摘要:目的：评价围手术期预防性应用抗菌药物现状及合理性。方法：采用回顾性调查的方法，随机抽查2009年度Ⅰ类切口手术围手术期病案500份，设计外科围手术期预防性应用抗生素调查表，对预防用药的适应证、用药种类、联合用药、给药时机及持续时间进行统计分析。结果：未使用抗生素5例，预防性使用抗生素495例，其中不合理80例（16.00％）。预防性使用抗生素总品规数为540，其中头孢菌素类453例（83.89%），青霉素类（包括加酶抑制剂）26例（4.81%），喹诺酮类44例（8.15%）。选用头孢唑啉钠178例（32.96%）居第一位，头孢替唑钠第二，151例（2796%）。结论：Ⅰ类切口手术患者围手术期预防性使用抗菌药物较为合理，但仍存在用药指征把握不严，抗菌药物的选择、抗菌药物使用时间较长等问题，有待进一步规范化管理。Abstract: Objective: To understand the current application of perioperative preventive antibiotics, and their rationality. Methods: Five hundred perioperative records of patients with incision Ⅰ were randomly chosen and surveyed in 2009. A questionnaire for prophylactic use of antimicrobial was designed. The indication of antimicrobial use, the species, combination, timing and drug duration were analyzed. Results: Our of 500, 495 used antimicrobial and 80 were unreasonable; 540 kinds of antimicrobial were used, included cephalosporin 453 cases (83.89%), penicillin class (including plus enzyme inhibitors) in 26 cases (4.81%), quinolone 44 cases (8.15%). Cefazolin sodium (178 patients, 32.96%) ranked first, second was cefazolin sodium (151, 27.96%). Conclusion: Perioperative use of antimicrobial prophylaxis in patients with incision Ⅰ is reasonable, but standardization management should be strengthened in the indication, species, and duration.
【摘要】 目的 了解外科围手术期预防性使用抗菌药物现状，评估其用药合理性。 方法 随机抽取2009年1-12月265例外科手术患者病历，根据《抗菌药物临床应用指导原则》和《卫生部办公厅关于抗菌药物临床应用管理有关问题的通知》对抗菌药物使用进行合理性评价。 结果 265例外科手术患者均使用了抗菌药物，使用率为100%，外科围手术期预防用抗菌药物不合理率为63.89%，存在的主要问题是用药指征过宽、起点过高、手术前预防用药时间不当、术后预防用药时间过长及盲目联合用药。 结论 外科围手术期抗菌药物预防性使用不合理现象突出，应积极开展合理使用抗菌药物培训，加强抗菌药物使用管理，规范围手术期抗菌药物的使用，从而提高外科围手术期抗菌药物使用合理性。【Abstract】 Objective To know the status of prophylactic use of antimicrobial agents in perioperative patients, and to evaluate the medication rationality. Methods The medical records of 265 patients who underwent the surgeries from January to December 2009 were randomly extracted, and the medication rationality was evaluated according to "Guiding Principles of Clinical Use of Antibiotics" and "Notice of Medical Department Office about Antibiotics Clinical practice Management Related Questions". Results All of the 265 perioperative patients were treated with antimicrobial drugs with a utilization rate of 100.00%, and the unreasonable rate of perioperative prophylactic use of antimicrobial agents was 63.89%. The main reasons included over-extended medication indications, high starting points, inappropriate time points of prophylactic medication, long duration of prophylactic medication and unreasonable drug combination. Conclusion The perioperative prophylactic use of antimicrobial agents is clinically unreasonable. It is necessary to carry out training on the rational use of antimicrobial agents to enhance the management of antimicrobial drug use and regulate the use of antimicrobial agents in perioperation.
ObjectiveTo understand the economic burden of disinfection supply to medical institutions in Yibin City, and explore the feasibility of establishing a regional centralized management model of disinfection supply center in Yibin City.MethodsFrom April to May 2018, 263 medical institutions in the eight counties and two districts of Yibin City were investigated by means of mobile phone application-designed questionnaire, to obtain the information of cost accounting and economic burden of disinfection supply.ResultsThere were 263 medical institutions involved in the survey, in which 61 (23.19%) had set up the central sterile supply department (CSSD), including 43 public hospitals and 18 private hospitals; 202 medical institutions were without CSSD, which were mainly secondary hospitals [195 (74.14%), including 120 public hospitals and 75 private hospitals]. The higher the hospital level was, the larger the average area of the CSSD was; the difference was statistically significant (χ2=40.009, P<0.001). The higher the hospital level was, the more full-time personnel were employed, and the difference was statistically significant (χ2=31.862, P<0.001), and the care staff were the majority (66.23%). The cost burden of CSSD was more than 1 million yuan in the tertiary hospitals, which was 100 000 yuan or above in 61.90% of the secondary hospitals, and was below 100 000 yuan in hospitals below secondary level. The higher the hospital level was, the higher the total cost burden became; the difference was statistically significant (χ2=37.995, P<0.001). ConclusionIn view of the heavy economic burden of CSSD in medical institutions and the unbalanced setting up of medical institutions below secondary level, the establishment of a regional CSSD centralized management model is a new direction, new trend, and new model for future development, which is conducive to improving the quality of disinfection and sterilization, reducing medical care costs, making rational use of health resources, effectively preventing hospital infections, and ensuring the medical safety.
目的 了解住院患者疼痛控制结局的现状及对疼痛控制的满意度，为疼痛管理提供依据。 方法 2012年5月运用便利抽样法选取206例住院患者为研究对象，采用调查问卷的方式了解患者疼痛管理现状和满意度。调查工具为自行设计的患者基本信息调查表、美国疼痛协会结局问卷修订量表。 结果 调查对象当前、过去24 h内最剧烈的疼痛程度及疼痛平均水平以轻度为主，分别占43.2%、42.2%、40.3%；疼痛对一般活动、情绪和其他康复活动的影响程度以中度为主，分别占52.4%、58.3%、53.4%；对疼痛处理结果的满意度以一般为主，占40.8%；78.6%的患者在入院时未被告知疼痛治疗的重要性；66.5%～84.5%的患者对疼痛和止痛药的认知均较差。 结论 二级医院住院患者的疼痛程度较轻，其对生活影响程度尚不严重，但患者对疼痛控制的满意度欠佳，对疼痛相关知识的认知也较差，急需医护人员采取相应的措施提高疼痛控制的效果和质量，从而提高患者在住院期间的满意度。
Objective To provide the evidence for anti-epidemic command and developing response plan through investigation on prophlactical disinfection in Deyang, the worst-hit areas after Wenchuan earthquake. Methods We used convenient sampling together with the report forms and the self-made questionnaire to collect information from 107 villages and 17 settlement spots for the disaster victims in 25 towns in Deyang disaster area. Results There were a total of 6 kinds of disinfectant, including the chlorine disinfectant, 2 kinds of peroxide disinfectant and 2 other types of disinfectant, which were delivered the Deyang disaster area through the National amp; Province CDC system allocation or the None-Goverment Organization donation. From May 17 to June 9, the large-scale preventive disinfection was carried out in the disaster area, covering tap water, the restroom and the latrine pit, trash, environment and sewage. All personnel who conducted the disinfection for prevention and public health in the villages and towns received the technical training for disinfection. Conclusion Various disinfectant types and difference specifications cause trouble in the training of manpower and the use of disinfectant. Preventive disinfection in the most serious disaster areas is better than in serious disaster areas. The main channel of obtaining the disinfectant is through the National amp; Province CDC. The daily-report system of the disinfected areas may monitor the progress of disinfectant use. The suitable disinfection may prevent the public health secondary disaster and protect the environment effectively.
目的:了解我院围手术期预防性应用抗菌药物情况,评价应用的合理性。方法:经对我院符合围手术期预防性应用抗菌药物要求的切口愈合良好的234例病历的适应症、用药种类、联合用药、给药方法及给药持续时间进行统计分析。结果:234例病历所涉及围手术期预防用药共计271例次,给药时机及给药持续时间合理225例次(8303％),不合理46例(16.97％)。围手术期抗菌药物使用一代头孢101例(37.27%),广谱青霉素类49例(1808%)、β-内酰胺酶抑制剂40例(14.76%)。其中单用、二联和三联用药分别为206例(88%)、25例(11％)和3例(128%),平均疗程为2.3天。结论:我院抗菌药物使用仍存在不足之处,加强抗菌药物的使用管理,规范围手术期抗菌药物的使用,需通过临床医师、药师及其他医务人员共同参与,提高我院抗菌药物合理使用水平。
【摘要】 目的 探讨肢体深度烧伤后，影响功能康复的相关因素。 方法 采用美国日常生活自理量表和功能性日常生活量表，对2009年4月-2010年7月来门诊复诊的101例肢体深度烧伤患者的功能康复情况进行问卷调查和统计学分析。 结果 接受专业康复的患者得分明显低于自我康复患者得分，差异有统计学意义（Plt;0.01）；不同性别、不同文化程度之间的比较差异有统计学意义（Plt;0.001）；年龄14～50岁的患者对是否接受专业康复的比较，差异有统计学意义（Plt;0.001）；年龄lt;14岁、gt;50岁及婚姻状况，在是否接受专业康复的比较差异无统计学意义（Pgt;0.01）。 结论 肢体深度烧伤后患者在专业医师的指导下进行专业功能康复比自我康复的患者效果更好，使得烧伤患者社会期日常生活自理能力得到提高。【Abstract】 Objective to explore the related factors affecting the function recovery of deeply burned limps. Methods Adopting ADL body independent living scale and functional daily life scale, the questionnaire survey of the function recovery situation and statistical analysis were performed on the patients from the 101 outpatient appointment patients whose limbs were deeply burned from April 2009 to July 2010. Results The score of patients who accepted professional rehabilitation was significantly lower than that of the self healing patients, and the difference was significant (Plt;0.01); the difference of sex and the comparison between different literate degree were statistically significant (Plt;0.001); the difference in whether to accept the comparison of the professional rehabilitation among the patients with age oflt;14 years old, gt;50 years old and different marital status was not statistically significant (Pgt;0.01). Conclusion patients with deeply burned limbs recover better under the professional function recovery direction of professional doctor than the patients who have self recovery.