介入上肢垫在经桡动脉介入治疗术后护理中的应用价值评价

目的：探讨介入上肢垫在经桡动脉介入治疗（TRI）术后护理中应用价值。方法：回顾性分析2011年6月-2013年5月本院心内科三病区收治的628例冠心病患者经桡动脉行冠状动脉介入治疗的临床资料。在常规护理基础上,根据有无采用介入上肢垫进行术后穿刺部位护理,将患者分为试验组298例（介入上肢垫护理）和对照组330例（非介入上肢垫护理）。通过护理记录对两组术后6h穿刺部位疼痛、肿胀、出血、指端紫绀等局部症状进行比较和评价。结果：试验组患者的局部疼痛、肿胀、出血等症状发生率均明显低于对照组,差异均有统计学意义（P〈0．0001）。结论：介入上肢垫能有效减少TRI术后患者肢体的局部相关并发症,值得在临床推广。     

经桡动脉行冠脉介入治疗术后术肢肿胀的原因分析与预防对策

目的总结经桡动脉行冠状动脉介入（PCI）术后术肢肿胀的原因,找出其预防措施。方法对2008年1月至2011年12月32例经桡动脉行PCI术后并发术肢肿胀的患者的临床资料进行回顾性分析。结果PCI术后术肢肿胀的发生与病人自身的因素、医护不当等有关。结论规范的术前准备与宣教,熟练的穿刺技术和严格的术后管理能有效地预防和减少PCI术后术肢肿胀的发生。     

经桡动脉途径冠脉造影体会

目的 观察经桡动脉冠脉造影的安全性和并发症的发生率.方法 对心内科2009年确诊或疑诊冠心病的患者行冠状动脉造影,Allen＇s试验阳性者均选经桡动脉途径.结果 116例经桡动脉途径造影患者中有2例出现术后术侧桡动脉搏动消失,手掌无缺血症状.1例术后出现上肢肿胀,加压包扎处理2 d后肿胀消除,桡动脉搏动仍然存在.无骨筋膜室综合征及腕管综合征等严重并发症出现.结论 经桡动脉途径冠脉造影安全可靠,并发症少.     

经桡动脉行冠状动脉造影术180例临床分析

目的评价经桡动脉途径对患者行冠状动脉造影（CAG）和经皮冠状动脉介入（PCI）治疗的可行性和安全性。方法对本院2005年6月至2009年4月的经桡动脉途径行冠状动脉造影（CAG）和经皮冠状动脉介入（PCI）治疗180例患者进行临床资料分析。结果经桡动脉穿刺成功175例,成功率为97．22％（其中5例经左桡动脉）;桡动脉插管成功174例,成功率为96．66％,6例经桡动脉手术失败后经股动脉手术成功。26例病人成功经皮桡动脉穿刺行冠状动脉介入治疗。术中、术后并发症：心律失常3例,血管迷走反射1例,桡动脉痉挛1例,术后穿刺部位小血肿3例,前臂肿胀2例,桡动脉搏动减弱3例,未见其他不良并发症。结论经桡动脉途径行CAG和PCI血管穿刺部位手术成功率高、并发症少,具有临床可行性和安全性。     

经桡动脉行冠脉介入治疗术后术肢肿胀的观察与护理

总结32例经桡动脉行冠脉介入治疗术后术肢肿胀的护理经验。主要是对术后手部血液循环及穿刺点的密切观察,及时发现术肢肿胀,及时正确处理和细心护理,对于保障和促进术后恢复起到了重要作用。     

活血止痛汤治疗骨折术后肢体肿胀疼痛的效果观察

目的:对活血止痛汤治疗骨折术后肢体肿胀疼痛的效果进行探讨。方法:随机抽取我社区在2011年1月—2013年12月治疗的90例骨折术后肢体肿胀疼痛患者,分为两组:对照组与观察组,对照组患者使用去痛片与抬高患肢进行治疗,而观察组患者在对照组治疗方案的基础上,再使用活血止痛汤进行治疗,对两组患者的肿胀疼痛治疗效果进行对比与分析。结果:观察组患者的治疗有效率为95.6%,对照组为64.4%,存在较大差异,具备统计学意义(P<0.05),且未有并发症的出现。结论:活血止痛汤在骨折术后肢体肿胀疼痛治疗中的应用,不仅大大提高了患者的治疗有效率,而且缩短了患者伤口的愈合时间,降低了患者的并发症发生率。     

活血止痛汤治疗骨折术后肢体肿胀疼痛的效果观察

目的：对活血止痛汤治疗骨折术后肢体肿胀疼痛的效果进行探讨。方法：随机抽取我社区在2011年1月—2013年12月治疗的90例骨折术后肢体肿胀疼痛患者,分为两组：对照组与观察组,对照组患者使用去痛片与抬高患肢进行治疗,而观察组患者在对照组治疗方案的基础上,再使用活血止痛汤进行治疗,对两组患者的肿胀疼痛治疗效果进行对比与分析。结果：观察组患者的治疗有效率为95.6%,对照组为64.4%,存在较大差异,具备统计学意义（P<0.05）,且未有并发症的出现。结论：活血止痛汤在骨折术后肢体肿胀疼痛治疗中的应用,不仅大大提高了患者的治疗有效率,而且缩短了患者伤口的愈合时间,降低了患者的并发症发生率。     

护理干预对缓解经桡动脉介入术后术侧上肢胀痛的效果观察

目的:探讨介入术后护理干预对缓解经桡动胀痛的临床效果。方法:对临床278例经桡动脉穿刺行介入术的患者随机分为两组观察组和对照组,比较干预护理对缓解上肢胀痛的影响。结果:观察组术侧上肢胀痛明显少于对照组。结论:桡动脉介入术后患者采取积极的护理干预,使患者术后胀痛发生率明显降低。     

品管圈活动在减少经桡动脉冠脉介入治疗术后术肢并发症中的应用

目的:探讨品管圈活动在减少经桡动脉冠脉介入治疗术后术肢并发症中的应用效果。方法:2015年7月在我科成立品管圈小组,对品管圈活动前后76例经桡动脉冠脉介入治疗患者术后术肢并发症进行分析、根据结果制定改进措施,落实活动质量。结果:品管圈活动展开后经桡动脉冠脉介入治疗术后术肢并发症明显减少,从45.95%降至15.38%,差异均有统计学意义(P<0.05)。结论:品管圈活动可有效减少经桡动脉冠脉介入治疗术后术肢并发症,减轻患者的痛苦,提高了患者舒适度。     

经桡动脉冠脉造影及介入治疗80例分析

目的 探讨经桡动脉造影及介入治疗的可行性和安全性.方法 选择80例有冠脉造影指征且行Allen＇s试验阳性的患者,以右侧桡动脉为手术路径,使用5F桡动脉鞘行冠脉造影检查.结果 桡动脉穿刺80例中76例成功,成功率为95%,失败4例,其中桡动脉痉挛3例,1例因肱动脉处斑块狭窄导丝不能通过,后均改股动脉途径;造影成功中对30例患者行介入治疗处理,未出现冠脉造影成功不能行介入治疗的情况.术后有5例发生手臂局部肿胀,未出现桡动脉闭塞等严重并发症.结论 经桡动脉行介入治疗安全可行,创伤小,并发症少,患者由于卧床时间缩短、术后无体位限制等原因,更乐于接受,值得推广.     

股动脉穿刺血管径路并发血肿应用腹舒粘敷贴效果观察

目的观察股动脉介入术后血管路径并发血肿,使用腹舒粘敷贴消肿及止痛效果。方法对入选股动脉穿刺路径并发血肿的40例患者,随机分为试验组和对照组,试验组以腹舒粘敷贴贴附于血肿处,对照组以局部温热敷后,涂抹喜疗妥软膏,连续7d,记录2种治疗方法后,血肿部位止痛起效时间、疼痛缓解程度及消肿情况。结果试验组止痛起效平均时间(30±6.2)min、对照组(48.5±13.7)min,差异有统计学意义(P<0.01);治疗24h后,试验组95.0%的患者有轻、中度疼痛,无重度疼痛;对照组50.0%的患者有重度疼痛,2组比较差异有统计学意义(P<0.01);治疗72h后2组消肿疗效比较,差异有统计学意义(P<0.05)。结论用于股动脉穿刺伤口血管并发血肿消肿、止痛效果好,操作简单,可减轻患者痛苦。     

四肢骨折术后并发症的中药防治

目的观察四肢骨折术后应用中药对并发症的防治效果。方法 72例四肢骨折患者随机分为观察组和对照组各36例,2组针对术后并发症进行治疗。其中观察组在上述治疗的基础上同时应用中药进行治疗,评价2组的治疗效果。结果 2组的性别、年龄、骨折类型等一般资料经统计学分析,差异无统计学意义(P>0.05)。观察组总有效率均明显高于对照组,差异有统计学意义(P<0.05)。结论中药应用于四肢骨折术后,能够显著提高治疗的疗效,减轻患肢的肿胀程度,缓解疼痛,加快骨折愈合,早日恢复肢体的活动功能,值得推广和应用。     

Percutaneous, endovascular treatment of innominate artery lesions is a safe and effective procedure

Percutaneous endovascular treatment (transluminar balloon angioplasty with or without stent implantation) of innominate artery lesions has become the treatment of choice prior to surgery in the past decades. Authors present the diagnostics, treatment and follow-up of two patients as examples from their largest series in the literature. A 74-year-old male patient with a history of hyperlipidemia, hypertension, nicotine abuse and lower limb claudication was admitted because of acute upper limb claudication and dizziness. Physical examination revealed blood pressure difference of 30 mmHg between his arms, and poststenotic flow pattern in the common carotid artery with retrograde flow in the vertebral artery on carotid duplex scan. Diagnostic angiography showed 80% stenosis of the innominate artery, which was treated with percutaneous transluminar balloon angioplasty with stent implantation. Follow-up examination at 5 months showed no significant restenosis or neurological complication. The second patient was a 59-year-old smoker female patient with hypertension and type 2 diabetes mellitus, who was evaluated for her upper limb claudication. Initial finding was the absence of radial pulse in the right side. Color duplex scan revealed proximal subocclusion, which was confirmed by angiography. In one stage, balloon angioplasty was made, with immediate pain relief. After 15 months the patient was symptom-free. These two cases demonstrate an excellent outcome of endovascular treatment of innominate artery lesions, as authors already reported in two retrospective studies. Balloon angioplasty with, or without stent deployment appears to be a safe procedure with excellent primary success rate. Review of international studies also indicates that endovascular therapy of the innominate artery is safe and effective.     

Resting injured limbs delays recovery: a systematic review

OBJECTIVES: Rest is commonly used as primary treatment, rather than just palliation, for injured limbs. We searched the literature for evidence of benefit or harm from immobilization or mobilization of acute limb injury in adults. DATA SOURCES: We systematically searched for and retrieved randomized controlled trials (RCTs) of mobilization or rest for treatment of acute limb injuries, in Medline (1966-2002), EMBASE, Web of Science, and the Cochrane library, in all languages. REVIEW METHODS: We examined patient-centered outcomes (pain, swelling, and cost), functional outcomes (range of motion, days lost from work) and complications of treatment. RESULTS: Forty-nine trials of immobilization for soft tissue injuries and fractures of both upper and lower limbs were identified (3366 patients). All studies reported either no difference between rest and early mobilization protocols, or found in favor of early mobilization. Reported benefits of mobilization included earlier return to work; decreased pain, swelling, and stiffness; and a greater preserved range of joint motion. Early mobilization caused no increased complications, deformity or residual symptoms. CONCLUSIONS: We should not assume any benefit for immobilization after acute upper or lower limb injuries in adults. Rest appears to be overused as a treatment. More trials are needed to identify optimal programs for early mobilization.     

活血汤治疗胫腓骨骨折术后肢体肿胀的应用

目的研究胫腓骨骨折术后肢体肿胀应用消肿活血汤治疗的临床疗效。方法随机抽取2017年1月—2018年7月本院接收并予以手术治疗的胫腓骨骨折患者73例,按入院时间先后顺序分为对照组(n=35,接受20%甘露醇125 mL静滴,2次/d,连续4天)与研究组(n=38,在对照组基础上加用7 d消肿活血汤口服),在治疗结束后以两组患者的“骨科肢体肿胀”评分来判断治疗效果。结果比较显示两组治疗后第1天肢体肿胀评分差异无统计学意义(P>0.05);治疗后第4天、第7天研究组肢体肿胀评分除第4天Ⅱ级患者与第7天Ⅲ级患者外均明显低于对照组(P<0.05)。结论对胫腓骨骨折术后肢体肿胀患者应用消肿活血汤能帮助其缓解肢体肿胀症状,促进其肢体尽早恢复健康。     

新伤续断汤加减治疗四肢骨折后急性疼痛肿胀的效果

目的 分析四肢骨折后急性疼痛肿胀患者应用新伤续断汤加减方的效果.方法 选择2019年11月—2020年11月收治的100例四肢骨折后急性疼痛肿胀患者,以随机抽样法为分组方法,将患者分别纳入对照组、研究组,各50例.对照组给予常规西医治疗,研究组加行新伤续断汤加减治疗.将临床疗效、治疗前后的疼痛评分和肿胀程度、疼痛和肿胀...     

The Prevalence of and Risk Factors for Neck Pain and Upper Limb Pain among Secondary School Teachers in Hong Kong

Objective: To investigate the prevalence and occupational risk factors of neck and upper limb disorders among secondary school teachers. Methods: One hundred secondary schools in Hong Kong were randomly chosen. Every full-time teacher received a questionnaire and a letter describing the purpose of the study. Questionnaires were collected 1 to 3 weeks later. Results: Among 3,100 secondary school teachers, the lifelong prevalence of neck pain and upper limb pain was 69.3% (2091/3018) and 35.8% (1088/3042) respectively. The lifelong cumulative incidence of both neck and upper limb pain was 31.6% (938/2966). Multiple logistic regression analysis showed that gender, age and working in head down posture were identified as risk factors for neck and upper limb pain. High workload, low colleague support and high anxiety were found to be significant on affecting the neck pain and upper limb pain developed after becoming teachers. Conclusions: Neck pain and upper limb pain were highly prevalent in secondary school teachers in Hong Kong. Gender, age, head down posture and some psychological factors were found to be significant risk factors.