论著

PDCA循环法及根本原因分析法在持续正压通气治疗重症肺炎患儿中的应用效果

Application of PDCA circulation method and root cause analysis method in the treatment of severe pneumonia in children with continuous positive pressure ventilation

:157-163
 
目的 探讨计划-实施-检查-处理(PDCA)循环法及根本原因分析法在持续正压通气治疗重症肺炎患儿中的应用效果。方法 选取2021年1月—2023年1月医院收治并接受鼻塞式持续正压通气治疗的重症肺炎患儿80例,基于随机数字表法分为两组,每组各40例。对照组接受常规护理,观察组采用PDCA循环法联合根本原因分析法护理干预。比较两组临床症状改善时间、血气指标[动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)、动脉血二氧化碳分压(PaCO2)]、肺功能指标[第1秒用力呼气容积(FEV1)、潮气量(VT)]、炎症免疫指标[单核细胞趋化蛋白-1(MCP-1)、可溶性髓系细胞触发受体-1(sTREM-1)、可溶性细胞间黏附分子-1(sICAM-1)]水平变化,比较两组患儿家属满意度情况。结果 观察组患儿咳嗽、气促、哮鸣音、心率恢复及紫绀等症状改善用时均低于对照组,比较差异有统计学意义(P<0.05)。干预前,两组患儿PaO2、SaO2、PaCO2、FEV1、VT、MCP-1、sTREM-1、sICAM-1水平比较差异均无统计学意义(P>0.05);干预后,两组患儿上述指标水平均有不同程度变化(P<0.05),观察组PaO2(97.18±7.90 mmHg vs 90.30±7.12 mmHg)、SaO2(93.58±3.82% vs 86.30±4.21%)、FEV1(2.66±0.46 L vs 1.97±0.34 L)、VT(11.92±1.89% vs 9.83±1.10%)水平均高于对照组,观察组PaCO2(36.70±3.97 mmHg vs 40.65±3.79 mmHg)、MCP-1(58.45±11.94 ng/L vs 74.46±16.69 ng/L)、sTREM-1(36.25±8.30 ng/L vs 51.57±9.51 ng/L)、sICAM-1(187.52±31.22 mg/L vs 243.73±46.79 mg/L)水平低于对照组,差异均有统计学意义(P<0.05)。观察组患儿家属满意度整体优于对照组(P<0.05);观察组总满意率(97.5% vs 77.5%)高于对照组,差异有统计学意义(P<0.05)。结论 PDCA循环法及根本原因分析法应用于接受持续正压通气治疗的重症肺炎患儿,能够有效促进患儿临床症状改善,有利于血气及肺功能恢复,且可降低炎症反应,患儿家属满意度较高。
Objective To explore the application effect of Plan-Do-Check-Action(PDCA)circulation method and root cause analysis method in the treatment of children with severe pneumonia with continuous positive pressure ventilation.Methods From January 2021 to January 2023,80 children with severe pneumonia who were admitted to hospital and received nasal plug continuous positive pressure ventilation treatment were enrolled in this study.Based on the random number table method,they were divided into two groups,with 40 cases in each group.The control group received routine nursing,while the observation group received PDCA circulation method combined with root cause analysis nursing intervention.The improvement time of clinical symptoms,changes in blood gas indicators[arterial partial oxygen pressure(PaO2),arterial oxygen saturation(SaO2),arterial partial pressure of carbon dioxide(PaCO2)],lung function indicators [(forced expiratory volume in 1 second,FEV1),tidal volume(VT)],and inflammatory immune indicators [monocyte chemotactic protein-1(MCP-1),soluble myeloid cell trigger receptor-1(sTREM-1),soluble intercellular adhesion molecule-1(sICAM-1)] levels between the two groups were compared,and the family members’ satisfaction of the two groups was also compared.Results The improvement time for symptoms such as cough,shortness of breath,wheezing,heart rate recovery and cyanosis in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Before intervention,there was no statistically significant difference in the levels of PaO2,SaO2,PaCO2,FEV1,VT,MCP-1,sTREM-1 and sICAM-1 between the two groups of children(P>0.05).After intervention,the levels of the above indicators in both groups of children showed varying degrees of change(P<0.05).The levels of PaO2(97.18±7.90 mmHg vs 90.30±7.12 mmHg),SaO2(93.58±3.82% vs 86.30±4.21%),FEV1(2.66±0.46 L vs 1.97±0.34 L),VT(11.92±1.89% vs 9.83±1.10%)in the observation group were higher than those in the control group.The levels of PaCO2(36.70±3.97 mmHg vs 40.65±3.79 mmHg),MCP-1(58.45±11.94 ng/L vs 74.46±16.69 ng/L),sTREM-1(36.25±8.30 ng/L vs 51.57±9.51 ng/L)and sICAM-1(187.52±31.22 mg/L vs 243.73±46.79 mg/L)in the observation group were lower than those of the control group,with statistically significant differences(P<0.05).The overall satisfaction of the observation group was better than that of the control group(P<0.05),the total family members’ satisfaction rate of the observation group was higher than that of the control group(97.5% vs 77.5%),with a statistically significant difference(P<0.05).Conclusions PDCA circulation method and root cause analysis method applied to children with severe pneumonia who receive continuous positive pressure ventilation treatment,can effectively promote the improvement of clinical symptoms,be conducive to the recovery of blood gas and lung function,and reduce inflammatory reaction,with high family members’ satisfaction.
论著

环泊酚应用于老年患者无痛胃肠镜的临床研究

Clinical study on the application of ciprofol in elderly patients undergoing painless gastroenteroscopy

:406-410
 
目的 观察环泊酚在老年患者无痛胃肠镜检查中的麻醉效果和不良反应。方法 选择80例65岁以上行无痛胃肠镜检查的老年患者,将患者随机分为环泊酚组(C组)40例和丙泊酚组(P组)40例。每例患者均静脉注射舒芬太尼0.08 μg/kg,30 s后C组给予环泊酚0.3 mg/kg、P组给予丙泊酚1.5 mg/kg。记录2组患者麻醉前(T0)、睫毛反射消失时(T1)、置入胃镜后即刻(T2)和操作结束时(T3)的心率(HR)和平均动脉压(MAP);记录2组患者检查操作时间、清醒时间、追加药物次数及静脉注射痛、呼吸抑制、呛咳、体动等不良反应发生情况。结果 2组患者行胃肠镜检查操作时间、麻醉清醒时间和追加药物次数比较差异无统计学意义(P>0.05)。与T0时间点(102.6±14.1 mmHg)比较,P组患者的MAP在T1(86.0±12.5 mmHg)、T2(86.1±13.2 mmHg)、T3(92.8±12.6 mmHg)时间点明显下降,差异有统计学意义(P<0.05);与C组T1(95.9±10.8 mmHg)、T2(96.3±9.6 mmHg)时间点比较,P组的MAP在T1(86.0±12.5 mmHg)、T2(86.1±13.2 mmHg)时均明显降低(P<0.05)。C组患者静脉注射痛、呼吸抑制的发生率明显低于P组(P<0.05);2组体动和呛咳的发生率比较差异无统计学意义(P>0.05)。结论 环泊酚0.3 mg/kg在老年患者胃肠镜检查中能提供和丙泊酚1.5 mg/kg相似的麻醉效果,环泊酚组的老年患者发生注射痛、血压下降、呼吸抑制的比例更低。
Objective To observe the effect of ciprofol and propofol in painless gastroenteroscopy in elderly patients.Methods A total of 80 elderly patients aged 65 or above who underwent painless gastroenteroscopy were randomly divided into a group of 40 patients receiving ciprofol(Group C)and a group of 40 patients receiving propofol(Group P).All patients were given sufentanil 0.08 μg/kg,and group C was given ciprofol 0.3 mg/kg,group P was given propofol 1.5 mg/kg after 30 seconds.The heart rate(HR)and mean arterial pressure(MAP)of two groups of patients before anesthesia(T0),at the disappearance of eyelash reflex(T1),after gastroscopy insertion(T2),and at the end of the procedure(T3)were recorded.The operating time,anesthesia awakening time,number of additional medications and the adverse reactions such as injection pain,respiratory depression,cough,body movements were also recorded.Results There were no significant differences(P>0.05)in the gastroenteroscopy operating time,recovery time and number of additional medications between the two groups.Compared with T0 time point(102.6±14.1 mmHg),the MAP of group P patients significantly decreased at T1(86.0±12.5 mmHg),T2(86.1±13.2 mmHg)and T3(92.8±12.6 mmHg)time points(P<0.05).Compared with Group C at T1(95.9±10.8 mmHg),T2(96.3±9.6 mmHg)time points,the MAP of Group P decreased significantly at T1(86.0±12.5 mmHg)and T2(86.1±13.2 mmHg)time points(P<0.05).The incidences of injection pain and respiratory depression in group C were significantly lower than those in group P(P<0.05).There was no statistically significant difference in the incidences of body movements and cough between the two groups(P>0.05).Conclusions Ciprofol 0.3 mg/kg combined with sufentanil can provide anesthesia effect similar to that of propofol 1.5 mg/kg combined with sufentanil in gastroenteroscopy of elderly patients.The proportions of injection pain,blood pressure decreasing and respiratory depression in elderly patients in the ciprofol group were lower.
论著

婴儿孤独症观察量表中文版的临床应用研究

Clinical application of the Chinese version of the Autism Observation Scale for Infants

:360-364
 
目的 检验婴儿孤独症观察量表中文版(AOSI)临床应用的灵敏度与特异度,评价其临床应用效果。方法 随机抽取1岁时曾在清远市妇幼保健院行AOSI评估,于2~3岁时诊断为孤独症谱系障碍(ASD)的48例患儿为ASD组,诊断为正常发展的46例幼儿作为对照组。比较两组患儿的18个条目得分和总分,采用受试者操作特征(ROC)曲线计算AOSI的特异度、灵敏度、阳性预测值与阴性预测值,并判断AOSI的最佳诊断(阳性)分界值;分析AOSI评估结果与《精神障碍诊断与统计手册(第5版)》(DSM-5)中ASD诊断标准的一致性。结果 两组研究对象性别、年龄比较差异无统计学意义(P>0.05)。ASD组各条目得分和总分均高于对照组,且差异具有统计学意义(P<0.01)。AOSI的曲线下面积(AUC)为1.00(P<0.01),95%置信区间为(1.00,1.00)。不同阳性分界线的灵敏度、特异度、阳性预测值、阴性预测值及一致性相比较,当约登指数等于1.00时AOSI的最佳诊断(阳性截断值)界线为9分时,其上述值均为1.00。AOSI评估结果与DSM-5中ASD的诊断标准完全相一致(Kappa=1,P<0.01)。结论 AOSI应用于评估1岁的婴儿,当取9分为诊断界值时,具有高度的灵敏度与特异度,能较好地预测该婴儿在2~3岁时是否患ASD;AOSI是婴儿期ASD筛查的重要工具,其评估结果可作为ASD高危儿早期干预的证据和ASD的辅助诊断工具,适合于临床推广应用。
Objective To test the sensitivity and specificity of the Chinese version of the Autism Observation Scale for Infants(AOSI)in clinical application and evaluate its clinical application effect.Methods Forty-eight children with autism spectrum disorder(ASD)diagnosed at the age of 2 to 3 years who had undergone AOSI evaluation in Qingyuan Maternal and Child Health Hospital at the age of 1 year(2021)were randomly selected as the ASD group,and 46 children with normal development were randomly selected as the control group.The scores of 18 items and total scores of the two groups of subjects were compared.The specificity,sensitivity,positive predictive value and negative predictive value of AOSI were calculated using the receiver operating characteristic curve(ROC),and the best diagnostic(positive)cut-off value of AOSI was confirmed.The consistency of AOSI evaluation results with the ASD diagnostic criteria in DSM-5 were compared.Results There was no statistically significant difference in genders or age between two groups(P>0.05).The scores of each item and total scores in the ASD group were significantly higher than those in the control group,and the difference was statistically significant(P<0.01).The area under the curve of AOSI(AUC=1.00,P<0.01)had a 95% confidence interval of(1.00,1.00).Comparing the sensitivity,specificity,positive predictive value,negative predictive value and consistency of different positive boundary points,when the Youden index was equal to 1.00,the optimal diagnostic(positive cut-off value)boundary for AOSI was 9 points,and all of the above values were 1.00. The AOSI evaluation results were completely consistent with the diagnostic criteria for ASD in DSM-5(Kappa=1,P<0.01).Conclusions AOSI has high sensitivity and specificity when it is used to evaluate the 1-year-old infant.When “9 points” is taken as the diagnostic threshold,it can better predict whether the infant has ASD at the age of 2~3 years.AOSI is an important tool for screening ASD in infancy.Its evaluation results can be used as evidence for early intervention of high-risk infants with ASD and as a assisting tool to diagnosis ASD,which is suitable for clinical application.
综述

温针治疗脑卒中后遗症的临床研究进展

Progress in clinical application of warm needling in sequelae of apoplexy

:342-349
 
脑卒中是临床常见的急性脑血管疾病,常有偏瘫、肩手综合征、下肢深静脉血栓等后遗症,严重影响患者的生活质量。温针疗法是中医传统的特色疗法,近年来,应用以温针为主的相关疗法治疗脑卒中后遗症的报道越来越多,在临床上得到广泛应用。本文归纳分析了近10年来温针疗法治疗脑卒中后肩手综合征、偏瘫、下肢深静脉血栓三大主要疾病的案例及研究,以期为相关研究与应用提供参考。
Stroke is a common acute cerebrovascular disease in clinical practice,which frequently leaves sequelae like hemiplegia,shoulder-hand syndrome and deep vein thrombosis of the lower extremities,and vastly reduces the quality of life of patients.Warm needling is a characteristic therapy of traditional Chinese medicine.In recent years,there have been more and more reports of warm needling-based related therapies for the treatment of stroke sequelae,and it has been widely used in clinical practice.This article summarizes and analyzes the cases and studies of warm needing therapy in the treatment of shoulder-hand syndrome,hemiplegia and deep vein thrombosis of the lower extremities after stroke in the past 10 years,so as to provide reference for related research and application.
医学教育

多样化教学在小儿外科临床见习中的应用

Application of diversified teaching in pediatric surgery clinical probation

:693-698
 
目的 探讨以多媒体教学法、标准患者教学法、案例教学法、手术观摩教学法等多种教学方法相结合的多样化教学,在小儿外科临床见习的教学实施效果评价。方法 以2022年、2023年参加小儿外科临床见习的儿科学生为研究对象,随机分为试验组和对照组,每组分别45人。试验组采用多样化教学进行临床带教,对照组采用传统教学法进行带教。对比两组儿科学生的理论知识分数、技能操作分数、临床知识评分及总成绩,师生满意度及家属对儿科学生的满意度。结果 试验组的理论知识分数(85.69±4.59)、技能操作分数(86.36±4.35)、临床知识评分(87.71±4.01)及总成绩(86.59±2.85)均高于对照组,差异有统计学意义(P<0.05)。在满意度评价中,试验组在教学方式、学习兴趣、自我评价、团队协作能力及对小儿外科的专业认可度分别为(4.84±0.37)(4.87±0.34)(4.89±0.32)(4.84±0.37)(4.91±0.29),均高于对照组,差异有统计学意义(P<0.01);而试验组及对照组对带教教师的理论知识水平分别为(4.80±0.46)(4.64±0.53),带教教师的积极性评分分别为(4.89±0.32、4.75±0.43),比较差异无统计学意义(P>0.05);带教教师在试验组专业知识掌握情况、临床实践操作能力、学生学习积极性及团队协作能力评分分别为(4.82±0.39)(4.87±0.34)(4.91±0.29)(4.93±0.25),均高于对照组,差异有统计学意义(P>0.05)。患儿家属对试验组在医师尊重孩子、医师非常关注孩子及医师鼓励孩子提问并积极解决问题方面评分分别为(4.91±0.29)(4.93±0.25)(4.91±0.29),均高于对照组,差异有统计学意义(P<0.05)。结论 在小儿外科临床见习采用多样化教学不仅能提高儿科学生的理论、技能、临床知识水平,还能提高师生满意度及儿科学生对小儿外科的专业认可度。
Objective To assess the impact of multimedia teaching methods,standard patient teaching methods,case teaching methods,and surgical observation teaching methods on clinical probation in pediatric surgery.Methods Pediatric students participating in clinical probation in pediatric surgery in 2022 and 2023 were randomly assigned to either the experimental group or the control group,with 45 students in each group.The experimental group received diversified teaching methods,while the control group received traditional teaching methods.A comparison was made between the two groups regarding theoretical knowledge scores,skill operation scores,clinical knowledge scores,total scores,teacher-student satisfaction levels,and family satisfaction levels of pediatric students.Results The experimental group demonstrated significantly higher theoretical knowledge scores(P<0.05),skill operation scores(P<0.05),clinical knowledge scores(P<0.05),and total scores compared to the control group.In terms of satisfaction evaluation criteria such as teaching style,learning interest,self-evaluation ability,teamwork skills and professional recognition of pediatric surgery(P<0.01),the experimental group showed significantly higher levels than the control group.There was no significant difference between the two groups regarding teachers’ theoretical knowledge level and enthusiasm score(P>0.05).However,the teachers in the experimental group scored significantly higher than those in the control group when it came to professional knowledge mastery,clinical practice ability,student learning enthusiasm,and teamwork skills(P>0.05).Conclusions Implementing diversified teaching approaches during pediatric surgery clinical probation not only enhances theoretical understanding,skills development,and clinical expertise among pediatric students,but also improves overall satisfaction levels for both teachers and students as well as enhances professional recognition of pediatric surgery students.
论著

间歇经口至食管管饲法联合自创吞咽功能训练在脑卒中吞咽障碍患者的应用研究

Application of intermittent oral to esophageal feeding combined with self created swallowing function training in stroke patients with swallowing disorders

:680-685
 
目的 探讨间歇经口至食管管饲法与自创吞咽功能训练联合应用于脑卒中吞咽障碍患者的效果。方法 选取河南大学淮河医院2022年1月—2023年12月收治的50例脑卒中吞咽障碍患者,应用随机数字表法将其分为两组,每组各25例。对照组采取持续留置鼻饲的同时应用自创吞咽功能训练进行训练,观察组采取间歇经口至食管管饲的同时应用自创吞咽功能训练进行训练。对比两组吞咽障碍改善情况、干预前后营养状况指标及生活质量变化,比较两组并发症发生率。结果 观察组总有效率高于对照组(P<0.05)。干预后两组血清总蛋白、白蛋白和血红蛋白水平和体质量指数均升高,观察组高于对照组(P<0.05)。干预后两组生活质量综合评定量表评分升高,观察组高于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论 对脑卒中吞咽功能障碍患者采取间歇经口至食管管饲法与自创吞咽功能训练,能够更有效改善患者吞咽功能,提升其生活质量,且可降低留置饲管营养支持过程中的并发症发生率。
Objective To explore the application effect of intermittent oral to esophageal feeding combined with self created swallowing function training exercises in stroke patients with swallowing disorders.Methods Fifty stroke patients with swallowing disorders admitted to our hospital from January 2022 to December 2023 were selected and divided into two groups by random number table method,both with 25 cases.Control group patients received continuous nasogastric feeding while using solf created swallowing function training exercises for training,while observation group patients received intermittent oral to oesophageal tube feeding and using solf created swallowing function training exercises for training.The improvement of swallowing disorders,changes in nutritional status indicators and quality of life before and after the intervention were compared,and also the frequency of complications.Results The observation group was generally more effective than the control group(P<0.05).After intervention,the serum total protein,albumin hemoglobin,and BMI levels of both groups of patients increased,with the observation group being higher than the control group(P<0.05).After the intervention,GQOLI-74 score increased in both groups,and the observation group was higher than the control group(P<0.05).The complication rate was lower in the observation group(P<0.05).Conclusions The intervention method of intermittent oral to esophageal tube feeding combined with self created swallowing function training exercises can further improve the swallowing function of stroke patients with swallowing dysfunction,improve their quality of life,and reduce the occurrence of complications during the nutritional support process of feeding tubes.
医院管理

PDCA管理法在医院药事管理中的应用分析

Analysis of the application of PDCA management method in hospital pharmacy management

:810-814
 
目的 分析PDCA管理法在医院药事管理中的应用效果。方法 将我院2 000批药品设置为研究对象,样本纳入的起始、截止时间分别为2022年1月、2022年12月,依据时间对纳入样本开展组别划分,将2022年1月—6月1 000批药品设置为PDCA管理前研究对象,期间接受常规药品管理;将2022年7月—12月1 000批药品设置为PDCA循环法管理后研究对象。对比PDCA管理前后药品不良事件发生率及药事管理质量评分。结果 PDCA循环法管理后药学差错事件发生率低于PDCA循环法管理前,分别为0.30%、1.90%,对比差异有统计学意义(P<0.05);PDCA循环法管理后建立药品质量监控体系、药品调剂制度、抗肿瘤药物分级管理方案和处方管理、临床药师参与四个维度评分较PDCA循环法管理前均有明显提升,分别为18.15±1.83、18.15±1.64、18.22±1.67、18.07±1.84,管理前后评分对比差异具有统计学意义(P<0.05)。结论 医院药事管理采用PDCA管理法可提升药事管理质量,降低药品不良事件发生率,值得应用。
Objective To analyze the application effect of PDCA cycle method in hospital pharmaceutical management.Methods A total of 2 000 batches of drugs in our hospital were included as research objects,the inclusion start and end of samples were January 2022 and December 2022.The included samples were divided into groups according to the time,1 000 batches of drugs from January 2022 to June 2022 were included as research objects before PDCA management,during which they were subjected to routine drug management.1 000 batches of drugs from July 2022 to December 2022 were included as the research objects under management by PDCA cycle method.The incidence of adverse drug events and the quality score of drug administration before and after PDCA administration were compared.Results The incidence of pharmaceutical error events after PDCA cycle management was lower than that before PDCA cycle management,which were 0.30% and 1.90%,respectively,and the differences were statistically significant(P<0.05).After PDCA cycle management,the scores of establishment of drug quality control system(18.15±1.83),drug dispensing system(18.15±1.64),anti-tumor drug grading management scheme and prescription management(18.22±1.67),clinical pharmacist participation(18.07±1.84)were significantly improved compared with those before PDCA cycle management,and the difference between scores before and after PDCA cycle management was statistically significant(P<0.05).Conclusions PDCA cycle can improve the quality of pharmaceutical management and reduce the incidence of adverse drug events,which is worthy of application.
论著

俯卧位通气在脓毒症合并急性肺损伤患儿的应用效果

The application effect of prone position ventilation in children with sepsis combined with acute lung injury

:796-800
 
目的 探讨俯卧位通气在脓毒症合并急性肺损伤患儿的应用效果。方法 选取泉州市儿童医院2020年9月—2023年9月收治的72例脓毒症合并急性肺损伤患儿,应用抽签法将其分为观察组与对照组,均为36例。对照组患儿实施常规仰卧位机械通气与对应护理,观察组患儿在常规护理基础上增加俯卧位通气与对应护理。对比两组患儿机械通气时间,干预前和干预3 d后气道平台压和心率水平,动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2),并计算动脉血氧分压与吸入气中的氧浓度分数比值(PaO2/FiO2),评价两组患儿预后及不良事件发生情况。结果 观察组机械通气时间明显低于对照组(P<0.05),干预后两组患儿气道平台压、心率均降低,且观察组低于对照组(P<0.05);干预后两组患儿PaO2/FiO2、PaO2水平升高,观察组高于对照组,PaCO2降低,观察组低于对照组(P<0.05);干预后两组患儿全身性感染相关性器官功能衰竭评分(SOFA)、急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)评分均降低,观察组低于对照组(P<0.05);两组患儿呼吸机管路折管、管路滑脱、压力性损伤等不良事件发生率对比差异无统计学意义(P>0.05)。结论 俯卧位通气在脓毒症合并急性肺损伤患儿的应用效果显著,可降低患儿气道平台压及心率,缩短机械通气时间,改善患儿通气功能,有助提升预后水平。
Objective To explore the application effect of prone position ventilation in children with sepsis complicated with acute lung injury.Methods From September 2020 to September 2023,72 children with sepsis and acute lung injury admitted to Quanzhou Children's Hospital were selected and divided into observation group and control group by drawing lots,both with 36 cases.The children in the control group received routine supine mechanical ventilation and corresponding nursing,and the children in the observation group added prone ventilation and corresponding nursing on the basis of routine nursing.By comparing the duration of mechanical ventilation,airway plateau pressure and heart rate level,PaCO2,PaO2,PaO2/FiO2,the prognosis and occurrence of adverse events in the two groups were evaluated.Results The mechanical ventilation time in the observation group was significantly shorter than that in the control group(P<0.05).After intervention,the airway plateau pressure and heart rate levels of the two groups of children decreased,and the observation group was lower than the control group(P<0.05).After the intervention,the levels of PaO2/FiO2 and PaO2 in the two groups of children increased,with the observation group higher than the control group,while the level of PaCO2 was lower,with the observation group lower than the control group(P<0.05).After the intervention,the SOFA and APACHE II scores of the two groups of children decreased,and the observation group was lower than the control group(P<0.05).There was no difference in the incidence of adverse events such as ventilator tube folding,tube slip and pressure injury between the two groups(P>0.05).Conclusions The application of prone position ventilation in children with sepsis combined with acute lung injury has a significant effect,which can reduce airway plateau pressure,lower heart rate,shorten mechanical ventilation time,improve ventilation function,and assist in improving prognosis.
专家述评

干细胞疗法及神经调控技术在脊髓损伤中的研究进展

Research progress on application of stem cell and neuromodulation technology in spinal cord injury

:689-704
 
脊髓损伤是一种高致残性中枢神经系统疾病,目前缺乏有效的治疗措施。干细胞组织工程兴起和神经调控技术的发展,给脊髓损伤的治疗带来新的希望。目前,多项针对脊髓损伤的干细胞相关治疗项目的临床研究已在全球注册,干细胞疗法是脊髓损伤领域的研究热点,具有良好的应用前景。而神经调控技术一直在临床上脊髓损伤后的康复治疗中发挥着重要作用,特别是靶向神经调控技术近年在脊髓损伤治疗方面取得突破性进展。有研究尝试联合干细胞疗法和神经调控技术应用治疗脊髓损伤,试图取得更好的效果。本文综述了干细胞疗法和神经调控技术在脊髓损伤治疗中的研究进展,旨在探讨其作用效果、修复机制、应用前景以及面临的问题,进一步为脊髓损伤的基础研究和临床转化提供参考。
Spinal cord injury is a highly disabling disease of the central nervous system without effective treatment to date.With the rise of stem cell and tissue engineering,and the breakthrough of neuromodulation technology,it brings new hope to the treatment of spinal cord injury.At present,a number of clinical studies on stem cell-related treatment projects for spinal cord injury have been registered worldwide,which has become a research hotspot.Neuromodulation technology has been playing an important role in the clinical rehabilitation of spinal cord injury.Especially,breakthroughs have been made in the treatment of spinal cord injury by targeted neuromodulation technology in recent years,which is encouraging.Some studies have attempted to combine stem cell therapy and neuromodulation technology to treat spinal cord injuries in an attempt to achieve better effect.This review summarizes the research progress of stem cell therapy and neuromodulation technology in the treatment of spinal cord injury,with the aim of discussing their effect,repair mechanisms,application prospect and various problems to face,and providing further reference for the basic research and clinical transformation of spinal cord injury.
医院管理

业财融合背景下医院科研物资一体化信息系统的设计与应用

Application of integrated information system for hospital research material based on business and financial integration

:1099-1104
 
在“放管服”改革的背景下,基于业财融合管理理念对医院科研物资进行一体化管理是发展趋势。但由于科研项目管理涉及众多部门,流程繁杂,致使医院科研物资管理面临诸多问题。为了改变现状,广州市某三甲医院探索构建基于业财融合的医院科研物资一体化信息系统,分别上线了科研物资采购平台和经费管理系统,并在实践中对信息系统进行了优化与设计。实践证明,该系统具有创新性和应用价值,对医院的财务管理和科研项目管理具有重要的参考意义。
Under the background of streamlining administration and delegating power,the integrated management of hospital scientific research materials based on the concept of integrating industry and finance is a development trend.However,due to the involvement of multiple departments and complicated processes in scientific research project management,the management of hospital scientific research materials faces many problems.In order to change the current situation,a Tertiary Grade A Hospital in Guangzhou explored the construction of an integrated information system for hospital scientific research materials based on the integration of industry and finance.They launched a scientific research material procurement platform and a funding management system,and optimized and designed the information system in practice.Practice has proven that the system is innovative and valuable,and it has important reference significance for the financial management and scientific research project management of hospitals.
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