胰岛素泵强化治疗2型糖尿病20例疗效观察与护理

2009年11月以来,我们应用美敦力胰岛素泵为20例2型糖尿病患者进行强化治疗,经精心护理,效果满意.现报告如下. 1 资料与方法 1.1 临床资料本组20例,男15例,女5例;年龄20-58岁;病程2～15年.均符合1999年WHO糖尿病诊断标准.12例长期皮下注射胰岛素,8例口服降糖药物治疗.     

纵隔巨大肿瘤误诊为腹腔占位性病变1例

患者女,37岁,因反复气促1 年,伴胸痛3个月,加重20 d入院.20 d前于当地医院B超检查见左上腹15 cm×15 cm的不均质异常回声,包膜尚清,中心少许液体,考虑左上腹不均质囊实混合性占位性病变.     

臂丛神经的MRI扫描技术探讨

<正〉本文总结20例臂丛神经扫描,以探讨其扫描技术 材料和方法 一、材料来源:本组20例为无臂丛损害症状和体征的自愿者男15例、女5例.年龄20～50岁.     

VSD负压引流术在骨科运用的护理

临床资料 1.一般资料.20例病例中,男15例,女5例,年龄25～56岁,平均年龄35岁.高处坠落致软组织缺损,骨外露12例,VSD引流8～20d,机器绞伤截肢3例,VSD引流7～15 d,9例因车祸致骨筋膜室综合征5例,VSD引流6～8 d.     

精索静脉曲张

精索静脉曲张系精索的静脉回流受阻或瓣膜失效血液反流引起血液淤滞,导致蔓状静脉丛迂曲和扩张.发病率在男性人群中为10%～15%,多见于青壮年.在男性不育人群中占15%～20%.     

15%乙醇冰袋降温效果观察

[目的]比较15%乙醇冰袋及清水冰袋降温效果,寻找更为有效的冷敷方法.[方法]选取符合标准的健康志愿者40名,随机分为两组,每组20名.实验组采用15%乙醇冰袋,对照组采用清水冰袋,分别于大腿皮肤区冷敷20 min.观察并记录冷敷前后冰袋及皮肤表面温度变化.[结果]两组降温效果比较差异有统计学意义(P<0.01).[结论]15%乙醇冰袋呈冰霜状,塑形性、降温效果均优于清水冰袋.     

肾虚不孕症验方

验方介绍 1方药 ①不孕Ⅰ号方:熟地20g,枸杞子15g,山萸肉12g,白芍9g,当归10g,桑椹子12g,山药10g,丹参15g,枳壳9g,以补肾阴养血为主.②不孕Ⅱ号方:仙茅10g,仙灵脾10g,熟地20g,菟丝子12g,覆盆子12g,当归9g,白芍10g,香附9g,黄芪15g,以补肾阳为主,佐以补肾阴.     

预防甲型肝炎中药验方一束

为了控制甲型肝炎的传播,除了切断传染源,注意饮食卫生,把好手、水及食物三关外,预防服药也是一种重要手段。许多中草药有抗肝炎病毒、清热保肝、消炎利胆作用,对甲型肝炎有一定预防效果,特介绍中药验方一束,以资参考。 1.茵陈15克,山栀15克,半边莲20克,柴胡10克,生甘草6克。 2.茵陈15克,板蓝根20克,黄柏10克,连翘     

烧伤患者的饮食护理

在治疗烧伤患者过程中,合理的饮食护理可增加机体抵抗力,加速创面愈合.现将我们对烧伤患者饮食护理的体会总结如下.1 一般资料55例烧伤患者,年龄为10个月～70岁,烧伤 面积大于5O%而且Ⅲ度烧伤大于20%20例,烧伤面积小于50%15例,大于30%15例,小于10%5例.     

眼球穿通伤36例临床治疗与护理

2006年1月～2007年1月,我院收治36例眼球穿通伤患者,经积极治疗与精心护理,取得满意效果.现报告如下. 　　1 资料与方法 　　1.1 临床资料 本组36例(37眼),男30例,女6例,10～42岁.双眼1例(2眼);单眼35例(35眼),其中右眼20例(20眼),左眼15例(15眼).……     

Community integration after burn injuries

Evaluation of community integration is a meaningful outcome criterion after major burn injury. The Community Integration Questionnaire (CIQ) was administered to 463 individuals with major burn injuries. The CIQ results in Total, Home Integration, Social Integration, and Productivity scores. The purposes of this study were to determine change in CIQ scores over time and what burn injury and demographic factors predict CIQ scores. The CIQ scores did not change significantly from 6 to 12 to 24 months postburn injury. Home integration scores were best predicted by sex and living situation; Social Integration scores by marital status; and Productivity scores by functional outcome, burn severity, age, and preburn work factors. The data demonstrate that individuals with burn injuries have significant difficulties with community integration due to burn and nonburn related factors. CIQ scores did not improve over time but improvement may have occurred before the initial 6-month postburn injury follow-up in this study.     

Physical outcomes of patients with burn injuries--a 12 month follow-up

There is only limited research documenting functional ability, physical fitness, and health related quality of life after burn injury. The objective of this study was to measure a comprehensive range of physiotherapy-related outcomes over a 12-month period for patients with significant burn injuries. A prospective study was performed on consecutive patients admitted to the Royal Adelaide Hospital over a 12-month period. Outcomes were measured at admission and discharge from hospital and at 1, 3, 6, and 12 months, and comprised the: Medical Outcomes Study 36-Item Short Form Health Survey, Quick Disabilities of the Arm, Shoulder and Hand questionnaire, Lower Extremity Functional Scale questionnaire, shuttle walk test, grip strength and scar appearance using the Matching Assessment with Photographs of Scars. A total of 86 patients (74 male, mean age 38 years) participated. There was a significant deterioration in all outcomes in the first few months after burn injury, with most outcomes improving towards baseline levels by 6 months. However, lower limb function (Lower Extremity Functional Scale) remained significantly reduced at 12 months and functional exercise capacity (shuttle walk test) was still markedly reduced at 6 months compared with predicted normal values. The total burn surface area significantly affected many of the outcomes. In conclusion, for this sample of patients after burn injury, there was an acceptable rate of recovery for physiotherapy-related outcomes, in that most measures had returned to near baseline levels by 6 months postinjury, with the exception of lower limb function and functional exercise capacity.     

Examining national burn care policies--is the Israeli burn care alignment based on national data?

The treatment of burn victims constitutes a considerable challenge both to the clinician in regard to mundane treatment and to health systems in regard to structural organization. The state of Israel is in dire need of competent burn care capabilities for political, geographical, and demographic reasons. Israel currently has five designated burn units but no burn center. A review of the recent literature suggests that larger burn centers can convey lower mortality rates and better functional outcomes for severe burn patients in comparison to smaller burn units. The objective of this study is to assess Israel's burn care alignment needs and capabilities based on Israel's burn patient and burn unit data. In addition, the authors aim to compare the burn care alignment capabilities with those of the country's European and American counterparts. Data of all the burn patients hospitalized in Israel's level 1 trauma centers' burn units between the years 1998 and 2005 according to the Israeli Trauma Registry were analyzed. Simultaneously, data regarding the setup and arrangement of each burn unit were obtained from each burn unit director via phone. Between the years 1998 and 2005, 974 adult patients with burns of the second degree or higher spanning 20% TBSA and more were hospitalized in the five hospitals that operate a functional specialized burn unit. The average hospitalization period was 32.4 days while the mortality rate was 21.1%. Currently, Israel's five burn units report possessing 27 burn beds and 14 burn intensive care unit beds. Due to the continuous risk for terror attacks and military campaigns and due to Israel's inability to refer excess burn patients to neighboring countries, Israel desperately needs efficient burn care capabilities. Israel currently trails both the United States and Europe in regard to burn beds and burn centers per population. The annual quantity and severity of burn patients in Israel largely exceeds the amount needed to justify an establishment of a burn center by the current American Burn Association guidelines, while the literature provides vast amount of evidence proving burn centers' efficacy in improving outcome, shortening hospitalization periods, and reducing costs. Taking all these elements into consideration, it might be prudent to establish a national burn center in Israel to promote burn care standards and disaster planning up to international standards.     

重度烧伤早期病人的创伤反应、功能体位与睡眠质量之相关分析

目的分析烧伤早期病人的创伤反应、功能体位与睡眠质量之间的相关性,为烧伤护理提供依据。方法随机将1999年3月～2001年3月收治的127例重度烧伤病人(BSA30%～50%,Ⅲ度占10%～20%)分为实验组和对照组,两组分别采用汉密顿焦虑量表(HAMA)、抑郁量表(HAMB)及维-辛氏睡眠量表对创伤反应、睡眠质量进行评估。实验组采用心理支持、放松疗法及功能体位舒适护理。结果实验组睡眠质量明显好于对照组(P<0.01)。结论烧伤病人的创伤反应、功能体位与病人的睡眠质量呈正相关。     

Impact of an inpatient rehabilitation facility on functional outcome and length of stay of burn survivors

This study reviewed the use of an inpatient rehabilitation unit for burn survivors. We hypothesized that adult burn patients admitted earlier to inpatient rehabilitation have an equal or better functional outcome than those remaining in acute burn center for rehabilitation care. Functional Independence Measure (FIM) data were prospectively collected on our burn center admissions dating January 2002 to August 2003. National rehabilitation data were acquired from eRehabData and burn literature. A total of 217 adult patients survived until hospital discharge, with 21 (9.7%) discharged to inpatient rehabilitation (REHAB). REHAB had larger burn injuries, more inhalation injuries, higher incidence hand/foot burns, and longer length of stay (LOS). REHAB had lower FIM upon rehabilitation facility admission than national averages but greater FIM improvement during comparable rehabilitation LOS. Although our earlier rehabilitation admission strategy results in more frequent rehabilitation unit referrals, patients had shorter burn center LOS and greater FIM improvement compared with limited national burn patient functional outcome data currently available.     

手深度烧伤早期功能治疗的临床研究

目的探讨手深度烧伤后早期功能治疗的方法和临床效果。方法回顾性分析2009年7月至2010年5月42例手部深度烧伤患者的临床资料,对其早期功能的治疗方法和临床效果进行总结。结果本组42例手部深度烧伤患者经医务人员精心治疗,治愈32例,显效6例,有效2例,无效2例,治愈率为76.19%,总有效率为95.24%。结论 早期功能治疗可减轻和预防手深度烧伤后并发症,是促进手功能恢复和预后的重要措施之一。     

Nonthermal surgical complications in burn patients

Patients with severe burn injuries are generally admitted to specialized units and managed by physicians who specialize in burn care. Complications requiring operative intervention and not directly related to the burn wound occur frequently but are easily overlooked. To determine the nature and frequency of these complications, we conducted a retrospective study of all burn cases in our burn unit over a 5-year period. Twenty-three of the 309 patients (7%) had 45 complications not related directly to the burn wound and required surgical intervention or consultation. The population with surgical complications was generally older (52 vs 42 years), more severely burned (36% vs 25% total body surface area), and had a higher mortality (44% vs 13%). Sixteen of the 23 patients with complications had a single surgical problem, while seven patients sustained multiple complications. In six of the 10 deaths, the surgical complication was believed to be either directly related or significantly contributory to the cause of death. Because the number of burn patients requiring surgical intervention is high, burn patients must be thoroughly examined for possible complications.     

Body image issues for children and adolescents with burns

Body image is a far-reaching, multidimensional, dynamic concept. Because burn injuries threaten the integrity of both the physical and psychologic identity, body-image issues related to burn injuries appear to be a meaningful area of investigation. Little research has been done to directly assess body-image issues for children and adolescents with burns. We reviewed the general findings that body-image adaptation occurs and is influenced by gender, social support, burn severity, overall adjustment, and developmental stage. It is suggested that body-image revision, if it occurs, is largely successful, but body-image issues may not be directly related to psychosocial adjustment after a burn injury.     

Roles and functions of occupational therapy in burn care delivery

The occupational therapist functions as an integral member of the burn care team and assists patients in achieving an optimal level of independence and a satisfying life style after a burn injury. With early assessment and ongoing occupational therapy intervention, an individual recovering from a burn injury should be able to return to a functional life style more rapidly.     

烧伤患者医院感染情况调查及健康教育

目的　了解烧伤患者医院感染情况及相关因素。方法　对 680例烧伤患者进行回顾性调查分析。结果　 680例患者中 ,医院感染率为 7.94% ,医院感染与年龄、文化程度、经济状况、烧伤严重程度及患者的遵医行为有关 ;创面、肠道、呼吸道为病原菌侵入的主要途径 ,共占 79.63 % ;革兰阴性杆菌仍为感染病原菌的首位 ,占 75 .80 % ;实施健康教育前后的医院感染率比较 ,差异有极显著性 (P <0 .0 1)。结论　积极开展针对性健康教育是预防和控制烧伤患者医院感染的有效举措