目的 了解神经外科住院患者医院感染情况及感染病原菌的分布情况,为预防和控制医院感染提供依据.方法 采用前瞻性和回顾性相结合的调查方法,对2012年神经外科住院患者发生的感染情况进行调查.结果 该科2012年全年共发生院内感染72例、86例次,感染率9.51％、例次感染率11.36％;感染部位以下呼吸道为主(55.81％),其次是胃肠道感染(15.12％)、泌尿系感染(11.63％)、颅内感染(9.30％).感染病原菌中,革兰氏阳性菌以金黄色葡萄球菌为主(25.47％),革兰氏阴性菌以鲍曼不动杆菌为主(19.81％).结论 神经外科患者医院感染率明显高于其他外科,昏迷、侵袭性操作、住院时间等是医院感染的危险因素.

Objective The purpose of the present study was to discuss the method to avoid spillage by means of adding chemotherapeutic drugs into sealed transfusion bottles.Methods 90 penicillin sealed bottles of the same batch number were randomly divided into the test group and the control group,each with 45 bottles.Standard method according to Basic Nursing was used to add chemotherapeutic drugs into transfusion bottles in the control group.Drugs were added into transfusion bottles under negative pressure in the test group.The operating time was measured,the spillage volume of puncture site was calculated and microbial detection of syringe was observed in the two groups.Results There was a significant difference in the spillage volume of puncture site between the two groups (P<0.01),but no difference was seen in the operating time and microbial detection of syringe (P>0.05),Conclusions The spillage volume of puncture site was reduced significantly by means of adding chemotherapeutic drugs into transfusion bottles under negative pressure.This can decrease chemotherapeutic professional exposing risks and drug wastage.

目的探讨异长春花碱药物非穿刺伤外渗的原因及预防措施.方法回顾性分析我科近2年使用NP方案化疗的20例患者.结果3例患者局部皮肤发生蜂窝组织炎,4例患者发生静脉炎.结论对引起非穿刺伤药物外渗的化疗药,要严格遵守化疗药物操作规程,合理使用血管,重点预防,重视追踪观察.

目的总结异长春花碱局部毒副反应的预防、治疗措施.方法回顾性分析52例经异长春花碱治疗的肺癌和乳腺癌患者,密切观察局部毒副反应,并将其分为静脉炎型、蜂窝织炎型、混和型三类.结果 20例发生局部毒副反应,按病例计算,发生率为35.25%.其中静脉炎型13例,未发生皮肤坏死,蜂窝织炎型5例,2例发生皮肤坏死,混合型2例.静脉冲管有明显疗效.结论异长春花碱局部毒副反应发生率较高,较为严重,采用粗大静脉、地塞米松冲管,冰敷等处理可以降低毒副反应.

前哨淋巴结是指肿瘤淋巴引流区域的第一站淋巴结,是区域淋巴结中最容易被肿瘤侵犯的淋巴结.通过对前哨淋巴结的病理检查,可以预测整个淋巴引流区域是否受到肿瘤侵犯.在黑色素瘤和乳腺癌的大量临床研究中已经肯定了前哨淋巴结活检技术的准确性和可行性.其它实体瘤的临床研究相对较少,但也有相似的结果,认为前哨淋巴结病理检查未发现肿瘤转移的患者,局部淋巴结转移的可能性很小,不需要进行局部淋巴结清除术,使手术范围缩小,避免了清除术可能带来的各种并发症.对于早期肿瘤患者,前哨淋巴结活检技术有着很高的临床应用价值.