摘要:目的：评价围手术期预防性应用抗菌药物现状及合理性。方法：采用回顾性调查的方法，随机抽查2009年度Ⅰ类切口手术围手术期病案500份，设计外科围手术期预防性应用抗生素调查表，对预防用药的适应证、用药种类、联合用药、给药时机及持续时间进行统计分析。结果：未使用抗生素5例，预防性使用抗生素495例，其中不合理80例（16.00％）。预防性使用抗生素总品规数为540，其中头孢菌素类453例（83.89%），青霉素类（包括加酶抑制剂）26例（4.81%），喹诺酮类44例（8.15%）。选用头孢唑啉钠178例（32.96%）居第一位，头孢替唑钠第二，151例（2796%）。结论：Ⅰ类切口手术患者围手术期预防性使用抗菌药物较为合理，但仍存在用药指征把握不严，抗菌药物的选择、抗菌药物使用时间较长等问题，有待进一步规范化管理。Abstract: Objective: To understand the current application of perioperative preventive antibiotics, and their rationality. Methods: Five hundred perioperative records of patients with incision Ⅰ were randomly chosen and surveyed in 2009. A questionnaire for prophylactic use of antimicrobial was designed. The indication of antimicrobial use, the species, combination, timing and drug duration were analyzed. Results: Our of 500, 495 used antimicrobial and 80 were unreasonable; 540 kinds of antimicrobial were used, included cephalosporin 453 cases (83.89%), penicillin class (including plus enzyme inhibitors) in 26 cases (4.81%), quinolone 44 cases (8.15%). Cefazolin sodium (178 patients, 32.96%) ranked first, second was cefazolin sodium (151, 27.96%). Conclusion: Perioperative use of antimicrobial prophylaxis in patients with incision Ⅰ is reasonable, but standardization management should be strengthened in the indication, species, and duration.
Objective To provide the evidence for anti-epidemic command and developing response plan through investigation on prophlactical disinfection in Deyang, the worst-hit areas after Wenchuan earthquake. Methods We used convenient sampling together with the report forms and the self-made questionnaire to collect information from 107 villages and 17 settlement spots for the disaster victims in 25 towns in Deyang disaster area. Results There were a total of 6 kinds of disinfectant, including the chlorine disinfectant, 2 kinds of peroxide disinfectant and 2 other types of disinfectant, which were delivered the Deyang disaster area through the National amp; Province CDC system allocation or the None-Goverment Organization donation. From May 17 to June 9, the large-scale preventive disinfection was carried out in the disaster area, covering tap water, the restroom and the latrine pit, trash, environment and sewage. All personnel who conducted the disinfection for prevention and public health in the villages and towns received the technical training for disinfection. Conclusion Various disinfectant types and difference specifications cause trouble in the training of manpower and the use of disinfectant. Preventive disinfection in the most serious disaster areas is better than in serious disaster areas. The main channel of obtaining the disinfectant is through the National amp; Province CDC. The daily-report system of the disinfected areas may monitor the progress of disinfectant use. The suitable disinfection may prevent the public health secondary disaster and protect the environment effectively.
目的:了解我院围手术期预防性应用抗菌药物情况,评价应用的合理性。方法:经对我院符合围手术期预防性应用抗菌药物要求的切口愈合良好的234例病历的适应症、用药种类、联合用药、给药方法及给药持续时间进行统计分析。结果:234例病历所涉及围手术期预防用药共计271例次,给药时机及给药持续时间合理225例次(8303％),不合理46例(16.97％)。围手术期抗菌药物使用一代头孢101例(37.27%),广谱青霉素类49例(1808%)、β-内酰胺酶抑制剂40例(14.76%)。其中单用、二联和三联用药分别为206例(88%)、25例(11％)和3例(128%),平均疗程为2.3天。结论:我院抗菌药物使用仍存在不足之处,加强抗菌药物的使用管理,规范围手术期抗菌药物的使用,需通过临床医师、药师及其他医务人员共同参与,提高我院抗菌药物合理使用水平。
ObjectiveTo investigate on preoperative hand-washing for analyzing the underlying problems, in purpose of preventing operation-related infection via strengthening the standardization of surgical hand-washing and hand-disinfection. MethodsFrom July to September 2014, surveillance video of pre-operative hand-washing was studied and analyzed. We randomly selected 100 subjects, and assessment was performed based on the self-made surgical hand-washing and hand-disinfection protocol. Grading was done strictly. The passing score was 60 or higher; a score of 70-79 meant good; and a score of 80-100 indicated excellence. ResultsIn the survey, 91 in the 100 subjects were qualified. Among the qualified subjects, there were 53% of excellence and 20% of good. The major problems included erroneous methods, step omissions, time lacking, pollution, wrong flushing method or dry-hand method, and insufficient washing time. ConclusionBased on the survey, the administration department is advised to strengthen the regulatory supervision and education training based on standard surgical hand-washing and hand-disinfection criteria, especially training interns and new staff, in purpose of reducing the incidence of operation-related infection and improving hospitalization management qualities.
Objective To understand the situation and technical level of aeromedical rescue in medical institutions in Qinling-Daba mountainous area. Methods A questionnaire survey was conducted on the staff of medical institutions of the medical consortium of Renmin Hospital of Hubei University of Medicine, located in Qinling-Daba mountainous area between June and September 2023. The basic information and development, demand, and knowledge mastery of aeromedical rescue were investigated. Results A total of 45 medical institutions participated in the research, 500 questionnaires were sent out, and 479 valid questionnaires were recovered, with an effective rate of 95.8%. Among them, there were 7 tertiary hospitals, 23 secondary hospitals, and 15 township health institutions; 11 medical institutions had participated in aeromedical rescue, and 17 hospitals had participated in aerial rescue drills. The survey subjects were mainly from emergency departments and intensive care medicine departments, women, aged>30 and ≤40 years old, undergraduate students, intermediate professional titles, and doctors. Twenty-one medical workers had received formal training in aeromedical rescue skills, 77 had received short-term theoretical and practical training, 123 had participated in short-term simulation exercises, and 93 had participated in aeromedical rescue activities. There was a statistically significant difference among the scores of first aid knowledge, aviation flight knowledge, and aeromedical rescue knowledge (9.34±0.35 vs. 4.65±2.91 vs. 3.28±3.44; F=15.048, P=0.001). There were statistically significant differences between first aid knowledge and aviation flight knowledge, as well as between first aid knowledge and aeromedical rescue knowledge (P<0.05). There was no statistically significant difference between aviation flight knowledge and aeromedical medical rescue knowledge (P>0.05). Conclusion There is an urgent demand for aviation rescue in medical institutions in Qinling-Daba mountainous area, and there is a shortage of professionals, so it is necessary to strengthen the training, rehearsal and practice of aeromedical rescue.
ObjectiveTo investigate the use of traditional and new-type antidepressants in the in-patients with depressive disorder. MethodsThe antidepressant use of 165 in-patients with depressive disorders from March 1st to April 30th, 2013 were investigated. ResultsThe new-type antidepressants became the best drug in clinic, and single drug use was carried out mostly. The most used drug was atypical antipsychotics. ConclusionThe use of antidepressant drugs in the in-patients with depressive disorder in our hospital is regular and reasonable.
ObjectiveTo understand the economic burden of disinfection supply to medical institutions in Yibin City, and explore the feasibility of establishing a regional centralized management model of disinfection supply center in Yibin City.MethodsFrom April to May 2018, 263 medical institutions in the eight counties and two districts of Yibin City were investigated by means of mobile phone application-designed questionnaire, to obtain the information of cost accounting and economic burden of disinfection supply.ResultsThere were 263 medical institutions involved in the survey, in which 61 (23.19%) had set up the central sterile supply department (CSSD), including 43 public hospitals and 18 private hospitals; 202 medical institutions were without CSSD, which were mainly secondary hospitals [195 (74.14%), including 120 public hospitals and 75 private hospitals]. The higher the hospital level was, the larger the average area of the CSSD was; the difference was statistically significant (χ2=40.009, P<0.001). The higher the hospital level was, the more full-time personnel were employed, and the difference was statistically significant (χ2=31.862, P<0.001), and the care staff were the majority (66.23%). The cost burden of CSSD was more than 1 million yuan in the tertiary hospitals, which was 100 000 yuan or above in 61.90% of the secondary hospitals, and was below 100 000 yuan in hospitals below secondary level. The higher the hospital level was, the higher the total cost burden became; the difference was statistically significant (χ2=37.995, P<0.001). ConclusionIn view of the heavy economic burden of CSSD in medical institutions and the unbalanced setting up of medical institutions below secondary level, the establishment of a regional CSSD centralized management model is a new direction, new trend, and new model for future development, which is conducive to improving the quality of disinfection and sterilization, reducing medical care costs, making rational use of health resources, effectively preventing hospital infections, and ensuring the medical safety.