消毒灭菌教育对碘酊与乙醇瓶污染的效果观察

目的消毒灭菌教育对碘酊、乙醇瓶口内壁污染的效果.方法 2003年加强对盛消毒液容器的消毒灭菌教育,并分别对教育前(2002年1～12月)与教育后(2003年1～12月)本院12个科室的治疗室、换药室的碘酊、乙醇瓶口内壁细菌污染情况进行对比研究.结果教育前容器污染率为13.82%,教育后为3.28%,差异有显著性意义(P＜0.01).结论加强消毒灭菌教育,采取有效措施可减少碘酊、乙醇瓶口污染的发生.     

碘酊乙醇棉签擦拭瓶盖的数量及放置时间对消毒效果的影响

目的 探讨2％碘酊、75％乙醇棉签安全消毒瓶盖的数量及消毒后安全放置的时间。方法 将0.9%氯化钠注射液（500ml)180瓶扮为6组，每组30瓶，均用1根碘酊棉签消毒、1根乙醇棉签脱磺，连续消毒6个瓶盖，分别取样行细菌培养。另取同样液体150瓶，分为A、B、C、D、E5组，每组30瓶，1根碘酊、乙醇棉签消毒1个瓶盖，分别于消毒后放置0．5、1、2、4、6min取样行细菌培养。结果 1根碘酊、乙醇棉签连续消毒至第4个瓶盖时污染数明显增加（P＜0．05）。消毒后放置4min时污染数明显增加（P＜0．05）。结论 1根2％碘酊、75％乙醇棉签连续消毒3个瓶盖，消毒后放置2min最为安全。     

介绍一种放置碘酊、乙醇瓶的固定架

在临床护理操作中，一般采用胶布将乙醇、碘酊瓶进行“8”字固定，以便携带。但随着现代医学的迅速发展，这种固定方法已经不符合医院感染管理要求。鉴此，笔者自行设计了一种放置乙醇、碘酊瓶的固定架，临床使用1年多，效果满意，介绍如下。     

介绍一种放置碘酊、乙醇瓶的固定架

在临床护理操作中,一般采用胶布将乙醇、碘酊瓶进行“8”字固定,以便携带。但随着现代医学的迅速发展,这种固定方法已经不符合医院感染管理要求。鉴此,笔者自行设计了一种放置乙醇、碘酊瓶的固定架,临床使用1年多,效果满意,介绍如下。1材料与制作方法材料:厚度2mm铝板,镀锌半圆头螺栓(M3×6)和镀锌螺母(M3)各2个。制作方法:①制作固定架。用长102mm、宽110mm铝板,在宽边中点(55mm)处划平行线,平行于沿线折成90直角,制成长102mm、宽和高分别为55mm的固定架,在架高39mm与宽的中线左、右各8mm处钻直径为3mm孔2个。②制作固定带。将长268mm、宽…     

乙醇酒精与空气消毒机对病房遥控器消毒的效果观察

目的:探讨乙醇酒精及空气消毒机对病房遥控器消毒效果.方法:2011年6月～2001年12月对病房遥控器表面用95％乙醇反复擦拭消毒和空气消毒机的消毒效果进行对照研究.结果:两种消毒方法差异没有统计学意义.     

医院消毒灭菌监测管理方法的改进

目的回顾性总结医院消毒灭菌效果监测结果,为控制医院感染的发生提供依据。方法对使用中的消毒液、无菌物品、物体表面、工作人员的手和空气消毒灭菌效果监测合格率进行统计分析,对存在的问题采用监测-反馈-教育-整改-监测的管理方法进行系统管理。结果监测采样共5234份,消毒灭菌监测合格率97.1%;1997~2003年各项消毒灭菌合格率呈逐年增高趋势,整改前、后合格率比较,差异有显著性意义(P<0.01)。结论监测-反馈-教育-整改-监测的管理方法是控制医院感染的有效措施。     

过氧乙酸与乙醇消毒听诊器听筒效果比较

目的比较过氧乙酸与乙醇消毒听诊器听筒的效果。方法将发热门诊60例发热待查患者听诊胸肺部后的60个听筒随机分为对照组与观察组各30个,分别用0.5%过氧乙酸棉球擦拭消毒和75%乙醇棉球擦拭消毒。两组听诊器听筒于消毒前、消毒后晾干由操作者取样本放入无菌试管内送细菌培养。结果观察组听筒消毒后细菌菌落数和病原菌污染阳性率显著低于对照组（均P〈0.01）。结论以0.5%过氧乙酸消毒听诊器听筒,灭菌效果优于75%乙醇。     

过氧乙酸与乙醇消毒听诊器听筒效果比较

目的比较过氧乙酸与乙醇消毒听诊器听筒的效果。方法将发热门诊60例发热待查患者听诊胸肺部后的60个听筒随机分为对照组与观察组各30个,分别用0.5%过氧乙酸棉球擦拭消毒和75%乙醇棉球擦拭消毒。两组听诊器听筒于消毒前、消毒后晾干由操作者取样本放入无菌试管内送细菌培养。结果观察组听筒消毒后细菌菌落数和病原菌污染阳性率显著低于对照组(均P0.01)。结论以0.5%过氧乙酸消毒听诊器听筒,灭菌效果优于75%乙醇。     

密封圈老化的脉动真空压力蒸汽灭菌器灭菌效果观察

目的:对密封圈老化的脉动真空压力灭菌器进行效果监测.方法:特嗜热腐肪杆菌芽孢菌片,按三点式分别放入更换密封圈前的脉动真空压力蒸汽灭菌器27锅次进行灭菌效果监测,按同样方法将更换密封圈后脉动真空压力蒸汽灭菌器27锅次进行灭菌效果监测,并将两组实验进行比较.结果:更换密封圈前灭菌嚣的灭菌合格率迭80%,更换密封圈后灭菌器的灭菌合格率为100%.结论:及时更换密封圈,保证良好的密封性能,才能保证灭菌效果合格.     

动微针联合域发或米诺地尔酊治疗雄激素性脱发的效果

目的 探究电动微针联合头皮营养敷料或米诺地尔酊在雄性激素性脱发（AGA）患者治疗中的应 用效果。方法 选取2020年9月-2023年7月我院皮肤科门诊收治的75例男性AGA患者为研究对象,随机分 为A组、B组、C组,每组25例。A组采用电动微针联合头皮营养敷料治疗,B组采用电动微针联合5% 米诺地尔酊治疗,C组采用5%米诺地尔酊单独外用治疗,比较三组临床疗效、并发症发生情况、毛发 密度与毛发直径。结果 B组治疗总有效率高于A组、C组（P ＜0.05）;B组、C组并发症发生率均高于 A组（P ＜0.05）;B组并发症发生率低于C组,但差异无统计学意义（P ＞0.05）;A组、B组治疗后毛发密 度、毛发直径均优于C组（P＜0.05）。结论 电动微针联合米诺地尔酊在促进毛发生长方面的效果最佳, 但米诺地尔酊的使用一定程度上会增加不良反应发生几率,为降低并发症发生风险,临床可根据患者情况 选择微针联合头皮营养敷料治疗方案,其治疗有效性及安全性均良好。     

Prevention of stress bleeding with ranitidine or pirenzepine and the risk of pneumonia

In a prospective, controlled, randomized trial of stress bleeding prophylaxis, 400 patients in a surgical intensive care unit received 50 mg pirenzepine (n = 200) or 200 mg ranitidine (n = 200) daily. The drugs were administered continuously via an intravenous line. The mean duration of the treatment was 3.9 days. Patients were included in the study if no long-term ventilation was expected. In patients with a stomach tube in place, the intragastric pH was determined every eight hours. Bleeding was defined as macroscopically visible. Along with stress bleeding, the development of postoperative pneumonia was documented. The intragastric pH was less than 4 significantly more often in patients treated with pirenzepine. In patients treated with ranitidine, six stress bleedings were observed, while in the pirenzepine group three bleeding episodes occurred. Seven of the nine bleeding patients were found to have a very high bleeding risk. In mechanically ventilated patients, a significantly higher risk of pneumonia was observed compared with non-ventilated patients (18.0% vs 2.7%). Fourteen of the 20 pneumonias occurred in patients treated with ranitidine. In ventilated patients treated with ranitidine, the pneumonia rate was 28.6%, while in the pirenzepine group the pneumonia rate reached only 9.1% (p less than 0.05). The increased frequency of pneumonia in patients treated with ranitidine appears to be caused by overgrowth of gram-negative bacteria in the stomach. Pirenzepine provides adequate protection against stress bleeding while also minimizing the danger of pneumonia caused by infection via the gastropulmonary route.     

大型综合医院中医科加床、调床隐患分析及防范对策

目的了解综合医院中医科加床、调床存在的安全隐患,为护理安全管理提供参考。方法对某大型综合医院中医科住院患者在加床、调床过程中存在的安全隐患进行回顾性总结,详细查阅病区每周、每月护理质量自查缺陷登记,归纳整理隐患内容,分析隐患发生原因,制订防范措施。结果因加床、调床引发安全隐患83起,居前3位的隐患是走廊无信号灯致液体滴空未及时更换液体或拔针（14．5％）、患者物品丢失（10．8％）、因走廊无固定氧气装置加床患者病情变化未及时处理（9．6％）。调床后相关项目未及时调整到位,如漏移床头卡、病例夹,漏改床头卡床号、治疗单床号、液体瓶上床号、静脉巡视单床号以及检验单、检查单床号等,发生率为2．4％～9．6％。结论综合医院中医科固定床位少,频繁的加床、调床存在诸多安全隐患。护理管理者应重视加床、调床存在的安全隐患,制订有效的安全防范措施,做好细节管理,杜绝差错事故发生,提高加床、调床患者的满意度。     

大型综合医院中医科加床、调床隐患分析及防范对策

目的 了解综合医院中医科加床、调床存在的安全隐惠,为护理安全管理提供参考.方法 对桌大型综合医院中医科住院患者在加床、调床过程中存在的安全隐患进行回顾性总结,详细查阅病区每周、每月护理质量自查缺陷登记,归纳整理隐患内容,分析隐患发生原因,制订防范措施.结果 因加床、调床引发安全隐患83起,居前3位的隐患是走廊无信号灯致液体滴空未及时更换液体或拔针(14.5%)、患者物品丢失(10.8%)、因走廊无固定氧气装置加床患者病情变化未及时处理(9.6%).调床后相关项目未及时调整到位,如漏移床头卡、病例夹,漏改床头卡床号、治疗单床号、液体瓶上床号、静脉巡视单床号以及检验单、检查单床号等,发生率为2.4%～9.6%.结论 综合医院中医科固定床位少,频繁的加床、调床存在诸多安全隐患.护理管理者应重视加床、调床存在的安全隐患,制订有效的安全防范措施,做好细节管理,杜绝差错事故发生,提高加床、调床患者的满意度.     

Dermabrasion of the skin: Prevention and/or treatment of hyperpigmentation

Dermabrasion of the face for multiple conditions requiring reconstructive surgery is still a valuable tool for the plastic and reconstructive surgeon. This article deals specifically with one of the most important complications, namely, hyperpigmentation.The specific effect of estrogens on hyperpigmentation and the manner of dealing with it by the use of hydroquinone ointment are discussed. Illustrative case histories and photographs are shown. The reversal of the hyperpigmentation caused by estrogens and treated by hydroquinone ointment are explained, and the conclusion is reached that this management leads to permanent satisfactory results.     

External circular fixation: a comparison of infection rates between wires and conical half-pins with threads outside or inside the skin

BACKGROUND: The purpose of this study was to evaluate if there is a difference in the rates of infection between Ilizarov wires and half-pins and between half-pins with threads outside and inside the skin in circular fixators modified by Catagni and Cattaneo. METHODS: Between May and December 2004, 218 patients with circular Ilizarov fixators for various orthopaedic indications who visited our Ilizarov clinic were subjected to a one-time evaluation of half-pins and wires. RESULTS: A total of 1,093 half-pins were checked and 34 (3.11%) of these were infected (50% with threads outside and 50% with threads inside the skin). Among a total number of 951 wires (1,092 pin tracts) checked, 45 (4.73%) were infected. CONCLUSIONS: We conclude that the circular Ilizarov fixation with conical half-pins and wires has similar rate of infection compared with conventional Ilizarov circular fixator. Moreover, there is no difference in infection rates between pins with threads inside the skin as compared to those with threads outside the skin.     

Contamination of anaesthetic gases with nitric oxide and its influence on oxygenation

Editor—I read with interest the article by Hess and colleagues¹and its accompanying editorial by Marczin² on the effect ofadministration of compressed air (AIRc) or nitrous oxide onarterial in ventilated patients, in comparison with a control period where synthetic air (AIRs) was used. Theauthors attributed a higher to increased nitric oxide contaminating the former two mixtures. The difference in when receiving AIRc vsAIRs (0.5 kPa) was not clinically significant, as might be expectedgiven that the nitric oxide levels with AIRc were much smallerthan those used therapeutically to improve oxygenation. The increase in with nitrous oxide was much more significant (2.2 kPa or >15%). However, from the evidenceavailable, it