标准化急救护理在急诊危重症患者抢救中的应用

目的探讨标准化急救护理在急诊危重症患者抢救中的应用方法及效果。方法随机选取我院急诊科2010年100例急诊危重患者为实验组,选取2009年100例急诊危重患者为对照组。实验组采用标准化急救护理实施救治;对照组采用常规的抢救程序对患者进行急救护理。比较2组患者抢救成功率、抢救时间及患者满意度。结果 2组患者抢救成功率比较无明显差异;但抢救时间、满意度实验组均明显优于对照组。结论实施标准化急救护理,对提高急救护理水平,改进及改善护理服务质量等方面具有重要的作用和意义。     

门诊患者突发意外急救系统的构建及管理

目的构建门诊患者突发意外急救系统,提高抢救成功率。方法构建门诊急救体系;合理配置急救物品,实行统一管理;制定门诊患者突发意外急救预案;加强护理人员急救意识及急救技能培训;多部门合作实施急救工作。结果完善门诊急救系统,提高护士急救技能,提高急救成功率。结论建立高效的门诊急救系统,能够提高抢救成功率,确保患者生命安全。     

36例严重多发伤病人的急救护理体会

目的探讨严重多发伤病人的急救护理,以提高抢救成功率。方法对我院2005-05~2009-05收治的36例严重多发伤病人的临床资料进行分析,通过快速判断伤情,准确执行急救程序(VICSO),针对性地做好术前准备、科间协作。结果全组抢救脱险32例,抢救成功率88.89%。4例因呼吸循环衰竭死亡,为院前死亡的主要原因。结论急救意识的强化,准确的判断伤情,科学应用急救程序是提高多发伤病人存活率的关键。     

突发公共事件中伤员的急救与护理

目的对突发公共事件批量伤员急救采取有效的护理,确保批量伤员的抢救成功率。方法通过对14批伤员临床抢救观察进行总结。根据突发公共事件批量伤员急救特点,迅速启动紧急急救护理程序,及时采取急救护理对策,确保抢救工作快捷、安全、高效地开展,降低致残率和死亡率。结果通过我们的积极抢救,158例伤员中3例经抢救无效死亡,155例伤员得到妥善的救治,治愈出院。结论通过对突发公共事件批量伤员急救采取有效的护理,使抢救成功率达到98.1%,降低了致残率和死亡率。     

交通事故性重型颅脑损伤118例院内急救分析

目的 对交通事故性重型颅脑损伤院内急救效果进行分析,评价院内急救的价值,并就如何进一步改善院内急救提出有关的建议。方法 通过回顾分析118例交通事故性重型颅脑损伤院内急救有关资料,记录患者受伤到入院时间、GCS评分、昏迷程度、瞳孔大小、血压、脉搏、呼吸情况,并比较入院进入急诊科和抢救后转出急诊科上述指标的变化,评价急救效果。结果 对GCS评分、昏迷程度、瞳孔大小、血压、脉搏、呼吸等指标进行卡方检验,差异均有统计学意义(χ2值分别为27.771、25.255、24.609、16.272、20.083、28.994,P值分别为0.026、0.034、0.039、0.047、0.042、0.021)。结论 通过不断优化急救流程,并有针对性地改善,可有效提升交通事故性重型颅脑损伤患者院内急救效果。     

阿片类药物过量中毒的急救

阿片类药物过量中毒的急救姜佐宁阿片类药品或毒品使用或滥用超过个体的耐受量时，极易产生过量的急性中毒。这在阿片类毒品流行的地区极为常见。需要妥善而又及时的救治，否则会导致死亡。阿片类过量中毒时的临床表现、及时诊断和积极抢救的知识经验，不仅戒毒专科医生应...     

高血压性脑出血病人的早期急救护理

高血压性脑出血病人发病急，病情变化快死亡率高，抢救的关键在于急性期的急救与护理，对降低病人死亡率，致残率，减少并发症具有很大意义。近年来，我们抢救高血压性脑出血病人300冽，由于注重加强早期救治和护理抢救效果满意，抢救成功率为％％。现总结如下。1；闲床资料本文300例均为高血压性脑出血病人，其中男196例，女lot例，年龄42岁一83岁，平均年龄62．5岁。发病1小时来诊268例，半小时来诊32例，发病诱因为动态发病An冽，静态发病34例。出血部位为内囊出血180例，外囊出血64例，脑干出血％冽。CT检查示出血量25Inl以下103例，3…     

交通事故性重型颅脑损伤院内急救后效果分析(附1107例报告)

目的 通过对交通事故性重型颅脑损伤在院内急救期间各生命体征、意识、瞳孔及时间等环节上的变化,显示院内急救的重要性和一般规律,为我国相关部门制定急性颅脑创伤的预防和控制措施做出参考依据. 方法 以南方医科大学珠江医院神经外科组织制定及71家医院专家委员会审定的《交通事故性重型颅脑损伤统计表》为依据收集自2008年4月1日至2009年3月30日因交通事故致重型颅脑损伤患者1107例的临床资料,根据在院内急救过程中患者意识状态、瞳孔变化、GCS评分、血压、呼吸、脉搏等指标在转入及转出急诊科间的变化,进行函数推算,分析判断病情发展趋势、抢救效果和下一步治疗措施. 结果 根据院内急救时间显示在10～60 min内入急诊的患者最多,尤其在10～30 min占总就诊患者的38.9％.直观发现,患者经过院内急救有效治疗后,意识状态、瞳孔变化、GCS评分、血压、呼吸、脉搏等指标中表现差的患者例数逐渐减少,表现中等、较好和好的例数增多,在进入下一步专科治疗之前,患者各项生命体征及检测指标逐渐趋于平稳.函数推算支持此结果. 结论 院内急救有效的治疗,及时控制各项指标稳定,正确判断伤情,提高院内急救一切合理措施,有助于提高交通事故性重型颅脑损伤患者的急救质量.     

腰大池－腹腔分流管的研制及临床应用

腰大池－腹腔分流管的研制及临床应用张楷文，只达石由天津市颅脑损伤抢救中心设计，天津市橡胶工业研究所医用研究室研制的腰大池。腹腔分流管，经３０例临床应用效果满意，现介绍如下。一、腰大池－腹腔分流管的结构及规格１．腰大池－腹腔分流管由硅橡胶等配方研制而成...     

急救护理干预在颅脑损伤患者急救中的应用价值

目的探讨急救护理干预在重型颅脑损伤患者急救中的应用价值。方法 83例重型颅脑损伤患者按照采用的护理方式,分为对照组(A组)及急诊护理干预组(B组)。A组由当班护理人员行常规护理救治措施,如保持患者呼吸道通畅;监测生命体征;建立静脉通道并抽血;配合医生气管插管等。B组由2人组成的护理小组实施急诊护理抢救,高年资的责任护士保持呼吸道通畅,监测生命体征以及配合医生气管插管,而辅助护士行建立静脉通道并抽血,遵医嘱及时给药并其他护理。比较两种护理实施过程中患者急诊科救治时间、急诊救治预后、急诊护理满意度、意外事件发生情况以及并发症发生情况等。结果 2组患者急诊科抢救时间比较,A组显著长于B组(P0.05);B组急诊救治预后明显好于A组(P0.05);B组急诊护理满意度明显优于A组(P0.05);2组意外时间发生情况比较,B组明显少于A组(P0.05);B组肺部感染、应激性溃疡、中枢性高热以及电解质紊乱等并发症明显少于A组。结论急救护理能缩短急诊抢救时间,显著提高患者抢救成功率,减少并发症,最大限度保障患者的生命安全。     

精神障碍合并新冠肺炎患者院前急诊转运体会

目的探讨严重精神障碍患者合并新冠肺炎如何安全规范的进行院前急诊转运。方法收集2020-02-05-02-25院前急诊转运的60例严重精神障碍合并新冠肺炎患者,并进行分析。结果60例患者全部为专科医院确诊病例,需转运至定点医院救治。除1例因高龄、多基础疾病的患者在转运途中死亡外,其余59例患者均安全转运至定点医院。结论精神障碍合并新冠肺炎患者属特殊群体,急诊转运途中采用规范的转运方案和特殊护理方式,提高患者依从性,可起到安全高效的转运效果,值得临床借鉴。     

Stereotactic clipping of arteriovenous malformations of the brain

The authors have developed a new technique for the stereotactic clipping of the feeding vessels of deep-seated arteriovenous malformations (AVM), for use when direct attack may be very dangerous or impossible. A special clipping device and the technique for its application are described. The instrument is introduced through a burr hole using the stereotactic apparatus designed by the authors. The clipping is monitored by intraoperative angiography. The method was used in 32 patients with supratentorial AVMs. It is concluded that in selected cases the method is effective, is less traumatic and gives successful results.     

Stereotactic clipping of arteriovenous malformations of the brain

The authors have developed a new technique for the stereotactic clipping of the feeding vessels of deep-seated arteriovenous malformations (AVM), for use when direct attack may be very dangerous or impossible. A special clipping device and the technique for its application are described. The instrument is introduced through a burr hole using the stereotactic apparatus designed by the authors. The clipping is monitored by intraoperative angiography. The method was used in 32 patients with supratentorial AVMs. It is concluded that in selected cases the method is effective, is less traumatic and gives successful results.     

Video/EEG, the epileptic monitoring system

Seventy-six seizures in thirty-four patients with epilepsy and suspicious of epilepsy were monitored by Video/EEG which was designed and made by the authors and identified by the scientific experts considered to be standard. The average time of each patient monitored was 6.7 hours. The positive record of fifty-six seizures were analyzed: The seizures of twenty-four patients (70.5%) were diagnosed as epileptic in nature; two patients (5.8%), the seizures were due to organic brain diseases and in eight patients (23.5%), they were pseudoseizures. The diagnostic rate for epileptic type was 87.5%. The clinical use of Video/EEG shows that functions of this apparatus has attained the international level as compared with the identical one made in foreign country. It is high qualified with multifunctions and low in price. It can also apply in fields of psychology. Psychiatry, biology and in studying of sleep, respiration etc. Therefore, the Video/EEG which we made is a apparatus suitable for our national condition.     

Low hospital inpatient readmission rate in patients with borderline personality disorder: a naturalistic study at Southern Health, Victoria, Australia

OBJECTIVE: To study how the standard management protocol and the special management contract relate to the clinical profile of patients with borderline personality disorder and their hospital admission pattern. METHOD: A retrospective review was undertaken using naturalistic data from the Client Management Interface over a 2-year period. The standard management protocol patient group and the special treatment contract patient group were compared with respect to variables which included basic demographic data, number of admissions, length of stay and comorbidity. RESULTS: Eighty patients received a diagnosis of borderline personality disorder. The majority (81.2%) were managed with the standard management protocol and only 41.5% had more than one admission. For those who received a special treatment contract (18.8%), 93.3% of them had more than one admission. The special treatment contract group had a significantly higher total number of admissions (p < 0.001), a higher number of admissions when they received (p < 0.001) and did not receive (p = 0.001) a diagnosis of borderline personality disorder, a higher number of comorbidities (p = 0.004) but not more presentations to the emergency department. CONCLUSIONS: Most patients with borderline personality disorder treated with the standard management protocol had a low readmission rate. The small group of patients with comorbidities managed with a special treatment contract had multiple readmissions but not more crisis presentations to the emergency department. Further studies are required to elucidate the therapeutic mechanism of the standard management protocol and special treatment contract and how that impacts on presentations and admissions to a hospital.     

Microsurgical treatment of large and giant paraclinoid carotid aneurysms using a revised endovascular suction decompression technique with Invatec Mo.Ma device

Endovascular retrograde suction decompression (RSD) with balloon occlusion of the internal carotid artery is helpful to facilitate clipping large and giant paraclinoid carotid aneurysms. The authors reported a revised endovascular technique without internal carotid access using Mo.Ma device and analyzed its feasibility. In the series, 15 consecutive patients harboring 15 large and giant paraclinoid carotid aneurysms were clipped with assistance of this revised RSD technique. The technical feasibility of the procedure, procedure-related complications, angiographic results, and clinical outcome were evaluated. Technical success was achieved in 14 patients with aneurysm neck clipping and internal carotid artery (ICA) patent. No complication related to this endovascular technique occurred. At follow-up (mean time 15.3 months), the modified Rankin Scale score was excellent in 11 patients, good in two patients and poor in one patient. Their preliminary experience indicates that revised retrograde suction decompression technique with Mo.Ma device seems effective and safe in the surgical treatment of large and giant paraclinoid ICA aneurysms.     

5000/聚醋酸乙烯酯多孔材料的制备及表征(英文发表）

背景：多孔聚合物材料的制备中，泡孔的直径及其分布的控制是当前研究中的难题，但目前尚无有效的解决办法。 目的：采用高内相比乳液模板法，以Span80为引发剂，制备聚醋酸乙烯酯多孔材料，研究制备工艺对其泡孔直径及其分布的影响。 设计、时间及地点：于2008-12/10在泰山医学院高分子化学实验室完成。 材料：苯乙烯，分析纯。二乙烯基苯，分析纯，。Span80,。苯乙烯(St)，分析纯，上海国药集团化学试剂有限公司；二乙烯基苯（DVB），化学纯，天津市永大化学试剂开发中心；Span80乳化剂，化学纯，天津市广成化学试剂有限公司；过硫酸钾，分析纯，天津市纵横兴工贸有限公司 。 方法：向装有电动搅拌器和温度计的250ml三颈烧瓶中加入连续相（苯乙烯、二乙烯基苯、致孔剂等）和乳化剂,搅拌并通过蠕动泵缓慢滴加含有过硫酸钾和CaCl2的水溶液，并控制反应温度。滴加完毕后，继续搅拌，然后移至60℃的水浴中继续聚合。然后，将聚合好的坚硬的固体，切成1cm 厚的小圆盘状，装入Soxlet提取器中，用无水乙醇作溶剂，抽提48小时。再将抽提好的固体放入烘箱中，在60℃下干燥48小时即可制得聚醋酸乙烯酯多孔材料。 多孔材料的泡孔和通道尺寸及其分布是表征多孔材料断面形态的重要参数。将烘干后的多孔材料小心掰断,将断面喷金，用扫描电镜进行观察。用3H-2000Ⅱ型全自动氮吸附比表面积测试仪测定多孔材料的比表面积。 主要观察指标：多孔材料的泡孔直径、泡孔形态。 结果：制备的聚醋酸乙烯酯多孔材料经过电镜分析，表征了它的泡孔形态， 结论：用高内相比乳液模板法，可以制备出泡孔直径可控的多孔材料。     

Perfusion CT helps decision making for thrombolysis when there is no clear time of onset

Current guidelines on thrombolysis post stroke with recombinant tissue plasminogen activator (rt-PA) exclude its use where time of onset is unknown, thus denying some patients potentially beneficial treatment. Contrast enhanced perfusion computed tomography (pCT) imaging can be used together with plain CT and information on clinical deficits to decide whether or not thrombolysis should be initiated even though the exact time of stroke onset is unknown. Based on the results of pCT and CT, rt-PA was administered to two patients with unknown time of stroke onset; one of the patients also underwent suction thrombectomy. Results in both cases were excellent.     

Pathological involvement of the motor neuron system and hippocampal formation in motor neuron disease-inclusion dementia

We report two patients with motor neuron disease-inclusion dementia, with special reference to the pathology of the motor neuron system and hippocampal formation. The ages of the patients at death were 55 and 62 years, and the disease durations were 8 and 3 years, respectively. The two patients exhibited progressive frontotemporal dementia in the absence of motor neuron signs. At autopsy, both cases exhibited frontotemporal lobar atrophy with ubiquitin-positive, and tau- and alpha-synuclein-negative neuronal inclusions. As expected from the clinical signs, in both cases, the upper and lower motor neuron systems were well preserved: no Bunina bodies or ubiquitinated inclusions were detected in the motor neurons. However, of great importance was that when visualized immunohistochemically, the Golgi apparatus and trans-Golgi network often exhibited fragmentation in the lower motor neurons (the spinal anterior horn cells). In one of the cases, a decrease in the amount of Golgi apparatus was also a frequent feature in the upper motor neurons (Betz cells in the motor cortex). Moreover, in both cases, circumscribed degeneration affecting the CA1-subiculum border zone was evident in the hippocampal formation. These findings further strengthen the idea that, pathologically, motor neuron disease-inclusion dementia is a rare phenotype of amyotrophic lateral sclerosis.