急诊科增添CRRT的可行性分析报告

尊敬的院领导：

随着我国医疗市场化改革的加快和深入，经济效益和社会效益成为医院发展提高水平的关键，增加医院的效益开展有竞争力的医疗项目是一重要途径。为进一步增强医院的急救水平，增强竞争力，急救部开展治疗急慢性肾衰、尿毒症、多脏器衰竭、重症肝炎、重症胰腺炎、炎败血症、急性心衰、腹水回收等病症以及救治各类食物药物中毒的新型持续血液净化系统项目非常必要，其可行性分析如下：

一、        每年有大量的药物、食物中毒的患者需要用血液灌流的方法抢救，以提高抢救成功率和减少由于毒物对内脏和神经的损伤造成的各种后遗症。

二、        手术病人、创伤患者的炎症介质，及各种原因引起的心衰，多脏器衰竭的病人都只能用CRRT的方法治疗，由于医院这方面的设备配备不齐，易导致医院的这部分病人会延误治疗或转院治疗。随着医院急诊科室规模的扩大，CRRT设备是必不可少的。

三、    效益成本分析：

1、一般知名三甲医院每月给患者做CRRT治疗最低为20例，我们以医院每月治疗10例CRRT患者为例：

每例患者按最低CRRT治疗时间8小时计算，每年预计有120例（10*12=120），每次利润有1500-3000700-800元，每年最低收入有180000-36000084000-96000元。投入一台SWS3000型设备需要35万元， 约二年半可以收回成本。CRRT治疗是以小时为单位计算，治疗时间越长，医院利润空间越大，例如：一个重症患者可能连续治疗8-68小时，一般利润可以万元为计量单位；回收成本的周期就会相应缩短。

2、在治疗CRRT的同时伴随治疗血液灌流，据统计医院每年救治中毒患者400例，每次利润有200-300元，每年最低收入80000-120000元。大大缩减了投入CRRT机的成本收回周期。

四、    持续血液净化系统性能特点

1、血液滤过、消耗材料、清除对象、适应症、并发症的描述

2、SWS-3000A型持续血液净化系统性能特点

（一）产品工作原理：

SWS-3000A型持续血液净化系统利用动力装置把血液从患者体内引出，经血液回路流入滤过器或透析器等净化装置进行净化，将血液中的新陈代谢产物（如肌酐、尿素氮、水分、无机盐等）或其他有毒有害的物质过滤清除，同时向血液回路中注入肝素抗凝，并补入置换液，维持患者的水和电解质平衡。净化后的血液在安全监控系统监测下安全输回患者体内。如此反复循环，通过净化血液来实现治疗患者疾病的目的。可用于治疗急慢性肾衰、尿毒症、多脏器衰竭、重症肝炎、败血症、急性心衰、腹水回收等病症以及救治各类食物药物中毒的新型持续血液净化系统，适用于各级医院的ICU、急症科、肾内科及血液净化中心等，是现在同类设备中唯一能把多种血液净化方法集于一体的多功能血液净化设备，实现了一机多用，能大大提高设备利用率。

（二）产品功能：

SWS—3000A型持续血液净化系统主要由主机、操作控制系统、血液回路系统、补液系统、废液排出系统和重量平衡系统六部分构成，内置4个泵，在选用不同的管路、滤器情况下，可进行多种模式的治疗。可无需连接水处理装置，实现床旁救治；台式和挂袋式两种重量平衡体统，适应不同经济春提患者。采用全中文液晶操作界面。

本机具有血液滤过（HF）、血液透析（HD）、血液灌流（HP）、血浆置换、床旁持续血液净化（CRRT）等功能。可在医院现有病房条件基础上快速地开展起血液净化项目，极大地提高医院血液净化救治水平，特别在对重症监护病人（多脏器衰竭做CRRT）的救治方面有较强的功能优势，从而提高医院的竞争实力。

（三）产品主要性能特点：

1.  具有人机对话功能

本机能在显示屏上选择不同操作模式，并可进行参数设定，在治疗中也可随意改变参数值（压力、温度、超滤量、补液量、血流量、肝素量等），操作简单方便；同时可以在显示屏上读取各种治疗参数，提醒各种报警及处理措施。

2．采用中文液晶操作界面

   本机采用中文液晶操作界面，勿需操作者具备较高的英文水平，操作方便易学，便于操作者迅速、准确使用本机，特别适合我国多数护士英文水平不高的国情。

3．具有大容量称重一体化平衡系统

本机独创具有负反馈和自适应功能的台式大容量称重一体化平衡系统，充分保证进液量、出液量和超滤量三者的平衡，可避免频繁停机更换液袋，又可消除累计误差，提高了治疗精度。本机最大容量为40Kg，精度为±20g，操作简单、方便，系统重复精度高，错误发生率小。

4．可在治疗中随意切换治疗方式，改变治疗参数，无需终止治疗或更换管路，无需重新自检。

在治疗中通过改变液晶显示屏上的参数（压力、温度、超滤量、补液量、血流量、肝素量等），可随意切换治疗模式，改变治疗参数时不会影响治疗。

5．具有滤器血凝状况报警提示监测

本机设有凝血报警监测器，通过对滤器中的压力变化进行监测，CPU根据压力变化范围，可自动判断滤器中是否出现凝血。如有凝血发生，本机会产生声光报警信号。

6．具备重要参数自动记录及自动累计功能，能进行报警原因自动识别、判断并提示处理方法

本机设置有超声波空气监测、血流量、肝素量、补液量、超滤量监测、凝血、漏血监测、治疗时间监测、补液温度监测、系统检测等监测功能；建立了独立的监测报警模块，当有异常情况发生时，向主控制器发出信号，在液晶显示屏中显示报警原因和报警级别，同时发出声光报警信号，并自动阻断血液循环回路，停止各个泵的运转，以确保患者安全。同时，治疗中所有重要参数（压力、温度、超滤量、补液量等）自动记录自动累计。

7．具备空气及漏血监测功能，并能进行报警级别显示

本机采用红外线光电传感器和光学器件联动，利用血液中的红细胞对红色光的吸收作用来鉴别是否混入了血液，实现漏血监测。

本机采用超声波自适应空气监测器，利用智能传感技术实现对血液中空气进行非接触式检测，并能在治疗时通过自动调整参数来适应不同的环境，达到准确监测血液中混入的空气。

8.毒物清除更彻底，不但能清除水溶性小分子毒物，而且能清除水溶性的中分子毒物（如菊酚，β2微球蛋白等），且血液动力学稳定性好（年老体弱患者﹑有低血压、高血压的患者﹑糖尿病患者以及做血液透析时失衡反应很严重的患者，在做血滤时不会出现血透的失衡反应，心律﹑脉搏、血压更稳定）

9、当出现报警时,液晶屏上自动显示报警原因及级别。

10、多种治疗模式，可用于各种危重治疗或常规性治疗。

11、自制置换液且兼容多种血液回路，大幅度降低治疗成本。

12、采用平板加热和红外测温双重控制，置换液温度控制更精准。

13、血流管路的设计同时满足承认和儿童的需要。

14、具有高容量血液滤过治疗功能，可清除多种炎症介质和细胞因子。

15、跨膜压及滤器压降双重监测功能，自动判断凝血状态。

16、微处理器控制和独立的安全监控系统，保证治疗过程安全可靠。

重庆山外山科技有限公司

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第二篇：提案报告写作Report and Technical Writing-Proposal

Report and Technical Writing-- Proposals

I. Checking the Exercises of “Analytical Reports”

1. What are the major differences between informational reports and analytical reports? (Ex. 1 on p.94)

Informational reports help the management collect information about corporate operations. Like informational reports, analytical reports collect and present data, but their emphasis is on analyzing, drawing conclusion and proposing recommendation.

2. What is the difference in function between a recommendation report and a feasibility report?

The function of a recommendation report is to persuade the management to accept the decision and take action. Unlike recommendation report, the function of a feasibility report is not to persuade the management to accept 1

the decision, but to make it believe that the decision is correct.

II. Introduction

A proposal is a document written to persuade readers to adopt a plan or a course of action. The readers may be colleagues within your organization or potential customers outside the organization. A proposal can be produced for internal or external use.

A proposal may be solicited or

unsolicited. It is solicited when you are asked by your superior to submit it. It is unsolicited when you decide on your own to submit the proposal to the superior without waiting for anyone to ask you to do so.

Because a proposal offers a plan to fill a need, readers will evaluate your plan based on how well you answer the following questions:

? What is the existing problem that

the proposal addresses?

? What do you propose to do?

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What is the benefit of what you propose?

? How do you plan to do it?

? When do you plan to do it? ? How much will it cost?

To answer these questions effectively, make certain that your proposal is organized and written to address the needs of your entire audience. You will likely have more than one reader because proposals often require more than one level of approval. As you assess your readers, take into account their role in the organization.

III. Organization (Structure) of a proposal

An internal proposal, often in memo form, is sent to a superior within your organization who has the authority to accept or reject the proposal. An internal proposal generally follows a three-part organization:

? Introduction

? Body

? Conclusion

3 ?

1. Introduction

The introduction of your internal proposal should establish that a problem exists and needs a solution. After you identify the problem, summarize your proposed solution and indicate its benefit and estimated total cost.

2. Body

The body of your internal proposal should offer a practical solution to the problem and provide the details necessary to inform and persuade your readers. You should pay attention to the following information:

1) Sufficient background

information to describe the extent of the problem

2) The methods to be used in

achieving the proposed solution

3) Information about equipment,

materials, and staff requirements

4) A breakdown of costs

5) A schedule for completing the 4

project, possibly broken down into separate tasks.

3. Conclusion

The conclusion of your internal proposal should tie everything together, restate your recommendation, and close with a spirit of cooperation. Keep your conclusion brief.

IV. Common Proposals and Samples

1. Business Proposals

A business proposal is a kind of analytical report, written to persuade the audience to follow a plan or a course of action.

Readers evaluate your proposal based on what you are proposing to do, how and when you are planning to do it, or how much it will cost. Therefore your proposal must be persuasive. Besides offering what you propose to do, you should emphasize the benefit your reader can get and your capability to fulfill your promise.

For details of organizations (introduction, 5

body and conclusion), read pp.107 and 108 of Xian. For a sample of business proposal presented in the memo format, look at p.106 of Xian.

2. Research Proposal

A project starts with planning based on research that leads to the writing of a feasibility report. A feasibility study requires preliminary research work. The writer at this stage may or may not have clear visualization of what lies ahead. If he /she has, it is still a hypothesis or proposition that awaits proof and verification. So he/she has to do some research, sometimes involving laboratory tests. If, on the other hand, he/she does not know much about what it will turn out to be, he/she has to do some research. In any case, a research proposal is necessary for a project, big or small, to initiate.

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Structure of a research proposal

Note that in many aspects a research proposal can differ from a research report. Now look at the structure of a research report:

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8

? NB: “Description of the analysis” in Part Three can be overlapped with “Narration of the procedures” in Part Two. “Conclusions and Recommendations” can be split into two parts.

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V. Assignment III

1. What is the difference between a solicited proposal and an unsolicited proposal?

2. What are the major characteristics of a business proposal?

3. What are the three parts that make up the organization (structure) of a proposal?

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