海警某基层单位医疗保障现状与需求调研

 目的 了解海警某基层单位医疗保障的现状与需求,为海警医疗建设提供科学参考依据。方法 2018-10至2019-04,便利抽样法选取3个海警基层单位行政管理人员作为调查对象,采用自制的《海警医疗保障状况与需求信息采集表》对其进行问卷调查。利用构成比和选择率进行相关统计分析。结果 本次调查共3个单位270名人员,男250名,女20名,年龄23~49岁,工龄1~32年,学历专科25.6%,本科72.6%,硕士1.9%,职务分布范围广。95.2%的人员认为拥有医疗应急预案和卫生信息化建设装备,但是大多数属于不完善状态。19.0%的人员认为拥有舰艇-岛礁-岸基三级救治平台, 78.7%的人员认为应该加强医疗体系建设,95.2%的人员认为执行任务时舰船需要配备卫生救援人员;对于医疗信息化建设的需求和医学远程会诊和急救指导的需求几乎达到100%。结论 海警某基层单位医疗保障现状不理想,分任务分类别准备预案,加强医疗信息化建设,加强梯队和救治平台建设都是下一步需要加强的方向。     

突发公共卫生事件情况下护航官兵口腔疾病诊治需求及应对措施

目的通过分析突发公共卫生事件情况下护航行动期间官兵口腔疾病的诊治需求, 了解海上口腔疾病处置特点, 并分析应对措施, 为后续护航口腔医疗保障人员提供参考、为提高海上口腔卫生保障能力提供依据。方法记录并分类统计护航期间舰员的不同口腔疾病及处置措施。结果护航期间就诊率最高的口腔疾病为牙结石阳性、龋病、溃疡、智齿冠周炎、楔状缺损、残根残冠;最多的海上口腔诊疗处置手段为牙体充填术、超声洁治术;引起海上口腔急诊的疾病主要是智齿冠周炎、急性牙髓炎、急性根尖周炎。结论突发公共卫生事件情况下护航期间官兵口腔诊疗需求大, 以龋病、牙周疾病、智齿冠周炎为主, 需加强任务期与非任务期口腔卫生保障力度。     

海警"一张图"卫勤决策支持系统设计

海警队伍是我国海上维权执法的新质力量.围绕远海有效维权、近海高效执法的任务定位,提升卫勤保障能力是海警建设的重要内容,而科学有效的卫勤决策是提升卫勤保障能力的关键[1,2] .随着大数据、人工智能、云计算、物联网等技术的不断发展,社会加速进入智能化建设时代,利用信息化、智能化技术手段,将多源信息融合于"一张图",是为管...     

我国海上舰艇官兵疾病谱的Meta分析

 

目的 对我国海上舰艇官兵疾病谱数据进行汇总,并运用Meta分析的方法计算出我国海上舰艇官兵的发病率,为海上舰艇官兵的卫勤保障工作提供循证依据。方法 检索中国知网(CNKI)、万方数据(WanFang Data)、重庆维普(VIP)、Web of Science、PubMed、Medline、Embase等数据库中有关我国海上舰艇官兵疾病谱的文献,使用RevMan5.3、Stata16.0软件对海上舰艇官兵疾病的发生率进行合并,检验异质性并选择相应的效应模型,采用Egger检验评估各文献发表偏倚。结果 共计3篇文献纳入研究,样本合计1295人,Meta分析结果显示,各系统疾病发病率排名前6位的是呼吸系统疾病(44.30%),损伤、中毒或外因的某些其他后果(22.48%),皮肤疾病(20.30%),眼耳鼻喉口腔疾病(18.82%),消化系统疾病(18.04%),肌肉骨骼系统或结缔组织疾病(13.51%)。结论 卫生部门应根据官兵发病情况,在任务前期,重点关注呼吸系统疾病,合理调配医疗资源,确保官兵圆满完成各项任务。

     

完善医院船海上医院人员组成的几点思考

中国海军首次组织医院船赴国外执行人道主义医疗服务,是对海军实行多样化军事任务、锻炼提高综合保障能力的实际检验.海上医院承担着应急作战海上卫勤保障、多样化军事行动卫勤保障、突发公共事件医疗保障、远海护航舰队官兵医疗服务保障的重要任务,医务人员应提高思想觉悟和思想认识,牢固树立服务医院、热爱医院、献身国防的意识.     

巴基斯坦洪灾皮肤病病谱分析

目的分析巴基斯坦洪灾期间患者皮肤病疾病谱、发病特点和规律,为今后在国际洪灾救援中合理配备医疗资源提供依据。方法回顾分析洪灾就诊患者资料,建立疾病谱,统计各类皮肤病发病例数及构成比。结果共调查患者1326例,疾病谱显示各类皮肤病均有不同程度发生,而高发皮肤病的类别及病种相对集中,居前三位的疾病类别依次是:变态反应性皮肤病548例(41.3%)、细菌感染性皮肤病388例(29.3%)、真菌感染性皮肤病202例(15.2%)。居前三位的疾病依次为皮肤瘙痒症228例(17.2%)、脓疱疮214例(16.1%)、湿疹205例(15.5%)。结论巴基斯坦洪灾过后皮肤病相对集中在某几类中某些疾病上,救援时应根据皮肤病疾病谱的变化,优化合理配置人员、药品及场地,以保证迅速高效完成医疗救援任务。     

某校毕业阶段医学生海上训练课程期间睡眠质量调查分析

目的分析某校毕业阶段医学生参加海上训练课程期间(校园准备阶段、海上训练阶段)的睡眠质量。方法采用匹兹堡睡眠质量指数量表(PSQI)对某校493名毕业阶段医学生进行睡眠质量调查, 校园准备阶段由各组调查者于2019年5月8日-10日在校内利用班会时间统一发放问卷并回收, 海上训练阶段由各组调查者于海上训练结束当天(2019年5月20日)在船舱发放问卷并回收。结果海上训练课程期间, 医学生校园准备阶段及海上训练阶段的PSQI得分分别为(6.59±2.46)分和(6.64±3.09)分, 2个阶段的睡眠障碍检出率分别为28.82%和34.15%, 差异无统计学意义(χ2=2.821, P=0.093);校园准备阶段主观睡眠质量、睡眠效率、睡眠障碍因子得分低于海上训练阶段, 睡眠时间因子得分高于海上训练阶段, 差异有统计学意义(P<0.001)。结论毕业阶段医学生参加海上训练课程期间睡眠质量问题较为普遍, 应高度重视学生的睡眠质量, 保证海上训练顺利进行。     

海警医务人员紧急救护知识与技能培训模式探讨

 目的 探讨海警医务人员紧急救护培训内容与模式,为海警医务人员培训体系构建提供参考,以期提高海上现场紧急救治能力。方法 选取2019年5月参加短期培训班的100名海警医务人员作为研究对象,对其开展封闭式、系统性紧急救护知识技能培训与考核,比较培训前后理论知识与实践技能考核成绩。结果 100名参训人员紧急救护理论知识和实践操作技能成绩均显著提高,培训前理论知识与实践技能成绩分别为77.95±7.15、6.59±1.24,培训后成绩分别提高到85.27±5.76、7.67±0.89,所有参训人员认为通过此次短期培训有所收获。结论 开展短期封闭式系统培训是提升海警医务人员保障能力的有力举措,培训效果显著,建议推广应用。     

驻新疆武警官兵2012—2016年新发肺结核住院情况分析

 目的 对驻新疆武警部队2012－2016年新发肺结核住院病例进行调查,观察5年来患者发病趋势及人群特点,为指导区内部队有效开展结核病防控提供依据。方法 收集驻新疆某总队医院2012-01至2016-12感染科确诊142例肺结核病例官兵患病资料,对符合条件病例按出院顺序逐人进行统计,剔除已确诊再次入院复查患者,完成全部病例登记后,再以年度为顺序,对季度、年度病例进行统计分析,对发病时间及特征人群进行分析。结果 142例中,男141例(99.3%),女1例(0.7%);年龄19~44岁,义务兵72例(50.7%),士官59例(41.5%),干部10例(7.0%)。新发肺结核类型主要是继发性肺结核75例(52.8%),其次为结核性胸膜炎67例(47.2%)。患者治疗依从性良好99例(69.7%),依从性欠佳43例(30.3%)。疗程结束后达到临床治愈的69例(48.6%),显著有效39例(27.5%),有效29例(20.4%),因退伍失去随访无法评价疗效5例(3.5%)。结论 应重点针对义务兵和士官人群做好部队结核病防治知识教育,同时要加强南疆驻村武工队,火车站、要道设卡执勤等驻村工作队人员防控。疾病在全年之中呈散发,每年第二、第三季度相对高发,应加强对高发时段的防控。     

军队医院内科技术与战时疾病诊治结合研究

1战时内科疾病保障任务与特点(1)内科保障任务:军队医院内科担负着战时内科疾病诊治和平时抢险救灾等重大任务。在平时做好准备的情况下,把内科战时的诊疗技术训练,作为战备训练的主要任务来完成,先后把战时容易群发的感冒、肠炎、痢疾和疟疾等10多种疾病的预防、治疗制定成内科疾病治疗常规,供内科医师岗位训练。(2)战时内科疾病特点:一是内科疾病常合并外科疾病,多为复合性多科性疾病并存,诊治时要全面分析,综合治疗;二是诊治环境不同,战时医疗环境相对简单,条件有限,需要具备在恶劣环境下诊治内科疾病的能力;三是辅助检查受限,战时很难提供较全面的辅助检查,主诊医师需有丰富的内科临床经验和较强的综合判断能力;四是群发性,战时如感冒、肠炎、痢疾及疟疾等内科疾病常为群发,因条件有限,隔离较为困难,因此早期诊断和治疗至关重要。2平时内科诊疗技术在战时的应用(1)战时内科疾病诊治的高技术性:现代战争的突发性、残酷性、全方位性及高科技性,给内科治疗带来了难以想像的困难。平时应注重培养内科医师的应急抢救能力,尤其是残酷环境下,如何处理内科疾病,如核战争、细菌战、化学战、心理战和微波武器等高科技战争对内科疾病的影响应有充分认识,军队医院内科危...     

Extent and etiology of aeromedical duty restrictions at a U.S. Coast Guard air station.

Aircrew are subject to flight and duty restrictions for various health-related problems. The major classifications of aeromedical limitations in the US Coast Guard are: Fit For Limited Duty (FFLD), fit for Duty Not Involving Flying (DNIF), and Sick In Quarters (SIQ). I studied the etiology and distribution of these restrictions among aircrew at a busy Coast Guard Air Station. Data were collected over a 6-month period from personnel Health Records and various medical reporting systems. A total of 391 health care episodes among 179 (56.6%) flight crew resulted in 1,961 days of flight/duty restriction. There were 1,349 (68.8%) days of DNIF, 439 (22.4%) days of FFLD, and 173 (8.8%) days of SIQ. The annual crude rate of restrictions per flight crew is 12.4 d. The most common causes for flight or duty restriction were infectious diseases of the respiratory and gastrointestinal tract and musculoskeletal problems. In conclusion, aeromedical flight/duty restrictions are substantial and have impact on flight crew availability.     

Use of sentinel health events (occupational) in computer assisted occupational health surveillance

The U.S. Coast Guard has developed a Coast Guard-wide comprehensive system for surveillance of workplace diseases. The American Medical Association's fifth edition of the Current Medical Information and Terminology (CMIT) was used as a reference to expand the basic list of 50 Sentinel Health Events (Occupational) [SHE(O)] published by the National Institute of Occupational Health and Safety (NIOSH), September, 1983. The expanded list of 107 sentinel events serves as a framework for the development of a computerized system of occupational health surveillance in the U.S. Coast Guard. This application of SHE(O) surveillance can have application in the early detection and prevention of environmental diseases.     

Statewide air medical transports for Massachusetts

In 1997, the Massachusetts Department of Public Health (MDPH) established a process to centralize air medical transport information. This database is one of the first statewide, population-based sources for civilian rotary-wing air medical transports (U.S. Coast Guard, police, and military missions are not included). The purpose of this database is to facilitate MDPH review of air medical transport service utilization, with input from a multidisciplinary committee. This article discusses the challenges in producing uniform data from multiple service submissions and presents aggregate "baseline" utilization information for 1996. These data served as a starting point for later studies using data linkage. This indexed article is the first to report statewide, population-based data for all types of air medical helicopter transports. The only other indexed "statewide air medical transport" paper focused on scene transports to trauma centers in Pennsylvania. A previous article by the authors in the July-September 2000 Air Medical Journal provided an overview of air medical transports for fatal motor vehicle crashes for 1 region of the state.     

Health and hygiene support for the troops]

As for prophylactic work, the main efforts of medical service were oriented to the reduction of non-combat medical losses. Prophylactic and current control was conducted taking into account the environmental conditions of the area. The authors make a conclusion that medical service at the initial stage of its activities was not properly ready to accomplish a variety of hygienic missions. It was especially difficult to carry out prophylactic measures aimed at the prevention of diseases and health states which were caused by specific environmental factors.     

Sixteen years with the Danish Search and Rescue Helicopter Service

The Danish helicopter rescue service in its present form was founded in 1966. The use of the Sikorsky (S-61) helicopter has generally been satisfactory. In 1973, the crew was supplemented by an aerospace-medically-educated and helicopter-trained physician. From 1973 to 1989 there were 5,733 missions, of which direct medical intervention occurred in 2075 cases; 94% of the missions supported the civilian public health service in Denmark. Many sorts of diseases and injuries have been seen, but especially trauma, abdominal, and cardiopulmonary diseases. Experience has shown the benefit of having a designated physician, specially trained in aerospace medicine and acute medicine/surgery, as a permanent crewmember.     

某大型水面舰艇远航期间疾病谱调查分析

目的:探讨大型水面舰艇远航期间官兵疾病发生特点和规律,提出针对性预防措施,为未来更好地执行远航卫勤保障任务奠定基础。方法:回顾性分析某舰艇医疗组在远航期间门诊、急诊及巡诊期间的伤病记录资料,根据记录信息将疾病按不同专科进行分类,分析远航官兵疾病分布特点和规律。结果:远航81 d,549人参与远航任务,共673例次伤病诊断结果纳入研究。其中呼吸系统、创伤\运动损伤、消化系统疾病位于系统发病的前3位,占发病总例次的70.58%;上呼吸道感染、手外伤和口腔溃疡分别占21.86%、5.65%和5.28%;需要手术及深度医疗的疾病发生率较高(24.59%),且以外伤和感染性疾病为主,集中于运动系统和消化系统。结论:远航期间官兵的疾病谱可能与舰艇生活环境、个人体质、远航生活经验以及性别相关;疾病防控应注意卫生宣教和环境消毒,尤其注意感染性疾病的预防,必要时建立个人卫生档案和疾病预警制度;同时,卫勤保障人员和卫勤物资的配备应与远航疾病谱的发生特点和分布规律相适应。