目的 分析2009—2011年惠州市区医院三七总皂苷制剂的用药情况,并评价其安全性。方法 根据惠州市区医院2009—2011年三七总皂苷制剂的用药金额和用药量以及药品DDD值,计算其DDDs,分析药品的用药金额排序、DDDs排序以及用药金额排序与DDDs排序的比值;从药物不良反应报告评价其安全性。结果 三七总皂苷制剂用药金额和DDDs逐年增加,口服制剂安全性优于注射剂。结论 三七总皂苷制剂用药金额和用药频度逐年增加,其安全性较好。

Objective To analyse the usage and safety of Panax Notoginseng Saponins Drugs of hospitals in Huizhou from 2009 to 2011. Methods Calculate the DDDs and analyse the sequence of consumption sum, the sequence of DDDs, the ratio of the sequence of consumption sum to the sequence of DDDs according to the consumption sum, the consumption amount and DDD of Panax Notoginseng Saponins Drugs of hospitals in Huizhou from 2009 to 2011. We evaluated its safety according to adverse event reports. Results The consumption sum and DDDs increased year by year, oral medication was safer than injection. Conclusion The consumption sum and DDDs of Panax Notoginseng Saponins drugs of hospitals in Huizhou increase year by year, and they are safe.

目的 通过分析收费员在工作过程中态度、行为及对工作内容的熟悉情况,提出提高医院窗口收费人员职业道德建设的一些措施。方法 对前来广州市南沙中心医院就诊的患者随机进行问卷调查,收集资料并进行统计分析。结果 调查显示,目前医院窗口存在以下问题:医患沟通不畅、收费员本身对工作内容熟悉程度不够、收费员在处理问题时的行为态度存在不足等。结论 提高医院收费人员的职业道德建设刻不容缓,其需要医院加强收费员的业务培训,建立合理有效的奖惩制度;收费员自身应积极投入到各自的岗位,做到诚实守信,爱岗敬业,廉洁自律,为医院树立良好形象。

随着医院后勤管理企业化和社会化进程的加快,医院后勤系统逐渐面对着自主经营、自我约束、自立发展的新格局。本文分析了目前医院后勤管理方面存在的问题,介绍了依托医院信息平台建设的医院后勤综合运营管理信息系统。通过质量管理、二级库房管理,被服管理等模块,理顺医院后勤业务流程,提高医院后勤业务工作的质量和效率,达到提升医院后勤业务综合管理水平之目的,并对医院后勤管理信息系统的发展方向和实施办法进行了探讨。

With the acceleration of hospital logistics management enterprise and socialization process, hospital logistics system gradually facing self-management, self-restraint, self-development of a new pattern. This paper analyzes the current hospital logistics management problems introduced relying on hospital information platform of integrated logistics operation and management of hospital information systems. Through quality management, two warehouse management, clothing management module, streamline hospital logistics business processes, improve the quality and efficiency of the hospital's logistics operations, to enhance the purpose of the hospital management level of integrated logistics services, logistics management and hospital information system direction and implementation methods were discussed.

目的 探讨2型糖尿病患者发生医院感染危险因素。方法 收集2010年1月—2015年1月我院收治890例2型糖尿病患者临床资料行回顾性分析,根据是否发生医院感染分为感染组(75例)和非感染组(815例),对两组患者相关因素进行分析。结果 2型糖尿病医院感染发生率为8.43%,好发于呼吸系统感染。年龄、病程、住院时间、血糖控制差、侵袭性操作、合并并发症、合并基础疾病为2型糖尿病患者发生感染的危险因素。结论 2型糖尿病患者发生医院感染危险因素较多,临床针对高危患者应重点进行预防,降低感染率,提高患者治疗效果。

目的 统计医院眼科门诊病人前15位疾病的构成变化及不同年龄段间差异。方法 对2008年—2011年眼科门诊病人诊断及治疗信息作横断面研究,分析逐年门诊量变化及疾病谱的变化。结果 4年来门诊共接诊患者22356人次,初诊病人20915例。4年初诊患者分别为1476、3795、7177、8467人次。其中男12088例(59.9%),女8087例(40.1%),平均年龄 33.75岁。未成年人占20.23%,中青年占72.33%,老人占7.44%。前15位的疾病构成4年间有一定的波动,但结膜炎、角膜异物及屈光不正所占比例较高。三个年龄组构成最高的疾病分别为屈光不正、结膜炎、白内障。结论 该院眼科门诊4年来就诊人数增加5倍有余。患者中青年、未成年患者比例高、老年患者比例低,男性比例高于女性。角膜异物等外伤性疾病较多,不同年龄段疾病谱各有特点。

Objective Describe the distribution of diagnoses at the ophthalmic clinic of a tertiary hospital in the first four years since its inception. And also analyse the patterns of diagnoses of different age. Methods Cross-sectional study was administered on all new patients seen by ophthalmologists at Nansha Central Hospital from 2008 to 2011. Results 59.90% (12088 cases) were male and 40.10% (8087 cases) were female. Juveniles, adults and the elders accounts for 20.33%, 72.33%, and 7.44% of all visitors respectively. The most common conditions were conjunctivitis (27.00%), refractive error (9.87%) and corneal foreign bodies (9.07%). There were more diagnoses of refractive error (32.26%, P<0.01) among the juveniles, while the elders had higher percentage of cataract diagnoses (27.81%, P<0.01). Conclusion The number of new patients visiting the ophthalmic clinic had increased six-fold over the four years. The proportion of younger patients was much higher than that of older ones and the male to female ratio was high.compared to the results of literature, the marked characteristic of the disease distribution was the high rate of ocular traumatic diseases. The most common diagnoses varied with age.

目的 观察联合缩宫素与间苯三酚在基层医院分娩中疗效。方法 选用高明区人民医院2013年8月—2014年10月要求自然分娩的初产妇200例,随机分成两组,孕妇进入临产时,观察组予双管输液,予缩宫素2.5U+5%葡萄糖注射液静滴,另一静脉通路5%葡萄糖注射液250 mL+间苯三120 mg静滴;对照组仅予缩宫素2.5U+5%葡萄糖注射液静滴。比较两组产妇各产程时间、分娩方式、新生儿情况、产后出血量。结果 观察组第一产程、第二产程、第三产程时间均短于对照组(P＜0.01),剖宫产率3%及新生儿窒息率3%均低于对照组21%,和13%;P＜0.01;产后2小时出血量较对照组少(109.38±16.13)mL vs(185.00±30.71)mL, P＜0.01。结论 临产孕妇联合间苯三酚与缩宫素,可缩短产程,降低剖宫产率,降低新生儿窒息发生率,减少产后出血量,推荐基层医院使用。

Objective To investigate the effect of oxytocin combined with phloroglucinol in childbirth in primary hospital. Methods A total of 200 primiparas admitted to department of obstetrics in Gaoming people's hospital from August 2013 to October 2014　were selected as study subjects. The cases were randomly divided into observation group (100 cases) and control group (100 cases). In labor, cases in control group were given oxytocin 2.5 U and 5% glucose injection 500 mL, and were given 5% glucose injection 250 mL and phloroglucinol 120 mg by double tube intravenous infusion. Cases in observation group were only given oxytocin 2.5 U and 5% glucose injection 500 mL intravenous infusion. The duration of delivery、delivery mode、the condition of newborn and volume of bleeding after labor were compared between two groups. Results For the first、second and third stages of labor, duration of delivery in observation group were significantly shorter than that in control group (P＜0.01), Both cesarean delivery rate [3%(3/100)] and the incidence of neonatal asphyxia[3%(3/100)] in observation group were significantly lower than that in control group 21%(21/100)and 13%(13/100;P＜0.01). The volume of bleeding during two hours after labor in observation group was less than that in control group (109.38±16.13)mL vs 185.00±30.71 mL, P＜0.01. Conclusion In the stages of labor, the use of oxytocin combined with phloroglucinol can shorten the duration of delivery, reduce the cesarean delivery rate and the incidence of neonatal asphyxia and reduce the volume of bleeding after labor. It is worth recommending to use in primary hospital.

目的 分析基层医院ICU VAP的危险因素及病原学情况。方法 回顾性分析2013年1月—2014年12月本院ICU收治的机械通气>48 h 的118例患者,分VAP组和非VAP组,分析VAP的危险因素及病原学情况。结果 VAP组与非VAP组在紧急气管插管,机械通气时间,抗生素种类,糖皮质激素,PPI及镇静药物使用>7天,返流,MODS,ICU停留时间的项目,两组比较差异有统计学意义。紧急插管:52.2％ vs 31.9％,P＝0.029;机械通气时间:(9.8±3.5)vs(7.3±2.8)天,P＝0.038;抗生素种类>2种:52.2％ vs 26.4％,P＝0.005;使用糖皮质激素:56.5％ vs 27.0％,P＝0.001;PPI使用>7天:65.2％ vs 40.3％,P＝0.008;镇静药物使用>7天:58.7％ vs 38.9％,P＝0.035;返流:50％ vs 29.2％,P＝0.022;合并MODS:47.8％ vs 22.2％,P＝0.004;ICU停留时间:(13.6±6.6)vs(10.2±5.3)天,P＝0.023。使用糖皮质激素、机械通气时间、ICU停留时间是VAP的独立危险因素(多因素Logistic分析的OR值:2.481、1.234、1.075)。基层医院ICU VAP主要以革兰氏阴性菌(82.3%)为主。结论 使用激素、机械通气时间、ICU停留时间是基层医院ICU VAP的独立危险因素;而VAP病原菌感染以G-菌为主,可经验使用G-菌敏感的抗生素。

Objective To analyze pathogens and risk factors of VAP in a general ICU of a primary hospital. Methods Totally 112 patients(from 2013-01 to 2014-12) under mechanical ventilation over 48 h were retrospectively studied. The patients were assigned into VAP group and non-VAP group. The independent risk factors and pathogens of VAP were analyzed. Results There was significant difference between VAP group and non-VAP group in terms of emergent tracheal intubation, MV time, types of antibiotics used, the use of hormones,the use of PPI and sedative drugs for more than 7 days, regurgitation, MODS, ICU stay time. Emergent tracheal intubation:52.2％ vs 31.9％,P＝0.029;MV time:9.8±3.5day vs 7.3±2.8day,P＝0.038;types of antibiotics used > 2 kinds:52.2％ vs 26.4％,P＝0.005;the use of hormones:56.5％ vs 27.0％,P＝0.001;the use of PPI >7day:65.2％ vs 40.3％,P＝0.008;the use of sedative drugs >7day:58.7％ vs 38.9％,P＝0.035;regurgitation:50％ vs 29.2％,P＝0.022;MODS:47.8％ vs 22.2％,P＝0.004;ICU stay time:13.6±6.6day vs 10.2±5.3day,P＝0.023. The use of hormones,MV time, ICU stay time were the independent risk factors of VAP[odds ratio(OR) of multivariate logistic regression:2.481、1.234、1.075]. The main pathogens of VAP were gram-negative bacteria (82.3%). Conclusion The study shows that the use of hormones,MV time, ICU stay time are the independent risk factors of VAP; gram-negative bacteria are the main pathogens of VAP. Once VAP occurs, they can be treated with anti-gram-negative bacteria antibiotics.

目的 通过构建结构方程模型,分析某三级甲等综合医院腹股沟疝患者住院费用的影响因素,旨在为合理控制腹股沟疝单病种费用提供依据。方法 收集4 328份高州市人民医院2016—2022年主要诊断疾病名称为腹股沟疝且行腹股沟疝手术的患者的病历资料,预分析单个影响因素,采用AMOS28.0拟合构建模型。结果 结构方程模型拟合达到标准。性别、年龄、费别、住院次数、入院途径、伴随病、单双侧疝对总费用所产生的总效应数值分别为0.008、-0.044、0.062、0.014、-0.119、0.106、0.236;性别、年龄、费别、住院次数、入院途径、伴随病、单双侧疝通过住院时间间接对住院费用产生影响。结论 对住院费用产生的影响因素有性别、年龄、费别、住院次数、入院途径、伴随病、单双侧疝、住院时间,建议推行患者预住院模式及日间手术,在正式住院前完成相关检查,优化医疗服务流程,从而合理有效控制单病种住院费用。

Objective By utilizing a structural equation model, to analyze determinants that affect the hospitalization costs for individuals with inguinal hernia at a tertiary-level comprehensive medical center, offering insights for the potential management of costs associated with this specific ailment. Methods This study entailed the compilation of 4 328 patient files from individuals who received surgical treatment for inguinal hernia at a third-level general hospital over the period spanning 2016 to 2022. Preliminary analysis was conducted on isolated variables, followed by the development of a model using AMOS 28. 0 for fit assessment. Results The fitting of structural equation model reached the standard. The total effect values of gender, age, cost, number of hospitalizations, admission route, concomitant disease, unilateral and bilateral hernia on the total cost were 0. 008, -0. 044, 0. 062, 0. 014, -0. 119, 0. 106, 0. 236, respectively. Gender, age, cost, number of hospitalizations, admission route, concomitant disease, unilateral and bilateral hernia indirectly affected hospitalization expenses through hospitalization days. Conclusions Gender, age, cost, number of hospitalizations, of admission, concomitant diseases, unilateral and bilateral hernia, and length of hospital stay have an impact on hospitalization costs. It is suggested to implement the pre-hospitalization mode and day surgery, complete relevant examinations before formal hospitalization, and optimize the medical service process, so as to reasonably and effectively control the hospitalization cost of single disease.

目的 深入了解河源市某综合医院职业暴露的真实情况,评估健康风险,从而提出有效的控制措施,并提升医院员工的职业防护意识,以保障他们的健康和安全。方法 采用回顾性调查,从暴露类型、环节、病原体种类、职业类别、工龄等方面,对河源市某综合医院在2022—2023年所发生的职业暴露事件进行统计分析。结果 在2022—2023年期间,该综合医院共计发生了93例血源性病原体职业暴露事件,以锐器伤为主,共80例,占86.02%;职业暴露最多的是护理人员,共发生61例,占65.59%;工作人员中工龄≤2年的职业暴露比例最多,共有71例,占76.34%;职业暴露的发生环节主要集中在处理丢弃锐器物以及进行检查、治疗、护理操作的过程中,均为30例,占32.26%;发生职业暴露的原因主要是缺少防护,出现34例,占36.56%;职业暴露主要发生在普通病房,为37例,占39.78%;其次为门急诊,均为15例,占16.13%;职业暴露发生的暴露源传染病病原体种类以不明病原体为主,为36例,占38.70%;其次是乙型肝炎病毒,为32例,占34.40%;所有发生职业暴露的员工均接受了全面的暴露风险评估、合理的预防性用药措施以及定期的健康监测。结论 医院管理部门需加强职业安全培训,特别是针对护理人员和低年资员工,严格执行标准操作规程,提供充足防护用品,改进医疗设备设计,建立完善的监测报告和保障体系,并强化监督和管理,以降低职业暴露风险,保障员工职业安全。

Objective To gain a deep understanding of the actual situation of occupational exposure in a general hospital in Heyuan City, assess health risks, propose effective control measures,and enhance the awareness of occupational protection among hospital staff to safeguard their health and safety. Methods A retrospective study was conducted to statistically analyze the occupational exposure events that occurred in a general hospital in Heyuan City from 2022 to 2023, in terms of exposure types, links, types of pathogens, occupational categories, and years of service. Results During the period from 2022 to 2023, a total of 93 cases of occupational exposure to blood-borne pathogens occurred in the general hospital, with sharp instrument injuries being the most common, accounting for 80 cases（86. 02%）; nurses accounted for the majority of occupational exposures, with 61 cases（65. 59%）; among the staff, those with a service time ≤ two years had the highest proportion of occupational exposures, with 71 cases（76. 34%）; the main occurrence of occupational exposures was in the processes of disposing of discarded sharp instruments and conducting inspections, treatments, and nursing operations, both accounting for 30 cases（32. 26%）; the main reason for occupational exposures was lack of protection, with 34 cases（36. 56%）; occupational exposures occurred mainly in general wards, with 37 cases（39. 78%）, followed by outpatient and emergency departments, both with 15 cases（16. 13%）; the types of infectious pathogens exposed in occupational exposures were mainly unknown, with 36 cases（38. 70%）, followed by hepatitis B, with 32 cases（34. 40%）; all staff who experienced occupational exposures received comprehensive exposure risk assessments,reasonable preventive medication measures, and regular health monitoring. Conclusions Hospital management departments need to enhance occupational safety training, particularly for nursing staff and junior-level employees, strictly enforce standard operating procedures, provide adequate protective equipment, improve medical device design, establish a comprehensive monitoring and reporting system, strengthen supervision, and manage to reduce the risk of occupational exposure and ensure the occupational safety of employees.

       目的   通过分析广州某三甲医院临床试验用药品规范管理体系构建前后试验用药品超温次数及质控发现缺陷项数量变化情况，为药物临床试验规范开展提供参考。方法   结合某医院临床试验用药品管理实践，以试验用药品超温次数、质控发现缺陷项数量占项目比为评价指标，使用卡方检验进行比较。结果   某医院实施临床试验用药品规范管理体系后，发生试验用药品超温次数由实施前的9次下降至3次，呈明显下降趋势，2018—2020年试验用药品管理方面质控发现缺陷项数量占项目比为70.25%，2021—2023年占项目比为18.90%，实施前后组间比较差异有统计学意义（P＜0.001）。结论   构建临床试验用药品规范管理体系，可以减少试验用药品超温次数和试验用药品管理方面质控发现缺陷项数量，从而保证药物临床试验的质量。

       Objective   To analyze the changes in the number of excessive temperature incidents and the proportion of quality control issues in drug management before and after the establishment of construction and practice of standardized management system in a tertiary hospital in Guangzhou，to provide a reference for drug clinical trials standard development．Methods  Based on the management practice of investigational medicinal products from a hospital，the number of excessive temperature incidents and the proportion of quality control issues in drug management were taken as evaluation index and compared using chi-square tests．Results  After implementing the standardized management system for investigational drugs，the number of temperature exceeding incidents decreased from 9 times to 3 times，showing an obvious decreasing trend，and from 2018 to 2020，the  proportion of quality control issues in drug management accounted for 70.25%，while from 2021 to 2023，it accounted for 18.90%．There was a statistically significant difference between the groups before and after the implementation（P＜0.001）．Conclusions  The establishment of  standardized management  system for investigational medicinal  products can  reduce the  number of excessive temperature incidents and the proportion of quality control issues in drug management，and ensure the quality of drug clinical trials．