73所口腔诊疗室管理现状调查分析

[目的]为规范化管理,建立完善的感染管理机制提供依据。[方法]根据《口腔诊疗器械消毒技术操作规范》的要求制定统一调查表,对73所口腔诊疗室管理现状进行调查。[结果]医务人员卫生防护意识不强,34.2%医务人员在诊疗期间不洗手。31.5%口腔诊疗区布局不合理。[结论]应加强监督检查及培训宣传,重视口腔诊疗感染管理。诊疗后的器械应采用消毒→清洗→灭菌的程序处理,口腔诊疗区每室至少设置1个水池,清洗消毒室至少应设3个水池。     

造血干细胞移植后输尿管狭窄1例

Ureteral stenosis is a comparatively rare complication following hematopoietic stem cell transplantation (HSCT). The etiology is still unclear and most believe that this may be due to the reactivation of BK virus in a state of immunodeficiency. In the later stages of ureteral stenosis with scarring, invasive interventions must be taken to relieve the hydronephrosis. Common treatments, such as D-J stent placement and permanent nephrostomy may not only entail the risk of infection, but also seriously affect the quality of life. Few cases of surgical intervention have been reported. In this article, a 25-year-old female was admitted to Peking University First Hospital suffering from recurrent flank pain. Seven years before, she developed hemorrhagic cystitis and bilateral urethritis 40 days after allogeneic HSCT. After continuous bladder irrigation and antiviral therapy, the left-sided hydronephrosis gradually alleviated while the right-sided one did not improve. D-J stents were used for urine drainage for 7 years before percuta-neous nephrostomy. Preoperative antegrade pyelography revealed significant hydronephrosis in the right kidney with long stricture of proximal-middle ureter. After comprehensive decision, she underwent ileal ureter replacement. The operation was successful. The segmental lesion was dissected and the scar tissue was removed. A 25 cm intestinal tube was isolated to connect the pelvis and bladder. An anti-reflux nipple was created at the distal end of ileal ureter to prevent the potential infection. The blood loss was minimal. After surgery, the drainage tube was removed in 2 weeks, the nephrostomy tube and the D-J stent was removed in 3 months. Follow-up mainly included clinical assessment, serologic testing, renal ultrasonography, blood gas analysis and radiological examination. During the follow-up of 6 years, she was symptom-free and no postoperative complications occurred. The serum creatinine level was stable. No hydronephrosis was observed under ultrasonography. Obvious peristaltic waves and ureteral jets of the ileal ureter was confirmed on cine magnetic resonance urography. To sum up, ureteral stenosis after HSCT is relatively rare. Obstruction caused by scarring is usually irreversible and surgical intervention should be designed according to the location and length of the lesion. Ileal ureter replacement can be a safe, feasible and effective method to solve this kind of complex stricture.     

国产内窥镜手术机器人系统在肾部分切除术中的初步临床应用

目的:探讨康多内窥镜手术机器人系统用于肾部分切除术的安全性及有效性。方法:本研究纳入2020年12月至2021年2月于北京大学第一医院就诊的符合入组条件的T 1期肾肿瘤患者。纳入标准：①需要进行肾部分切除治疗的患者;②肿瘤TNM分期为T 1期;③R.E.N.A.L.评分≤9分;④年龄18～75岁...     

上尿路梗阻回肠代输尿管患者术后症状与生活质量的相关性研究

目的 描述上尿路梗阻回肠代输尿管患者术后的症状和生活质量水平,并分析二者的相关性。方法 采用一般资料调查表、自设上尿路梗阻回肠代输尿管手术相关症状量表、健康调查简表对北京市某三级甲等医院回肠代输尿管数据库中95例患者进行问卷调查。结果 患者总体症状得分为0～1.44分（中位数为0.23分）,生活质量各领域得分最高的是生理机能领域（84.78±16.18）分,最低为生理职能领域（57.89±43.49）分。症状总体与生活质量各领域均呈负相关（r=-0.297～-0.559,P<0.01）。结论 上尿路梗阻回肠代输尿管患者术后存在多种症状,以排尿、肾积水、精力症状为主,且症状越重,其生活质量越差。因此,改善症状有助于提高患者的生活质量。     

新型冠状病毒肺炎疫情防控期间医预阶段和基础医学阶段在线教学情况调查

目的:分析新型冠状病毒肺炎疫情防控期间医预阶段和基础医学阶段在线教学情况,为提高在线教学质量提供参考。方法:本研究采用问卷调查方法。选取2020年2月24日至3月1日北京大学医学部医预阶段和基础医学阶段的五年制临床医学专业和八年制基础医学专业105名本科生及其10名授课教师为研究对象,进行在线教学与传统教学比较、在线教...