舒适护理对剖宫产患者疼痛及应激水平的影 响简

目的 探讨舒适护理对剖宫产患者疼痛及应激水平的影响.方法 选择2011年6月～2013年4月义乌市中医医院妇产科50例行择期剖宫产术患者作为研究对像,将其随机分为对照组和观察组,每组各25例.对照组给予常规观察和护理,观察组在对照组护理的基础上给予舒适护理,观察两组患者入手术室时和手术结束前10 min的焦虑自评量表评分（SAS评分）和皮质醇（Cort）水平变化,采用视觉模拟评分法（VAS评分）记录患者术后24 h的疼痛情况,并使用调查表的形式调查患者对护理的满意度,并对以上数据进行统计分析.结果 ①干预前两组SAS焦虑自评差异无统计学意义（P＞0.05）,干预后对照组和观察组的SAS评分分别为（48.62±8.36）、（35.31±5.96）分,两组比较,差异有高度统计学意义（P＜0.01）;②干预前Cort水平两组间差异无统计学意义（P＞0.05）,干预后对照组和观察组的Cort水平分别为（3.49±0.91）、（2.38±0.52）分,两组比较,差异有统计学意义（P＜0.05）;③干预后观察组的VAS评分、患者满意度均优于对照组（P＜ 0.05或P＜0.01）.结论 舒适护理干预可有效缓解剖宫产患者疼痛症状,减轻患者的手术应激反应,提高患者的满意度.     

心理干预在急性胰腺炎胃肠减压患者中的应用

目的 探讨心理干预在急性胰腺炎胃肠减压患者中的作用.方法 在256例急性胰腺炎胃肠减压患者中选取152例自然条件相当的病人随机分为两组:对照组和心理干预组,心理干预组在一般常规护理的基础上在插管前、中、后给予针对性的心理护理,评定两组的焦虑值(SAS、VAS评分),测定两组病人置管前后30分钟的血压和心率,评估首次和再次置管成功率.结果 干预组置管后30分钟的SAS、VAS评分显著低于对照组(均P＜0.01);置管后30分钟的血压、脉搏明显低于对照组(P＜0.01);首次和再次置管成功率明显高于对照组(P＜0.001).结论 对急性胰腺炎胃肠减压患者实施有效的心理干预,能减轻患者的恐惧、焦虑症状,提高插管的成功率和置管的有效性.     

心理干预护理在甲亢患者护理中的应用效果

目的:分析在甲亢患者护理中心理干预的临床应用效果。方法:收集2014年1月-2015年6月我院收治的74例甲亢患者为研究对象,将其随机分为对照组与观察组各37例,对照给予常规护理,在常规护理基础上对照组给予心理干预,对比分析两组患者护理前后焦虑、抑郁程度及血压升高、心率加快发生情况。结果:护理前,两组SAS评分、SDS评分对比,无明显差异(P0.05);护理后,观察组患者SAS评分、SDS评分低于对照组,数据差异显著(P0.05)。观察组血压升高、心率加快发生率低于对照组,数据差异明显(P0.05)。结论:在甲亢患者护理中心理干预的临床应用效果显著,建议在临床上推广。     

音乐疗法对局部麻醉乳腺手术患者焦虑的干预效果

目的:观察音乐疗法对局部麻醉乳腺手术患者焦虑的干预效果。方法:将100例局部麻醉手术患者分为对照组和观察组,对观察组患者进行音乐干预,采用汉密尔顿焦虑量表进行焦虑程度测定,并监测血压和心率的变化。结果:与对照组相比,观察组患者的焦虑程度有所降低,血压和心率也有所下降(P﹤0.05)。结论:音乐疗法能有效干预局部麻醉手术患者的焦虑心理。     

心理行为干预对全脑血管造影患者负性情绪及血压的影响

目的:探讨采用心理行为干预对全脑血管造影患者负性情绪和血压的影响。方法:选择2015年5月-2016年6月在本院行全脑血管造影术患者56例,根据护理方式不同将患者分为对照组(给予常规护理干预)与观察组(给予心理行为干预),各28例。比较两组患者负性情绪(SAS、SDS评分)及血压变化情况。结果:手术前,两组患者的血压水平及SAS、SDS评分比较,差异均无统计学意义(P0.05);观察组手术期间收缩压、舒张压水平均优于对照组,差异均有统计学意义(P0.05);手术后,观察组的SAS、SDS评分均低于对照组,差异均有统计学意义(P0.05)。结论:采用心理行为干预可有效改善全脑血管造影患者的焦虑、抑郁等负性情绪,可调节患者的血压水平。     

CT增强前患者心理护理的方法及干预效果

目的:探讨CT增强前患者心理护理的方法及干预效果。方法:收集我院接受CT增强扫描的患者,部位为心脏、肺部、肝脏、头颅等。分为:研究组和对照组。对照组CT增强前不接受心理护理,研究组术前进行心理护理。对比(1)两组护理前后血压、心率水平。(2)两组护理前后焦虑评分。结果:两组护理前血压、心率、焦虑评分比较无差异(P0.05);两组护理后血压、心率、焦虑评分比较有差异(P0.05)。结论:通过心理护理可以改善CT增强前患者不良情绪,稳定血流动力学。     

人性化护理干预在剖宫产手术中的应用效果评价

目的评价人性化护理干预在剖宫产手术中的应用效果。方法选取2016年1月~2017年1月在我院行剖宫产手术的200例产妇作为研究对象,采用随机数字表法随机分为两组。对照组予常规护理,干预组予围术期实施人性化护理,对两组产妇的焦虑心理、疼痛程度及护理满意度进行评价。结果经配对t检验显示,干预前两组患者的SAS、VAS评分比较,差异无统计学意义(P0.05);干预后,两组患者的SAS、VAS评分均明显降低,且干预组显著低于对照组,差异有统计学意义(P0.05)。经χ2检验显示,干预组的护理满意度显著高于对照组,差异有统计学意义(P0.05)。结论于剖宫产手术围术期实施人性化护理,具有患者痛苦少、护理满意度高等优点,显著减轻了患者的焦虑心理,提高了护理质量及改善了医患关系。     

全程综合性心理干预加音乐疗法对缓解人工流产手术患者焦虑心理的研究

目的 探讨全程综合性心理干预加音乐疗法对缓解人工流产手术患者焦虑心理的效果.方法 选取做人工流产手术的女性60例,随机分为观察组30例和对照组30例,观察组给予全程综合性心理干预加音乐疗法,对照组按传统方法施行人工流产手术,观察两组患者心理和生理变化情况.结果 观察组焦虑、疼痛程度均低于对照组,心率、血压波动范围小,两者比较差异具有统计学意义(P＜0.05).结论 全程综合性心理干预加音乐疗法能缓解人工流产手术患者焦虑心理.     

音乐疗法联合心理护理在剖宫产围手术期应用的效果评价

目的音乐疗法联合心理护理在剖宫产围手术期应用效果观察。方法将120名剖宫产患者随机分为治疗组和对照组,治疗组60例和对照组60例。治疗组采用音乐疗法联合心理护理治疗,对照组采用常规治疗。结果干预前两组患者焦虑状态无显著性差异(P0.05);干预后实验组患者焦虑值明显低于对照组,两组比较有显著性差异(P0.05)。治疗组总满意度为91.67%,对照组总满意度为81.67%,两组总满意度比较差异有统计学意义(P0.05)。结论音乐疗法联合心理护理能改善剖宫产患者心理焦虑和疼痛。     

综合护理干预在降低手术室患者手术应激中的作用

目的探究综合护理干预在降低手术室患者手术应激中的作用。方法选择2013年7月‐2014年7月前来就诊的120例待手术患者为研究对象。将其分为对照组与干预组。对照组行常规手术室护理,干预组在常规手术室护理基础上行综合护理干预,对两组患者舒适度,心理与生理应激情况,护理满意度进行调查。结果术前24 h两组患者的心率,血压情况比较差异无计学意义;手术开始时,干预组患者相关血压、心率以及舒适程度明显好于对照组,P0.05;两组患者术前抑郁自评量表(SDS)、焦虑自评量表(SAS)比较差异无统计学意义;两组患者术后疼痛感评分和术中肌肉紧张程度比较差异有统计学意义(P0.05);术后干预组患者的SDS、SAS评分明显比对照组低(P0.05),干预组舒适度与护理满意度上要好于对照组(P0.05)。结论综合护理干预是优质护理的根本体现,可全面提升护理质量,减少患者手术应激,保证手术的安全性,值得进一步在临床中推广。     

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.     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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…     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.