2012年我院儿科药品不良反应报告分析

目的 了解我院儿科不良反应（ADR）发生的特点,为儿科合理用药提供参考.方法 对我院儿科2012年收集到的62例药品不良反应报告进行统计学分析.结果 62例药品不良反应报告中,抗生素占首位,87.1%.静脉给药方式为主要途径.临床表现以皮肤损害最常见.结论应加强ADR的监测,有ADR征兆时及时处理,以免发生更严重的ADR.     

2011-2013年医院感染现患率调查分析

目的调查医院感染发生情况,为改进医院感染监测方法及预防与控制措施提供依据。方法以医院感染专职人员为主,临床各科室医院感染监控人员配合,采用床旁和病历相结合的调查方式,对2011年9月16日、2012年10月11日及2013年8月28日（0∶00-24∶00）所有住院患者进行现患率调查,填写个案调查表和床旁调查表,并对调查结果进行统计分析。结果 3次调查医院感染现患率平均为2.17%,例次感染率平均为2.61%,发生医院感染现患率前3位的科室是ICU、高内科、外一科;医院感染主要分布在下呼吸道;抗菌药物使用率平均为54.70%,呈逐年下降趋势。使用抗菌药物病原学培养送检率平均为45.81%,共检出病原菌67株,革兰阴性菌为主。结论 3次现患率调查,阐明了医院感染的基本情况及发展动态,发现了医院感染高危科室和感染主要部位,对于今后制定感染控制措施、加强医院感染监督检查具有重要作用。     

2010-2012年我院消毒灭菌效果监测分析

目的 分析该院消毒灭菌效果.方法 回顾性分析医院2010-2012年消毒灭菌及环境卫生学监测资料.结果 采集样本5707份,合格5433份,合格率95.20%.样本量与其合格率整体呈上升趋势,空气合格率由86.76%升至97.48%;物体表面合格率由87.77%升至96.90%;医务人员手合格率由87.18%升至91.67%;使用中消毒液浓度合格率由91.89%升至95.45%;使用中灭菌剂浓度合格率由83.33%升至97.87%;紫外线灯合格率由83.85%升至98.38%;消毒物品合格率由85.71%升至94.44%（P＜0.01）.灭菌物品、灭菌剂、透析水及透析液在每年的生物监测中,合格率均为100.00%.结论 该院消毒灭菌工作质量及环境卫生质量得到不断提高.     

社区健康教育在慢性阻塞性肺疾病患者实施长期家庭氧疗中的作用

目的：研究社区健康教育对慢性阻塞性肺疾病患者实施长期氧疗的方法及优势。方法选择2012年6月-2013年12月本社区收治的慢性阻塞性肺疾病患者90例,根据就诊的先后顺序随机分为两组。对照组患者使用一般社区干预方法,试验组患者在对照组干预的基础上给予社区健康教育,观察两组患者的干预效果。结果在健康教育后,试验组患者治疗依从性高于对照组患者,差异有统计学意义（ P ＜0.05）;家庭氧疗3个月后,试验组患者的 PaO2、血氧饱和度（SaO2）、用力肺活量（FVC）、1秒末用力呼气容积（FEV1）均高于对照组,差异有统计学意义（P ＜0.05）。结论加强社区健康教育可以有效地提高慢性阻塞性肺疾病患者家庭氧疗的依从性,改善患者肺部功能。     

急性白血病化疗后医院感染的临床分析

目的 探讨急性白血病（AL）实施化疗后医学感染的发生情况.方法 选取本院2010年2月～2011年2月收治的急性白血病患者83例,随机分为3组.A组使用抗生素治疗,B、C组均采用抗生素联合G-CSF治疗,分析3组的医院感染情况.结果 83例患者中,发生感染44例（53.01％）,其中A组21例,B组18例,C组5例.44例感染患者中,检出致病菌28例（63.64％）,主要为大肠埃希菌、铜绿假单胞菌及肺炎克雷伯菌.经治疗,C组的发热时间及ANC恢复时间较A、B组明显缩短（P＜0.05）.结论 对于急性白血病尽早实施抗生素与G-CSF联合治疗,可有效降低患者的感染发生率,缩短患者的发热时间与ANC恢复时间,治疗效果显著,值得临床推广应用.     

信息化建设在医院药学中的作用

随着医院信息化建设的不断完善,对药事管理、药品调配、临床药学等医院药学工作的开展日趋重要。通过运用医院信息系统和合理用药监测系统软件实现药品监管、处方质控、药学信息收集、指导患者合理用药等药学工作．改变传统的药学服务模式并使其逐步向临床药学转变,促进医院药学的发展。     

2012年医院感染现患率调查分析

目的了解医院感染现状,评估危险因素及抗生素使用情况,为制定感染控制措施提供依据。方法调查前2d,对所有参加调查人员进行培训。采用横断面调查方法,床旁调查与病历查看相结合,填写统一的个案调查表和床旁调查表,最后由感染管理科对调查数据进行统计分析。结果实查率为99．39％,医院感染现患率为6．44％,感染部位以下呼吸道为主,占60．87％;现患率最高的科室是呼吸内科,为23．68％;抗菌药物使用率为61．66％,病原学标本送检率为16．92％。结论医院应重点防控呼吸内科、神经内科患者呼吸道感染和泌尿道感染,合理使用抗生素,提高病原学标本送检率,遏制细菌耐药。     

Narrative review of anxiety and depression in patients with esophageal cancer: underappreciated and undertreated

Depression and anxiety are emotional disorders that commonly affect patients with esophageal cancer. As a result of its high morbidity, mortality, and complication rates, this population is at particularly high risk for developing or exacerbating affective disorders; even when compared to patients with other forms of cancer. Many of the medical conditions and social behaviors that predispose patients to this disease are also independently associated with affective disorders, and likely compound their effects. Unfortunately, in the existing literature, there is wide variability in study design and diagnostic criteria. There is no standard method of evaluation, many studies are limited to written surveys, and widespread mental health screening is not included as a part of routine care. As a result, the prevalence of these illnesses remains elusive. Additionally, psychiatric and psychosocial illness can affect compliance with surveillance and treatment, and gaps in knowledge may ultimately influence patient outcomes and survival. This review will discuss the existing literature on depression and anxiety in patients with esophageal cancer. It will highlight current methods of psychological evaluation, the prevalence of affective disorders in this population, and their effects on treatment, compliance, and outcomes. It will also discuss possible screening tools, treatments and interventions for these comorbid illnesses that may improve oncologic outcomes as well as quality of life.     

Characteristics and Inpatient Outcomes of Primary Biliary Cholangitis and Autoimmune Hepatitis Overlap Syndrome

Background and AimsPrimary biliary cholangitis (PBC) and autoimmune hepatitis (AIH) are hepatobiliary diseases of presumed immune-mediated origin that have been shown to overlap. The aim of this retrospective trial was to use national data to examine the characteristics and outcomes of patients hospitalized with overlapping PBC and AIH (PBC/AIH).MethodsThe National Inpatient Sample was used to identify hospitalized adult patients with PBC, AIH, and PBC/AIH from 2010 to 2014 by International Classification of Diseases-Ninth Edition Revision codes; patients with hepatitis B virus and hepatitis C virus infection were excluded. Primary outcomes measures were in-hospital outcomes that included mortality, respiratory failure, septic shock, length of stay, and total hospital charges. Secondary outcomes were the clinical characteristics of PBC/AIH, including the comorbid extrahepatic autoimmune disease pattern and complications of cirrhosis.ResultsA total of 3,478 patients with PBC/AIH were included in the study. PBC/AIH was associated with higher rates of Sjögren’s syndrome (p<0.001; p<0.001), lower rates of Crohn’s disease (p<0.05; p<0.05), and higher rates of cirrhosis-related complications when compared to PBC or AIH alone. There were similar rates of mortality between the PBC/AIH, PBC, and AIH groups. The PBC/AIH group had higher rates of septic shock when compared to the PBC group (p<0.05) and AIH group (p<0.05) after adjusting for possible confounders.ConclusionsPBC/AIH is associated with a lower rate of Crohn’s disease, a higher rate of Sjögren’s syndrome, higher rates of cirrhosis-related complications, and significantly increased risk of septic shock compared to PBC and AIH individually.     

813名医院职工体检结果分析及干预措施

目的：了解医院职工的整体健康水平,为制订干预措施提供参考。方法选取2013年1~12月的813名医院职工体检资料作为研究对象,按异常指标分布、年龄、性别及工种进行汇总分析。结果指标异常检出率由高到低依次为高脂血症(47.85%)、乳腺增生症(18.06%)、慢性宫颈炎(17.89%)、肝功异常(15.74%)、心电图异常(14.88%)、体重超重或肥胖(11.93%)、胆囊息肉样变(10.33%)。不同工种间的心电图异常、肝功异常、体重超重或肥胖、慢性胆囊炎、高血压或血压偏高检出率比较,差异有统计学意义(P<0.05)。男性与女性、≥40岁与<40岁职工之间的体重超重或肥胖、肝功异常、胆囊息肉样病变、慢性胆囊炎、高血压或血压偏高检出率比较,差异有统计学意义(P<0.05)。结论医院职工的健康状况不容乐观,应积极采取干预措施,提高职工的整体健康水平。