普通外科术前患者对术后康复知识了解情况的调查

康复知识教育是以医院为基础,以患者及其家属为服务对象,帮助掌握卫生保健知识,以提高人们预防疾病和战胜疾病的能力,加快患者康复。通过对2007年1月～2009年1月在我科住院准备接受普通外科手术治疗的62例,住院患者手术后机体康复知识了解程度的调查,探讨如何在护理中有针对性地对患者及陪护人员进行康复教育指导。     

深航转运地震伤员出川的做法与体会

2008年5月12日,四川汶川地区发生8.0级特大地震.自5月20日至31日,中国民航完成了四川I省人民政府安排的大规模转运重伤员任务,国航、东航Jll航、深航、鹰联航5家航空公司共执行99班包机,分别将3495名重伤员从成都转运至广州、上海、南京、沈阳,南宁、合肥、珠海、青岛、深圳、烟台、柳州、福州、济南、无锡、大连、杭州、温州和太原等19个城市治疗.同机运送的还有家属陪护人员3168人,医护人员941人次.为支援四JII灾区的抗震救灾工作,国航、东航、Jll航、深航、鹰联航5家航空公司专门改装了9架飞机,用于灾区重伤员的运输.其中,从5月21日至5月30日止,深航共飞行22个班次,从成都空运地震伤员746名、家属(陪护)人员674名、护送医护人员211人次、机务人员12人次和记者3名,分别转送至深圳、南宁、南京、广州、合肥、济南、无锡和温州(表1).现将深航转运地震伤员出川的做法与体会介绍如下.     

美军卫生勤务改进措施

本文论述了美军为提高卫生勤务工作效率而正在采取的改进措施，重点是加强指战员的自救互救培训和各级医务人员（包括预备役人员）的培训。美军特别强调卫生员战地救护技能和战区外科军医野战条件下手术技能和伤员医学分类技能的培训。美军医学科研部门正在研究战区条件下伤员复苏的新方法和创伤局部注射抗生素的新方法。     

致敬!士官“军医”

正在一般人眼里,"军医"都是干部身份,都是在大学深造多年的技术精英,但在军营基层里,有这么一群人,他们身份虽为士官,但是凭借高超的技能和为兵服务的热情,在本职岗位建功立业,赢得广大官兵响亮的掌声和敬意……"教头"是个兵彭理,东部战区总医院下属原86临床部卫生员培训队队长兼战救教员,三期士官,先后参加上级组织的军事卫勤演习、专业比武、抗洪抢险等训练保障任务,5次被评为优秀士官、军事训练先进个人。他先后担任东部战区卫生专业职业技能鉴定战救考评员、卫生员培训队队长兼战救教员,无锡联保中心卫     

浅谈儿科陪护的心理状态及语言沟通

儿科护士的工作对象一是患儿 ,二是患儿的家属或陪护。目前 ,我国的 95 %以上的住院患儿是独生子女 ,几乎所有的病人至少是留一位陪护 ,由于家长与护士接触较多 ,易产生矛盾 ,这些矛盾势必会影响护患关系 ,甚至影响治疗和护理。近几年来 ,我们注意了陪护人员的心理状态 ,加强与陪护人员交流与沟通 ,减少了护患纠纷和不必要的误会 ,从而使每一位陪护人员理解护士的工作 ,并取得他们的支持和配合。1　陪护人员的心理状态　　恐惧和焦虑感　由于现今家庭 ,绝大多数是独生子女 ,当孩子患病住院时 ,家庭成员心情异常的紧张和焦虑 ,父母的担心就更…     

门诊急诊工作应注意的几个问题

急诊病人大部分是发病急、病情重、变化快,陪护和护送人多。如果没有一个良好的急救环境和秩序,会直接影响抢救工作的顺利进行。从门诊急救室工作实践来看,搞好急救室工作管理,是当前门诊部管理工     

4140名南战区空军航空兵心理健康状况影响因素比较

目的研究南战区空军航空兵心理健康状况的影响因素,为采取心理干预措施提供参考依据。方法采用症状自评量表对4140名南战区空军航空兵进行心理健康状况调查和分析。结果①南战区空军航空兵症状自评量表总分为121.69±34.17,地勤人员SCL-90总分和各项因子分值在四类人员中均处于最高,飞行员SCL-90总分和各项因子分均在四类人员中最低;②士官SCL-90总分和各项因子分值均低于干部与义务兵,干部SCL-90总分和各项因子分均高于义务兵,并在躯体化、强迫症状、抑郁、敌对、偏执等因子上差异显著;③除恐怖外,大专以上学历的官兵SCL-90各项得分均高于高中组官兵和初中组官兵,并在强迫症状、抑郁和偏执因子上差异显著;④在躯体化及敌对因子上,30～35岁及35岁以上的官兵得分均显著高于20～25岁及25～30岁年龄段的官兵,30～35岁年龄段的官兵抑郁因子得分最高,20岁以下的官兵恐怖因子得分最高。结论南战区空军航空兵心理健康状况与部职别、年龄和文化程度关系密切,需重点关注以下人群:地勤人员、团以下干部、30～35岁年龄段官兵以及高学历官兵。     

对美军医疗保健体制(MHS)改革演化的分析

美军MHS（Military Health System）是为现役军人及其家庭成员、退役人员及家属和其他有资格在MTF（military treatment facility）、军队医院和诊所接受服务的人员提供卫生保健的军队卫生服务体系。MHS为现役军人成员和家属提供军队医疗保障服务可追溯到18世纪70年代。1884年，美国国会指定军队医务工作者和合同军医要无条件地参与军人及家属的免费医疗服务。直到二次世界大战，这种卫勤保障形式才发生了改变。随着海外驻军和国内人群的增加，美军卫勤保障范围处于动态扩张发展时期，引发更多更具内涵的卫生服务需求。     

航空卫生工作特点与宏观做法

笔者在参加《中国人民解放军空军航空卫生工作规则》(下称《规则》)编写中,就目前航空卫生工作问题参阅了一些文献资料,进行了梳理和探索,现发表以下见解,与同行切磋。1 航空卫生工作特点1.1 参与人员多,专职人员少《规则》明确指出:组织实施航卫工作必须强化大卫生观念。做好航卫工作,仅仅依靠航卫工作者的努力是不够的,因为专职人员只有航空军医、体检军医、空勤科军医和疗养科军医,所占数量较少,必须调动各级行政领导和相     

南战区6580名官兵疲劳状况及相关因素分析

目的调查分析南战区6 580名官兵疲劳状况及相关因素。方法采用疲劳量表-14(FS-14)对南战区6 580名官兵的疲劳状况进行调查和分析。结果南战区陆军和海军官兵体力疲劳、脑力疲劳和疲劳总分明显高于空军官兵,陆军脑力疲劳和疲劳总分明显高于海军;干部和士官体力疲劳、脑力疲劳和疲劳总分明显高于义务兵;大专以上学历官兵体力疲劳、脑力疲劳和疲劳总分明显高于高中学历官兵,大专学历官兵体力疲劳和疲劳总分明显高于初中学历官兵;已婚官兵体力疲劳、脑力疲劳和疲劳总分明显高于未婚官兵,以上均具有统计学差异(P<0.05或P<0.01)。结论南战区官兵疲劳状况需重点关注以下人群:陆军官兵、干部和士官、高学历官兵和已婚官兵。     

"和谐使命-2010"任务期间口腔疾病就诊情况分析

目的 初步调查海军护航人员口腔医疗需要,并了解亚非等欠发达国家的华侨和当地民众的口腔健康概况.方法 根据临床检查结果分类记录,并进行统计和分析.结果 阻生智齿和可能由此引起的智齿冠周炎是我海军护航人员最常见的口腔疾病,其次是龋病及其继发病和牙体硬组织缺损.华人华侨的口腔健康状况好于当地民众,当地民众的口腔健康状况相对较差,可以见到罕见病例和常见病中的少见类型.结论 海军护航任务人员需要进行专门的口腔卫生勤务服务,做到执行任务前普查普治.与当地民众相比,华人华侨文化背景和经济收入是其口腔健康状况相对较好的重要因素.不同国家的人均经济收入水平、国家医疗保障制度对当地民众的口腔健康状况有重要影响.

Abstract：

Objective To investigate the medical demands of oral health care for naval escort personnel and find out the oral health status of the Chinese, overseas Chinese and local people in the Asian -African underdeveloped countries. Methods Based on the results obtained from clinical examinations, data were recorded, sorted, and analyzed by using Excel. Results Impacted wisdom tooth and resulting pericoronitis was the most prevalent oral disease that prevailed among the naval escort personnel. The less prevalent disease was dental caries and secondary pulpitis and apical periodontitis. Dental hard tissue defect was the last most popular disease. The oral health status of Chinese and overseas Chinese was better than that of the local people. Unusual cases or hardly observed categories of unusual cases were seen among the local people. Conclusions Specialized oral medical service was required for the naval escort personnel, who should have medical screening and receive dental treatment before deployment. When compared with the local people, the cultural background and economic income of the Chinese and overseas Chinese were 2 most influential factors for their better oral health status. Per capita income levels and national heath care system in different countries had great effect on the oral health status of the local people.     

"和谐使命-2010"任务期间口腔疾病就诊情况分析

目的 初步调查海军护航人员口腔医疗需要,并了解亚非等欠发达国家的华侨和当地民众的口腔健康概况.方法 根据临床检查结果分类记录,并进行统计和分析.结果 阻生智齿和可能由此引起的智齿冠周炎是我海军护航人员最常见的口腔疾病,其次是龋病及其继发病和牙体硬组织缺损.华人华侨的口腔健康状况好于当地民众,当地民众的口腔健康状况相对较差,可以见到罕见病例和常见病中的少见类型.结论 海军护航任务人员需要进行专门的口腔卫生勤务服务,做到执行任务前普查普治.与当地民众相比,华人华侨文化背景和经济收入是其口腔健康状况相对较好的重要因素.不同国家的人均经济收入水平、国家医疗保障制度对当地民众的口腔健康状况有重要影响.     

南海某岛礁作业人员身体健康及卫生服务状况调查与分析

目的 探讨南海某岛礁作业人员的身体健康状况和对卫生服务的需求，以提供合理的医疗卫生服务。方法 采用“健康状况及卫生服务意向”调查表对南海某岛礁作业人员进行“重复性横断面”团体调查，并以船员及海岸人员作对照。结果 南海海域4种作业人员的两周患病率和慢性病患病率均明显高于全国患病水平。其中，礁员和船员两周患病率明显高于岛员，但4种作业人员间慢性病患病率差异无统计学意义。两周患病率中，感冒患病率位于各种疾病之首；慢性病患病率中，各单位以胃病患病率最高。岛礁人员就诊率和住院率均较低，有43．69％的患者因各种原因未能就诊，12．79％的患者需要住院而未能住院；1年内个人外出诊治占患病人次数的39．35％，个人自购药品占患病人次数的45．82％。反映意见最多的是药品供给问题，占总调查人数的23．69％。结论 南海某岛礁作业人员患病率明显高于全国水平，其中两周患病率礁员明显高于岛员；基层卫生单位所提供的医疗卫生服务尚不能满足其卫生需求。     

Removal of unexploded ordnance from patients: a 50-year military experience and current recommendations

BACKGROUND: Retained unexploded ordnance in a patient presents the surgeon with unique emotional and technical challenges. This report is a compilation of data to determine management strategies for these potentially catastrophic injuries. METHODS: All identified military cases from World War II to the present were reviewed. Cases were reviewed for site of injury, type of munition, personnel and equipment precautions, and outcome. Interviews were conducted with available involved surgeons. RESULTS: Thirty-six patients were identified with retained ordnance. Four were moribund upon arrival and died before operation. All of the remaining 32 patients survived the removal of the unexploded ordnance. Thirteen injuries involved the trunk, 4 involved the head and neck, and 18 involved extremities. The majority of missiles (51%) were 40-mm projectiles. No incident was identified in which a round exploded during transportation, preparation, or removal. Explosive Ordnance Disposal assistance was available to the surgical team for all but one patient during and after the Vietnam War. Measures used to reduce the chance of premature explosion are discussed. CONCLUSIONS: Isolation of the operating room and protection of personnel and equipment are essential. Patients should be triaged in the delayed category, because most are not morbund on arrival and all patients operated on survived. Explosive Ordnance Disposal expertise should be used. Knowledge of and adherence to several basic principles will protect personnel and equipment while permitting optimal patient care.     

Dental data of the Athens 2004 Olympic and Paralympic Games

The Athens University, School of Dentistry, accepted the challenge to organize the Dental Health Services in the Athens 2004 Olympic and Paralympic Games in order to provide the best quality of oral health services to the athletes, coaches, escort members and Olympic Village personnel. Data from the whole activity protocol of the Athens 2004 Games Dental Health Services - the reception, admission and treatment protocols, the facilities and the infrastructure, the number of cases treated per specialty and the experience gained - were recorded. During the Olympic Games, there were more than 1400 dental cases in more than 650 patients, elite athletes, escort members, coaches and staff of the Olympic Village. Among them 313 fillings, 100 root canal therapies, 57 mouthguards and 9 dental trauma cases were treated. During the Paralympic Games, there were more than 240 dental cases in more than 220 patients. Among them 73 fillings, 12 root canal therapies, 21 extractions and 3 dental trauma cases were treated. In such events, highly trained dentists are needed and if possible, specialized in operative dentistry or endodontics. The role of team dentist seems to be of great importance.     

Prevalence of reported pain, widespread pain, and pain symmetry in veterans of the Persian Gulf War (1990-1991): the use of pain manikins in Persian Gulf War health research

The reporting of pain was compared for U.K. Persian Gulf War veterans, veterans from the Bosnian conflict, and personnel employed in the military at the time of the Persian Gulf War but not deployed (era comparison group). Pain manikins were used to assess the prevalence of the reporting of pain in different body sites and the prevalence of the reporting of widespread pain, in relation to comparison samples. Data from > 8,195 veterans were collected from a previously reported, cross-sectional, population-based, postal questionnaire survey. A greater proportion of Persian Gulf War veterans reported pain in the majority of the 25 areas of the body, compared with the Bosnia and era comparison groups. A greater proportion of Persian Gulf War veterans also fulfilled American College of Rheumatology criteria for widespread pain, compared with the Bosnia and era comparison groups (odds ratio, 1.82; 95% confidence interval, 1.51-2.20). Participants were much more likely to report pain in an opposite limb if pain was reported in the first limb (odds ratio, 36.9; 95% confidence interval, 31.7-43.0). Widespread pain was also more prevalent in the Persian Gulf War veteran sample compared to the comparison groups. Several years after the end of the Persian Gulf War, veterans still report pain. The mechanisms of this remain unclear. Implications for baseline monitoring of the health of military personnel are discussed.     

神经内科中病房护理危机预测以及干预的对策

目的探讨神经内科的病房中可能会出现、发生的危机,并且从中研究应对的策略方法,从而来保讧医患这双方的安全。方法成立起来相关的质量管理控制小组,针对病房的管理以及其中对病人的治疗、护理过程以及患者陪护等等方面上可能会出现的一些突发性的事件进行评估,并且从而来制定处理相对应的方法,对科室中的所有护士进行相关的知识以及技能培训,通过考核让护士将质量提高上来,并且针对患者以及陪护人员进行相关的一些宣传教育。结果自从开始实施质量管理核心小组之后,神经内科病房危机发生的几率有了明显的下降。结论神经内科病房中进行危机预测以及相对应的对策研究,能够大大地提高护卫的危机意识以及对危机的敏感性,同时还增强了护士对于危机事件的处理能力,将医患这两者之间的关系有了明显的和谐促进作用,同时也将危机的发生率降低到了一定的程度。     

南京日遗化武处置的医学防护和毒剂洗消

侵华日军在第二次世界大战结束时,将大量化学武器遗弃在我国境内。目前,中日双方正对部分日遗化武进行联合处置。作为任务的医疗保障和应急救援力量,针对日遗化武处置现场化学事故具有突发性、复杂性、破坏性等特点,本文对可能发生的化学战剂事故进行医学防护和洗消方面的探讨,有利于提高对日遗化武危害性的认识和应急处置能力,减少和避免日遗化武处置过程中对相关人员的伤害和环境污染,更好地完成好日本遗弃在华化学武器处置的医学保障任务。     

Self-reported health of Persian Gulf War veterans: a comparison of help-seeking and randomly ascertained cases

The objective of this study was to compare self-selected Persian Gulf War veterans attending a health assessment program with veterans ascertained in an epidemiological study to determine why Gulf War veterans do, or do not, present for clinical assessment. A postal survey was sent to randomly selected United Kingdom Armed Forces personnel who served in the Persian Gulf conflict. Outcome measures included a symptom checklist, health perception, physical functioning, psychological distress, post-traumatic stress symptoms, and health attributions. A total of 173 survey respondents had also attended the Medical Assessment Program (MAP). MAP attendees were more likely to be female, older, and working part time or not working at all. They had poorer health perception and reported higher levels of illness, and they differed in terms of their health attributions. The belief that one had Gulf War syndrome and attributing health problems to Gulf War service were the most powerful predictors of MAP attendance, even when controlling for the level of physical functioning. The findings suggest that health beliefs rather than symptoms are more important predictors of attendance of an assessment program and that Gulf War veterans who attended the MAP have different characteristics than those who did not. This suggests that MAP patients are unrepresentative of the wider deployment to the Persian Gulf.     

Aeromedical evacuation: remembering the past, bridging to the future

Operations Desert Shield/Desert Storm saw the largest mobilization of aeromedical evacuation (AE) assets since the Vietnam War. Ultimately, more than 1,950 AE personnel were deployed to support the medical airlift of personnel. With aircrews based at 17 locations in the region, at its peak the system could move up to 3,600 intratheater and 2,500 intertheater casualties per day. Fortunately, the demand for AE fell far short of predictions. During the period from August 12, 1990, to March 31, 1991, more than 12,500 patients were successfully airlifted using converted cargo aircraft, a concept originally validated in World War II. The authors describe the Operations Desert Shield/Desert Storm AE system and identify the efforts underway to construct a new aeromedical evacuation system capable of meeting the needs of the battlefield of the 21st century.