目的 了解广州市属医院儿科医生职业倦怠的现状及其社会支持的相关性,对儿科医生的职业倦怠干预提供参考依据。方法 采用职业倦怠量表和社会支持评定量表对广州市属医院儿科医生进行方便抽样调查,并运用Excel和SPSS 25.0对调查结果进行统计描述、方差分析和相关分析。结果 广州市属医院370名儿科医生中共有272人(73.51%)出现不同程度的职业倦怠,中度倦怠者居多,为117人(31.62%)。职业倦怠三个维度中情感耗竭维度得分最高,为(21.64±7.17)分;社会支持总分为(37.68±8.24)分,客观支持、主观支持、支持利用维度得分分别为(7.71±3.23)、(22.53±5.03)、(7.44±1.92)分。其中社会支持处于水平低者居多,为227人(61.35%)。职业倦怠各维度和社会支持各维度两两之间均呈负相关。结论 广州市属医院儿科医生存在较严重的职业倦怠状况,社会支持状况大多处于低水平,尤其客观支持状况较差。社会支持水平越高,职业倦怠程度越轻,提示在缓解职业倦怠时应当充分考虑社会支持对其职业倦怠的影响作用。

Objective By understanding the current situation of job burnout of pediatricians in Guangzhou municipal hospitals and the correlation of social support, to provide reference basis for pediatricians to intervene in job burnout. Methods The Burnout Inventory and the Social Support Rating Scale were used for pediatricians in Guangzhou municipal hospitals, and Excel and SPSS 25.0 were used to conduct statistical description, variance analysis and correlation analysis of the survey results. Results There were 272 pediatricians (73.51%) showed different degrees of job burnout of the 370 pediatricians in Guangzhou municipal hospitals, among which 117 pediatricians (31.62%) showed moderate burnout. Among the three dimensions of job burnout, the highest score was emotional exhaustion (21.64±7.17). The total score of social support was (37.68±8.24), and the dimensions of the objective support, the subjective support and the utilization of support were (7.71±3.23), (22.53±5.03), (7.44±1.92), respectively. Among them 227 (61.35%) had low level of social support. Additionally, there was a negative correlation between each dimension of job burnout and each dimension of social support. Conclusion Pediatricians in Guangzhou municipal hospitals have more serious job burnout, and most of them have low level of social support, especially poor objective support. The higher level of social support will have the lower degree of job burnout. It suggests that the impact of social support on job burnout should be fully considered for alleviating job burnout.

目的 本文对广州市妇女儿童医疗中心2014—2016年院间转运的神经系统患儿进行流行病学分析,探讨危重神经系统疾病患儿转运的安全性。方法 将2014年1月—2016年12月年广州市妇女儿童医疗中心神经系统疾病危重患儿转运986例进行回顾性分析。结果 986例神经系统疾病危重患儿的转运,转运途中无1例死亡,转运男女比例为1.91∶1,转诊患儿的年龄分布主要集中在1月～2岁11个月,占56.64%;转诊患儿无季节性差异,93.96%的疾病是“抽搐查因”和“颅内感染”,81.12%转诊患儿转运半径在150公里以内。结论 由于基层医院受医疗技术、医疗设备的限制,神经系统疾病危重患儿有必要转诊到三级医院进行救治;根据转运神经系统疾病危重患儿的流行病学特征,转运中心应该采取应急措施达到及时安全有效的院间转运。

Objective Children with nervous system diseases needed transfer between hospitals in Guangzhou women and children medical center from 2014 to 2016 was analyzed by the epidemiological method. To explore the safety of the critically ill children with transshipment in diseases of the nervous system. Methods 986 children with nervous system diseases needed transfer between hospitals was given a retrospective analysis. Results In 986 cases transit there were no deaths, male to female ratiowas 1.91∶1; referral of children's age distribution was mainly concentrates in 1 months to 2 years 11 months old, accounting for 56.64%; there was seasonal difference with referral children; 93.96% of the disease were “tic check for” and “intracranial infection”; 81.12% of children of the referral transfer within 150 km radius. Conclusion Critically ill children with nervous system disease referred to a tertiary hospital for treatment is necessary because of the grass-roots hospitals restricted by medical technology and equipments. According to the epidemiological characteristics of transport of critically ill children with nervous system disease, transit center should take emergency measures to arrive timely, safe and effective among hospitals.

目的 分析我院2011—2015年我院儿科住院患者下呼吸道病原菌分布及其耐药性。方法 采用全自动生化鉴定仪对痰标本分离株进行鉴定,用全自动微生物药敏系统和纸片扩散法对病原菌的耐药性进行检测,并用头孢硝噻吩纸片法对β-内酰胺酶进行检测。结果 2011—2015年共分离得到下呼吸道病原菌518株,包括肺炎链球菌(21.62%)、金黄色葡萄球菌(16.99%)、流感嗜血杆菌(14.48%)、肺炎克雷伯菌(11.97%)、大肠埃希菌(8.11%)、卡他莫拉菌(5.41%)、鲍曼不动杆菌(3.86%)和铜绿假单胞菌(3.86%)等。药敏结果显示,肺炎链球菌对克林霉素(90.18%)、红霉素(92.86%)和复方新诺明(87.50%)的耐药率较高,金黄色葡萄球菌则对青霉素G(90.91%)和红霉素(68.18%)有较强耐药性,未发现对万古霉素或利奈唑胺耐药的革兰阳性球菌。流感嗜血杆菌对氨苄西林耐药率为32%,与其β-内酰胺酶阳性率较一致,肺炎克雷伯菌和大肠埃希菌对头孢类药物(17.33%~45.33%)和喹诺酮类药物(34.67%~50.67%)耐药性较高,并发现1株碳青霉烯耐药的肺炎克雷伯菌。结论 本院下呼吸道感染病原菌谱较广,主要包括多种革兰阳性球菌和革兰阴性杆菌,并对多种抗菌药物表现出较强耐药性,临床应注重合理应用相关抗生素,严格防控病原菌的医院感染及传播。

Objective To analyze the antimicrobial resistance and the profile of pathogens from lower respiratory tract infections in pediatric in patients. Methods Sputum bacterial isolates were identified by an automated biochemical identification system. Antimicrobial resistance was detected by an automated drug susceptibility detection system and the disc diffusion method. The β-lactamases was tested by the nitrocefin disc detection method. Results Five hundred and eighteen bacterial pathogens were isolated from sputum samples during 2011-2015, including streptococcus pneumoniae(21.62%), staphylococcus aureus(16.99%), haemophillus influenzae(14.48%), klebsiella pneumoniae(11.97%), escherichia coli(8.11%), moraxelle catarrhalis(3.8%), acinetobacter baumanii(3.86%) and pseudomonas aeruginosa(3.86%). High resistant rates were detected for S. pneumoniae to clindamycin(90.18%), erythromycin(92.86%) and sulfamethoxazole (85.50%), while S. aureus was highly resistant to penicillin G(90.91%) and erythromycin(68.18%). Resistance to vancomycin and linezolid was not detected for gram positive cocci. The resistant rate to ampicillin was 32% for H. influenzae, which was in concordance with the production of β-lactamases. Relatively high resistance was detected for K. pneumoniae and E. coli to cephalosporins and quinolones. A carbapenem-resistant K. pneumoniae isolate was also detected. Conclusion Multiple bacterial species were isolated from lower respiratory tract infections in our hospital, including different species of gram positive cocci and gram negative bacilli, and these isolates exhibited high resistance to antibiotics tested. The clinical use of antibiotics and hospital infection and transmission of these pathogens should be controlled.