静脉留置针在临床中的新用途

静脉留置针除用于静脉输液外,还可用于胸腔穿刺、腹腔穿刺及臂丛神经阻滞麻醉。     

介绍几种特殊病儿的静脉穿刺

小儿静脉穿刺是儿科治疗和抢救的一项基本措施 ,也是护理工作的一项基本功。提高一次性穿刺成功率对及时和抢救重危患儿生命及特殊病种患儿生命将起到重要作用 ,现就一些营养不良型、失血失液型、肥胖型、水肿型等特殊患儿静脉穿刺操作方法及常见静脉穿刺部位浅谈一下。1　常见静脉穿刺部位1 1　头部静脉常用穿刺部位1 1 1　额静脉　前额隆起部 (滑车上静脉内侧 1～ 2ｃｍ处 ) ,常用于静脉输液。1 1 2　滑车上静脉　眼眶内眦眉上 3～ 4ｃｍ ,常用于静脉输液、静脉用药。1 1 3　颞浅静脉　外耳前上方 (太阳穴后上方约 2ｃｍ处 ) ,常用…     

两种小儿头皮静脉穿刺方法的效果比较

目的：提高小儿头皮静脉穿刺成功率,减轻穿刺疼痛。方法：将168例患儿随机分为试验组和对照组各84例,试验组穿刺者行静脉穿刺时操作侧手臂肘部固定在输液操作台上形成支撑,对照组穿刺时操作侧手臂悬空,比较两组患儿静脉穿刺一次成功率和疼痛程度。结果：试验组患儿静脉穿刺一次成功率明显高于对照组;疼痛评估得分明显低于对照组,差异有统计学意义。结论：肘部支撑法用于小儿头皮静脉穿刺是一种可行的方法,值得推广。     

介绍小儿静脉血管穿破后的几种补救方法

小儿静脉穿刺是儿科门诊工作中一项重要的技能操作,是患儿和家长衡量护士技术水平高低的重要指标。临床操作中经常会发生因静脉血管的穿破导致的穿刺失败,近年来,我们采用了静脉穿刺补救法用于小儿静脉血管穿破后的补救,提高了静脉穿刺成功率,取得满意效果。现报告如下。     

幼儿头皮静脉穿刺约束带的制作与应用

小儿头皮静脉穿刺和静脉采血是门诊注射室常见的一项基本操作，常用于小儿疾病的治疗和抢救中，但是绝大多数患儿在穿刺时因疼痛的刺激或恐惧，出现躁动或用手伸抓穿刺部位，从而影响了穿刺成功率。当不使用约束带穿刺时需要家属或其他护理人员一起协助，但由于经验不足，经常导致穿刺失败，而且浪费时间和人力，目前临床上使用的其他约束带由于设计不针对头皮静脉输液和静脉采血，因此，不适用于婴幼儿头皮静脉穿刺。我院制作了一种结构简单、使用方便、安全可靠、省时省力的婴幼儿头皮静脉穿刺约束带，应用于临床，效果良好，报告如下。     

静脉穿刺引导仪在小儿头皮静脉穿刺中的应用研究

[目的]提高小儿头皮静脉穿刺成功率，解决穿刺难题。[方法]将小儿头皮静脉穿刺病人随机分成实验组和对照组。实验组用静脉穿刺引导仪进行静脉穿刺，对照组用手工静脉穿刺。将肉眼可见头皮静脉与肉眼不可见头皮静脉均随机分成实验组和对照组。分析两组不同静脉一次穿刺成功率。[结果]使用静脉穿刺引导仪穿刺肉眼不可见的静脉一次成功率明显高于徒手穿刺。[结论]静脉穿刺引导仪能提高小儿头皮静脉穿刺成功率，特别对肉眼不可见的静脉有较好的穿刺效果。     

静脉穿刺引导仪在小儿头皮静脉穿刺中的应用研究

[目的]提高小儿头皮静脉穿刺成功率,解决穿刺难题.[方法]将小儿头皮静脉穿刺病人随机分成实验组和对照组.实验组用静脉穿刺引导仪进行静脉穿刺,对照组用手工静脉穿刺.将肉眼可见头皮静脉与肉眼不可见头皮静脉均随机分成实验组和对照组,分析两组不同静脉一次穿刺成功率.[结果]使用静脉穿刺引导仪穿刺肉眼不可见的静脉一次成功率明显高于徒手穿刺.[结论]静脉穿刺引导仪能提高小儿头皮静脉穿刺成功率,特别对肉眼不可见的静脉有较好的穿刺效果.     

提高静脉穿刺成功率的护理技巧总结

总结了3000例各类病人的手背静脉穿刺,并对影响穿刺成功率的因素进行研究。主要包括对手背摆放的位置,进针技巧,止血带的张力,头皮针的选择,拔针方法及对肥胖病人、水肿病人、老年人、寒冷天气时如何提高穿刺成功率的方法进行总结,并将硝酸甘油注射液用于手背静脉穿刺中的具体操作进行了介绍。认为手背静脉穿刺掌握好穿刺技巧和要领,加之配合硝酸甘油注射液在手背静脉穿刺中的局部应用,可提高手背静脉穿刺的成功率,具有推广价值。     

离心方向静脉穿刺在静脉穿刺困难病人中的应用

[目的]探讨离心方向静脉穿刺在静脉穿刺困难病人中的应用。[方法]将300例静脉穿刺难度大的病人随机分为观察组和对照组，每组150例，对照组采用常规向心方向静脉穿刺，观察组采用离心方向静脉穿刺。比较两组病人一次性静脉穿刺成功率、输液成功率和回血率。[结果]观察组病人一次性静脉穿刺成功率、输液成功率和回血率均高于对照组（P〈O．05）。[结论]穿刺困难静脉行离心方向静脉穿刺输液，回血快，一次性穿刺成功率和输液成功率高。     

锁骨下静脉穿刺置管术临床应用体会(附272例报告)

目的：总结应用锁骨下静脉穿刺置管术的体会。方法：回顾性分析272例锁骨下静脉穿刺置管术的临产资料。结果：272例锁骨下静脉穿刺置管术用于监测中心静脉压、指导补液194例，血液净化55例，临时经静脉心内膜心脏起搏8例，慢性疾病长期静脉输液15例，271例穿刺成功，发生并发症7例，其中误入锁骨下动脉6例，1例发生气胸．无感染及栓塞等并发症。结论：锁骨下静脉穿刺置管术可广泛用于临床急救及其他治疗。     

首次住院治疗鼻咽癌病人应对方式和社会支持的相关性分析

[目的]探讨首次住院治疗鼻咽癌病人应对方式和社会支持的相关性.[方法]采用Jalowiec应对量表、肖水源的社会支持量表对入住放疗三区的150例鼻咽癌病人进行问卷调查.[结果]不同人群特征的鼻咽癌病人首次住院治疗期间所采取的应对方式不同：男性多采用逃避、情感应对方式;老年人多采用听天由命应对方式;文化程度高者多采用面对、乐观应对方式;自费病人多采用逃避应对方式;医保病人多采用支持应对方式.面对、乐观、支持应对方式与社会支持呈正相关;逃避、听天由命、情感应对方式与社会支持呈负相关.[结论]良好的社会支持有助于鼻咽癌病人在住院治疗期间采取积极的应对方式面对疾病、配合治疗.     

应用自动同步负压活检装置进行肾穿刺的护理

目的 :探讨应用自动同步负压活检装置进行肾穿刺的护理方法。方法 :应用自动同步负压活检装置对 72 0例肾病患者进行肾活检的护理。结果 :肾活检 72 0例 ,成功率 99.9%。 11例出现肉眼血尿 ,3例发现包膜下小血肿。结论 :应用自动同步负压活检装置进行肾穿刺的护理方法简单、易行 ,科学性、实用性强     

临床使用抗生素的调查分析

对１９９５年２月～６月全院各科出院病历１２０３份进行回顾性调查，结果有９３９例使用抗生素，其中儿科使用率最高，产科最低。４７．９％用于治疗感染，５２．１％用于预防感染；４．８％参考药敏试验结果用药。给药途径以静脉为多，使用抗生素以青霉素为多。提出临床应合理应用抗生素     

静脉输液拔针后两种按压法的效果观察

对静脉输注脑活素、蝮蛇抗栓酶的病人，在输注结束拔针后，采用大面积按压法按压穿刺部位，并与传统的按压法进行了比较。输注脑活素的２２８例次中，１０８例次采用传统按压法，皮下出血率为３７．９６％；１２０例次采用大面积按压法，皮下出血率为３．３３％，二者比较有显著性差异（Ｐ＜０．００５）；输注蝮蛇抗栓酶的２３０例次中，１１０例次采用传统按压法，皮下出血率为４５．４５％，１２０例次采用大面积按压法，皮下出血率为５．００％，二者比较有显著性差异（Ｐ＜０．００５）。本结果提示静脉输注抗凝、溶栓类药物拔针后，大面积按压法优于传统按压法。     

Rapid sequence induction (RSI) in trauma patients: Insights from healthcare providers

BACKGROUND: We aimed to describe the current practice of emergency physicians and anaesthesiologists in the selection of drugs for rapid-sequence induction (RSI) among trauma patients. METHODS: A prospective survey audit was conducted based on a self-administered questionnaire among two intubating specialties. The preferred type and dose of hypnotics, opioids, and muscle relaxants used for RSI in trauma patients were sought in the questionnaire. Data were compared for the use of induction agent, opioid use and muscle relaxant among stable and unstable trauma patients by the intubating specialties. RESULTS: A total of 102 participants were included; 47 were anaesthetists and 55 were emergency physicians. Propofol (74.5%) and Etomidate (50.0%) were the most frequently used induction agents. Significantly higher proportion of anesthesiologist used Propofol whereas, Etomidate was commonly used by emergency physicians in stable patients (P=0.001). Emergency physicians preferred Etomidate (63.6%) and Ketamine (20.0%) in unstable patients. The two groups were comparable for opioid use for stable patients. In unstable patients, use of opioid differed significantly by intubating specialties. The relation between rocuronium and suxamethonium use did change among the anaesthetists. Emergency physicians used more suxamethonium (55.6% vs. 27.7%, P=0.01) in stable as well as unstable (43.4 % vs. 27.7%, P=0.08) patients. CONCLUSION: There is variability in the use of drugs for RSI in trauma patients amongst emergency physicians and anaesthesiologists. There is a need to develop an RSI protocol using standardized types and dose of these agents to deliver an effective airway management for trauma patients.     

人性化护理对慢性肾衰竭行血液透析患者生活质量的影响

目的:探讨人性化护理应用于行血液透析的慢性肾衰竭患者的临床效果。方法:将92例行血液透析的慢性肾衰竭患者随机分为实验组(n=47)和对照组(n=45)。对照组给予常规护理,实验组给予人性化护理。结果:实验组生活质量评分显著优于对照组(P0.01)。结论:对行血液透析的慢性肾衰竭患者采取人性化护理,可以显著提高患者舒适度,改善患者生活质量,值得在临床上应用和推广。     

胺碘酮对恶性室性心律失常治疗的疗效观察

目的 :观察胺碘酮对恶性室性心律失常治疗的疗效。方法 :对收入 CCU符合入选条件的 6 7例恶性室性心律失常患者随机分为 2组治疗。治疗组 32例 :部分病例采用胺碘酮转复 ;其余采用电转复 ,成功后用胺碘酮维持窦性心律 (窦律 )。对照组 35例 :应用利多卡因转复及维持窦律 ;利多卡因无效者改用胺碘酮治疗。结果 :治疗组转复成功率 83.33% (10 /12 ) ,维持窦律成功率 81.2 5 % (13/16 ) ,总有效率 78.12 % (2 5 /32 ) ,均明显高于对照组〔分别为 5 7.14 % (8/14 )、6 2 .2 5 % (10 /16 )和 5 4 .2 9% (18/35 )〕,且对照组中应用利多卡因转复及维持窦律失败的部分病例使用胺碘酮仍有效。结论 :胺碘酮是治疗恶性室性心律失常最有效的药物之一 ,特别是应用其它抗心律失常药物治疗无效的病例 ,应用胺碘酮可收到良好的治疗效果。     

Effect of the use of sleep medication in Dutch hospitals on the use of sleep medication at home

Insomnia is an important nursing problem in hospitals. Although the use of sleep medication is often criticized, it is one of the commonest interventions with regard to sleep problems. In this study, the effect of the administration of sleep medication in Dutch hospitals on the use of sleep medication at home is investigated. Only patients were included who had never used sleep medication before admittance in hospital. Results show that patients who used sleep medication for at least 5 days in hospital (n=233) used sleep medication more often at home after discharge than patients who did not use sleep medication in hospital (n=55). Furthermore, the study showed that those patients who used at least 5 days' sleep medication, especiaIly those patients who used sleep medication more often in hospital, also used sleep medication more often at home. This is in line with the addictive effects of sleep medication. From these results it can be concluded that the administration of sleep medication is not without danger. Therefore, it is recommended to search for alternative interventions, especially for patients who are in hospital for a longer period.     

Consulting the Internet before visit to general practice. Patients' use of the Internet and other sources of health information

OBJECTIVES: To describe where patients in Danish general practice get information about health and disease, particularly how patients prepare for a visit to their GP, with special reference to use of the lnternet. DESIGN: Structured interviews. SETTING: Four Danish general PATIENTS: 93 consecutive patients after visiting their GP. MAIN OUTCOME MEASURES: The patient's report about we of the Internet and different mass media in preparation for the consultation. RESULTS: Only two patients never looked for health information. Of all patients, 20% had used the Internet to get health information, 8% because of the current visit, i.e. a third of all with Internet access had used it because of the current visit. Women used the sources of information more than men did. Personal contact with family, friends or neighbours was the most commonly used source. CONCLUSION: The Internet is used in direct preparation for a visit to the general practitioner. The vast majority of patients use the mass media for information. In general practice, the main source of information on a health-related subject is personal contact with family and friends.