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目的:探索HMISS 7级医学信息系统在完善PIVAS闭环管理模式信息化建设中的应用。方法:观察HIMSS 7级创建的信息系统在PIVAS的应用情况,通过比较信息系统升级前后PIVAS管理各环节的相关指标,评价其改造效果。结果:PIVAS信息系统改造后处方合格率由98.14%提高到98.96%;前置处方审核时间由每日(4 821.56±31.42)s缩短为(2 464.22±48.26)s;内部差错发生率由0.314‰降至0.175‰;1批和4批成品液体平均打包时间分别由(1 920.54±24.16)s和(1 026.13±40.31)s缩短到(1 141.46±38.70)s和(546.22±35.28)s;病区护士满意度由93.61%升高到97.56%。结论:HIMSS 7级评审标准下的PIVAS信息化系统建设可以有效实现工作流程的闭环管理,提升工作效率,减少用药差错,提高病区满意度。  相似文献   
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目的分析综合护理在烧烫伤患儿护理中的应用效果。方法选取2020年5月至2021年7月蚌埠市第三人民医院收治的62例烧烫伤患儿为研究对象,按照随机数字表法将其分为观察组(31例)与对照组(31例)。对照组采用常规护理干预,观察组采取综合护理干预,比较两组患儿的护理总有效率、并发症发生率以及家属满意度。结果观察组的并发症总发生率低于对照组,差异有统计学意义(P<0.05);观察组患儿的护理总有效率高于对照组,差异有统计学意义(P<0.05);观察组患儿家属对护理总满意度高于对照组,差异有统计学意义(P<0.05)。结论在烧烫伤患儿护理期间,采用综合护理干预方法能够促进患儿康复,具有满意的临床效果,值得推广。  相似文献   
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单髁置换术(UKA)对单间室骨关节炎患者来说是一种可选择的术式。与全膝关节置换术(TKA)比较,UKA的优势包括手术风险低、恢复快、患者满意度高、住院时间短等。然而,与TKA比较,UKA的翻修率更高,假体生存率更低。假如能提高传统UKA的假体生存率和降低其翻修率,UKA将会发挥独特的优势。目前,机器人辅助UKA正引起人们的关注。机器人系统在UKA中已被用于提高骨准备、部件对齐和量化韧带平衡等方面,最终目的是改善术后运动学和提高假体生存率,以及降低翻修率。本文将介绍目前可用的两种机器人系统的基本原理和机器人辅助UKA相较于传统UKA的表现及优势。  相似文献   
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消化道重建是胃癌手术的关键操作之一,其质量直接影响术后相关并发症的发生及远期的营养状况及生活质量,合理选择完全腹腔镜下胃癌根治术后消化道重建的方式对降低术后并发症及改善术后营养状况及生活质量具有积极意义。本文通过对完全腹腔镜下远端胃切除术、全胃切除术常用的消化道吻合方式的优势及不足进行论述,探索目前可能的最优吻合方式,阐述完全腹腔镜近端胃切除术吻合方式的进展,并对生理学、生物力学重建理论的进展进行介绍。  相似文献   
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BackgroundRestricted kinematically-aligned total knee arthroplasty (KA-TKA) is a reasonable modification to avoid the alignment outlier that may cause implant failure. However, despite a noted high incidence of constitutional varus in Japanese individuals, there has been no investigation into how many knees require the restriction in restricted KA-TKA (RKA-TKA) among Japanese patients. Therefore, we conducted a study using preoperative long-leg radiograms.MethodsWe studied long-leg radiographs of 228 knees in 114 consecutive patients. The numbers of knees within the safety range and their corrective osteotomy angle in the restriction algorithms advocated by Almaawi et al. (2017) and MacDessi et al. (2020) were evaluated.ResultsAccording to the algorithms used by Almaawi et al. and MacDessi et al., out of 228 knees, 46 (20%) and 39 (17%) fell within the safety range, respectively. The mean correction angles of the hip-knee-ankle angle, lateral distal femoral angle and medial proximal tibial angle were 2.8 ± 3.4°, 0.4 ± 1.4° and 2.4 ± 2.8° in the algorithm used by Almaawi et al., while they were −4.9 ± 4.7°, 1.1 ± 2.5° and −6.0 ± 3.4° in the algorithm used by MacDessi et al. Most of the knees needed to be restricted in order to perform RKA-TKA, regardless of the algorithm used.ConclusionsBased on a preoperative analysis of long-leg radiograms in a Japanese population, most knees fall out of the safety range in RKA-TKA. Surgeons must consider whether to allow component outlier or to perform corrective osteotomy that likely requires soft tissue release.  相似文献   
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BackgroundFull-thickness bone resorption around the humeral stem in shoulder arthroplasty is an increasingly recognized phenomenon, but the impact on outcomes remains unclear. This study aims to investigate prevalence of bone resorption in patients with the Zimmer-Biomet Comprehensive reverse shoulder arthroplasty and the impact on the functional outcomes.MethodsA retrospective analysis was carried out on 65 consecutive patients with primary reverse total shoulder arthroplasty using the Comprehensive Shoulder System from 2014 to 2020, with a minimum of 12-month follow-up. The prevalence of humeral bone resorption was graded from 0 to 4, and risk factors for these changes and their impact on functional outcomes were further investigated.ResultsThe majority of patients (75%) were female with an average age of 75 years (53-93), with an overall average follow-up of 26 months (12-60). Bone resorption occurred in 53 patients (82%), and full-thickness bone resorption occurred in only 8 patients (12%). Metaphyseal bone (zones 1 and 7) is mostly at the risk of high-grade resorption. There was no difference in the final Oxford Shoulder Score between patients who had differential resorption grades from 0 to 4 (P = .5742). None of the risk factors from the previous literature including age, sex, indication for surgery, rotator cuff tear and repair, and intramedullary occupation ratio of the implant showed any impact on the rate of resorption.ConclusionFull-thickness humeral bone resorption occurred in approximately 12% of patients when using the Comprehensive reverse shoulder arthroplasty, but it has no impact on the functional outcomes or revision rate in the short-to-medium term.  相似文献   
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Background and aimsAlthough antithrombotic treatments are established for coronary artery disease (CAD), they increase the bleeding risk, especially in malnourished patients. The total thrombus-formation analysis system (T-TAS) is useful for the assessment of thrombogenicity in CAD patients. Here, we examined the relationships among malnutrition, thrombogenicity and 1-year bleeding events in patients undergoing percutaneous coronary intervention (PCI).Methods and resultsThis was a retrospective analysis of 300 consecutive CAD patients undergoing PCI. Blood samples obtained on the day of PCI were used in the T-TAS to compute the thrombus formation area under the curve. We assigned patients to two groups based on the geriatric nutritional risk index (GNRI): 102 patients to the lower GNRI group (≤98), 198 patients to the higher GNRI group (98<). The primary endpoint was the incidence of 1-year bleeding events defined by Bleeding Academic Research Consortium criteria types 2, 3, or 5. The T-TAS levels were lower in the lower GNRI group than in the higher GNRI group. Kaplan-Meier analysis showed worse 1-year bleeding event-free survival in the lower GNRI group compared with the higher GNRI group. The combined model of the GNRI and the Academic Research Consortium for High Bleeding Risk (ARC-HBR) had good calibration and discrimination for bleeding risk prediction. In addition, having a lower GNRI and ARC-HBR positivity was associated with 1-year bleeding events.ConclusionA lower GNRI could reflect low thrombogenicity evaluated by the T-TAS and determine bleeding risk in combination with ARC-HBR positivity.  相似文献   
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