福建省救护车出诊相关人员现状的调查

救护车是用于紧急医疗服务以及突发公共卫生事件医疗救援的机动车辆[1].国家和福建省对救护车车辆的分类、车辆的性能指标、医疗舱的指标、车载抢救设备及车辆标识作出明确规定[2].但是,在急救车辆和车载车辆标准化后,救护车出诊的相关人员,对急危重患者成功转运和救治起着关键作用.为了解救护车出诊相关人员现状,笔者对福建省救护车调度员、出诊医生、护士、驾驶员、担架员现状进行调查,对院前急救系统人员进行评估,进而为改进各级医院院前急诊绿色通道的人力资源建设提供依据.     

依托型急救中心急性中毒流行病学与急救特点分析

Objective Acute poisoning is frequently encountered at emergency department. This study was to investigate the epidemiology and characteristics of patients with acute poisoning who were treated at the Emergency Center, Fujian Provincial Hospital, China. Method We retrospectively analyzed the gender, age, causes of poisoning, types of poisons, poisoning route, emergency diagnoses, outcomes, and prognoses of these patients.Results Altogether 2867 patients with acute poisoning were treated from January 2004 to December 2009. The ratween 18 and 40 years old. The incidence of acute poisoning was as high as 11.33% in January each year. The incidence of poisoning was in a descending order: alcohol poisoning (54.55%), medication poisoning (25.95%), pesticide poisoning (5.65%), and drug poisoning (4.88%). Most (56.44%) of the patients with drug poisoning were under 25 years and their mean age was significantly lower than that of patients with medication poisoning or alcohol poisoning ( P ＜ 0.01 ). Approximately 69.54% of the patients were followed up after emergency treatment, 30.39% were hospitalized, and four patients died. Conclusions Acute poisoning is largely alcohol poisoning and medication poisoning in a city. The emergency green channel "pre-hospital emergency care-emergency department-hospital treatment" can significantly improve the survival rate of patients with acute poisoning.     

善得定治疗肝硬化食管胃底静脉曲张破裂出血17例

善得定治疗肝硬化食管胃底静脉曲张破裂出血１７例刘赐惠林才经肝硬化食管、胃底静脉曲张破裂出血来势凶险，病死率极高。以往常用三腔管压迫、垂体后叶素止血，副作用和并发症多，给临床治疗带来困难。我们自１９９３年以来，应用善得定治疗肝硬化食管、胃底静脉曲张破裂...     

福建省急救中心116例院前猝死的流行病学研究

目的 回顾性调查分析我中心116例院前猝死的流行病学资料,探讨有效提高本地区猝死综合防治能力的策略.方法 回顾性分析我中心2007-01～2009-01间院前猝死116例流行病学资料,分析患者发病的年龄、性别、时间、地点、死因、现场心电图表现、反应时间.结果 本组116例猝死患者中男女比例为1.7∶1;平均年龄66.6岁;每日多发时段为8∶00～11∶00(28.45%)及16∶00～19∶00时(20.7%);且约3/4的患者发生在家中(74.14%),现场无一例目击者行心肺复苏术;死因主要为心脑血管疾病(68.98%);现场心电图多为室颤(42.24%)、心室停搏(46.55%);我中心平均反应时间为8.34 min.结论 通过本研究分析,我们提出"四早",即早期预防、早期监测、早期复苏、早期除颤,这对于提高本地区院前猝死的综合防治能力有重要意义.     

我国大中城市院前心脏性猝死流行病学调查分析

目的调查我国大中城市院前心脏性猝死患者流行病学情况，探讨院前心脏性猝死病例特点。方法从我国8个大中城市急救中心系统数据库中导出2008年度全部死亡数据，就其有完整记录的资料进行统计分析。结果①院前心脏性猝死的调度时间、到达时间、现场时间、返回时间、总时间、急救半径分别为（2．12±1．02）min、（14．10±7．05）min、（24．79±12．08）min、（13．79±6．61）min、（54．80±25．36）min、7．90±3．92（km）；②院前心脏性猝死的病例数以第一季度为最多，且最多时间段是8：00～10：00，最少时间段是2：00～4：00；③男性院前心脏性猝死明显多于女性，但年龄明显小于女性；④院前心脏性猝死目击者CPR为4．48％，医护人员现场CPR成功率2．26％。结论①心脏性猝死已成为我国大中城市最常见的院前死亡原因；②加强心血管病防治，提高中老年患者的常见急危重症早期识别与院前急救水平以及普及公众CPR对降低死亡有重要意义。     

急性苯类中毒临床救治体会（附5例报告）

近来我科收治二起 5例急性苯类化学物质中毒 ,经对症及高压氧治疗后康复出院 ,取得满意结果 ,现报告如下。1　临床资料1.1　一般资料 :5例均为男性油漆工 ;年龄 2 0～ 2 8岁。 5例患者均在近于密闭空间使用含苯化学物质进行油漆。发生中毒时间半小时到 10小时不等。入院时 ,本组患者 5例中 ,4例神志昏迷 ,1例神态恍惚、步态不稳 ;全身皮肤多处出现化学灼伤。入院体检 :P110～ 132次 /分 ,R32～ 40次 /分 ;BP10 / 6 k Pa1例 ,其余 4例尚属正常范围。双肺闻及较为广泛的干湿性罗音。5例均出现不同程度的低氧血症 ,在吸氧 5 L /分状况下 ,S…     

我国八个大中城市院前急救流行病学调查分析

Objective To investigate the epidemiological information of patients in pre-hospital medical care for our large and medium-sized cities and probe the patients' characteristic. Method The data in 2008 were exported from the computer databases of 8 large and medium-sized cities' emergency medical centers in our country.The thorough records of data were conducted to statistical analysis. Results ( 1 ) The scheduling time, running time, rescue time, returning time, total time and service radius in the pre-hospital medical care group were 2.16± 1.10(min), 14.01 ±6.82(min), 12.12±5.96(min), 14.08± 6.85(min), 42.34± 20.21(min)and 8.50±4.18(km), and the above parameter in the non-death group were 2.19 ± 1.13(min), 14.15 ± 7.14(min),11.60±6.72(min), 14.92 ±6.89(min), 41.86± 19.53(minutes) and 8.63±4.31(Km), and the above parameter in the death group were 2.10± 1.08(min), 13.68 ± 7.14(min), 25.25 ± 12.34(min), 13.75±6.48(min), 54.74 ± 25.47(min) and 7.86± 3.91(Km), and the above parameter in the non-sudden cardiac death group were2.09± 1.03(min), 13.58±6.78(min), 25.53± 12.34(min), 13.60± 6.54(min), 53.79±23.77(min) and 7.67 ± 3.86(Km), and the above parameter in the sudden cardiac death group were 2.12 ±1.02(min), 14.10±7.05(min), 24.79± 12.08(min), 13.79±6.61(min), 54. 80 ± 25. 36( min) and 7.90±3.92(Km) respectively. The scheduling time, running time, returning time and service radius in the death group were less than those of the non-death group, but the rescue time and total time of the former were more than those of the latter respectively ( P ＜ 0.05 or P ＜ 0. 001 ). The scheduling time and returning time didn' t have significant difference between the sudden cardiac death group and the non-sudden cardiac death group respectively ( P ＞ 0.05), but the running time, total time and service radius of the sudden cardiac death group were more than those of the non-sudden cardiac death group, and the rescue time of the former was less than that of the latter respectively ( P ＜ 0.05 or P ＜ 0.001 ). (2)The patients' amount in pre-hospital medical care group, the non-death group, the death group, the non-sudden cardiac death group and the sudden cardiac death group were at most in first quarter, and the least time slice of patients' amount were 4:00～ 6:00, 4:00～6:00, 4:00～ 6:00, 22:00～ 24:00, 2:00～4:00 respectively, and the most time slice of patients' amount were 20:00～ 22:00, 20:00～22:00, 8:00～ 10:00, 2:00 ～ 4:00, 8:00 ～ 10:00 respectively. (3)In 241 876 cases of pre-hospital medical care group, the patients' amount of trauma was at most, whose age grades was by far among21 ～50, and the others in sequence were nervous system, circulatory system, other group, digestive system, respiratory system and poisoning group respectively, whose age grades in nervous system, circulatory system and respiratory system was by far above 51, especially above 70. The patients' age grades in other group and digestive system had two climax age groups, which the one was 21 ～ 30, and the other was above 70. The patients' age grades in poisoning group was by far among 21 ～ 50, which the patients' amount of acute alcoholism was at the most. (4) In 12 568 cases of death group, the death amount of circulatory system, other group, respiratory system, nervous system and digestive system ranked at the lst,2nd,4th,5th 8th respectively, whose age grades was by far above 51, especially above 70,and the patients' amount of sudden cardiac death was at the most in the death amount of circulatory system. The death amount of trauma and poisoning group ranked at the 3rd, 6th respectively, whose age grades was by far among 21 ～ 50. (5)The total amount, the death amount and the sudden cardiac death amount of male patients were more than those of female patients. (6)The percentage of the death group to the pre-hospital medical care group was 5.20%, and the percentage of the sudden cardiac death group to the pre-hospital medical care group was 1.29%,and the percentage of the sudden cardiac death group to the death group was 24.87 %, and the percentage of the sudden cardiac death group to the circulatory system group was 67.33 %. Conclusions ( 1 )The trauma and the sudden cardiac death are the overriding reason of disease and the overriding reason of death in our large and medium-sized cities respectively. (2) It is very important to cut the death rate of the middle-old age patients by strengthening prevention and cure of cardiovascular and cerebrovascular diseases, discerning the critical illness early and improving the level of pre-hospital medical care. (3)It is a strong method to decrease the total amount and the death amount of the trauma, especially in traffic accident, by strengthening safety in production, observing traffic regulation and enhancing the legal awareness.     

147例慢性胃病血清癌胚抗原测定结果分析(摘要)

癌胚抗原(Carcinoembryonic antigen简称CEA)存在于体内多种组织脏器中。当这些器官发生病变时,血清、局部组织及病变周围分泌液中的CEA也相应增加,据此我们测定慢性胃病患者空腹血清中CEA含量,以探讨其临床意义。现报告如下。     

福建医科大学急诊内科学教学体系的建立

针对该校刚成立的急诊医学系，探讨适合该校的急诊内科教学体系。建立了具有该校特色的急诊内科教学体系，该教学体系较好地解决了急诊内科学中的教学矛盾与困难，对其他院校建立急诊内科学教学体系具有较大的借鉴价值。     

消化道疾病血清β_2微球蛋白测定及其临床意义

近10余年来,医学界对β_2微球蛋白(β_2-Micro globulin,以下简称β_2-m)的生物学功能和临床意义作了许多研究。1980年Karlsson发现多种血液病及实体恶性肿瘤患者血清β_2-m浓度异常增高,引起注意。我院自1986年开始应用放射免疫法(R_1A)测定血清β_2-m,现将经纤维内窥镜检查和病理确诊的消化道疾病153例的检测结果报道如下。