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Analysis of Standard Nursing Psogtam in Emergency Department

目的:讨论规范急诊科仪器设备的管理，提高护士抢救患者的质量和效率。方法:对监护室的急救仪器设备定点定位放置，规范管理；设计操作保养维修流程图，规范护士的行为；加强培训考核力度，使护士熟练掌握急救技能。结果:急救仪器设备地完好率、患者抢救的成功率、医生对护士的满意度均有所提高。结论:规范了急救设备的管理，有效的提高了护理质量，及时杜绝了护理隐患的发生。

旋髂深血管蒂骨瓣移植治疗青壮年股骨颈骨折

目的 总结旋髂深血管蒂骨瓣移植治疗青壮年股骨颈骨折的手术方法及临床疗效。 方法 2003 年1 月－ 2006 年12 月，收治28 例青壮年股骨颈骨折患者。男21 例，女7 例；年龄17 ～ 48 岁，平均34 岁。致伤原因：车祸伤19 例，高处坠落伤9 例。新鲜骨折20 例，陈旧性骨折8 例。伤后至手术时间1 ～ 42 d。根据Garden 骨折分型：Ⅲ型12 例，Ⅳ型16 例。术前Harris 髋关节功能评分为（14.6 ± 6.2）分。采用手术切开复位、空心加压螺钉固定后，取大小为4.0 cm × 1.5 cm × 1.5 cm 的旋髂深血管蒂骨瓣植骨治疗。 结果 28 例术后切口均Ⅰ期愈合，无感染等并发症发生。患者术后均获随访，随访时间12 ～ 48 个月，平均21 个月。27 例股骨颈骨折愈合，愈合时间3 ～ 5 个月，平均3.7 个月；1 例发生骨折不愈合。3 例术后2 年发生股骨头坏死，行保守治疗。术后Harris 髋关节功能评分为（89.3 ± 10.4）分，与术前比较差异有统计学意义（P lt; 0.05）。 结论 旋髂深血管蒂骨瓣移植治疗青壮年股骨颈骨折可改善骨折端的血运，促进骨折愈合，降低股骨头坏死的发生率。

急性视网膜坏死并发GATA2综合征一例

早期康复护理预防腰椎间盘突出症术后神经根粘连

目的　总结防治腰椎间盘突出症术后神经根粘连的有效方法。 方法　将2005年3月－2008年4月收治的腰椎间盘突出症手术患者82例随机分为早期康复组（A组，44例）和常规对照组（B组，38例），两组患者一般资料比较差异无统计学意义（P＞0.05），有可比性。A组采用康复护理功能锻炼，B组采用常规护理方法。疗效采用日本骨科学会（JOA）下腰痛功能评定表评分，并计算功能改善率。 结果　术后2周，两组各时间点JOA评分均较术前明显提高，差异有统计学意义（P＜0.05）；两组术前JOA评分比较差异无统计学意义（P＞0.05）；治疗后各时间点A组评分均高于B组（P＜0.05）。治疗后2周A、B组JOA改善率比较差异无统计学意义（P＞0.05）；治疗后3、6、12、24个月A组改善率均高于B组（P＜0.01）。 结论　早期康复护理预防腰椎间盘突出症术后粘连疗效显著、安全。

Research progress on the correlation between parameters related to blood routine examination and acute cerebral infarction

Acute cerebral infarction is characterized by high incidence rate, high recurrence rate, high disability rate and multiple complications. Early evaluation and treatment of acute cerebral infarction is particularly important to improve the survival rate and prognosis of patients. As an easily available clinical laboratory indicator, blood routine test can reflect the pathological changes in the body to a certain extent. In recent years, many studies have shown that the indicators such as red cell volume distribution width, mean platelet volume, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in blood routine examination have important values in the onset, severity and prognosis of acute cerebral infarction. This article reviews the correlations of the above parameters and ratio parameters with acute cerebral infarction, in order to provide some reference and basis for clinical diagnosis, treatment and prognosis evaluation of acute cerebral infarction.

创伤性室间隔缺损的诊断和治疗

摘要 目的　总结3例创伤性室间隔缺损诊断和治疗的经验。　方法　1992年5月～1997年5月先后收治3例创伤性室间隔缺损，并施行了修补术。　结果　3例患者术后均恢复顺利，无并发症发生。　结论　在心脏开放伤中，应注意创伤性室间隔缺损的诊断，伤后8～12周是进行修补术的最好时机。

Spinal metastases and metastatic spinal cord compression: interpretation for National Institute for Health and Care Excellence (NICE) 2023 guideline

Spine is a common site of metastasis in patients with malignant tumors, and tumor metastasis to the spine can lead to pain, pathological fractures, and nerve compression. In order to optimize the diagnosis and management of patients with spinal metastases and metastatic spinal cord compression (MSCC), the National Institute for Health and Care Excellence (NICE) in the UK proposed the first diagnostic and treatment guidelines for patients with MSCC (or at risk of MSCC) in 2008. In recent years, with the rapid advancement of spinal surgery and radiotherapy technology, the standardized process of MSCC diagnosis and treatment urgently needs to be updated. In 2023, NICE launched new guidelines for spinal metastases and MSCC. Based on a thorough study of the guidelines, this article discusses and interprets pain management, corticosteroid treatment, application of bisphosphonates and denosumab, tools for assessing spinal stability and prognosis, radiation therapy, surgical timing and approach, etc., providing reference for clinical diagnosis and treatment in China.

Causes and precautions of drug dispensing errors in hospital pharmacy

Objective To analyze the causes of drug dispensing errors and reduce the error rate through scientific precautions, and improve the quality of pharmaceutical service. Methods According to the PDCA cycle, existing problems were found in dispensing between January and June 2013, and the causes were analyzed. Then, from July 2013, strategies were developed to decrease the dispensing error rate. The variation trend of dispensing error rate from January 2013 to June 2017 were observed. Result The dispensing error rate decreased since the beginning of PDCA cycle, from 0.042‰ (the first quarter of 2013) to 0.003‰ (the second quarter of 2017). Conclusion The PDCA cycle is an effective intervention to detect the errors during drug delivery in inpatient pharmacy, which could improve the quality of pharmaceutical service and insure the patients’ safety.

胸腔镜辅助治疗左心室错构瘤一例

101例心脏粘液瘤的外科治疗体会

目的总结101例心脏粘液瘤的诊断和治疗经验，以提高疗效。方法回顺性分析101例心脏粘液瘤患者的临床资料，其中左心房粘液瘤94例，右心房粘液瘤6例，双心房粘液瘤1例，均在体外循环下行粘液瘤摘除术；同期行二尖瓣成形术5例，二尖瓣机械瓣置换术1例，三尖瓣成形术32例，冠状动脉旁路移植术1例，激光心肌打孔血运重建术1例。结果术后死亡1例，100例患者经治疗痊愈出院。随访84例，随访率84％（84／100）；随访时间3个月～5年，复发1例。结论心脏粘液瘤术前超声心动图检查诊断准确率高，一经确诊应尽早手术；手术的关键是保持瘤体完整，将瘤体连同蒂部周围部分组织一并切除。