医院组织文化的认知调查分析

文章对组织文化调查问卷的认知部分进行了分析研究,并针对出现的问题,提出医院文化建设和管理方面的建议。     

云南罗平医院员工对医院的认同度分析

通过问卷调查和访谈分析,调查了云南罗平医院194名员工对医院的认同度,调查对象包括行政、临床和后勤人员,从医院管理模式、医院绩效考核、医院薪酬待遇等方面用描述统计方法分析了数据,显示了医院员工的认同度情况及管理中存在的问题,并分析了不同因素对医院员工的认同度影响,为进一步改善医院管理状况,提高管理水平提供了参考。     

无痛麻醉在拔牙术中的临床应用

目的：评价无痛麻醉技术的临床麻醉效果，寻求一种更有利于手术进行的局麻技术。方法：选择120例就诊于齿槽外科门诊需要拔牙的患者，将其随机分为对照组和实验组，每组60例。对照组施常规局麻，实施组施无痛麻醉技术，观察每组麻醉结束、术中及术后的血压、心率变化。结果：对照组与实验组对比，术中、术后观测指标的变化无显著性差异，麻醉结束后的观测指标15以下者无显著性差异，15岁以上者有显著性差异。结论：无痛麻醉技术与常规的局麻技术一样可以达到麻醉的目的，无痛麻醉可减少麻醉注射中因疼痛所引起的血压、心率的变化。     

The structure of memorized knowledge in students and clinicians: an explanation for diagnostic expertise

This paper provides for the first time evidence of a consistent difference in the memory structures of novice and expert clinicians. The diagnostic performance of first- and third-year clinical medical students, senior house officers, registrars and consultants on four clinical problems in general medicine was studied. Comparisons were made of all diagnostic interpretations offered and the forceful features (personally important pieces of information which act as a key to particular memory structures which in turn give rise to the clinical interpretation) from which these were derived. Results demonstrate that the numbers of interpretations made and the numbers of forceful features identified did not differ significantly between groups (P greater than 0.05). However, the actual interpretations made in three out of four cases, and the actual forceful features identified in all cases, did differ significantly between groups (P less than 0.05). The numbers of interpretations made by all groups were large and demonstrated enormous variability. Highly individualized multiple responses to clinical information are associated with easy diagnoses. We conclude that there is no difference between groups of differing clinical experience in the breadth of thought but that there are marked differences in the precise content and structure of thought. This allows coherent explanation of variation in diagnostic expertise with clinical experience. The significance of the findings is discussed.     

打造医院品牌增强核心竞争力

企业的竞争靠产品质量,医院的竞争靠特色技术.面对医疗市场的新形势、新任务、新要求和新挑战,如何打造医院品牌,增强核心竞争力,围绕这一课题,本文提出要始终坚持用科学发展观统揽全局,坚定不移地走特色兴院之路,力求在培养重点学科上谋求新突破;在培养人才上谋求新作为;在强化经营理念上谋求新创新;在提高服务质量上谋求新发展.     

门静脉化疗对合并癌栓的原发性肝癌术后复发的预防作用

目的　探讨门静脉导管保留术并根据体外肿瘤药敏试验定期行门静脉化疗对合并门静脉癌栓的原发性肝癌术后复发的预防作用。方法　术前经B型超声或CT证实有门静脉癌栓的原发性肝癌病人 6 2例随机分成对照组 (2 9例 )和治疗组 (33例 )。治疗组在肝癌联同门脉癌栓切除术中常规行门静导管保留术 ,术后根据体外肿瘤药物敏感性试验选用敏感性化疗药物定期行门静脉化疗。对照组在肝癌及门静脉癌栓切除术后未行特殊治疗。结果　对照组与治疗组术后半年、1年复发率分别为 1 4例 (4 8.3% )、2 2例 (75 .9% )和 9例 (2 7.3% )、1 6例 (4 8.5 % ) ;两组术后半年、1年死亡率分别为 1 1例 (37.9% )、1 9例 (6 5 .5 % )与 6例 (1 8.2 % )、1 2例 (36 .4 % )。两组比较均有显著性差异 (P <0 .0 5 )。结论　肝细胞肝癌伴门静脉癌栓行手术切除有较好的疗效。而术后根据药物敏感性试验通过门静脉化疗可明显降低术后复发率 ,延长生存期     

Bilateral continuous paravertebral block used for postoperative analgesia in an infant having bilateral thoracotomy

We describe the successful postoperative pain management in an 11-month-old infant who underwent bilateral thoracotomy, using continuous infusions of bupivacaine into two directly placed paravertebral catheters. Haemodynamic parameters and pain scores were measured 1–2 h for 60 h while the infusions were continued and, intermittently, blood samples were taken for subsequent measurement of serum bupivacaine concentrations. The technique provided effective pain relief and the infant required no other analgesia postoperatively. There were no adverse haemodynamic consequences or complications relating to either catheter placement or drug infusions. Serum concentrations of bupivacaine remained below toxic levels throughout the study period, though accumulation did occur.     

我国医院药学的形成与发展

本文通过对医院药学的形成与发展的讨论,旨在确立该学科(也可说领域)的学术技术内容,尽快形成一个完善的学科,以利推进临床药物治疗学的发展,推进医药科学的进步。     

教学医院学科人才绩效评价体系的构建与应用研究

目的：建立临床医学院学科人才绩效评价体系，促进临床医学院人才建设，提高学科人才管理水平。方法：运用系统方法、层次分析方法、专家咨询法、权值因子判断表法等建立绩效评价指标体系，并在某临床医学院实测应用，反馈验证评价体系的可靠性和科学性。结果：经实测应用，此体系对学科人才的评估总分呈正态分布，一、二级指标区分度较高，三级指标独立性强，其变量间相关率(经偏相关纠正)为2．67％。结论：此评价体系有较强的可靠性和科学性，具有一定的创新性，能综合评价学科人才的绩效水平。