目的 分析2016至2020年江西省口腔医院传染病四项检测结果,为临床防控工作提供依据.方法 对10022例门诊及住院患者的静脉血用酶联免疫吸附试验(ELISA)检测HBsAg、抗-HCV,抗-HIV,抗-TP.结果 各年度HBV阳性率分别为8.67％、8.67％、10.99％、9.84％、9.12％;HCV阳性率分别为0％、0.15％、0.20％、0.15％、0.15％;HIV阳性率分别为0.08％、0.29％、0.15％、0.15％、0％;TP阳性率分别为0.97％、1.09％、0.75％、0.98％、1.24％.按性别分类,男性人数为4979例,女性为5043例;HBV阳性率分别为10.56％、8.59％(P<0.05);HCV阳性率分别为0.20％、0.08％;HIV阳性率分别为0.18％、0.06％;TP阳性率分别为1.14％、0.89％.按科室分类,住院患者为5783例,门诊患者4239例;HBV阳性率分别为9.44％、9.74％;HCV阳性率分别为0.17％、0.09％;HIV阳性率分别为0.14％、0.09％;TP阳性率分别为1.05％、0.97％.结论 对口腔医院患者进行传染病四项检测,可以了解患者感染情况,提醒医务人员加强自我保护与提高防范意识,控制院内感染,预防职业暴露,减少医疗纠纷,对患者、医务人员及医院都有非常重要的意义.

Objective The failure mode and effect analysis (FMEA) were used to monitor the managerial process of high-value consumables in the implantation surgery, and establish the traceable management process for high-value consumables of the implantation surgery. Methods FMEA was used to carry out risk assessment process, formulate specific measures for improvement. The risk priority number(RPN),the qualified rate of the management index of implant surgical consumables,the patients satisfaction, and the number of adverse events reported were compared before and after the implementation of this process management. Results After FMEA was used to conduct management over implant surgery consumables,the RPN value decreased dramatically due to difficulty of traceability, information recording, and imperfect management system, thereby showing that the difference was statistically significant (t=16.655, 10.664, 9.321, P<0.01). Quality management measures: the access to consumables meets the requirements,complete information record,quality of stock consumables,paste bar code standard, charge accurate, return visits and records on time, consumables traceability, patient satisfaction rate were 99.2%(373/376),96.7%(363/376),99.5%(374/376),95.6%(361/376),98.6%(371/376), 95.7% (360/376), 100.0% (376/376), 97.1% (365/376), respectively after the implementation of this process management, which were higher than 90.9% (355/390), 81.8% (319/390), 94.2% (367/390), 91.3% (356/390),84.7%(330/390),87.3%(341/390),87.5%(342/390),91.8%(358/390)before the implementation of this process management, thereby showing that the difference was statistically significant (χ2=7.149-49.371, P<0.01).The number of adverse consumables event reports increased from 0 up to 5. Conclusions It was feasible and effective to improve the level of hospital management and ensure the safety of patients by using the FMEA model in the implantation surgical high-value consumables.

Objective To investigate the effect of different sampling status on handwashing monitoring results,improve and simplify the sampling process and monitor the handwashing effect. Methods The washed-hands of doctors and nurses during Jan-uary 2012 to December 2014 in our hospital were the experimental subjects,according to the sampling status,the subjects were di-vided into experimental group(wet hands group) and control group(dry hands group). And according to wear a mask or not,the sub-jects were divided into experimental group (not wearing mask group) and control group (wearing mask group). Bacterial colonies were counted after samples were incubated in 37℃ for 48h. Results There was no statistical difference in bacterial colonies and acceptability between wet hands group and dry hands group,but they had significant differences between not wearing mask group and wearing mask group. Conclusion There is no effect of wet or dry hands on monitoring result. But it can affect the monitoring result by wearing a mask or not. It is important to wear a mask for preventing contamination.

目的：探讨PDCA循环管理方法在手卫生监测效果中的运用。方法回顾总结2013-2014年本院运用PDCA循环管理方法在手卫生监测效果中的作用及经验。结果2013-2014年，手卫生的依从性由41.9%上升到77.6%，差异有统计学意义（χ2=374.57，P<0.05)；手卫生洗手的合格率由73.1%上升到91.9%，差异有统计学意义（χ2=15.46，P<0.05)。结论在医院手卫生的监测效果和依从性方面，运用PDCA循环管理方法的效果显著。

Objective The purpose of this study was to evaluate the disinfection effectiveness and properties of acrylic resin via microwave irradiation. Methods Forty acrylic resin base dentures fabricated in a standardized procedure were chosen and divided into Group A,B,C and D randomly. Group A,B and C were immersed in 200ml distilled water and submitted to microwave irradiation at 700W for 3,4,5 minutes individually. Group D was used as positive control. Bacteria specimens from each group were got for culture and numbers were calculated. Then the four groups were tested for the flexural strength and impact strength by universal test machine before and after microwave irradiation sterilization. Results The germicidal ratio of Group B was more than 90% ,while the ratio of group C was 100%. There was no significant difference in flexural strength and impact strength between group C and group D. Conclusions Microwave irradiation for 5 minutes at 700W produced sterilization of dentures contaminated with all bacteria whereas the denture strength is not affected. Microwave irradiation at 700W solution for 5 minutes was effective to sterilize acrylic resin base dentures.

OBJECTIVE To evaluate the effect of chlorine disinfectant on dimension change and disinfection of plaster model.METHODS Alginate impressions were obtained in clinic by the same way,and poured the plaster model with water and chlorine disinfectant in concentration 500 mg/L and 1000 mg/L,respectively.After the treatment the models were sampled at standard sites.The CFU were counted after culture;plaster models were obtained in lab with standard impression using water and chlorine disinfectant in concentration 500 mg/L and 1000 mg/L,respectively.The dimension changes of plaster models were measured accurately.RESULTS The CFU number of chlorine disinfectant group was significantly decreased compared with water group (water group:14.667±4.61;500 ml/L cholrine group:4.3±3.592 and 1000 ml/L chlorine group(2.2±1.989,P0.01);the dimension of plaster models of three groups showed no differences (P0.05).CONCLUSION It may get some degermation effects and will not change the model by using chlorine disinfectant in plaster model.

医疗服务是一种特殊的服务行业,服务对象是病人,是社会人群中需要特殊关照与护理的人.在与患者接触时离不开语言的交流.现代医院部门庞大,工作量大,医患之间难以避免地会发生一些医疗纠纷,而在对待投诉病人时则更须注重语言艺术.笔者通过在接待医疗投诉工作中体会到:客观地分析与判断病人的心理反应与需求,充分地应用规范的语言和沟通技巧,这将在处理医疗纠纷中产生良好效应.

前列腺疾患是老年男性常见疾病,经耻骨上前列腺摘除术是治疗前列腺增生症(BPH)的常用方法.但病人切口疼痛,以及膀胱颈痉挛是术后常见的问题,给病人不仅带来很大痛苦,而且可发生继发性出血和引流管阻塞等并发症,影响病人康复[1].笔者自1994～1995年对前列腺摘除术后患者采用硬脊膜外推注镇痛药治疗,镇疼效果良好,现将其临床应用及护理体会报告如下.

重危病人的尿量监测已发展到以每小时或每分钟来观察尿量,而临床上观察尿量时常取留置导尿后接引流袋的方法来监测,用量杯比较后发现尿量越少测得量越不准确,自制尿液计量器克服了这一不足.经多年临床应用,尤其对肾移植术后、心脏体外循环术后及多脏器功能衰竭、各重危病人的尿液监测,效果良好,为临床诊断和治疗提供了可靠的依据.此尿液计量器取材方便,制作简单.现介绍如下.