急诊内科患者就诊疾病特点与去留处置分析

目的探讨我院急诊科患者的就诊疾病特点,分析其去留处置规律,总结经验,为提高医院管理、人才培养方向及急诊科医务人员的诊治水平提供数据支持。方法将2017年1月1日-2017年12月31日的患者资料按照患者年龄、性别、就诊时间、疾病症状或诊断、去留进行分类,并将数据通过EXCEL软件对结果进行汇总分析。结果27961例就诊患者中男女比例为1.14:1,男性占53.36%,女性占46.64%。急诊留观患者为15904例,占全部患者56.84%;急诊住院患者为9886例,占全部患者的35.36%;离院或转院患者为2071例,占全部患者的7.41%。结论应加强对疾病的健康宣教,可减少患病率,减轻急诊科医师接诊压力。合理分配医务人员和严格执行医院各种制度,可提高患者满意度和救治能力。为医院和急诊科建设与发展提供数据支持,便于确定医院建设重点和急诊科人才培养方向,提高急诊科医务人员的诊治水平。     

The disposal of used sharps by diabetic patients living at home

The disposal of sharps generated in the community has been identified as an area of public health and environmental health concern. While there is a large amount of literature on sharps disposal practices in healthcare settings, the sharps disposal practices of diabetic patients living at home has been poorly documented. This study describes the sharps disposal practices of diabetic patients in South Staffordshire, an English health district. A randomly selected sample of 1,348 adult (aged >or= 16 years) diabetic patients were obtained from the district population-based diabetes register. A self-administered questionnaire was posted to the sample. Non-responders received up to two reminders. A response rate of 91% was achieved. Household containers were used by: 34.1% of respondents for syringes; 35.1% for lancets; and 27.6% for needles. Sharps boxes were the least used method of sharps disposal. Many respondents indicated that they had received only verbal information on how to dispose of their sharps. Those who recalled receiving information were more likely to dispose of their sharps safely. The results of this study suggest that sharps are disposed of in the most convenient manner, into the household waste. This contributes to environmental pollution and places people at risk of physical and psychological trauma.     

二溴海因消毒剂的杀菌原理与应用

二溴海因是一种新型的消毒杀菌剂。其具有抗菌谱广,杀菌力强,稳定性高,使用量小,无毒低味,安全环保,不受pH值影响及水体条件限制等特点,可广泛应用于国境口岸消毒,以提高口岸卫生处理工作的整体水平和拓宽口岸消毒用药范围。为此,对二溴海因的理化性质,作用机理,对微生物的杀灭作用以及在口岸的应用范围作一综述,以便在国境口岸卫生处理工作加以推广。     

潍坊市医疗机构医疗欠费处理存在问题及对策

目的：分析潍坊市医疗机构医疗欠费追讨及处理情况,探讨存在问题及改进措施。方法：采用分层整群随机抽样方法,抽出潍坊市19所各级各类医疗机构,对其医疗欠费处理情况进行问卷调查和统计学分析。结果：医疗欠费已经对部分医疗机构的经营和发展产生了一定的影响;医疗欠费追讨方式单一,效果不够理想;医务人员和专业诊疗科室承担了过多的欠费追讨责任;医疗欠费损失后果全部由医疗机构承担,政府、社会缺乏救助办法。建议：政府应建立面向弱势群体的危急重疾病医疗救助基金;医疗机构内部应设置专职或兼职的医疗欠费管理机构,采取多种手段,加大欠费追讨力度;完善医疗欠费相关法律规定。     

静脉滴注阿奇霉素不良反应的处置

目的:探讨阿奇霉素静脉滴注不良反应的处置。方法:观察80例门诊应用阿奇霉素静脉滴注患者,随机分为对照组40例,观察组40例。通过在输注前后不同处置措施,进行疗效评价。结果:对照组和观察组在胃肠道反应、局部反应、皮肤过敏反应三个方面显著不同,差异有统计学意义(P<0.05)。结论:在阿奇霉素静脉滴注前后注意询问病史,观察患者反应,及时对症处理能有效减轻或消除不良反应。     

城市生活垃圾健康危害研究进展

人类目前正承受着垃圾处理的巨大压力,特别是城市垃圾的问题已严重困扰城市。垃圾对人们日常生活特别是身体健康方面的影响也越来越受到重视。本文就垃圾产生遗传毒性,发育毒性甚至诱发肿瘤等方面的研究展开综述。     

我国药品不良反应/事件处理现状调研及对策

目的:了解当前我国药品不良反应/事件的处理现状,探讨我国建立药品不良反应救济机制的可能性。方法:阐述药品不良反应/事件的基本理论,并以浙江省为例,调查研究当前我国药品不良反应/事件的处理现状及存在的问题。结果与结论:调研发现当前药品不良反应/事件处理情况混乱,如存在对药品不良反应/事件与医疗事故的概念混淆不清,缺乏专业的纠纷调解机构,给付标准欠缺,地区差异巨大,给付方单一,风险无法社会共担等问题,无法从根本上保障受害者、医疗机构等各方权益。建议采取相应措施,如建立一专门调解医疗纠纷的机构,规定医疗机构应投保责任险,并尝试建立药品不良反应救济机制。     

输尿管镜嵌顿的预防及处理（附14例报告）

目的：探讨输尿管镜嵌顿的预防及处理。方法：对3500例输尿管镜检及输尿管镜下气压弹道碎石术术中发生输尿管镜嵌顿的病例资料作回顾性分析。结果：3500例患者中,发生输尿管镜嵌顿14例,其中,男8例,女6例,平均年龄44.5岁。嵌顿部位位于上段输尿管2例,中段3例,下段9例。8例成功退镜,6例失败（其中4例行开放输尿管纵向切开退镜、输尿管吻合或移植术,2例因输尿管严重撕脱行肾脏切除）,随访1 - 3年,预后良好。结论：输尿管镜是诊断和治疗输尿管疾病的常用方法,操作不当可导致严重的并发症,如能妥善处理,则预后良好。     

门诊药房药患纠纷的处置预案与技巧

目的：建立门诊药房药患纠纷处置预案,提高门诊药房对纠纷的应急处理能力。方法：分析药患纠纷产生的原因,根据门诊药房的工作特点和工作中的处理经验建立具体的药患纠纷处置预案,并总结药患纠纷的处置技巧。结果：药惠纠纷的原因包括药师、患者、医院其他部门等方面因素。处置预案需坚持“大事化小,小事化了”,坚持“无限沟通”原则。处置过程中需掌握倾听、换位思考、无限沟通等技巧。结论：门诊药房建立药患纠纷处置预案、掌握药患纠纷处置技巧是非常必要的,能及时有效地化解矛盾、解决纠纷,最大程度地降低药患纠纷造成的影响和损失。     

Skeletal muscle glucose uptake,glycogen synthase activity and GLUT 4 content during hypoglycaemia in type 1 diabetic subjects

In healthy subjects, hypoglycaemia induces a profound 80% reduction in skeletal muscle glucose uptake and a similar suppression of glycogen synthase activity. The aim of this study was to examine the efficacy of this counterregulatory mechanism in type 1 diabetic subjects, who are especially prone to hypoglycaemic incidents. Nine type 1 diabetic male subjects were examined twice; during 120 min of hyperinsulinaemic (1.5 mU·kg-¹·min-¹