医院业务流程再造探索

通过对流程再造的描述,对医院业务流程再造的研究现状进行综述,阐述医院实施服务流程再造的意义及原则,说明医院服务流程再造可有效提高医疗护理服务质量及医院效益、减少患者的医疗费用,进而提高患者与医护人员的满意度、促进医院建设.     

直肠癌伴肝肺转移术中放疗1例报道

正直肠癌肝转移患者自然生存时间为6-12个月,同时伴有肺转移的生存时间更短~([1]),直肠癌目前以手术治疗为主,对于可行根治术切除的中晚期直肠癌患者目前先行术前化疗或放化疗结合,使肿瘤降期,提高RO切除率~([2])。但目前资料表明术前放化疗可以增加局部控制率,但未能增加长期生存率~([3]),由于术前同步放化疗治疗时间较长,对于晚期患者极有可能发生肿瘤进展,导致可切除病灶进展为不可切     

TURP与SPPC治疗老年良性前列腺增生症798例

良性前列腺增生症属于老年男性常见疾病。有资料显示,60岁男性中组织学检查50%可见前列腺增生改变,甚至可以高达83%。本研究分析经尿道前列腺汽化电切术(TURP)与前列腺经膀胱摘除术(SPPC)治疗老年良性前列腺增生症的疗效。     

实体瘤患者发生血流感染的病原学特点及预后分析

目的探讨实体瘤患者发生血流感染(BSI)的病原学特点及导致患者死亡的影响因素,为合理使用抗菌药物提供临床依据。方法选择2012年1月-2014年12月医院220例实体瘤并发BSI的患者为研究对象,分析患者病原学特点,统计患者的年龄、性别、住院天数、基础疾病等基本信息,采用单因素变量和多因素Logistic回归方法评估影响14-d病死率及住院病死率的影响因素。结果 220例患者共检出病原菌234株,其中革兰阴性菌102株占43.6%,革兰阳性菌100株占42.7%,真菌9株占3.9%,复数菌23株占9.8%;革兰阴性菌住院病死率高于革兰阳性球菌及真菌(P=0.014);多因素Logistic分析结果显示,实体瘤患者发生BSI 14-d病死率与GCS≤8分及血小板≤50g/L有关,住院病死率与脓毒性休克、Child-C级、GCS≤8分有关(P0.05)。结论实体瘤患者BSI的病死率较高,早期识别、有效地逆转器官功能衰竭是降低实体瘤患者BSI病死率有效的方法。     

锦州市企业职业健康监护基本情况分析

职业健康监护是对职业人群的健康状况进行各种检查,了解掌握人群的健康状况,早期发现工人健康损害征象的一项健康监控方法与过程,是职业病防治工作的重要组成部分[1]。为了解企业职业健康监护一般情况以及作业人员接触的主要职业病危害因素。收集了锦州市2009-2012年间开展职业健康检查企业的相关资料,对企业规模、所属行业以及职业健康监护过程中职业相关疾病的检出情况进行分析。     

三棱火针加拔罐治疗腘窝囊肿30例

ObjectiveTo explore the therapeutic effect of the fire needling with the three-edged needle and the cupping on popliteal cyst.MethodsA total of 60 patients of popliteal cyst were divided into two groups, 30 cases in each one according to the random number table. In the fire needling group, the burnt-red three-edged needle was inserted to the deep layer of the cyst. After the fluid was squeezed out, the cupping was exerted. The treatment was given 1 to 2 times a week, for 4 weeks totally. In the western medication group, prednisolone acetate 25 mg was injected in the cyst capsule, once a week, for 4 weeks totally. The effective rate, recurrence rate and Rauschning–Lindgren grading were evaluated before and after treatment.ResultsThe total effective rate was 80.0% in the fire needling group and was 83.3% in the western medication group, without statistical significance in comparison (P > 0.05). The recurrence rate was 6.7% in the fire needling group and was 30% in the western medication group. The recurrence rate in the fire needling group was lower than that in the western medication group, indicating the statistical significance (P < 0.05). After treatment, Rauschning–Lindgren grade was different statistically as compared with that before treatment in either group (both P < 0.05). Rauschning–Lindgren grade was distributed in 0 to I in the fire needling group after treatment, which was different significantly as compared with the western medication group (P < 0.05).ConclusionThe combined treatment with the fire needling combined with cupping therapy achieves the satisfactory effect on popliteal cyst and the very low recurrence rate and it is easy in operation and deserves to be promoted in primary care.     

小剂量静脉慢推心得安引起心跳骤停4例报告和分析

心得安是β-受体阻滞剂的代表药物之一。目前,在临床上仍较广泛应用于窦性心动过速、房性早搏、室上性心动过速及心房扑动、心房颤动等心律失常的治疗,现报告并分析应用小剂量心得安静脉慢推治疗室上性心动过速引起心跳骤停4例。     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁

2005年2-11月，我们采用经闭孔无张力尿道中段悬吊术（TVT—O）治疗女性压力性尿失禁患者15例，近期疗效满意，现报告如下。     

薯蓣皂苷对培养乳鼠心肌细胞缺氧／复氧损伤的保护作用

目的研究薯蓣皂苷对培养乳鼠心肌细胞缺氧／复氧损伤的保护作用并探讨其作用机制。方法采用体外培养乳鼠心肌细胞，建立缺氧／复氧损伤模型，以薯蓣皂苷进行干预。心肌细胞随机分为5组：空白对照组（C组）；缺氧／复氧组（A／R组）；薯蓣皂苷（Dioscin）低、中、高剂量干预组（Dioscin＋A／R组）。分别观察各组心肌细胞搏动频率；MTr法测细胞存活率；用Rhl23荧光探针标记线粒体，检测荧光强度以反映线粒体膜电位（△ψm）变化；Fluo-3负载心肌细胞，激光扫描共聚焦显微镜观察细胞内钙离子浓度变化。结果薯蓣皂苷干预组心肌细胞搏动频率、细胞存活率、△ψm与A／R组比较明显升高；细胞内平均钙离子荧光强度显著低于A／R组。结论从细胞水平初步证实薯蓣皂苷预处理心肌细胞对A／R损伤有一定保护作用，保护机制可能涉及对线粒体膜保护和防止细胞内钙超载等。