追踪延伸护理服务在川崎病患儿中的应用

目的:探讨追踪延伸护理服务在川崎病患儿中的应用效果。方法:选择2010年8月～2012年9月在我院儿科收治的123例川崎病患儿,根据有无开展追踪延伸护理服务分为对照组56例和观察组67例,对照组患儿给予川崎病常规护理,观察组患儿给予追踪延伸护理服务。比较两组患儿家属健康知识掌握程度、基础护理质量合格率和护理服务满意度。结果:观察组患儿家属健康知识掌握程度优于对照组(P<0.05),观察组患儿基础护理合格率和患儿家属对护理服务的满意度高于对照组(P<0.05)。结论:追踪延伸护理服务能够减少川崎病患儿住院时间和住院费用,提高患儿家属对疾病的认识程度及对护理服务的满意度。     

二维斑点追踪成像技术评价冠心病患者左室长轴应变

目的:运用二维斑点追踪成像(STI)技术评价静息状态下冠心病患者左室长轴应变,探讨该参数在评判冠心病不同危险程度中的价值.方法:疑诊冠心病患者51例,根据冠状动脉造影结果将患者分为冠心病高危组、冠心病低危组及对照组,获得清晰的心尖四腔、三腔、两腔图像后存盘供脱机分析.测量参数:左室18节段平均长轴应变(MLS),基底水...     

病案复印流程优化探讨

目的提出病案复印工作流程优化方法及策略,进一步提高病案复印服务质量。方法对某三级甲等综合医院的病案复印工作进行跟踪调研,分析和总结现行病案复印流程及存在的问题。结果病案复印工作量越来越大,现行工作流程缺点显著,因此灵活转换工作模式,病人复印病案高峰时应用环节分工优化流程,同时加强复印流程宣传,提高业务水平和服务态度,优化《病历复印申请表》的设计,加强协作,增强团队意识是提高病案服务质量的有效策略。结论优化后的病案复印流程能够有效提高服务质量,并加强病案人员的团队合作精神和工作效率。     

外科跌倒高危患者跟踪评估监控流程的应用与效果

目的评价应用外科住院患者跌倒流程管理降低跌倒发生率的效果。方法将跌倒高危患者跟踪评估监控流程应用于外科临床并进行动态管理,比较流程实施前（2009年）和实施后（2010年）外科高危跌倒预报率和跌倒发生率。结果2009年的预报率为0．5479％,2010年的预报率为1．5842％,差异有统计学意义（x。=17．8252,P〈0．01）;2009年跌倒发生率为0．2307％,2010年跌倒发生率为0．0278％,差异有统计学意义（）（2=4．2306,P〈0．05）。结论跌倒高危患者跟踪评估监控流程能提高外科跌倒高危预报率,降低跌倒发生率,能有效预防外科住院患者跌倒的发生。     

320层动态容积CT对正常人髌骨运动轨迹的初步研究

目的 探讨320层容积CT运动功能成像在正常人髌骨运动轨迹的应用价值.方法 回顾性分析30例应用320层容积CT运动功能成像检查的动态膝关节扫描数据.所有志愿者分别在屈膝0°～120°时行320层CT检测,测量不同屈曲角度时髌骨中点在三维坐标中的位置,分析不同角度时髌股关节排列关系.结果 随膝角的变化,在0°～90°时,髌骨迅速沿Y轴方向(即矢状面)向下移动约(53.87±0.45)mm,随后进入平台期,变化甚微.当屈膝至10°～30°时,髌骨沿X轴向内侧移动达最大程度,范围在(2.31±0.52)～(3.36±0.43)mm,而后向外侧运动,至120°时达到最大值,平均为(8.53±0.44)mm.在Z轴上,初时呈平台期,30°后呈快速下降趋势.在整个屈膝过程中,髌骨的滑行轨迹类似于开口向外的弧形.结论 320层容积CT运动功能成像可以快速、无痛对髌骨运动轨迹进行准确定位.

Abstract：

Objective To evaluate the diagnostic value of tracking movement of normal patellar using volume scan on sensation 320 CT. Method Data of dynamic scans of 30 knees was collected using the motor function of 320 CT and retrospectively analyzed. The data of movement of the patellorfemoral joint was obtained during flexion (from 0° to 120°) within 10-sec by 320 CT from all volunteers. The 3D coordinate of the center of patella was recorded to investigate the dispose relation of patellofemoral joint.Result With the knee angle changed from 0° to 90°, the patella moved rapidly along the Y-axis direction ( sagittal plane) down about (53.87 ± 0. 45 ) mm, and then entered the plateau phase with little change.When the knee flexion reached 10°-30° ,the patellar movement along the X-axis reached the largest range of (2. 31 ±0. 52)-(3.36 ± 0. 43 ) mm, and subsequently moved to the opposite lateral direction with the maximum about (8. 53 ± 0. 44 ) mm at 120°. In the Z axis, the track initially showed plateau, and then presented a rapidly downward trend after 30°. The patellar tracking is like an outward arc during the whole knee flexion. Conclusion The motor functional imaging of 320 CT can pinpoint the patelar tracking in a fast, painless way.     

Outcomes of Veterans Undergoing TAVR Within Veterans Affairs Medical Centers: Insights From the Veterans Affairs Clinical Assessment,Reporting, and Tracking Program

ObjectivesThis study sought to describe clinical and procedural characteristics of veterans undergoing transcatheter aortic valve replacement (TAVR) within U.S. Department of Veterans Affairs (VA) centers and to examine their association with short- and long-term mortality, length of stay (LOS), and rehospitalization within 30 days.BackgroundVeterans with severe aortic stenosis frequently undergo TAVR at VA medical centers.MethodsConsecutive veterans undergoing TAVR between 2012 and 2017 were included. Patient and procedural characteristics were obtained from the VA Clinical Assessment, Reporting, and Tracking system. The primary outcomes were 30-day and 1-year survival, LOS >6 days, and rehospitalization within 30 days. Logistic regression and Cox proportional hazards analyses were performed to evaluate the associations between pre-procedural characteristics and LOS and rehospitalization.ResultsNine hundred fifty-nine veterans underwent TAVR at 8 VA centers during the study period, 860 (90%) by transfemoral access, 50 (5%) transapical, 36 (3.8%) transaxillary, and 3 (0.3%) transaortic. Men predominated (939 of 959 [98%]), with an average age of 78.1 years. There were 28 deaths within 30 days (2.9%) and 134 at 1 year (14.0%). Median LOS was 5 days, and 141 veterans were rehospitalized within 30 days (14.7%). Nonfemoral access (odds ratio: 1.74; 95% confidence interval [CI]: 1.10 to 2.74), heart failure (odds ratio: 2.51; 95% CI: 1.83 to 3.44), and atrial fibrillation (odds ratio: 1.40; 95% CI: 1.01 to 1.95) were associated with increased LOS. Atrial fibrillation was associated with 30-day rehospitalization (hazard ratio: 1.79; 95% CI: 1.22 to 2.63).ConclusionsVeterans undergoing TAVR at VA centers are predominantly elderly men with significant comorbidities. Clinical outcomes of mortality and rehospitalization at 30 days and 1-year mortality compare favorably with benchmark outcome data outside the VA.     

《X、γ射线立体定向放射治疗系统质量控制检测规范》（WS 582—2017）追踪评价结果分析

目的 了解《X、γ射线立体定向放射治疗系统质量控制检测规范》（WS 582—2017）使用过程中遇到的问题,对标准的科学性、合理性、适用性及可操作性等方面进行评价,为进一步完善该标准提出合理化建议。方法 采用问卷和现场调查相结合的方式对标准进行追踪评价,对回收的调查表进行审核并补正标号,采用Excel办公软件录入数据,用SPSS 13.0进行统计分析。结果 使用标准单位均知晓标准的发布。技术服务机构和生产厂家培训率为71.9%和85.7%,监督机构和医疗机构分别为33.3%和43.5%。技术服务机构和生产厂家对标准内容熟悉率为71.7%、68.1%,监督机构和医疗机构对标准内容熟悉率为18.5%、54.8%。调查对象均对标准X刀章节掌握不够。超过一半的调查对象认为标准检测方法可操作性、实用性一般。结论 使用人员对标准的协调性认可度较高,对标准的实用性和检测方法的可操作性认可度一般,宣传、培训力度有待提高,部分检测指标及方法需要实例及说明。     

《职业性放射性疾病诊断总则》（GBZ 112—2017）卫生标准追踪评价

目的 了解《职业性放射性疾病诊断总则》（GBZ 112—2017）卫生标准应用情况,为标准的修订、宣贯和标准化管理提供依据。方法 针对标准宣贯、实施、质量和效益四个评价目标,采用调查表,对八省一集团中的职业病诊断机构、职业病诊断医师、卫生行政监督人员和放射工作人员进行问卷调查和统计学分析,对标准实施状况和实施效果追踪评价。结果 共调查了21家职业病诊断机构、93名职业病诊断医师、70名卫生行政监督人员、1329名放射工作人员;诊断机构中有85.7%建立了诊断标准学习制度,57.1%配备了诊断医师标准培训经费;标准知晓率为75.6%～80%,标准培训率为48.4%～55.7%;GBZ 112—2017标准采用率为0;42.9%和48%诊断机构分别具备物理剂量估算和生物剂量估算能力,同时具备两种能力的诊断机构仅占42.9%;对标准11项条款判定的可行率分别为90%～97%,认可标准与法律法规一致性95%～97%,标准的满意度86%～87.1%。结论 本文为卫生标准跟踪评价工作积累了材料,为职业性放射性疾病诊断总则卫生标准的修订、宣贯和管理提供了客观依据。