膝关节镜下前交叉韧带重建术的护理配合

目的:探讨膝关节镜下前交叉韧带重建术的手术护理配合。方法:对35例行膝关节镜下前交叉韧带重建术患者的临床资料及手术配合过程进行回顾性分析,总结该手术的护理配合要点。结果:手术配合顺利,术中、术后无并发症发生,关节功能恢复良好。结论:术前认真评估患者、用物准备齐全、术中密切配合是确保手术质量的关键。     

膝关节镜下自体组织前交叉韧带重建术的手术护理体会

膝关节镜下交叉韧带重建术是用于膝关节交叉韧带损伤的新的手术治疗方法.患者术前护理和术前准备,护理人员对手术程序认知和配合的熟练程度,会直接关连到病人术中护理质量和手术效果,影响到病人的术后康复.因此,做好术前护理和术中配合,掌握围手术期可阶段护理要点至关重要.本文就膝关节镜下自体组织前交叉韧带重建术的手术护理问题作一回顾和探讨.     

膝关节镜下前交叉韧带重建术的手术护理配合体会

目的:探讨和总结膝关节镜下前交叉韧带重建术的术中护理配合体会。方法:对30例行膝关节镜下前交叉韧带重建术患者的临床资料及手术配合过程进行回顾性分析,总结该手术的护理配合要点及防止并发症注意事项。结果:30例手术均顺利完成,术中、术后无并发症发生。结论:术前用物准备齐全、术中严格遵守无菌技术操作,熟悉的手术配合是确保手术质量的关键。     

关节镜下重建膝前交叉韧带术的康复护理

目的:探讨膝关节镜下前交叉韧带重建术的康复护理,最大限度地减少术后并发症。方法:对38例采用关节镜下重建前交叉韧带患者,手术前制定科学系统的康复计划,进行心理护理和疾病知识宣教,手术后指导患者进行循序渐进的功能锻炼。结果:平均随访17个月,38例患者膝关节稳定性较术前明显改善,关节活动度正常,所有患者均临床治愈出院,无关节内感染病例。结论:早期进行综合康复护理,有助于膝关节镜下前交叉韧带重建术后膝关节功能的恢复。     

关节镜下自体肌腱与人工韧带移植重建交叉韧带的手术配合体会

目的:探讨膝关节镜下不同方式重建前交叉韧带手术的术中护理配合。方法:对70例膝关节交叉韧带损伤的患者,在关节镜下行交叉韧带重建手术的术前准备、术中配合情况、术后回访进行总结。结果:在良好的护理配合下,膝关节镜下重建交叉韧带手术取得了满意的治疗效果,手术时间缩短,无严重并发症发生,术后关节恢复较好。结论:准确熟练的手术配合可以提高手术效率,促进患者早日恢复。     

膝关节镜下前交叉韧带重建术的手术护理配合体会

目的：探讨和总结膝关节镜下前交叉韧带重建术的术中护理配合体会。方法：将36例膝关节镜下前交叉韧带重建术的患者随机分成对照组和观察组,分别18例一组。对照组进行膝关节镜下常规手术的护理配合,观察组给与镜下前交叉韧带手术的特定护理配合。结果：观察组Ⅰ期愈合率为92.3%,术后6周膝关节屈曲至120°-130°的达90.4%,8-10周膝关节屈伸功能恢复正常的达到89.7%。对照组Ⅰ期愈合率为90.1%,术后6周膝关节屈曲至120°-130°的达85.2%,8-10周膝关节屈伸功能恢复正常的达到80.3%。结论：术中正确摆放体位、密切观察病情变化、术中熟练配合,关节镜的正确使用和消毒是手术顺利完成的重要保证。有利于创伤缩小,骨道定位准确,重建的韧带可达到牢固的生物学固定,并可降低术后并发症及其感染,有利于减轻患者术后疼痛,利于关节早期活动,促进患者术后康复。     

关节镜下前交叉韧带损伤自体肌腱重建的手术护理配合

目的探究关节镜下交叉韧带损伤自体肌腱重建的手术护理配合要点。方法选取我院收治的28例进行膝关节镜下自体肌腱重建后交叉韧带术患者进行分析研究,在术前做好物品准备及患者准备工作,术中注意患者的体位调整,术后帮助患者进行功能训练。结果为患者进行良好的护理配合后,有效缩短了患者手术及住院时间,降低了术中感染的发生概率,患者术后满意率达100%。结论在对膝关节镜下自体肌腱重建后交叉韧带手术患者进行护理时要从术前、术中、术后三个方面进行,这就要求手术护士积极配合术前及术中的各项操作,在术后积极帮助患者进行康复锻炼。     

膝关节镜下前交叉韧带重建术围术期护理

目的:探讨膝关节镜下前交叉韧带重建术围术期护理方法。方法:对本院2008年5月~2011年12月收治的84例关节镜下前交叉韧带重建术的临床护理方式及效果进行了回溯式分析。结果:84例患者术后膝关节功能恢复良好及无感染、出血等并发症的发生。结论:膝关节镜下前交叉韧带重建术围术期护理与治疗同样重要,精心的护理是膝关节镜下前交叉韧带重建的成功关键。     

膝关节前交叉韧带重建术的护理及功能康复

目的探讨膝关节镜下行前交叉韧带重建术后的康复护理。方法选择在我院接受治疗的18例膝关节前交叉韧带发生损伤的患者作为研究病例,在膝关节镜下行前交叉韧带重建术后,对患者进行系统的护理以及功能康复训练。结果全组病人均顺利康复出院,所有病人术前症状消失,完全恢复其正常的行走,其步态和关节的稳定性,还有活动度均显示正常。结论膝关节镜下行ACL重建术,手术成功的首要条件是术前进行有效的心理护理,术后进行系统的护理,越早进行有目的、有计划、循序渐进的功能锻炼,越能够保证患者成功康复。     

膝关节镜下交叉韧带重建术后关节僵硬的临床分析及预防护理

目的探讨膝关节镜下交叉韧带重建术后关节僵硬的原因及减少此并发症的护理对策。方法对2010年至2014年膝关节镜下前、后交叉韧带重建术后发生关节僵硬患者的情况进行回顾性总结分析。结果 190例病例中,有5例发生关节僵硬需回院手法松解治疗。膝关节镜交叉韧带重建术后发生关节僵硬的原因与下列因素有关:在康复锻炼阶段护士没有进行有效的指导;患者缺乏相关手术方面的知识,对术后的功能锻炼没有引起重视;患者对疼痛无法忍受,担心伤口会在锻炼的过程中撕裂而对活动产生了恐惧感,不能够很好地配合医护人员;没有遵循循序渐进的原则;出院后终止了锻炼等。结论加强术后早期功能锻炼是预防僵硬的有效措施。     

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.