积水潭医院进修总结

积水潭医院进修总结 进 修 总 结 2013年7 月—2014年7月～经科室安排及院领导批准～我在北京市积水潭医院进修学习～主修创伤骨科及手外科。北京市积水潭医院是国内著名的骨科医院～技术与理念与国际接轨～一直走在世界的前沿。也是北京市骨科创伤中心～被誉为:“北京市骨科航空母舰”。 积水潭医院以骨科和烧伤科为重点学科～内、外、妇、 眼、口腔、耳鼻喉、皮肤性病、中医内科、中医正骨、针灸、理疗康复科等并驾齐驱的三级甲等综合性医院。北京积水潭医院手外科创建于1958年～我国手外科创始人～“中国手外科之父”王澍寰院士～领衔创立了中国第一个手外科专业。1963年～他创造了世界第一例“断指再植”手术成功的奇迹～震惊世界。成为世界上规模少有的以急诊手外伤治疗和功能重建而闻名的临床中心。一年的进修生活～让我学到了很多先进的技术与理念～在创伤常见疾病的诊断和治疗方面～尤其对足踝、肩肘骨折的诊治及手术技巧方面～有了一个较大的提高,对手外科的各项操作有了充分的认识。会对我以后的工作产生积极而深远影响～使我对未来的工作更加自信。在积水潭医院进修的在这一年的时间里～我遵守劳动纪律～遵守科室的各项规章制度～严格要求自己～努力做到不迟到、不早退、不无故旷工及擅自离开工作岗位。对待病人和蔼可亲～态度良好～努力将书本上的理论知识和基本技能应用于实践。在此过程中我不断总结学习 方法 快递客服问题件处理详细方法山木方法pdf计算方法pdf华与华方法下载八字理论方法下载 和临床经验～尽力提高独立思考、独立解决问 题 快递公司问题件快递公司问题件货款处理关于圆的周长面积重点题型关于解方程组的题及答案关于南海问题 、独立工作的能力～r included in the County, with the right of abode overseas natural persons; (2) expand the scope of borrower type of occupation; (3) to apply for a loan for business borrowers, as well as the business unit controller or major shareholders. 2, the maximum loan amount (1) to cancel "a maximum loan amount of RMB 300,000" requirement; (2) both for personal consumption and business purposes, different methods were used to determine the loan amount. 3, the loan terms (1) the loan terms with borrowers and not more than 60 years of age; (2) lending operation, should be based on the borrower's production cycle and the anticipated income situation, scientifically and rationally determine the loan period. (E) loans: the three rejected. (F) receive and investigate: 1, defines the principles and requirements of pre-loan investigation, focusing on investigating first source of repayment, and a double investigation. 2, the provision of customer information: (1) "available on request" information, customer reference case where the account manager deciding whether to request; (2) proof of income can refer to the approach in annex format or other format to meet the Bank's requirements; (3) loan operation shall provide the information management unit; (4) copy of the account manager shall verify the information and sign it to confirm. 3, provided for a borrower, guarantor and main contents of units operated by pre-loan investigation. 4, loans for business and apply for amounts in excess of 500,000 yuan, account managers should refer to the measurement limit estimates demand for working capital loans. (G) loans: the loan origination process, provides lenders responsible for review. (H) loans to pay: defined the trustee payments and autonomous operational requirements for payment. 在科室主任及各位医生的指导下～我基本掌握了骨科常见病的基本操作～对于以前所学的东西做到了温故而知新～从而让我认识到临床实践工作的特殊性与必要性。 一、手外科 按照积水潭医院进修安排～我参加了为期半年的手外科学习 培训 焊锡培训资料ppt免费下载焊接培训教程 ppt 下载特设培训下载班长管理培训下载培训时间表下载 ～大大提高了我的手外科技术及理论知识。通过各位老师的授课及带教～进一步巩固和丰富了我的手外科理论知识。另外～老师们的标本示教～手术演示～使自己对一些手术的关键步骤有了更深的认识。院领导及科主任一直强调手外科是骨科医生的基本功～通过对手外科半年的学习～我深刻领会到了其真正内涵和见识的卓越。 二、AO技术学习 AO技术学习是此次进修之前的另一必修完成科目。此次学习班非常正规～讲师团有来自国内外一些著名的骨科专家。质量很高～要求严格。此次学习班内容～围绕骨折治疗的AO原则～涵盖了基础理论和临床基本骨折的治疗。课程安排相当紧凑～使我真正掌握了骨折的基本固定技术～如张力带固定技术、加压螺钉固定技术、外固定支架固定技术等。同时～通过AO基础学习班的学习～使我对AO原则:解剖复位～坚强固定～保护软组织血运～早期功能锻炼有了更高的认识。最后获得国际AO组织颁发的AO基础学习班证书～为以后工作打下基础。 三、创伤骨科的学习 r included in the County, with the right of abode overseas natural persons; (2) expand the scope of borrower type of occupation; (3) to apply for a loan for business borrowers, as well as the business unit controller or major shareholders. 2, the maximum loan amount (1) to cancel "a maximum loan amount of RMB 300,000" requirement; (2) both for personal consumption and business purposes, different methods were used to determine the loan amount. 3, the loan terms (1) the loan terms with borrowers and not more than 60 years of age; (2) lending operation, should be based on the borrower's production cycle and the anticipated income situation, scientifically and rationally determine the loan period. (E) loans: the three rejected. (F) receive and investigate: 1, defines the principles and requirements of pre-loan investigation, focusing on investigating first source of repayment, and a double investigation. 2, the provision of customer information: (1) "available on request" information, customer reference case where the account manager deciding whether to request; (2) proof of income can refer to the approach in annex format or other format to meet the Bank's requirements; (3) loan operation shall provide the information management unit; (4) copy of the account manager shall verify the information and sign it to confirm. 3, provided for a borrower, guarantor and main contents of units operated by pre-loan investigation. 4, loans for business and apply for amounts in excess of 500,000 yuan, account managers should refer to the measurement limit estimates demand for working capital loans. (G) loans: the loan origination process, provides lenders responsible for review. (H) loans to pay: defined the trustee payments and autonomous operational requirements for payment. 积水潭创伤骨科分为三个病区～在三个病区学习使我收获很大。积水潭医院创伤病人很多～各种病人、各种病例几乎都能见到～同一种骨折病人手术室内能见到多次。通过手术的操作、带教老师的耐心讲解、认真的术后总结及业务学习、结合在图书馆查阅大量的医学文献～我已掌握以下技术: 1、Mippo(微创)技术的应用在经过老师们的讲课及手术～术后看书和总结～我对Mippo技术有了透彻的了解～也掌握了这种技术～领会了技术精髓。它是一种骨折相对稳定技术～适用于关节外、骨折粉碎严重、软组织条件不允许切开复位的骨干骨折～如股骨髁上骨折、胫骨远端骨折等。Mippo技术不等于小切口技术～无论大小切口手术～都应尽量保存骨块血运～而不应把解剖复位建立在破坏局部及骨块血运的基础上。但有时患者并不理解功能复位的含义～以骨折是否解剖复位作为衡量手术成败的标准～应用此项技术需要术前和患者有良好的沟通。 2、髓内钉技术～近年来随着人均寿命增加～我国已步入老龄社会～骨质疏松症病人已超过6000万人～据报道显示:我国每5分钟就有一例髋部骨折病人。半年来～我接触到很多高龄髋部骨折病人～固定不再局限于空心螺钉、DHS上～而是应用诸多国际上先进的髓内固定系统～如 PFN 、PFNA、Ganma钉 、Ganma3、intertan等。其优点是:杠杆力臂短～弯曲力臂小～手术创伤小～失血少～很好解除了患者痛苦～减少了手术并发症～尤其适合粗隆下骨折病人。目前～髓内钉技术治疗髋部骨折已成为“金标准”～从国际会议、固内会议～还有各种r included in the County, with the right of abode overseas natural persons; (2) expand the scope of borrower type of occupation; (3) to apply for a loan for business borrowers, as well as the business unit controller or major shareholders. 2, the maximum loan amount (1) to cancel "a maximum loan amount of RMB 300,000" requirement; (2) both for personal consumption and business purposes, different methods were used to determine the loan amount. 3, the loan terms (1) the loan terms with borrowers and not more than 60 years of age; (2) lending operation, should be based on the borrower's production cycle and the anticipated income situation, scientifically and rationally determine the loan period. (E) loans: the three rejected. (F) receive and investigate: 1, defines the principles and requirements of pre-loan investigation, focusing on investigating first source of repayment, and a double investigation. 2, the provision of customer information: (1) "available on request" information, customer reference case where the account manager deciding whether to request; (2) proof of income can refer to the approach in annex format or other format to meet the Bank's requirements; (3) loan operation shall provide the information management unit; (4) copy of the account manager shall verify the information and sign it to confirm. 3, provided for a borrower, guarantor and main contents of units operated by pre-loan investigation. 4, loans for business and apply for amounts in excess of 500,000 yuan, account managers should refer to the measurement limit estimates demand for working capital loans. (G) loans: the loan origination process, provides lenders responsible for review. (H) loans to pay: defined the trustee payments and autonomous operational requirements for payment. 杂志文章报道上可见一斑。然而～这些内植物多为进口材料～价格较为昂贵～但我相信随着国产器械的大量出现～髓内钉技术必然成为治疗髋部骨折的主流。所以我也重点学习了此技术～包括从闭合复位到内植物植入～经过反复实践～已熟练的掌握。 3、Ilizarov外固定支架的应用～以前～只是在书上和杂志上听说过ilizarov外固定支架～此支架用于矫形外科和复杂创伤的治疗～解决了不少矫形外科过去无法救治的难题～尤其在骨缺损、骨不连、骨关节畸形的治疗上。Ilizarov治疗原理来源于“牵引性骨发生”这一事实。在积水潭医院学习期间多次和黄雷教授手术～并向其请教其关键点～有时间翻阅相关书籍～并借ilizarov外固定支架展览机会～向此支架技术总监学习。之所以我对此技术感兴趣原因是:以前我科有过大段骨缺损病例～最终因为没有好办法治疗～延误了治疗。我认为～此技术可以为我们提供一种治疗骨不连、骨缺损以及高能量暴力造成胫前肌损伤～导致足下垂畸形等损伤的治疗手段。目前～此技术在北京积水潭医院应用较多。我会继续钻研此技术～希望有一天在我院也能开展。 另外～我在创伤骨科的学习中～亲眼目睹了吴兴宝教授导航技术的应用～李庭教授对Lisfrac、及踝关节损伤的处理,肘关节专家蒋协远教授对肘关节“恐怖三联征”～肘关节周围骨折的处理～对以后创伤救治有了更加深刻认识。 在临床实践中才发现实际工作所见并非想象那么简单～并非如书上说写那么典型～好多时候都是要靠自己平时在工作中的经r included in the County, with the right of abode overseas natural persons; (2) expand the scope of borrower type of occupation; (3) to apply for a loan for business borrowers, as well as the business unit controller or major shareholders. 2, the maximum loan amount (1) to cancel "a maximum loan amount of RMB 300,000" requirement; (2) both for personal consumption and business purposes, different methods were used to determine the loan amount. 3, the loan terms (1) the loan terms with borrowers and not more than 60 years of age; (2) lending operation, should be based on the borrower's production cycle and the anticipated income situation, scientifically and rationally determine the loan period. (E) loans: the three rejected. (F) receive and investigate: 1, defines the principles and requirements of pre-loan investigation, focusing on investigating first source of repayment, and a double investigation. 2, the provision of customer information: (1) "available on request" information, customer reference case where the account manager deciding whether to request; (2) proof of income can refer to the approach in annex format or other format to meet the Bank's requirements; (3) loan operation shall provide the information management unit; (4) copy of the account manager shall verify the information and sign it to confirm. 3, provided for a borrower, guarantor and main contents of units operated by pre-loan investigation. 4, loans for business and apply for amounts in excess of 500,000 yuan, account managers should refer to the measurement limit estimates demand for working capital loans. (G) loans: the loan origination process, provides lenders responsible for review. (H) loans to pay: defined the trustee payments and autonomous operational requirements for payment. 验积累～所以只有扎实投入学习～好好体会才能慢慢积累经验。 r included in the County, with the right of abode overseas natural persons; (2) expand the scope of borrower type of occupation; (3) to apply for a loan for business borrowers, as well as the business unit controller or major shareholders. 2, the maximum loan amount (1) to cancel "a maximum loan amount of RMB 300,000" requirement; (2) both for personal consumption and business purposes, different methods were used to determine the loan amount. 3, the loan terms (1) the loan terms with borrowers and not more than 60 years of age; (2) lending operation, should be based on the borrower's production cycle and the anticipated income situation, scientifically and rationally determine the loan period. (E) loans: the three rejected. (F) receive and investigate: 1, defines the principles and requirements of pre-loan investigation, focusing on investigating first source of repayment, and a double investigation. 2, the provision of customer information: (1) "available on request" information, customer reference case where the account manager deciding whether to request; (2) proof of income can refer to the approach in annex format or other format to meet the Bank's requirements; (3) loan operation shall provide the information management unit; (4) copy of the account manager shall verify the information and sign it to confirm. 3, provided for a borrower, guarantor and main contents of units operated by pre-loan investigation. 4, loans for business and apply for amounts in excess of 500,000 yuan, account managers should refer to the measurement limit estimates demand for working capital loans. (G) loans: the loan origination process, provides lenders responsible for review. (H) loans to pay: defined the trustee payments and autonomous operational requirements for payment.