手术室感染来源与控制管理对策

手术室是对患者进行诊疗和抢救的重要场所,为确保手术安全,做好手术室预防感染工作至关重要,关系到患者预后及治疗效果。因此,为确保各类手术的成功,必须认真、严肃地对待医院手术室的感染管理工作。本文基于当前手术室感染来源的分析,对手术室感染控制提出几点管理对策。     

层流手术室手术部位感染的控制与管理

目的：探究手术室医院感染管理的措施，认识手术室手术部位感染控制与管理工作的重要性。方法通过制定手术室医院感染管理的规章制度，加强对手术室环境管理以及采取科学的方法来管理手术器械等措施，来对手术室手术部位感染进行控制与管理。结果实施了各项有利于手术室预防医院感染的措施，手术部位感染得到了有效的控制。结论重视手术室医院感染管理，才能保证手术的质量与安全。     

浅谈手术室感染的现状与对策

手术室是感染的高危科室之一,它担负着对病人进行手术和抢救急危重病人的任务。因此,其工作质量直接影响手术病人的预后及医院的医疗效果,感染严重者可以危及生命。为此,要控制手术感染,最重要的是建立、健全一整套手术室科学管理系统和管理对策,以确保手术安全,防止感染的发生。     

手术室在控制医院感染中的护理措施

为了降低手术室感染的发生率,加强对手术室医院感染工作认识的重要性,本文对我院手术室感染中存在的问题进行相应的分析,并给予采取相应的护理措施,来控制手术室感染的发生率,通过对手术室环境、一次性医疗用品、手术人员、患者、手术操作及手术废弃物给予相应的护理后,使得本院手术室感染得到有效的控制,各项指标均在正常范围内,确保了医院的护理质量与安全.     

浅谈手术室医院感染的控制和管理

手术室是感染的高危科室之一,是患者集中手术治疗的重要场所,最易引起交叉感染,手术室内部的环境,手术用品以及手术人员的工作质量将直接影响手术患者的预后及医院的医疗效果[1] .因此,预防和控制医院感染是手术室极为重要的环节,是手术室质量管理工作中不可缺少的部分,对提高医疗质量,确保手术安全有着十分重要的作用.我院手术室在医疗过程中,加强对医院感染的预防和控制,使医院感染管理取得了一定的成绩,现总结如下.     

基层医院手术室的感染控制与监测

目的探讨基层医院手术室感染管理存在的问题与改进措施。方法深入调查,提出基层医院手术室感染管理存在的问题,采取相应的对策和措施。结果加强手术室医务人员的培训和医院感染管理能有效地控制基层医院感染的发生。结论基层医院手术室的医院感染管理工作需进一步加强,各级人员必须加以重视,控制好手术室的医院感染,确保医疗护理质量与安全。     

手术室医院感染存在因素及控制对策

手术是医院治疗疾病的重要手段，手术室是实施手术的重要场所，也是医院感染的高危科室之一，它担负着对病人进行手术和急危重病人的抢救任务，其工作质量直接影响手术病人的预后及医院的医疗效果，手术室感染严重者可危及病人生命。当前手术室医院感染控制已成为手术室医护人员最重要的任务之一。我院自2003年以来，针对手术室医院感染的存在因素采取了一系列有效对策，现介绍如下：     

手术患者医院感染的预防与控制

目的：预防与控制手术患者手术后的医院感染，降低手术患者的医院感染发生率，确保手术患者的安全。方法：加强手术器械消毒供应质量管理、手术室内部的医院感染管理、临床科室对围手术期患者的管理、围手术期抗生素合理应用的管理及手术患者医院感染的目标监测五个方面的工作，多部门、多科室紧密协作，实行全过程质量控制。结果：通过全过程质量控制，降低了手术患者的感染率。结论：手术患者医院感染的预防与控制涉及多个层面，诸多环节，需要医院各相关部门、科室紧密协作，实行全过程质量控制。     

手术室感染的主要原因及对策

<正>手术室是医院的重要组成部分,也是院内控制交叉感染的重点之一,随着医学事业的迅猛发展和外科医疗手段的不断进步,一些新开展手术和高难手术的成功,对手术室的医院内感染管理提出了更高的标准和要求,因此,手术室的医院感染管理工作必须严肃认真,一丝不苟,为确保各类手术的成功奠定基础,最大限度地降低医疗护理纠纷的发生。本文就手术室的医院感染原因及管理对策探讨如下。     

手术室医院感染及控制对策

手术室是医院感染的高危科室，它担负对病人进行手术和急危重病人的抢救任务，其工作质量直接影响手术病人的预后及医院的医疗效果，感染严重者可危及病人的生命。避免手术室感染是保证手术成功的关键。现将我院手术室感染因素及控制对策讨论如下。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.