目的 观察双层痰液处置杯在痰液封闭消毒管理中的效果.方法 将60例肺结核患者按方便抽样法分为观察组和对照组各30例,对照组患者使用普通加盖痰杯收集痰液,观察组患者使用双层痰液处置杯收集痰液.比较两组患者痰液暴露发生率及患者使用痰杯依从性.结果 观察组痰液暴露发生率低于对照组,使用痰杯依从性高于对照组,比较差异均有统计学意义(P＜0.05).结论 双层痰液处置杯可降低痰液暴露发生率,提高患者使用痰杯依从性.

Objective To improvethe control of infection source by improving the continuous quality of sputum disposal management. Methods PDCA method based on the management of tuberculosis sputum disposal of the hospital quality improvement. The cross-sectional survey of tuberculosis ward in 32 cases of hospital patients, as control group.PDCA first round of "sputum cup distribution and use of work flow" for quality improvement,the reason leading the work flow of workers to nurse led work flow,the improved cross-sectional survey in 36 cases of hospital patients as experimental group 1.Aiming at the problem of low utilization rate of special sputum cup in the improvement of the first round of PDCA,the improvement of the sputum cup was carried out,On this basis, the "special sputum disposal Cup" was designed to obtain the national patent authorization. After the second round of improvement, the cross-sectional investigation in 35 patients in the hospital,as the experimental group 2.Results After two rounds of PDCA improvement,experimental group 2 groups compared with control,bedside sputum cup configuration was not in place rate decreased from 53.1% (17/32)to 0,the difference was statistically significant(Χ2=24.916,P<0.05);configuration after the sputum cup unused rate from 53.1%(17/32)down to 8.6%(3/35),the difference was statistically significant(Χ2=15.846,P<0.05).Conclusion PDCA method can improve the quality of management standard sputum disposal. Ward sputum cup ration is standardized sputum disinfection ward-based nurse intervention and leading sputum cup release, ward can improve the sputum cup ration, improved sputum containers (sputum cup) can improve patient compliance standard of spitting.

肺结核是一种经飞沫和空气传播的呼吸道传染病,做好患者的痰液管理是有效控制肺结核传播的重要举措.但目前临床上使用的痰杯主要存在以下弊端:(1)杯子内放置1:2000含氯消毒液,患者吐痰时消毒液对眼鼻造成不良刺激;(2)储存痰液的杯子对患者的视觉造成不舒服的感受;(3)杯身和盖子分离,导致盖子丢失或封闭不严,造成空气二次污染;(4)消毒和处置这些工具存在一定的困难.为此我们研制出一款新型的痰液处置杯,可以直接对痰液进行处置,吐痰小孔的设计能有效地避免消毒液和痰液对使用者造成的不良刺激,同时开盖按钮的设计方便患者使用、携带方便,处置便捷,从而提高患者使用医用痰杯的依从性,有效地切断肺结核的传播途径.

新型隐球菌脑膜炎由新型隐球菌感染引起，是中枢神经系统最常见的真菌感染，病情重，病死率高。其临床表现与结核性脑膜炎相似，临床常被误诊为结核性脑膜炎。现将误诊为结核性脑膜炎的新型隐球菌脑膜炎死亡1例结合文献复习如下，供同行借鉴。