急诊科转诊脓毒症患者的培养结果分析

三级综合性医院急诊科接收的转诊患者中脓毒症(sepsis)患者占有一定比例[1-2],脓毒症的确诊最好有病原学结果,但由于多种原因,患者在转出医院常无病原学结果,导致接受医院患者是由何种原因所致的脓毒症诊断困难,治疗上在很大程度上还依赖临床经验.关于脓毒症的病原谱在住院部或ICU患者中研究较多,而针对急诊转诊患者的相关临床流行病学资料还相对缺乏.笔者回顾性地对急诊转诊脓毒症患者进行研究,对其病原学结果进行分析,现报道如下.     

96例青海玉树地震伤员心理评估调查

Objective Provided the basis on psychological treatment for the earthquake wounded, through investigated the psychological healthy condition of them in Yushu, Qinghai Province. Method To investigated the 102 cases earthquake wounded from 15 - 18 April 2010 who transported from Yushu, Qinghai to West China hospital of Sichuan University; Accept standard: The wounded (96 cases) who could cooperated this investigative; Adopted the Hamiton anxiety scale( HAMA) to had a review investigation for the wounded in the from of talk, and used the SPSS statistics software to have the Wilcoxon Mann-Whitney test and correlation analysis for the investigation data. Results There were 55 of the 96 cases have been confirmed anxiety, HAMA > 14 points; 16 cases had serious anxiety (HAMA > 29 points); The average score in all of them equal to (17.3 ±10.8) points. And there was a remarkable difference between male and female. The age is possible have related degree with the wounded anxious. What the main in their characteristics of them was Psychic anxiety. Conclusions There was apparent anxiety of them whom came from Yushu, Qinghai, and they needed proactive psychological treatment, female、 middle-aged and elderly need more.     

96例青海玉树地震伤员心理评估调查

目的 通过调查了解青海玉树地震伤员的心理健康状况,为地震伤员的心理治疗提供依据.方法 对2010年4月15日至2010年4月18日转入四川大学华西医院的102例青海玉树地震伤员进行调查;纳入标准:能配合调查的所有伤员(96例);采用汉密尔顿焦虑量表对伤员进行谈话式回顾性调查,并采用SPSS 10.0统计软件对调查数据进行秩和检验及相关性分析.结果 所调查的96例伤员中有55例存在焦虑(汉密尔顿评分>14分),其中16例存在严重焦虑(汉密尔顿评分>29分),所调查的伤员焦虑量表得分为(17.3±10.8)分,其中男性亚组与女性哑组伤员之间差异具有统计学意义,年龄可能与伤员焦虑程度相关,精神性焦虑占主要成分是本次地震伤员的焦虑特点.结论 在青海玉树地区的地震伤员存在明显焦虑,需要积极心理干预,且女性、中老年伤员需要更多的心理治疗.     

三种胃管固定方法在急诊洗胃中的应用

目的比较临床上常见的3种急诊洗胃胃管固定方法优劣。方法将2010年1月-2014年8月收治的300例急诊洗胃患者随机抽签分为A组(100例)注射器固定胃管,B组(100例)一次性口垫固定胃管,C组(100例)气管导管固定器固定。3组患者一般资料差异无统计学意义(P>0.05),具有可比性。观察3组洗胃过程中出现的不良反应以及置管时间、洗胃时间。结果 3组患者在口腔内相关损伤和胃管脱落、咬闭方面,差异有统计学意义(P<0.05);在误吸方面,A组与B、C组之间差异有统计学意义(P<0.05),B、C组之间差异无统计学意义(P>0.05)。3组患者在留置胃管时间上差异无统计学意义(P>0.05)。在洗胃时间上,3组两两比较差异均有统计学意义(P<0.05)。结论气管导管固定器固定胃管的方法在洗胃不良反应方面优于一次性口垫固定法及注射器固定法,并可以缩短洗胃时间。     

96例青海玉树地震伤员心理评估调查

Objective Provided the basis on psychological treatment for the earthquake wounded, through investigated the psychological healthy condition of them in Yushu, Qinghai Province. Method To investigated the 102 cases earthquake wounded from 15 - 18 April 2010 who transported from Yushu, Qinghai to West China hospital of Sichuan University; Accept standard: The wounded (96 cases) who could cooperated this investigative; Adopted the Hamiton anxiety scale( HAMA) to had a review investigation for the wounded in the from of talk, and used the SPSS statistics software to have the Wilcoxon Mann-Whitney test and correlation analysis for the investigation data. Results There were 55 of the 96 cases have been confirmed anxiety, HAMA > 14 points; 16 cases had serious anxiety (HAMA > 29 points); The average score in all of them equal to (17.3 ±10.8) points. And there was a remarkable difference between male and female. The age is possible have related degree with the wounded anxious. What the main in their characteristics of them was Psychic anxiety. Conclusions There was apparent anxiety of them whom came from Yushu, Qinghai, and they needed proactive psychological treatment, female、 middle-aged and elderly need more.     

急诊医师沟通能力现状调查及培训效果评价

目的探讨急诊医师医患沟通能力现状及干预对策。方法对2010年-2013年参加急诊医师医患沟通能力培训班的66名学员进行沟通能力现状调查,对所有学员进行系统性培训,培训结束后再次进行沟通能力调查,然后进行自身前后对照。结果参加培训的学员中78.8%在本次培训之前未参加过医患沟通培训,51.5%的学员认为沟通能力的提高主要通过长期临床经验的积累;学员自我评价每年发生沟通障碍次数为2、3、4、≥5次的学员分别占10.6%、22.7%、24.2%、34.8%;学员在进行培训前情景模拟角色扮演中得分为(5.374±0.686)分,经过培训后其得分为(6.717±0.517)分,两者相比差异有统计学意义(P=0.024)。结论所调查的急诊医师对医患沟通培训认知不够且普遍医患沟通能力需要改善;经过系统学习后其医患沟通能力能够得到显著提高。