简要介绍了等离子手术刀头的使用方法,阐述了等离子手术刀头临床使用风险的主要表现和特点,分析了导致或可能导致等离子手术刀头使用风险的原因,提出了应从医疗器械注册人(生产厂家)、使用单位(医疗机构)、政府及社会3个层面对等离子手术刀头使用风险进行控制.

Abstract This study was designed to establish the composition of wound dressing based on poly(2‐hydroxyethylmethacrylate)‐chitosan (PHEM‐CS) hydrogels‐loaded cerium oxide nanoparticle (CeONPs) composites for cutaneous wound healing on nursing care of the chronic wound. The as‐synthesised PHEM‐CS/CeONPs hydrogels nanocomposites were characterised by using UV–visible spectroscopy, scanning electron microscopy, Fourier transform infrared spectroscopy, X‐ray diffraction, and thermo gravimetric analysis. The influence of PHEM‐CS/CeONPs hydrogels nanocomposites on the gelation time, swelling ratio, in vitro degradation, and mechanical properties was investigated. The as‐prepared PHEM‐CS/CeONPs hydrogels nanocomposites dressing shows high antimicrobial activity against Staphylococcus aureus and Escherichia coli. Similar trends were observed for the treatment of biofilms where PHEM‐CS/CeONPs hydrogels nanocomposites displayed better efficiency. Furthermore, the biological properties of PHEM‐CS/CeONPs hydrogels nanocomposites had non‐toxic in cell viability and excellent cell adhesion behaviour. After 2 weeks, the wounds treated with the PHEM‐CS/CeONPs hydrogels nanocomposite wound dressing achieved a significant closure to 98.5 ± 4.95% compared with the PHEM‐CS hydrogels with nearly 71 ± 3.55% of wound closure. Hence, this study strongly supports the possibility of using this novel PHEM‐CS/CeONPs hydrogels nanocomposites wound dressing for efficient cutaneous wound healing on chronic wound infection and nursing care.

Under the background of high quality development of public hospitals, information management of medical consumables has become a trend. In order to improve the fine management level of medical consumables, the medical consumables information management platform was constructed from the aspects of information architecture, function modules, management process and security guarantee, etc., linking logistics information, supervision information and the use of evaluation information, realizing the whole process management of medical consumables and reducing operating costs. It is pointed out that the platform should be further improved by adding medical consumables multiple identification, establishing consistency evaluation system and adding mobile terminals.

目的:研究医院注射耗材在临床应用中对注射泵注射速率的影响,以提高注射泵使用的安全性及准确性.方法:运用注射泵分析仪测定10 ml、20 ml和50 ml的3种规格注射器与80 cm和120 cm两种延长管组合的6种注射通路注射速率,利用Excel和SPSS软件计算分析6种注射通路注射速率偏差与设定速率的相关性、相同规格注射器与不同规格延长管组合下的注射速率偏差的相关性以及相同规格延长管与不同规格注射器组合下的注射速率偏差的相关性.结果:6种注射通路注射速率偏差与设定速率均无相关性(Rs=0.555,Rs=-0.169,Rs=0.519,Rs=-0.515,Rs=-0.182,Rs=0.584;P>0.05);检验10 ml、20 ml和50 ml的3种规格注射器分别联合80 cm与120 cm延长管的注射速率偏差均有相关性(Rs=0.952,Rs=-0.169,Rs=0.519;P<0.05);相同规格延长管与不同规格注射器组合下的注射速率偏差均有相关性(H=26,H=519,H=26.541;P<0.05).结论:注射速率偏差的变化趋势与注射速率的区间具有相关性,并在中高速区间开始平稳并趋于一定的数值.精细化泵注药物或用药评价时对注射速率精确度要求较高的药物注射尽量选择在中高速区间;在泵注药物时较大容量注射器和较短长度延长管的注射通路对注射速率的影响最小.

目的:构建基于模糊层次分析法(FAHP)的医疗机构医疗装备综合效益评价方法体系,为医疗机构医疗装备综合效益评价提供理论和决策依据.方法:运用模糊数学理论构建医疗装备综合效益评价方法体系.应用层次分析法,从临床效益、社会效益、成本效益和工程效益4个方面选取14个指标构造评价指标体系并计算指标权重,应用群决策理论进行评价指数专家评分,最终应用矩阵算法求出综合效益评价分值,并以陕西省人民医院在用的3台1.5T核磁共振(MR)设备(分别标记为A、B、C)为例,对评价方法体系构建进行详细解析.结果:对3台1.5T MR设备的综合效益评价结果排序显示,MR(C)评价最高,主要得益于临床效益和成本效益较好,MR(A)评价次之,主要是成本效益和工程效益方面比较薄弱,MR(B)评价最低,主要是受临床效益影响,其临床效益评价相对比较低,该评价结果得到专家一致认可.结论:基于FAHP的医疗装备综合效益评价方法体系具有较强的逻辑性、系统性和实用性,能为医疗机构管理者提供更为科学、量化和直观的评价结果与参考数据,为医疗机构管理和引进医疗装备提供理论依据和方法参考.

目的 初步探讨新型全麻插管口舌保护器有效性临床应用价值.方法 选取2016年9月～11月我院耳鼻咽喉科手术患者594例,简单随机分为常规组394例和口舌保护器组200例.常规组全麻插管应用传统的压舌板,口舌保护器组应用新型全麻插管舌保护器进行手术.比较两组患者术后插管的移位程度及口腔损伤发生率.结果 两组患者气管插管术后移位发生率比较,差异无统计学意义(P>0.05).口舌保护器组口腔损伤发生率为2.00％,低于常规组的5.33％,差异具有统计学意义(P<0.05).结论 应用新型全麻插管舌保护器能更好的保护口腔组织,降低口腔组织的损伤的发生率.

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.

医用耗材招用存在着依据难以客观化和评价不全面等问题.通过对医用耗材精益招用实质分析,引入CEA(成本—效果分析法)、CMA(最小成本分析)、CUA(成本—效用法)、CBA(成本—效益法)等卫生经济学评价方法,将医用耗材性价比由主观、定性判定转向客观、定量判定,达到降低医疗成本,提高医疗效益的目的.通过案例分析,说明卫生经济学评价方法,尤其是成本-效果法在医用耗材精益招用中的应用成效.

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.

Endotracheal intubation can enhance anaesthesia effect and ensure patient safety. Conventional intubation anesthesia existence hidden danger, lumen by extrusion deformation, lead to ventilation, and may damage the patient 's lip and tongue. The incidence of oral-tongue injury was 2.0 % in 200 patients with general anesthesia by new oral-tongue protection device, which was lower than that of conventional method. It is showed that the device is safe and effectively protect the oral-tongue of patient, which with the promotion and conversion value.

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.

As the auxiliary equipment for life supporting and drug treatment, the safe use of the injection pump has always been the key point for the quality control of medical equipment. This paper analyzes the typical clinical adverse events and expounds the mechanism of quality risk sources for injection pumps in various aspects including the engineering technology, medical care and clinical pharmacy, which provides theoretical bases for prevention of the clinical application risks so as to improve the application and operation of injection pumps.

建立直属器材管理部门的手术耗材二级库是解决手术安全风险问题的有效手段.文章分析了当前医院耗材二级库管理存在的问题,并对手术二级库的关键技术和运行方法进行了阐述.同时以某院为例,对手术耗材二级库降低耗材安全风险、方便临床使用、杜绝行业不正之风和提高医院经营效益的相关情况进行了分析.

In this article, medical consumable materials supply catalog technology was introduced through the principle, method and application of topic studies, at the same time bar code tags to tag and identify medical consumable materials were introduced. These two techniques established the correspondence between the real supplies logistics and information flow system, provided foundation for medical supplies all process tracking and traceability management. Supply catalog and encoding identification technology provide a new solution for the effective management of medical consumable materials.

The legitimacy and effectiveness of qualification documents greatly affect the quality of hospital medical supplies.Medical consumables qualification management technology based on platform of supply catalog is established by the promotion of information technology and application software.Then,in the traditional supplies qualification management,the low efficiency,the high cost and other problems are solved.License expiring,authorization failure and other difficulty in the management process of medical consumables are avoided.Finally,the audit of medical consumables qualification is achieved with the application of network information technology.Medical consumables management system is implemented,which eliminated any problems about medical supplies in the last six years.

一体化手术室是医院手术室建设的新选择.通过对常规手术室与一体化手术室的优缺点进行对比,分析一体化手术室的利弊,为医院管理者提供参考,以便在手术室建设上达到综合考量、科学决策、合理投资的目的.

现将自1998年5月至2006年5月收治的55例妊娠期肝内胆汁淤积症(ICP)的治疗体会,报道如下. 临床资料 1 一般资料 55例患者年龄20～36岁,平均23.8岁.初产妇48例,经产妇7例;孕早期1例,孕中期45例,孕晚期9例.实验室检查:丙氨酸氨基转移酶(ALT):正常2例,升高低于3倍以下18例;总胆汁酸(TBA):15～92.5 μmo/L;血总胆红素(TBIL)全部超过正常,其中21例在80μmo/L以下;碱性磷酸酶(ALP)均超过正常范围.