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1、最新PreventionofSurgicalSiteInfections外科手术部位感染的预防-药学医学精品资料PatientRiskFactorsDiabetesNicotineuseAlteredimmunestatus,suchassteroiduseorchemoMalnutritionProlongedpreoperativehospitalstayObesityInfectionpresentatsiteremotetoincisionPreoperativenarescolonizationwithStaphylococcusaureusSu
2、rgicalCareImprovementProject(SCIP)measuresAntibioticProphylaxis:UsecorrectantibioticAdministerwithinonehourofincision(2hrsifvancomycinisused)RedoseiflengthyprocedureStopantibioticswithin24hrs(48hrsforcardiacsurgery)DosageeffectIfasurgicalsiteiscontaminatedwith>100,000microorganism
3、spergramoftissue,theriskofSSIismarkedlyincreased.Thedoseofcontaminatingmicroorganismsrequiredtoproduceinfectionmaybemuchlowerwhenforeignmaterialispresentatthesite(i.e.,100staphylococcipergramoftissueintroducedonsilksutures).Microorganismsmaycontainorproducetoxinsthatincreasetheira
4、bilitytoinvadeahost,producedamagewithinthehost,orsurviveonorinhosttissue.Manygram-negativebacteriacantriggerthesystemicinflammatoryresponsesyndromethatsometimesleadstomultiplesystemorganfailure.Oneofthemostcommoncausesofmultiplesystemorganfailureinmodernsurgicalcareisintra-abdomin
5、alinfection.Mangram,AliciaMDandtheHospitalInfectionControlPracticesAdvisoryCommittee.GuidelineforthePreventionofSurgicalSiteInfection,AmerJourInfCont,Vol.27.No.2,1999.PathogenEffectStaphaureus,groupAStrepandClostridiumperfringensrequireonlyasmallinoculumtocausesevereinfectionSolim
6、itthedose!!APICTextofInfectionControlandEpidemiology,p23-2,3rdEd.2009AdditionalPreventionMeasuresAirflowmovesoutofORtopushairoutLimitORtraffic-airmaycontainmicrobial-ladendust,lint,skinsquames,orrespiratorydroplets.Themicrobiallevelinoperatingroomairisdirectlyproportionaltothenumb
7、erofpeoplemovingaboutintheroom.MinimizetheRiskAppropriatesiteprepAppropriatehandscrubAdequatefingernailcareHealthyhealthcareprovider读后感的写作方法1、读后感，顾名思义，先“读”后“感”。读是基础，感是重点。3、读后感的基本结构：叙→议→联→结。⑴“叙”：概述原文。【叙】这篇课文讲的是一个小女孩刻苦读书的故事。小女孩常常不顾吃饭就赶去书店读书，有时，一本书要到几家书店才能读完。⑵“议”：在叙的基础上选择感受最深的一点来议论，提
8、出自己的见解或主张。【议】读了这篇课文，我对她的刻苦读书、不怕累的
