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临床科室技术标准

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临床科室技术标准

  • 16页
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FA5ux^Gjqv^$UE9wEwZ#Qc@UE%&qYp@Eh5pDx2zVkum&gTXRm6X4NGpP$vSTT#&ksv*3tnGK8!z89AmYWpazadNu##KN&MuWFA5uxY7JnD6YWRrWwc^vR9CpbK!zn%Mz849Gx^Gjqv^$UE9wEwZ#Qc@UE%&qYp@Eh5pDx2zVkum&gTXRm6X4NGpP$vSTT#&ksv*3tnGK8!z89AmYWpazadNu##KN&MuWFA5uxY7Jv#nD6YWRrWwc^vR9CpbK!zn%MzFA5uxY7JnD6YWRrWwc^vR9CpbK!zn%Mz849Gx^Gjqv^$UE9wEwZ#Qc@UE%&qYp@Eh5pDx2zVkum&gTXRm6X4NGpP$vSTT#&ksv*3tnGK8!z89AmYWpazadNu##KN&MuWFA5uxY7Jv#nD6YWRrWwc^vR9CpbK!zn%MzXNQExJB8VK#%W7m$ZA5JdkVWce9APz^FvJzwYWCcyAh*bnxBvaFQH8YHV$#&3Q3vdWe3YXvbJr附件四川省综合医院评审临床科室技术标准第一部分：三级医院临床科室技术标准104104一、三级甲等医院104（一）内科1.心血管内科（1）顽固性心力衰竭的诊治（2）复杂心律失常的诊治（3）急性大面积心肌梗塞的处理（静脉溶栓治疗）（4）难治性心力衰竭的处理（5）难治性心律失常的处理（6）急性大面积心肌梗塞的处理：急诊冠状动脉成形术（PCI），应用主动脉气囊自搏（IABP）（7）心脏疾病监护（CCU）（8）心脏电复律104 （9）心脏永久性起搏，包括：单、双起搏器，双心室同步化起搏（CRT）、体内自动除颤复律（ICD植入）（10）心脏电生理检查及射频消融术（包括三位电解剖系统指示下复杂心律失常的射频消融术）。（11）心脏血液动力学检测（12）心血管造影术（冠脉、心室）（13）冠状动脉成形术与支架植入术（14）二尖瓣气囊扩张术（15）先天性心脏病介入治疗2.呼吸内科（1）慢性阻塞性肺疾病急性加重期的诊断与治疗（2）慢性肺源性心脏病肺心功能失代偿期的诊断与处理（3）支气管肺癌的诊断与综合治疗（4）支气管哮喘急性重度发作、危重度发作的诊断与治疗（5）弥漫性间质性肺疾病的诊断与治疗（6）急性呼吸窘迫综合征的诊断与治疗（7）肺血栓栓塞症的诊断与治疗（8）重症肺炎的诊断与治疗（9）睡眠呼吸障碍的诊断与治疗（10）胸膜及纵隔疾病的诊断与治疗（11）肺功能检查及心肺运动试验（12）呼吸支持技术及危重症监护（ICU）（13）诊断性纤维支气管镜术（14）胸腔置管引流术（15）经皮肺穿刺活检术（16）诊断性胸腔镜术（17）气管支气管气囊扩张术3.内分泌科（1）先天性肾上腺增生症的诊断与治疗（2）正常甲状腺功能病态综合症的诊断（3）嗜铬细胞瘤诊断与治疗（4）尿崩症的诊断与治疗（5）原发性醛固酮增多症的诊断与处理（6）垂体瘤的诊断与处理（7）腺垂体功能减退症的诊断与处理（8）性腺疾病的诊断与处理（9）垂体危象的处理（10）甲状腺炎的诊断与治疗（11）异位内分泌综合症的诊断与治疗（12）钙磷代谢及甲状旁腺疾病的诊断与处理（13）胰岛细胞瘤的诊断与处理（14）甲状腺功能亢进症的同位素治疗（15）内分泌肿瘤的CT等影像学诊断（16）胰岛细胞抗体测定：胰岛素抗体（IAA）、胰岛细胞表面抗体（ICA）、谷氨酸脱羧酶抗体（GADA）、TSH受体抗体（TRAb）（17）骨密度测定（双能X线）（18）甲状腺穿刺活检（19）胰岛素泵的使用、动态血糖检测（20）甲状腺吸碘率（21）内分泌激素测定：生长激素（GH），性激素：雌二醇（E2）、促性腺激素（FSH）、促黄体激素（LH）、维生素D、睾丸酮（T）、泌乳素（PRL）4.消化内科（1）胆道镜检查取石、活检（2）急诊内镜（胃镜、结肠镜）检查、止血、取异物104 （3）逆行胰胆管造影（ERCP）、EST、ENBD（4）肝动脉栓塞术（TAE）（放射科导管造影）（5）经皮经肝胆道造影（PTC）和引流(PTCD（6）超声导向下肝穿刺术超声导向下肝穿刺术（7）选择性腹腔动脉、肠系膜上、下动脉造影（8）食管静脉曲张套扎或硬化剂治疗（9）食道狭窄扩张术，支架置放术（10）消化道动力学测定（液体、固体）（11）早期胃肠癌的诊治，放大内镜、染色内镜、智能成像、EMR、ESD（12）消化道激素测定，内分泌试验（13）超声导向下肝穿刺术（14）超声内镜（15）经颈内静脉肝内静脉内支架分流术（TIPS）（16）小肠镜或胆囊内镜（17）内镜下经皮胃造瘘（PEG）5.肾内科（1）原发性肾小球肾炎疾病的诊治（2）肾小球疾病的诊治（3）间质性肾脏病的诊治（4）继发性肾脏病的诊治（5）肾性高血压的诊治（5）急、慢性肾功能衰竭的诊治与非透析治疗（6）血液净化（血液透析、腹膜透析、血液滤过、血浆置换）、CRRT（持续性肾脏替代治疗）（7）肾小球功能（肌酐清除率、尿蛋白分析）检查（8）肾小管功能（浓缩等）检查（9）肾脏活检（经皮与直视）及肾组织的病理检查（光镜、电镜及免疫病理）6.血液内科（1）多发性骨髓瘤的诊治（2）再生障碍性贫血的诊治（骨髓病理诊断）（3）免疫性血液病的诊治（4）骨髓异常增生综合征的诊治（5）单克隆抗体的临床应用（6）血液病细胞免疫表型检查（7）疑难、罕见血液病的诊治（8）急性白血病的诊治（MIC）分型（9）慢性白血病的诊治（10）出血及血栓性疾病的实验室检查及诊治（11）免疫性血液病的实验室检查及诊治（12）血浆置换术在血液病的应用（13）掌握造血干细胞移植在临床的适应症7.神经内科（1）危重病人（昏迷、脑疝、肌无力危象、癫痫持续状态、呼吸肌麻痹）的抢救（2）脑血管病的诊断、鉴别诊断及规范化治疗（3）颅内高压的对症治疗及病因检查（4）神经系统脱髓鞘疾病的诊断、鉴别诊断和治疗（5）癫痫的诊断分型及规范治疗（6）帕金森病及帕金森综合症的诊断、鉴别诊断和处理（7）脑电图、T-CD、血管彩超及肌电图检查（8）变性疾病及肌肉疾病的诊断与鉴别诊断（9）主要抗癫痫药物（苯妥因钠、卡马西平、丙戊酸钠、鲁米钠及安定类等）的血浓度检测104 （10）全脑血管造影（DSA）在神经科的应用（11）诱发电位（包括磁运动诱发电位）录象检测或长程脑电图等检查（12）肌肉、神经及脑组织活检、脑脊液的细胞学检查(二)外科三级甲等医院除完成三级乙等医院开展的技术项目以外，还应开展以下技术项目。1.普外（1）复杂胰腺癌、肝门胆管癌根治术（2）胰十二指肠切除术：包含保留幽门的胰十二指肠切除术（3）高位胆管损伤修复术（4）胰管切开取石+胰肠吻合术（5）保留十二指肠胰头切除术、节段性胰腺切除术（6）肝三叶切除术、尾叶肿瘤切除术（可选）（7）腹腔镜下胆道探查术、胆道）、脾切除术（8）脾部分切除术（可选）（9）肝门成形术（10）腹腔镜肝部分切除术（11）门体静脉分流手术（12）胆囊癌根治术2.骨科(1)人工全髋关节翻修术及人工膝关节置换术(2)骶骨肿瘤根治术(3)臂丛神经探查修复术(4)上位颈椎损伤的内固定术（寰枢内固定术、枕颈内固定术）(5)断指再植术或骨科微创技术3.神经外科(1)开展显微镜神经外科手术(2)开展三脑室、四脑室、部分鞍区、桥小脑角肿瘤切除术(3)脊髓髓内肿瘤。(4)开展大型脑血管畸形切除术、前循环颅内动脉瘤夹闭术(5)设专科重症加强监护室（专科ICU）(6)开展血管内介入治疗或放射外科治疗4.泌尿外科(1)肾上腺疾病手术(2)肾癌根治手术(3)膀胱全切肠道疾病手术(4)复杂尿道疾病手术(5)复杂肾结石手术(6)各类腔道泌尿外科手术5.胸心外科（1）复杂性先天性心脏病的外科治疗（包括法洛氏四联症、右室双出房室膈缺损、三尖瓣下移畸形、大动脉转位、合并重度肺动脉高压的左向右分流的先心病等）（2）心脏多瓣膜置换及瓣膜成形术（3）冠状动脉搭桥术（4）胸主动脉手术，如主动脉缩窄手术，胸主动脉瘤切除（包括降主动脉瘤切除及升主动脉瘤Bentall或Cabrol手术等）（5）心律失常的外科治疗，如改良迷宫手术等（6）复杂纵隔肿瘤切除术（7）气管支气管成形术（包括肺叶袖式切除术，气管肿瘤切除术、104 气管隆凸切除重建术等）（8）颈及胸上段食管癌切除术（9）复杂食管癌切除术6.烧伤外科一般科室：能开展以下技术项目：(1)大面积烧伤的治疗(2)呼吸道烧伤的治疗(3)切削痂植皮手术(4)皮瓣移植术(5)皮管移植术(6)游离皮瓣移植术(7)异体皮开窗、自体皮嵌入术(8)各类断层皮片的切取术及异体皮制备(9)烧伤截肢术重点专科：除符合以下基本条件外，还能开展以下技术项目：基本条件：(1)学科带头人具有主任医师职称(2)专业水平居国内先进行列(3)专业人才形成梯队(4)具有20张以上床位，有开展本专业医疗、教学、科研所需的配套设备（包括设备中心的有关设备）技术项目：(1)大面积严重烧伤的抢救成功率、半死亡率（LA50）：烧伤面积80%，三度烧伤面积50%(2)中重度吸入性损伤的治疗(3)微粒自体皮、大张异体皮混合移植术(4)真皮支架（真皮皮浆）、自体上皮混合移植术(5)血管游离移植术、肌皮游离移植术(6)游离皮瓣复合组织瓣移植术(7)各部位深度烧伤创面修复术(8)功能部位深度烧伤早期修复术、各部位烧伤晚期功能障碍功能重建术(9)多器官功能衰竭的早期诊断和治疗（三）妇科1.妇科肿瘤标志物的检测、病理诊断（包括冰冻快速诊断）、影象学诊断2.腹腔镜诊断与经腹腔镜手术3.复杂尿路修补4.内膜癌根治术5.复发性肿瘤诊治（包括残端癌根治）6.介入诊疗法在妇科疾病中的应用7.腹主动脉旁淋巴结清扫术8.各种途径盆底（吊带）手术及盆底修补术9.各种妇科严重出血的诊治和抢救10.严重盆腔感染及感染性休克抢救和诊治生殖内分泌计划生育科1.难治性功血的诊治2.促排卵和检测排卵及卵巢过度刺激综合症的诊治3.有严重并发症的各期妊娠终止技术4.性激素及内分泌激素的检测及临床应用5.腔镜（宫腔镜、阴道镜、腹腔镜等）技术在生殖内分泌计划生育疾病诊治方面的应用6.骨质疏松症的诊治（四）产科104 1、产科疑难危重症的诊治及抢救2、妊娠合并症（心脏病、高血压、肾功衰、免疫性疾病、内分泌疾病、血液疾病等）危重病人的诊断处理和抢救。3、子痫发生率（院内）：<0.1%4、产后出血发生率：阴道分娩<3—4%剖宫产<6%5、产后出血死亡率：06、围产儿死亡率：<12%7、会阴III度裂伤发生率：<0.05%8、会阴侧切伤口感染率（合并生殖道性病者除外）：<5%9、产前出血（>500毫升）的诊治10、产后出血（>800毫升）的诊治11、羊水栓塞、DIC的诊治和抢救12、高危妊娠监测手段：胎心监护仪（内）彩超对出生缺陷的检测新生儿头皮血气测定胎盘功能监测13、产前遗传学诊断技术：绒毛、羊水、脐血、母血14、多胎妊娠减胎术15、妊娠合并瘢痕子宫或子宫破裂的诊治及抢救16、中央性前置胎盘、胎盘植入的诊治和抢救（五）儿科1、先天性心脏病的诊治（包括介入治疗）2、设新生儿重症监护室（NICU）：危重新生儿转运系统，新生儿呼吸窘迫综合症（包括高频通气）诊治，PICC静脉高营养治疗3、早产儿、超低体重儿的医护质量管理4、小儿消化道疾病的诊治（包括消化道内镜、胃内环境的检查）5、遗传代谢内分泌疾病的诊断（基因、染色体、生化检查）6、静脉高营养治疗7、腹泻病原学的诊断和防治（病原学检查）8、癫痫、脑瘫、智力低下的诊治（脑电图、B超、视觉、听觉、体感诱发电位检查，神经康复治疗）9、难治性肾病的诊治（包括肾穿、病理检查），肾衰的诊治（包括腹透、血透治疗）10、小儿糖尿病酸中毒昏迷的诊断与抢救11、白血病的诊治（包括干细胞移植）104113二、三级乙等医院113(一)内科1.心血管内科(1)顽固性心力衰竭的诊治(2)复杂心律失常的诊治(3)急性大面积心肌梗塞的处理（静脉溶栓治疗）(4)心脏疾病监护（CCU）(5)心脏电复律(6)心脏永久性起搏2.呼吸内科113 （1）慢性阻塞性肺疾病急性加重期的诊断与治疗（2）慢性肺源性心脏病肺心功能失代偿期的诊断与处理（3）支气管肺癌的诊断与综合治疗（4）支气管哮喘急性重度发作、危重度发作的诊断与治疗（5）急性呼吸窘迫综合征的诊断与治疗（6）肺血栓栓塞症的诊断与治疗（7）重症肺炎的诊断与治疗（8）睡眠呼吸障碍的诊断与治疗（9）胸膜及纵隔疾病的诊断与治疗（10）肺功能检查（11）呼吸支持技术及危重症监护（ICU）（12）诊断性纤维支气管镜术（13）胸腔置管引流术（14）经皮肺穿刺活检术（15）诊断性胸腔镜术3.内分泌科（1）原发性慢性肾上腺皮质功能减退症的诊断与处理（2）库欣综合症的诊断与处理（3）代谢综合征的诊断与处理（4）甲状腺功能亢进症浸润性突眼的诊断与治疗（5）原发性骨质疏松症的诊断与处理（6）内分泌腺肿瘤的CT等影像学诊断（7）胰岛素释放试验（8）内分泌激素测定：免疫活性胰岛素（IRI）、免疫活性C肽（IRC）、甲状腺球蛋白抗体（TGAb）、甲状腺过氧化物酶抗体（TPOAb）、促甲状腺激素（TSH）、皮质醇、促肾上腺皮质激素（ACTH）（9）骨密度测定（10）糖化血红蛋白（HbA1c）测定（标准化的方法）4.消化内科（1）胆道镜检查取石、活检（2）急诊内镜（胃镜、结肠镜）检查、止血、取异物（3）逆行胰胆管造影（ERCP）、EST、ENBD（4）肝动脉栓塞术（TAE）（放射科导管造影）（5）经皮经肝胆道造影（PTC）和引流(PTCD)（6）超声导向下肝穿刺术（7）选择性腹腔动脉、肠系膜上、下动脉造影（8）食管静脉曲张套扎或硬化剂治疗(9)食道狭窄扩张术，支架置放术（10）消化道动力学测定（液体、固体)5.肾内科（1）原发性肾小球肾炎疾病的诊治（2）肾小球疾病的诊治（3）间质性肾脏病的诊治（4）继发性肾脏病的诊治（5）肾性高血压的诊治（6）急、慢性肾功能衰竭的诊治与非透析治疗（7）血液净化（血液透析、腹膜透析、血液滤过、血浆置换）（8）肾小球功能（肌酐清除率、尿蛋白分析）检查（9）肾小管功能（浓缩等）检查6.血液内科（1）多发性骨髓瘤的诊治（2）再生障碍性贫血的诊治（骨髓病理诊断）（3）免疫性血液病的诊治113 （4）骨髓异常增生综合征的诊治（5）单克隆抗体的临床应用（6）溶血性贫血的诊治（7）常见出血性疾病[特发性血小板减少性紫癜、血友病、弥漫性血管内凝血（DIC）诊治（8）急性粒细胞减少或缺乏的诊治（9）骨髓穿刺及细胞形态学分类（10）出血及血栓性疾病的诊治（11）急性白血病的诊治（组织化学染色或免疫学确定亚型）（12）慢性白血病的诊治（13）淋巴瘤的诊治7.神经内科（1）癫痫的诊断及规范化治疗（2）帕金森病的诊断和处理（3）中枢神经系统脱髓鞘疾病的诊治（4）中枢神经系统寄生虫病的诊治（5）危重病人（昏迷、脑疝、肌无力危象、癫痫持续状态、呼吸肌麻痹）的抢救（6）脑血管病的诊断、鉴别诊断及规范化治疗（7）颅内高压的对症治疗及病因检查（8）神经系统脱髓鞘疾病的诊断、鉴别诊断和治疗（9）癫痫的诊断分型及规范治疗（10)帕金森病及帕金森综合症的诊断、鉴别诊断和处理（11)脑电图、T-CD、血管彩超及肌电图检查(二)外科28三级乙等医院除开展二级甲等医院的技术项目以外，还能开展以下技术项目。1.普外（1）左、右半肝切除术（2）先天性胆总管囊肿切除术+胆肠吻合术（Roux-en-Y）（3）坏死性胰腺炎清创引流术（4）胰体尾肿瘤切除术2.骨科(1)胸腰椎前后路手术治疗(2)骨关节肿瘤的切除或保肢治疗(3)先天性髋关节脱位保守治疗与手术治疗(4)周围神经损伤的探查吻合术(5)腰椎滑脱的减压固定术3.神经外科(1)开展垂体肿瘤、脑胶质瘤、侧脑室肿瘤、前中颅窝脑膜瘤及听神经瘤切除术(2)颈段椎管肿瘤切除术(3)开展简单颅内动脉瘤夹闭术、脑动静脉畸形切除术(4)颅底畸形寰枕减压术(5)开展部分功能神经外科手术（癫痫、帕金森、精神病等）(6)开展脑血管成像检查（DSA/MRA或CTA）4.泌尿外科（1）前列腺开放及电切手术（2）单纯肾切除术（3）尿道会师及后尿道拖入术113 （4）肾盂输尿管交界狭窄成型术5.胸心外科(1)体外循环下常见心脏病心内直视手术:如房间隔缺损修补术、室间隔缺损修补术、肺动脉瓣狭窄交界切开术、肺静脉异位引流矫治术、单瓣膜置换术、左房黏液瘤摘除术等(2)心包大部分切除术(3)动脉导管未闭切断缝合术或结扎术(4)纵隔肿瘤切除术(5)食管癌根治术(6)漏斗胸矫治术(7)中央型肺癌肺叶切除术、肺减容术(8)肺段切除术、全肺切除术、肺减容术(9)胸腔镜微创手术（三）妇科1.复杂子宫全切2.绒癌的诊断与综合治疗3.外阴癌根治术4.宫颈癌根治术5.子宫内膜异位症的诊治6.阴道子宫切除术7.阴道成形术8.显微外科输卵管吻合术9.腔镜（宫腔镜、阴道镜）技术的应用10.外阴宫颈疾病（感染及性传播疾病）的诊治11.其它辅助治疗（激光、理疗等）在妇产科疾病中的应用生殖内分泌计划生育科1、功血的诊治2、原发及继发不孕症的诊治3、月经紊乱和闭经的诊治4、青春期、更年期妇女保健5、各种避孕及复孕技术的开展6、各种异位妊娠的诊治及大出血、出血性休克、DIC的抢救（四）产科71、妊娠合并内、外科并发症的诊治2、产前诊断：血液、绒毛、羊水3、分娩期高危儿处理（低体重儿、异常儿、母有并发症新生儿）4、高危妊娠监测手段：胎心监护仪（外）5、开展腹膜外剖腹产6、母婴血型不合（包括新生儿溶血症）的诊治7、多胎妊娠的处理（五）儿科1、新生儿窒息的复苏及合并症的抢救（包括缺血缺氧性脑病、颅内出血）2、新生儿感染的诊治（病原学、免疫功能诊断、成分输血）3、新生儿高胆红素血症（包括溶血病）的诊治（免疫抗体检查、光疗、换血疗法）4、呼吸衰竭的诊治和抢救（血气分析、呼吸机的应用）5、哮喘的诊治（小儿肺功能、免疫功能、过敏原的检测）6、严重感染合并休克或脑病脑疝的抢救7、心内膜心肌炎疾病的诊治（包括心衰）8、心电图、超声心动图、心肌酶谱的检查9、心律失常的诊治（除颤、起博器的应用）113 10、先天性心脏病的诊治（心导管、心血管造影）11、儿童心理卫生咨询，各年龄段的智力测评12、感染性疾病（传染病）的隔离诊治113第二部分：二级医院临床科室技术标准一、二级甲等医院113(一)内科1.心血管内科（1）急慢性心力衰竭的处理（2）重症心律失常的诊治（3）心脏病骤停及心脏性猝死的抢救（4）心源性休克的抢救（5）原发性高血压的诊治（6）冠状动脉粥样硬化性心脏病的诊治（7）心脏瓣膜病的诊治（8）心肌疾病的诊治（9）床旁心电监护（10）心脏超声心动图（11）急性肺水肿的抢救（12）顽固心律失常的处理（13）急性心肌梗塞的诊断与处理（14）心包穿刺术（15）心脏运动负荷试验（16）心脏临时起搏（17）动态心电图2.呼吸内科（1）慢性阻塞性肺疾病的诊断与治疗113 （2）慢性肺源性心脏病的诊断与治疗（3）支气管哮喘的诊断与治疗（4）肺癌的诊断（5）肺炎与肺脓肿的诊断与处理（6）大咯血的抢救（7）自发性气胸的治疗（8）胸腔积液的诊治（9）呼吸衰竭的诊断与治疗(10)肺通气功能检查（11）血气分析(12)呼吸支持技术（13）胸腔穿刺术（14）痰液的病原学检测3.内分泌科（1）甲状腺功能亢进症的诊断与治疗（2）甲状腺功能减退症的诊断与治疗（3）原发性骨质疏松症的随访与治疗（4）内分泌激素测定：总三碘甲腺原氨酸（TT3）、总甲状腺素（TT4）、促甲状腺素（TSH）（5）甲状腺危象的抢救（6）甲状腺超声波检查4.消化内科（1）常规内镜（胃镜、结肠镜）检查（2）黄疸的鉴别诊断（3）上消化道出血的诊治（4）肝昏迷、肝功能衰竭的诊治（5）急性出血性坏死性胰腺炎的诊治（6）急性梗阻性化脓性胆管炎的诊治（7）急性弥漫型腹膜炎的诊治（8）急诊内镜检查（9）超声导向下肝穿刺术（10）重症急性梗阻性化脓性胆管炎的诊治（11）缺血性肠病的诊治（12）胆道镜检查（可配合肝胆外科）（13）经皮经肝胆道造影（PTC）和引流(PTCD)5.肾内科（1）急性肾小球肾炎的诊治（2）肾病综合征的诊治（3）泌尿系统感染的诊治（4）原发性与原发性肾小球疾病的诊治（5）肾性高血压的诊治（6）肾功能测定（血肌酐、尿素氮、内生肌酐清除率）（7）泌尿系统超声、核素及影像学检查（8）慢性肾功能衰竭的诊治（包括结肠、腹膜透析）6.血液内科（1）常见营养性、缺铁性贫血的诊治（2）慢性白血病的诊治（3）再生障碍性贫血的诊治（4）溶血性贫血的诊治（5）常见出血性疾病[特发性血小板减少性紫癜、血友病、弥漫性血管内凝血（DIC）诊治（6）急性粒细胞减少或缺乏的诊治（7）骨髓穿刺及细胞形态学分类（8）出血及血栓性疾病的诊治113 （9）急性白血病的诊治（组织化学染色或免疫学确定亚型）（10）淋巴瘤的诊治7.神经内科专科（1）脑血管病的诊断、鉴别诊断及治疗（2）颅内高压的对症治疗及常见病因检查（3）中枢神经系统炎性疾病的诊治（4）脑电图和脑脊液的检查（常规、生化）(二)外科二级甲等医院除开展二级乙等医院的技术项目以外，还能开展以下技术项目。1.普外（1）胆肠吻合术（2）左外叶切除术（3）门奇断流术（4）胰腺假性囊肿内引流术（5）Oddi氏括约肌成形术2.骨科（1）全身复合性损失的诊断与治疗（2）四肢大血管损伤的修复（3）骨、关节、胸腰椎脊柱结核病灶清除术（4）腰椎间盘脱出髓核摘除术（5）脊柱外伤后路减压固定术及人工半髋关节置换术3.神经外科（1）大脑半球（凸面）表浅肿瘤切除术（2）高血压小脑出血血肿清除术（3）颅内压增高的内外减压术（4）脑积水分流术（5）单纯性脊髓髓外肿瘤切除术（6）颈椎狭窄椎管减压术4.泌尿外科（1）输尿管上段切开取石术（2）膀胱部分切除术（3）膀胱破裂修补术（4）肾囊肿去顶减压术（5）输尿管下段结石取石及输尿管膀胱再吻合术5.胸心外科（1）贲门、食管下段肿瘤切除术（2）周围型肺癌肺叶切除术（3）喷门括约肌切开成形术（4）食管良性肿瘤切除术（5）胸膜纤维板剥除术（6）膈疝修补术（三）妇科1、卵巢癌性畸胎瘤剥（切）除术2、计划生育复杂并发症处理3、内分泌诱发排卵4、未破裂宫外孕的诊治5、有异常的人流、取环术113 （四）产科1、围产期新生儿监护及抢救（包括窒息复苏）2、高围妊娠监测及系统管理3、产前诊断技术（器官发育明显畸形的彩超监测、中枢神经管缺陷做甲胎蛋白筛查、21-3体做唐氏筛查）4、输卵管通液术及子宫输卵管造影5、妊娠合并内外科合并症的诊治6、产程监护和产程并发症的处理（五）儿科1、小儿弥漫性血管内(DIC)、出凝血疾病的诊治2、白血病的诊治3、新生儿高胆红素血症的诊治4、感染性休克、脑疝的诊治和抢救5、神经系统疾病的诊治113113二、二级乙等医院113（一）内科1.心血管内科（1）急慢性心力衰竭的处理（2）重症心律失常的诊治（3）心脏病骤停及心脏性猝死的抢救（4）心源性休克的抢救（5）原发性高血压的诊治（6）冠状动脉粥样硬化性心脏病的诊治（7）心脏瓣膜病的诊治（8）心肌疾病的诊治（9）床旁心电监护（10）心脏超声心动图2.呼吸内科（1）慢性阻塞性肺疾病的诊断与治疗（2）支气管哮喘的诊断与治疗（3）肺癌的初步诊断（4）肺炎与肺脓肿的诊断与处理（5）大咯血的抢救（6）自发性气胸的治疗（7）胸腔积液的诊治（8）胸腔穿刺术（9）痰液的病原学检测3.内分泌科（1）糖尿病及其酮症酸中毒、高渗性非糖尿病昏迷的诊断与治疗（2）甲状腺疾病的筛查（3）原发性骨质疏松危险人群的筛查113 （4）高脂血症的诊断与治疗（5）痛风的诊断与治疗（6）水、电解质代谢与酸碱平衡失常的诊断与治疗（7）血糖监测（8）葡萄糖耐量试验4.消化内科（1）常规内镜（胃镜、结肠镜）检查（2）黄疸的鉴别诊断（3）上消化道出血的诊治（4）肝昏迷、肝功能衰竭的诊治（5）急性出血性坏死性胰腺炎的诊治（6）急性梗阻性化脓性胆管炎的诊治（7）急性弥漫型腹膜炎的诊治（8）急诊内镜检查（9）超声导向下肝穿刺术（10） 重症急性梗阻性化脓性胆管炎的诊治5.肾内科（1）急性肾小球肾炎的诊治（2）肾病综合征的诊治（3）泌尿系统感染的诊治（4）原发性与原发性肾小球疾病的诊治（5）肾性高血压的诊治（6）肾功能测定（血肌酐、尿素氮、内生肌酐清除率）（7）泌尿系统超声、核素及影像学检查6.血液内科（1）常见营养性、缺铁性贫血的诊治（2）慢性白血病的诊治（3）再生障碍性贫血的诊治（4）溶血性贫血的诊治（5）常见出血性疾病[特发性血小板减少性紫癜、血友病、弥漫性血管内凝血（DIC）]诊治（6）急性粒细胞减少或缺乏的诊治（7）骨髓穿刺及细胞形态学分类7.神经内科(1)脑血管病的诊断、鉴别诊断及治疗(2)颅内高压的对症治疗及常见病因检查(3)中枢神经系统炎性疾病的诊治(4)脑电图和脑脊液的检查（常规、生化）(二)外科1.普外（1）常见急腹症外科处理（肝胆胰、肝血管、胆道、胃肠）（2）外伤性肝破裂修补术（3）外伤性脾破裂脾切除术（4）胆囊切除术、胆道探查术2.骨科（1）各类开放性骨折的急诊处理（2）手外伤清创术（3）四肢骨干骨折的手术治疗（4）截肢（指，趾）术（5）骨关节化脓性感染的诊断治疗113 3.神经外科（1）开放性颅恼损伤清创术（2）颅骨凹陷性骨折复位术（3）颅骨成形术（4）各类外伤性颅内血肿清除术（5）高血压脑出血血肿清除术（6）腰椎椎板切除减压术与椎间盘突出髓核摘除术4.泌尿外科（1）包皮环切术（2）膀胱穿刺造瘘术（3）精索静脉高位结扎术（4）睾丸切除术（5）膀胱切开取石术5.胸心外科（1）胸腔闭式引流术（2）肺裂伤修补术（3）肋间血管缝扎止血术（4）肺大庖切除，胸膜固定术（5）肺楔形切除术（6）肋骨肿瘤切除术（7）心包开窗术（三）妇科1、子宫肌瘤剔除术2、宫外孕诊治3、子宫全切术4、附件切除术5、前庭大腺囊肿处理6、急性盆腔炎诊治7、有异常的人流、取环术（四）产科1、产科一般出血处理2、产科感染处理3、产道损伤处理4、高危妊娠诊断和处理（子痫、胎位异常）5、围产期保健（五）儿科1、各种肺炎及其并发症的诊治2、败血症及颅内感染性疾病的诊治3、心肌炎及心律失常的诊治4、哮喘的诊治5、新生儿硬肿症的诊治6、新生儿窒息复苏7、小儿急性出血性疾病的诊治8、小儿营养性贫血及再生障碍性贫血的诊治9、小儿惊厥及癫痫的诊治10、小儿急性中毒的诊治及抢救11、小儿急腹症的鉴别诊断12、小儿急慢性肾炎及肾病的诊治13、小儿感染性疾病（包括常见传染病）的隔离诊治14、小儿腹泻的诊治（常见病原学检测和液体疗法）113'

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