ObjectiveTo sum up experiences of precaution and provide evidence to prevent such accidents in the future via analyzing the nosocomial infection in newborn babies who were infected by rotavirus. MethodsWe investigated and monitored the 8 cases of nosocomial infection occurred between July 7th and July 14th, 2012 by epidemiologic and environmental hygienic methods, and analyzed the existing risk factors and took measures to control. ResultsThere were 8 nosocomial infected cases among the 45 newborn babies who were hospitalized. The infection rate was 17.8% and the accident lasted for 7 days. The distribution of space, time and population was clustered. Environment and hands were the main media to spread the virus. ConclusionThe accident was a suspected nosocomial infection caused by rotavirus in the hospital. It can be controlled effectively through intensive cleaning and sterilizing, isolated touching, and improving the medical staff's compliance and accuracy rate of hand sanitation.
目的 探讨优质护理服务在妇科临床护理路径（CNP）实施中的应用效果。 方法 2010年4月－2011年4月纳入妇科CNP的住院患者中随机抽取150例，并选择同期病区全部17名护士作为对照组；在2011年5月－12月纳入妇科CNP并实施优质护理服务的住院患者中随机抽取150例，并选择同期病区全部22名护士作为试验组。比较两组患者疾病相关知识知晓率、患者及护士工作满意率、平均住院日的差异。 结果 试验组患者疾病相关知识知晓率、患者及护士满意率优于对照组，且平均住院日明显缩短。 结论 优质护理服务应用于改进CNP管理质量，可提高患者疾病相关知识知晓率和护患满意率，缩短住院时间，减轻医疗负担，有利于CNP的实施。
目的 回顾分析不同内固定方式对老年股骨粗隆间骨折的临床疗效。 方法 1999年3月－2009年5月采用内固定手术治疗121例股骨粗隆间骨折患者，根据内固定方式不同分为4组：动力髋螺钉（DHS；A组43例）、经皮加压钢板（PCCP；B组19例）、股骨近端髓内钉（PFN；C组27例）、Gamma钉（D组32例）。4组患者年龄、骨折类型（Tronzo-Evans分型）等一般资料比较差异无统计学意义（P＞0.05），具有可比性。记录手术时间、术中出血量及术后引流量、术中术后并发症、骨折临床愈合时间、术后髋关节功能恢复程度，比较评价各组临床疗效。 结果 术后各组患者切口均Ⅰ期愈合，无伤口感染等早期并发症发生。患者均获随访，随访时间18～108个月，平均56.4个月。与A组比较，B、C、D组手术时间明显缩短，术中出血量及术后引流量减少，骨折愈合时间缩短，差异均有统计学意义（P＜0.01），A组较差；B、C、D各组间两两比较差异无统计学意义（P＞0.05）。术后并发症发生率A组较高，与其余各组比较差异有统计学意义（P＜0.05）。末次随访时各组髋关节功能Harris评分比较差异无统计学意义（P＞0.05）。 结论 B、D组及C组3种手术方法在治疗老年患者股骨粗隆间骨折具有创伤小、并发症少等优势，与A组法比较更有利于老年患者术后康复，但应注意骨折的良好复位及内固定物位置。
目的 探讨德阳市道路交通伤中人员分布的流行病学特点。 方法 回顾性统计分析德阳市2003年－2005年发生的5 300例道路交通伤资料，总结其中的规律和特点。 结果 在5 300例交通伤中，伤亡人员以男性居多（男︰女= 2.58︰1），其中16～55岁的青壮年占了全部伤亡人员的75.72%；工人、农林牧渔业人员和学生占交通伤的比例最高，达52.73%。步行、二轮摩托车和自行车是造成人员伤亡的最主要三个原因，三者比例达到了59.34%。 结论 加强交通安全意识的教育，加大交通法规的宣传和贯彻力度，加强部门间协作是减少交通伤发生的有效措施。Objective To investigate the epidemiological characteristics of the distrubution of people with trauma due to traffic accidents in Deyang City. Methods The data of 5 300 road traffic accidents from 2003 to 2005 in Deyang were retrospectively analyzed. The rules and characters were summarized. Results More males were injured or dead than females in the 5 300 road traffic accidents (male : female = 2.58︰1 ). The young adults aged from 16 to 55 accounted for 75.72% of all the casualties. The workers, agriculture employees and students had the largest percentage (52.73%) of the injuries. Walking and riding motorcycles and bicycles were the main causes leading to the injury, which occupied 59.34%. Conclusion The effective measures to reduce trauma due to traffic accidents will attribute to enhance the personnel awareness of road safety education, improve the publicity work and enforcement of traffic laws, and strengthen collaboration of different epartments.
Objective To establish a repeatable, simple, and effective model of rat crush injury and crush syndrome (CS) so as to lay a foundation for further study on CS. Methods A total of 42 female Sprague Dawley rats (2-month-old, weighing 160-180 g) were divided randomly into the control group (n=6) and experimental group (n=36). The rats of the experimental group were used to establish the crush injury and CS model in both lower limbs by self-made crush injury mould. The survival rate and hematuria rate were observed after decompression. The biochemical indexes of blood were measured at 2, 4, 8, 12, 24, and 48 hours after decompression. The samples of muscle, kidney, and heart were harvested for morphological observation. There was no treatment in the control group, and the same tests were performed. Results Seven rats died and 15 rats had hematuria during compression in the experimental group. Swelling of the lower limb and muscle tissue was observed in the survival rats after reperfusion. The liver function test results showed that the levels of alanine transaminase and aspartate aminotransferase in the experimental group were significantly higher than those in the control group (P lt; 0.05). The renal function test results showed that blood urea nitrogen level increased significantly after 2 hours of decompression in the experimental group, showing significant difference when compared with that in the control group at 12, 24, and 48 hours after decompression (P lt; 0.05); the creatinine level of the experimental group was higher than that of the control group at 4, 8, 12, and 24 hours, showing significant difference at 8, 12, and 24 hours (P lt; 0.05). The serum K+ concentration of the experimental group was higher than that of the control group at all time, showing significant difference at the other time (P lt; 0.05) except at 2 hours. The creatine kinase level showed an increasing tendency in the experimental group, showing significant difference when compared with the level of the control group at 4, 8, 12, and 24 hours (P lt; 0.05). The histological examination of the experimental group showed that obvious edema and necrosis of the muscle were observed at different time points; glomeruli congestion and swelling, renal tubular epithelial cell degeneration, edema, necrosis, and myoglobin tube type were found in the kidneys; and myocardial structure had no obvious changes. Conclusion The method of the crush injury and CS model by self-made crush injury mould is a simple and effective procedure and the experimental result is stable. It is a simple method to establish an effective model of rats crush injury and CS.
Objective To explore the effectiveness of Colorado 2TM system in the stabil ity reconstruction of sacroil iac joint fracture and dislocation in Tile C pelvic fracture. Methods Between February 2009 and January 2011，8 cases of Tile C pelvic fracture were treated with Colorado 2TM system. There were 3 males and 5 females with an average age of 34.4years (range，22-52 years). Fractures were caused by traffic accident in 3 cases, by fall ing from height in 3 cases，and by crash of heavy object in 2 cases. According to Tile classification, 5 cases were classified as C1-2, 2 cases as C1-3，and 1 case as C2. The time between injury and operation was 5-10 days (mean, 7 days). After skeletal traction reduction, Colorado 2TM system was used to fix sacroil iac joint, and reconstruction plate or external fixation was selectively adopted. Results The postoperative X-ray films showed that the reduction of vertical and rotatory dislocation was satisfactory, posterior pelvic ring achieved effective stabil ity. All the incisions healed by first intention, and no blood vessel or nerve injury occurred. Eight patients were followed up 6-24 months (mean, 12 months). No loosening or breakage of internal fixation was observed and no re-dislocation of sacroil iac joint occurred. The bone heal ing time was 6-12 months (mean, 9 months). According to Majeed’s functional criterion, the results were excellent in 5 cases, good in 2 cases, and fair in 1 case at last follow-up. Conclusion Colorado 2TM system could provide immediate stabil ity of pelvic posterior ring and good maintenance of reduction effect, which is an effective method in the therapy of sacroil iac joint fracture and dislocation in Tile C pelvic fracture.
Objective To summarize the cl inical characteristics of 596 patients with fracture in Wenchuan earthquake and to investigate the therapeutic methods and effects of early treatment. Methods From May 12th 2008 to May 21st 2008, 596 patients with fracture caused by Wenchuan earthquake were treated, including 283 males and 313 females aged1.9-102 years (median 43 years). The time from injury to hospital ization varied from 12 minutes to 4 days. There were 132 cases of upper extremity fracture, 496 cases lower extremity fracture, 10 cases clavicular fracture, 16 cases scapular fracture, 23 cases pelvis fracture, and 59 cases spinal fracture. Among them, 183 cases were open fracture and 413 cases were closed fracture. And 214 cases had multiple fracture (35.9%) and 68 cases had crush injury in l imbs which scored (6.84 ± 2.48) points according to the mangled extremity severity score (MESS). Thirty-six cases were combined with neurovascular injury. The wound of the open fracture was contaminated at different degrees, but no gas gangrene was observed. Open fracture was treated with suturing or no suturing after debridement, open reduction and internal or external fixation. Closed fracture was fixed with spl ints, cast and traction. Forty-nine patients whom were highly suspected as osseous fascia compartment syndrome received incision decompression timely, and 34 patients whose MESS were above 7.0 points or suffering from crush injury of l ifethreatening systemic symptoms received amputation. Results Apart from 34 patients receiving amputation, 460 patients achieved functional reduction of fracture after manipulative reduction and 102 cases got satisfactory reduction after surgery. Postoperatively, 289 patients were transferred to other hospitals. Among the rest 307 patients, 34 with severe wound infection were healed after multiple debridement, anti-infection, and skin flap transplantation (16 cases healed by first intention and 18 cases healed by second intention), 42 cases with crush syndrome were treated with open decompression and amputation, and nodeep venous thrombosis of lower l imb, stress ulcer and death were observed after operation (29 cases healed by first intention and 13 cases healed by second intention). Conclusion By aiming at the features of fracture caused by earthquake, the prompt and professional treatment can achieve good therapeutic effects.