目的 探讨神经科住院患者留置针安全的持续质量管理。 方法 选择2011年8月－10月100例神经科住院患者，按入院时间先后排序分为对照组和试验组，每组50例。对照组运用静脉留置针的常规护理方法进行护理，试验组在给予常规护理方法的同时实施一系列持续质量管理的措施，包括安排护理业务查房、组织操作示范、应用留置安全健康宣传小卡片对患者进行宣教、定期不定期的留置质量检查、将留置针安全作为一项交班内容、强调优质护理指针。留置针留置第3天对两组患者使用同一自制量表调查留置期间的安全问题及患者对护理的评价，并对两组调查结果进行统计分析。 结果 试验组留置期间不良事件发生率为6.0%，对照组为34.0%，两组差异有统计学意义（χ2=12.250，P=0.000）；试验组对留置针留置安全知识的4个方面知晓情况均优于对照组（P=0.000）；试验组对护理满意度较对照组好（P=0.000）。 结论 持续质量管理增加了神经科住院患者留置针留置安全、增进了患者对相关健康知识的掌握，提高了患者对护理的满意，值得临床推广。
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 总结1例噬血细胞综合征的临床表现及治疗方案。 方法 2009年12月收治1例以皮疹为突出表现的噬血细胞综合征患儿的临床表现及治疗效果。 结果 患儿的皮疹表现突出，临床较少见；采用HLH-2004方案治疗后临床症状、体征及实验室指标短时间内恢复正常。近期随访，一般情况良好，血液学指标基本正常。 结论 患儿采用HLH-2004方案治疗后预后良好。