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find Author "汪华学" 2 results
  • 有创-无创序贯机械通气治疗COPD急性加重

    目的 评价有创-无创序贯机械通气治疗COPD 急性加重( AECOPD) 的临床疗效。方法 选择ICU 收治的AECOPD 患者13 例为序贯组, 同样病情患者12 例为对照组。临床出现“肺部感染控制窗”后, 序贯组拔除气管插管, 应用口鼻面罩双水平正压通气直至脱机; 对照组继续有创机械通气, 以压力支持方式脱机。比较两组患者机械通气时间、住院时间、呼吸机相关性肺炎( VAP)患病率和患者转归。结果 与对照组比较, 序贯组有创机械通气时间显著缩短[ ( 4. 33 ±1. 05) d 比( 10. 13 ±2. 06) d, P lt; 0. 001] , ICU 住院时间显著缩短[ ( 8. 79 ±2. 07) d 比( 11. 96 ±2. 11) d, P lt;0. 005] , VAP 发生数显著减少[ 0 比6 例, P lt;0. 01] 。总机械通气时间、总住院时间、再插管率和病死率均无显著性差异( P gt; 0. 05) 。结论 对需要机械通气的AECOPD 患者, 采用有创-无创序贯机械通气治疗, 可以缩短有创机械通气时间和ICU住院时间, 降低VAP 患病率。

    Release date:2016-09-14 11:23 Export PDF Favorites Scan
  • Quality control of intensive care unit in Anhui province from 2013 to 2015: a cross-sectional survey

    ObjectiveTo investigate the baseline of quality control system for intensive care unit (ICU), and to provide a scientific basis for the development of ICU in Anhui province.MethodsA questionnaire was used to investigate the quality control indexes in 108 hospitals in Anhui province from 2013 to 2015. SPSS 20.0 statistical software was used to analyze and statistically describe the survey results.ResultsA total of 110 questionnaires from 108 hospitals were received, including 43 tertiary hospitals and 65 secondary hospitals. In these 110 ICUs, 96.36% were integrated ICU. The total average number of ICU beds was 14.46±7.12, accounting for 1.58%±1.04% of the total hospital beds. The ratios of practicing physicians-beds and registered nurses-beds were 0.57±0.24: 1 and 1.54±0.79: 1, respectively. A total of 29 hospitals (26.36%) met the conditions that the ratio of the total number of beds in the ICU to the hospital was 2% to 8%. Only 5 ICU (4.55%) could meet the conditions that each bed covered an area ≥15 m2. The average incidence of ventilator-associated pneumonia, catheter-related blood stream infection and catheter-related urinary tract infection in ICU patients were (17.30±15.36) ‰, (3.07±3.93) ‰, and (3.49±4.27) ‰, respectively. The incidences in the tertiary hospitals were higher than the secondary hospital. There was no ICU to achieve all 19 key technologies. 42.73% directors of ICU engaged in the professional career more than 10 years. Only 2.73% of the medical institutions in the intensive medical staff performance distribution than the average level of hospital.ConclusionICU in Anhui province has been achieved a rapid development, and has covered all municipal hospitals and more than 80% of the county-level hospitals. But it confronts with a series of problems, such as lack of medical resources, the construction of talent echelon lag, low overall level of discipline, lack of specialist, work intensity, low performance and a series of constraints which restricted the development of disciplines. It strongly suggests that we should further improve the quality control system of critical care medicine, standardize the quality control process, improve and implement the standardized operation standard of critical care medicine, strengthen the construction of disciplines talent echelon. We are expected to enhance the overall level of discipline and to ensure medical quality and safety.

    Release date:2018-06-04 08:48 Export PDF Favorites Scan
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