静脉输液外渗的原因分析及预防

静脉输液外渗的原因分析(1)患者因素:①新生儿:新生儿因全身都分布有胎脂,需做静脉输液者,有的是皮肤苍白,有的是皮肤青紫,能做穿刺的地方只有头皮,可见的血管很少,穿刺难度大,固定后易脱落,加之哺乳或喂食影响,使其易外渗。②婴幼儿:婴幼儿由于哭闹、不配合,其血管短、不直,且家长都很紧张,无形中给护理人员增加了压力,给静脉穿刺增加了难度;在输液过程中小儿天性好动,难于固定,易发生外渗,一发生外渗又难于表达疼痛的感受,所以小儿外渗多于成人,严重外渗也多于成人。③老年人:老年人由于生理、心理、行为功能减退,容易失控导致注射针头移…     

婴幼儿头皮静脉针固定方法介绍

一岁以下的婴幼儿，多采用头皮静脉输液，由于婴幼儿哭闹、出汗多、不合作，易造成胶布脱落引起药液外渗。所以头皮静脉穿刺成功后，固定非常重要、它关系到整个输液过程是否能顺利完成。     

静脉输液外渗的原因分析及机制

<正>静脉输液外渗是临床工作中经常遇到的护理问题,一旦发生,如果不采取积极正确的措施,将会发生严重的后果;所以认真分析发生静脉输液外渗的原因,采取积极的预防措施及相应的护理对策具有重要的意义。1静脉输液外渗的原因分析1.1患者因素①新生儿。新生儿因全身都分布有胎脂,需做静脉输液者有的是皮肤苍白,有的是皮肤青紫,仅能做穿刺的地方只有头皮,可见的血管很少,穿刺难度     

婴幼儿头皮静脉穿刺技巧和护理体会

婴幼儿静脉输液是一项难度大、穿刺技术要求高及需要耐心、细致的工作。婴幼儿静脉输液不仅要求护士有娴熟的穿刺技术，良好的心理素质，丰富的临床经验，还要对患儿进行心理及人文护理。婴幼儿头皮静脉穿刺是新生儿及婴幼儿常见输液方法，因婴幼儿头皮静脉极为丰富，分支多，表浅易固定，输液过程中体位舒适，易于保暖，不影响其他治疗和护理工作。笔者在多年上千例婴幼儿静脉输液实践中和结合理论学习总结出以下几点体会。     

两种小儿头皮静脉输液针固定方法的效果比较

2岁以下的婴幼儿，多采用头皮静脉输液，由于婴幼儿哭闹、出汗多、不合作，使围定头皮针的胶布不易粘牢，易造成针头滑出，或针头刺破血管壁使局部药液外渗，常需重复穿刺。所以头皮静脉穿刺成功后，固定非常重要，它关系到整个输液过程是否能顺利完成。在临床护理工作中，笔者就小儿头皮静脉穿刺针的固定方法进行了研究、改进，并与传统固定法进行了效果比较。现报告如下。     

股静脉留置输液在新生儿颅内出血中的应用

目的 :通过对股静脉留置输液和头皮静脉留置输液比较 ,从而减轻对新生儿颅内出血的刺激。方法 :对 80例新生儿颅内出血患儿 ,分别进行头皮静脉留置输液和股静脉留置输液 ,对重复穿刺、液体外渗和局部静脉炎进行比较。结果 :股静脉留置输液在重复穿刺、液体外渗和局部静脉炎明显少于头皮静脉输液 ,二种输液方法经统计学分析有明显差异 (P <0 .0 1)。结论 :股静脉留置输液不但减少对患儿的刺激及痛苦 ,而且减少再出血现象 ,同时提高护理工作效率和护理质量     

腋下静脉与手背静脉留置针在新生儿输液中的比较

目的 探讨腋下静脉在新生儿输液中的应用价值.方法 将新生儿60例,(其中早产儿20例)分为腋下静脉留置针穿刺组与手背静脉留置针穿刺组,比较两组患儿住院过程中反复穿刺的次数,留置时间的长短,输液外渗及红肿发生率.结果 腋下静脉穿刺组较手背静脉穿刺组的留置时间长,反复穿刺次数少,外渗及红肿发生率低.两组穿刺成功率比较差异无统计学意义(P>0.05).结论 腋下静脉穿刺留置时间长于手背静脉穿刺留置时间,减少了住院期间患儿反复穿刺、外渗及红肿,减轻患儿住院期间的痛苦和多次穿刺带来的血管损伤,利于新生儿的留置及应用.     

新生儿腋静脉留置针穿刺效果探讨

［摘要］目的　探讨新生儿腋静脉留置针穿刺应用效果．方法　将云南省第三人民医院儿科2015年9月至2016年2月采用静脉留置针穿刺输液新生儿180例,随机选择90例作为实验组,采用腋静脉留置针穿刺输液,90例作为对照组,采用四肢静脉穿刺输液．比较2组的应用效果．结果　实验组与对照组在留置针脱落、静脉炎、药物外渗、留置时间等方面进行对比,差异有统计学意义（P＜0.05）．结论　新生儿留置针穿刺输液过程中,采用腋静脉留置针穿刺输液能防止留置针脱落、减少静脉炎的发生及降低药物外渗的发生率,并且可以延长留置时间．该穿刺操作简便易行、易学、无需特殊的设施设备,经济实用,纸胶布,适宜在新生儿病房推广应用.     

湿润烧伤膏外用在治疗输液所致静脉炎中的效果分析

婴幼儿烫伤后静脉输液治疗是相当重要的救治措施。但由于输液量大、刺激性药物多、留置针留置时间长、患儿因疼痛躁动造成穿刺失败;血管壁通透性增强,液体大量外渗等原因常造成静脉炎的发生。为减轻患儿痛苦,减少静脉损伤,     

33%硫酸镁湿热敷对静脉炎、输液外渗的疗效观察

静脉炎、输液外渗是临床上最常见、最易发生的静脉输液造成的一种炎症,由于患者躁动不安或周围静脉穿刺位置不妥引起静脉输液过程中液体渗出或外渗至皮下,导致皮下组织出现肿胀疼痛,影响肢体功能,从而导致静脉炎的发生,严重者可致皮肤坏死,增加患者痛苦,易引起护患冲突。我院采用33%硫酸镁湿热敷治疗输液外渗及静脉炎,收到了较好的疗效,现总结如下。     

表皮生长因子受体酪氨酸激酶抑制剂在非小细胞肺癌应用的瓶颈——获得性耐药

以表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI）分子靶向治疗研究为肇始,转化性研究使基础实验和临床实践间的鸿沟迅速填平,改变着人们认识治疗肺癌的视角。无可否认,EGFR-TKI上市后极大地延伸了肿瘤学家治疗肺癌的手段,但不管从临床经验、临床研究数据、分子生物学层面还是文献计量学的角度,     

益智健脑颗粒联合针灸对阿尔茨海默病大鼠学习记忆的影响

目的观察益智健脑颗粒联合针灸对阿尔茨海默病（Alzheimers disease,AD）大鼠学习记忆的影响。方法将大鼠随机分为假手术组（A组）、模型组（B组）、针灸组（C组）、益智＋针灸组（D组）各10只,B、C、D 3组分别以海马CA1区注射β淀粉样蛋白25-35（Aβ25-35）造模,A组注射等量的双蒸水,各组分别治疗20 d后行Morris水迷宫试验,观察大鼠学习记忆能力变化。结果B组较A组的平均潜伏期明显延长,差异具有统计学意义（P〈0.05）;与B组比较,C组、D组的平均潜伏期明显缩短,过台次数增多,差异具有统计学意义（P〈0.05,P〈0.01）;与C组比较,D组的潜伏期缩短,过台次数增多,差异具有统计学意义（P〈0.05）。结论益智健脑颗粒联合针灸能够提高Aβ25-35介导的AD模型大鼠的学习记忆能力。     

New Mechanism of Herb-herb Interaction between Ginseng and Trogopterus Based on CYPs in Rat Livers

The study was designed to investigate the potential mechanism of herb-herb interaction between ginseng and Trogopterus （Trg） based on Cytochrome P450 isozymes （CYPs） in rat livers. We estimated the influence on CYP1A2, CYP2E1, and CYP3A1/2 activity caused by ginseng and Trg used in combination. The CYP1A2 and CYP2E1 enzyme activity were induced by ginseng and Trg used in combination. And this induction effect was caused via inducing CYP1A2 and CYP2E1 protein expression which was supposed caused by inducing the gene expression of CYP1A2 and CYP2E1.     

Liuwei Dihuang,a traditional Chinese herbal formula,suppresses chronic inflammation and oxidative stress in obese rats

OBJECTIVE： To investigate the anti-inflammatory, anti-oxidative stress, and adipokine-ameliorating effects of Liuwei Dihuang （LWDH）, a traditional Chinese herbal formula, in obese rats. METHODS： After 2 weeks of acclimation with free access to regular rodent chow and water, obese-prone-caesarean-derived （OP-CD） rats were fed a modified AIN-93G diet containing 60% energy from fat. Treatment was performed twice daily by gavage feeding with 500, 1 500, or 3 500 mg/kg body weight LWDH suspended in water （n=12 rats per group）. Twelve obese-resistant-CD （OR-CD） rats were fed the atherogenic diet and gavaged with water, and served as the normal control. Blood biomarkers of inflammation, oxidative stress and adiponectin were measured post-sacrifice and used to determine the treatment effect of LWDH and assess the suitability of OR/OP-CD rats for studying these parameters. RESULTS： After 9 weeks of treatment, LWDH lowered serum C-reactive protein （CRP） and tumour necrosis factor-α （TNF-α） levels. Serum interleukin-6 （IL-6） levels showed a tendency towards reduction, but were not significantly different from the OP-CD control. Liver superoxide dismutase （SOD） activity was increased in response to all three doses of LWDH, while the levels of reduced （GSH） and oxidized glutathione （GSSG） and thiobarbituric acid reactive substances （TBARS） were unchanged. Serum adiponectin levels were increased in response to oral administration of LWDH at the dose of either 500 or 1 500 mg/kg body weight. In addition, comparisons between OR-CD and OP-CD rats revealed differential, and for some biomarkers, conflicting characteristics of high-fat diet-fed OP-CD rats in reference to obese human subjects in terms of inflammatory and oxidative stress biomarkers and circulating adiponectin levels. CONCLUSION： The results show, for the first time, the anti-inflammatory, anti-oxidative stress and adiponectin-ameliorating effects of LWDH in obese rats. The suitability of the OP-JOP-CD rat model as     

中医疗法治疗运动性疲劳的研究进展

随着竞技体育的发展，运动员经常承受着大负荷、超强度的体力训练，因此极易产生运动性疲劳。疲劳的出现使肌内压增高，局部缺血，造成氧化代谢、H^＋排出率与pH值降低，血乳酸增高，从而影响肌纤维神经传导速度和肌内收缩力量，减弱了肌肉保护能力。致使较多的冲击力传到骨骼上，故易导致疲劳骨折的发生,严重影响了运动员的训练和比赛成绩，对运动员身心产生不必要的伤害。运动性疲劳消除手段的研究一直是竞技体育工作和运动医学关注和研究的焦点。     

Effects of tacrolimus and cyclosporine treatment on metabolic syndrome and cardiovascular risk factors after renal transplantation: a meta-analysis

Background The therapeutic success of renal transplantation has been largely attributable to the development of effective and balanced immunosuppressive treatment regimens.This study provides a meta-analysis of a series of randomized controlled trials that compared the effects of tacrolimus and cyclosporine on metabolic syndrome （MetS） and cardiovascular risk factors after renal transplantation.Methods We searched various electronic databases and bibliographies,including MEDLINE,the Cochrane Central Register of Controlled Trials,and EMBASE,for relevant studies published prior to October 2012.Results Our meta-analysis included five randomized controlled trials that examined a total of 923 patients.The tacrolimus group and the cyclosporine group exhibited no significant differences in MetS incidence after renal transplantation; risk ratio （RR）：1.06,95％ confidence interval （C/）：0.73-1.55,P=0.76.Cyclosporine treatment was associated with a higher incidence of hyperlipidemia （RR：0.50,95％ CI：0.39-0.64,P ＜0.01）.Although there were no statistically significant differences,cyclosporine treatment was associated with a higher incidence of hypertension （RR：0.91,95％ CI：0.83-1.00,P=0.06） after renal transplantation compared to tacrolimus treatment,and tacrolimus treatment was associated with a higher incidence of diabetes after renal transplantation （RR：1.79,95％ CI：0.98-3.27,P=0.06） compared to cyclosporine treatment.Conclusions Compared to tacrolimus treatment,cyclosporine treatment was associated with a higher incidence of hyperlipidemia.Future large-scale studies are expected to be conducted to further confirm our findings.     

糖络方联合弥可保治疗2型糖尿病周围神经病变的临床观察

目的观察益气养阴活血通络之糖络方联合弥可保治疗2型糖尿病周围神经病变的疗效。方法将65例患者随机分成治疗组（中西药组）和对照组（西药组）,均在西药降血糖基本达标的同时,对照组单纯口服弥可保,治疗组口服弥可保的基础上加用糖络方内服,治疗8周。结果总有效率及治疗后证候积分比较,治疗组优于对照组,差异有统计学意义（P〈0．05）;治疗后肌电图比较,治疗组优于对照组,差异有统计学意义（P〈0．01）。结论益气养阴活血通络之糖络方联合弥可保治疗2型糖尿病周围神经病变疗效优于单用弥可保,是治疗该病的有效方剂之一。     

程丑夫教授论治情志病验案举隅

程丑夫是国家级名老中医,湖南中医药大学第一附属医院主任医师、教授、博士生导师,享受政府特殊津贴专家,出身于中医世家,从医40余年,经验丰富,对于内科系统及疑难杂症的治疗颇有心得,笔者有幸跟师学习,聆听教诲,受益匪浅,现将程师论治情志病的经典验案略陈一二。1思虑伤脾案患者肖某,女,27岁。初诊：2014年5月20日。半年前因婚变后出现忧心忡忡,多思多虑,近1月来反复腹部胀满,刻诊：腹胀,食后为甚,呃逆,无反酸,通气后可减轻,无腹痛,不欲食,夜寐不安,二便调。舌红苔厚白腻,脉弦,BP：110／70mmHg。     

Comparison of result judgment algorithm of test for interfering factors in the bacterial endotoxins test among Chinese, Japanese, European, American, and Indian pharmacopeias

Background The bacterial endotoxins test （BET） is a method used to detect or quantify endotoxins （lipo-polysaccharide,LPS） and is widely used in the quality control of parenteral medicines/vaccines and clinical dialysis fluid.It is also used in the diagnosis of endotoxemia and in detection of environment air quality control.Although BET has been adopted by most pharmacopoeias,result judgment algorithms （RJAs） of the test for interfering factors in the BET still differ between certain pharmacopoeias.We have evaluated RJAs of the test for interfering factors for the revision of BET described in the Chinese Pharmacopoeia 2010 （CHP2010）.Methods Original data from 1 748 samples were judged by RJAs of the Chinese Pharmacopoeia 2010,the Japanese Pharmacopoeia 2011 （JP2011）,the European Pharmacopoeia 7.0 （EP7.0）,the United States Pharmacopoeia 36 （USP36）,and the Indian Pharmacopoeia 2010 （IP2010）,respectively.A SAS software package was used in the statistical analysis.Results The results using CHP2010 and USP36,JP2011,EP7.0,and IP2010 had no significant difference （P=-0.7740）.The results using CHP2010 of 1 748 samples showed that 132 samples （7.6%） required an additional step; nevertheless there was no such requirement when using the other pharmacopeias.The kappa value of two RJAs （CHP2010 and EP7.0） was 0.6900 （0.6297-0.7504） indicating that the CHP2010 and other pharmacopoeias have good consistency.Conclusions The results using CHP2010 and USP36,JP2011,EP7.0,and IP2010 have different characteristics.CHP2010 method shows a good performance in Specificity,mistake diagnostic rate,agreement rate,predictive value for suspicious rate,and predictive value for passed rate.The CHP2010 method only had disadvantages in sensitivity compared with other pharmacopeias.We suggest that the Chinese pharmacopoeia interference test be revised in accordance with the USP36,JP2011,EP7.0,and IP2010 judgment model.     

WHO西太区与“世界中医药学会联合会”中医名词术语国际标准比较研究：精、神、气、血、津、液部分

精、神、气、血、津、液是中医理论中6个非常重要的概念，有关术语在《WHO西太区传统医学国际标准名词术语》中一共收录了59条，“世界中医药学会联合会”（以下简称世中联）《中医基本名词术语中英对照国际标准》中收录了58条。血、津、液的内涵较为具体，有一定的物质基础，理解并不困难。翻译上虽有差异，但亦不难统一。精、神、