简介:由于基层医务人员专业技术水平不够高,基层卫生队基础设施不够完善等原因,部分患者需要转诊到上级体系医院治疗。转诊是为了让患者得到及时正确的诊治,但目前基层卫生队转诊率偏高,过高的转诊率在一定程度上反映出基层卫生机构的诊断水平及救治能力还不够。如何加强卫生队建设,提高基层卫勤保障能力,提高为兵服务质量,从而降低转诊率,以下几点提供参考。
简介:目的探讨无边界应急机动队在肾脏病专科护理管理中的应用方法和效果。方法应用无边界组织的管理模式,按照制订的无边界应急机动队人员选拔标准在肾脏科选拔18名护士,成立肾脏病研究所无边界应急机动队,制订护理管理的具体要求和激励机制,对护士进行专科理论和技能培训。根据护理工作需要,对其进行统一管理调配。结果应急机动队一年共完成特级护理626人次,特级护理时间5460h,机动护士工作时间1027d;提高了危重患者气道管理、液体管理、导管护理、环节质量和门诊患者满意度(P〈0.01);提高了无边界应急机动队护士的专科抢救技能。结论无边界应急机动队缓解了应急情况下护士编制相对不足的问题,提高了危重患者的护理质量。
简介:AIM:Toinvestigatethespecialtyoftranscranialsurgerythroughpterionalapproachforremovalofcranio-orbitaltumors,introducetheophthalmologicalexperiencesofenteringtheorbittoreducetheincidencerateofassociatedcomplicationsofthisoperation.·METHODS:Weperformedaretrospectiveanalysisofaseriesof37casesinvolvingpatientswhounderwenttranscranialsurgerythroughpterionalapproachfortreatmentofcranio-orbitaltumorsinourdepartmentinthepast8years.Pterionapproachcraniotomywasperformedtoallpatients.Afterremovingtumorsintheskullbytheneurosurgeon,ophthalmologistremovedtumorsinorbit.Wetookmeasuresbelowtodecreasecomplications,includinggroundingopticcanalthroughanabrasivedrillingwhennecessary,hangingvariousextraocularmusclestobeexposedforprotection,refrigeratingbyrefrigerationheadstoremovetumors,atlastsewinguporbitseptumaftersurgery.·RESULTS:Tumorswereremovedcompletelyin32cases,andincompletein5casesduetoextensiveinvasionintothecavernoussinusorsphenoidsinus.Ofallthecases,benigntumorsweredemonstratedin28cases(75.6%,28/37)andmalignantin9(24.3%,9/37).Themostcommonlesiontypewasmeningiomain11cases(29.7%,11/37).Extraocularmuscles(EOM)impairment,occurringin21cases(56.7%,21/37),wasthemostfrequentpostoperativecomplication.Themostseriousconsequencewasvisionlossoccurredin4cases(10.8%,4/37).Othercomplications,suchas11casesoftransientblepharoptosis29.7%(11/37),5casesofmydriasisin13.5%(5/7);2casesofcerebrospinalrhinorrheain5.4%(2/37).·CONCLUSION:Cranio-orbitaltumorscanberemovedcompletelyusingtranscranialapproach,andthepterionalapproachoffersexcellentexposure.Cooperationofinterdisciplinaryteamofneurosurgeonsandophthalmologistsconducestofulluseofrespectiveprofessionaladvantages.Theexperienceofophthalmicoperationtechnologycandecreaseoccurrenceofocularcomplicationsaftersurger