住院病人安全告知的做法与体会

医院应为住院病人提供一个安全的休养环境，医务人员有告知病人注意自身安全的责任，病人有遵守院规、配合医务人员完成治疗的义务。为加强住院病人安全防范，防止安全隐患，减少安全纠纷，我院自2002年8月开始对每位新入院病人使用书面安全告知，并注意履行住院期间的告知义务，同时加强了安全防范措施，2年来全院未发生一例护理安全纠纷，现将我们的做法与体会介绍如下：     

痛风患者的护理

2002-01～2004-02我们共收治痛风18例,护理体会如下. 1 临床资料 本组男14例,女4例,年龄43～75岁,平均51.7岁.受累关节单侧拇趾9例、双侧拇趾5例,单侧柘趾关节3例,单侧拇指关节1例.血尿酸3.72～4.56mmol/L,病程10 d～8 a,均无痛风石结节及关节畸形出现.本组均经综合治疗症状控制.     

气管切开病人两种吸痰程序的效果观察

目的 观察两种不同吸痰程序的效果.方法 将40例气管切开病人随机分为实验组(n=20)和对照组(n=20),实验组患者吸痰方法为先湿化气道再经气管插管吸痰,对照组20例则先经气管插管吸痰再湿化气道.结果 实验组肺部感染发生时间较对照组晚,感染率、黏膜损伤发生率、吸痰次数及吸痰后30 min氧饱和度均值,与对照组比较差异有统计学意义(P<0.01).结论 先湿化气道再吸痰效果优与先吸痰再湿化气道.     

小儿急性肺损伤的短期肺功能随访

Objective To study the pulmonary functions of pediatric ALI/ARDS(acute lung injury/acute respiratory distress syndrome) survivors. Method A prospective cohort study of all survivors of ALI/ARDS in the PICU of Beijing Children's Hospital was performed. Patients were divided into three groups(0-3 years of age,3 ～ 7 years of age, and over 7 years of age) and followed up three months after diagnosis. Results There were 36 survivors in total of 44 ALl patients, three patients lost follow-up, 12 died and 21 survived. Five survivors refused to participate in the study because of asymptomatic, and one was unable to participate because of lymphoma com-bined with sepsis. A total of 15 children completed the whole survey (11 patients were less than 3 years old, andfour were over 7 years of age). Twelve patients had no discomfort in their respiratory tracts. Three months after be-ing enrolled, the pulmonary functions of all children improved, especially in terms of tidal volume and respiratory compliance (P<0.05). Conclusions The abnormal respiratory symptoms and signs in most children disap-peared three months after discharge. Most survivors still have pulmonary dysfunction at 3 monthes after discharge, but better than discharge.     

儿童多器官功能障碍综合征的研究

1 引言 MODS是指机体受到严重感染、创伤、休克、中毒及大手术等急性损害24 h后,同时或序贯性出现2个或2个以上的器官或系统功能障碍甚至衰竭,以致不能维持内环境稳定的临床综合征.MODS是儿童ICU的主要死亡原因,儿童作为一个特殊群体,其MODS的发生、发展以及临床诊疗过程与成人比较有一定差异,本文重点介绍儿童MODS的特点.     

小儿急性肺损伤的短期肺功能随访

Objective To study the pulmonary functions of pediatric ALI/ARDS(acute lung injury/acute respiratory distress syndrome) survivors. Method A prospective cohort study of all survivors of ALI/ARDS in the PICU of Beijing Children's Hospital was performed. Patients were divided into three groups(0-3 years of age,3 ～ 7 years of age, and over 7 years of age) and followed up three months after diagnosis. Results There were 36 survivors in total of 44 ALl patients, three patients lost follow-up, 12 died and 21 survived. Five survivors refused to participate in the study because of asymptomatic, and one was unable to participate because of lymphoma com-bined with sepsis. A total of 15 children completed the whole survey (11 patients were less than 3 years old, andfour were over 7 years of age). Twelve patients had no discomfort in their respiratory tracts. Three months after be-ing enrolled, the pulmonary functions of all children improved, especially in terms of tidal volume and respiratory compliance (P<0.05). Conclusions The abnormal respiratory symptoms and signs in most children disap-peared three months after discharge. Most survivors still have pulmonary dysfunction at 3 monthes after discharge, but better than discharge.     

小儿急性肺损伤的短期肺功能随访

Objective To study the pulmonary functions of pediatric ALI/ARDS(acute lung injury/acute respiratory distress syndrome) survivors. Method A prospective cohort study of all survivors of ALI/ARDS in the PICU of Beijing Children's Hospital was performed. Patients were divided into three groups(0-3 years of age,3 ～ 7 years of age, and over 7 years of age) and followed up three months after diagnosis. Results There were 36 survivors in total of 44 ALl patients, three patients lost follow-up, 12 died and 21 survived. Five survivors refused to participate in the study because of asymptomatic, and one was unable to participate because of lymphoma com-bined with sepsis. A total of 15 children completed the whole survey (11 patients were less than 3 years old, andfour were over 7 years of age). Twelve patients had no discomfort in their respiratory tracts. Three months after be-ing enrolled, the pulmonary functions of all children improved, especially in terms of tidal volume and respiratory compliance (P<0.05). Conclusions The abnormal respiratory symptoms and signs in most children disap-peared three months after discharge. Most survivors still have pulmonary dysfunction at 3 monthes after discharge, but better than discharge.     

口腔颌面外科学PBL教学实践与研究

目的:研究PBL教学法在口腔颌面外科教学中的教学效果,探讨PBL教学法实施中存在的问题。方法:随机将口腔专业学生分为两组,试验组采用PBL教学法,对照组采用传统教学法。结果:两组学生期末考试成绩学习成绩比较差异有统计学意义。结论:在口腔颌面外科教学中应用PBL教学法对提高教学质量,对培养学生主动学习能力、分析和解决问题的能力以及独立思考能力和逻辑思维能力非常有效。     

下肢动脉硬化闭塞症合并糖尿病足的介入治疗进展

下肢动脉硬化闭塞症（PAD）是糖尿病晚期的严重并发症之一,严重影响糖尿病患者的生存质量,轻者出现间歇性跛行、静息痛,重者出现糖尿病足坏疽,甚至危及生命。糖尿病合并下肢动脉硬化闭塞症造成的肢端缺血坏死,依靠单纯的内科药物治疗,如扩张血管、改善微循环等有一定疗效,但由于下肢大血管病变问题未能解决,许多患者因严重的肢端缺血坏死而导致截肢。     

盐酸莫西沙星氯化钠注射液不良反应二例

例1：男性,76岁,主因反复咳嗽、咯痰10年,加重3d入院。血常规：白细胞13．8&#215;10^9/L,红细胞4．5&#215;10^12／L,入院后拍胸部X线片提示双肺感染,听诊双肺呼吸音粗,可闻及干湿性口罗音,诊断为慢性支气管炎急性发作,给予盐酸莫西沙星氯化钠注射液（拜复乐）400mg,1次／d静脉滴注抗感染治疗。10min后患者开始出现全身皮肤瘙痒症状,但无红斑现象,减慢滴速后瘙痒症状有所缓解,静脉滴注大约300mg后患者瘙痒症状加重,并出现明显的四肢肌肉痉挛抽搐,伴有明显兴奋感。