我院2010年药品不良反应报告回顾性分析

目的了解该院药品不良反应(ADR)发生的特点及规律,促进临床合理用药。方法对该院2010年收集到的1 031例ADR报告进行统计分析。结果 ADR的发生率男性与女性之比为1.01∶1,多发于60岁以上人群,以住院患者多见,发生级别以一般不良反应为主,给药途径以静脉滴注为主。抗感染药物占50.53%,主要为喹诺酮类和头孢菌素类。ADR临床表现以皮肤及附件损害和消化系统损害为主。ADR转归中,好转占89.04%。结论临床应重视抗菌药物和中药注射剂的合理使用,加强ADR监测,减少或避免ADR的发生。     

我院271例药品不良反应报告分析

目的:了解我院药品不良反应(ADR)发生的一般情况及影响因素。方法:收集我院2007年6月～2008年12月上报的271例ADR报告,分别对患者的年龄、性别、上报科室分布、给药途径、药品种类、ADR累及器官或系统及临床表现等进行统计、分析。结果:271例ADR中,共涉及药品14类91种,其中抗肿瘤药引发ADR最多,有152例(占56.09%),其次是抗微生物药,有26例(占9.59%);给药途径以静脉滴注所占比例最大,有247例(占91.14%);引发消化系统的ADR较多,有79例(占29.19%)。结论:抗肿瘤药、抗微生物药应用及以静脉滴注给药方式是引发ADR的主要因素,临床应重点加强监管。     

某市应对化学恐怖袭击事件医学救援能力的调查

【目的】对某市医务人员应对化学恐怖事件的能力进行调查。【方法】采用流行病学调查表对医务人员的化学品急性中毒知识进行综合考核,并将有关变量量化后进行统计学处理。【结果】被调查者综合考核得分普遍偏低,平均为（60.51±16.268）分。部队医院医务人员的得分高于地方医院（P〈0.05）,化学品中毒防治专科医院医务人员的得分高于一般普通医院（P〈0.05）。【结论】某市医务人员应对化学恐怖事件的能力还需提高。     

少数民族中以社区为基础的疟疾控制：一个中缅边境佤族社区的疟疾防治进展

案例研究可为卫生政策的制定和调整提供有用的信息和启示。本文根据1997年以来中缅边境地区一个佤族社区疟疾防治进展,经验和教训的总结,分析影响疟疾流行及其控制的因素,讨论国家和国际公共卫生问题,以及给卫生政策的启示。     

病案信息资源规范管理面临的问题和对策

随着病案信息资源利用渠道的增多,病案信息资源规范管理的力度必须日益加大。文
章就目前医院病案信息资源规范管理的现状及存在的组织领导、机构建设、管理体制、人员素质及
病案质量管理上的问题进行了探讨,并提出了一些可供参考的对策。     

Bilateral phlegmasia dolens associated with Trousseau's syndrome: a case report

Hasegawa S, Aoyama T, Kakinoki R, Toguchida J, Nakamura T. Bilateral phlegmasia dolens associated with Trousseau's syndrome: a case report.Phlegmasia dolens is a rare disorder caused by massive venous thrombosis. The clinical condition is subclassified as phlegmasia cerulea dolens (PCD) and phlegmasia alba dolens. The 2 forms differ in the venous area affected and remaining blood flow, causing arterial involvement and resulting in a difference in therapeutic strategy and prognosis. In PCD, the mortality rate is high, and amputation for venous gangrene is needed. Phlegmasia alba dolens is a mild form of PCD; the collateral venous system is intact, and the prognosis is better than for PCD. We experienced a rare case of bilateral phlegmasia dolens associated with Trousseau's syndrome. The patient was diagnosed with phlegmasia alba dolens because the artery was not occluded. She was treated with anticoagulant therapy, the placement of a vena cava filter, and a rehabilitation program. The bilateral soleus muscles underwent necrosis, and the occurrence of equinus foot disturbed her walking, but careful rehabilitation with stretching, a range of passive motion exercises by a physical therapist, a tilting table, and ergometer training strengthened the muscles and allowed the patient to walk unaided 8 months after onset. Through this case, we hope to learn more about the pathogenesis of phlegmasia dolens and clinical treatment measures.     

Transitional cell carcinoma of the urethra [correction of ureter] in a patient with buttock pain: a case report

Murphy DR, Morris NJ. Transitional cell carcinoma of the ureter in a patient with buttock pain: a case report.This case reports on a patient with an unusual presentation of a rare tumor: urethral transitional cell carcinoma (TCC). Urethral TCC occurs in approximately 0.7% to 4.0% of patients who have had primary bladder cancer. The initial symptoms usually involve hematuria, with approximately a third of patients reporting flank area pain. Buttock pain and the absence of hematuria are uncommon with this disorder. The patient was initially suspected to have piriformis syndrome, but when he did not respond as expected to treatment, and because of his history of primary bladder cancer, further evaluation was undertaken and the diagnosis was made. The patient responded well to radiation and chemotherapy. Musculoskeletal physicians should be particularly suspicious of the presence of urethral TCC in a patient with a history of primary bladder cancer who reports low back or buttock pain, particularly if the patient does not respond quickly to treatment.     

Long-term ventilation for high-level tetraplegia: a report of 2 cases of noninvasive positive-pressure ventilation

Toki A, Tamura R, Sumida M. Long-term ventilation for high-level tetraplegia: a report of 2 cases of noninvasive positive-pressure ventilation.Ventilator-dependent patients with tetraplegia rarely use noninvasive positive-pressure ventilation (NPPV) for long-term ventilation. We report 2 patients with high-level traumatic tetraplegia who were able to return home after being changed from traditional ventilation to NPPV. When they were referred to our hospital from acute care hospitals 2 to 6 months after injury, both were on tracheostomy ventilation with a cuff inflated 24 hours a day, and tidal volume (Vt) settings were low. In case 1, a man with complete C1 tetraplegia was admitted to our hospital 6 months after injury. We changed ventilator settings to high Vt and introduced NPPV. He was discharged home with NPPV with a volume-setting ventilator. Case 2 involved a man in his late twenties with complete C1 tetraplegia who was discharged home with NPPV. After discharge, he trained in glossopharyngeal breathing by himself, enabling him to breathe up to 1900mL of maximum insufflation capacity. Both have lived nearly 1 year without pulmonary complications in the community. They use visiting nurses 3 times a week and services of visiting caregivers. Further study is needed to determine the usefulness of NPPV for long-term ventilatory management.     

Winged scapula caused by a dorsal scapular nerve lesion: a case report

Akgun K, Aktas I, Terzi Y. Winged scapula caused by a dorsal scapular nerve lesion: a case report.Dorsal scapular nerve lesions are quite rare. A case of a 51-year-old man who had right shoulder pain, weakness of right arm elevation, and prominence of right scapula for 6 months is presented. The condition had been abruptly developed after lifting a heavy box overhead on which he felt a sharp pain in the right shoulder. On clinical examination, there was a prominence of the lower medial border and inferior angle of the right scapula compared with the left. In addition, the right scapula was located more lateral. Magnetic resonance imaging of the thorax revealed the presence of a thinner rhomboid major muscle with a pathologic signal compared with the other side. Needle electromyography of the right rhomboid muscle revealed a long duration, polyphasic motor unit potential with reinnervation potentials, and spontaneous activity. According to these findings, the patient was diagnosed as having a winged scapula because of dorsal scapular nerve lesion.     

医院传染病报告信息化对疫情报告质量影响的评价分析

目的 评价传染病报告信息化对医院内部传染病报告质量的影响,探讨医院传染病报告信息系统的优势和存在问题.方法 比较医院传染病报告信息化前、后,传染病漏报、迟报、报告卡填写质量情况.结果 传染病报告信息化后,传染病漏报率、迟报率、报告卡完整率和准确率分别为0.6%、2.0%、99.3%和99.3%,漏报率比信息化前降低了15.9%(χ~2=436.997,P<0.001),迟报率比信息化前降低了9.3%(χ~2=185.984,P<0.001),报告卡完整率比信息化前升高了26.0%(χ~2=599.704,P<0.001),准确率比信息化前升高了46.7%(χ~2=1266.333,P<0.001).结论 医院传染病报告实行信息化,能有效控制医院传染病迟报、漏报,提高报告卡填写质量.