医院档案管理工作创新方法初探

档案管理是医院管理中一项重要的内容。医院传统档案管理已经不能满足现代化社会发展的要求,基于此需要加强对医院档案管理的创新,只有在加快医院档案管理创新的基础上才能提高档案管理的效率和水平,并推动社会的进一步发展,可见创新医院档案管理方法是时代发展的必然选择。该文主要针对现阶段创新医院档案管理工作方法的相关问题进行研究,目的是为医院档案管理纳入新的工作方法,提高医院管理水平。     

Successful Use of Surgically Placed Impella 5.0 and Central Extracorporeal Membrane Oxygenation Circuit in a Patient with Postcardiotomy Shock

The Impella 5.0, a percutaneously inserted left ventricular assist device, has been used to support patients who have severe heart failure or who are undergoing high-risk percutaneous coronary intervention. We report our surgical placement of the Impella 5.0, through a graft sewn to the aorta, to unload the left ventricle of a 59-year-old man who was undergoing venoarterial extracorporeal membrane oxygenation for postcardiotomy shock. The patient underwent successful placement of a long-term left ventricular assist device before his discharge from the hospital. The versatility of the Impella 5.0 is exemplified in this patient who was successfully bridged to long-term support.     

药学干预对喹诺酮类药物应用影响

目的 探索药学干预对喹诺酮类药物应用的影响.方法 选取2016年3月—2017年3月到医院接受喹诺酮类药物治疗的患者进行研究,分为药物干预前、干预后两组,喹诺酮类药物使用过程中采用药学干预的方法 进行护理,对比干预前后喹诺酮类药物的耐药率、不合理用药率和不合理使用情况.结果 药学干预后,喹诺酮类药物对肺炎克雷伯菌、大肠埃希菌和铜绿假单胞菌的耐药率降低,且不合理联合用药、不合理用法用量和用药禁忌等不合理用药率也显著降低,不合理使用情况也在逐渐减少(P<0.05).结论 药学干预对喹诺酮类药物的应用效果显著.     

Impact and Predictors of Noncircular Left Ventricular Outflow Tract Shapes on Estimating Aortic Stenosis Severity by Means of Continuity Equations

Determining aortic stenosis (AS) severity is clinically important. Calculating aortic valve (AV) area by means of the continuity equation assumes a circular left ventricular outflow tract (LVOT). The full impact of this assumption in calculating AV area is unknown. Predictors of noncircular LVOT shape in patients with AS are undefined.In 109 adult patients with AS who underwent multiplanar transesophageal echocardiography, we calculated AV area by means of the standard continuity method and by a modified method involving planimetric LVOT area.We found 54 circular, 37 horizontal-oval, 8 vertical-oval, and 10 irregular LVOTs. Area derived by direct planimetry correlated better with the modified than the standard continuity method (r=0.89 vs r=0.85; both P=0.0001). Valve areas of patients with mild, moderate, or severe AS by planimetry were more often mischaracterized with use of the standard than modified method (29 vs 18; P <0.0001). Horizontal-oval AV area derived by planimetry (1.28 ± 0.55 cm²) was underestimated by the standard method (1.05 ± 0.47 cm²; P=0.001), but not by the modified method. Congenital AV morphology and low cardiac index were the only multivariate predictors of horizontal-oval shape. Low cardiac index was the only predictor of noncircular shape.More than half our patients with AS had noncircular LVOTs. Using the modified method reduces mischaracterizations of AS severity. Congenital AV morphology and low cardiac index predict horizontal-oval or noncircular shape. These data suggest the value of direct LVOT measurement to calculate AS severity in patients who have congenital AV or a low cardiac index.     

护理专案改善在减少住院患者跌倒中的应用

目的了解护理专案改善在降低住院患者跌倒发生率中的应用效果。方法将医院2016年1月—2018年12月的80例住院患者随机分组,传统护理组对于住院患者给予传统护理,护理专案模式组对于住院患者采取护理专案模式。比较两组满意评分;护理人员工作积极性评分;护理前后住院患者对跌倒危险因素的掌握水平、住院患者遵医行为;跌倒的发生率。结果护理专案模式组满意评分、住院患者对跌倒危险因素的掌握水平、住院患者遵医行为、护理人员工作积极性评分、跌倒的发生率对比传统护理组有优势,P<0.05。结论住院患者实施护理专案模式效果确切,可提高护理服务质量和住院患者自我防护能力,降低跌倒的发生率。     

益母草制剂的开发与应用

益母草制剂在临床中应用广泛,主要用于多种妇产科疾病的治疗,且效果显著。其中,益母草注射剂、益母草颗粒、益母草片是临床上最常见的益母草剂型,其有效性和安全性在长期的临床实践中得到认可。本论文结合项目组对益母草制剂的二次开发研究思路,对上述具有代表性的益母草制剂的制剂工艺、质量控制和临床应用进行介绍,以期为益母草制剂的现代研究和临床安全应用提供一定的参考。     

PBL教学法在核医学课间实习教学中的应用研究

目的 通过与LBL教学法对比,探讨PBL教学法在核医学科课间实习教学中的应用效果.方法 选取哈尔滨医科大学2016级临床医学专业本科二班学生72人,随机分为实验组和对照组,每组各36人,在课间实习教学中分别实施PBL教学法和LBL教学法.实习结束后,通过考试及问卷调查,进行教学法评价.结果 观察组在考试成绩、学习兴趣、学习热情、教学满意度、培养临床思维、增强知识点掌握等教学法评价指标均优于对照组,具有统计学意义(P<0.05).结论 与LBL教学法相比,PBL教学法应用于核医学科课间实习教学中更能激发学生学习兴趣、增强综合素质,从而提高教学效果.