基于浅静脉血管评级的护士能级匹配联合视觉辅助技术在CT增强扫描检查静脉留置针穿刺中的应用效果

目的 探讨基于浅静脉血管评级的护士能级匹配联合视觉辅助技术在CT增强扫描检查静脉留置针穿刺中的应用效果。方法 将82例行CT增强检查的患者按照检查的时间顺序分为对照组(45例)和观察组(37例)。对照组行常规静脉留置针穿刺,观察组基于浅静脉血管评级情况匹配相应能级护士和视觉辅助技术进行静脉留置针穿刺。比较两组患者的静脉留置针一次性穿刺成功率、一次性CT增强扫描成功率、造影剂外渗发生率及穿刺时间。结果 观察组患者一次性穿刺成功率及CT增强扫描成功率均高于对照组,造影剂外渗发生率低于对照组(均P<0.05),但两组穿刺时间差异无统计学意义(P>0.05)。结论 在CT增强扫描检查中,采用基于浅静脉血管评级的护士能级匹配联合视觉辅助技术实施静脉留置针穿刺,可以提高静脉留置针一次性穿刺成功率和一次性CT增强扫描成功率,降低造影剂外渗发生率,确保医疗安全。     

深静脉留置针在危重病患者CT增强扫描中的应用

目的 探讨深静脉留置针与普通静脉留置针在危重病患者CT增强扫描中的应用效果,为危重病患者CT增强扫描提供最佳穿刺工具及方法.方法 将采用静脉留置针行CT增强扫描的506例患者随机分为试验组(260例)和对照组(246例).试验组患者使用深静脉留置针,对照组患者使用常规静脉留置针,比较两组患者造影剂外渗率、一次穿刺成功率及一次增强成功率.结果 试验组和对照组患者造影剂外渗率(0.08%与11.79%)比较,差异有统计学意义(P＜0.01);一次增强成功率(98.08%与94.31%)比较,差异有统计学意义(P＜0.05);而一次穿刺成功率(95.00%与96.34%)比较,差异无统计学意义(P＞0.05).结论 CT增强扫描时配合使用高压注射器,在危重病患者中深静脉留置针明显优于普通静脉留置针,可降低造影剂外渗率,减轻患者的痛苦及保证增强效果.     

静脉留置针和蝶翼针头在CT增强护理中的应用比较

目的:探讨静脉留置针和蝶翼针头在CT增强护理中的应用价值比较。方法:采用回顾性方法,选取收治的CT增强患者250例,把他们随机分为两组,对照组和观察组,每组各125例患者,对照组患者使用蝶翼针头进行静脉穿刺后做CT增强扫描,观察组使用静脉留置针做静脉穿刺后做CT增强扫描,比较两组患者一次穿刺成功率、造影剂外渗率以及一次增强成功率,观察其疗效。结果:采用静脉留置针进行CT增强扫描的患者均顺利完成扫描,未出现造影剂渗漏现象;而采用传统蝶翼针头时,其中22例患者完成扫描却有少量造影剂外渗,另有4例患者造影剂大量外渗,被迫中断增强扫描。结论:在对患者进行CT增强扫描时静脉留置针明显比蝶翼针头有更好地效果,有效地避免了造影剂外渗的不良后果。     

耐高压留置针在CT/MRI增强检查中的应用价值研究

目的:探讨耐高压留置针在计算机断层扫描/磁共振成像(CT/MRI)增强检查中的应用价值.方法:选取1000例行CT/MRI增强检查的患者为研究对象,依据留置针不同分为对照组和观察组,每组各500例.增强扫描检查注入造影剂时,观察组患者使用耐高压留置针;对照组使用常规静脉留置针,比较两组患者进入检查室到开始CT/MRI检查所用时间(T1)及检查结束到离开检查室所用时间(T2)、造影剂外渗发生率、不良事件发生率及满意度.结果:观察组T1、T2及总耗时、造影剂外渗发生率及护理不良事件总发生率低于对照组(P＜0.05),总满意率高于对照组(P＜0.05).结论:在CT/MRI增强检查中使用耐高压留置针可减少外渗发生率,缩短护理耗时,减少不良事件发生风险,提高满意度.     

不同型号静脉留置针在CT增强检查中的应用效果比较

目的 对比两种不同型号(18 G与20 G)静脉留置针在CT增强检查中的应用效果.方法 选择2016年1~7月期间在我院接受CT增强检查的300例患者为研究对象,根据随机数表法分为18 G组和20 G组,每组150例,在CT增强检查中分别采用带延长管的18 G、20 G静脉留置针,比较两组患者的应用效果.结果 两组患者的年龄、性别等比较差异均无统计学意义(P>0.05);18 G组和20 G组患者的一次穿刺成功率(92.00%vs 95.33%)、造影剂外渗率(1.33%vs 2.00%)及CT增强效果优良率(100%vs 98.67%)比较差异均无统计学意义(P>0.05);18 G组患者达到设定流速的比例为99.33%,明显高于对照组的92.67%,差异有统计学意义(P<0.05).结论 18 G静脉留置针在CT增强检查中具有更好的应用效果.     

CT增强扫描病人两种注射针的应用效果分析

目的探讨CT增强扫描病人最佳注射针的应用效果。方法选取2009年10月南充市中心医院CT室增强扫描的病人200例,随机分为蝶形针组和留置针组,每组各100例,比较两组病人静脉穿刺成功率、静脉外渗率、病人满意率及成本。结果蝶形针组病人静脉穿刺成功率97%,静脉外渗率5%,病人满意率87%,成本4元;留置针组病人静脉穿刺成功率100%,静脉外渗率0,病人满意率95%,成本17.6元.两组比较,留置针组静脉外渗率、病人满意率均优于蝶形针组（P〈0.05）,但成本高于蝶形针组13.6元,静脉穿刺成功率两组无差异性（P〉0.05）。结论为了减少CT增强病人注射的并发症,保护病人血管,提高病人满意率,选用留置针较好。     

护理干预在新生儿静脉留置针输液中的效果分析

目的探讨针对性护理干预在新生儿静脉留置针输液中的护理效果。方法选择需行静脉留置针输液的新生儿共185例,上述患儿随机分为两组,观察组和对照组,对照组患儿实施静脉留置针常规护理干预,观察组在对照组护理干预的基础上实施针对输液外渗、堵管、针头脱出、静脉炎等具有针对性的护理干预。在输液过程中观察两组患儿静脉留置针的留置时间,有效利用率,输液外渗、堵管、针头脱出、静脉炎的发生率。结果观察组静脉留置针留置的时间、留置针的有效利用率均高于对照组,差异均有统计学意义(P<0.05);堵管的发生率低于对照组,差异有统计学意义(P<0.05);观察组液体外渗、针头脱出、静脉炎的发生率与对照组无差异(P>0.05)。结论在新生儿静脉留置针应用过程中实施针对性的护理干预有助于提高静脉留置针留置时间,留置针的有效利用率,减少堵管,从而提高静脉留置针输液效果。     

护理干预在新生儿静脉留置针输液中的效果分析

目的:探讨护理干预在新生儿静脉留置针输液中的护理效果。方法:选择需行静脉留置针输液新生儿共300例,上述患儿随机分为两组,观察组和对照组,对照组患儿实施静脉留置针常规护理干预,观察组在对照组护理基础上实施针对输液外渗、粘贴伤、针头脱出等专门护理干预;在输液过程中观察两组患儿是否出现输液外渗、是否出现透明贴产生的粘贴伤,观察输液过程中是否出现针头脱出等情况。结果:观察组输液外渗发生率低于对照组,差异有统计学意义(P<0.05);观察组粘贴伤发生率低于对照组,差异有统计学意义(P<0.05);观察组针头脱出发生率低于对照组,差异有统计学意义(P<0.05)。结论:新生儿静脉留置针应用过程中实施专门的护理干预有助于减少输液外渗、粘贴伤、针头脱出等发生率,提高静脉留置针输液效果,护理效果显著。     

CT室增强扫描病人两种注射针的应用研究

目的:对CT室增强扫描病人注射针的应用效果进行探讨。方法:随机的选取我院实施CT室增强扫描的患者200例,将其均分为两组,分别作为对照组与观察组,对照组的患者应用蝶形针注射,观察组的患者应用留置针注射,对两组患者的静脉外渗率、穿刺成功率、穿刺成本及患者的满意度进行对比分析结果:两组患者相比,静脉穿刺成功率没有明显的差异,而在静脉外渗率及患者满意度上具有明显的差异,并且P0.05,差异具有统计学意义,观察组明显优于对照组,但是观察组的穿刺成本远远高于对照组。结论:在实际的CT室增强扫描注射工作中,为了有效保护患者血管,减少并发症的发生,提升患者的满意度,留置针注射具有较好的应用效果。     

静脉留置针置管改进技术对穿刺成功率的影响

目的 探讨静脉留置针的不同穿刺方法对静脉留置针穿刺成功率的影响.方法 将行静脉留置针穿刺的160例肺癌患者随机分为观察组80例和对照组80例.对照组按传统的静脉留置针的方法穿刺并固定,观察组采用改良的静脉留置针的方法穿刺并用贴膜固定,比较两组穿刺的成功率.结果 观察组的静脉留置针的一次性穿刺成功率为97.5%,对照组为77.5%,差异有统计学意义（P＜0.05）,且渗液渗血、发生静脉炎等并发症发生情况与对照组比较,差异无统计学意义（P＞0.05）.结论 采用改良的静脉留置针的穿刺方法可明显提高静脉留置针的穿刺成功率,节约护理操作时间,对穿刺局部并发症的发生无影响.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.