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An Analysis of 4109 Cases in Prehospital Care by ICD10

摘要:目的: 通過分析地市級急救中心院前急救資料,探討ICD10疾病分類方法在院前急救中的實用性。 方法 :回顧性分析2007年1~12月份自貢市急救中心出診的全部有效急救患者的急診診斷以及隨訪診斷,使用ICD10編碼進行歸類,比較疾病性別構成比。 結果 :全年院前急救4109例,排5位的疾病分別為損傷、中毒和外因的某些其他后果(484%)、循環系統疾病(170%)、消化系統疾病(81%)、呼吸系統疾病(64%)、精神和行為障礙(52%),損傷、中毒和外因的某些其他后果、循環系統疾病以及消化系統疾病出診量男性多于女性(P＜005),耳和乳突疾病以及妊娠、分娩和產褥期疾病出診量女性多于男性(P＜005)。 結論 :采用ICD10標準對院前急救病譜分類有進一步探討的價值。Abstract: Objective: To investigate the value of ICD10 in prehospital care by the analysis of cases in Zigong Urgent Rescue Center. Methods : All cases of prehospital care during the year of 2007 were studied, whose emergency Diagnoses and followup diagnoses were recorded, and they were classified by international classification of diseases 10th revision (ICD10). The gender composition ratio of diseases was analyzed. Results : Four thousand one hundred and nine cases of prehospital care in 2007 were included. Topfive diseases were injury, poisoning and certain other consequences of external causes (484%), diseases of the circulatory system (170%), diseases of the digestive system (81%), diseases of the respiratory system (64%), and mental and behavioral disorders (52%) respectively. The amout of the male prehospital cases was more that of than the female’s in the diseases of injury, poisoning and certain other consequences of external causes, diseases of the circulatory system, diseases of the digestive system (P＜005); the amount of the female prehospital cases was more than that of the male’s in the diseases of the ear and mastoid process, pregnancy, childbirth and the puerperium (P＜005). Conclusion : Further research on the spectrum of diseases classified by ICD10 is valuable.

The Relationship between Pathological Feature of Liver Biopsies and Serological Markers of Bhepatitis in Patients with Chronic Asymptomatic Hepatitis B Carrier

摘要:目的:分析慢性乙肝病毒攜帶者肝組織病理與年齡、病程、血清學及肝臟免疫組化指標的相關性,以確定孰是對病理進程影響最主要的指標。方法:對134例臨床診斷的慢性乙肝病毒攜帶者進行乙肝血清學標志物、肝功能、肝活組織病理及免疫組化的檢查。結果:①病理表現為不典型增生者HBeAg陰性組少于HBeAg陽性組,而表現為慢性肝炎者前者多于后者,差異均有顯著性;HBVDNAlt;105亞組分析兩組病理表現無統計學差異;兩種病理表現類型在年齡18~40歲組及gt;40歲組明顯多于lt;18歲,差異均有顯著性;兩種病理類型在免疫組化雙陽性組均多于單陽性組及全陰

Analysis of the Reason of the Misdiagnosis about Three Aortic Dissections

目的:探討主動脈夾層患者誤診的原因,提高主動脈夾層患者的早期診斷率,為及時、正確救治患者生命提供有力的科學依據。方法:回顧性分析3例主動脈夾層患者實際診斷與誤診的情況,查明誤診原因。結果:3例主動脈夾層患者經檢查后證實,1例誤診為急性食道撕裂傷或消化性潰瘍,占33.33%;1例誤診為急腹癥,占33.33%;1例誤診為急性顱內病變,占33.33%。結論積極評估其病情的危險程度,監測生命體征,快速建立靜脈通道,同時仔細詢問相關病史,認真查體,積極采取相應輔助檢查,可降低誤診率。

Status of Adverse Drug Reactions of Terfenadine on Documents

摘要:目的: 分析特非那定所致不良反應的臨床特征、相關因素,為臨床藥物治療中藥品不良反應的防治提供參考依據。 方法 :檢索1986～2008年國內文獻源特非那定的不良反應資料,并加以分析研究。 結果 :34例不良反應報告中女性明顯多于男性;不良反應以心血管系統損害最多(23例,占6766%),其次為皮膚及附件損害(5例,1470%);不良反應預后較好。 結論 :患者的性別、體質、合并用藥等因素能影響不良反應的發生,對于引起心律失常不良反應臨床應提高警惕,減少不良反應的發生。Abstract: Objective: To analyze the clinical features、correlation factors of ADRs caused by Terfenadine drugs and provide beneficial references for preventing and curing the ADRs. Methods :To collect and analyze the cases of ADRs caused by Terfenadine from medical journals of 19862008 Results :Women were more than men in 34 ADRs;cardiovascular system lesions accounted for 6766%,skin and its appendix lesions accounted for 1470%;ADRs prognosis well. Conclusion :The occurrence of ADRs caused by Terfenadine due to many factors such as sex、age and combination drug,ect. The ADRs caused by second generation antihistamine drugs must be reconstred.

Retrospective Analysis of the Causes of Death and Its Clinical Data in 149 of Dead Inpatients with Diabetic Nephropathy

Investigation and Analysis of Perioperative Prophylactic Use of Antimicrobial in 500 Cases with Incision

摘要:目的：評價圍手術期預防性應用抗菌藥物現狀及合理性。方法：采用回顧性調查的方法，隨機抽查2009年度Ⅰ類切口手術圍手術期病案500份，設計外科圍手術期預防性應用抗生素調查表，對預防用藥的適應證、用藥種類、聯合用藥、給藥時機及持續時間進行統計分析。結果：未使用抗生素5例，預防性使用抗生素495例，其中不合理80例（16.00％）。預防性使用抗生素總品規數為540，其中頭孢菌素類453例（83.89%），青霉素類（包括加酶抑制劑）26例（4.81%），喹諾酮類44例（8.15%）。選用頭孢唑啉鈉178例（32.96%）居第一位，頭孢替唑鈉第二，151例（2796%）。結論：Ⅰ類切口手術患者圍手術期預防性使用抗菌藥物較為合理，但仍存在用藥指征把握不嚴，抗菌藥物的選擇、抗菌藥物使用時間較長等問題，有待進一步規范化管理。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.

老年科職業陪護現狀分析及應對對策

目的:分析老年科職業陪護現狀,探索完善職業陪護的管理之路。方法:采用自行設計的問卷調查表隨機對100名老年患者及其職業陪護進行調查。結果:63.0%的患者因情感需求而選擇職業陪護,對職業陪護大多比較認同,但對職業陪護的滿意率僅40%。結論:職業陪護符合老年患者實際需求,但必須加大專職陪護的綜合素質培訓力度,提高職業陪護管理效能。

Efficiency Analysis of Somatostatin for the Treatment of Peptic Ulcer Complicated by Upper Gastrointestinal Bleeding

目的:比較國產生長抑素與進口生長抑素治療消化性潰瘍出血的經濟效果。方法:將120例消化性潰瘍伴出血的患者隨機分成國產生長抑素及進口生長抑素組,分別給予國產生長抑素、進口生長抑素治療3天,觀察療效,并進行藥物經濟學評價。 結果: 國產生長抑素、進口生長抑素治療上消化道出血成本分別為558元和4116元,有統計學差異(P＜005);有效率分別為925%和968%,無統計學差異 (Pgt;005),成本—效果比分別為60324和425207,有統計學差異(P＜005)。結論: 從藥物經濟學角度分析,國產生長抑素治療消化性潰瘍出血較進口生長抑素更為經濟。

Adverse Drug Reactions in Our Hospital: A Retrospective Analysis of 67 Cases

目的:了解我院藥品不良反應(ADR)發生的特點。方法:對我院2006年1月至2009年8月收集到的67例ADR報告進行回顧性統計分析。結果:我院報告ADR例數最多的部門為新生兒,有51例(7612%);0~28 d年齡段患兒ADR發生率較高(5223%),且男性高于女性;靜脈給藥方式是導致ADR的主要因素(9701%);ADR發生率最高的為抗感染藥(8056%),其中絕大多數是由頭孢菌素類和青霉素類引發;臨床表現以皮膚及其附件損害最為常見(8841%)。結論:兒童用藥更應該加強ADR的監測,提高ADR報告的質量,合理、規范使用藥物,尤其是抗菌藥物,以減少或避免ADR的發生。

Analysis of Causes in Elder Adult Patients with Urinary Tract Infection

摘要:目的:了解老年住院患者發生尿路感染的病因,為臨床治療提供依據。方法:回顧性分析我院2007年1月至2007年12月發生尿路感染的老年住院患者臨床資料,分別統計各種病因。結果:共收集52例臨床資料,發生上尿路感染17例,下尿路感染35例。前列腺增生或前列腺炎6例,尿路結石7例,單純尿路感染10例。結論:老年人由于器官衰老萎縮和免疫功能減退,抗病毒能力下降,尿路感染是老年人常見的疾病之一,應引起重視,注意根據尿細菌培養結果與尿藥物敏感結果使用敏感抗生素,并注意保護腎功能。