簡介:房顫的規(guī)范化治療遵循原則1.發(fā)作頻繁的陣發(fā)性房顫要積極恢復(fù)并維持竇性,首選藥物治療2.明確與肺靜脈或上腔靜脈肌袖相關(guān)的房顫可以進(jìn)行電隔離消融治療,但要嚴(yán)格掌握適應(yīng)癥3偶發(fā)的房顫不須長期治療,發(fā)作不能自行終止時予以電復(fù)律或藥物終止即可。4.病程不超過半年的持續(xù)房顫也應(yīng)盡量恢復(fù)竇律并維持藥物治療,預(yù)防復(fù)發(fā)。5.對于病程超過半年的持續(xù)房顫,不足一年者仍可試行電復(fù)律或藥物轉(zhuǎn)復(fù)。6.永久性房顫、藥物或電隔離未成功的陣發(fā)性房顫采用控制心室率的方法,同時要進(jìn)行抗凝治療。7.與甲狀腺功能亢進(jìn)有關(guān)的房顫首先要糾正甲狀腺功能。治療策落控制心室率、轉(zhuǎn)復(fù)和維持竇性心律、以及預(yù)防栓塞性事件。藥物復(fù)律和電復(fù)律的治療規(guī)程1.復(fù)律病人選擇藥物復(fù)律主要使用于頻繁的陣發(fā)性房顫、時間不超過半年的持續(xù)房顫,房顫持續(xù)時間超過半年、不足一年者如果迫切要求復(fù)律也應(yīng)給予機會?,F(xiàn)有的臨床實踐表明,持續(xù)時間超過半年的房顫復(fù)律成功的機會明顯減少,而超過一年者決大多數(shù)都不能成功轉(zhuǎn)復(fù)。另外,持續(xù)時間越長,發(fā)生血栓栓塞的機會越多,轉(zhuǎn)復(fù)后維持竇律越困難,因此一般將持續(xù)房顫復(fù)律的指征掌握在半年以內(nèi)。電復(fù)律使用于房顫發(fā)作時心室律恨快、患者出現(xiàn)血壓下降或心功能不全需要立即終止的情況。2.復(fù)律前的準(zhǔn)備確定有無器質(zhì)型心臟病,了解心功能狀況,有無相關(guān)心外疾病,有無誘發(fā)因素,為此,都應(yīng)檢查心臟超聲、肝脾超聲、甲狀腺功能等。同時,也要判斷竇房結(jié)和房室結(jié)功能。持續(xù)時間超過48小時的患者復(fù)律前要抗凝3周。一般使用華法令,使用劑量通過監(jiān)測凝血指標(biāo)來調(diào)整。INR值為2–3比較合適,既能達(dá)到有效抗凝目的,又不會發(fā)生出血并發(fā)癥。對于持續(xù)時間不超過一周的患者,如果食管超聲確認(rèn)沒有左心房內(nèi)血栓的,可連用數(shù)日低分子肝素后進(jìn)行復(fù)律治療。竇房結(jié)和房室結(jié)功能低下的患者,有明確永久起搏適應(yīng)癥的要安置起搏器后再進(jìn)行復(fù)律。永久起搏治療不明確者,需要在臨時起搏保護(hù)下進(jìn)行電復(fù)律;對于藥物復(fù)律者,在心電監(jiān)護(hù)下用藥,如出現(xiàn)較多的長間歇或心動過緩的相關(guān)癥壯,應(yīng)停藥,最好安置起搏器后再進(jìn)行復(fù)律。電解質(zhì)不正常的要于糾正后再開始復(fù)律治療。甲狀腺功能亢進(jìn)應(yīng)先行治療。無器質(zhì)型心臟病或心功能不全的患者,要治療基礎(chǔ)心臟病和心功能不全,不能只著眼于房顫。3.同步直流電擊復(fù)律一般在病房即可,要在單間內(nèi)進(jìn)行,家屬和其他患者不得在場,以免影響工作。復(fù)律前患者禁食4–6小時。如有活動義齒需摘除。連接好除顫器的心電監(jiān)護(hù),專人記錄血壓、心率、心律、用藥情況。靜脈注射咪唑3–5㎎,或20–30㎎使患者入睡,具體用藥情況根據(jù)患者神智情況而定,以電擊時患者無痛覺、電擊后又能盡快醒來為度。對于老年人需特別注意劑量勿過,以免發(fā)生呼吸抑制。兩個除顫電極板通常分別放在心尖部和靠胸骨右緣鎖骨下區(qū)域,一般陰極在心尖部,首次電擊能量一般100–200J根據(jù)患者的胖瘦程度和以前的電擊效果酌情決定。如果復(fù)律未成功,可每次增加電能50–100J,立即再次電擊1–2次,如300J仍未成功,放棄電擊復(fù)律。復(fù)律成功后立即呼喚病人,令起盡快醒來,并檢查有無栓塞征象。有栓塞征象者,按其治療原則進(jìn)行治療。無論復(fù)律成功與否,電擊后都要繼續(xù)監(jiān)護(hù)1–2小時,注意患者血壓、心率、心律情況及進(jìn)行相應(yīng)臨床處理。對于非急診電擊復(fù)律的患者,復(fù)律后繼續(xù)用電擊復(fù)律前的用藥以維持竇性心律。對于急診電擊復(fù)律的患者,根據(jù)具體情況決定復(fù)律后的治療方案。4.藥物復(fù)律藥物復(fù)律通常采用口服的方法,復(fù)律后要繼續(xù)用藥以維持竇性心律,復(fù)律和維持竇性心律是一連續(xù)治療過程。在我國。常用藥物有胺碘酮、普羅帕酮、莫雷西嗪、索他洛爾。陣發(fā)性房顫的藥物復(fù)律可以在房顫發(fā)作時開始,也可在竇律時開始。歲、無高血壓、栓塞病史、近期心衰病史的房顫,使用阿司匹林300325㎎/天對于防栓塞并發(fā)癥既安全又有效;而對于大于65歲,特別是75歲以上,先前存在基礎(chǔ)心臟病或危險因素的房顫應(yīng)給予華法令治療。用藥方法現(xiàn)在主張從維持量開始,用23㎎,INR維持在2.03.0。華法令與阿司匹林應(yīng)避免合用??傊?,當(dāng)前階段,房顫不是通過一種手段可以解決的,需因人而宜注意患者的個體差異,為每個患者考慮最佳方案。不能從一極端走向另一極端。對于年輕患者的陣發(fā)性房顫,尤其是局灶性起源者,射頻消融術(shù)是最佳選擇,對于所有初發(fā)的患者,給予一次電復(fù)律機會還是有必要的。如不能維持竇性心律,則不必勉強,充分控制心室率即可。對于發(fā)作兩次以上的患者,首先考慮的應(yīng)該是控制心室率。另外,所有患者有必要服用房顫華法令抗凝,在沒充分證據(jù)證實患者所有時間都維持竇性心律,均要考慮抗凝治療。華法令臨床應(yīng)用1.華法林的用藥和劑量調(diào)整中國人華法林的初始劑量建議為3MG大于75歲的老年人和出血的高?;颊?應(yīng)從2MG開始,每天1次口服,目標(biāo)INR依病情而定,一般為20~30。不推薦使用初始沖擊量,否則可能使蛋白C活性下降,造成一過性高凝狀態(tài),甚至導(dǎo)致血栓合并癥。應(yīng)了解病人的年齡,身體狀況,患病史,治療和用藥史,生活習(xí)慣,尤其是否有血液病和出血病史。華法林的應(yīng)用應(yīng)該嚴(yán)格掌握適應(yīng)證,多數(shù)情況應(yīng)停用阿司匹林。華法林應(yīng)用得當(dāng)雖然也很安全,但在醫(yī)生沒有掌握用法之前最好不要使用,尤其在不具備監(jiān)測條件的地方不要用華法林抗凝。變通的辦法是固定小劑量不監(jiān)測使用華法林,試驗證明這種方法效果不好,也不是絕對安全。用藥前常規(guī)測定INR,第3天也必須測定INR,如果此時INR在15以下,應(yīng)該增加05MG/D如果INR在15以上,可以暫時不增加劑量,等待7天后INR測定的結(jié)果如果INR與基礎(chǔ)水平比較變化不大,可以增加1MG/D。我們的觀察證明,起始劑量2MG過小,會增加達(dá)標(biāo)需要的時間和增加測定INR的次數(shù)。根據(jù)INR值確定下次服用的華法林劑量,第1周至少查3次INR,1周后改為每周1次,直到第4周。INR達(dá)到目標(biāo)值并穩(wěn)定后連續(xù)2次在治療的目標(biāo)范圍,每4周查一次INR。如遇INR過高或過低,或由于某種原因改變了華法林的劑量,應(yīng)根據(jù)INR值和劑量調(diào)整情況確定下次觀察INR的時間。劑量調(diào)整應(yīng)依據(jù)INR值,每次增減的量為05~1MG/D。每次調(diào)整劑量之前,應(yīng)仔細(xì)尋找INR發(fā)生變化的原因,并且應(yīng)該參考先前一段時間測定的INR數(shù)值。如果以往INR一直很穩(wěn)定,偶爾出現(xiàn)INR增高的情況,只要INR不超過35~40,可以暫時不調(diào)整劑量,3~7天再查INR。INR測定也不宜過勤。許多因素,包括旅行、膳食、環(huán)境、身體狀況、患其他疾病和用藥,都會使INR發(fā)生變化。當(dāng)有影響用藥反應(yīng)的因素存在時,如感冒病人服用阿司匹林,因故停用藥物或者服藥不規(guī)則時,應(yīng)額外多做幾次INR,以便及時調(diào)整藥物劑量,維持INR在治療的目標(biāo)范圍以內(nèi)。2影響INR的部分因素某些藥物可通過抑制VK依賴性凝血因子的合成、增加代謝清除和干擾其他止血途徑影響華法林的藥代動力學(xué)。食物中VK的攝入和吸收的波動影響華法林的療效。肝功能不全使VK依賴的凝血因子合成障礙,對華法林的反應(yīng)增強。高代謝狀態(tài),如甲狀腺功能亢進(jìn),增加凝血因子的代謝,增強華法林的療效。維生素K能夠拮抗華法林的抗凝藥效,從而降低抗凝作用。為了維持華法林穩(wěn)定的抗凝強度,病人有必要保持飲食的相對平衡,尤其是富含VK的綠色蔬菜的攝入量保持相對平衡。3使用口服抗凝藥物出血處理口服抗凝藥物華法林在有適應(yīng)證的病人能有效防止血栓栓塞的發(fā)生。合理用藥和監(jiān)測,嚴(yán)重出血尤其腦出血事件少見,與安慰劑或者不用華法林比較沒有顯著性增加。使用口服抗凝藥物腦出血的發(fā)生率非常低,總體上年發(fā)生率05或更低,與阿司匹林比較無顯著性差
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簡介:OCUSINGONWAYSANDMEANSOFIMPROVINGANDUPGRADINGWORK,FURTHERDEVELOPMENTOF“THREETOSPLIT“AFULLYGRASP“NOUNAUTHORISED“CREATEDTHETOWNSHIP“NOUNAUTHORISED“CREATEDTHEEXISTINGBUILDING“ONEHOUSEHOLD,ONEDOCUMENT“SURVEYANDFILESTORAGEWORKMUSTBEUNCONDITIONALANDFULLCOVERAGEMAINCORRIDORLEADINGTOTHETOWNROAD,RIVERVILLAGE,THECENTRALBUILTUPAREAOFTHETOWNONBOTHSIDESMUSTBETOCREATEA“NOUNAUTHORISEDVILLAGE“ACCORDINGTO“FIVEHUNDREDVILLAGES“CREATEDANDSHANTYTOWNS,VILLAGES,OLDHOUSES,RECONSTRUCTIONOFOLDPLANT,EXPANDCREATE,UPGRADINGCREATESFILES,THEREAL“NOUNAUTHORISEDVILLAGE“CREATEDINTOTHEBENEFITOFTHEPEOPLEOFVERYGOODTHINGBTOSTRICTLYMANAGECOUNTASUNAUTHORISEDCONTROLSPROMOTINGTHE“NEW“CONTROLWORKTOMOVETHECENTEROFGRAVITY,MANAGEMENTMEASURESTOTHEFRONT,ANDEARNESTLYPIPESEFFECTIVELYASTRICTNEWUNAUTHORISEDNETWORKRESPONSIBILITYSECTORSSUCHASLAND,HOUSINGANDBASICSTATIONSSTATIONSANDTHETOWNSHIPOFGRIDACCOUNTABILITYMECHANISMSMUSTBESTRICTLYINACCORDANCEWITHTHENEWREGULATORYREQUIREMENTS,EFFECTIVEIMPLEMENTATIONOFTHEAREAOFRESPONSIBILITYOFTHENEWINSPECTIONS,SUPPRESSION,DEMOLITIONWORKTOENSURETHATTHENEW“ZEROTOLERANCE“SECOND,PUBLICSECURITY,WATER,ELECTRICITY,WATER,OCEANSANDFISHERIES,TOURISMCOLLABORATION,MARKETSUPERVISIONDEPARTMENTSSHOULDSTRICTLYENFORCETHEILLEGALCONSTRUCTIONOFDISPOSALOFRELEVANTPROVISIONSOFTHEREGULATIONS,EFFECTIVEFULFILMENTOFRESPONSIBILITIES,PARTICULARLYINELECTRICITYANDWATERSUPPLY,ANDOTHERUNITSMAYNOTBENEWILLEGALBUILDINGSTOSUPPLYWATERANDELECTRICITYSUPPLYWHILEMOREREGULATIONTOPREVENTPERSONALPRIVACYVIOLATIONSILLICITTRADINGINILLEGALCONSTRUCTIONINTHEMINISTRYOFPUBLICSECURITYSECTORTOSTRICTLYFROMTHEBLOWTHREEISTOCREATEADDITIONALOFFENCEREPORTINGSYSTEMOFINCENTIVESACCORDINGTOBUILDINGLAWANDCOVERSANAREAOFNATURE,TOREPORTTIMELYDEGREEDIVIDEDREPORTGRADE,EFFECTIVEAFTERTHEREMOVALOFCERTAININCENTIVESCINTEGRATEDIMPLEMENTATION“,BUILDINGDEMOLITION,MODIFICATION,USE“COMBINATIONDEMOLITIONISTHEMEANSANDPURPOSEBUILTISTOADHERETOTHEBUILDINGDEMOLISHED,COMBINATIONOFCONSTRUCTIONANDDEMOLITIONWASTE,DEMOLISHEDWITHCOMBINEDEFFORTSTOIMPROVETHESCIENTIFICLEVELOFTHREETOSPLITSECOND,WEMUSTPAYATTENTIONTO“THREETOSPLIT“AND“FIVEHUNDRED“AND“FIVEWATERTREATMENT“,“THREEOFTHEFOURSIDES“,THESHACKDISTRICTTRANSFORMATION,ANDDANGEROUSOLDROOMTRANSFORMATIONAND“TWOROADSIDES“,SERIESWORKORGANICCOMBINEDUP,ACTIVEDORIVER,ANDALONGDEMOLITIONWORK,ANDMANPOWERADVANCEVILLAGEINTHE,ANDOLDRESIDENTIALDEMOLITIONWORK,TOIMPROVEDMASSESHOUSINGCONDITIONSANDLIVEENVIRONMENTTHREETOPUT“THREEMODIFIEDASPLIT“ASTRADITIONALLOW,ANDSMALL,ANDBULKINDUSTRYSTRUCTURETRANSFORMATIONUPGRADEOFIMPORTANTINITIATIVESTOCAUGHT,SPEEDUPADVANCEINDUSTRYPARK,EFFECTIVEOPTIMIZATIONPARKENVIRONMENTANDIMPROVEIDLELANDOFUTILIZATION,REALACHIEVEDENVIRONMENTIMPROVEDANDPRODUCTIVITYDEVELOPMENTMUTUALPROMOTINGTOTALWINFIVE,FIRMLYIMPLEMENT,PROMOTINGWORKAHEAD,TOCREATEHIGHLIGHTSTHIRDDEPLOYMENT,IMPLEMENTATIONOFSEVEN,THENITISIMPERATIVETOSTRENGTHENRESPONSIBILITYANDIMPROVETHEMECHANISMSANDIMPLEMENTATIONALLLOCALITIESANDDEPARTMENTSMUSTBECONVINCEDTHATGOALS,GOINGALLOUT,MUSTERINGSPIRIT,WORKTOGETHERTOENSURETHATTHISYEARSOBJECTIVESCARRYOUTTASKS,ATTHEFOREFRONTFIRST,WEMUSTSTRENGTHENTHELEADERSHIPTOIMPLEMENTDEPARTMENTSATALLLEVELSSHOULDALWAYSWORKANDRURAL“FIVEWATERTREATMENT“,“THREETOSPLIT“INANIMPORTANTPOSITION,ANDCARRYTHEMAINRESPONSIBILITY,MAINLEADERPERSONALLY,LEADERSARRESTEDANDLAYERSOFRESPONSIBILITYRANKTRANSMISSIONPRESSUREESTABLISHEDHIERARCHICALACCOUNTABILITY,ANDWORKTOGETHERTOPROMOTETHEWORKOFTHEMECHANISM,ACONCERTEDEFFORTPAYATTENTIONTOIMPLEMENTATIONCOUNTYNONGBAN,FLOOD,THREETOONEDOWNTOFURTHERPLAYALEADINGCATCHTOTAL,INTEGRATEDANDCOORDINATEDROLEOFALLKINDSIS“LONG“,“SHERIFF““INSPECTOR“TOEFFECTIVELYFULFILLTHEIRRESPONSIBILITIES,FORMEDTHEALIGNMENTONTHEFIRELINEANDMANAGEMENTALIVELYSITUATIONSECOND,WEMUSTSTRENGTHENTHETESTIMPLEMENTATIONOFTHEGOVERNORROLEPLAYTHEGOVERNORGOTTHEBATON,FORAGRICULTURALANDRURALFOCUSAND“FIVEWATERTREATMENT“,“THREETOSPLIT“WORK,REFINEIMPROVEASSESSMENTMETHODSANDEVALUATIONSYSTEM,ACCURATEASSESSMENTCOMBINEDWITH“DAREPLAY,TREEBENCHMARK“STYLEBUILDINGFIVEMAJOROPERATIONS,CARRYONANDGAINFIRSTHANDEXPERIENCEOFSUPERVISION,INPARTICULAR,TOSTRENGTHENTHEFOCUSONTHE“LONG“SIGNS“GOLEFT“,“NAMES“SUCHASSUPERVISION,URGEDALLLEVELSLONGERONDUTYINPLACETHROUGHTHESUPERVISORYASSESSMENT,TOPROMOTEHABITS,STIMULATINGPOWERTHIRD,WEMUSTSTRENGTHENIMPLEMENTATIONSTYLEDEPARTMENTSATALLLEVELSTOWORKINRURALAREASAND“FIVEWATERTREATMENT“,“THREETOSPLIT“ASTRAININGCADRESFORMAJORPLATFORMS,COMPETEAGAINSTLARGEEXAMINATIONROOM,INSPECTIONCADRESWORKPERFORMANCEOFTHERING,WATERCONTROLANDTHEJAPANESEPULLEDAWORKOUT,TRAINING,DISCOVERYANDSELECTIONOFCADRESTHANGOODCATCHUP,FIRSTTOEXCELLENCEORIENTEDPARTYMEMBERSANDCADRESATALLLEVELSMUSTADHERETOTHERURAL,WATERCONTROLANDTHEJAPANESEPULLEDAGRASSROOTS,“PUTDOWNTHESHELF,LEANED“PRAGMATICSTYLE,THESPIRITOFPLAY,BECOMEABENCHMARKMODELFOUR,WEMUSTSTRENGTHENPROPAGANDAIMPLEMENTATIONCOMPREHENSIVEUTILIZATIONOFMICROCREDIT,MICROBLOGGING,NEWMEDIA,MINING,SUMMARIZING,GOODPUBLICITYWORKINTHECOUNTRYSIDEAND“FIVEWATERTREATMENT“,“THREETOSPLIT“ADVANCEDMODELS,POINTTOGATHERPOSITIVEENERGYFORTHECOMMUNITYTOSEETHERESULTSOFOURWORKINTIME,INCREASEPUBLICAWARENESS,PARTICIPATIONRATES,SATISFACTIONANDSUPPORTPLAYGONGQINGFU,AMASSORGANIZATIONANDGRASSROOTSSUCHASSCHOOLS,COMMUNITYTHEROLEOF目錄1、編制依據(jù)22、工程概況221、工程概況222、文明施工目標(biāo)23、文明施工及環(huán)境管理架構(gòu)24、文明施工及環(huán)境管理保證措施35、文明施工管理制度66、環(huán)境管理方案及保護(hù)措施961、環(huán)境保護(hù)組織管理依據(jù)862、環(huán)境保護(hù)具體管理措施863、施工現(xiàn)場環(huán)境因素管理措施107、安全生產(chǎn)管理措施及保證體系12OCUSINGONWAYSANDMEANSOFIMPROVINGANDUPGRADINGWORK,FURTHERDEVELOPMENTOF“THREETOSPLIT“AFULLYGRASP“NOUNAUTHORISED“CREATEDTHETOWNSHIP“NOUNAUTHORISED“CREATEDTHEEXISTINGBUILDING“ONEHOUSEHOLD,ONEDOCUMENT“SURVEYANDFILESTORAGEWORKMUSTBEUNCONDITIONALANDFULLCOVERAGEMAINCORRIDORLEADINGTOTHETOWNROAD,RIVERVILLAGE,THECENTRALBUILTUPAREAOFTHETOWNONBOTHSIDESMUSTBETOCREATEA“NOUNAUTHORISEDVILLAGE“ACCORDINGTO“FIVEHUNDREDVILLAGES“CREATEDANDSHANTYTOWNS,VILLAGES,OLDHOUSES,RECONSTRUCTIONOFOLDPLANT,EXPANDCREATE,UPGRADINGCREATESFILES,THEREAL“NOUNAUTHORISEDVILLAGE“CREATEDINTOTHEBENEFITOFTHEPEOPLEOFVERYGOODTHINGBTOSTRICTLYMANAGECOUNTASUNAUTHORISEDCONTROLSPROMOTINGTHE“NEW“CONTROLWORKTOMOVETHECENTEROFGRAVITY,MANAGEMENTMEASURESTOTHEFRONT,ANDEARNESTLYPIPESEFFECTIVELYASTRICTNEWUNAUTHORISEDNETWORKRESPONSIBILITYSECTORSSUCHASLAND,HOUSINGANDBASICSTATIONSSTATIONSANDTHETOWNSHIPOFGRIDACCOUNTABILITYMECHANISMSMUSTBESTRICTLYINACCORDANCEWITHTHENEWREGULATORYREQUIREMENTS,EFFECTIVEIMPLEMENTATIONOFTHEAREAOFRESPONSIBILITYOFTHENEWINSPECTIONS,SUPPRESSION,DEMOLITIONWORKTOENSURETHATTHENEW“ZEROTOLERANCE“SECOND,PUBLICSECURITY,WATER,ELECTRICITY,WATER,OCEANSANDFISHERIES,TOURISMCOLLABORATION,MARKETSUPERVISIONDEPARTMENTSSHOULDSTRICTLYENFORCETHEILLEGALCONSTRUCTIONOFDISPOSALOFRELEVANTPROVISIONSOFTHEREGULATIONS,EFFECTIVEFULFILMENTOFRESPONSIBILITIES,PARTICULARLYINELECTRICITYANDWATERSUPPLY,ANDOTHERUNITSMAYNOTBENEWILLEGALBUILDINGSTOSUPPLYWATERANDELECTRICITYSUPPLYWHILEMOREREGULATIONTOPREVENTPERSONALPRIVACYVIOLATIONSILLICITTRADINGINILLEGALCONSTRUCTIONINTHEMINISTRYOFPUBLICSECURITYSECTORTOSTRICTLYFROMTHEBLOWTHREEISTOCREATEADDITIONALOFFENCEREPORTINGSYSTEMOFINCENTIVESACCORDINGTOBUILDINGLAWANDCOVERSANAREAOFNATURE,TOREPORTTIMELYDEGREEDIVIDEDREPORTGRADE,EFFECTIVEAFTERTHEREMOVALOFCERTAININCENTIVESCINTEGRATEDIMPLEMENTATION“,BUILDINGDEMOLITION,MODIFICATION,USE“COMBINATIONDEMOLITIONISTHEMEANSANDPURPOSEBUILTISTOADHERETOTHEBUILDINGDEMOLISHED,COMBINATIONOFCONSTRUCTIONANDDEMOLITIONWASTE,DEMOLISHEDWITHCOMBINEDEFFORTSTOIMPROVETHESCIENTIFICLEVELOFTHREETOSPLITSECOND,WEMUSTPAYATTENTIONTO“THREETOSPLIT“AND“FIVEHUNDRED“AND“FIVEWATERTREATMENT“,“THREEOFTHEFOURSIDES“,THESHACKDISTRICTTRANSFORMATION,ANDDANGEROUSOLDROOMTRANSFORMATIONAND“TWOROADSIDES“,SERIESWORKORGANICCOMBINEDUP,ACTIVEDORIVER,ANDALONGDEMOLITIONWORK,ANDMANPOWERADVANCEVILLAGEINTHE,ANDOLDRESIDENTIALDEMOLITIONWORK,TOIMPROVEDMASSESHOUSINGCONDITIONSANDLIVEENVIRONMENTTHREETOPUT“THREEMODIFIEDASPLIT“ASTRADITIONALLOW,ANDSMALL,ANDBULKINDUSTRYSTRUCTURETRANSFORMATIONUPGRADEOFIMPORTANTINITIATIVESTOCAUGHT,SPEEDUPADVANCEINDUSTRYPARK,EFFECTIVEOPTIMIZATIONPARKENVIRONMENT浙商國際商貿(mào)中心建筑工地安全文明專項施工方案第3頁組長負(fù)責(zé)文明施工現(xiàn)場全面工作;副組長負(fù)責(zé)文明施工、環(huán)境管理的日常工作;組員1負(fù)責(zé)現(xiàn)場圍蔽、現(xiàn)場防火、治安綜合治理;組員2負(fù)責(zé)封閉管理、廚房、廁所;組員3負(fù)責(zé)施工文件資料、衛(wèi)生保健;組員4負(fù)責(zé)材料堆放、施工現(xiàn)場;組員5負(fù)責(zé)現(xiàn)場宿舍、宣傳、環(huán)境保護(hù)。4、文明施工及環(huán)境管理保證措施、文明施工及環(huán)境管理保證措施嚴(yán)格執(zhí)行建筑施工安全檢查標(biāo)準(zhǔn)及寧夏省文明施工規(guī)定,做好各項管理工作。41、制定并嚴(yán)格執(zhí)行以下文明施工措施和規(guī)范,設(shè)立專職文明施工現(xiàn)場管理小組責(zé)任人,24小時管理以下主要內(nèi)容⑴、現(xiàn)場環(huán)境衛(wèi)生管理;⑵、噪音防護(hù)處理;⑶、汽車出入高壓水槍沖洗;組員3樊超組員4劉軍組員5敖志超組員1王聰組長楊進(jìn)起副組長楊衛(wèi)軒組員2鄧瑞組員3樊超組員4劉軍組員5敖志超組員1王聰組長楊進(jìn)起副組長楊衛(wèi)軒組員2鄧瑞組員3樊超組員4劉軍組員5敖志超
下載積分: 6 賞幣
上傳時間:2024-03-17
頁數(shù): 19
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