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专题:危重症患者诊疗指南干货,速速围观!

2017-05-27 MedSci MedSci原创

现代诊疗技术的快速发展,高精尖的医疗设备得到了广泛的应用,对从事危重症患者诊疗的医务人员素质提出了更高的要求,危重症的专业性和综合性都比较强,它整合了内科、外科、护理等多个专业的高端技术。危重病人的病情严重随时可能变化,如果抢救及时,护理得当,病人可能转危为安,反之,即可发生生命危险。因此对危重病人的护理是一项非常重要而严肃的工作,是争分夺秒的战斗。梅斯小编整理了危重症患者诊疗相关指南,供大家参考


现代诊疗技术的快速发展,高精尖的医疗设备得到了广泛的应用,对从事危重症患者诊疗的医务人员素质提出了更高的要求,危重症的专业性和综合性都比较强,它整合了内科、外科、护理等多个专业的高端技术。危重病人的病情严重随时可能变化,如果抢救及时,护理得当,病人可能转危为安,反之,即可发生生命危险。因此对危重病人的护理是一项非常重要而严肃的工作,是争分夺秒的战斗。梅斯小编整理了危重症患者诊疗相关指南,供大家参考! 
一、规范篇 
1、中国卫生行业标准-重症监护病房医院感染预防与控制规范(WS/T509-2016) 
本标准规定了医疗机构重症监护病房(ICU)医院感染预防与控制的基本要求、建筑布局与必要设施及管理要求、人员管理、医院感染的监测、器械相关感染的预防和控制措施、手术部位感染的预防与控制措施、手卫生要求、环境清洁消毒方法与要求、床单元的清洁与消毒要求、便器的清洗与消毒要求、空气消毒方法与要求等。本标准适用各级综合医院依据有关规定设置的ICU。 2、急诊危重症患者院内转运共识——标准化分级转运方案 
鉴于急危重症患者具有病情危重、病情变化快、且常常依赖生命支持手段及转运难度大等特点,因此亟需规范并优化院内转运流程,以保证急危重症患者院内转运安全。根据急诊危重症患者的特点以及急诊院内转运的临床实践,本共识协作组制定了“降阶梯预案、充分评估、优化分级、最佳路径、动态评估”为原则的分级转运方案,以保证转运安全。 二、诊疗篇
1、2016 ATS/ACCP临床实践指南:危重症患者机械通气撤机 
2016年10月,美国胸科学会(ATS)、美国胸科医师学会(ACCP)发布了危重症患者机械通气撤机指南,指南专家组共提出了与康复协议,呼吸机撤机协议,以及气囊漏气试验相关的4条建议。 2、床旁超声在急危重症临床应用的专家共识 
随着超声技术的发展和普 及,特别是肺部超声的突破,床旁超声为急诊医师提供了越来越多急危重症患者的临床信息,被誉为可视 “听诊器”, 因此,急诊床旁超声也受到急诊医师的广泛关注。本共识以 急诊临床思维为导向,结合国内外超声发展现状,主要针对几种常见的急危症超声影像和流程进行梳理,进一步规范和 推广急诊床旁超声的临床应用。 3、支气管镜在急危重症临床应用的专家共识 
按照卫计委《呼吸内镜诊疗技术管理规范2012》规定:有3年以上临床工作经验,累计参与呼吸内镜诊疗技术操作50例次者即可独立进行操作。因此,每个进行气管镜操作的急诊医生都应该在经验丰富的上级医师指导下,接受系统正规的气管镜的理论与实践紧密结合的培训,最终能够独立、规范地处理临床常见问题。 4、谷氨酰胺在危重症患者中临床应用的专家推荐意见(节录) 
谷氨酰胺(glutamine,GLN)作为人体氨基酸之一,广泛地参与机体的各种生物活动。研究表明,在危重症状况下,适宜的GLN 供给对于维持正常肠屏障功能、降低炎性介质水平是必需的[1]。但最近也有一些重要的质疑性研究,对GLN 的临床应用引起不同意见的争论。

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    2017-05-28 明天会更好!

    学习了,谢谢分享!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1707443, encodeId=a8eb1e0744397, content=<a href='/topic/show?id=25df20e54dc' target=_blank style='color:#2F92EE;'>#专题#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20754, encryptionId=25df20e54dc, topicName=专题)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f4231418733, createdName=108807375_62823137, createdTime=Tue Aug 22 04:54:00 CST 2017, time=2017-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284000, encodeId=fe621284000f6, content=<a href='/topic/show?id=cdb79594643' target=_blank style='color:#2F92EE;'>#重症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95946, encryptionId=cdb79594643, topicName=重症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c3a189, createdName=longqijun248, createdTime=Mon May 29 01:54:00 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1526127, encodeId=a764152612ef5, content=<a href='/topic/show?id=a08b36e6548' target=_blank style='color:#2F92EE;'>#危重症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36765, encryptionId=a08b36e6548, topicName=危重症患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bfbf11697948, createdName=liuquan, createdTime=Mon May 29 01:54:00 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203365, encodeId=9242203365e7, content=学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Sun May 28 00:06:42 CST 2017, time=2017-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203224, encodeId=ebbd20322403, content=比较全面, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KwF3IOBZ2PuqN4kVibCFp38BFYZ90a6ib4FiaNtfuyfaVl9kdqIuS7cYIicicMdkX3KteMgTwK54c4ybH/0, createdBy=f2571354424, createdName=wangxy0513, createdTime=Sat May 27 13:55:13 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203212, encodeId=fcf820321200, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6uiaa8Rp49ibOhXXPica7icVOgRWzYu3UJYe0BpHicBXialCN3bbvN85QtImfQVRMgCQkfGbL4c0bv1jD/0, createdBy=f7c21673796, createdName=guangyi1980, createdTime=Sat May 27 12:42:13 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203207, encodeId=0b4920320e19, content=学习了!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=078f1661649, createdName=wei834766788, createdTime=Sat May 27 11:57:35 CST 2017, time=2017-05-27, status=1, ipAttribution=)]
    2017-05-27 wangxy0513

    比较全面

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1707443, encodeId=a8eb1e0744397, content=<a href='/topic/show?id=25df20e54dc' target=_blank style='color:#2F92EE;'>#专题#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20754, encryptionId=25df20e54dc, topicName=专题)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f4231418733, createdName=108807375_62823137, createdTime=Tue Aug 22 04:54:00 CST 2017, time=2017-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284000, encodeId=fe621284000f6, content=<a href='/topic/show?id=cdb79594643' target=_blank style='color:#2F92EE;'>#重症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95946, encryptionId=cdb79594643, topicName=重症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c3a189, createdName=longqijun248, createdTime=Mon May 29 01:54:00 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1526127, encodeId=a764152612ef5, content=<a href='/topic/show?id=a08b36e6548' target=_blank style='color:#2F92EE;'>#危重症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36765, encryptionId=a08b36e6548, topicName=危重症患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bfbf11697948, createdName=liuquan, createdTime=Mon May 29 01:54:00 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203365, encodeId=9242203365e7, content=学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Sun May 28 00:06:42 CST 2017, time=2017-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203224, encodeId=ebbd20322403, content=比较全面, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KwF3IOBZ2PuqN4kVibCFp38BFYZ90a6ib4FiaNtfuyfaVl9kdqIuS7cYIicicMdkX3KteMgTwK54c4ybH/0, createdBy=f2571354424, createdName=wangxy0513, createdTime=Sat May 27 13:55:13 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203212, encodeId=fcf820321200, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6uiaa8Rp49ibOhXXPica7icVOgRWzYu3UJYe0BpHicBXialCN3bbvN85QtImfQVRMgCQkfGbL4c0bv1jD/0, createdBy=f7c21673796, createdName=guangyi1980, createdTime=Sat May 27 12:42:13 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203207, encodeId=0b4920320e19, content=学习了!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=078f1661649, createdName=wei834766788, createdTime=Sat May 27 11:57:35 CST 2017, time=2017-05-27, status=1, ipAttribution=)]
    2017-05-27 guangyi1980

    学习了

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1707443, encodeId=a8eb1e0744397, content=<a href='/topic/show?id=25df20e54dc' target=_blank style='color:#2F92EE;'>#专题#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20754, encryptionId=25df20e54dc, topicName=专题)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f4231418733, createdName=108807375_62823137, createdTime=Tue Aug 22 04:54:00 CST 2017, time=2017-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284000, encodeId=fe621284000f6, content=<a href='/topic/show?id=cdb79594643' target=_blank style='color:#2F92EE;'>#重症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95946, encryptionId=cdb79594643, topicName=重症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c3a189, createdName=longqijun248, createdTime=Mon May 29 01:54:00 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1526127, encodeId=a764152612ef5, content=<a href='/topic/show?id=a08b36e6548' target=_blank style='color:#2F92EE;'>#危重症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36765, encryptionId=a08b36e6548, topicName=危重症患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bfbf11697948, createdName=liuquan, createdTime=Mon May 29 01:54:00 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203365, encodeId=9242203365e7, content=学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Sun May 28 00:06:42 CST 2017, time=2017-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203224, encodeId=ebbd20322403, content=比较全面, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KwF3IOBZ2PuqN4kVibCFp38BFYZ90a6ib4FiaNtfuyfaVl9kdqIuS7cYIicicMdkX3KteMgTwK54c4ybH/0, createdBy=f2571354424, createdName=wangxy0513, createdTime=Sat May 27 13:55:13 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203212, encodeId=fcf820321200, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6uiaa8Rp49ibOhXXPica7icVOgRWzYu3UJYe0BpHicBXialCN3bbvN85QtImfQVRMgCQkfGbL4c0bv1jD/0, createdBy=f7c21673796, createdName=guangyi1980, createdTime=Sat May 27 12:42:13 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203207, encodeId=0b4920320e19, content=学习了!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=078f1661649, createdName=wei834766788, createdTime=Sat May 27 11:57:35 CST 2017, time=2017-05-27, status=1, ipAttribution=)]
    2017-05-27 wei834766788

    学习了!!!!!

    0

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