中医药项目预算监控平台信息安全等级保护实践

信息安全等级保护制度是国家信息安全保障的基本制度、基本策略、基本方法.概述中医药项目预算监控平台基本情况,从定级与备案、安全建设、等级测评等方面介绍其信息安全等级保护工作的实践并总结经验,以期为中医药行业信息系统安全等级保护工作提供借鉴.     

多参数心电监护仪保护套的改良与应用

目的:对多参数心电监护仪保护套进行改良,组配成便捷、高效的多参数心电监护仪,以提高心电监护仪导联线的使用寿命,减少科室的耗材成本及提高护理工作效率。方法:选取2012年1月—2013年12月我院急诊及临床各科室使用深圳市迈瑞器械有限公司生产的原装心电监护仪(型号:BeneView/T5)12台随机分为观察组与对照组,每组6台,观察组对传统的仪器外套进行了改良,添加一个布套以分别存放各种导线及电极片。观察两组导线观察期内导线的维修情况。结果:两组各导线维修次数比较,血压、体温联接导线维修情况比较差异无统计学意义(P均>0.05);心电、血氧联接导线维修情况比较有统计学意义,(P均<0.05)。结论:多参数心电监护仪保护套改良后,导线维修次数减少,降低了科室的耗材成本且便于护理人员操作,提高了护理工作效率,值得临床推广应用。     

我院5年间冠脉介入术中碘造影剂过敏反应监测报告分析

目的研究和分析冠脉介入术中碘造影剂发生过敏反应的特点,为降低碘造影剂在冠脉介入手术中的使用风险提供参考。方法选用回顾性研究方法,对阜外心血管病医院2007～2012年住院冠脉介入手术（包括冠脉造影）中发生碘造影剂过敏反应病例资料,分别按照患者性别、年龄、临床表现以及引起过敏反应的碘造影剂种类等进行描述性统计分析。结果在79102监测到48例非离子型碘造影剂过敏反应,发生率0．61％o（48,78600）。其中男性患者为44例、女性患者为4例,男女比例11：1;涉及药品包括碘海醇、碘佛醇、碘帕醇、碘克沙醇、碘普罗胺等常用的非离子型碘造影剂,以碘普罗胺和碘克沙醇为多。过敏反应临床表现多样,以皮疹等皮肤黏膜表现最为常见,过敏性休克最为严重,其中死亡2例。结论在冠脉介入术中应用非离子型碘造影剂安全性良好,但仍需重视对其药品不良反应的监测、报告与分析;早期识别、早期干预,以提高用药安全与冠脉介入手术安全。     

The Surveillance Error Grid

Introduction:Currently used error grids for assessing clinical accuracy of blood glucose monitors are based on out-of-date medical practices. Error grids have not been widely embraced by regulatory agencies for clearance of monitors, but this type of tool could be useful for surveillance of the performance of cleared products. Diabetes Technology Society together with representatives from the Food and Drug Administration, the American Diabetes Association, the Endocrine Society, and the Association for the Advancement of Medical Instrumentation, and representatives of academia, industry, and government, have developed a new error grid, called the surveillance error grid (SEG) as a tool to assess the degree of clinical risk from inaccurate blood glucose (BG) monitors.Methods:A total of 206 diabetes clinicians were surveyed about the clinical risk of errors of measured BG levels by a monitor. The impact of such errors on 4 patient scenarios was surveyed. Each monitor/reference data pair was scored and color-coded on a graph per its average risk rating. Using modeled data representative of the accuracy of contemporary meters, the relationships between clinical risk and monitor error were calculated for the Clarke error grid (CEG), Parkes error grid (PEG), and SEG.Results:SEG action boundaries were consistent across scenarios, regardless of whether the patient was type 1 or type 2 or using insulin or not. No significant differences were noted between responses of adult/pediatric or 4 types of clinicians. Although small specific differences in risk boundaries between US and non-US clinicians were noted, the panel felt they did not justify separate grids for these 2 types of clinicians. The data points of the SEG were classified in 15 zones according to their assigned level of risk, which allowed for comparisons with the classic CEG and PEG. Modeled glucose monitor data with realistic self-monitoring of blood glucose errors derived from meter testing experiments plotted on the SEG when compared to the data plotted on the CEG and PEG produced risk estimates that were more granular and reflective of a continuously increasing risk scale.Discussion:The SEG is a modern metric for clinical risk assessments of BG monitor errors that assigns a unique risk score to each monitor data point when compared to a reference value. The SEG allows the clinical accuracy of a BG monitor to be portrayed in many ways, including as the percentages of data points falling into custom-defined risk zones. For modeled data the SEG, compared with the CEG and PEG, allows greater precision for quantifying risk, especially when the risks are low. This tool will be useful to allow regulators and manufacturers to monitor and evaluate glucose monitor performance in their surveillance programs.     

Perioperative use of bispectral (BIS) monitor for a pressure ulcer patient with locked‐in syndrome (LIS)

The bispectral (BIS) monitor uses brain electroencephalographic data to measure the depth of sedation and pharmacological response during anaesthetic procedures. In this case, the BIS monitor was used for another purpose, to demonstrate postoperatively to the nursing staff that a patient with history of locked‐in syndrome (LIS), who underwent pressure ulcer debridement, had periods of wakefulness and apparent sensation, even with his eyes closed. Furthermore, as patients with LIS can feel pain, despite being unable to move, local block or general anaesthesia should be provided for sharp surgical debridement and other painful procedures. This use of the BIS has shown that as a general rule, the staff should treat the patient as though he might be awake and sensate even if he does not open his eyes or move his limbs. The goal of this study was to continuously monitor pain level and communicate these findings to the entire wound team, i.e. anaesthesiologists, surgeons and nurses.     

探讨有创血压监测功能监护仪的合理配置

目的：优化某三甲医院住院部科室有创血压监测功能监护仪的配置方案。方法统计各科室该监测功能使用情况,医疗设备租赁中心的租赁记录并进行计算。结果根据2012年相关使用记录,制定出了具有该监测功能的监护仪的再分配计划表。结论对监护仪使用记录进行研究有助于提高设备使用效率,合理降低成本。     

基于注册技术审评的第二类病人监护仪产品注册临床要求

就第二类病人监护仪产品首次注册的临床要求进行介绍,以期能为生产企业从事注册相关的人员及审评人员提供参考。     

泉州空港口岸入境人员红外测温系统监测结果分析

目的 探讨旅检口岸入境人群体温监测的科学方法,以提高口岸卫生检疫核心能力与检疫把关效能,进一步完善口岸卫生检疫工作.方法 对2009年9月-2012年8月泉州晋江机场入境发热人员的基本情况、医学检查处理情况等资料进行统计分析.结果 共检出发热人员71例;以婴幼儿（≤3岁）和儿童（4 ～12岁）多见,不同季节、入境时间筛查率不同,时间分布以9-10月为高峰期;不同地区入境航班筛查率不同,其中以菲律宾入境航班最高达49.78例/10万人,体温以中热（38.1～39.0）为主,占60.29％,诊断结果以“上呼吸道感染”为主,占47.06％;发现4例乙型流感、2例甲型H3型流感和1例甲型H1N1流感.结论 发热人员的筛查率可能与不同季节、人员来自的不同地区有关,应当根据不同的传染病流行季节,不同的航班调整措施,并加强仪器设备的科学设置、人员的培训以及后续的跟踪监管.