农村孕产妇急危重症的家庭因素及管理对策研究

目的 :本文采取 1∶ 2病例对照的方法 ,通过对影响我国农村地区孕产妇急危重症发病的家庭因素进行调查研究 ,采用条件 logistic回归的统计方法进行分析 ,得出影响我国农村地区孕产妇急危重症发生的家庭因素主要为家庭性质、家庭经济状况、丈夫的年龄、文化程度和抽烟嗜好。在此基础上 ,从家庭因素和管理对策两个层面提出减少农村孕产妇急危重症发生几率的措施     

能力型医院:21世纪医院管理新思路

21世纪是个革新的时代 ,医院管理也需要不断改革、创新。在激烈竞争的今天 ,医院只有以能力为核心 ,建立能力型医院 ,才能提高医院实力和经济效益。而在设计能力型医院时 ,应从医院管理职业化、能本管理、知识管理和建立学习型医院等方面出发 ,并从医院开发和员工自我开发两个层次来建立医院能力的开发机制。     

腹部B超在新生儿坏死性小肠结肠炎诊断中的价值

目的探讨腹部B超在新生儿坏死性小肠结肠炎（NEC）诊断中的价值。方法选择2011年4月至2013年4月我院新生儿科收治的临床可疑NEC早产儿,患儿在诊断可疑NEC后常规行腹部正侧位X线片及腹部B超检查,并在12 h后复查X线片和腹部B超,以出现肠壁增厚、肠壁积气、门静脉积气之中的任何一项判定为阳性结果,均未出现判为阴性结果。采用诊断性检验方法,以灵敏度、特异度、准确度及ROC曲线评估腹部B超诊断NEC的价值。结果共纳入93例可疑NEC早产儿,男49例,女44例;胎龄（31.4±2.1）周;体重（1825±236）g。第1次检查腹部B超阳性61例,X线平片阳性52例,腹部B超的灵敏度和特异度分别为90.5%和54.9%,准确度66.6%,ROC曲线下面积（AUC）=0.727（95%CI 0.622～0.831）。12 h后复查腹部B超阳性69例,X线平片阳性53例,腹部B超的灵敏度和特异度分别为88.7%和45.0%,准确度74.2%,AUC=0.668（95%CI 0.554～0.783）。结论腹部B超结合临床表现可能优于Bell法在NEC的诊断,具有重要的临床应用价值。     

米力农、硝普钠联合机械通气治疗小儿重症手足口病临床观察

目的 研究米力农、硝普钠联合机械通气治疗小儿重症手足口病的临床疗效。方法 38例符合手足口病诊断标准的重症患儿随机分为两组,治疗组19例,对照组19例,对照组给予常规治疗,治疗组在常规治疗的基础上加用米力农、硝普钠联合机械通气,比较两组治疗效果。结果 治疗组患儿心输出量(CO)、射血分数(EF)、左室内径缩短率(LVDFS)、心脏指数(CI)、每博输出量(SV)值与对照组比较,差异有统计学意义(P<0.05)。结论 米力农、硝普钠联合机械通气治疗小儿重症手足口病有较好的疗效,值得推广应用。     

农村贫困地区2002年至2006年县级卫生机构人员流动状况调查

Objective To probe into the HR development of healthcare professionals in poor rural areas. Methods 51 county-level healthcare institutions from 13 counties in six provinces were sampled to study the turnover from 2002 to 2006. Results The number of healthcare professionals per 1 000 population in the poor counties investigated was in average lower than that of counties in the same province; the inflow of personnel was higher than that of outflow. Of the inflow, 43. 50％ were fresh university graduates, and 40. 58％ were transferred from other organizations, 95.83％ have degrees of technical secondary schools and above, and 87. 17％ were healthcare professionals. 70. 44％ of the outflow were retirees, and 22. 33％ were transferred outside; 28. 00％ have only senior high school degrees or below, 69. 74％ were healthcare professionals. Conclusions The quality of healthcare personnel has been improved to some extent; but the risk of brain drain remains a challenge. An appropriate mechanism of personnel turnover should be built, and graduates from medical schools should be directed to reinforce healthcare teams in poor areas.     

农村贫困地区2002年至2006年县级卫生机构人员流动状况调查

Objective To probe into the HR development of healthcare professionals in poor rural areas. Methods 51 county-level healthcare institutions from 13 counties in six provinces were sampled to study the turnover from 2002 to 2006. Results The number of healthcare professionals per 1 000 population in the poor counties investigated was in average lower than that of counties in the same province; the inflow of personnel was higher than that of outflow. Of the inflow, 43. 50％ were fresh university graduates, and 40. 58％ were transferred from other organizations, 95.83％ have degrees of technical secondary schools and above, and 87. 17％ were healthcare professionals. 70. 44％ of the outflow were retirees, and 22. 33％ were transferred outside; 28. 00％ have only senior high school degrees or below, 69. 74％ were healthcare professionals. Conclusions The quality of healthcare personnel has been improved to some extent; but the risk of brain drain remains a challenge. An appropriate mechanism of personnel turnover should be built, and graduates from medical schools should be directed to reinforce healthcare teams in poor areas.     

慢性舒张性心力衰竭合并COPD老年患者的临床护理措施分析

目的研究探讨慢性舒张性心力衰竭(DHF)合并慢性阻塞性肺病(COPD)老年患者的临床护理措施。方法对2009年3月至2013年4月期间来我院治疗的80例DHF合并COPD老年患者进行临床干预性护理;待护理3个月后,对患者血压、心率、肺功能等指标进行测定。结果对所有患者实施干预性护理措施后,患者的心肺功能、血压与干预前相比均有明显改善,差异具有统计学意义(P<0.05)。结论对慢性舒张性心力衰竭合并慢性阻塞性肺病老年患者实行临床干预性护理,对患者的血压、心肺功能的恢复有显著的疗效,同时也减轻了患者的痛苦,有利于患者恢复健康。     

阿托伐他汀对慢性心力衰竭患者心功能及心室重塑的影响观察

目的研究分析阿托伐他汀对慢性心力衰竭患者心功能及心室重塑的影响。方法将2011年12月至2012年10月于本院采用辛伐他汀进行治疗的31例慢性心力衰竭患者设置为对照组,同时将同一时期采用阿托伐他汀治疗干预的31例患者设置为观察组,然后将两组患者心功能及心室重塑指标分别于治疗前与治疗后进行检测,并对照两组的检测指标。结果观察组治疗后的心功能及心室重塑指标分别优于对照组,P均<0.05,有显著性差异。结论阿托伐他汀对慢性心力衰竭患者心功能及心室重塑的影响较为突出,对于此类患者的治疗效果优于辛伐他汀。