目的:研究制定高压氧舱火灾事故预防控制策略,提高高压氧舱隐患预防能力和安全管理效率.方法:分析高压氧舱火灾事故发生原因,根据燃烧三要素(火三角)的性质,从严格禁止可燃物、严格控制助燃剂和严格消除火源3个方面,制定高压氧舱火灾事故预防控制策略,结合安全管理实践,制定"高压氧舱安全使用与管理制度".结果:医院高压氧舱火灾预防控制制度实施后,高压氧舱正常开机率、违规操作率、违禁物品入舱率、未签知情同意书发生率和治疗不良反应发生率等相关指标明显改善,违规操作率、违禁物品入舱率和未签知情同意书发生率均降为0;高压氧舱的安全使用率由71％提升到100％,综合管理评价分值由72.25％提升到95.75％,达到了高压氧舱火灾事故的预防控制管理要求.结论:高压氧舱火灾事故预防控制策略可提升高压氧舱医疗安全,规范高压氧舱的业务流程管理和风险防控管理,提高设备安全管理效率.

目的:调查陕西省各级医疗机构高值医疗设备配置现状,提供高值医疗设备配置管理的科学依据和建议决策.方法:采用德尔菲问卷调查法对陕西省内随机选取的173家医疗机构展开调查,借助软件统计分析各级医疗机构高值医疗设备配置情况,包括配置结构、配置分布、进口与国产配置水平和配置效益.结果:配置结构方面,手术设备、超声诊断设备和实验诊断设备配置占比较高;教学科研与学科建设设备、放射治疗设备和血库设备占比较低.配置分布方面,三级、二级和一级医疗机构分别为208.9、46.7和0.7台/家.进口与国产配置水平方面,三级、二级和一级医疗机构进口与国产设备配置数量比值总和分别为100.6、40.7和0.4.配置效益方面,配置效益与业务效益具有正相关性,其中实验诊断设备效益相对较好,教学科研与学科建设设备相对较差.结论:陕西省各级医疗机构高值医疗设备配置现状表现为结构同质化、分布级别化、进口与国产配置水平失衡化、效益业务化.卫生行政管理部门和各级医疗机构需要统筹规划,针对性地加强高值医疗设备的整体管理水平,确保各级医疗机构均衡、综合发展,逐步整体优化陕西省高值医疗设备的配置.

新医改将药品供应保障改革作为重点关注内容之一,而医用耗材由于在产品特征、使用方式、流通特点等方面的特性,且存在更新快、品种多、流通体系复杂、行业规范较少等突出特点,成为本次改革中的难点,通过对医疗器材流通领域的变化进行预测研究,为从业者提供可供参考的转型方向.通过对医用耗材流通领域改革政策及措施的解读,分析新医改措施对医疗器材行业造成的影响,以成本分析的方法为基础,对流通领域的变化进行预测.提出医疗器材流通领域将由垂直化体系向扁平化体系变化,相关行业主体分工将发生改变.预测结果对从业者行业定位,制订应对措施,具有积极意义.

目的:构建医用装备诊疗检查需求预测的差分自回归移动平均(ARIMA)模型,为管理决策提供参考依据.方法:以2013-2018年医院核磁共振(MR)诊疗检查数据为基础序列,应用SPSS统计软件建立ARIMA模型,运用拟合评价指标对预测模型进行拟合评价.选取2019年MR检查数据对预测数据进行精度检验,预测2020年MR检查数据.结果:构建的预测模型描述为ARIMA(0,1,1)(0,1,0)12,该模型拟合评价总体良好;2019年的数据精度检验评价合理且检验合格,预测数据在置信区间为95％的相对误差控制在-5.74％～5.82％,预测精度良好.该模型可用于2020年MR检查需求预测.结论:SPSS统计软件的运用简化了预测模型的构建、评价和应用,构建的ARIMA预测模型和预测数据可作为医疗机构进行医技排程统筹管理、医技资源整体调度、装备配置合理优化和诊疗服务满意提升的决策参考.

目的 构建介入类耗材使用全流程风险防控平台,提高介入类耗材的质量安全管理水平.方法 对介入类耗材的使用全流程风险点和管理点进行分析,借助信息化技术构建平台,优化和改善介入类耗材的使用全流程的管理.结果 介入类耗材风险防控平台的使用,使耗材降价幅度达33％,库存差错率降幅31％,追溯风险降幅42％,科室再无自用情况发生.结论 介入类耗材风险防控平台的构建,提高了耗材使用效率和风险环节的重点管理水平,达到以医疗安全服务为重心的严格管控要求.

目的:针对医用耗材资质管理存在的问题,构建基于云模式的医用耗材资质管理体系管控平台.方法:采用SOA(Service-Oriented Architecture)的理念和信息化管理模型进行设计,基于Java和Oracle 10g开发环境,利用浏览器/服务器(Browser/Server,B/S)架构,以Web工作流引擎为管理平台,实现企业自主上传资质信息、医院自动审核资质的医用耗材资质管理体系管控平台.该平台包括医院管理系统、接口管理系统和供应商管理系统三大模块.结果:医用耗材资质管理体系管控平台实现了在混合云平台的资质及时更新和信息实时共享.应用该平台后,每天处理资质审查业务完成件数由5件上升到20件,每件资质审查办理周期由2～7 d调整到实时处理,差错率由9.67％降低到0.67％,且维护更新方式由医院被动审查变为企业主动上传.结论:医用耗材资质管理体系管控平台实现了多用户、多企业在同一运行平台的资源共享,将耗材资质管理工作变得更为高效、实用和便捷,具有较高的推广价值,对未来智慧型医院的信息化建设工作具有引导和借鉴作用.

目的:通过对大型医用设备日常使用情况的数据统计和分析,基于SPSS主成分分析法对大型医用设备经济效益进行分析与评价.方法:建立经济分析与评价的指标体系,对指标数据进行标准化处理,借助SPSS19.0软件确定主要成分指标并计算综合评价值,以反映大型医用设备的经济效益.结果:通过实例计算,证明基于SPSS的主成分分析法可直观反映大型医用设备的经济效益.结论:基于SPSS的主成分分析法可以全面、系统、准确、直观地评价含有大量、复杂经济指标的大型医用设备的经济效益,使医疗机构的成本核算和经济投资更科学化、全面化、精细化,有利于做好医疗机构的资产管理和经济管理,为提高其经济效益和社会效益提供数据依据.

将大型公立综合医院的耗占比控制在20％以内是新医改的重要目标.本研究从医院医用耗材采供消三大环节入手,通过精益招用、精准管控、精确分析理念,对"三精"管理方法在医用耗材管理中的实践效果进行了介绍."三精"运管应用收获了显著的社会效益和经济效益.

实现医用耗材精细化管理,关键是构建精准管控体系.分析了当前医用耗材在购入和溯源环节存在的缺陷,依托医用耗材来源、流通、使用等过程管理规范,开发出连通供应目录库、中心库、二级库的医用耗材精准管控体系,实现了计划、领用、计费、使用的全过程精准管控,达到供应渠道清晰、出入库业务规范、库存周转快速、收费准确、溯源到位的管理目标.

医用耗材是患者医疗费用支出的重要组成部分.介绍了医用耗材进行精确分析的重要性,提出医用耗材精确分析理论,探讨数据挖掘技术在医用耗材管理领域的应用价值,对精确分析方法中的分类、聚类、关联等数学模型进行了具体阐述,并举例说明了不同精确分析方法的应用操作实践,为下一步深入开展医用耗材精确分析指明了方向.

Objective To execute experimental study injection rate and volumetric error and to explore their correlations with sizes of injectors and extension tube,so as to lay a foundation for the quality control of the injection pump.Methods Simulation experiment was carried out with involving in 10,20 and 50 ml of injectors and 80 and 120 cm extension tubes,and 6 kinds of connection systems were formed with auxiliary appliances.The injection rate and flow reading of the flow meter were obtained and then compared with the set values,and the correlations were proved between sizes of auxiliary appliances and the precision of injection dose and rate.Results In case other conditions kept the same,the injector with larger capacity behaved better in controlling injection rate and dose,and the shorter extension tube gained advantages over the longer one in regulating the precision for injection and injection dose.Conclusion The experiment contributes to the selection of auxiliary appliances and the enhancement of quality control,and the further research provides references for process design and materials selection of the injector.

The current situation of medical equipment management informatization was introduced in China,and its deficiencies were described in standard,top-level design,data island and etc.A development strategy divided into preliminary,intermediate and advanced levels was put forward,which used business support,data fusion and iterative analysis as the tools.The steps and methods for medical equipment management informatization were studied,and it's pointed out industrial informatization was of great significance to enhance the quality,efficacy and ability of medical equipment management.

The problems in the quality management of medical equipment were analyzed,which included the awareness needing to be improved,the lack of standards,the disjunction between government leading business and hospital practice,etc.The importance of construction of the medical equipment quality control system was pointed out.Furthermore,the operation mechanism of medical equipment control was introduced from four aspects,including the sound quality management standards,the business process and work report,the information report and processing pathway,the analysis,assessment and intervention.

Medical consumables "two votes" policy is the core of medical and health care reform.It is the important measure to deepen medical and health care reform,and to promote pharmaceutical industry.It will change medical consumables tradition inevitably.Faced with a very complex social and business environment,the promotion of medical consumables "two votes" policy faces a lot of problems,business and medical circles needs new forms of circulation and logistics solutions."Engineering-business-hospital industrial chain logistics public service platform" as the backing,with cloud technology as the means of transformation and the promotion,fall to the ground to provide support for the new policy.

Objective:Using NGS sequencing platform,study the distribution and characteristics of ovarian cancer gene mutations and look for targets of medicines;by analysis the mutation sites,types and frequency,com-bined with the tumor markers,predict the recurrence or metastasis,then screening,early intervention on a regular ba-sis.Methods:16 cases from ovarian tissue paraffin specimens by clinically confirmed,using the high-throughput se-quencing Ion torrent PGM platform,test the 2835 gene loci of 50 genes and the data analysis.Results:50 genes mu-tations were in the concentrated in EGFR,KDR,KIT,KRAS,NOTCH1 and SMAD4,TP53 seven 21 gene loci.TP53 mutations among the proportion were as high as 75％,and mutation of 4 exon c.215C>G has the highest percent-age.Conclusion:The patients with ovarian cancer can be according to the target gene mutations in accurate treat-ment,TP53 high mutation rate suggests it plays an important role in the occurrence of tumor development,combined with clinical study can provide the basis for recurrent branch predictions.

The present study aimed to prepare oral impression material based on polysiloxane via optimized process and formulation, using α, ω-dihydroxy polydimethylsiloxane as matrix, tetraethyl orthosilicate as cross-link agent, dibutyltin dilaurate as catalyst, fumed silica as reinforcing filler, precipitated calcium carbonate as compatibilizer fillers, liquid paraffin as plasticizer. This kind of oral impression material was of low preparation cost and easy to be popularized. Impression accuracy was analyzed by molding shrinkage. Curing time was confirmed by the velocity of cross-linking. Mechanical properties were characterized by tensile strength and tear strength. The results showed that curing time, impression accuracy and mechanical properties were optimum with 100 g polysiloxane, 6 mL cross-linking agent, 7 mL catalyst, 16 g reinforcing filler, 56 g compatibilizer fillers, and 30 mL plasticizer respectively. Curing time was 10 minutes and molding shrinkage was below 0.79％. Tensile strength, elongation at break and tearing strength of oral impression material were 1.19 kPa, 24％ and 3.87 kN/m respectively, and the demould property was fine.

Objective To explore and study the mechanism of quality control for that using traditional medical equipment risk source recognition cannot fully explain the injection pump in the clinical use of adverse events. Methods According to the typical case, we studied the influence of injection pump alarm reliability on the different auxiliary materials through the simulation experiment and data analysis. Results The experimental data and statistical analysis results shown that the larger capacity of the syringe was, or the longer of the extension tube was, the longer of the delay time on blocking alarm was. The delay of blocking alarm was related to the rate of injection. The syringe had no obvious effect on the delay of the pump discharge alarm. Conclusion The auxiliary materials influenced the alarm reliability of injection pump in different infusion conditions. This study can not only provide a high guiding value to reduce the risk of the clinical use of injection pump, but also can enrich and perfect the medical equipment risk source in theory in a certain extent.

分析了医用耗材物联网建设目标及建设要点.医用耗材物联网以智能化识别、跟踪、管控为主要内容,分别对医用耗材院内物流管理和服务进行集约统筹,可建立从计划、采购、入库、出库到最终用于患者的全流程运行体系,并能有效提高医用耗材的管理和服务水平.

针对现行高值医用耗材管理存在的医疗风险,通过构建新的管理机制以及新的服务运行体系,研究分库房模式管理的必要性和可行性,为高值医用耗材的院内流通和使用提供解决方案.

Medical consumables procurement is one of the key links in the logistics management. The methods and manners that medical consumables are purchased occupy an important position in the hospital management. This paper focuses on the current condition and inefifciency existing in the process of hospital consumables procurement. Through reinforcing the importance of consumables procurement, optimizing purchasing process and technical means, perfecting PDCA circulation mechanism, a scientiifc and modernization medical consumables procurement management system is constructed. As a result, the procurement business is further developed and procurement technology is improved.