目的 评价基于PDCA循环的品管圈活动对提高药房帐物相符率的效果.方法 组建品管圈活动小组,选定提高药房账物相符率为活动主题,应用PDCA循环开展设定目标、解析原因、拟定并实施对策和确认效果等一系列品管圈活动.结果 通过品管圈活动,门诊药房帐物相符率由活动前的82.35％提高到92.51％,目标达成率104.63％,进步率12.34％.结论 基于PDCA循环的品管圈活动提高了药房账物相符率,减少了医院的经济损失,提高了患者满意度.

目的:探讨医院门诊智慧药房建设的模式.方法:将萍乡市人民医院全自动发药机、智能配发机、扫码报到机、语音呼叫系统与医院信息系统(HIS系统)整合为全自动发药系统,将处方调配流程中涉及的各个方面与自动化设备相结合,形成处方调配的闭环管理.比较实施前后患者候取平均等待时间、单位时间内发放的处方数和调剂内差率.结果:全自动发药系统结合预配候取模式在门诊药房实行以来,高峰时段内发放的处方数实施前为(287.87±12.80)张/h、实施后为(340.17±17.20)张/h;患者候取平均等待时间实施前为11.3 min,实施后为5.6 min;门诊药房调剂内差率实施前为1.33％,实施后为0.18％(P<0.05),3组数据比较差异有统计学意义.结论:传统药房向智慧药房转型是医院药学发展的趋势,根据医院实际情况设计出一套行之有效的自动化流程是成功转型的关键.

高学历人才健康成长,事关医院长远发展和医院综合实力提高.科学分析高学历人才流失对医院发展的影响,建立完善科学的防范机制,打造高水平医疗人才队伍,成为医院核心竞争力的重心.本文就高学历人才流失对地市医院发展的影响进行分析,提出了预警机制与对策,为医院核心竞争力提升提供借鉴价值.

OBJECTIVE:To explore the characteristics and regularity of adverse drug reactions(ADRs) in our hospital in order to provide reference for the clinical use of drugs and drug safety evaluation.METHODS:442 cases of ADRs reports collected in our hospital from 2009 to 2010 were analyzed statistically.RESULTS:Of total 442 ADRs cases,it involved 159 kinds of drugs,ADRs occurring in patients over the age of 60 was the highest(138 cases,accounting for 31.22%);the largest number of ADRs were caused by intravenous injection(349 cases,accounting for 78.96%);the most likely ADRs(209 cases,accounting for 47.29%) were caused by anti-infective drugs,followed by traditional Chinese medicines(64 cases,14.48%);the main types of ADRs were damage to the skin and its appendents(223 cases,accounting for 50.45%),followed by the damage of digestive system and cardiovascular system;there were 11 new ADRs which were mainly related with traditional Chinese medicines;7 cases of drug-induced anaphylactic shock(21.88%) were primary among 32 cases of serious ADRs and secondly were abnormal liver function and fever.CONCLUSION:We should pay attention to and strengthen ADR monitoring and rational use of drugs in order to reduce or avoid the occurrence of ADRs.

Pathological and physiological characteristics of the elderly and problems in taking medicines were collected to address the measures to ensure rational drug use and drug safety in the elderly. Prescriptions should be adjusted according to the physical condition of the elderly. Problems in using these medicines should be noted and pharmaceutical care should be provided. Compliance could be achieved by the co-efforts of the elderly, their family and medical staff, so that adverse reactions and risks of using medicines could be reduced and rational safe and effective medication would be achieved.

Medical institutions should notice the importance of high-risk drug management, establish high-risk drug management system, determine responsibilities of physicians, pharmacists and nurses, reduce medication errors and and promote the level of medicine rational use. This article introduced the practice and experience of high-risk drug management carried out in our hospital and summarizes the methods of high-risk drug management in hospital. In the future, management and scientific research should be strengthened. With the use of modem information technology, improvement of patient education enhancing their compliance and establishment of evidence-based guidelines for injury prevention in China due to high-risk drug, complete and scientific high-risk drug management system could be formed.

OBJECTIVE:To introduce our experience with the clinical pharmacy work carried out in our hospital. METHODS:The clinical pharmacy work carried out in our hospital was elaborated. RESULTS&CONCLUSIONS:The practice of clinical phar-macy work has solved some practical problems,gained approval and welcome among clinicians,promoted the rational use of drugs,improved clinical pharmacists’confidence in engaging in clinical pharmacy,and gradually a“patient-centered”pharmacy management mode has been achieved. It is necessary to develop high level clinical pharmacists,enhance their communication and collaboration,to be included into hospital planning,ensure the time access to clinic and establish a clinical way of thinking,to fa-cilitate the carrying out of clinical pharmacy work.

目的：分析医院制剂室目前所面临的管理现状与存在问题。方法从医院制剂室管理现状入手，对制剂室的效益产值、人员储备、硬件建设、检验能力、生产工艺、质量管理、相关政策等方面存在的问题进行分析。结果医院制剂存在品种减少、效益下滑、人才流失、设施落后、管理欠缺等问题。结论制剂室应不断顺应形势发展需要，重新定位，加强人员队伍建设，改善硬件设施，实现医院制剂与医院发展并存。

OBJECTIVE:To provide reference for the improvement of ADR monitoring in Pingxiang area.METHODS:Questionnaire survey was conducted among the doctors from hospitals,including 5 third-class hospitals,15 second-class hospitals,and 14 first-class hospitals,and the data of samples were analyzed statistically.RESULTS:The medical workers had a comparable good recognition degree toward the knowledge such as English abbreviation of ADR,conception of ADR,whether there were ADR after the drug went on sale and so on,but had a comparable poor recognition degree toward the knowledge such as monitoring and responsibility department of ADR,whether ADR were malpraxis,whether Drug Management Law included lawful articles of ADR and so on.Different workers had different recognition degree toward ADR,and pharmaceutical workers had a higher recognition degree toward ADR than the other 3 kinds of workers.Medical workers had a right attitude for the report of ADR on the whole,but there were errors yet.Medical institution didn't go into depth on monitoring and didn't attach enough importance to the ADR.CONCLUSION:We should intensify the propaganda and training of ADR knowledge,correct the report attitude of ADR,strengthen the report awareness of the medical workers,reinforce the emphasis degree of the medical institutions and improve the monitoring level for ADR.

目的分析医院处方不合格的现状及其探讨产生的原因。方法回顾性统计分析了我院从2008年5月起正式实施《处方管理办法》后,从2009年4月~2010年3月份一年多来的处方不合格现状,并进行探讨不合格处方产生的原因。结果在医院严格实施《处方管理办法》,以及在医院药师的有效干预下,处方合格率大幅度提高,处方不合格率从27.82%下降为5.61%。结论处方合格率的提高有利于提高医院服务质量和减少一些不必要的医疗纠纷。

Objective To observe prospectively and systematically the efficacy and safety of rh-endostatin injection(YH-16,Endostar) durative transfusion combined with the chemotherapy on kinds of advanced malignancies.Methods Endostar combined with chemotherapy were administrated to 37 malignant cases of Stage Ⅲ～Ⅳ confirmed by histopathology or cytopathology.The 37 patients were randomly divided into two groups: experimental group(n=16) treated with endostar durative transfusion combined with chemotherapy: 135 mg endostar was solved in 3 mini-transfer pump was administered by continuous infusion for 360 hours and repeated after 21 days later.Control group(n=21),treated with endostar combined with chemotherapy,was confirmed by histopathology or cytopathology.15 mg endostar solved in 500 mL of normal saline was slow 21intravenously dropped from day 1 to day 14 and repeated 7 days later.The chemotherapy agents which were not used before or not cross-resistant to pre-chemotherapeutic agents were selected to be given simultaneously.The regimen was repeated every 21days.The efficacy was evaluated strictly after 2 cycles according to RECIST criteria,and quality of life(QOL) was evaluated according to Karnofsky scores.Results Experimental groups treatment efficiency was obviously higher than that in the control group(P0.01);life quality improvement and toxic effects were similar to each other in 2 groups.Conclusion The life quality of patients with kinds of advanced malignancies may be improved by endostar combined with the related chemotherapy.It is worthy of clinical generalization and further clinical observation.

目的研究小儿术前应用氯胺酮的最佳途径和剂量。方法不同剂量给药及肌肉注射给药进行临床效果对照比较。结果小儿术前口服8mg/kg氯胺酮后,能入睡,与父母分开时无反应,能接受静脉穿刺或硬膜外穿刺,减少术中其它麻醉药用量且唾液分泌、喉痉挛、肌肉强直等副作用明显减少。结论口服氯胺酮是小儿术前较好的给药方法。

OBJECTIVE: To discuss the role of clinical pharmacists participating in successful treatment of critically ill children with Influenza A (H1N1). METHODS: Considering patients' conditions, clinical pharmacists participated in drug treatment in respect of pharmacokinetics, phannacodynamics, drug interactions and adverse drug reactions and so on. RESULTS: Combining with advantages of grade three class A comprehensive hospital, medical treatments had been achieved by multidisciplinary corporation. The symptoms of children under critically care disappeared completely and all test indicators returned normal so that critically ill children were cured. CONCLUSION: Clinical pharmacist is an important component of the medical team. Therefore, clinical pharmacists participating in clinical drug treatment can improve clinical efficacy and safety of drug treatment.

目的:探索基层医院临床药师培养的最佳模式。方法:对本地区临床药师的培养现状进行调研分析。结果:目前由卫生统一部署和组织的临床药师培训模式,在基层医院较难实施。结论:各地方都应努力探索适合本地区的临床药师培养模式,掌握适当的的培训方法,以促进临床药学工作的快速发展。

目的:应用多元线性回归分析研究合理用药评价的效果和评价项目的优化。方法:收集合理用药检查原始数据,利用SPSS10.0软件,对数据进行处理。结果:影响合理用药的16个因素中,高度影响的有6个:抗生素使用方法和时间、抗生素使用调整分析记录、预防使用抗生素、其他药品适应证、其他药品使用方法和时间、其他药品合理联用。其余10个因素影响较小,可以结合其他方面数据针对性采取有效措施,提高合理用药水平。结论:本法简单、高效、针对性强,分析合理用药准确、直观,可以采取有效措施预测、控制和提高用药水平。

<正>中心摆药工作是医院药剂科工作的重要组成部分,是加强医院药品管理及药学服务的一个重要环节。但在摆药过程中出现的差错又成了一个新的问

目的观察在常规治疗肾病综合征的基础上,应用贺斯加速尿和血浆白蛋白加速尿治疗肾病综合征水肿对肝肾功能、凝血功能、血淀粉酶、血脂的影响及扩容、利尿消肿效果的差异,以分析贺斯在治疗肾病综合征水肿中的有效性、安全性、经济性,为临床应用提供依据。方法将50例肾病综合征患者随机分为对照组(A组)和治疗组(B组),两组均在常规治疗肾病综合征的基础上,A组予静滴白蛋白后推注速尿;B组予静滴贺斯(羟乙基淀粉200/0.5氯化钠注射液德国Fresenius Kabi公司生产)后推注速尿,20滴/min,1次/d,观察两组患者水肿消退时间、出现多尿时间、肝肾功能、凝血功能、血淀粉酶、血脂、24h尿蛋白的变化及不良反应、费用。结果两组各项指标比较,凝血功能、水肿消退时间、出现多尿时间:两组间治疗后有统计学意义(P<0.05),其他无统计学意义,均未出现不良反应,两组费用治疗组较对照组低,B组具有有效性、安全性、经济性。结论贺斯加速尿治疗肾病综合征水肿,可防止肾病的高凝状态,减少血栓形成,利尿、消肿效果与应用白蛋白组有统计学显著差异,安全,经济实用。

A 40-year-old woman with acute pyelonephritis received an intravenous infusion of cefotaxime sodium 2 g dissolved in 250 ml of sodium chloride 0.9%.No adverse reactions were found.Later,fleroxacin 0.4 g dissolved in 500 ml of glucose 5% was infused intravenously.She developed chill after receiving about 250 ml of the infusion.Her BP was 100/70 mmHg,and HR was 84 beats/min.The infusion was stopped.She was given IM promethazine and IV dexamethasone.Approximately 17 minutes later,convulsion of her extremities,undetectable blood pressure,heart arrest,and respiratory arrest occurred in the woman.Despite continuous resuscitation efforts,she died.

目的 观察杏丁注射液治疗脑梗死的疗效. 方法 将本院2004年9月～2006年2月住院脑梗死患者100例随机分为治疗组和对照组,每组各50例;治疗组用杏丁注射液静脉注射,对照组用丹参注射液静脉注射,14 d为一个疗程. 结果 治疗组总有效率为96%,对照组为86%,治疗组疗效优于对照组(P<0.01). 结论 杏丁注射液治疗脑梗死具有显著的临床疗效,而且不良反应小.

对我院2007年6月1~30日6577张门诊西药房处方按照《处方管理办法》的要求进行分析,经统计发现在处方书写规范、选药不合理等方面存在诸多问题,提示亟待提高临床医师、药师对《处方管理办法》及相关知识的学习和执行水平,提高处方质量和合理用药水平。