中医医院膝关节骨关节炎住院患者的治疗情况--附892份病历分析

为了解中医医院膝关节骨关节炎住院患者的治疗现状,对湖南省12家中医医院5年膝关节骨关节炎住院患者治疗情况进行调查,摘录其相关治疗资料,并进行统计学分析处理.结果显示892例中,78.8%者内服中药汤剂,19.4%外用中药,所用中药性味多为辛温,内服药以祛风湿、补虚类药物居多,外用药以祛风湿、活血化瘀类药物为主.25.1%采用针灸治疗,常用穴位有膝眼、足三里、阳陵泉、阴陵泉、血海、梁丘等.13.1%接受推拿按摩治疗,但大多数病案未记载具体手法.46.2%内服NSAIDs,19.5%使用抗生素,15.4%使用激素类药物.表明中医医院对膝关节骨关节炎住院患者常采用中西医结合方法治疗,中医治疗多为各种方法组合的综合疗法,中药多选择性味辛温之品,祛风湿药、补虚药和活血化瘀类药物为临床常用中药.     

一例恶性肿瘤晚期患者由住院至居家全程照护模式的探索实践

通过为1例晚期肿瘤患者提供由住院到居家无缝隙对接的全程照护,以远程医疗为媒介,为居家患者提供症状控制指导、舒适护理指导、心理灵性的支持以及最后的哀伤辅导。真正做到全人、全家、全程、全团队的“四全照顾”。最终做到患者善终、家人善别、生者善生。     

Primary prophylaxis for individuals with severe haemophilia: how many hospital visits could treatment prevent?

OBJECTIVES: To assess how many hospital visits primary prophylaxis with clotting factor could prevent. DESIGN: The potential for reducing hospital visits was assessed by comparing rates of in-patient, Out-patient and day-case visits per patient-year for individuals with severe (< 1 IU dL-1) haemophilia who had never received primary prophylaxis with attendance rates for individuals with mild/moderate (1-50 IU dL-1) haemophilia. Hospital attendance data were collected retrospectively for the period 1988-97 inclusive for individuals who were aged 18 years or over. SETTING: Data were obtained on patients who were registered at the Katharine Dormandy Haemophilia Centre (KDHC), London, UK. OUTCOME MEASURES: In-patient stays, Out-patient and day-case visits. RESULTS: Individuals with mild/moderate haemophilia were 45% (31-56), 36% (30-41) and 70% (68-73) less likely to have required in-patient, Out-patient and day-case visits than were individuals with severe haemophilia. HIV serostatus and age were also shown to be significant and independent predictors of the rate of Out-patient and day-case visits, but not the rate of in-patient stays. CONCLUSION: These results suggest that primary prophylaxis for individuals with severe haemophilia could significantly reduce the demand for in-patient stays, and Out-patient and day-case visits.     

4514例高血压住院患者中肾血管性高血压的病因构成分析

目的观察省级综合性医院高血压专科住院患者中肾血管性高血压的状况，从而为继发性高血压的检出提供流行病学支持。方法采用SPSS11．5统计软件对病例数超过30的分别计算检出率及95％可信区间（95％CI），不足30的以绝对数表示，计数资料采用行×列表卡方检验，计量资料采用t检验，回顾性分析1997年-2005年间在高血压专科住院诊断明确的4514例高血压患者的临床资料，观察住院高血压患者中肾血管性高血压构成以及在不同性别、不同年龄、不同民族人群间的分布特征。结果（1）4514例高血压住院患者中原发性高血压3783例，检出率为83．81％；肾血管性高血压85例，检出率1．93％。（2）大动脉炎所致肾动脉狭窄占肾血管性高血压的51．77％，动脉粥样硬化所致肾动脉狭窄占。肾血管性高血压的36．47％，先天性所致肾动脉狭窄占肾血管性高血压的11．76％。结论肾血管性高血压的检出率为1．93％，其患病年龄低于原发性高血压。     

Thoughts and feelings of in-patients with advanced terminal cancer: implications for terminal care improvement

The purpose of this study was to clarify how terminally ill patients think and feel while hospitalized, thereby providing some insight into improving the quality of terminal care. The subjects of the study were eight terminally ill patients with cancer. The researchers obtained the patients' consent and their doctors' permission prior to conducting the interviews. Individual, semi-structured interviews were conducted. The patients' thoughts and feelings were extracted and then categorized according to particular themes. As a result, we came up with four major categories: maintaining pain control, living an ordinary life, hoping for improvement of physical condition, and having family nearby. The desire to live life to its fullest given their situation, as well as to maintain a hopeful attitude about their future proved very important. The presence of family also played a crucial role. These factors must be taken into consideration in achieving better care for terminally ill patients.     

对住院内科患者开展人性化护理服务的调查

目的详细了解内科患者在住院期间对人性化护理服务的需求，探讨人性化护理的服务措施。方法采用自行设计的调查问卷对60名内科住院患者进行调查，调查内容包括环境和护理服务两方面。结果内科患者在环境和健康教育方面的需求强烈，同时在护理服务的细节、护士的仪表和语言上也提出了合理的建议。结论为进一步提高护理服务质量，应从营造一个良好的住院环境和提供优质、全面的护理服务人手，注重患者的心理需求和人格尊严，真正体现人性化的服务理念。     

乌鲁木齐市某医院自治区级医保住院病人现状调查分析

目的 通过比较乌鲁木齐市某医院2006-2008年自治区级医保住院病人的相关信息,了解自治区级医保的运行现况及发展趋势并据此提出可行性建议.方法 将所有研究对象的数据用Excel2003建立数据库,对医保住院病人的人次构成、费用构成、医疗费用进行分析并进行恰当的统计学描述.结果 (1)自治区级医保住院病人均次费用介于省属、部属住院病人均次费用之间;(2)退离休组的统筹费用及统筹比例3年期间均高于在职组;(3)哈萨克族与维吾尔族区医保住院病人均次费用及统筹比例较其他族别高.结论 自治区级医保为进一步建立健全全区多层次医疗保障体系,完善我区基本医疗保险制度以及减轻参保职工住院费用压力等方面都发挥了重要作用,但仍然存在不足.     

2009年—2011年我院住院患者抗菌药物应用情况分析

目的：了解本院住院患者2009年—2011年抗菌药物使用的变化情况,全面掌握本院抗菌药物近年的使用情况,进一步加强抗菌药的使用管理,更好地为临床合理抗菌素提供参考。方法：对本院2009年—2011年期间抗菌药物的使用情况进行统计分析,并每年随机抽取100份病历,统计联合用药及药敏试验情况。结果：3年间抗生素类药的销售金额占全年药品销售总金额的比例呈逐年下降趋势。但抗菌药物使用率和联合用药率均较高。药敏试验率逐年上升。结论：本院抗生素的使用中存在许多问题,还需进一步加强对抗生素合理使用的监督、检查及规范化管理。     

Recruitment of frail older people to research: lessons learnt through experience

BACKGROUND: With the emphasis on the need for clinical governance and evidence-based practice in the healthcare industry there is increasing pressure on researchers to provide tangible research evidence of the effectiveness of new treatments, interventions and services. Recruiting an adequate size of sample is an important factor in the success or otherwise of a study to answer the research question. Difficulty in the recruitment of older people to research is widely acknowledged. However, much can be achieved to maximize the success of this process. AIMS OF THE PAPER: This paper describes and explores our experience of recruiting frail, older people to research, with particular emphasis on ensuring quality in the process of research related to ethical practice. CONCLUSIONS: Recruitment of frail older people to research can be a complex process in which the awareness and integrity of the researcher is key in upholding the principle of nonexploitation. It is important not to underestimate this difficulty and to ensure that the data collection period is sufficient to recruit adequate numbers. There is a need to continue to develop and refine recruitment skills and strategies to maximize the involvement of frail older people to research while protecting their right to refuse.