颈椎损伤患者的后送体会1例

我国是地震灾害最频发的国家之一。近年发生的较大地震有四川汶川地震、青海玉树地震、云南彝良地震及最近发生的四川芦山地震。地震灾难不仅能在瞬间夺走人们宝贵的生命,而且还会留下大量伤员。据统计,由地震造成的受伤人数是死亡人数的3倍〔1〕。如何及时、有效地后送地震伤员,对于降低死亡率及致残率意义重大。由于受到     

无线定位技术在门诊信息系统中的应用研究

分析几种无线定位技术的优缺点,介绍其在门诊信息系统中的应用,包括电子导医、无线门诊输液系统、医疗设备与资产管理、药品定位及自动化库存管理、人员定位、呼叫系统以及输液病人体征检测等.     

卵巢过度刺激综合征相关因素分析及中西医结合护理体会

目的 探讨卵巢过度刺激综合征（OHSS）相关因素及中西医结合护理体会.方法 选择2011年5月～2013年5月江苏省中医院采用辅助生殖技术的患者393例,分析并比较OHSS在年龄、体重指数、不孕时间、不孕原因、促排卵方案、HCG当日＞12 mm卵泡数等因素间的分布情况;采用Logistic回归分析对OHSS相关因素进行分析.结果 本组发生OHSS共11例,发生率为2.9％.OHSS患者及无OHSS患者在多囊性卵巢综合征（PCOS）或多囊卵巢（PCO）改变、人体绒膜促性腺激素（HMG）＋人绝经促性腺素（HMG）方案、HCG当日雌激素（E2）值、HCG当日＞12 mm卵泡数等方面差异有统计学意义（P＜0.05）.PCOS或PCO改变（OR=6.226,P＜0.05）、HCG＋HMG方案（OR=5.475,P＜0.05）、HCG当日E2值（OR=1.480,P＜0.05）、HCG当日＞12 mm卵泡数（OR=2.148,P＜0.05）与OHSS发生相关,且均为危险因素（OR＞1.000）.结论 OHSS是多种因素共同作用的结果,中医特色的舒适护理模式可提高护理服务质量,节约医疗成本,体现以人为本的护理内涵.     

卫生专业技术人员职称评审工作实践及体会

职称评审工作与专业技术人员的切身利益密切相关,也是人事部门的重要工作。对卫生专业技术人员的职称评审,遴选出优秀的专业技术干部,能够有效促进医学院校医、教、研全面发展,进而提高医学院校的整体实力及水平。笔者就职称评审的范围、程序、标准、监督等方面作简单概述,并总结工作经验和体会。     

Abstracts for the 2008 NAEMSP Scientific Assembly

Abstract

Objectives. To date, most patient safety studies have been conducted in relation to the hospital rather than the prehospital setting and data regarding emergency medical services (EMS)-related errors are limited. To address this gap, a study was conducted to gain an in-depth understanding of the views of highly experienced EMS practitioners, educators, administrators, and physicians on major issues pertaining to EMS patient safety. The intent of the study was to identify key issues to give direction to the development of best practices in education, policy, and fieldwork. Methods. A qualitative study was conducted using processes described by Lincoln and Guba (1985) to enhance the quality and credibility of data and analysis. Purposive sampling was used to identify informants with knowledge and expertise regarding policy, practice, and research who could speak to the issue of patient safety. Sixteen participants, the majority of whom were Canadian, participated in in-depth interviews. Results. Two major themes were identified under the category of key issues: clinical decision making and EMS's focus and relationship with health care. An education gap has developed in EMS, and there is tension between the traditional stabilize-and-transport role and the increasingly complex role that has come about through “scope creep.” If, as expected, EMS aligns increasingly with the health sector, then change is needed in the EMS educational structure and process to develop stronger clinical decision-making skills. Conclusion. The results of this study indicate that many individual organizations and health regions are addressing issues related to patient safety in EMS, and there are important lessons to be learned from these groups. The broader issues identified, however, are system-wide and best addressed through policy change from health regions and government.     

Peripheral artery disease: therapeutic advances

Peripheral arterial disease (PAD), usually caused by atherosclerosis, is defined as an obstructive arterial disease of the lower extremities that reduces arterial flow during exercise or, in advanced stages, at rest. It affects more than 8.5 million people in the USA. PAD may appear as an asymptomatic arterial disease with abnormal noninvasive test results, or as a symptomatic disease presenting with atypical limb pain, classic intermittent claudication, or critical limb ischemia. The spectrum of PAD is not a continuum. Patients who present with critical limb ischemia may have experienced minimum symptoms. PAD results in limitation of exercise and walking ability, described as intermittent claudication. Patients with PAD are physically impaired and have a higher risk of cardiovascular events; therefore, the treatment goals are aimed at decreasing their cardiovascular risk, as well as improving exercise and daily functional performance. Apart from supervised exercise, which is a major treatment modality for patients with PAD, as of yet there have been very few significant pharmacological breakthroughs in the treatment of PAD that increases blood flow to the ischemic limb. Although percutaneous intervention has markedly improved the treatment of PAD, bypass surgery continues to play an important role. For the most part medical therapy for PAD is designed as a secondary prevention for cardiovascular risk. These include antiplatelet therapy, statins, ACE-inhibitors, smoking cessation and possibly antihypertensive therapy. Revascularization is most beneficial for patients with lifestyle limiting symptoms, acute or chronic limb ischemia with resting pain or nonhealing ulcers. In the following review article we will try to explore the clinical role of some of the latest developments in this field.     

Treatment adherence following national antiretroviral rollout in South Africa

The national antiretroviral (ARV) programme in South Africa commenced in 2004. ARV drugs became readily available to all South Africans due to the concerted efforts of ‘access to all’ campaigns. This study investigates medication adherence among a sample of South Africans after the ARV rollout in order to gain insight into the adherence challenges they face. A semi-structured questionnaire was completed by 439 participants from across the country. The results show that only 40% of the respondents were able to reach the optimum adherence level of 90% or above. The patients who displayed below-optimum adherence often had not been part of an ARV-preparation programme, did not have HIV-treatment supporters, lacked general knowledge about drug adherence, and felt unsupported by healthcare providers in their day-to-day effort to adhere to their medications. They often had no money for food or transportation, ran out of ARVs for various reasons, suffered from HIV-treatment fatigue, battled with depression, abused alcohol, could not disclose to sexual partners that they were on ARVs, and often had to hide or skip ARV dosages because they feared stigma and discrimination. Suggestions to assist patients to adhere to their ARV medications are made.     

混合型生物人工肝治疗设备的研制

目的:结合临床应用需求,研制一种新式混合型生物人工肝治疗应用系统。方法:以2个可编程控制器(PLC)作为控制系统核心,辅以多种安全监测报警装置,具有密闭、洁净和恒温的生物反应治疗环境,为离线混合型生物人工肝治疗提供一体化集成解决方案。结果:该设备能实现对血液流量、流速、质量等参数的精确控制,并提供温度、气泡、漏血等参数的报警监测功能。控制系统操作简便,人机界面友好,并为封闭式生物反应离线治疗过程提供实时影像监控。结论:新型治疗设备实现了混合式生物反应人工肝的离线治疗,有效缩短了生物人工肝治疗时间,同时改善了生物治疗环境。     

计算机三维动画技术在创伤骨科教学课件中的应用及优势

结合实践介绍了在创伤骨科临床课件制作中三维动画技术的具体应用,分析了该技术在临床教学中的诸多优势,并探讨了三维动画技术在骨科医学教育中的应用原则。