目的 探討神經科住院患者留置針安全的持續質量管理。 方法 選擇2011年8月－10月100例神經科住院患者，按入院時間先后排序分為對照組和試驗組，每組50例。對照組運用靜脈留置針的常規護理方法進行護理，試驗組在給予常規護理方法的同時實施一系列持續質量管理的措施，包括安排護理業務查房、組織操作示范、應用留置安全健康宣傳小卡片對患者進行宣教、定期不定期的留置質量檢查、將留置針安全作為一項交班內容、強調優質護理指針。留置針留置第3天對兩組患者使用同一自制量表調查留置期間的安全問題及患者對護理的評價，并對兩組調查結果進行統計分析。 結果 試驗組留置期間不良事件發生率為6.0%，對照組為34.0%，兩組差異有統計學意義（χ2=12.250，P=0.000）；試驗組對留置針留置安全知識的4個方面知曉情況均優于對照組（P=0.000）；試驗組對護理滿意度較對照組好（P=0.000）。 結論 持續質量管理增加了神經科住院患者留置針留置安全、增進了患者對相關健康知識的掌握，提高了患者對護理的滿意，值得臨床推廣。
Objective To assess the clinical efficacy of ultrasonic atomization of penicillin combined with erythromycin in children with acute suppurative tonsillitis. Methods From July 2007 to December 2007, 70 children with a confirmed diagnosis of acute suppurative tonsillitis were randomized into two groups. Thirty-one patients in the control group received continuous 5-day treatment of routine intravenous drip of penicillin (200000units/ (kg?d)), twice a day, while 39patients in the trial group received, in addition to the routine treatment, another 5-day treatment of ultrasonic atomization of 0.1 g erythromycin and 10ml saline diluted by 10ml sterile water, 15min for each treatment, twice a day. Observation of the clinical efficacy of the two groups and statistical analyses were conducted. Results The cure rate and total effective rate of the trial group were 61.54% and 97.44%, and those of the control group were 35.48% and 77.42%, respectively. The pyretolysis rates at 48 h and 72 h in the trial group were 75.36% and 89.74%, and those in the control group were 45.16% and 61.29%, respectively. The improvement rates of pharyngodynia at 48 h and 72 h in the trial group were 76.92% and 92.31%, and those in the control group were 48.39% and 70.97%, respectively. The results of both rank sum test and chi-square test revealed significant differences between the trial group and the control groups (Plt;0.05), which indicated that the trial group was superior to the control group in terms of cure rate, total effectiveness rate, pyretolysis rate and improvement of pharyngodynia. During ultrasonic atomization, 3 patients experienced mild nausea and vomiting, all of which disappeared after rest. No other adverse reactions were recorded. Conclusions Ultrasonic atomization of penicillin combined with erythromycin for children with acute suppurative tonsillitis is worthy of clinical application due to its better efficacy and safety profile.
目的 總結1例噬血細胞綜合征的臨床表現及治療方案。 方法 2009年12月收治1例以皮疹為突出表現的噬血細胞綜合征患兒的臨床表現及治療效果。 結果 患兒的皮疹表現突出，臨床較少見；采用HLH-2004方案治療后臨床癥狀、體征及實驗室指標短時間內恢復正常。近期隨訪，一般情況良好，血液學指標基本正常。 結論 患兒采用HLH-2004方案治療后預后良好。