ObjectiveTo analyze standards of alginate-based medical devices at home and abroad, and to emphasize key issues of quality control that should be concerned about.MethodsBased on investigation of alginate application in medical devices and alginate-related medical standards, alginate-related technical indicators and quality control points were comprehensively analyzed.ResultsWith the rapid development of alginate-based medical materials and medical devices, the relevant standards at home and abroad have been elaborated on the basic technical indicators and detection methods. In addition to Chinese Pharmacopoeia, China has issued one alginate standard for tissue engineering and three alginate related product standards.ConclusionConsidering the special physical and chemical properties of alginate, researchers also need to focus on the sterilization method, expiry date, molecular weight, and ratio of α-L-guluronic acid to β-D-mannuronic acid of alginate, and impurity content.
目的：慢性腎臟疾病中腎性高血壓常見，危害大且不易控制，本文就臨床護理實踐進行總結。方法：腎性高血壓患者男性82例，女性74例，予限水鹽攝入,飲食療法,休息與心理護理,以及合理的降壓藥治療，加強觀察等。結論：腎性高血壓控制不佳者，在降壓藥使用基礎上注意休息，控制水鈉入量，并加強其心理治療，解除心理負擔，有利于控制血壓。
ObjectiveTo investigate whether continuous quality improvement (CQI) measures can reduce the episodes of peritonitis. MethodsWe analyzed the data of 114 cases of peritoneal dialysis related peritonitis from January to December 2011 before applying CQI measures and 72 cases from January and December 2012 after applying CQI measures in West China Hospital. Then we studied the episodes, cause and pathogenic bacteria species of peritonitis in peritoneal dialysis patients. We implemented the process of reducing the episodes of peritonitis by applying PDCA four-step design: plan-do-check-act. ResultsThe episodes of peritonitis were reduced from per 60.8 patient-months (0.197/patient-years) to per 66.6 patient-months (0.180/patient-years) after applying CQI measures. The positive rate of pathogenic bacteria culture was both 50.0% before and after applying CQI measures, in which 66.7% were gram-positive cocci. The curing rate of peritonitis was increased from 57 case/times (76.3%) to 87 case/times (79.2%). Switching to hemodialysis rate was reduced from 17 cases/times (14.9%) to 10 cases/times (13.9%). Death cases was reduced from 9 cases/times (7.9%) to 5 cases/times (6.9%). ConclusionThese results show that the incidence of peritoneal dialysis related peritonitis decreases and the curing rate increases through CQI measures.
目的 分析持續腹膜透析患者發生腹膜炎的情況及相關因素，降低腹膜透析患者腹膜炎發生率、退出率，提高患者的生存率、生活質量。 方法 回顧分析2011年1月－6月收治的41例在家中行持續非臥床性腹膜透析且發生腹膜炎患者的臨床資料，觀察腹膜炎的發生率及轉歸，腹膜炎癥狀出現后初始的處理，對腹膜炎的誘因進行分析。 結果 41例腹膜透析患者共發生腹膜炎43例次，痊愈35例（85.4%），轉血液透析3例（7.3%），死亡3例（7.3%）。在癥狀出現初期，3例（7.3%）患者繼續在家觀察，10例（24.4%）患者立即到當地就醫，15例（36.6%）患者采用電話咨詢，13例（31.7%）患者到腹膜透析中心就診；18例（43.9%）患者直接將腹膜透析引流液帶到醫院進行藥敏試驗。就感染誘因而言，16例（39.0%）患者未嚴格進行空氣消毒，13例（31.7%）患者未嚴格進行環境清潔，10例（24.4%）患者操作過程存在污染行為。 結論 加強對居家行腹膜透析患者的初次培訓、操作指導及監測，可避免腹膜炎的發生，提高患者生活質量。
目的 比較兩種不同方法護理腹膜透析患者導管出口處的效果。 方法 選取2008年7月－2009年12月51例患者作為試驗組，直接采用聚維酮碘溶液擦洗導管出口處，2007年1月－2008年7月45例患者作為對照組，先用生理鹽水清洗遂道口，再用聚維酮碘溶液擦洗導管出口處。比較兩組導管出口處感染的情況及操作所需時間。 結果 試驗組出口評分系統（ESS）＜2分15例，2～3分34例，≥4分7例；對照組＜2分10例，2～3分24例，≥4分16例；兩組差異有統計學意義（P＜0.05）。試驗組護士操作時間為（3.0 ± 1.0）min，患者操作時間為（5.0 ± 1.5）min；對照組護士操作時間為（8.0 ± 2.0）min，患者操作時間為（10.0 ± 2.0）min；兩組差異有統計學意義（P＜0.05）。 結論 聚維酮碘溶液直接清洗、消毒導管出口處降低了感染的發生率，減少了操作環節和所需物品，縮短了操作時間。
Objective To investigate the change of pathogenic distribution and drug resistance in peritoneal dialysis associated peritonitis (PDAP). Methods The clinical data of all the patients undergoing continuous ambulatory peritoneal dialysis and suffered from PDAP between January and December in 2014 was retrospectively collected, and the pathogens, drug resistance, outcomes and underlying causes were analyzed. Results A total of 64 patients had 72 cases of PDAP. Only 36 strains (50.0%) had positive culture results, among which 24 strains (66.7%) were Gram-positive bacteria strains, 7 strains (19.4%) were Gram-negative bacteria strains, and 5 strains (13.9%) were fungi. For Gram-positive bacteria strains, the resistance rates to vancomycin, linezolid and rifampicin were all 0%; the resistance rate to levofloxacin, gentamycin and cefazolin was 14.3%, 26.3% and 50.0%, respectively. For Gram-negative bacteria strains, the resistance rates to amikacin and imipenem were both 0%; the resistant rate to gentamycin, ceftazidime, levofloxacin and ampicillin was 28.6%, 28.6%, 42.9% and 100.0%, respectively. Conclusions The pathogenic spectrum and drug resistance in PDAP have been markedly changed. Selection of antibiotics should be chosen according to the characteristic of the pathogenic spectrum and drug resistance of each center. Great effort is still needed to improve the culture positive rate of the effluent dialysate and to improve the recovery rate of peritonitis.