新型智能化数字门诊楼设计与应用

本院门诊大楼于2005年12月启用,大楼的通信网络、楼宇设备集成、医疗业务与办公设备自动化系统及建筑节能与交通系统均充分体现了高度智能化。在信息化建设上以提供人性化服务为目标,设计出一套高度集成、就医环节简约的门诊就医系统,实现“一站式”就医新模式,大大提高了医院内部管理水平和医疗质量,进一步加强了医院数字化、信息化、智能化建设。     

妇产科医疗纠纷成因分析及管理对策

随着社会进步,人们的对生命质量的要求与维权意识不断增强。当医疗服务质量与人们期望之间的差距较大时,医疗纠纷及鉴定发生率明显升高。妇产科是医疗纠纷好发科室,本文结合临床病例分析了该科医疗工作特点及纠纷成因,提出：“以人性化为基础的优生-围产期保健的医学服务模式”有利于减少医疗纠纷,并列举了防范妇产科医疗纠纷的管理对策。     

急诊科护士健康教育认知状况的调查分析

目的 调查急诊护士实施健康教育的认知状况．以期为做好急诊健康教育提供借鉴。方法 采用问卷调查对北京市5所综合性医院106名护理人员进行了调查。结果 护士均能认识到急诊开展健康教育的重要性,但对于健康教育基本知识的认识．以及是否有能力进行健康教育的回答,高职称护士明显优于低职称护士。调查还显示大部分护理人员健康教育知识缺乏,其所具备的知识结构不能满足现行整体护理的要求。结论 应加强护士健康教育基本知识、基本技能的培训,以期提高医疗及服务质量。     

When Following the Rules Feels Wrong

The Covid‐19 pandemic has created a clinical environment in which health care practitioners are experiencing moral distress in numerous and novel ways. In this narrative reflection, a pediatric palliative care physician explores how his hospital's strict visitation policy set the stage for moral distress when, in the early months of the pandemic, it prevented two parents from being together at the bedside of their dying child.     

Aplastic Anemia Frequency and Management in Pediatric Liver Transplantations Due to Non-A-E Hepatitis

Background: Hepatitis-associated aplastic anemia (HAAA) is a rare complication that presented with bone marrow failure after acute hepatitis. HAAA usually occurs in adolescent men within 1-6 months following hepatitis. Most of HAAA’s etiology has non-A-E viral hepatitis.Methods: Our retrospective study included patients with acute fulminant hepatitis who had been treated in Ege University Pediatric Gastroenterology, Hepatology and Nutrition Department and İzmir Kent Hospital Clinical, laboratory, and epidemiological data of the patients were collected from the files.Results: In this study, 499 children underwent liver transplantation (LT) in two pediatric transplantation centers. Sixty-eight (13.6%) out of 499 patients, underwent liver transplantation due to fulminant hepatic failure (FHF). Therefore, a total of 64 patients (34 girls, 30 boys) with a diagnosis of FHF have included in the study. Thirty-two (50.0%) of 64 FHF were due to non-A-E hepatitis and 4 out of the 64 patients (6.2%) with FHF developed HAAA. All of the patients received prednisolone as immunosuppression treatment after LT. Three patients were also given Tacrolimus and 1 received an additional mycophenolate mofetil. One of the patients was given prednisolone and cyclosporine treatment without tacrolimus. Bone marrow transplantation was performed in 1 patient (25.0%). Two of the patients received immunosuppressive treatment including rabbit-derived anti-thymocyte globulin, cyclosporine, and initially prednisolone.Conclusion: In children who underwent liver transplantation for non-A-E FHF are at high risk to develop aplastic anemia. The clinicians should be alert after orthotropic liver transplantation patient could develop aplastic anemia and early treatment with immunosuppressive therapies result in a more successful outcome.     

利百素凝胶防护髋部骨折术后伤肢肿胀的效果观察

目的 观察复方七叶皂苷(利百素)凝胶防护髋部骨折术后伤肢肿胀的临床效果.方法 60例股骨颈、粗隆骨折术后患者随机分为2组,利百素凝胶组30例,对照组30例,观察测量术后3天、7天伤肢肿胀程度,临床症状进行比较.结果 利百素凝胶组与对照组在防护伤肢肿胀方面有显著性差异.结论 术后外涂利百素,能快速明显减轻伤肢肿胀,有效防止下肢深静脉血栓形成.     

儿科护士疼痛知识和应对态度的调查

目的调查上海市儿科护士疼痛知识的掌握程度,比较上海市3所三级甲等儿科专科医院护士掌握疼痛知识程度的差异。方法采用问卷调查法,问卷为Renne Manworren的“儿科护士疼痛知识和态度调查”（Pediatric Nurses’Knowledge and Attitudes Survey Regarding Pain,PNKAS）。3所医院回收的有效问卷为609份,回收率为85％。结果上海市儿科护士掌握疼痛知识的平均得分为16．67,其正确率仅为39．7％,3所医院护士掌握疼痛知识的程度存在显著差异。其中正确率最高的两题和正确率最低的两题,在3所医院完全相同。结论上海市儿科护士疼痛知识缺乏,同时信念和文化影响护士的疼痛管理能力。建议提供相应的疼痛管理培训课程,把疼痛管理作为儿科护理质量的一个重要指标,并在上海儿科护士中开展疼痛管理项目。     

Rash as a presenting complaint in a child with COVID-19

Cutaneous manifestations are becoming increasingly well-documented in adults with COVID-19. There is now also a growing body of literature regarding skin involvement in children, with reports of papulovesicular, petechial and widespread macular and papular lesions, and chilblains (pernio). We describe the case of a 13-year-old boy with confirmed COVID-19 in the United Kingdom who presented with skin findings localized to the plantar aspects of the feet, axillae, and lower limbs. The morphology was predominantly maculopapular but also included petechiae and annular lesions.