目的 开展卫生应急演练并总结经验,探讨演练在提高新发传染病应急处置能力中的作用。方法 以桌面演练和功能性演练为手段,在广州某三甲医疗机构开展演练活动,并对演练效果进行评价。结果 全院共51个科室开展新发传染病防控卫生应急演练,全院演练平均得分4.87。演练为新发传染病应急处置积累了实战经验,达到了锻炼队伍、提高能力的作用。结论 卫生应急演练是检验和提高新发传染病应急处置水平的重要手段,医疗机构通过推进演练活动的制度化、规范化和常态化,可促进新发传染病应急处置工作能力提升。

Objective To carry out health emergency exercises and summarize experiences, and to explore the role of exercises in improving emergency response capabilities for emerging infectious diseases. Methods Using tabletop exercises and functional exercises as means, the exercises were conducted in a tertiary class healthcare facilitie in Guangzhou, and the effects of the exercises were evaluated. Results A total of 51 departments in the hospital conducted health emergency exercises for the prevention and control of emerging infectious diseases, and the average score of the exercises was 4.87. The exercises accumulated actual combat experience for emergency treatment of emerging infectious diseases, and achieved the effect of training the team and improving the capabilities. Conclusion Health emergency exercise is an important mean to test and improve the emergency response capability of emerging infectious diseases. Healthcare facilities can promote the improvement of emergency response capabilities of emerging infectious diseases by promoting the institutionalization, standardization and normalization of exercise activities.

目的 探讨市区院前急救流行病学特征,为制定院前急救策略和合理调配急救资源提供参考依据。方法 采用回顾性资料收集方法选取我院2013—2014年院前急救患者14000例(对照组),2017年院前急救患者9 630例(观察组)作为研究对象,对两组的性别、年龄、死亡原因等建立数据库,采用描述性研究和圆形分布方法进行统计分析,并对比两组数据,分析院前急救患者变化趋势。结果 对照组急救患者性别男性所占比例高于女性,年龄45~55岁所占比例最高,死亡原因创伤所占比例最高,心脑血管疾病其次;观察组急救患者性别男性所占比例高于女性,但低于对照组男性所占比例,年龄45~55岁所占比例最高,但比例低于对照组,死亡原因创伤所占比例最高,心脑血管疾病其次。结论 根据院前急救时间分布规律合理调配急救资源,充分发挥院前急救功能,提高院前急救水平。

目的 探讨医护合作客观结构化临床考试(OSGE)培训对手术室低年资护士应急能力的影响效果。方法 对36名手术室低年资护士进行医护合作OSGE培训,于培训前和培训后3个月对低年资护士进行手术意外事件应对能力、实际参与应对手术意外事件能力以及对手术配合满意度的测评。结果 培训后低年资护士在医护配合、抢救仪器准备、抢救能力、病情评估、应对能力的得分显著提高,在护士抢救到位时间、抢救仪器到位时间、静脉穿刺成功时间明显缩短,医护对手术配合满意度明显提升,与培训前比较差异均有统计学意义(P＜0.05)。结论 对手术室低年资护士进行医护合作OSGE培训,可提高其对手术意外事件应对能力和实际参与应对手术意外事件能力,提高医护人员对手术配合的满意度,降低手术风险。

Objective To explore the effect of Objective structured clinical examination (OSGE) training on theemergency ability of nurses in the operation room. Methods Medical cooperation OSGE training was taken for 36 junior nurses in operation room. We evaluated their undergo operation contingency ability, participation contingency ability and operation cooperation in 3 months before and after training. Results After the training, the junior nurses in medical care cooperation, rescue ability, equipment preparation, condition assessment, coping ability were significantly higher. Nurses′s in-place time, equipments in place time, puncture time were shortened. Cooperation satisfaction was improved significantly. Compared with that before training, the differences were statistically significant (P<0.05). Conclusion Medical cooperation OSGE training for junior nurses in operation room may improve undergo operation contingency ability, coping contingency ability and operation cooperation, reduce the risk of surgery.

目的 探讨在急诊冠心病快速心律失常患者中应用胺碘酮治疗的临床效果。方法 选取在我院接受治疗的164例冠心病快速心律失常患者进行研究,采用随机数字表法将其随机分为对照组和研究组,每组82例。对照组给予利多卡因治疗,研究组给予胺碘酮治疗,比较两组患者的临床治疗效果及不良反应发生情况,同时比较研究组中不同类型心律失常患者的治疗效果。结果 研究组患者治疗总有效率为89.0%,对照组为64.6%,两组比较均有差异(P＜0.05);采用胺碘酮治疗的研究组患者中,室性早搏患者的治疗总有效率最高,其次为阵发性房颤、持续性房颤、阵发性室性心动过速、室性心动过速,其中室性早搏和阵发性房颤治疗总有效率高于心动过速(P＜0.05)。结论 胺碘酮治疗急诊冠心病快速心律失常在适应症和禁忌症的严格掌握和心率、血压的密切监测的前提下效果更为确切,可作为首选药物应用。

目的 对急诊留观病历中存在的质量问题予以分析,探索提高其书写质量的有效措施,优化管理流程。方法 根据卫生部《病历书写基本规范》、《医疗机构病历管理规定》和《广东省病历书写与管理规范》对2015年6月—12月某院1200份急诊留观病历进行质量检查,对其问题进行汇总分析。结果 发现存在质量缺陷的病历998份,缺陷数4478项,以缺权利义务告知书、授权委托书或填写漏项、出观记录入观情况简单复制、缺验单、病程记录过于简单等缺陷位居前四位,占78.67%。结论 急诊留观病历缺陷突出。临床医师及医院管理者需要就此进行针对性整改,以提高和控制急诊留观病历质量。

Objective To analyze deficiencies of medical records from emergency observation room and explore effective procedures to enhance writing quality of medical records and its management. Methods One thousand two hundred medical records from emergency observation room during June to December 2015 were analyzed according principles of medical records writing,regulations for medical records management in medical institutions by Ministry of Health and regulation for medical records writing and management in Guangdong province. Results 998/1200 medical records were found with deficiency and the total deficiencies were 4478 items. The prominent four types of deficiencies, occupying 78.67%, included absence or incompleteness of the notification of the rights and obligations and power of attorney, simple copy and paste of the medical records, absence of medical test results and too simplicity of the recording of the disease process. Conclusion Prominent deficiencies were found in medical records from emergency observation room. The clinical physicians and hospital administrators should take effective procedures to improve and control the quality of the medical records.

目的 通过比较术前螺旋CT诊断与X线、超声诊断,并分析螺旋CT的影像学表现,探讨急诊螺旋CT在外伤性肠及肠系膜损伤诊断及定位的价值。方法 回顾性分析经手术证实的65例行急诊平扫的肠或肠系膜损伤的术前CT、X线、B超等影像诊断结果,比较不同影像报告与术后诊断的符合情况,分析外伤性肠及肠系膜损伤的CT诊断的特点。结果 对肠及肠系膜损伤的CT诊断准确率高于X线、B超诊断准确率,差异有统计学意义(P=0.012,P<0.001),螺旋CT对外伤性肠及肠系膜损伤有对应的征象,利于做出定位诊断。结论 螺旋CT对腹部外伤性肠及肠系膜损伤具有良好的诊断及定位的价值。

Objective To investigate the value of spiral CT in enteral and mesenteric injury diagnosing and localizing caused by abdominal traumatic emergency,by the means of analyzing and comparing the preoperative CT report to X-ray and b-ultrasound reports. Methods 65 cases of confirmed enteral or mesenteric injury were recruited to explore their preoperative CT、X-ray and b-ultrasound features.Statistical analysis was conducted to calculate and compare the rate of sensitivity of 3 different test in diagnosing enteral and mesenteric injury. Results The accuracy of CT in diagnosing enteral and mesenteric injury were better than X-ray and b-ultrasound,the differences were statistical significance(P=0.012,P<0.001),and the CT features can help to localize the injury position. Conclusion Spiral CT scans have value in diagnosing enteral and mesenteric injury.