医务人员和患者互动 构建和谐医患关系

医患关系是医护人员在医疗护理过程中与患者建立起来的人际关系，是一种目的一致，医患双方互动的特殊人际关系。医患双方关系的基础是一致的，没有根本的利害冲突，而且双方都是在对方的利益上得到体现和满足。但是近几年来我国医疗纠纷频繁发生，医患关系日趋紧张，医患矛盾不断发生，深入探究其原因，有政府、患方、医方、媒体等诸多因素。作为医务工作者，构建和谐的医患关系不能一味的埋怨外部因素，要眼睛向内，要善于分析自身的问题，正视并克服自身的不足，从服务环境、服务理念、服务态度、服务效果等各方面查找原因，积极调动患者和家属参与，医患互动，共同构建和谐的医患关系，才能缓解医患矛盾，消除医患之间的紧张关系。本文结合本单位医患概况就医务人员在构建和谐的医患关系中，如何发挥自己的主导作用，并充分调动患者和家属的积极性，浅谈几点看法。     

防范儿科医疗纠纷的对策

作为儿科医务工作者，如何应对不断发生的医疗纠纷，化解医患矛盾，是值得十分关注的课题。     

加强质量内涵建设 从源头上防范医疗纠纷

我国当前医患之间的矛盾和冲突已经达到“白热化”的程度，军队医院同样存在医疗纠纷，发生了医疗纠纷的处理难度和引起的后果也众所周知。如何防范医疗纠纷的发生，已经成为医疗管理的重要内容。我们认为，防范医疗纠纷，必须加强医院的内涵建设，从医疗质量建设入手，从源头上进行治理。本文根据医疗质量概念发生的新的变化，结合医疗纠纷处理的实践体会谈几点看法。     

军地联合处置一起重大医疗纠纷患方集体上访的启示

医疗纠纷作为一种突出的社会矛盾,是目前困扰医疗卫生领域的顽疾.医患矛盾是转型期社会矛盾在卫生行业的集中体现,近年来医疗纠纷日益普遍,已成影响社会稳定的突出问题.一些患方对现有法定医疗纠纷解决机制缺乏信任,信访成为其终极选择,以致越级集体上访的突出信访问题不时发生.由于处理医疗纠纷的疑难性、应对集体上访的紧迫性,妥善处置患方集体上访成为各级军队机关信访工作的一个难点.妥善处置患方集体上访,有利于医患矛盾的化解,有利于和谐社会的构建,有利于社会稳定的维护.     

加强质量内涵建设从源头上防范医疗纠纷

我国当前医患之间的矛盾和冲突已经达到“白热化”的程度,军队医院同样存在医疗纠纷,发生了医疗纠纷的处理难度和引起的后果也众所周知。如何防范医疗纠纷的发生,已经成为医疗管理的重要内容。我们认为,防范医疗纠纷,必须加强医院的内涵建设,从医疗质量建设入手,从源头上进行治     

妥善处理医疗纠纷信访的实践与思考

通过建立多元化医疗纠纷信访处理体系,有助于妥善处理重点医疗纠纷信访,及时化解医患矛盾。为进一步解决医疗纠纷信访中存在的问题,需要建立健全问题整改、军民融合重大医疗纠纷调处、信访责任追究和非正常信访终结等机制。     

浅谈基层医院院前急救医疗风险的防范

急诊急救是社会关注的热点、难点问题，而院前急救又是急诊医疗服务体系的首要环节，稍不注意即可引发医疗纠纷、事故，导致医患双方在人力、物力、财力、精力上的巨大损失。医患之间的矛盾在当今社会形式下，已处于白日化状态。如何减少医疗纠纷，规避医疗风险，是我们急救人员所要面对的事实。笔者根据自己多年从事急诊急救的经验谈几点体会。[第一段]     

加强门诊检验报告管理 防范医患矛盾发生

门诊检验报告的管理，历来是门诊令人头痛的大问题，以往由于检验报告误发、丢失、破损等原因，引起医患矛盾、医疗纠纷时有发生。此外，由于我院地处滇南边境地区，患者主要来源于边境城乡镇，且少数民族居多，患者就诊时，语言交流仍存在困难，造成患者对检验报告误领、丢失。我院为体现一切以患者为中心，对门诊检验报告的管理做了一些改进，既方便就诊患者，又提高了医疗服务质量，从而减少医患矛盾的发生，现将我们的做法和体会介绍如下。     

多方联动 积极处置 确保医疗安全

近年来,在医患关系紧张、矛盾冲突升级的背景下,我院在医疗纠纷防范与处理工作中,牢牢把握工作大局,紧紧抓住关键环节,始终坚持防范不松懈、发生不惧怕、协商不关门、原则不让步、矛盾不激化的＂五不＂原则,以狠抓医德医风、提高医疗质量为根本抓手筑牢关口防线,以坚持换位思考、充分体谅患方为出发点畅通诉求渠道,以合情合理协商、依法循规应诉为基本办法力图公平解决,所有医疗纠纷均得到妥善处理,未因医疗纠纷处理不当引发群体性事件,保障了正常诊疗秩序,确保了医疗安全。主要有以下一些做法和体会。     

我院医疗纠纷的特征分析及其防范管理措施

近年来,随着人们法律及维权意识的不断增强,医疗纠纷的发生日益增多.所谓医疗纠纷,通常是指医患双方对医疗后果及其原因认识不一致而发生争议,并向卫生行政部门或司法机关提出追究责任或赔偿损失的案件.医疗纠纷的发生严重影响了医院的声誉和医疗秩序,对医患双方均产生不良影响.医疗纠纷的产生多是由于医疗质量欠缺、责任心不强及医患沟通不到位等[1-3].目前,有关医疗纠纷的根源、特点及防范措施各医院报道不一.为了进一步认识我院医疗纠纷的原因及特点,更好地防范医疗纠纷的发生,现将我院近5年来的医疗纠纷案例进行回顾性分析,并提出相应的防范管理措施.     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.