final follow up. A functional assessment using the AOFAS scoring system. Radiological parameters recorded included three angles (Böhler’s, Gissane and posterior facet inclination angles) and three distances (calcaneal length, height and width). Any complications were reported at any follow-up.ResultsThe mean patient’s age was 33 ± 15.2 years, 8 (40%) patients with type II fractures, 10 (50%) patients with type III fractures, and 2 (10%) with type IV fracture according to Sanders classification. After a mean follow-up of 9 months, the mean AOFAS score was 84, excellent in 9 patients (45%), good in 9 (45%), and fair in 2 (10%). At the final follow-up the Böhler’s angle, Gissane angle and PFIA was 25.1° ± (5.2), 119.9° ± (9.4) and 51.7° ± (5.9) respectively and the calcaneal height, length and width was 41.8 mm ± (2.1), 75.1 mm ± (3.01) and 40.9 mm ± (2.6) respectively. We had no cases of deep infection, 20% had significant subtalar arthritis.ConclusionThe closed reduction and percutaneous fixation technique for DIACF management offered acceptable clinical and radiographic outcomes, with fewer complications when compared to other management options. 相似文献
3.
《Anaesthesia and Intensive Care Medicine》2019,20(12):681-686
Tracheal intubation is the act of placing a tube into the trachea. The tube enables oxygen delivery and removal of carbon dioxide, while also allowing for the administration of pharmacological agents. Intubation is the most reliable method of maintaining an airway under anaesthesia, and for protection against aspiration of stomach contents. Traditionally, intubation is achieved by direct visualization of the glottis, but now indirect laryngoscopy (via a videolaryngoscope) is a common alternative. Prior to embarking upon intubation, a thorough patient history and examination must be undertaken by the laryngoscopist; equipment must be prepared and checked; a trained assistant present; and an experienced anaesthetist available in case assistance is required. Once the endotracheal tube has been placed, correct positioning must be confirmed via both clinical examination and monitoring, including capnography. Tracheal intubation is a procedure that should only be undertaken by trained operators and is not without risk. It is important to note that it is failure to oxygenate patients rather than failure to intubate that ultimately leads to serious morbidity and mortality. The Difficult Airway Society has produced guidelines on how to manage unanticipated difficulty in tracheal intubation; it is essential that every practitioner trained to intubate patients is familiar with these algorithms and the key principles of safe airway management. 相似文献
4.
Christopher N. Cooley Tyler J. Beranek Matthew A. Warpinski Robert Alexander Amanda O. Esquivel 《The American journal of emergency medicine》2019,37(2):199-203
Introduction
In the United States there has been a large increase in participation in lacrosse for both males and females. The purpose of this study was to analyze the number of head injuries, injury rates (calculated using the reported number of participants) and types of head injuries that are seen in emergency departments in the United States.Methods
We compared injuries between male and female lacrosse participants. This was a retrospective study using a publicly available database produced by the US Consumer Product Safety Commission and information about lacrosse participation from US Lacrosse.Results
A linear regression was performed and showed a positive correlation between number of head injuries to males and time from 2002 to 2010 (R2?=?0.823; p?=?0.001). While the number of injuries to the head in female lacrosse participants was not significant. There was a negative correlation between the number of head injuries to males from 2010 to 2016 (R2?=?0.800; p?=?0.007), but again, there was no significance for female injury count (R2?=?0.417; p?=?0.117). Other significant differences between head injuries in males and females included the mechanism of injury and the type of injury recorded.Conclusion
The most recent data from 2010 to 2016, suggest that both males and females have had a decrease in injury rate. However the total number of female head injuries is not significantly decreasing and as the sport continues to grow there will likely be more total head injuries and visits to the emergency department. 相似文献5.
6.
自发性气胸的临床特点与治疗对策 总被引:8,自引:8,他引:0
目的通过对多种自发性气胸的临床表现采用不同的治疗方法,达到治愈。方法根据不同临床表现及气胸压缩程度采取人工抽气、闭式引流术、胸膜粘连术等检测效果。结论96例病人中治愈90例,说明采用适用的方法可有效地治疗自发性气胸。 相似文献
7.
应用无死腔气管插管提高正常和急性肺损伤兔的机械通气效率 总被引:2,自引:1,他引:1
目的:观察无死腔气管插管能否提高急性呼吸衰竭常规机械通气的效果。方法:应用一种新型无死腔气管插管和普通聚氯乙烯气管插管对正常和急性肺损伤兔进行常规通气,对两种气管插管的肺气体交换和气道内气体动力学及血流动力学变化进行比较。无死腔气管插管用2根Potex气管插管远端3cm处纵切后对粘而成。5只新西兰成年兔,麻醉下气管切开,在持续应用潘龙阻断自主呼吸条件下,随机用新型气管插管和普通气管插管Servo900C进行机械通气,每次持续30分钟,测定并记录动脉血压、气道压力、血流动力学参数和呼气末CO2浓度。结果:在正常肺和急性肺损伤条件下,新型气管插管可使所有动物的PaCO2和生理死腔/潮气量(VD/VT)下降,PaCO2分别下降1.40±0.20kPa(1kPa=7.5mmHg)和1.60±0.30kPa(P<0.01),VD/VT分别下降0.13±0.02和0.15±0.04(P<0.01);PaO2、气道压力和血流动力学无显著变化。结论:无死腔气管插管可明显提高常规机械通气效率。 相似文献
8.
泵式自体输血过滤引流系统在急症救护中的应用 总被引:5,自引:1,他引:4
自体输血、胸腔闭式引流,是缓解血源矛盾、赢得抢救时机、防治心肺衰竭及ARDS/MOF的重要措施。笔者研制成功的手控泵式储血过滤引流系列在战地、灾害现场,以及平时的心肺手术中,共应用3000余例,现重点对其功能设计和用于自体输血、紧急救护做讨论和评估。 相似文献
9.
Abstract: The use of neuromuscular electrical stimulation (NMES) for rehabilitation of gait in spinal patients is widely known. The best results can be obtained with the use of biomechanical sensors and a closed loop NMES system. One of the biggest problems faced in the design of control systems for closed-loop operation, in gait rehabilitation, is the variation of the mechanical conditions during the phases of gait. This work presents a new approach to ease the design of rule-based closed loop systems for operation in conditions such as gait rehabilitation. 相似文献
10.
肱骨近端骨折手术与非手术治疗方法疗效分析 总被引:19,自引:0,他引:19
目的分析肱骨近端骨折手术及非手术治疗方法的疗效。方法2002~2003年对43例肱骨近端骨折分别采用切开复位解剖钢板、拉力螺钉、克氏针固定及手法复位夹板固定治疗。采用Constant-murley评分方法评定疗效。结果所有患者随访10~19个月,平均11.5个月。24例手术患者中优11例,良8例,可4例,差1例,优良率为79.2%;19例非手术患者中优6例,良7例,可6例,优良率为68.4%;手术疗效明显优于非手术疗效,差异有显著性意义(P<0.05)。X线片示无骨折不愈合及肱骨头坏死发生。结论对Neer分型中Ⅰ型和Ⅱ型中部分患者应采用非手术手法复位夹板固定治疗。而Ⅲ、Ⅳ型应采用手术方法治疗,主要采用解剖钢板固定。拉力螺钉、克氏针作为一种辅助手段,在手术中不宜过多使用。 相似文献