斜视手术切口选择及手术配合分析

目的了解斜视手术不同切口的效果。方法采用4种结膜切口方式,观察临床效果。结果通过50例58只眼手术,不同术式各有利弊。结论根据临床需求选择合适的切口,才能利于视功能恢复并达到美容目的。     

简易放腹水装置的制作

腹腔穿刺是一项常规的无菌技术,常由医生进行穿刺,护士配合医生完成.常规方法是穿刺成功后用灭菌的50 mL注射器连接乳胶管进行抽吸,并记录引流量.现介绍一种简易放腹水装置,经临床使用,效果较好.     

早产儿视网膜病变筛查的护理研究

目的探讨早产儿视网膜病变筛查的护理方法。方法将464例早产儿按就诊体重分为三组：〈2500g168例,2500-3500g132例,〉3500g164例;按使用硫酸阿托品眼膏的不同浓度分为四组：0．25％硫酸阿托品158例,0．5％硫酸阿托品112例,0．75％硫酸阿托品91例,1％硫酸阿托品103例。观察各组患儿在随机使用药物时有无不良反应,在筛查中做好护理。结果同组体重患儿在不同浓度硫酸阿托品眼膏的使用中不良反应差异无显著意义（P〉0．05）;同浓度的硫酸阿托品眼膏在不同体重分组的患儿使用中不良反应差异也无显著意义（P〉0．05）。结论硫酸阿托品眼膏在早产儿散瞳应用中是安全的。充分散瞳,认真做好筛查护理,可以为筛查工作的顺利进行提供有力的保证。     

静脉药物配置中心在细胞毒性药物管理中的作用

目的评价静脉药物配置中心（PIVAS）在细胞毒性药物管理中的作用。方法从环境和人力技术支持等方面探索静脉药物配置中心在细胞毒性药物管理中的作用。结果静脉药物配置中心为细胞毒性药物的配制提供了环境的支持,减少了护士在配制过程中的职业损害,药师在细胞毒性药物处方制定、标准化配制、药学监控和药学咨询上提供技术支持。结论静脉药物配置中心在细胞毒性药物的配制中发挥着重要作用。     

康复治疗学专业本科学历教育的探讨

为了争取与国际康复医学教育接轨,我院在康复治疗学专业教育方面进行了不断的改革与探索,重新制订了符合国际标准和国内本科教育标准要求的课程设置和教学计划,优化了教学内容与课程体系,完善与修订了教学大纲和实习指导,进行了教学方法改革,形成了与该专业人才培养模式相适应的理论教学体系和实践体系,探索了符合中国国情的办学模式.     

Remifentanil analgesia for aspiration of follicles for oocyte retrieval

Remifentanil is an esterase-metabolized ultra-short acting mu-agonist opioid with a rapid clearance. The aim of this study was to determine the efficacy of remifentanil infusion for the short-lasting, but painful, transvaginal puncture for oocyte retrieval. Eighty consenting adult women (ASA I and II) aged 30.5 +/- 5 years and with a body weight of 69.1 +/- 9.1 kg were enrolled in this prospective study. After an oral premedication with 7.5 mg midazolam, all patients received 3 l/min oxygen. Subsequently, the remifentanil infusion was started with a rate of 0.3 microg/kg/min. Remifenanil doses were adjusted as needed for painless puncture and sufficient oxygen saturation in steps of 0.05 microg/kg/min. Dosage requirements, blood pressure, heart rate, oxygen saturation (pulse oxymetry, SaO2) and the level of analgesia were recorded every 3 minutes. Follicular aspiration lasted 11.8 +/- 4.1 min and the time of remifentanil infusion was 18.7 +/- 4.6 min. Dosage requirements of remifentanil were 0.3 microg/kg/min in 48.7% of all patients, but 27.8% needed only 0.25 microg/kg/min and 16.6% needed only 0.2 microg/kg/min. However, 4.2% of patients needed 0.35 microg/kg/min and 2.7% of all cases needed 0.4 microg/kg/min. Vital parameters remained nearly unchanged. Oxygen saturation decreased significantly from 99.2 +/- 0.7% to 98.2 +/- 2.4% after 3 min and to 94.9 +/- 7.2% after 10 min. Nine women showed motoric reactions to puncture. In many cases, the infusion of remifentanil after premedication with midazolam provided a suitable and satisfying anaesthesia for oocyte retrieval. Some patients, however, showed motoric reactions to vaginal puncture, while in other cases significant and clinical relevant decreases in Hb-oxygen saturation occurred. Therefore, we no longer carry out remifentanil infusion for transvaginal oocyte retrieval. We now prefer a remifentanil infusion of 0.2 microg/kg/min and propofol (1 mg/kg initially with intermittent doses of 0.5 mg/kg) combined with assisted ventilation by mask.     

Rationale for the use of extracorporeal treatments for sepsis

Sepsis is the leading cause of disability and mortality among critical patients; moreover, it causes high economic expenditures. Although very much is known about the pathophysiology of this condition and its mediators despite great investments directed to its control, mortality rates remain high. Recent treatment manuals emphasize the value of early goal-oriented therapy and also point to the high efficacy of activated protein C. Extracorporeal blood clearance may potentially become a new approach to treating this condition. There are reports on its positive clinical results that are likely associated with the effective removal of septic mediators. Human and animal studies, few and rather alike as they are, have yielded promising results. It is evident that the use of these procedures is justified; however, their efficiency in sepsis requires large-scale, correctly conducted studies.