配药注射器有效使用时间的探讨

[目的]明确注射器启封后的有效使用时间。[方法]随机抽取10个临床科室用于启封后配制抗生素药液与非抗生素药液注射器100具，每隔1h采样培养做微生物鉴定。[结果]启封后配制抗生素药液的注射器5h内无细菌生长．7h内样本合格率为95．42％；配制非抗生素类药液注射器4h内无细菌生长，7h内样本合格率为81．43％。[结论]配药注射器使用有效时间为4h。但要注意配药环境、操作方法等因素的影响。     

一次性配药器和注射器抽吸药液效果比较

临床护士为病人输液配制药液时常规用一次性注射器抽吸药物，现行操作手法烦琐，费时费力。实用新型一次性配药器(专利号：ZL02213530．8)的出现，可以有效地解决这些问题。现将一次性配药器和注射器抽吸药液效果比较如下。     

一次性配药器的研制及应用

目的 设计和研制一次性配药器,以弥补用注射器配制药物的不足。方法 通过配药针内的空气和液体出入腔使液体瓶和药物瓶之间相互贯通,达到药物溶解或稀释后,再回流到液体瓶(袋)内,完成药液配制。结果 用注射器与配药器两种配药方法相比较,在减少操作环节、杜绝污染等方面,二者有较大差异。结论 配药器配药明显优于注射器配药。     

一次性配药器的研制及应用

目的设计和研制一次性配药器,以弥补用注射器配制药物的不足.方法通过配药针内的空气和液体出入腔使液体瓶和药物瓶之间相互贯通,达到药物溶解或稀释后,再回流到液体瓶(袋)内,完成药液配制.结果用注射器与配药器两种配药方法相比较,在减少操作环节、杜绝污染等方面,二者有较大差异.结论配药器配药明显优于注射器配药.     

负压自动吸液配药器

负压自动吸液配药器是配制静脉输液药液的辅助器具，用以取代传统的应用注射器抽注药液配制静点液的手工操作。1结构负压自动吸液配药器的基本原理与结构和电动吸引器相同，它包括电动吸气泵、负压瓶和导管3部分（附图）。连接在吸气泵和负压瓶之间导管，为橡胶导管。吸气泵、负压瓶及该段导管均不需无菌。连接在负压瓶与静脉输液瓶之间导管、及一端连接静脉输液瓶，另一端接吸药液导管。这两段导管均为一次性无菌塑料管，并带有无菌针头，可用一次性输液管代替。2应用方法工作时打开吸气泵，使负压瓶和静脉输液瓶产生负压，手持导管针柄端…     

静脉输液加药器的研制与临床应用效果评价

目的探索静脉输液加药的改良方法,提高工作效率。方法研制静脉输液加药器,对所加的液体分别进行无菌检查、内毒素检查、微粒检测,并与传统的注射器加药方式进行工作效率对比。结果用加药器配制药液的不溶性微粒明显少于注射器配制的药液(P<0.0001),根据对4种临床常用规格药物进行工作效率比较,可提高配液效率70%～240%(P<0.0001)。结论采用该静脉输液加药器加药明显优于传统的手工操作,具有配药时间短、无液体滴漏、操作简单方便等优点,减少了污染环节及机会。     

介绍一种一次性配药器

使用一次性注射器配药 ,按护理教科书的要求 ,操作者为避免药液污染 ,需一手固定安瓿和注射器 ,另一手拉动活塞柄 ,双手均不可触及活塞[1] 。此种方法费时费力 ,不易推广。因此 ,在实际工作中 ,大多数护士操作不规范 ,即用单手握注射器活塞抽吸药液 ,不仅污染了活塞 ,同时也污染了药液[2 ] ,增加了医院内感染和交叉感染的机会。为了提高工作效率、减少医院内感染 ,研制了一种一次性配药器。1　配药器的构成　　配药器由带有直管型腔体与椭圆形或圆球形气囊的软性塑料构成 ,其中直管形腔体的一端为连接注射针头的乳头。直管形腔体上标有容量…     

2种配药方法致密封瓶瓶塞碎屑脱落的比较

从密封瓶内吸取药物是护理人员最常见的操作之一，在操作中我们会遇到针头堵塞或瓶塞碎屑脱落到注射器针筒内。韩芳的2种配药方法比较中，传统的垂直配药方法针头堵塞率为16．04％，斜面法为5．25％，王丽霞等预防加药时针孔堵塞的方法致针头堵塞率为1．11％。张碧淦等采用垂直插人法致瓶塞碎屑发生率为19．33％，侧插人法为7．33％,斜面背侧加压法为1．33％。注射器针筒内混有瓶塞碎屑的     

YXQ—AI型药液吸引器的研制与使用

长期以来 ,临床上静脉给药前药液准备一直沿用手持针筒加药法。为了简化配液操作程序 ,我们研制出ＹＸＱ ＡＩ型药液吸引器 (产品注册号 :粤药管械 (准 ) 2 0 0 0第 2 5 40 0 5 0号 ;以下简称药液吸引器 )代替注射器配药 ,经临床使用效果满意。现介绍如下。1　产品结构与功能ＹＸＱ ＡＩ型药液吸引器主要由负压真空泵、贮液瓶、负压表等组成 ,外形美观小巧 (2 3ｃｍ× 15ｃｍ× 2 5ｃｍ) ,重量轻 (3ｋｇ)。配套管道 (制作材料与一次性输液器相同 )主要由 12号针头、吸液管 (有 3种 :一种有计量漏斗 ,控制药液摄入量的精确度在 1ｍｌ以上 ,容…     

配药注射器有效使用时间的探讨

[目的 ]明确注射器启封后的有效使用时间。 [方法 ]随机抽取10个临床科室用于启封后配制抗生素药液与非抗生素药液注射器10 0具 ,每隔 1h采样培养做微生物鉴定。 [结果 ]启封后配制抗生素药液的注射器 5h内无细菌生长 ,7h内样本合格率为 95 .42 %;配制非抗生素类药液注射器 4h内无细菌生长 ,7h内样本合格率为81.43 %。 [结论 ]配药注射器使用有效时间为 4h。但要注意配药环境、操作方法等因素的影响。     

The compatibility and stability of midazolam and dexamethasone in infusion solutions

The delivery of subcutaneous medication by continuous infusion is common in palliative medicine. Many centers combine multiple medications, but the analytical confirmation of the compatibility and stability of these combinations has rarely been performed. This study examined the compatibility and stability of midazolam and dexamethasone using high performance liquid chromatography. Nine different solutions were prepared in polypropylene syringes by combining these two drugs with 0.9% sodium chloride. When these two drugs were combined in a syringe, there was significant loss of midazolam over 48 hours, with only 60-80% of the initial concentration remaining in syringes stored at 35-39 degrees C. This study demonstrates that cloudiness of a solution is not the only predictor of drug loss and that drug loss may occur even in solutions that remain clear at time of preparation. The clinical implications of these results are that dexamethasone and midazolam should not be combined in syringe driver solutions.     

一次性输液器瓶塞穿刺针插入液体软包装袋胶塞位置的研究

目的探讨一次性输液器瓶塞穿刺针插入液体软包装袋胶塞的位置,防止静脉输液过程中顺管流液的发生。方法从住院的老年患者需要进行静脉输液的492例中随机抽取400例,分成实验组和对照组,实验组200例应用一次性输液器瓶塞穿刺针插入液体软包装袋胶塞的中心位置,并与对照组应用一次性输液器瓶塞穿刺针插入液体软包装袋胶塞加入药物的位置做对照,观察2组漏液情况。结果实验组和对照组漏液情况,数据经统计学处理,差异有显著性意义(P<0.05)。2组漏液率比较,实验组漏液率为0,而对照组漏液率为20%。结论一次性输液器瓶塞穿刺针插入液体软包装袋胶塞的中心位置方法简单,操作方便易行,避免药物的丢失,提高护理工作质量。     

皮肤发疱仪的研制与黑素细胞培养移植治疗白癜风

目的：进一步研制皮肤发疱仪．研究和观察局部皮肤发疱与黑素细胞培养后移植治疗白癜风的方法与效果。方法：采用从发疱壁上获取黑素细胞、纯黑素细胞培养与增殖、移植区刮除种植法、黑素细胞培养移植治疗白癜风。结果：25例白癜风患者中31块皮损进行了自体黑素细胞培养移植．总有效率为90％。结论：皮肤发疱仪临床应用效果好，操作方法较简单，黑素细胞培养后移植治疗白癜风面积大，色素分部均匀，值得临床推广和应用。     

A Cost Minimization Analysis of Ready-to-Administer Prefilled Sterilized Syringes in a Dutch Hospital

PurposePreparation errors occur frequently during conventional preparation of parenteral medication in the clinical environment, causing patient harm and costs for the national health care system. The use of ready-to-administer prefilled sterilized syringes (PFSSs) produced by the hospital pharmacy can reduce preparation errors and the risk of bacteremia from contamination of the intravenous medication. The aim of this research is to compare the total costs of the conventional preparation method (CPM) with the PFSS method.MethodsIn this cost-minimization analysis, costs related to the preparation of the medication, bacteremia from contamination, adverse drug events as a result of preparation medication errors, and wastage of syringes were taken into account. Annual costs in a general Dutch hospital were consistently calculated. Three scenarios were analyzed: (1) all preparations as CPM (864,246 administrations per year), (2) all preparations as PFSSs, and (3) 50% as PFSSs and 50% as CPM. Deterministic and probabilistic sensitivity analyses were performed.FindingsThe first scenario found higher annual costs at €14.0 million (US$16.0 million) compared with the second scenario (€4.1 million, US$4.7 million). The most realistic situation (third scenario) found savings of €4.9 million (US$5.6 million) compared with the first scenario. Sensitivity analyses revealed that cost savings of PFSSs were strongly influenced by decreased risk of medication errors and contamination of intravenous medication. Extrapolating these results nationwide indicated potential savings of >€300 million (US$342 million) if only PFSSs were used.ImplicationsThe use of PFSSs prepared in the hospital pharmacy yielded cost savings compared with the CPM on the ward in the Dutch hospital.     

Compatibility of haloperidol and hyoscine-<Emphasis Type="Italic">N</Emphasis>-butyl bromide in mixtures for subcutaneous infusion to cancer patients in palliative care

The administration of drugs by s.c. infusion is routinely practiced in palliative medicine for the management of patients who are no longer able to take oral medication. It is not uncommon for two or more drugs to be combined in s.c. infusion solutions. Unfortunately, the compatibility and stability of haloperidol and hyoscine- N-butyl bromide has not yet been determined. The objective of this study was to study the compatibility and stability of solutions containing both drugs in polypropylene syringes. Nine different solutions were assessed for up to 15 days following preparation. The solutions were prepared in polypropylene syringes with 0.9% saline as a diluent and stored at 4 degrees C and 25 degrees C. High-performance liquid chromatography was the analytical technique used to measure haloperidol and hyoscine- N-butyl bromide. The initial concentration ranges were 0.3125-1.25 mg/ml for haloperidol and 2.5-10.0 mg/ml for hyoscine- N-butyl bromide. Haloperidol was precipitated at a concentration of >/=1.25 mg/ml when it was combined with hyoscine- N-butyl bromide. Concentrations of hyoscine- N-butyl bromide lower than 10 mg/ml in mixtures with haloperidol or 0.625 mg/ml of haloperidol in mixtures with hyoscine- N-butyl bromide for s.c. infusion allow for the administration of both drugs without any significant loss after storage at 25 degrees C for periods of up to 15 days, with approximately >/=90% and 88%, respectively, of haloperidol and hyoscine- N-butyl bromide remaining. However, after storage of the mixtures for equivalent periods at 4 degrees C the losses of hyoscine- N-butyl bromide observed at the end of the study were higher than 20%, while the percentages of haloperidol remaining after 15 days at this temperature were >/=94.37%.     

Aseptic efficacy of prefilled syringes in a polluted environment

INTRODUCTION: To evaluate the aseptic efficacy of prefilled syringes compared with ampules when used in a polluted environment similar to that at a disaster site. METHODS: The researchers tested epinephrine, 0.1%, atropine sulfate, 0.05%, and lidocaine hydrochloride solutions, 2% (Group A) as well as lidocaine hydrochloride, 10%, sodium bicarbonate, 8.4%, and glucose solutions, 50% (Group B), that frequently are used for intravenous injection and intravenous infusion respectively in Disaster Medicine. Each of these solutions in 10 prefilled syringes (PFSs) and 10 ampules was placed in a box of contaminated soil along with needles and empty syringes for ampules. In the box, each was taken out of its package, all syringes were connected with a needle, and empty syringes were filled with a solution. After this procedure, all syringes were taken out of the box to check their contents for bacterial contamination. RESULTS: No bacterium was observed in any of the 10 PFS samples of Group A and B solutions. In contrast, out of 10 ampule samples, six of the 10 samples containing epinephrine, nine of the 10 containing atropine sulfate, all 10 samples containing lidocaine hydrochloride, 2%, and all of the ampule samples containing Group B solutions tested positive for bacteria. A statistically significant difference was observed between the PFS and ampule samples in all six solutions. CONCLUSION: Results indicate that, in environments with airborne contaminants, the use of prefilled syringes may be useful for preventing bacterial contamination of the medicine inside.     

改良吸痰术的临床应用效果

目的观察改良吸痰术的临床应用效果。方法便利抽样法选取2010年6月至20u年6月在兰州总医院收治的人工气道患者56例为研究对象,按人院先后将其分为观察组和对照组,观察组患者采用改良吸痰术,对照组患者采用传统吸痰术,比较两组患者吸痰操作准备时间,以及两组患者吸痰前、吸痰即时、吸痰后即时血氧饱和度值、吸痰后血氧饱和度恢复时间和吸引接头细菌培养结果。结果两组患者吸痰前血氧饱和度的差异无统计学意义（均P〉0．05）,操作准备时间、吸痰即时和吸痰后即时血氧饱和度、吸痰后血氧饱和度恢复时间差异均有统计学意义（均P〈O．01）。对照组有6个接头被痰液、浸泡液感染,感染率为21．4％;观察组仅有1个接头被痰液、浸泡液污染,差异有统计学意义（P〈O．05）。结论改良吸痰术省时、便捷,对患者的不良影响小,较传统吸痰法更为科学、合理、安全性好,能有效减少感染的发生率。     

改良抽吸药液操作技术在肌内注射苄星青霉素中的应用

目的探讨改良抽吸药液操作技术在肌内注射苄星青霉素中的应用及效果。方法将62例（246人次）肌内注射苄星青霉素的患者随机分为对照组30例（119人次）和观察组32例（127人次），对照组采用常规抽吸药液方法进行肌内注射。观察组采用改良式抽吸药液方法进行肌内注射。观察两组患者一次注射成功率及注射过程中疼痛程度。结果对照组10．9％感到重度疼痛，观察组为1．6％，两组比较差异有统计学意义（x^2=43．71，P〈0．01）。观察组一次注射成功率为98．4％高于对照组的89．1％，两组比较差异有统计学意义（x^2=45．09，P〈0．01）。结论采用改良式抽吸药液操作技术能提高肌内注射苄星青霉素一次成功率，减轻了患者的痛苦，值得II缶床推广使用。     

乳腺癌根治术后防治伤口皮下积液方法的探讨(附203例报告)

目的 评价乳腺癌术后防治伤口皮下积液方法的效果。方法 对1996－1998年我科采用伤口负压引流装置和1999－2001年改进引流方法（伤口放置多根管和腋下加压缝合）防治伤口皮下积液的情况进行比较。结果 采用负压引流装置93例患者中，28例发生皮下积液（30．1％），改进引流方法110例患者中，5例发生皮下积液（4．5％），结论 改进引流方法对防治皮下积液的效果优于负压引流装置方法。