普外科手术切口感染中抗生素的预防作用分析

目的 研究普外科手术切口感染中抗生素的预防作用.方法 选择2011年2月~2015年12月在我院进行诊治的普外科手术患者80例,随机分为观察组与对照组,每组各40例.对照组患者在术后使用抗生素,观察组患者在术前1h使用抗生素,比较两组患者的疼痛评分和手术切口感染发生率.结果 观察组患者的疼痛评分和手术切口感染发生率明显低于对照组(P<0.05).结论 普外科手术患者在手术前1h科学、合理地使用抗生素可以有效改善患者的疼痛情况,降低术后手术切口感染的发生率,改善患者的预后.     

抗菌药物不同给药时间对普外科手术患者预防术后切口感染的临床疗效比较

目的:比较抗菌药物不同给药时间对普外科手术患者预防术后切口感染的临床疗效。方法:选取2014年8月—2016年8月期间普外科收治的手术患者122例,采用抽签法将其分为对照组和观察组,每组61例;对照组患者术后给予抗菌药物预防感染,观察组患者术前1 h给予抗菌药物预防感染,比较两组患者用药后切口感染率和视觉模拟评分法(Visual analogue scale,简称VAS)的疼痛评分值。结果:观察组患者用药后切口感染率明显低于对照组(P<0.05),VAS疼痛评分值明显低于对照组(P<0.05)。结论:采用抗菌药物术前1 h用药切口感染的发生率低于术后用药。     

外科手术中患者切口感染临床分析

目的 对普外科手术患者切口愈合情况进行观察与记录,对其感染情况以及引起感染的原因做出统计和分析,并寻求有效地治疗手术切口感染的方法。方法 采取随机抽取的方法 ,抽取进行普外科手术患者200例,随机分为实验组和对照组,每组100例。对照组患者采取在术前术后使用抗生素的治疗方法 ,实验组患者采用在术中使用抗生素的治疗方法。结果 经过对两组患者的治疗结果进行总结后发现,实验组100例患者进行普外科手术后,有2例患者出现切口感染的现象;而对照组100例患者中有20例患者出现切口感染的情况。实验组患者手术切口感染情况明显优于对照组（P〈0.05）。结论 对普外科手术患者术中使用抗生素,比术前术后使用更能有效的减少患者出现切口感染的情况。     

普外科术后预防感染的护理措施及体会

目的 探讨护理因素在预防普外科术后感染中的作用及临床护理体会.方法 632例普外科术后患者根据收治时间段分为观察组和对照组,观察组根据术式和病情制定围手术期特定护理措施,对照组患者采用常规护理；根据《医院感染诊断标准》观察切口外观情况,同时检测血清降钙素原(PCT)和C-反应蛋白(CRP)含量,判断两组术后感染发生率.结果 观察组PCT含量(2.1±0.9) μg/L,CRP含量(29.7±8.6) mg/L,术后切口感染率1.3％(4/316);对照组PCT含量(14.4±0.7)μg/L,CRP含量(36.2±8.3)mg/L,术后切口感染率6.3％(20/316),两组术后感染率差异有统计学意义(t=7.155,P=0.011)；Ⅰ类手术切口术后无感染,Ⅱ类手术切口感染率为4.8％ (6/126),≥Ⅲ类手术切口感染率为36.0％(18/50),三组不同手术切口类型间感染率差异有统计学意义(P＜0.05).结论 科学的围术期护理措施,能有效降低普外科术后感染发生率,改善患者预后情况.     

抗生素在普外科术后切口预防中的应用

目的 探讨和分析抗生素在普外科术后切口预防中的应用.方法 此次研究选择我院在2014年6月～ 2016年6月期间收治的199例普外科手术患者作为研究主体,回顾分析患者切口感染情况.结果 本次研究术切口感染发生率为6.03％.阑尾切除术以及胆囊切除术的术后切口感染率比总感染率高,而肠道修补术、肝脾切除术以及乳房癌根治术的术后切口感染率比总感染率低.术前、术后使用半量的头孢菌素类抗生素、青霉素类抗生素以及喹诺酮类抗生素的术后切口感染率均少于术后使用全量抗生素的术后切口感染率.结论 导致普外科术后切口感染的因素有很多,比如手术类型以及使用抗生素方法等,抗生素使用合理对切口感染预防的意义明显.     

200例普外科手术切口感染的临床分析

目的对普外科手术切口感染进行临床分析。方法随机抽取我院2009年10月至2010年10月期间的普外科手术患者400例,在患者同意的基础上随机分为两组,对照组和实验组,每组各200例患者。其中对对照组中的患者在术前术后进行抗生素的使用,而对实验组中的患者在术中进行抗生素的使用。对两组患者的切口感染情况进行比较分析。结果对照组中有18例普外科手术患者术后出现切口感染情况,而实验组中有2例患者出现切口感染情况,即相对于对照组,实验组中患者出现切口感染的情况更少,<0.05。结论为有效的减少普外科手术患者的切口感染情况的发生,应根据患者的具体情况于手术过程中进行相关抗生素的使用。     

抗生素在普外科手术中预防切口感染的临床观察

目的通过回顾性分析抗生素在普外科手术中预防切口感染的临床观察。方法采用回顾性调查2010年2月～2011年3月我院528例普外科手术患者的切口感染情况。结果手术类型的不同对术后切口感染率的有影响,胆囊切除术、阑尾切除术、肠道修补术等手术的感染率较高,高于总感染率6．06％,而乳房癌根治术及肝、脾切除术的感染率相对较低,低于总感染率6．06％。抗生素的不同使用方法对术后切口感染也有影响。无论使用哪种抗生素,术前术后各使用半量的抗生素的术后切口感染率均低于术后使用全量的抗生素的术后切口感染率。P〈0．05．具有统计学意义。结论普外科手术切口感染的因素很多．包括手术的类型和抗生素的使用方法等。合理使用抗生素对预防切口感染临床意义重大。     

抗生素在预防普外科手术切口感染中的价值分析

目的：探索普外科手术切口感染中使用抗生素预防感染的效果。方法：回顾性分析我院普外科收治的168例患者的临床资料,统计不同时间段使用抗生素的切口感染率、不同抗生素使用方式的切口感染率以及不同种类抗生素的切口感染率。结果：术前、术中、术后使用抗生素的切口感染率分别为6.15%、2.04%、5.56%,术中使用抗生素的切口感染率最低,P＜0.05;单用抗生素的切口感染率2.63%明显低于联用抗生素的6.52%,P＜0.05。在抗生素种类上,切口感染率对比差异不明显,P﹥0.05。结论：在普外科手术切口感染的预防中,在麻醉诱导期用药,单一用药的效果较好,不同的手术、手术切口类型的不同会对抗生素预防感染的效果产生不同的影响,应结合具体情况合理选择抗生素。     

切口保护套对腹部急症手术部位感染的预防作用

目的 探讨切口保护套在腹部急症手术中预防手术部位感染的临床应用效果.方法 设计一种腹部急症手术保护套,选择本院2011年1月至2012年1月间收治的128例腹部急症手术患者作为观察组,术中使用切口保护套对切口进行保护,选择之前术中未使用切口保护套的100例患者作为对照组,对两组的感染率进行比较.结果 观察组使用切口保护套后术后切口的感染率明显降低,与对照组比较,差异有统计学意义(P＜0.05).结论 在腹部急症手术中应用切口保护套可显著降低术后切口感染率,值得临床推广.     

621例普外科I类手术切口感染的临床分析

目的：对普外科I类手术切口的患者术后切口感染进行临床分析,为I类切口不预防使用抗菌药物提供依据。方法随机抽取我院2010年1月至2014年1月期间普外科I类手术切口的患者621例,分为2组,其中观察组279例患者在围手术期进行预防性抗生素的使用,对照组342例患者在围手术不使用抗生素,对两组患者术后切口感染情况进行比较分析。结果观察组中有2例患者术后出现切口感染,对照组中有3例患者出现术后切口感染。观察组、对照组中患者术后切口感染无显著差别。结论普外科I类手术切口围手术期不进行预防性抗生素的使用是安全的。     

上海市社区卫生服务中心医务人员伦理学知识调查及建议

目的:调查上海社区卫生服务中心医务人员的伦理学知识认知情况.方法:采取分层抽样方式,于2016年6—8月对上海市245家社区卫生服务中心的7552名医务人员进行问卷调查.结果:医务人员对伦理学知识非常了解、基本了解、了解很少和完全不了解的人数分别为536人(7.1%)、5411人(71.7%)、1536人(20.3%)和69人(0.9%).不同岗位、职称、学历的医务人员之间存在着明显的伦理学知识认知差距.结论:上海社区卫生服务中心医务人员的伦理学知识了解程度仍有待提高,需加强伦理学知识的学习和应用.     

Nifedipine in the treatment of hypertension in the elderly

The effect of nifedipine monotherapy, retard tablets, 20 mg bid, was evaluated in 23 hypertensive patients, mean age, 79 +/- 2 years. Twenty-one patients completed an eight-week study. Blood pressure (BP) decreased to 160/90 mm Hg in 15 patients; in four additional patients diastolic BP dropped by 15% to 28%. In a subset of five patients with isolated systolic hypertension, a significant reduction in systolic BP was noted. Side effects were relatively mild and only two patients discontinued the study. The results suggest that nifedipine monotherapy offers an alternative, logic, therapeutic approach to hypertension in the elderly.     

Studies on the receptors involved in the action of the various agents in the phenylbenzoquinone analgesic assay in mice

1. Tolerance to the activity of several narcotic analgesics (morphine, levorphanol, and methadone) and several narcotic-antagonist analgesics (pentazocine, cyclazocine, and nalorphine) was studied in the mouse phenylbenzoquinone stretching test. Virtually complete tolerance was induced by chronic treatment with each of the narcotic agents, while no apparent tolerance was induced by the narcotic antagonists.2. In morphine-tolerant mice there was a high degree of cross-tolerance to the effects of not only the other narcotic drugs but also to those of the narcotic antagonists, acetylsalicylic acid, and physostigmine.3. The effects of morphine and pentazocine were antagonized by naloxone but not by atropine, while the effects of physostigmine were antagonized by atropine but not by naloxone. Neither atropine nor naloxone antagonized the effect of acetylsalicylic acid.4. The results of the tolerance study suggest that there is a fundamental difference in the consequences of receptor interaction for the narcotic and the narcotic-antagonist analgesics. Morphine-tolerant mice exhibit cross-tolerance non-specifically. The selectivity of naloxone and atropine differentiates the narcotic and narcotic-analgesics from the other two agents used in this analgesic test.     

Interactions among the cannabinoids in the antagonism of the abdominal constriction response in the mouse

The ability of ⁹-tetrahydrocannabinol (THC), cannabinol (CBN), cannabidiol (CBD), 11-OH THC and 8,11-diOH THC to antagonise the abdominal constriction response in the mouse induced by formic acid, phenylquinone, 5-hydroxytryptamine, prostaglandin E₁ (PGE₁) and bradykinin was tested. THC was an effective antagonist against all nociceptive agents with an ED₅₀ in all cases between 1.0 and 2.6 mg/kg. CBN, while also effective against all nociceptive agents, was less potent than THC, with an ED₅₀ range between 46.2 and 112.5 mg/kg. CBD in doses as high as 200 mg/kg was without effect. Using PGE₁ as the nociceptive agent, 11-OH THC was equipotent to THC while 8,11-diOH THC was inactive. Naloxone, while able to antagonise the antinociceptive effect of morphine against formic acid-induced writhing, did not reverse the antinociceptive effects of THC. There were no pharmacological interactions between THC, CBD and CBN.     

Neurotensin causes a greater increase in the metabolism of dopamine in the accumbens than in the striatum in vivo

Differential pulse voltammetry with carbon fibre electrodes was used to study the effect of central administration of neurotensin on the extracellular level of 3,4-dihydroxyphenylacetic acid (DOPAC) in the nucleus accumbens and the striatum in anaesthetised rats. Intracerebroventricular injection of neurotensin (10 micrograms) increased the peak height for DOPAC 20 min after administration in the nucleus accumbens but only after 40 min in the striatum. The maximum increase was similar in both regions, with 30% and 27% above the pre-injection basal level, respectively. Neurotensin (1 micrograms) however increased the extracellular level of DOPAC in the nucleus accumbens alone. Neurotensin (0.1, 1.0 and 3.0 micrograms/0.5 microliter), injected into the ventral tegmental area, induced a potent and long-lasting elevation of the peak height for DOPAC in the nucleus accumbens, while the same doses in the substantia nigra produced effects on the metabolism of dopamine in the striatum of smaller amplitude and shorter duration. The maximum effect of each dose was about 2.5 times greater in the mesolimbic, compared to the nigrostriatal system. Amphetamine (2 mg/kg, s.c.) decreased the extracellular level of DOPAC with a similar magnitude, both in the nucleus accumbens (52%) and the striatum (47%). Intracerebroventricular administration of neurotensin (1 micrograms), 5 min after amphetamine, did not alter the effect of amphetamine on the extracellular level of DOPAC either in the nucleus accumbens or the striatum. However, neurotensin (10 micrograms) partially reversed the effect of amphetamine in the nucleus accumbens and had a similar but smaller and delayed effect in the striatum. The results from the present study, together with previous neurobehavioural studies, suggest that neurotensin has a relatively selective action on the mesolimbic dopaminergic system in the rat.     

Role of the liver in the disposition of intravenous nitroglycerin in the rat

Previous studies have indicated that the liver is the main site of nitroglycerin (NTG) elimination when the drug is systematically infused. To examine this hypothesis, we measured the apparent systemic clearance (Cls) of nitroglycerin in anesthesized rats receiving a constant intravenous infusion at a dose of 100 micrograms per kg per min. Animals were divided into shunt and sham groups; the former had undergone a portal vein ligation 10 days prior to the study, while the latter was subjected to a sham operation. On the study day, half of the animals of each group also received probenecid at 200 mg/kg, i.v., a drug previously reported to inhibit organic nitrate ester reductase (ONER) activity in rat liver. Arterial NTG samples were obtained at 41, 43 and 45 min of infusion in all four experimental groups; Cls was 439 +/- 32 ml per kg per min (mean +/- S.E.) in sham, 460 +/- 44 in sham and probenecid, 477 +/- 39 in shunt, and 461 +/- 34 in shunt and probenecid animals. During NTG infusion, hepatic blood flow (measured with a constant infusion of indocyanine green) was decreased markedly in shunted rats as was liver/body weight, indicating hepatic atrophy. The specific activity of hepatic ONER was similar in all four groups. In spite of marked differences in hepatic blood flow and hepatic mass, the Cls was similar in all four groups. The liver does not appear to be a major site for the elimination of systemic nitroglycerin as hitherto assumed.     

女性医务人员健康状况的研究

目的探讨女性医务人员健康状况的特点。方法对2877例医院工作人员健康查体资料进行统计学分析。结果①女性医务人员中,41.0%的人员患有不同类型的疾病,略高于男性患病率（36.8%）,二者差异有统计学意义（P=0.029）;②女性医务人员高脂血症为31.9%（212/665）,低于男性（65.9%,274/416）;③脂肪肝患病率女性（32.6%,181/556）,亦低于男性（45.9%,151/329）;④女性相关疾病中,乳腺疾病和子宫肌瘤的患病率分别为4.8%和3.4%;而宫颈糜烂为20.2%;⑤女性医务人员高血糖为11.0%（77/702）,高血压为4.6%（56/1229）。结论女性医务人员中妇科与乳腺疾病是健康体检的重点,代谢性疾病也应加以关注。     

人文关怀在手术室护理中的应用

目的探讨在手术室护理中人文关怀的作用。方法将2012年5月至2012年11月200例手术患者随机分为两组,对照组100例,采取术前、术中常规护理,观察组100例,在对照组的基础上给予患者人文关怀,对比两组护理满意度及疗效。结果对照组各项指标满意度低于实验组(P<0.05),与对照组比较,实验组的住院时间明显缩短,痛苦小,并发症发生率低,P<0.05,差异均有统计学意义。结论 "以人为本"的人文关怀理念应用于手术室中,可充分提高护理质量及患者的满意度。