广东省农村饮用水监测实验室水质砷化物和氟化物及氯化物检测能力评估

目的 评估广东省市、县农村饮用水监测实验室的检测能力和水平,确保全省农村饮用水监测结果准确可靠.方法 国家有证标准样晶水质砷、氟化物和氯化物各90份,编号后分发至全省90个实验室检测,采用"标准值±扩展不确定度"评价检测结果,并用稳健统计评价法作比较评价.结果 全省参加实验室均准时反馈实验结果.砷采用氢化物原子荧光法和锌-硫酸系统新银盐分光光度法、氟化物和氯化物采用离子色谱法测定结果的满意率较高.全省农村饮用水监测实验室水质砷、氟化物和氯化物标准样品考核平均满意率分别为66%(59/90)、72%(65/90)和72%(65/90),3个项目的 考核结果均不满意为7.8%(7/90).砷、氟化物和氯化物结果采用稳健统计法评价的满意率均大干不确定度评价法的满意率,且样本数小.偏差大.结论 广东省农村饮用水监测实验室的检测能力有所提高,但与国家对农村饮用水监测点实验室检测能力和质量控制的要求还存在一定差距.实验室内部质量控制应纳入日常检验工作,提高实验室的检测技术水平.

Abstract：

Objective To assess the proficiency of water monitoring laboratory at rural, county, and provincial levels in Guangdong province, to ensure the province's drinking water monitoring results accurate and reliable. Methods State quality of certified reference materials as water arsenic, fluoride and chloride of 90 copies each were numbered and distributed to 90 monitoring laboratories in the province for testing, The measurement results of the participatory labs were evaluated through normative values and expanded uncertainty, and were compared with those of robust statistics method. Results All participatory labs had timely feedback of their measurement results. The qualified rate was higher when arsenic was tested by hydride generation atomic fluorescence spectrometry and zinc-new silver salt of sulfuric acid spectrophotometric system, while fluoride and chloride by ion chromatography. The average qualified rates of water arsenic, fluoride and chloride of the province's rural drinking water quality monitoring laboratory were 66% (59/90), 72% (65/90) and 72% (65/90), respectively.Seven participatory labs failed the proficiency testing of all three analytes and unqualified rate was 7.8% (7/90)among the ninety participated monitoring labs. The qualified rates of robust statistics method for arsenic fluoride and chloride were greater than those evaluated by the expanded uncertainty, and large deviations with small sample sizes. Conclusions The testing ability of drink-water monitoring labs in Guangdong province has improved.However, by comparison with the requirements of national quality control and testing skills, there is still a gap. It is suggested that internal quality control be included in routine inspeetion to improve laboratory testing technology.     

丙泊酚复合芬太尼用于纤维支气管镜检查

目的探讨丙泊酚复合芬太尼用于纤维支气管镜(纤支镜)检查的可行性、最佳使用剂量及对呼吸、循环功能的影响。方法选择140例ASAⅠ或Ⅱ级患者,分别采用丙泊酚复合芬太尼静脉麻醉组(P组,n=75)和单用利多卡因局麻组(L组,n=65),比较其在纤支镜检查时的耐受情况,术中SBP、DBP、HR、SpO2的变化及患者术后感受。结果P组SBP、DBP、HR、SpO2变化均小于L组(P<0.05),患者清醒后自我感受显著优于L组。结论丙泊酚复合芬太尼用于纤支镜检查安全有效。     

异丙酚复合瑞芬太尼用于纤维支气管镜检查的临床观察

目的 观察异丙酚复合瑞芬太尼对纤维支气管镜检查患者呼吸、循环功能及舒适度的影响,探讨该方法 的安全性与有效性.方法 选择拟行纤维支气管镜检查患者130例,ASAⅠ～Ⅱ级,随机分为两组,C组(n=65)采用单独利多卡因表麻行纤维支气管镜检查,R组(n=65)采用异丙酚复合瑞芬太尼静脉麻醉.观察两组患者纤维支气管镜检时的耐受情况以及术中SBP、DBP、HR、SpO2、PETCO2的变化,询问患者术后感受.结果 R组患者术中SBP、DBP、HR较平稳,SpO2、PETCO2与对照组差异无显著性,R组患者术后感受显著优于C组.结论 异丙酚复合瑞芬太尼用于纤维支气管镜检查较单独利多卡因表麻下镜检期间循环波动更小,安全有效,且能明显地提高纤维支气管镜检查时患者的舒适度.     

学生离奇死亡1例

抑制死在国內偶有报道，但大多是由于压迫颈动脉窦引起，本文介绍打击胸部造成胸腺轻微挫伤引起抑制死一例。     

医用生物蛋白胶在埋伏下颌第三磨牙拔除术的应用

目的　观察埋伏阻生牙拔除术应用医用生物胶止血、缓解疼痛及肿胀的效果。方法　在门诊患者中 ,依据曲面断层X线片选择两侧埋伏阻生程度相近者为研究对象 ,一侧创口术后即刻喷涂医用生物蛋白胶 ,另一侧进行常规处理。结果　拔牙创喷涂医用生物胶组 ,有 2 5例的出血时间少于 10min ,常规对照组仅为 2例 (P <0 .0 0 1) ;试验组中轻微疼痛者 19例 ,对照组为 4例 (P <0 .0 0 1) ;两组患者都以中或重度肿胀为常见 (P >0 .0 5 )。结论　埋伏阻生牙拔除术中应用医用生物胶 ,可以显著缩短术后出血时间、缓解术后疼痛 ,但对减轻术后肿胀的发生效果不明显。