{"nowTime30":1782381773200,"lyBarModerator":null,"metaSearch":{"description":"为了使医疗单位树立正确的风险意识，有效地化解医疗风险，2007年6月，卫生部颁布了《关于推动医疗责任保险有关问题的通知》，推动医疗单位参加医疗责任保险，以化解医患矛盾，处理医疗纠纷。那么，医疗责任险是什么意思、医疗纠纷是什么意思？\n\n\n\n所谓的医疗责任险是指医疗单位投保交纳保险费用成为被保险人，保险","keywords":"医疗责任险是什么意思_洞医","title":"医疗责任险是什么意思_洞医","channels":null},"identificate":{"id":"694a92a2e9ed11e7a3d800163e04584d","isDel":0,"createAt":1514259154100,"createBy":"e8f7486fbba411e7a3d800163e04584d","createName":"1516932689@qq.com","updateAt":0,"updateBy":null,"updateName":null,"userId":"e8f7486fbba411e7a3d800163e04584d","realName":"王瑞","certifiedStatus":2,"phone":"18201617331","email":"1516932689@qq.com","hospitalId":"14654","departmentId":"2032","illName":"冠心病","illId":"14fcc36fbadb11e6a61c00163e04584d","cardType":2,"cardImg":"http://01luntan.com/ly_img/1533708809392.jpg","idCardImg":"","identityType":2,"stop":0,"departmentName":"心血管内科","hospitalName":null},"canEdit":null,"adList":[],"lyBar":{"id":"1937","isDel":0,"createAt":1483430801976,"createBy":"system","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"userId":null,"name":"尿毒症","type":102,"twoCode":"http://zhao01.com/zly_img/zly_wx.jpg","image":null,"provinceId":null,"cityId":null,"illId":"0476f072badb11e6a61c00163e04584d","hospitalId":null,"keyWord":null,"totleTopic":0,"barDesc":null,"discussBarType":null,"metaSearch":"{\"channels\":{\"病友社区\":{\"description\":\"为病友提供:尿毒症论坛_尿毒症论坛贴吧_病友交流平台_病友论坛，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"尿毒症论坛_尿毒症论坛贴吧_病友交流平台_病友论坛\",\"title\":\"尿毒症论坛_尿毒症论坛贴吧_病友交流平台_病友论坛\"},\"治疗\":{\"description\":\"为您提供:尿毒症治疗方法_尿毒症早期如何治疗_尿毒症怎么治疗最好等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"尿毒症治疗方法_尿毒症早期如何治疗_尿毒症怎么治疗最好\",\"title\":\"尿毒症治疗方法_尿毒症早期如何治疗_尿毒症怎么治疗最好\"},\"症状\":{\"description\":\"为您提供:尿毒症的早期表现_尿毒症早期状态_尿毒症的症状有哪些等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"尿毒症的早期表现_尿毒症早期状态_尿毒症的症状有哪些\",\"title\":\"尿毒症的早期表现_尿毒症早期状态_尿毒症的症状有哪些\"},\"并发症\":{\"description\":\"为您提供:尿毒症透析后遗症_尿毒症治愈后后遗症_尿毒症的危害等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"尿毒症透析后遗症_尿毒症治愈后后遗症_尿毒症的危害\",\"title\":\"尿毒症透析后遗症_尿毒症治愈后后遗症_尿毒症的危害\"},\"饮食\":{\"description\":\"为您提供:尿毒症吃什么食物最好_尿毒症不能吃的东西_尿毒症吃啥东西好等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"尿毒症吃什么食物最好_尿毒症不能吃的东西_尿毒症吃啥东西好\",\"title\":\"尿毒症吃什么食物最好_尿毒症不能吃的东西_尿毒症吃啥东西好\"},\"病因\":{\"description\":\"为您提供:尿毒症是怎么引起的_怎么导致尿毒症_怎么样会得尿毒症等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"尿毒症是怎么引起的_怎么导致尿毒症_怎么样会得尿毒症\",\"title\":\"尿毒症是怎么引起的_怎么导致尿毒症_怎么样会得尿毒症\"},\"病友求助\":{\"description\":\"为您提供:尿毒症是遗传病吗_尿毒症可以治愈吗_尿毒症晚期还能活多久等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"尿毒症是遗传病吗_尿毒症可以治愈吗_尿毒症晚期还能活多久\",\"title\":\"尿毒症是遗传病吗_尿毒症可以治愈吗_尿毒症晚期还能活多久\"},\"预防\":{\"description\":\"为您提供:怎样预防尿毒症的发生_怎样预防尿毒症?_平时怎么预防尿毒症等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"怎样预防尿毒症的发生_怎样预防尿毒症?_平时怎么预防尿毒症\",\"title\":\"怎样预防尿毒症的发生_怎样预防尿毒症?_平时怎么预防尿毒症\"}},\"description\":\"为您提供:尿毒症早期症状表现_儿童尿毒症症状有哪些症状_尿毒症有遗传吗_尿毒症病友的治疗经验等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"尿毒症早期症状表现_儿童尿毒症症状有哪些症状_尿毒症有遗传吗\",\"title\":\"尿毒症早期症状表现_儿童尿毒症症状有哪些症状_尿毒症有遗传吗\"}","adInfo":null},"isLikeThisTopic":null,"lastTopics":[{"id":"3879","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"尿毒症如何预防？","content":"<p style=\"text-align:center\"><span style=\"color: rgb(88, 88, 88); font-family: Arial, simsun; font-size: 14px; line-height: 26.6667px; text-indent: 28px; background-color: rgb(255, 255, 255);\"><img src=\"http://01luntan.com/ly_img/uimgs/1486395535228.jpg\" title=\"1486395535228.jpg\" alt=\"11b2ceb2-4a8b-4172-9337-630370d190a7.jpg\"/></span></p><p><span style=\"color: rgb(88, 88, 88); font-family: Arial, simsun; font-size: 14px; line-height: 26.6667px; text-indent: 28px; background-color: rgb(255, 255, 255);\">定期体检：常规的血压、血常规、尿常规、肝肾功能检测就能发现早期肾脏病的蛛丝马迹</span><br/><br/><span style=\"color: rgb(88, 88, 88); font-family: Arial, simsun; font-size: 14px; line-height: 26.6667px; text-indent: 28px; background-color: rgb(255, 255, 255);\">多喝水：多饮水保障肾脏有效血液灌注，多排尿可以促进代谢产物的排出</span><br/><span style=\"color: rgb(88, 88, 88); font-family: Arial, simsun; font-size: 14px; line-height: 26.6667px; text-indent: 28px; background-color: rgb(255, 255, 255);\">该吃的药一个不能少，不该吃的“补药”一样不要碰。所谓的补药能免则免，真要补肾的话，在尿量允许的情况下多饮水，水才是“软黄金”</span><br/><br/><span style=\"color: rgb(88, 88, 88); font-family: Arial, simsun; font-size: 14px; line-height: 26.6667px; text-indent: 28px; background-color: rgb(255, 255, 255);\">合理饮食：低蛋白饮食和严格限盐。尿毒症患者每天每千克体重进食蛋白质0.6克加酮酸；盐每天3克</span><br/><span style=\"color: rgb(88, 88, 88); font-family: Arial, simsun; font-size: 14px; line-height: 26.6667px; text-indent: 28px; background-color: rgb(255, 255, 255);\">搬走尿毒症的三座大山：高血压、蛋白尿、贫血是尿毒症的三座大山，搬走三座大山有效延缓肾功能恶化</span></p>","barId":"1937","topicTypeId":null,"topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"4420","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"尿毒症的护理措施","content":"<p style=\"text-align: center;\"><img title=\"1486396113272.jpg\" src=\"http://01luntan.com/ly_img/uimgs/1486396113272.jpg\" alt=\"20130928113801-2014794721.jpg\" /><span lang=\"EN-US\" style=\"font-size: 12pt; line-height: 200%;\">&nbsp;&nbsp;&nbsp;</span></p>\n<p style=\"text-align: left;\"><span style=\"font-size: 12pt; line-height: 200%; font-family: 宋体;\">&nbsp; 尿毒症的护理是需要从多个方面做好的，例如尿毒症的患者如果皮肤出校搔痒，护理的时候就不能用手去搔伤皮肤而是应该采用热水去擦浴。</span></p>\n<p>&nbsp;</p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;&nbsp;&nbsp; </span><span style=\"font-size: 12.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">慢性肾衰竭是指各种肾脏病导致肾脏功能渐进性不可逆性减退，直至功能丧失所出现的一系列症状和代谢紊乱所组成的临床综合征，简称慢性肾衰。慢性肾衰的终末期即为人们常说的尿毒症。尿毒症不是一个独立的疾病，而是各种晚期的肾脏病共有的临床综合征，是慢性肾功能衰竭进入终末阶段时出现的一系列临床表现所组成的综合征。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;&nbsp;&nbsp; 1.</span><span style=\"font-size: 12.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">卧床休息，出现烦躁不安、抽搐时防止舌咬伤，加用床挡。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;&nbsp;&nbsp; 2.</span><span style=\"font-size: 12.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">给予高热量、高维生素，优质低蛋白饮食，高血压病人应限钠盐的摄入，透析治疗病人应予以优质高蛋白饮食。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;&nbsp;&nbsp; 3.</span><span style=\"font-size: 12.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">呼吸有氨味者，应加强口腔护理。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;&nbsp;&nbsp; 4.</span><span style=\"font-size: 12.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">皮肤搔痒，可用热水擦浴，切忌用手搔伤皮肤</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;&nbsp;&nbsp; 5.</span><span style=\"font-size: 12.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">病人思想负担重，使病人失去安全感和信心，护士应对病人加强解释工作，增加战胜疾病的信心，积极配合治疗和护理。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;&nbsp;&nbsp; </span><span style=\"font-size: 12.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">在上面的文章里面我们介绍了什么是尿毒症，我们知道尿毒症给患者的身体带来了严重的伤害，一旦患上了尿毒症，那么治疗起来是非常麻烦的，所以我们要做好对于尿毒症患者的护理，上文详细介绍了尿毒症的护理措施。</span><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 200%;\">&nbsp;&nbsp;</span></p>","barId":"1937","topicTypeId":null,"topicThemeId":"1035","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":4},{"id":"7585","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"尿毒症可能并发哪些疾病","content":"<p style=\"margin-right: 0px; margin-left: 0px; text-indent: 0px; text-align: center; line-height: 200%;\"></p><p style=\"margin-right: 0px; margin-left: 0px; text-indent: 32px; text-align: center; line-height: 200%;\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><img src=\"http://01luntan.com/ly_img/uimgs/1510711039069.png\" title=\"尿毒症可能并发哪些疾病\" alt=\"尿毒症可能并发哪些疾病\" width=\"600\" height=\"372\"/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">找良医网</span><span style=\";font-family:宋体;line-height:200%;font-size:16px\">向您详细介绍尿毒症有哪些并发病症，尿毒症还会引起哪些疾病？</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">尿毒症并发症</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\"font-family: 宋体;\">尿毒症是肾功能衰竭晚期所发生的一系列症状的总称。慢性肾功能衰竭症状主要体现为有害物质积累引起的中毒和肾脏激素减少发生的贫血合骨病。早期最常见的是恶心、呕吐食欲减退等消化道症状。进入晚期尿毒症阶段后，全身系统都会受累，出现心力衰竭、精神异常、昏迷等严重情况，危及生命。过去认为尿毒症是不治之症，自本世纪</span><span style=\"font-family: 宋体;\">0年代之后开展了透析方法及肾移植手术，使尿毒症病人的寿命的以明显延长。</span><br/></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">在尿毒症期，除上述水、电解质、酸碱平衡紊乱、贫血、出血倾向、高血压等进一步加重外，还可出现各器官系统功能障碍以及物质代谢障碍所引起的临床表现，兹分述如下。</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">(一)神经系统症状</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><span style=\"font-family:宋体\">神经系统的症状是尿毒症的主要症状。在尿毒症早期，患者往往有头昏、头痛、乏力、理解力及记忆力减退等症状。随着病情的加重可出现烦躁不安、肌肉颤动、抽搐</span>;最后可发展到表情淡漠、嗜睡和昏迷。这些症状的发生与下列因素有关：</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">①某些毒性物质的蓄积可能引起神经细胞变性;</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">②电解质和酸碱平衡紊乱;</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">③肾性高血压所致的脑血管痉挛，缺氧和毛细血管通透性增高，可引起脑神经细胞变性和脑水肿。</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">(二)消化系统症状</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><span style=\"font-family:宋体\">尿毒症患者消化系统的最早症状是食欲不振或消化不良</span>;病情加重时可出现厌食，恶心、呕吐或腹泻。这些症状的发生可能与肠道内细菌的尿素酶将尿素分解为氨，氨剌激胃肠道粘膜引起炎症和多发性表浅性小溃疡等有关。患者常并发胃肠道出血。此外恶心、呕吐也与中枢神经系统的功能障碍有关。</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">(三)心血管系统症状</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><span style=\"font-family:宋体\">慢性肾功能衰竭者由于肾性高血压、酸中毒、高钾血症、钠水潴留、贫血及毒性物质等的作用，可发生心力衰竭，心律失常和心肌受损等。由于尿素</span>(可能还有尿酸)的剌激作用，还可发生无菌性心包炎，患者有心前区疼痛;体检时闻及心包摩擦音。严重时心包腔中有纤维素及血性渗出物出现。</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">(四)呼吸系统症状</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><span style=\"font-family:宋体\">酸中毒时患者呼吸慢而深，严重时可见到酸中毒的特殊性</span>Kussmaul呼吸。患者呼出的气休有尿味，这是由于细菌分解睡液中的尿素形成氨的缘故。严重患者可出现肺水肿，纤维素性胸膜炎或肺钙化等病变，肺水肿与心力衰竭、低蛋白血症、钠水潴留等因素的作用有关。纤维素性胸膜炎是尿素剌激引起的炎症;肺钙化是磷酸钙在肺组织内沉积所致。</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">(五)皮肤症状</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><span style=\"font-family:宋体\">皮肤瘙痒是尿毒症患者常见的症状，可能是毒性产物对皮肤感受器的剌激引起的</span>;有人则认为与继发性甲状旁腺功能亢进有关，因为切除甲状旁腺后，能立即解除这一痛苦的症状。此外，患者皮肤干燥、脱屑并呈黄褐色。皮肤颜色的改变，以前认为是尿色素增多之故，但用吸收分光光度计检查，证明皮肤色素主要为黑色素。在皮肤暴露部位，轻微挫伤即可引起皮肤淤斑。由于汗液中含有较高浓度的尿素，因此在汗腺开口处有尿素的白色结晶，称为尿素霜。</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">(六)物质代谢障碍</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">1.糖耐量降低</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">尿毒症患者对糖的耐量降低，其葡萄糖耐量曲线与轻度糖尿病患者相似，但这种变化对外源性胰岛素不敏感。造成糖耐量降低的机制可能为：</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">①胰岛素分泌减少;</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">②尿毒症时由于生长激素的分泌基础水平增高，故拮抗胰岛素的作用加强;</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">③胰岛素与靶细胞受体结合障碍，使胰岛素的作用有所减弱;</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">④有关肝糖原合成酶的活性降低而致肝糖原合成障碍。目前认为引起上述变化的主要原因可能是尿素、肌酐和中分子量毒物等的毒性作用。</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">2.负氮平衡</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">负氮平衡可造成病人消瘦、恶病质和低白蛋白血症。低白蛋白血症是引起肾性水肿的重要原因之一。引起负氮平衡的因素有：</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">①病人摄入蛋白质受限制或因厌食、恶心和呕吐而致蛋白质摄入减少;</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">②某些物质如甲基胍可使组织蛋白分解代谢加强;</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">③合并感染时可导致蛋白分解增强;</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">④因出血而致蛋白丢失;</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">⑤随尿丢失一定量的蛋白质等。</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><span style=\"font-family:宋体\">尿毒症时大量尿素可由血液渗入肠腔。肠腔细菌可将尿素分解而释放出氨，氨被血液运送到肝脏后，可再合成尿素，也可合成非必需氨基酸，后者对机体是有利的。因此有人认为，尿毒症病人蛋白质的摄入量可低于正常人，甚至低于每天</span>20g即可维持氮平衡，但必须给予营养价值较高的蛋白质，即含必需氨基酸丰富的营养物质。近年来有人认为。</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><span style=\"font-family:宋体\">为了维持尿毒症病人的氮平衡，蛋白质摄入量应与正常人没有明显差异</span>;而且认为，单纯为了追求血液尿素氮的降低而过分限制蛋白质的摄入量，可使自身蛋白质消耗过多，因而对病人有害而无益。</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><br/></span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\">3.高脂血症</span></p><p style=\"margin-right:0;margin-left:0;text-indent:32px;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\";font-family:宋体;line-height:200%;font-size:16px\"><span style=\"font-family:宋体\">尿毒症病人主要由于肝脏合成甘油三酯所需的脂蛋白</span>(前β-脂蛋白)增多，故甘油三酯的生成增加;同时还可能因脂蛋白脂肪酶(lipoprotein lipase)活性降低而引起甘油三酯的清除率降低，故易形成高甘油三酯血症。此种改变可能与甲基胍的蓄积有关。</span></p><p><br/></p>","barId":"1937","topicTypeId":null,"topicThemeId":"1034","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"13922","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"尿毒症是怎么造成的","content":"<p style=\"margin-top:0;margin-right:0;margin-bottom:0;text-indent:28px;padding:0 0 0 0 ;text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;line-height:200%\"><span style=\"font-family: 宋体;color: rgb(75, 75, 75);letter-spacing: 0;font-size: 16px\"><span style=\"font-family:宋体\">我的一个大学同学检查出患有尿毒症了，看着他平时挺正常的，很健康的，没想这就突然住院了，我对这个病不是很了解，平时我们经常一起吃饭，我很纳闷他怎么会得尿毒症。尿毒症</span></span><span style=\"font-family: 宋体;color: rgb(75, 75, 75);letter-spacing: 0;font-size: 16px\"><span style=\"font-family:宋体\">这个病</span></span><span style=\"font-family: 宋体;color: rgb(75, 75, 75);letter-spacing: 0;font-size: 16px\"><span style=\"font-family:宋体\">是怎么造成的</span></span><span style=\"font-family: 宋体;color: rgb(75, 75, 75);letter-spacing: 0;font-size: 16px\"><span style=\"font-family:宋体\">？</span></span></p><p><br/></p>","barId":"1937","topicTypeId":null,"topicThemeId":"1033","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":6},{"id":"17682","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"医疗纠纷责任的追究","content":"<p style=\"text-indent: 28px; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">在生活中，医疗纠纷是很常见的一种纠纷形式，而法律上对医疗纠纷的责任追究也有相关的制度规定。以下是由</span></span><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">找良医网</span></span><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">为大家整理的医疗纠纷责任的追究制度，希望能帮到你们。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0px; line-height: 200%; text-align: center;\"><img title=\"医疗纠纷责任的追究制度\" src=\"http://01luntan.com/ly_img/uimgs/1535427904318.jpg\" alt=\"医疗纠纷责任的追究制度\" width=\"600\" height=\"372\" /></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 28px; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">医疗纠纷责任追究的制度</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　(一)、医疗纠纷责任追究制度是执行医疗质量和医疗安全的核心制度，是良好解决医疗纠纷和医疗事故，尤其是进一步做好防范医疗事故的具体措施。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　(二)、医疗人员有过错的医疗纠纷是指医疗机构及其医务人员在医疗活动中，违反医疗卫生法律、行政法规、部门规章和诊疗护理规范、常规，过失造成患者人身损害的纠纷。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　(三)、医疗差错是指在诊疗活动中，医务人员虽有失职行为或技术过失，但未给患者造成死亡、残废、或组织器官损害导致功能障碍的不良后果。分为严重差错和一般差错。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　(1)严重医疗差错是指由于医务人员的失职行为或技术过失，给患者造成一定痛苦，延长治疗时间。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　(2)一般医疗差错是指医务人员虽有失职行为或技术过失，但未给患者造成痛苦。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　(四)医疗人员有过错的医疗纠纷、医疗差错的直接(主要)责任人，是指其行为与患者的不良结果之间有直接的关系，并对不良结果起决定作用的人员。由复杂原因或多环节因素而产生的医疗纠纷、医疗差错，根据有关人员在造成不良结果过程中所起的作用，确定其所负责任。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　医疗纠纷投诉的形式</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　1、医疗纠纷发生后，医疗机构和医务人员有上报的义务，但是在某些条件下，医务人员可能会不上报。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　2、作为患方及时向医疗机构科室负责人、向医疗机构负责医疗服务质量监控的部门或者专(兼)职人员投诉，有利于医疗机构及时了解并固定情况，也可以避免事后直接责任医务人员不按照实际情况上报，引起次生的其他纠纷。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　3、患方还可以直接向卫生行政部门投诉，这样有利于卫生行政部门在第一时间介入，有利于卫生行政部门固定证据，同时也有利于患方通过卫生行政部门调解，尽早处理纠纷。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　4、现在各地卫生行政部门大多都设有专门的处理医疗纠纷的专门机构或专职人员。向卫生行政部门投诉，也有利于保留、保存证据。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　医疗纠纷的防范技巧</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　1、严格执行各项规章制度、技术操作规程、诊疗常规。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　严格执行规章制度，首先要提高全体医务人员对规章制度在保证医疗质量和安全、防范医疗纠纷工作中的重要地位和作用的认识，它既保护病人的利益，更保护医务人员自身，是防范医疗纠纷的关键。其次，要经常学习、熟练掌握、应用各种规章制度、技术操作规程，规范科室和个人的医疗行为。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　2、严格按照岗位、职称履行职责，禁止跨学科、跨专业收治病人。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　《执行医师法》规定：</span>&ldquo;医师在注册的执业范围内进行医学诊查，疾病调查、医学处置</span><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">？</span></span><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&rdquo;医师超出自己学科范围的医疗活动是不允许的，这也是保证患者医疗安全的规定。在临床实践中，</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　误诊是难以避免的，一旦发现应及时请相应学科医师会诊、协助手术，使误诊得到纠正，如果自作主张，一错再错，造成事故，将承担法律责任。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　3、严格履行首诊负责制和首问负责制。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　首诊负责制是医疗管理的四项基本原则之一，要求首诊医师必须把接诊病人妥善处理完毕，特别是涉及多学科的疾患或复合创伤，首诊医师应请相关学科会诊，得出结论性意见，使病人有所归属，方能告一段落。首问负责制指患者向医院任意工作人员询问时，都要给予圆满答复，自己不能回答的要替患者问询，直至患者得到满意答复。首问负责制不仅是提高医院服务质量的需要，也是医疗安全管理的需要，特别是急症病人，可以及时得到指导性答复，以免延误诊治时机</span>;反之，不负责任的答复会延误诊治，甚至造成恶劣后果，形成医疗纠纷。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　4、严守病人隐私，尊重和维护病人的各种权利是医师应尽的义务。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　为患者保守秘密也是临床诊断、治疗的需要，只有患者无顾虑地向医师提供病史，医师才能对疾病有一个全面的认识，为明确诊断、确定病因和有效治疗提供保证。如果不能严守病人隐私，不仅不利于诊治，严重者还会给患者带来社会舆论的压力、人际关系的变化和沉重的心理负担，引起纠纷。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　根据国家有关法律法规，患者在医疗活动中享有生命权、身体权、健康权、平等医疗权、知情同意权、隐私权、诉讼权、部分免责权。医务人员应充分了解和维护患者的各种权利、义务，避免不必要的医疗纠纷。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　5、充分履行告知义务，正确对待知情同意书的签字意见。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　《医疗机构管理条例实施细则》第</span>32条规定：&ldquo;医疗机构应当尊重患者对自己的病情、诊断、治疗的知情权利。在实施手术、特殊检查、特殊治疗时，应当向患者做必要的解释。因实施保护性医疗措施不宜向患者说明情况的，应当将有关情况通知患者家属。&rdquo;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　《病历书写基本规范</span>(试行)》第25条规定：&ldquo;特殊检查、特殊治疗同意书是指在实施特殊检查、特殊治疗前，经治医师向患者告知特殊检查、特殊治疗的相关情况，并由患者签署同意检查治疗的医学文书，内容包括特殊检查、特殊治疗项目名称、目的、可能出现的并发症及风险，患者签名、医师签名等。&rdquo;目前常用的有住院病人授权委托书、住院病人离院责任书、手术同意书、麻醉同意书、输血同意书、特殊检查治疗申请同意书等。要求病员本人、家属、主治医师、科室主任、医务科、分管院长逐级签字、审批，病人本人因文化程度不能签字者要求按指印，家属签字。 医生向患者及家属交待各种操作可能发生的危险及履行签字手续，</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　一方面使患者理解临床医学的风险，另一方面医生要针对这些风险，做好充分的防范措施和一旦发生意外的应急补救措施。而这一点有时在医务人员中不能正确理解，以为只要患者、家属签字后就万事大吉，就可以推卸责任和逃避风险，其实不然，即使履行了各种签字手续，但医务人员在操作过程中只要有失误和过错，没有按操作常规、程序进行，出现并发症及不良后果，同样不能免责。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　临床中还存在着同一疾病治疗方法各异，或在学术上治疗方案有争议的情况，医师在选择时一定要讲明利弊，充分征求患者及家属意见，尊重其选择权。同时医师必须尊重医学科学理论，提出倾向性意见以供患者参考。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　6、重视医疗文件的书写和保管。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　医疗文件是医护人员临床思维的凭证，是诊疗过程中的原始记录，有很强的书证作用</span>;在医疗纠纷中，是进行技术鉴定、司法鉴定、分清责任的依据。一旦发生纠纷，医疗文件缺三丢四，势必使当事人处在被动地位和承担应有的责任。各种医疗文件应按照有关规定、法规书写、保管，不得随意变更、销毁(病历保存15年，普通、急诊儿科处方保存1年，医疗用毒性药品、精神药品及戒毒药品处方保留2年，麻醉药品处方保留3年，输血资料保存10年)。在病历修改时要更加慎重，应按时间顺序在病程记录中详细描述，不得在病历中涂改或插写。书写过程中出现错字时，应当用双线划在错字上，不得采用刮、粘、涂等方法掩盖或去除原来的字迹。住院病历各种记录必须按要求及时、详细记录完成，特别是抢救记录、会诊记录、手术记录、麻醉记录、上级医师查房记录、交接班记录等。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">　　7、满足患者的心理需要，密切医患关系。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　患者需要被关怀、被尊重，需要了解诊断、治疗信息，同时他们还会有对今后家庭、工作等问题的种种顾虑。这些都需要医务人员很好地了解，予以解决或满足。首先，医护人员在接诊时，必须着装整洁，热情主动，使患者对医护人员产生信任和依托感。在诊治过程中要换位思维、设身处地地为患者提供温馨、便利、安全、有效的服务。实践证明，很多医疗纠纷的发生并非由于医疗技术，而是因为某种细节的服务不周，得不到患者及家属的理解而致的。</span></span></p>\n<p>&nbsp;</p>","barId":"1937","topicTypeId":null,"topicThemeId":"1032","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":17},{"id":"2195","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"尿毒症有什么现象","content":"<p style=\"text-align: center;\"><img title=\"1486396173060.jpg\" src=\"http://01luntan.com/ly_img/uimgs/1486396173060.jpg\" alt=\"2620_160311113623_1.jpg\" /></p>\n<p><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　在众多的肾脏病患者中，有不少病人肾脏功能衰竭进入尿毒症期(简称为肾衰)而不自知，从而未能得到及时、合理的治疗。有些人甚至自觉身体&ldquo;一向健康&rdquo;，一旦发病，医生告诉他已是尿毒症时，自己愕然，家人愕然，不敢相信、不肯接受这一事实。尿毒症有什么现象如何及早发现?&nbsp;</span><br /><span style=\"color: #ffffff;\">中国论文网 http://www.xzbu.com/6/view-2877409.htm</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　肾脏有强大的潜在代偿能力，因而肾功能在罹病而逐渐减退时，仍能承担人体的基本功能，因此，患者自觉&ldquo;一切正常&rdquo;。当肾脏损坏日渐增多，代偿力随之衰竭，最后不胜负荷而全线崩溃时，生命已处于危险之中。&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　其实，尿毒症的发生和发展，必然有一个逐渐加重的过程。这个过程有时尽管十分隐蔽，但也必然有不少&ldquo;蛛丝马迹&rdquo;可以寻找。对于一个重视自己身体的&ldquo;有心人&rdquo;，只要善于发现这些不显眼的迹象，到医院检查尿液和血液，便知底蕴了。&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　&ldquo;蛛丝马迹&rdquo;在哪里?请细看其详。&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　乏力&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　乏力可能是很早的表现，但最容易被忽视，因为引起乏力的原因太多了。特别是那些在事业上&ldquo;全力搏杀&rdquo;的人，大多将之归咎于工作紧张和劳累。若稍加休息而症状好转，则更易误导。&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　面色苍黄&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　这是由于贫血所致。由于这种表现发生和发展十分缓慢，因而在一段不太短的时间内不会出现明显的&ldquo;反差&rdquo;，就像人们在正常的相处中，难以发现各种缓慢发展的变化一样。&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　浮肿&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　浮肿是一个比较易于发现的表现。但由于开始时间歇出现而且症状较轻，也可能未能引起患者注意。常见症状是:早晨起床时，眼睑浮肿，午后消退；劳累时，双脚浮肿，休息后消失，这常被误为过劳的现象而被忽略；若发展到持续性或全身性浮肿时，已是病不轻了。&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　胃口不佳&nbsp;</span><br /><span style=\"font-family: Arial, 宋体; font-size: 14px; line-height: 25.2px; background-color: #ffffff;\">　　这是由于尿毒素潴留，影响消化功能所致。多数人未加注意。待病情发展，将会出现腹闷胀不适、恶心、呕吐，甚至大便次数增多或便质稀烂。此时，病已较重，即使病人上医院就诊，但仍有可能只将注意力集中在消化道方面，被误作肠炎之类的诊断，忽略了基础病变――肾功能衰竭。&nbsp;</span></p>","barId":"1937","topicTypeId":null,"topicThemeId":"1029","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":2},{"id":"1039","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"浙大一院医疗技术新突破 治疗万名尿毒症患者","content":"<p class=\"f_center\" style=\"margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; white-space: normal; text-align: left; background-color: #ffffff;\"><span style=\"text-align: justify; text-indent: 2em;\">30多年前，&ldquo;尿毒症&rdquo;是一个可以和&ldquo;死亡&rdquo;划上等号的名词。1990年6月30日，被尿毒症&ldquo;判了&ldquo;死刑&rdquo;的老王在浙大一院接受了肾移植手术。25年过去了，他的生活和患病前几乎没什么两样，&ldquo;就是每天要吃一颗抗排异的药，运动、吃饭也不需要有什么顾虑。&rdquo;对老王以及另两位在1990年接受肾移植的病友来说，这25年来的每一天，都是一个&ldquo;赚到&rdquo;的日子。</span></p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">上周五下午，刚刚获得国家科技进步二等奖的浙大一院陈江华团队从北京人民大会堂赶回杭州，陈江华教授向大家介绍了团队的工作成果，&ldquo;以后我们不仅要做治病的&lsquo;下医&rsquo;，更要做&lsquo;中医&rsquo;、做能有效预防的&lsquo;上医&rsquo;。&rdquo;在陈江华看来，患病率高达10.8%的慢性肾脏病，怎么防治才是关键。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">本周四，陈江华团队也将坐诊钱报微信&ldquo;浙江名医馆&rdquo;的空中诊室，为大家解答与肾病有关的各种问题。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\"><strong>一项名称很长的技术</strong></p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\"><strong>让肾病患者多活了很多年</strong></p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">陈江华教授的获奖项目为&ldquo;终末期肾病肾脏替代治疗关键技术创新与推广应用&rdquo;，这个技术对肾脏病人意味着什么？</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">浙江大学附属第一医院党委副书记、肾脏病中心主任陈江华告诉钱江晚报记者，终末期肾病是严重威胁人类健康的重大疾病，患者主要依赖肾移植、血液透析和腹膜透析三种肾脏替代治疗手段，&ldquo;由于这三种方法均存在技术局限和瓶颈，通过单一替代治疗的患者，长期生存率均不理想。要进一步提高患者的长期生存率，亟需技术突破和体系创新。&rdquo;</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">&ldquo;我们团队历经31年系列研究，取得了一系列治疗技术突破，建立了一体化治疗体系，极大地延长了患者的生命，提高了他们的生活质量。&rdquo;陈江华教授介绍说。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">简单地说，肾病病人被送到医院后，往往被用于一套固定的治疗方案，可是每个人的病情都有差异，技术的适合性也各不相同，如果仅用单一的技术手段来治疗，不能保证每个病人都能获得良好的治疗效果。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">在综合患者病情、家庭状况、卫生医疗可行性等因素后，通过技术创新，陈江华团队在国际上率先提出并建立了以肾移植为核心，以血液透析和腹膜透析为辅助的肾脏替代一体化治疗体系，实现了从单一技术为治疗手段的医疗模式，转变为以病人利益和疗效最大化为目的的个体化医疗模式，显著提高了患者的长期生存率。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">陈江华团队迄今共完成终末期肾病肾脏替代治疗10447例，患者10年生存率达到82.2%，达到国际领先水平。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">光看这些数字可能感觉还不深，可是和美国的数字做一下对比，就厉害了，在美国，终末期肾脏病接受透析的患者5年生存率还不到50%。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\"><strong>在国际上率先实现</strong></p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\"><strong>一滴尿液诊断鉴别急性排斥</strong></p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">治疗肾病，血液透析、腹膜透析并不是长久之计，肾移植才是最理想的治疗方法。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">可是肾移植的难度很大，移植后排异、特异性感染等都是棘手的问题。怎么尽早甄别出排异易感人群和移植后急性排异？陈江华团队在国际上率先实现了仅用一滴尿液来诊断和鉴别诊断急性排斥，准确率分别达到94.1%和96.9%。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">这样一来，陈江华团队就利用预警平台甄别出低危和高危人群，并针对性地制订了个体化免疫干预方案。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">针对高危人群，团队建立了去敏治疗和强化干预方案，使高危受者的急性排斥发生率从53.7%下降到14.6%。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">针对低危人群，团队建立了优化免疫抑制方案，使肾移植受者平均减少了30.1%的免疫抑制剂用量，显著降低了毒副作用和治疗费用，使这些患者的急性排斥发生率保持在5%以下。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">除此之外，陈江华和他的团队还找到了一个导致肾移植病人一年内死亡的原因，这个原因叫做卡氏肺孢子虫感染，找到了原因，预防方案的建立则水到渠成了。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">而在肾移植方面，还有一个难题是乙肝患者肾移植术后易发生重症肝炎，病死率高，甚至一度成为肾移植禁忌症。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">陈江华和团队的做法是建立乙肝病毒复制和变异监测技术，在国际上率先制定了术前抢先抗病毒结合低肝毒性优化免疫抑制技术，使乙肝携带者安全地接受肾移植治疗。团队随后将该技术应用于接受乙肝表面抗原阳性供肾的受体，安全地扩大了供肾来源。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\"><strong>改良透析技术</strong></p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\"><strong>实现长期透析&ldquo;零感染&rdquo;</strong></p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">经过长期的研究和临床实践，陈江华团队在国内最早开展了自体大隐静脉移植血管内瘘术、异体动脉移植血管内瘘术和带袖套（CUFF）的长期导管髂外静脉的植入术，解决了保障血透患者血管通路这一技术难题。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">团队还在亚太地区第一个解决了无菌无热源透析用水问题，显著改善了血透患者的微炎症状态及相关并发症。针对血透患者的心脑血管疾病，团队建立了预防异位钙化、继发性甲旁亢防治和&beta;阻滞剂药物干预综合防治技术，使长期血透患者的心脑血管疾病年病死率下降至0.55%~1.04％。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">为防止血液透析交叉感染，团队研发了一次性血透上下机护理包、穿刺针和改良的密闭式血透管路，迄今连续42.3万余人次血透无一发生乙肝、丙肝交叉感染。</p>\n<p style=\"text-indent: 2em; margin-top: 26px; margin-bottom: 26px; color: #252525; font-family: 宋体, sans-serif; line-height: 28px; text-align: justify; white-space: normal; background-color: #ffffff;\">针对不同患者的腹膜特性、临床状况和残余肾功能水平，陈江华团队制定了递增式腹膜透析治疗技术，使残余肾功能年下降速率降至1.0&plusmn;1.1 ml/min，同时使治疗费用大幅降低。针对农村偏远地区终末期肾病患者就医困难的局面，团队创建了腹膜透析分级网络管理技术，建立了腹膜透析远程会诊和网络数据库，使一流的医疗技术直接覆盖到县区和乡镇，极大地惠及了终末期肾病患者。</p>\n<p>&nbsp;</p>","barId":"1937","topicTypeId":null,"topicThemeId":"1026","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1}],"pageObj":{"list":[],"list4Map":null,"pageBegin":0,"pageSize":5,"pageNumber":0,"totalPage":0,"totalRow":0},"loginUser":null,"replies":[],"forumUserFans":null,"herfList":[],"only":"0","topic":{"id":"17006","isDel":0,"createAt":1534997307032,"createBy":"e8f7486fbba411e7a3d800163e04584d","createName":"王可可","updateAt":0,"updateBy":null,"updateName":null,"userId":"e8f7486fbba411e7a3d800163e04584d","title":"医疗责任险是什么意思","content":"<p style=\"text-indent: 28px; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">为了使医疗单位树立正确的风险意识，有效地化解医疗风险，</span>2007年6月，卫生部颁布了《关于推动医疗责任保险有关问题的通知》，推动医疗单位参加医疗责任保险，以化解医患矛盾，处理医疗纠纷。那么，医疗责任险是什么意思、医疗纠纷是什么意思？</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0px; line-height: 200%; text-align: center;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><img title=\"什么是医疗责任险与医疗纠纷\" src=\"http://01luntan.com/ly_img/uimgs/1534997388206.jpg\" alt=\"什么是医疗责任险与医疗纠纷\" width=\"600\" height=\"372\" /></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 28px; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">所谓的医疗责任险是指医疗单位投保交纳保险费用成为被保险人，保险公司作为保险人收取保险费用在保险单明细表中列明的保险期限或追溯期及承保区域范围内，被保险人的投保医务人员在诊疗护理活动中，因执业过失造成患者人身损害，在保险期限内，依法应由被保险人承担民事赔偿责任时，保险人根据保险合同的约定负责赔偿的保险。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　医疗行业本身就是高风险行业，近年来医疗纠纷增多的原因主要还是国家对法律的普及，中国公民的维权意识增强，并不是完全的坏现象。医闹的出现，是因为处理医疗纠纷的有关规定复杂，程序漫长，患方在维权过程中遭遇困惑被少数不良分子利用而产生，它的出现应当是暂时现象。当然医闹现象的产生也与医疗纠纷的处理难度困扰医疗单位，医疗单位撇开原则进行让步密不可分。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　为了使医疗单位树立正确的风险意识，有效地化解医疗风险，</span>2007年6月，卫生部颁布了《关于推动医疗责任保险有关问题的通知》，推动医疗单位参加医疗责任保险，以化解医患矛盾，处理医疗纠纷。根据这个通知，南京市开始在几个区县进行了试点，今年下半年，通知了各公立医院全部参保，使医疗责任险成为准强制保险。南京市卫生局局长陈天明介绍说，所谓的医疗责任险，通俗地说就是医院为自己的医疗安全买份保险，一旦出现医疗纠纷需要赔偿时，由保险公司负责向患者理赔。医院买保险的成本会不会转嫁给患者？对此陈天明局长保证，医院购买保险的经费，按规定计入医疗机构成本，从业务收入中列支，不得因参加医疗责任险而提高收费标准增加患者负担。</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　对于参加医疗责任保险，大医院是欢迎的。因为大医院医疗纠纷多，医疗事故或医疗过错也大，赔付金额多，保险公司参加处理纠纷，可以减轻大医院的压力，又能在一定程度上降低医闹生存空间，本来每年用于赔偿医疗纠纷的钱款，现在用于交纳保险费用，可能还有节余。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　患方对医疗单位参加医疗责任保险持无所谓态度，因为法律没有对医疗单位参加医疗责任保险后有所改变，处理医疗纠纷还是适用过错赔偿制度。处理医疗纠纷的过错认定和赔偿，还是不因保险公司的参与难度减少。只是将原来医疗过错的买单人，由医疗单位变更为保险公司而已。因为公立医疗单位本身就具有强大的赔偿能力，过去就不存在赔偿不起的问题，所以，医疗单位参加医疗责任保险后，患方在医疗纠纷案件中，还是只用担心医方的诊疗行为是否存在过错和过错与损害结果之间的因果关系的问题。而不用担心赔偿不起问题。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　医疗纠纷和医疗事故自古有之，它是医院和医务人员都不愿发生事情，所以该发生时还会发生，不会因购买了医疗责任保险而减少。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　从事医疗工作和参与车辆交通人员是高风险职业，交强险是为参与交通的车辆所有人和驾驶员因可能发生交通事故而没有赔偿能力，由保险公司承担赔偿责任设立的强制保险险种。而医疗责任险不是为从事医疗工作人员可能没有赔偿能力而设立，而将它定为强制保险，仅仅减轻了大医院的压力，但是增加了医疗纠纷处理的参与人，增加了处理成本。处理成本是需要有人为它买单，是医院？是保险公司？是国家？是患者？但可以预见，最终买单人可能还是公民或患者。将医疗责任规定为强制保险，较失妥当，还是将它放在商业保险，实行自愿原则较好。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\">&nbsp;</span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 16px;\"><span style=\"font-family: 宋体;\">　　参加医方责任保险只对大医院是利好，对小医院利好有限或利空，对患方无所谓或增加维权的难度，不增加患者的经济负担的说法，还得拭目以待。</span></span></p>\n<p style=\"text-indent: 0; text-autospace: ideograph-numeric; line-height: 200%;\"><span style=\";font-family: 宋体; line-height: 200%; font-size: 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