试论新世纪初期医院综合院力评价

作者阐述了医院综合院力的内涵与提出背景，提出了新世纪初期综合院力的评价内容体系，即一级评价内容7项，二级评价内容39项，三级评价内容15l项，并就各指标评价内容进行了讨论分析。     

腹腔镜胆囊切除术420例临床分析

目的 :探讨基层医院临床应用腹腔镜胆囊切除术 (LC)的适应证 ,研究术前评估LC难度的标准。方法 :回顾分析 4 2 0例LC的临床资料。结果 :成功施行LC 4 10例 ,中转开腹 10例 ,严重并发症 3例。结论 :根据病史及B超检查可在术前判断LC的难易度 ,只要掌握LC技术 ,对手术难度大的患者行LC是安全的 ,果断地中转开腹是避免LC严重并发症的最好方法。腹腔引流对严重炎症渗出及可疑损伤病例是必要的。     

结防机构与医疗机构合作提高肺结核患者发现率

目的了解目前医疗机构与结防机构间合作提高肺结核患者发现方法的实施效果及存在问题。方法采用回顾性调查方法,调查各县区结防门诊根据转诊登记资料、追踪登记表和日常对医疗机构的督导记录;搜集综合医疗机构结核患者发现、报告以及转诊情况数据,搜集医疗机构发现患者到结防机构后诊断复核情况。结果①城市和农村地区医疗机构发现肺结核患者的报告和转诊情况有差异,报告情况城市好于农村,转诊情况农村好于城市;②医疗机构发现肺结核患者的查痰率低仅为13.3%;③结防机构对医疗机构发现未到结防机构就诊肺结核患者的追踪率为94.1%,不同追踪方式追踪到位情况有差异,结防机构医生追踪到位情况最好,到位率为74.2%。追踪未到位原因主要是报告卡姓名或地址等信息有误和患者住院治疗;④实施医疗机构与结防机构间合作措施后,被调查地区结防机构的就诊人数和发现的活动性肺结核患者数均较去年同期增加。结论医疗机构与结防机构间合作实施结核病控制,可提高肺结核病患者发现数量和治疗管理质量。     

高原地区部队医院谋求新发展应处理好七个关系

从高原部队医院实际出发,阐述了适应新形势谋求新发展应处理好的七个关系:即继承与创新的关系;坚持“姓军为兵的服务方向与对外有偿服务的关系;基础建设与人才建设的关系;日常医疗保障与科研的关系;发挥自身特色与学习借鉴的关系;硬件建设与软件建设的关系;科技研究与成果转化的关系。     

影响医疗服务满意度评价因素初步分析

目的　分析病人对医疗服务满意度评价的影响因素。方法　采用随机抽样的方法 ,对 5 10人进行了问卷抽样调查。结果　影响病人对医院服务满意度评价的因素依次为 :医生的医疗技术不高占 39 5 % ,医院服务态度不好占 2 2 8% ,医药费太高占 2 1 1% ,看病排队占 16 6 %。病人对医生服务态度好的评价标准依次是 :耐心倾听病人诉说占 6 1 6 % ,责任心强、看病认真占 30 6 % ,对病人热情、主动占 7 8%。结论　可靠的医疗技术和良好的服务态度是影响病人对医院服务满意度评价的最重要的两个因素。耐心倾听病人诉说是影响医生服务态度的最重要因素。病人的年龄、职业、文化、经济收入等因素对医疗服务的满意度评价均有作用     

医院图书馆过刊剔旧工作的思考

分析了医院图书馆过刊剔旧的必要性与可行性,提出了剔旧原则与建立全国性文献剔除网络中心的设想.     

托吡酯和丙戊酸钠治疗特发性全面性强直阵挛发作的临床疗效比较

目的:探讨中等剂量托吡酯(商品名:妥泰)200mg对特发性全面性强直阵挛(GTCS)发作的疗效。方法:64例GTCS患者分成三组,妥泰单药治疗21例,妥泰联合丙戊酸钠治疗22例,另外21例采用丙戊酸钠治疗作对照。结果:妥泰单药组及联用药组治疗GTCS有效例数明显高于单用丙戊酸钠组,差异显著(P<0.05);同时单用妥泰组与联用丙戊酸钠组疗效相近(P>0.05)。结论:妥泰治疗GTCS疗效优于丙戊酸钠,且妥泰单一用药与联用丙戊酸钠治疗疗效相近。     

Prevalence of anti-HCV in institutionalised mentally handicapped subjects

Data on the prevalence of antibody to hepatitis C virus among 278 subjects in an institution for the mentally handicapped were analysed by risk factors. A prevalence of 4% was found, higher than blood donors belonging to the same area (1.4%). No differences in prevalence with regard the length of residence, age, sex, degree of retardation or for presence of HBV markers were observed.     

Responsiveness and calibration of the general well-being adjustment scale in patients with hypertension

We examined the discriminant ability and responsiveness of the General Well-Being Adjustment Scale in patients enrolled in a randomized clinical trial of antihypertensive therapy. We also tried to translate the effects of physical symptoms on general well-being. This secondary analysis used demographic, clinical, physical symptom, and general well-being data for 545 white, male hypertensive patients. General well-being was measured by the General Well-Being Adjustment Scale (GWB) collected on 2 occasions over 8 weeks of treatment. Patients with any one of 14 physical symptoms or problems, compared to those without symptoms, had lower GWB scores (p < 0.003 to p < 0.0001). Decreases of 2.83–8.76 points in GWB scores were observed in patients developing physical symptoms over the 8 week study period (p < 0.05 to p < 0.0001). These effects were demonstrated in patients developing cold sensitivity, sexual problems, chest pain, shortness of breath, loss of taste, nausea, hot or cold spells, numbness and tingling, dry mouth, blurred vision, and dizziness. We conclude that the GWB is responsive to clinically meaningful changes in symptoms and may provide a more complete evaluation of the effects of medical treatment. The GWB is a valid and responsive measure of health status outcomes in the evaluation of antihypertensive treatment.