目的 探讨清洗消毒流程改进在手术器械供应中的应用效果.方法 选取2018年1月至2020年10月广东省阳江市中西医结合医院消毒供应室收取的382件手术器械作为研究对象,供应室于2019年6月进行清洗消毒流程改进,比较流程改进前、后手术器械清洗消毒及供应情况,包括清洗消毒时间、清洗消毒合格率与器械清点符合率,并比较改进前、后102名医护人员对手术器械清洗消毒及供应的满意度.结果 改进后,手术器械的清洗时间短于改进前,清洗消毒合格率及器械清点符合率均高于改进前,差异有统计学意义(P<0.05);改进后,手术室医护人员对手术器械清洗消毒及供应的满意度高于改进前,差异有统计学意义(P<0.05).结论 清洗消毒流程改进应用于手术器械供应,能缩短手术器械的清洗时间,改善清洗消毒合格及清点符合情况,并可提升手术室医护人员的满意度.

目的：探讨异丙酚联合芬太尼用于胃镜检查临床效果。方法选取我院消化内科近期行胃镜患者160例，采用随机数字表法分为对照组（80例）和观察组（80例）；对照组患者给予芬太尼行无痛胃镜镇静；观察组在此基础上加用异丙酚行无痛胃镜镇静；比较两组患者临床麻醉效果，意识及定向力恢复时间等。结果对照组和观察组麻醉总有效率分别为81.25%，98.75%；其中对照组患者麻醉优秀15例，良好50例，较差15例；观察组患者麻醉优秀31例，良好48例，较差1例；观察组患者临床麻醉效果显著优于对照组（P＜0.05）；观察组患者意识和定向力恢复时间均显著少于对照组（P＜0.05）。结论异丙酚联合芬太尼用于胃镜检查可有效提高镇静效果，促进术后苏醒。

Objective To report a novel technique named as injection flush and catheter push technique(abbreviated as “flushing and pushing technique”) for the treatment of urethral calculi and to report the indication, clinical effect and safety of this procedure. Methods Flushing and pushing technique was performed on 47 patients of urethral calculi. All patients were male, aged 7-81 years old, mean age was 43 years. Anterior urethral calculi in 21 cases, 26 cases with posterior urethral calculi. Method of operation:The catheter was inserted into the urethra with catheter tip touch the calculi. Fingers hoop the penis at the position slightly lower the urethral calculi, hoop the root of penis if calculi was at bulbous urethra or posterior urethra to form a closed cavity or relatively closed cavity between the calculi and the hooped urethra. Water was injected into the sealed cavity from catheter and urethra calculi moved toward the proximal urethra by the increased water pressure. Push catheter toward the bladder, form a relatively closed cavity and continue water injection, then calculi was flushed back into the bladder. We analyzed the clinical feature and treatment result of these 47 patients. Results Urethra calculi of all the 47 cases was pushed back into the bladder by flushing and pushing technique successfully. Urethral calculi was smashed with 1 case in the process of being crushed back into the bladder, did not need any subsequent processing. Among the 46 cases, 40 underwent extracorporeal shock wave lithotripsy as outpatients and were treated successfully, calculi discharged smoothly. 6 cases complicated with bladder calculi or (and) benign prostatic hyperplasia were treated with transurethral endoscopic bladder pneumatic lithotripsy, operations were successful, bladder calculi was washed and sucked out. Patients were followed up for 1 to 12 months, average 7.3 months, found no urethral stricture. Conclusion Pushing urethra calculi back into the bladder with flushing and pushing technique is rapid, easy processing, safe and minimally invasive. Urethral calculi may treated as bladder calculi with ease after pushed back into the bladder, with high success rate, low hospitalization rate, low cost and less complications.