With the rapid development of medical science, medical laws and regulations, medical record is becoming more and more important. In this paper, we took the medical record in a Grade A Class Three hospital in Shanghai as the study, object and analyzed the current situation and problems of quality management about medical record. Finally, this paper put forward some countermeasures to improve the quality of management.

Medical disputes have become a serious issue in China. A crisis cannot usually be predicted and managed through a cost–benefit strategy; therefore, researchers believe that prevention is better than containment and post-crisis resolution. This study aimed to identify solutions to prevent medical disputes in surgical cases through early warning and intervention of potential cases.

目的 总结专科手术队参加核化生恐怖袭击军地联合应急医学救援演练的经验,为开展相关救治工作提供借鉴.方法 结合专科手术队执行核化生恐怖袭击军地联合应急医学救援演练任务工作实际,进行回顾总结.结果 完善预案、精心筹划、严密组织、强化保障是完成演练任务的根本保证;专科手术队在车辆展开、车辆防护、收治流程、手术预案等方面开展了一些工作,并从人员配置、操作与物资装备的规范性等方面提出改进建议.结论 在完成核化生恐怖袭击军地联合应急医学救援等重大任务后及时总结经验,对未来执行应急救援任务有参考意义.

To start with the current situation and task of emergency medical response in the general hospi -tal, and combined with organization and participation of multi -times emergency medical rescue practices and con-sideration along with the literature review and expert consulting , a basic framework of the emergency response for general hospital was constructed , which included three modules as the emergency command system , the emergency response method and emergency physical supply .Then the strategies and key point of to implement this emergency response system were also discussed .

Objective To discuss the medical resource allocation for oceangoing voyage.Methods Analyzing the characteristics of oceangoing voyage,introducing the medical support task of oceangoing voyage and summarizing the practical experience.Results Medical resource should be allocated reasonably according with characteristics and medical support task of oceangoing voyage.Conclusion It is helpful to accomplish medical support during oceangoing voyage by reasonable allocation of medical staff,medical consumable and medical equipment.

随着医学知识的普及和人们法制观念的增强，求医个体加强了对医疗服务质量的要求和自我保护意识，医疗纠纷日渐增多，影响医院正常的医疗秩序，甚至威胁医务人员的人身安全［1］。为提高医疗质量，保障患者安全，本院在建立医疗安全预警和预控体系上，开展重点患者术前行政谈话，并取得良好的效果。

Training for war preparedness is the important way to enhance the support ability of Specialist Surgical Team.In this article,based on the characteristic and need of the mission of Specialist Surgical Team,actuality and problems were discussed.Finally,the suggestions about content,plan,and assessment of training were proposed.

<正>二次手术是指手术过的病人进行"非计划再次手术",也就是俗称的"二进宫"[1]。近年来,随着某"三甲"专科医院手术数量不断增多,肝胆胰二次手术也明显上升,严重影响了医院的效益和患者的安全。对医院来说,存在许多环节漏洞,需要强化医疗质量管理;对患者来说,增加痛苦和费用,需要建立风险分担机制[2]。本文拟通过查阅并整理2006—2010年期间发生的223例"二进宫"手术的病例资料,从医源性角度对肝胆胰二次手术进行回顾性研究分析。

<正>由于医疗工作是高风险的工作,稍有疏忽就可能给患者带来健康甚至生命安全方面的损害,所以医疗质量和安全是医院管理中的重要议题[1]。近年来,我院围绕创建"国际一流研究型专科医院"的目标,通过坚持创新管理,深化内涵建设,在医院规模、技术能力和装备条件和管理水平等方面都取得了长足进步。尤其在医疗质量与安全管理上,开展医疗

医疗欠费是患者接受医疗服务,即占有医护人员的劳动及消耗医疗物化劳动,而未能及时支付相应费用所形成的一种经济关系[1].本文以上海东方肝胆外科医院的45例欠费病例为例,分析造成医疗欠费的原因.

<正>军队医院,不仅承担着部队伤病员的诊治,更需要在诊治地方患者上获得经济、社会效益与技术、知识经验。与地方医院比较,军队医院有着自己的优势,但其自身也存在许多不足。面对新医改的出台,军队医院认识形势适应医改,参与竞争并发展自己,是必须认真思考的问题。

在"5·12"汶川大地震后的抗震医疗救灾中,我院开通了东方肝胆外科医院吴孟超院士率领的有关专家与四川抗震救灾医疗队的远程会诊热线,并成功为1名因被垮塌房屋砸中而造成多个脏器受伤的53岁女性伤者进行了远程医疗会诊,对这名危重、多发伤伤病员的救治提供了有力的技术指导.

目的:调查介入治疗患者抗菌药物预防使用情况,分析存在问题。方法:对2009年4月非手术科室中介入治疗患者抗菌药物预防使用情况进行调查,再应用SPSS 11.0 For Windows统计软件对结果进行分析。结果:650例病例中,抗菌药物预防使用率达99.8%,平均使用天数为3.73 d;使用频率前3位的依次是头孢菌素类、林可霉素类和硝基咪唑类;只使用一种抗菌药物的患者486例,占74.88%;非限制使用类抗菌药物为1 061例次,占总使用例次的43.45%。结论:针对介入治疗患者的抗菌药物预防使用情况欠合理,需要制定整改措施。

In the situation of serious earthquake,numerous disadvantages may occur,such as the wide distribution of the injuries,the vile condition of medical treatment as well as the heavy traffic jams etc and all these factors make it difficult for commanders to direct the troops,so the earthquake relief seems troublesome.The article probed into the way to use the theories of disaster medicine to direct the relieving mission under the terrible condition,and try to achieve the goal of scientific organization,rational rescue and to play the medical troops' role to the full.

To strengthen the prevention and control of nosocomial infection,the article discussed the main means,which included special duty training regularly,control of high risk factors,development and implement of management regulation according to related laws and standards,carrying out performance assessment,prolonged supervisory monitoring mechanism.

To investigate the relationship between hospital level and medical risk,the paper analyzed the three factors(hospital,society and patient),distribution and management system of medical risk from hospital management point of view through the survey according to hospitals' level and bed amount,and also analyzed control methods which based on pre-research.The paper provided reference for risk manager in hospital through analysis of the diversity of medical risk measures in different hospital levels.

To improve the serious situation of medical risk,the paper analyzed influence factors in medical risk through logistic regression analysis,which aimed to instruct hospital to strengthen medical risk management according to the analysis results.

Objective Through the investigation and analysis,Find the influencing factors of nosocomial infection,seek to control the incidence of nosocomial infection methods and countermeasures.Methods Use retrospective study to find 293 infection cases,and 286 normal cases,then process Logistic regression analysis of the second category.Results The influencing factors of nosocomial infection are:the number of days hospitalized,ICU days,age,blood transfusion,the number of days serious ill,the sections change times.Conclusion In order to control the incidence of nosocomial infection,focus on the crowd of high-risk factors,bring in the performance appraisal,establish the HIS to realtime monitor.

有研究表明,巨大灾害的亲历者由于受到强烈的惊吓和悲恸刺激,会使其处于一种非正常的心理状态,如果不及时治疗,容易产生灾后综合征,甚至引起自杀[1].

灾难医疗救援可分为3个阶段,即救人救命阶段、防病防疫阶段和恢复重建阶段[1].其中在救人救命阶段构建起的三级医疗后送体系,主要包括伴随救援队空入一线的一级现场救治医疗队、作为后送枢纽进行前接后送的二级早期救治医疗机构和作为医疗终的三线专科医疗后方医院.