茶树精油在失禁性皮炎重症患者护理中的应用

目的探讨对患者失禁性皮炎的重症患者使用茶树精油护理的临床效果。方法对本院重症患者展开研究,选取2017年3月～2019年3月60例失禁性皮炎的患者进行研究,采用随机分组的方式,将其中30例使用3M液体敷料和造口护肤粉进行常规护理的患者纳入对照组,其余30例使用茶树精油护理的患者纳入观察组,比较两组患者的护理效果。结果观察组护理IAD的分级显示轻度、中度和重度的患者与对照组比较差异有统计学意义(P 0.05);观察组平均护理时间、平均护理次数和皮肤愈合时间分别为(2.34±0.88)d、(2.33±0.74)次和(3.12±1.06)d,与对照组的(4.56±1.09)d、(10.57±3.21)次和(6.96±1.25)d比较差异有统计学意义(P 0.05)。结论对失禁性皮炎的患者使用茶树精油护理不仅可以减轻患者的痛苦,还可保障创面的清爽,促进皮疹的消退和炎症的吸收,加速新陈代谢,加快患者创面的愈合,在一程度上减少护理工作量,临床应用价值显著。     

结构化皮肤护理管理模式对重症监护室长期卧床患者失禁性皮炎的预防效果

目的 探讨结构化皮肤护理管理模式对重症监护室长期卧床患者失禁性皮炎的预防效果及患者舒适度体验.方法 选取2018年1月至2020年1月长期卧床患者90例随机分为研究组和对照组,每组45例.对照组采用常规护理方法,研究组采用结构化皮肤护理管理模式;比较2组患者IADS评分与皮肤暴露大便频率、失禁性皮炎发生率及舒适度体验....     

集束化护理在重症患者大便失禁皮肤干预中的应用分析

目的:分析集束化护理在重症患者大便失禁皮肤干预中的应用效果。方法:对某院收治的82例重症大便失禁患者进行研究,随机分为对照组(常规护理)与观察组(集束化护理),对比两组患者护理效果。结果:观察组失禁性皮炎发生率低于对照组,数据差异显著(P<0.05);且观察组护理时间、护理费用少于对照组,护理满意度评分高于对照组,数据差异显著(P<0.05)。结论:集束化护理在重症患者大便失禁皮肤干预中的应用效果显著。     

银离子胶体分散剂对ICU重症患者失禁性皮炎疗效观察

目的:观察银离子胶体分散剂在ICU重症患者失禁性皮炎治疗中的效果。方法:将ICU出现失禁性皮炎的40例重症患者随机分为观察组与对照组。观察组采用银离子胶体分散剂治疗,对照组采用婴儿护臀霜治疗,比较两组的疗效。结果:用药1周后,观察组的疗效明显优于对照组。结论:银离子胶体分散剂是治疗ICU重症患者失禁性皮炎的有效手段,可有效促进愈合,减少患者痛苦。     

集束化护理策略对干预大便失禁重症患者失禁性皮炎发生的效果观察

目的研究集束化护理策略对干预大便失禁重症患者失禁性皮炎发生的效果。方法选取我院在2013年10月至2014年10月收治的ICU重症患者,共60例,随机分为对照组和观察组。对照组实施常规护理策略,观察组实施集束化护理策略干预大便失禁的重症患者失禁性皮炎的发生,比较分析两组患者的临床效果。结果观察组患者失禁性皮炎的发生显著低于对照组,差异具有统计学意义(P<0.05);观察组患者的护理时间显著低于对照组,差异具有统计学意义(P<0.05)。结论集束化护理策略对干预大便失禁重症患者失禁性皮炎的发生效果显著,有效减少失禁性皮炎的发生,减轻患者痛苦,显著改善患者的生活质量,临床上值得进一步推广应用。     

硝酸咪康唑散用于失禁相关性皮炎的观察及护理

目的：探讨在失禁相关性皮炎患者临床护理当中,硝酸咪康唑散的应用效果,为失禁相关性皮炎患者临床有效护理提供重要依据。方法选取2012年6月至2014年12月我院的失禁相关性皮炎住院患者86例,随机分成观察组和对照组,每组43例,观察组护理人员主要使用硝酸咪康唑散进行临床护理,对照组护理人员主要使用护臀膏进行临床护理,观察对比两组临床护理效果。结果经过观察对比,观察组患者护理效果明显比对照组要好,且患者伤口愈合时间明显比对照组要短,复发率也明显比对照组要低,差异具有统计学意义（ P＜0．05）。结论在失禁相关性皮炎患者临床护理当中,硝酸咪康唑散的应用效果是比较好的,可以促进患者皮炎痊愈,值得大力推广。     

3M伤口保护膜、造口护肤粉联合造口袋在治疗失禁性皮炎中的应用

目的研究治疗大小便失禁患者肛周、会阴部失禁性皮炎,使用3M伤口保护膜、造口护肤粉联合造口袋,并分析其应用效果。方法研究对象为本科收治的48例因大小便失禁引起的肛周、会阴部失禁性皮炎患者,将其分为实验组和对照组,分别为24例。对照组患者使用的皮肤护理是传统的方法;而实验组患者使用的皮肤护理是使用3M伤口保护膜、造口护肤粉联合造口袋。比较两组患者的以下情况：皮炎的改善;皮炎的愈合时间;皮炎的复发率。结果两组患者的皮炎改善比较,实验组比对照组治疗效果好;实验组的皮炎愈合时间比对照组要快;实验组的皮炎复发率也比对照组要低。两组患者的治疗效果比较,P〈0.05,差异有统计学意义。结论治疗大小便失禁患者肛周、会阴部失禁性皮炎,使用3M伤口保护膜、造口护肤粉联合造口袋的效果良好。     

造口护理粉联合液体敷料在ICU失禁性皮炎患者的护理应用

目的 探讨造口护理粉联合液体敷料在ICU失禁性皮炎患者中的应用价值.方法 选取2015年1月至2016年3月因失禁性皮炎于我院ICU就诊的60例患者进行研究并随机分组,所有患者均接受常规护理,对照组30例患者加用氧化锌软膏,观察组则在常规护理基础上联合采用造口粉及液体敷料,比较两组患者愈合时间及复发情况,比较两组患者临床疗效差异.结果 对照组失禁性皮炎愈合时间(6.18±2.27)d,观察组(4.03±1.35)d,两组比较差异显著(P<0.05),两组患者有效率比较差异显著(P<0.05).结论 造口护理粉联合液体敷料对于ICU失禁性皮炎疗效显著,可促进疾病康复,提高临床疗效,值得临床推广应用.     

氧疗联合造口粉及安普贴的使用治疗失禁性皮炎疗效观察

目的观察氧疗联合造口粉及安普贴治疗失禁性皮炎的临床疗效。方法以我院2013年1月~2014年10月收治的80例失禁性皮炎患者为研究对象,随机将其分为两组,对照组患者给予造口粉+3M伤口保护膜治疗,观察组患者则行氧疗联合造口粉及安普贴治疗,比较两组临床疗效、护理时间、护理次数及愈合时间。结果观察组治愈率、总有效率均为100.00%,与对照组的82.50%、90.00%比较,差异有统计学意义(P0.05)。两组平均护理时间[(2.35±1.05)d VS(4.45±1.34)d]、护理次数[(1.51±0.60)次VS(11.40±2.78)次]及愈合时间[(2.78±1.00)d VS(4.69±0.88)d]比较,差异有统计学意义(P0.05)。另外,观察组再发率明显少于对照组(P0.05)。结论氧疗联合造口粉及安普贴治疗失禁性皮炎疗效明确,能有效缩短愈合时间,减轻护理工作量,值得临床推广。     

全程标准化流程管理在老年重症患者失禁性皮炎防治中的应用价值

目的 分析全程标准化流程管理在老年重症患者失禁性皮炎防治中的应用价值。方法 纳入2019至2020年该院收治的100例老年重症患者作为研究对象,应用随机数字表法分为对照组和研究组,每组50例。对照组给予常规管理,研究组则给予全程标准化流程管理,对2组患者管理前后风险评分、发生情况、愈合情况和满意度进行分析。结果 管理前2组风险评分差异无统计学意义(P>0.05);管理后观察组的风险评分显著低于对照组(P<0.05)。观察组病情轻、中、重度的患者均少于对照组,总发生率显著低于对照组(P<0.05)。观察组的愈合时间显著短于对照组(P<0.05),满意度显著高于对照组(P<0.05)。结论 全程标准化流程管理在老年重症患者失禁性皮炎防治中的应用价值高,可有效的降低患者失禁性皮炎发生风险和发生率,加速失禁性皮炎愈合进程,提升患者满意度。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

基层医院护士在临床合理用药中的作用

目的充分利用护士在医师和患者间的特殊地位和作用,促进基层临床合理用药。方法从护士的工作性质出发,论述护士参与促进合理用药的方便和优势。结果通过实践,护士在促进合理用药中的作用得到有效发挥,基层合理用药环境得到极大改善。结论充分利用护士与医师和患者间的特殊桥梁作用,在基层医院促进合理用药,规范医师用药行为,防止药物滥用,引导患者安全用药,降低药源性疾病。