ObjectiveTo evaluate the operation status of the clinical departments of a hospital through the establishment of the evaluation index system and comprehensive evaluation model.MethodsThe data on workload, service difficulty, service efficiency, health economics and other related indicators of the clinical departments of a hospital from January to June 2018 were collected. The comprehensive evaluation model was constructed by comprehensive scoring method. The data of each index were centralized, then the comprehensive evaluation model of clinical departments was established and the scores were calculated by weighted summation. Microsoft Excel 2010 and SPSS 17.0 software were used for data processing.ResultsThere were certain differences in comprehensive scores and detailed indicators among different clinical departments. Ranked by comprehensive scores, the top three surgical departments were Department of Thoracic Surgery (1.45), Department of Breast Surgery (1.32), and Department of Vascular Surgery (1.22), and the top three internal departments were Department of Oncology (5.76), Department of Cardiology (3.47), and Department of Hematology (3.41).ConclusionsIn general, there are some differences in the operating conditions among different departments. There are also differences in the detailed indicators among different departments. The results can be used to find out problems and gaps, and finally improve the operation of the departments.
Objective To investigate the status of nutrition, nutritional support, and postoperative nutrition-related complications in patients with spinal deformity during orthopedic perioperative period. Methods From February to August 2021, patients who underwent spinal orthopedic surgery for spinal deformity in Peking University Third Hospital were collected. A survey was conducted using self-designed questionnaire, including patient’s general information (gender, age, and type of spinal deformity), nutrition-related information (risks of malnutrition, forms of nutritional support), and postoperative nutrition-related complications. Results A total of 39 patients with spinal deformity were enrolled, and 46.2% (18 cases) were at risk of malnutrition. There were a total of 174 times of nutritional support, and 96.0% (167 times) were parenteral nutrition. The patients’ energy intake from nutritional support accounted for 34.41% of the daily goal energy intake averagely. At admission, one day after operation, and at discharge, the prealbumin was (215.51±34.69), (172.85±31.85), and (163.67±29.15) mg/L, respectively, and the hemoglobin was (138.08±15.67), (119.92±18.01), and (117.69±14.76) g/L, respectively, which were significantly lower one day after operation and at discharge than those at admission (P<0.01). The incidence of postoperative nutrition-related complications during hospitalization was 5.1% (2/39). Conclusions Patients undergoing spinal deformity orthopedics are at high risk of overall malnutrition during the perioperative period, their clinical nutritional interventions are mostly based on parenteral nutrition with a single infusion of nutritional preparations, and the nutritional status is not significantly improved. However, the incidence of postoperative nutrition-related complications is low. Standardized nutrition interventions should be strengthened in the future.
【Abstract】ObjectiveTo compare the reliability of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and APACHE Ⅲ to estimate mortality of critical patients in abdominal surgery. MethodsTwo hundred and sixtyone critical patients in abdominal surgery were included in this study. The clinical data of the first day in ICU were collected and evaluated with both APACHE Ⅱand APACHE Ⅲ prognostic systems and statistical analysis were performed. Probability of survival (Ps) was compared with actual mortality. ResultsThe scores of APACHE Ⅱ and APACHE Ⅲ of death group were significantly higher than those of survival group respectively (P＜0.01). The actual mortality of patients whose Ps was no more than 0.5 was higher than that whose Ps was over 0.5 (P＜0.01). With two prognostic systems, the scores and mortality were the highest in pancreatitis patients and the lowest in patients with gastrointestinal malignant tumor. ConclusionAPACHE Ⅱ and APACHE Ⅲ prognostic systems can be effectively applied to the estimation of mortality of critical patients in abdominal surgery. For certain diagnostic categories, APACHE Ⅲ is better than APACHE Ⅱprognostic system.
目的 了解国内医院品质管理圈（品管圈）活动的发展现况，为品管圈活动的进一步推广和研究提供依据。 方法 2012年2月－6月采用文献研究法，检索公开发表于国内学术期刊的有关品管圈活动的所有文献，并阅读分析全文。 结果 共收集符合要求的文献125篇，文献主要来源于我国东部地区、类型以回顾性分析为主，主题内容侧重护理质量与药事服务管理。 结论 我国医院品管圈活动发展迅速，涉及面广，但研究方法、研究内容如社区发展等方面仍亟待进一步加强。
ObjectiveTo investigate the prognostic value and consistency of prognostic nutritional index (PNI) and patient-generated subjective global assessment (PG-SGA) in perioperative nutritional status of patients with esophageal cancer.MethodsClinical data of 224 patients, including 186 males and 38 females with an average age of 63.08±8.42 years, who underwent esophageal cancer surgery in our hospital from November 2017 to August 2018 were retrospectively reviewed. The PNI was calculated according to the results of the first time blood and biochemical tests, and the PG-SGA assessment was also performed. According to the PNI value, the patients were divided into a good nutrition group (PNI≥45, 60 patients) and a malnutrition group (PNI<45, 164 patients). According to the PG-SGA score, the patients were divided into a good nutrition group (PG-SGA<4, 75 patients) and a malnutrition group (PG-SGA≥4, 149 patients). Nutrition-related haematological indexes and body mass index (BMI) were compared between the two groups, and the consistency of PNI and PG-SGA for nutritional assessment was analyzed.ResultsThe nutrition-related haematological indexes in different PNI groups were statistically different in the perioperative period (P<0.01). The longitudinal changes of prealbumin in patients of different PG-SGA groups were statistically different (P<0.05); the BMI of patients in different PG-SGA groups was statistically different in the perioperative period (P<0.01). The Kappa coefficient of the two indicators was 0.589 (P<0.001).ConclusionBoth PNI and PG-SGA can predict the nutritional risk of patients with esophageal cancer to some extent. PNI is an objective monitoring indicator, and PG-SGA is a subjective evaluation indicator, the combined use of which can more comprehensively reflect and predict the nutritional status of patients, and provide an important reference to the development of individualized nutrition support programs.
ObjectiveTo explore the prevalence and risk factors of hypertension in Anyue County from June 2011 to June 2013. MethodsUsing stratfied random cluster sampling method, 5 391 people over 15 years of age were selected from 3 residential areas and 3 natural villages to finish a questionnaire and blood pressure measurement. ResultsThe total prevalence rate of hypertension in Anyue County was 18.77%. The prevalence rates of hypertension in urban areas and rural areas were 21.75% and 16.20%, and the difference was significant (χ2=27.120, P<0.001). In both urban and rural areas, the prevalence rate of hypertension increased with age (χ2=475.634, P<0.001; χ2=394.026, P<0.001). The percentages of awareness, treatment and control in Anyue County were 31.30%, 24.41%, and 9.09%. The percentages of awareness, treatment and control in urban areas were 40.15%, 33.70%, and 11.23% and were 20.68%, 13.65%, and 6.61% in rural areas. There were significant differences in the percentages of awareness, treatment and control between urban and rural areas (χ2=44.475, P<0.001; χ2=54.861, P<0.001; χ2=8.202, P=0.004). The logistic regression analysis showed that age (OR=1.061, P<0.001), diabetes (OR=1.550, P<0.001), hyperlipemia (OR=2.372, P<0.001) and smoking (OR=1.335, P<0.001) were the risk factors for hypertension; and it showed that high level of education was a protective factor for hypertension (OR=0.755, P<0.001). ConclusionBecause of high prevalence and low percentages of awareness, treatment and control in Anyue County, the prevention and control situation of hypertension are grim. We should focus on the control of smoking, blood lipid and blood glucose.
ObjectiveTo explore the infection condition of Acinetobacter baumannii at the Neurosurgery Intensive Care Unit (NICU), and analyze the possible risk factors. MethodsWe retrospectively analyzed the clinical data of Acinetobacter baumannii infection patients with craniocerebral injury treated at the NICU between January 2011 and June 2013. We collected such information as infection patients' population distribution, infection site, invasive operations and patients' nurse-in-charge level and so on, and analyzed the possible risk factors for the infection. ResultsThirty-one patients were infected with Acinetobacter baumannii, and they were mainly distributed between 60 and 80 years old. The main infection site was lower respiratory tract, followed in order by urinary tract, gastrointestinal tract, skin and soft tissue. The risk factors might be related to age, invasive operation, nurse working ability, etc. ConclusionThe patients at the NICU are vulnerable to infection of Acinetobacter baumannii. Reducing invasive diagnosis and nursing procedures, providing optimal care, and carrying out specialized nurse standardization training may be the important means to effectively reduce the infection.