目的 探讨局部麻醉（以下简称局麻）腹股沟疝无张力修补术在基层医院的应用价值。方法 分析内蒙古医学院附属人民医院2010年10月至2011年12月期间242例行局麻腹股沟疝修补手术患者的临床资料。结果 除1例因过度紧张而停止手术外，其余手术顺利。平均手术时间50min，所有患者术后0.5～4h （平均2h） 均能下床活动，切口疼痛时间0.5～1d。无一例发生尿潴留；12例患者术后阴囊轻-中度水肿，切口感染1例。全部病例术后观察1～2d出院。门诊随访2～15个月（平均8个月），复发2例。结论 局麻下腹股沟疝无张力修补术安全、疼痛轻微、禁忌证少、复发率及费用低，值得在基层医院推广。
【摘要】 目的 探讨在基层医院建立脑卒中单元模式的临床意义。 方法 将2006年1-3月和2007年同期共381例脑卒中患者分为脑卒中单元组和普通病房组。脑卒中单元组按照脑卒中单元模式进行治疗，普通病房组按照传统方法治疗，分别于治疗前、治疗后7、15、30 d时，对比分析两组患者神经功能缺损及疗效。 结果 脑卒中单元组和普通病房组治疗后，随时间两组的神经功能缺损评分（NIHSS）均逐渐降低，两组在治疗后15、30 d时差异有统计学意义（P=0.007），脑卒中单元组家属满意度明显高于普通病房组（P=0.002）。 结论 在基层医院脑卒中单元模式对脑卒中患者的治疗效果明显优于传统治疗。【Abstract】 Objective To investigate the clinical significance of setting up stroke unit model in basic hospital. Methods Three hundreds and eighty-one stroke patients were randomly divided into stroke unit group (n=186) and general ward group (n=189). The stroke unit group patients were treated with the stroke unit model designed by ourselves, while the control group patients were treated with traditional method, The clinical efficacy was compared before treatment, seven days, 15 days and 30 days after treatment. Results Improvement in neurological score was significantly better among patients treated in the SU than in the GW. NIHSS scores gradually reduce in the both groups after treatment, which were significantly lower than those in the control group on 15 days and 30 days after treatment(P=0.007,0.004). The satisfactory of relatives in the stroke unit group was better than that in the general ward group(P=0.002). Conclusion The efficacy of treatment with stroke unit model was better than that of treatment with traditional method in the stroke patients.
ObjectiveTo explore the current situation of nosocomial infection, sample test and use of antibiotics in the in-patients, so as to provide scientific evidence for control and prevention of nosocomial infection. MethodsBedside investigation and medical records checking were adapted to conduct cross-sectional survey among all the in-patients in 2013 and 2014. ResultsOn July 16 th, 2013 (00:00-24:00) and September 10 th, 2014 (00:00-24:00), a total of 1 400 in-patients were investigated in whom 68 with nosocomial infection were diagnosed, with a prevalence rate of 4.86%. No statistical difference were found between the two year's prevalence rate (χ2=1.341, P=0.264). The prevalence rate of Intensive Care Unit, Department of Neurosurgery (including Department of Thoracic Surgery) and Department General Surgery ranked the first three places, and the most common infection position was respiratory tract (61.76%). The usage rate of antibiotics was 48.00% in the two years, and no statistical difference was observed in the usage rate between the two years (χ2=1.309, P=0.261). Therapeutic use (67.86%) and onefold use (90.33%) accounted for most of antibiotics use. Test rate of therapeutic antibiotics use was 49.17% and no statistical difference was observed in the test rates between the two years (χ2=2.023, P=0.170). ConcluslonsThe nosocomial infection rate was stably high in the two years. To prevent and control nosocomial infection effectively, medical personnels knowledge and skills on nosocomial infection should be improved, surveillance and guidance towards key departments should be strengthened and clinicians' diagnosis and treatment behaviors should further be regulated.
ObjectiveTo summarize the experience of microsurgery in primary hospital for the posterior communicating artery aneurysms (PCOAan). MethodsThe clinical data of 48 patients with PCOAan who underwent microsurgery from January 2008 to December 2012 were retrospectively analyzed. ResultsAll the necks of aneurysms of 48 cases were successfully clipped, Acording to the Glasgow outcome score (GOS), the early curative effects were good in 36 cases (75.0%, GOS 4-5) poor in 10 cases (20.8%, GOS 2-3) and death in 3 cases (2.1%, GOS 1). After the operation was carried out, the operation time was shorten, aneurysm intraoperative rupture rate was lower, postoperative complications were lower, and the average medical expense was reduced; the difference was significant in 24 cases before and after the operation (P<0.05). ConclusionMicrosurgery for PCOAan is an effective method which should be popularized in primary hospitals.
摘要:目的: 探讨基层医院急诊“120”院前救治水平的影响。 方法 :分析301例死因,年龄及百分比。 结果 :急诊致死原因疾病病谱前9位分别是交通事故,猝死,溺水,意外伤害,自杀,电击伤,刀伤,一氧化碳中毒及呼吸道梗塞,“无名氏”群体86例占285%,这部分给临床和社会带来了新问题,这仍有待今后继续探讨。 结论 :完善基层医院“120”体系,提高救治水平。Abstract: Objective: To explore the factors relate to prehospital“120”Emergency Medical Services cases death. Methods : Analysis the cause for death, ages and percentage of the age in 301 cases. Results : Traffic accident, sudden death, drowns, accident, suicide, electric burn, knife trauma, anthracemia and respiratory tract obstruction were the leading cases in the diseases spectrum of the cause for death in emergency cases. 86 cases were anonym, which brought new problems to clinic treatment and provoked social issue, accounting for 285% in total cases. These remain us to study henceforth. Conclusion : Consummate the “120” Emergency MedicalServices system in grassroots hospital and enhance the level of cure.
ObjectiveTo explore the application of tracking method in intravenous treatment in primary hospitals, in order to improve the quality of nursing of intravenous therapy. MethodsFor the 22 events of venous transfusion adverse reactions between January and March 2013, we used tracking methodology for tracking and analyzing the reasons. Through this, we regulated and implemented specific improvement scheme, perfected rules and regulations to improve the work process. ResultsThrough reason analysis and improving regulations, the number of intravenous infusion adverse reactions was decreased from 22 in the first quarter to 0 in the fourth quarter of the year. ConclusionTracking methodology used for regulating the intravenous treatment behaviors of basic-level hospitals nurses can reduce the occurrence of adverse transfusion reaction