加强手卫生依从性管理对降低医院感染发生率的效果观察

目的 探讨加强护理人员手卫生依从性管理对降低医院感染发生的效果.方法 选取EICU30名医护人员为研究对象,2020年7月-12月进行常规管理,2021年1月-6月进行加强手卫生依从性管理,比较干预前后手卫生依从性、手卫生知识得分及医院感染情况.结果 干预后手卫生依从性及手卫生知识得分均较高且医院感染发生率较低,P＜0...     

3种结肠镜前肠道准备方法效果对比及临床应用

结肠镜前肠道准备条件直接关乎镜检结果,甚至关乎微小病变是否漏诊,故肠道准备对内镜医师来说至关重要。但现在肠道准备的多种方法是否适合于每位患者,同时做到清洁效果良好,这一点值得我们临床探讨。因此,探讨不同肠道准备方法的优劣,对于结肠镜检查前准备是十分必要的。现我院结肠镜检查肠道准备常用3种方法。     

MRI of the hand in psoriatic and rheumatical arthritis

Magnetic resonance imaging (MRI) of the hand in patients with psoriatic arthritis (PA) was evaluated and compared with MRI of the hand in patients with rheumatoid arthritis (RA). Both MRI and X-ray examinations of the hands were performed in 28 PA patients and 18 RA patients.The MRI showed a PA pattern characterized by a more pronounced soft tissue swelling as compared with RA patients. Diffuse and pronounced periarticular oedema that spread to the subcutis was evident in 24 (85.7 %) PA patients. Subchondral changes were characteristic of PA patients, and were observed in 12 of 28 PA patients (42.8 %). In these cases, conventional X-ray examination failed to show any bone change. These two changes were not seen in RA patients. Our preliminary results indicate that MRI might play a role in differential diagnosis between PA and RA especially in the early phase of the disease in which conventional radiological examination is negative.     

Study of age dependence of epiphyseal ossification of the hand skeleton

Radiological analysis of the hand skeleton is a key pillar of forensic age diagnostics in living subjects undergoing criminal proceedings. The present study investigated whether ossification stage classification of selected epiphyses of the hand could provide added value to hand radiograph analysis. Hand radiographs from 265 male and 164 female subjects aged 10–18years old who had been X-rayed due to traumatological indications were therefore assessed. Epiphyseal ossification of selected elements of the hand skeleton (ulna, radius and third metacarpal, basal phalanx, mesophalanx and telephalanx) was graded based on the criteria of the five-stage classification system of Schmeling et al. (Int J Legal Med, 118:5–8, 2004) for clavicular epiphyseal cartilage. Stage 5 (absence of the epiphyseal scar) does not occur in the radius of men before the age of 18. Stage 5 can therefore be regarded as a potential parameter for valid determination of a minimum age of 18 years for forensic age estimation in criminal proceedings.     

Osteoscintigraphy and brachydactylia of the hand

Few reports have addressed scintigraphic abnormalities in the configuration of the hands. The purpose of this report is to present a case of congenital brachydactylia of the hands and to emphasize both acquired and projectional scintigraphic findings of brachydactylia.     

精神病医院消毒灭菌效果的监测体会

目的:探讨如何提高消毒灭菌的合格率、降低医院感染发生率.方法:使用改善医院整体环境、加强监督管理、强化人员培训、信息化、突出工作重点的方法改善消毒灭菌效果监测工作,然后对1999～2004年医院消毒灭菌合格率与医院感染发生率进行调查.结果:医院消毒灭菌合格率逐年上升,医院感染发生率逐年下降.结论:改善医院整体环境、加强监督管理、强化人员培训、信息化、突出工作重点可以改善消毒灭菌效果与降低医院感染发生率.     

湿润暴露疗法治疗手部Ⅱ度、浅Ⅲ度烧伤89例临床分析

目的：观察湿润暴露疗法对手部深度烧伤的疗效。方法：对89例(134只)手部Ⅱ度、浅Ⅲ度烧伤创面采用湿润暴露医疗技术,观察其治疗效果、愈合后瘢痕形成及手部功能恢复情况。结果：本组所有创面均一期愈合,仅有8例(8只)形成程度不同的瘢痕,瘢痕形成率6．0%。结论：湿润暴露疗法治疗手部Ⅱ度、浅Ⅲ度烧伤具有控制创面感染,减轻疼痛,促进创面愈合的作用,可有效减少瘢痕形成,避免手部功能障碍。     

电针对缓解肩手综合征腕部水肿与疼痛疗效的观察

目的:探究电针对于中风后肩手综合征的腕部疼痛和肿胀的缓解作用.北京老年医院卒中病房确诊肩手综合征的14例病例.方法:根据参照江藤氏肩手综合征诊断标准对患者将14例病例分为两组,实验组给予康复训练配合电针治疗,对照组仅做康复训练.对两组患者的疼痛和水肿进行评价.结果:两组的病人的水肿和疼痛均有所改善(P＜0.05),实验组的效果优于对照组(P＜0.01).结论:电针配合康复训练对于治疗中风后肩手综合征是有效的方法.     

军事坑道内空气微生物污染调查及其消毒

目的:通过对51条军事坑道内空气微生物污染调查及其消毒,为坑道环境提供安全保障.方法:用撞击法和沉降法监测空气细菌总数、真菌数、链球菌数及厌氧菌数.用二氧化氯以10 mg/m3量对空气进行消毒.结果:①空气细菌总数及链球菌基本正常.②半密闭型坑道通道及房间空气真菌数最高,中位数分别为5 950 cfu/m3及9 500 cfu/m3.③密闭型坑道空气厌氧菌分别是半密闭型及通风型通道的4.2倍及3.8倍.④空气细菌总数及真菌数消亡率均在90%以上.结论:军事坑道内空气中含有大量真菌及厌氧菌,对进驻人员健康有一定危害.二氧化氯消毒剂对坑道空气消毒效果满意.     

Metastatic tumours of bones of the hand and foot

Metastases in the bones of the hands and feet are rate. The literature relating to these tumours has been reviewed, and 43 new cases are reported. In the comulative total of cases, metastases to the hand outnumber those to the foot 2:1 (196 cases as against 94). Bronchial carcinoma is the most common neoplasm metastasising to the hand. Subdiaphragmatic neoplasms such as gastrointestinal, vesical, renal and uterine malignancies, metastasise more frequently to the foot. A possible explanation for this latter finding is the retrograde spead of tumour emboli from the vertebral venous plexus down incompetent leg veins.     

Experimental protocol for the kinematic analysis of the hand: definition and repeatability

A quantitative and objective method based on the optoelectronic kinematic analysis of hand segments and on the calculation of global and partial parameters, which provide measures of the degree of long finger and thumb extension is proposed for the evaluation of the hand's voluntary range of motion and maximal opening of the fingers and thumb. To test the precision and repeatability of the method, the protocol was applied on 14 healthy subjects (28 hands). The proposed parameters are repeatable and show a precision between 5.5° and 10.4° (mean value: 7.3°), comparable to values obtained with other methods. Advantages of the present approach include simultaneous analysis of all fingers, absence of cumbersome connecting cables and no need for individually customized devices. The method, also applied to the paretic hands of two hemiplegic stroke patients before and after electrical stimulation of the wrist and finger extensor muscles, has shown encouraging results for its clinical feasibility and utility in addition to functional tests.     

手部创伤患者应用桡动脉掌浅支腕横纹游离皮瓣修复的临床效果观察

目的：探讨手部创伤患者应用桡动脉掌浅支腕横纹游离皮瓣修复的临床效果。方法回顾性分析我院2010年7月～2013年3月收治的20例（20指）手部创伤患者[男性14例,女性6例;年龄18～49岁,平均（33.8±12.5）岁]进行桡动脉掌浅支腕横纹游离皮瓣修复的临床资料,参照美国手外科推荐的系统评定方法评定屈伸肌腱疗效。结果术后对20例患者进行随访观察,随访6～12个月,平均（8.7±1.4）个月。有2指发生感染,2指皮瓣出现局部坏死,经过换药和对症处理后皮瓣均存活,感染得到控制;其余16指皮瓣外观良好,肿胀程度较轻,色泽与原手指皮肤接近。随访中：20指上皮化全部成功,X线检查骨折愈合良好;1指指甲再生缓慢,2指钩甲畸形,2指伤口恢复后触感觉较健侧迟钝。所有伤指在骨折及伤口愈合后经过适当的功能锻炼,手指关节活动均良好。所有患者在第6个月时进行手功能评价,优14例（70％）、良3例（15％）、中3例（15％）。结论手部创伤患者应用桡动脉掌浅支腕横纹游离皮瓣修复简便易行,术后患者皮瓣存活率高,手功能恢复好。