ABSTRACT
Objective To explore the problems existing in management of medical records under new situation,especially the cognition of medical workers when the patients required to seal up or seize medical records.As a result,we further discussed existing problems in management of medical records under new situation and the countermeasures. Methods Self-designed questionnaires were used to investigate 75 doctors and 75 nurses.The results underwent analysis. Results The analysis showed that 27.7% doctors and 29.4% nurses didn't know any question.While 50.0% doctors and 55.7% nurses didn't know how to deal with when patients wanted to seal up the medical records,which became the issue that most doctors and nurses did not know. Conclusions Doctors and nurses should be familiar with concerned legal knowledges and strengthen the consciousness of medical records management in order to make the medical records the real evidence in the dispute settlement or court of law.
ABSTRACT
Objective To identify the correlation factors associated with cerebral intragenic ischemia after temporary parent arterial occlusion in intracranial aneurysm surgery. Methods One hundred and eighteen patients who underwent temporary arterial occlusion in the 120 aneurysms (from a group of 324 consecutive aneurysm patients treated from 1996 to 2002) were reviewed retrospectively. These variables included sex, age, presence of preoperative subarachnoid hemorrhage (SAH), neurological clinical grade, operational timing, duration of arterial occlusion, numbers of temporary occlusion, mode of arterial occlusion, intraoperative aneurysm rupture, hypertension, the location of temporary occlusion, aneurysm size, hyperglycemia, atheromatous mass. Univariate and multivariate were used to investigate the relationship between the variates and postoperative ischemic changes. Results The total times of temporary occlusion were 156, with an average of 1.30. The duration of arterial occlusion ranged from 1 to 45 min (9.75?7.75). Seventeen patients (14.4%) demonstrated evidence of new infarction in the vascular territory subjected to temporary arterial occlusion. Conclusion In the univariate analysis, age, presence of preoperative SAH, duration of arterial occlusion, atheromatous mass are all significantly correlated with postoperative ischemic injuries. Multivariate logistic regression revealed that the age, older more than 60 (P= 0.010 3 , relative risk=4.335), and the duration of arterial occlusion, lasting more than 20 min (P= 0.032 9 , relative risk=4.177), have significant correlation with the injuries. Based on these findings, temporary occlusion is safe and useful in aneurysm surgery and the postoperative cerebral ischemia is less likely to occur when the duration of clipping is shorter than 20 min.
ABSTRACT
This article reviews the advances in the transradial cerebral angiography in recent years. Outcoming with the comprehensive informations of this approach possessing characteristics of safety, less invasiveness and fewer complications. Therefore this procedure is welcomed by patients and ought to be used routinely. (J Intervent Radiol, 2006, 15: 315-318)