选用不同品牌、型号注射器对微量注射泵用药精度的影响

目的:证实在日常护理操作中选用不同品牌、型号注射器对微量注射泵用药精度的影响.方法:应用临床医学工程学实验及医学循证的方法加以实证.结果:通过模拟实际临床使用环境,并经实验及医学循证证实不同品牌、型号注射器对微量注射泵用药精度确有影响.结论:微量注射泵用药是一个由环境条件、应用材料、操作人员素质、患者状况等多个系统构成的综合平台,选用不同品牌、型号注射器会影响微量注射泵用药精确度及安全实效性.     

微量注射泵流速的质量控制研究

通过对微量注射泵进行质量控制检测,研究注射管路和注射器规格等对微量注射泵流速的影响,提出在实际应用中减小这些影响的措施,以保证微量注射泵在临床治疗中的应用安全。     

微量注射泵药物输注动力学的研究进展

近些年,微量注射泵在许多临床科室被日益广泛应用,尤其在各种危重病人的抢救治疗中,其重要性日益得到重视,但由于微量注射泵本身固有的缺陷以及静脉注射的外联设备等诸多因素影响,时常在药物注射过程中出现输注动力学改变,国外对于微量注射泵的药物输注动力学已经进行了多年的深入研究,研究的领域涉及微量注射泵的启动延迟、阻塞报警延迟、输注速度和剂量的波动,以及上述变化的相关影响因素,并初步探索了相应的临床对策。但此项研究在国内未受到重视,本文对国外的研究进展进行综述。     

史密斯注射泵高低阻塞报警的调整

目的：通过改变微量注射泵的阻塞报警阈值,确保临床微量注射用药的安全。方法：通过分析微量注射泵的设计得到产生阻塞报警的原理,对于不同类型的微量注射泵应用不同的调试方法,改变影响报警阈值的因素,达到改变报警阈值的目的;结果：经设备剂量检测调试后的微量注射泵95％能达到规定的安全值,极少数微量注射泵需进行不同的处理,以满足临床应用安全。结论：改变注射泵的报警影响因素可以达到改变报警阈值的目的。     

一次性使用无菌注射器对微量注射泵的误差分析

本文介绍了一次性使用无菌注射器现状、存在的问题及解决方法,并分析了一次性使用无菌注射器对微量注射泵形成的误差。     

液体喷射注射器机械性能评价试验

从喷射注射的穿透性能、喷射完全度和扩散性能三个角度出发，对研发的液体喷射注射器分别进行了穿透压强测试、对具有一定硬度不同厚度的硅胶进行喷射注射以及对一定硬度的凝胶进行喷射注射．并与国外同类产品进行了实验对比。测试实验表明，自制液体喷射注射器具有与国外同类产品相一致的机械性能．所构建的穿透性能、注射完全度和注射扩散度评价能反映液体喷射注射器注射的有效性。     

论微量注射泵的故障诊断与维修

微量注射泵是临床常用的输液装置之一，是将药物用微量注射泵输送到患者血管内，以达到输液治疗目的。微量注射泵可以在输液过程中起到准确控制输注药液滴数的作用，可大大提高临床静脉用药的效果，对于危重患者来说，微量注射泵是抢救生命的必备工具。因此当微量注射泵发生故障，很可能引发医疗事故，而为了尽可能预防事故发生，日常工作中应当对微量注射泵进行故障诊断与维修。针对该项工作本文以JMS注射泵为例展开相关研究。JMS注射泵是一款微量注射泵，是一种精度非常高的输液装置，主要用于静脉给药。它的工作原理是通过电子脉冲信号驱动丝杆泵，在输液管道内形成一定压力，将药液或药物等液体以一定的速度通过导管输送到血管中。该技术被广泛应用于临床治疗中，给患者带来了良好的治疗效果。但是，在实际使用过程中，由于操作者技术不到位或者其他原因，JMS注射泵很容易发生故障。围绕该注射泵，研究首先介绍了微量注射泵的基本原理，其次提出了常见故障诊断、处理方法，最后给出了预防故障建议。     

注射器种类对注射泵应用质量影响的试验研究

目的:本研究旨在评估不同品牌注射器对注射泵应用质量的影响。方法:将贝朗8714843型注射泵分别与10ml贝朗、洁瑞、新津牌注射器和50ml贝朗、洁瑞、玉升牌注射器配合使用,检测其实际流速,对比结果。结果:使用10ml非贝朗注射器时,流量误差严重超标,分别为7.30%和-14.14%。使用50ml非贝朗注射器时,准确度变化较小,平均误差分别为0.23%和-1.15%。结论:注射器种类对注射泵应用质量的影响不可忽视,在临床使用中应慎重选择。     

陕西省农村基层安全注射现状调查分析

为了解陕西省基层安全注射现状,采用分层多阶段随机抽样法,对陕西省6个地区(市)所辖6个县(区,市)30个乡(镇)180个村的乡村医生调查,发现陕西省乡村级预防接种和临床治疗中以玻璃注射器和一次性注射器混合使用为主(分别占54.8%和59.0%);预防接种和临床治疗采用多人一管注射的分别占44.3%和9.1%;在玻璃注射器灭菌中,水冲洗或浸泡、酒精棉擦拭方式分别占16.9%和42.7%;在一次性注射器处理中,重复使用和丢弃分别占1.3%和18.9%;有36.4%～74.0%的乡村医生不清楚计划免疫针对传染病和常见传染病传播途径及其危害性;认为多人一管不会有问题的占26.7%,接种人数多或缺少注射器时,可进行只换针头方式注射的占33.9%～61.7%.提示在陕西省基层预防接种和临床治疗中都应注意玻璃注射器和一次性注射器的安全注射问题;多人一管注射方式,水冲洗或浸泡、酒精棉擦拭灭菌玻璃注射器,反复使用和丢弃一次性注射器等是非安全注射的主要因素;乡村医生安全注射知识水平及责任心,特别是对不安全注射引起传染病及危害性后果的认识亟待进一步培训提高;对一次性注射器使用后统一回收或在包装上注明"严禁重复使用"是防止不安全注射的方法之一.     

微量泵在糖尿病酮症酸中毒中的临床应用

目的:探索微量注射泵与静脉滴注治疗糖尿病酮症酸中毒的临床疗效.方法:选取2017年9月~2019年11月在本院治疗的糖尿病酮症酸中毒患者72例为观察对象,分为两组.微量注射泵组(实验组)38例患者,采用微量注射泵注射胰岛素方案治疗;静脉滴注组(对照组)34例患者,采取静脉滴注胰岛素方案治疗.比较两组患者的临床疗效以及各项指标的变化情况.结果:①经过治疗发现微量注射泵组患者的总有效率对比静脉滴注组具有明显优势,P<0.05.②经过治疗发现微量注射泵组患者血酮转阴时间短、住院时间少、血糖达标时间短及维持胰岛素量小对比静脉滴注组具有明显优势,P<0.05.结论:采用微量注射泵的方式注射胰岛素治疗糖尿病酮症酸中毒效果确切,对比临床疗效及各项指标等方面有明显的优势.     

Effects of increasing syringe availability on syringe-exchange use and HIV risk: Connecticut, 1990–2001

Syringe-exchange programs (SEPs) in Connecticut operate with caps on the number of syringes exchanged per visit. We investigated the effects of legislation increasing the cap on drug injectors' access to clean syringes through the SEPs in New Haven and Hartford. The mixed design of this study included longitudinal and crosssectional data from individuals and ecological data from program operations. Five parameters—syringe return rate, syringes per visit to the SEP, syringe reuse rate, syringe human immunodeficiency virus (HIV) prevalence, and syringe sharing—were monitored through syringe tracking and testing of SEP syringes and by interviewing injectors. Two increases in the cap—from 5 to 10 and then from 10 to 30—had little effect on the five parameters that measured injectors' access to clean syringes. In contrast, access to clean syringes increased when the New Haven SEP first began operations, when syringes first became available at pharmacies in Hartford, and when the agency running the Hartford SEP changed. Legislation providing piecemeal increases in the cap may not, by themselves, be sufficient to increase injectors' access to clean syringes and decrease the risk of human immunodeficiency virus transmission in this population.     

The Washington Needle Depot: fitting healthcare to injection drug users rather than injection drug users to healthcare: moving from a syringe exchange to syringe distribution model

Needle exchange programs chase political as well as epidemiological dragons, carrying within them both implicit moral and political goals. In the exchange model of syringe distribution, injection drug users (IDUs) must provide used needles in order to receive new needles. Distribution and retrieval are co-existent in the exchange model. Likewise, limitations on how many needles can be received at a time compel addicts to have multiple points of contact with professionals where the virtues of treatment and detox are impressed upon them. The centre of gravity for syringe distribution programs needs to shift from needle exchange to needle distribution, which provides unlimited access to syringes. This paper provides a case study of the Washington Needle Depot, a program operating under the syringe distribution model, showing that the distribution and retrieval of syringes can be separated with effective results. Further, the experience of IDUs is utilized, through paid employment, to provide a vulnerable population of people with clean syringes to prevent HIV and HCV.     

Spatial Access to Sterile Syringes and the Odds of Injecting with an Unsterile Syringe among Injectors: A Longitudinal Multilevel Study

Despite the 2010 repeal of the ban on spending federal monies to fund syringe exchange programs (SEPs) in the USA, these interventions—and specifically SEP site locations—remain controversial. To further inform discussions about the location of SEP sites, this longitudinal multilevel study investigates the relationship between spatial access to sterile syringes distributed by SEPs in New York City (NYC) United Hospital Fund (UHF) districts and injecting with an unsterile syringe among injectors over time (1995–2006). Annual measures of spatial access to syringes in each UHF district (N = 42) were created using data on SEP site locations and site-specific syringe distribution data. Individual-level data on unsterile injecting among injectors (N = 4,067) living in these districts, and on individual-level covariates, were drawn from the Risk Factors study, an ongoing cross-sectional study of NYC drug users. We used multilevel models to explore the relationship of district-level access to syringes to the odds of injecting with an unsterile syringe in >75% of injection events in the past 6 months, and to test whether this relationship varied by district-level arrest rates (per 1,000 residents) for drug and drug paraphernalia possession. The relationship between district-level access to syringes and the odds of injecting with an unsterile syringe depended on district-level arrest rates. In districts with low baseline arrest rates, better syringe access was associated with a decline in the odds of frequently injecting with an unsterile syringe (AOR, 0.95). In districts with no baseline syringe access, higher arrest rates were associated with increased odds of frequently injecting with an unsterile syringe (AOR, 1.02) When both interventions were present, arrest rates eroded the protective effects of spatial access to syringes. Spatial access to syringes in small geographic areas appears to reduce the odds of injecting with an unsterile syringe among local injectors, and arrest rates elevate these odds. Policies and practices that curtail syringe flow in geographic areas (e.g., restrictions on SEP locations or syringe distribution) or that make it difficult for injectors to use the sterile syringes they have acquired may damage local injectors’ efforts to reduce HIV transmission and other injection-related harms.     

注射器和输液泵的匹配问题

讨论了恒速输液泵与注射器之间的匹配问题,对同一输液泵使用13个品牌注射器的实际泵速进行了比较,证明使用非指定注射器可能导致泵注速度较大的误差,给临床及科研工作造成不良影响,认识并重视该问题是目前可行的规避手段。     

推广自毁式一次性注射器的政策可行性

课题研究证明，用自毁式一次性注射器取代普通一次性注射器具有良好的成本效果，在经济上是可行的。对医务人员、注射器生产厂商、消费者和卫生行政管理人员进行了利益相关分析，证实了这种策略也具有可行性。并对推广自毁式一次性注射器提出了具体政策建议。