医疗设备管理中存在的问题及对策

为了发现并及时纠正医疗设备管理中存在的问题，科学地引导和决策医院购置医疗设备，我们对分部所属三所医院的医疗设备特别是价值8万元以上大型医疗设备的购置、使用、维修、保养等方面的情况进行调查分析。1存在问题及原因分析1．1部分医疗设备引进论证不够充分（1）科学预测不够。有的医院在购置医疗设备时，盲目求多、求全，一哄而上，加之信息闭塞或对广告缺乏科学分析，没有进行反复论证和科学决策，未能预测其发展前景，致使有些设备引进时或引进后不长时间就已落伍。造成了资金浪费。（2）对本地区经济承受能力考虑不足。我部医院病…     

铁调素调节蛋白研究进展及其在航天医学中的作用

空间站所处真空、高辐射和微重力环境,以及空间站结构及功能设计决定了空间站在轨维修的特点。空间站维修方案的优化,维修策略的制定,航天货运计划的安排以及空间站可维修性设计更改都要求量化分析空间站在轨维修的复杂度。基于复杂度理论及其工程应用的研究,本文回顾了复杂度理论的发展,梳理了任务复杂度研究进展及其评价方法应用,并在前人研究的基础上,明确了空间站在轨维修任务复杂度概念,搭建了维修任务复杂度评价模型以定量分析在轨维修任务。本文研究成果可为空间站维修任务的开展以及维修手册的优化提供一定的方法参考。     

军队中心医院医技科室设备使用与养护的体会

军队中心医院医技科室集中了医院许多大中型医疗检诊设备。如何使用和管理好这些设备,发挥设备的最大效能,减少维修成本,是医技科室日常管理中重要工作之一。     

某三甲医院病种收支模型构建及实施效果评价

目的 探寻有效评价规范临床路径、控制医疗成本的方法。方法 以某三甲医院2021年各科室疾病谱为例,通过对病种次均费用、收入结构、平均住院日、成本等项目进行分析,测算次均毛利润。结合临床路径,对药占比、耗占比和平均住院日等指标进行优化,并与科室进行探讨,在结合临床实际的基础上对该病种相关运营管理指标提出合理化建议,形成病种收支模型。结果 病种收支模型应用于临床以来,有效降低了药占比和耗占比,缩短了平均住院日,科室收入结构优化,病种次均毛利润增长,科室经济效益显著提升。结论 将合理的病种收支模型与临床路径的诊疗行为相结合,有助于医院临床路径的管理及医疗成本的管控,实现医疗质量与效益的同步推进。     

空间站在轨维修任务复杂度评价方法研究进展

空间站维修方案的优化,维修策略的制定,航天货运计划的安排以及空间站可维修性设计更改都要求量化分析空间站在轨维修的复杂度。基于复杂度理论及其工程应用的研究,对复杂度理论的发展进行回顾,梳理了任务复杂度研究进展及其评价方法应用,明确了空间站在轨维修任务复杂度概念,并重点讨论了空间站在轨维修任务复杂度评价中的几个关键问题。     

FCR 5000型CR影像阅读器常见故障分析与检修

FCR5000型计算机X线摄影系统(computed radiography,CR)是日本富士公司于1998年推出市场的4栈口影像读取装置。其影像阅读器涉及电子、机械、计算机等诸多学科和技术,是一种复杂的大型医疗设备,维修费用较大,一旦停机将给医院造成较大的损失。笔者根据多年来对该机型的维修经验     

军队医院医疗设备科学化管理的探讨与实践

医院医疗设备管理是医院建设与管理重要组成部分。本文从做好医疗设备购置论证、落实医疗设备采购办法、加强医疗设备质量控制、注重医疗设备成本效益分析和加强医疗设备管理队伍建设等方面,就军队医院医疗设备科学化管理进行了探讨与实践。     

医疗设备的维护检修与管理

医疗设备在医院高效率使用是体现医院医疗安全管理质量重要的标志,医院医疗设备的检查维修已经成为现代医院管理的一个重要的领域.     

几种监护仪的日常使用注意事项

医院的大型医疗设备通常都能够得到足够的重视并配有专人管理,而一些为数不少的小型监护设备,从故障现象上就能够发现,在存放和使用上并不规范,由此引发的故障和停机维修,不但会给科室和医院造成损失,有的还会酿成事故。     

浅谈用接口转换维修医疗设备

在维修医疗设备时很多用户工程师都遇到过这样的情况:已查明机器故障苦于没有现成备件可替换,需要向设备厂家购买,但价格昂贵,特别是早期的大型医疗设备.这时除了向厂家购买备件外,某些故障其实还可以用转换方式来实现,不但可以缩短停机时间,还能给医院节省一大笔费用.现将我院出现的几例设备故障及转换方法介绍如下.     

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.