压疮的防治及护理

压疮是由于局部软组织持续受压,血液流动学改变,导致软组织、细胞缺血缺氧,营养代谢障碍而发生的变性坏死。从病理、生理学角度准确地概括为压迫性溃疡。其发生原因是由多种因素引起的复杂病理过程,长期卧床的病人局部组织受压过久,皮肤经常受摩擦、潮湿等物理性刺激,全身营养缺乏,继发感染等会导致压疮形成。一旦发生压疮,影响病情,给病人增加痛苦,严重时引起脓毒败血症而危及生命,所以压疮一直是临床护理工作中较为棘手的问题。因此它是基础护理质量管理中的一个重要方面。     

压疮护理新进展

褥疮是因长期卧床局部受压 ,引起神经营养紊乱及血液循环障碍 ,局部组织持续缺血 ,营养不良而发生的软组织坏死。近年来这一名词渐被废弃 ,因为它不仅发生于卧床病人 ,许多也发生于坐位 ,现多采用压迫性溃疡或压疮 ,它从其发生的病理、生理学角度更准确地概括了本病的实质[1] 。它是临床常见的并发症之一 ,且很容易引起感染 ,一旦恶化会给病人带来极大的痛苦 ,甚至发生败血症而导致死亡 ,故是护理工作需攻克的“顽症”。压疮多好发于长期卧床、脊髓损伤、慢性神经系统疾病 (主要是脑血管病 )、体质虚弱、各种消耗性疾病及老年病人 ,若有低白…     

压疮的防治及护理

压疮是由于局部软组织持续受压,血液流动学改变,导致软组织、细胞缺血缺氧,营养代谢障碍而发生的变性坏死[1].从病理、生理学角度准确地概括为压迫性溃疡[2].其发生原因是由多种因素引起的复杂病理过程,长期卧床的病人局部组织受压过久,皮肤经常受摩擦、潮湿等物理性刺激,全身营养缺乏,继发感染等会导致压疮形成.一旦发生压疮,影响病情,给病人增加痛苦,严重时引起脓毒败血症而危及生命,所以压疮一直是临床护理工作中较为棘手的问题[3].因此它是基础护理质量管理中的一个重要方面.     

凡士林预防压疮的疗效观察

目的观察凡士林预防长期卧床病人发生压疮的效果。方法将84例易发生压疮的长期卧床病人随机分为实验组与对照组各42例,在常规护理均相同的情况下,实验组患者受压部位局部涂擦凡士林,对照组不用凡士林,比较2组病人压疮的发生率。结果实验组压疮发生率显著低于对照组(P<0.05)。结论凡士林预防压疮的效果明显,且能减少病人翻身的次数。     

凡士林预防压疮的疗效观察

目的 观察凡士林预防长期卧床病人发生压疮的效果.方法 将84例易发生压疮的长期卧床病人随机分为实验组与对照组各42例,在常规护理均相同的情况下,实验组患者受压部位局部涂擦凡士林,对照组不用凡士林,比较2组病人压疮的发生率.结果 实验组压疮发生率显著低于对照组(P＜0.05).结论 凡士林预防压疮的效果明显,且能减少病人翻身的次数.     

脑卒中病人预防压疮的护理体会

脑卒中是老年人的常见病、多发病,也是目前人类疾病死亡的三大原因之一。由于病人卧床时间较长,身体机能退化,自主活动能力受限,营养状况较差,免疫功能降低等因素,导致局部组织长期受压,血液循环障碍,极易发生压疮。一旦发生压疮,不仅降低病人的生活质量,增加护理难度,延长住院时间,而且增加了病人的痛苦和经济负担,影响疾病的康复。因此,加强护理,降低压疮发生率尤为重要。     

脑卒中病人预防压疮的护理体会

脑卒中是老年人的常见病、多发病,也是目前人类疾病死亡的三大原因之一.由于病人卧床时间较长,身体机能退化,自主活动能力受限,营养状况较差,免疫功能降低等因素,导致局部组织长期受压,血液循环障碍,极易发生压疮.一旦发生压疮,不仅降低病人的生活质量,增加护理难度,延长住院时间,而且增加了病人的痛苦和经济负担,影响疾病的康复.因此,加强护理,降低压疮发生率尤为重要.     

压疮的预防及护理体会

压疮是临床最常见的并发症之一，多发生于长期卧床、年老体弱、局部组织受压过久、血液循环障碍以及营养不良和恶病质的病人。另外，运动感觉功能衰退、反应迟钝也是导致压疮发生的原因之一。压疮的发生不但给病人带来痛苦，也影响疾病的治愈和身体的康复。并发感染时可导致败血症而危及生命，因此临床上护士做好压疮的预防及护理尤为重要。     

德莫林粉剂在压疮治疗中的应用

压疮是临床上常见的并发症,特别是长期卧床及有慢性消耗疾病的老年人更易发生,是临床护理工作中的重点,也是评判基础护理质量的重要标准。是由于病人局部组织长期受压,血液循环障碍,组织营养缺乏,导致皮肤失去正常功能而引起组织破损甚至坏死[1]。压疮病情轻者可给病人带来痛苦,影响疾病治疗,病情重者可导致败血症危及生命[2],给护理工作增加了许多工作量,在医院护理上采取了许多预防性措施,可避免压疮发生,但不能杜绝压疮发生。在临床上大部分压疮在家中发生,主     

谈预防压疮的体会

由于骨折病人卧床时间长,肢体不能自主活动以及翻身受限制,使局部组织受压力、摩擦力的作用,血液循环障碍,持续缺血、缺氧,营养不良,易导致压疮等皮肤并发症的发生,最终导致局部组织的坏死而形成溃疡[1-3].     

Intracranial pressure. Intracranial pressure monitoring

Based on the data on the current literature, the authors present the basic physiological and pathophysiological aspects of measurement of intracranial pressure and discuss indications for its monitoring and clinical value.     

Plasma osmotic pressure and oncotic pressure

Water distribution in the body fluid is controlled by osmotic pressure and oncotic pressure of plasma. Lower plasma osmotic pressure induces intracellular edema, while lower plasma oncotic pressure induces extracellular edema. The increase in osmo-active substance in plasma induces increase in plasma volume (or extracellular fluid), and then results in extracellular edema.     

Systolic pressure variation and pulse pressure variation during modifications of arterial pressure

OBJECTIVE: This study was performed to investigate the effect of vasopressor therapy on systolic pressure variation (SPV) and pulse pressure variation (PPV) compared to experimentally measured left ventricular stroke volume variation (SVV). DESIGN AND SETTING: Prospective study in a university laboratory. SUBJECTS: Twelve anesthetized and mechanically ventilated pigs. INTERVENTIONS: Increase in mean arterial pressure (by 100%) using phenylephrine and decrease (by 38%) using adenosine. MEASUREMENTS AND RESULTS: SPV and PPV were calculated and compared to SVV derived from aortic blood flow measurements. SPV was significantly affected by changes in arterial pressure [4.6% (1.5) vs. 6.3% (2.1), p[Symbol: see text]<[Symbol: see text]0.05, increased vs. decreased arterial pressure], whereas PPV did not change during modifications of arterial pressure. During baseline conditions and decreased afterload, correlation with SVV was good both for SPV (r[Symbol: see text]=[Symbol: see text]0.892 and r[Symbol: see text]=[Symbol: see text]0.859, respectively) and for PPV (r[Symbol: see text]=[Symbol: see text]0.870 and r[Symbol: see text]=[Symbol: see text]0.871, respectively) (all p[Symbol: see text]<[Symbol: see text]0.001). Correlation with SVV was only moderate during increased arterial pressure (r[Symbol: see text]=[Symbol: see text]0.683 for SPV and r[Symbol: see text]=[Symbol: see text]0.732 for PPV, p[Symbol: see text]<[Symbol: see text]0.05). CONCLUSION: For guiding fluid therapy in patients under vasopressor support, PPV seems superior to SPV.     

Intracranial pressure and cerebral perfusion pressure in near-drowning

Intracranial pressure (ICP) and cerebral perfusion pressure (CPP) were strictly controlled in 11 pediatric victims of near-drowning. Three outcome groups were defined: complete recovery, persistent vegetative state, and death. In the early postimmersion phase (first 72 h), CPP was consistently above 50 mm Hg in all patients. There were occasional, nonrepetitive, and easily controllable ICP spikes above 15 mm Hg in three patients from each group. Repeated ICP spikes above 15 mm Hg were observed in some patients with adverse outcome only after 72 h. Successful control of ICP and CPP did not ensure intact survival, and sustained late intracranial hypertension is more likely a sign of profound neurologic insult rather than its cause.     

Pulmonary artery pressure versus pulmonary capillary wedge pressure and central venous pressure in shock

Evidence is presented from 43 dogs and 30 patients that under conditions of severe hemorrhagic, traumatic or septic shock, there may be partial obstruction of the pulmonary microcirculation due to disseminated intravascular coagulation (DIC) particularly in the pulmonary venules. This may cause the left atrial pressure to fall and the pulmonary artery pressure to rise, in some cases drastically. Pulmonary edema may result. This dangerous rise in pulmonary artery pressure is not reflected by the wedged pulmonary artery catheter which will monitor only the status of the left heart. Central venous pressure (CVP) may remain within normal limits even after pulmonary artery pressure has risen to dangerous levels with the development of pulmonary edema. It is only with right ventricle failure against the high pulmonary pressure that CVP rises. It is concluded that pulmonary artery pressure measurements are very important in monitoring intravenous fluid administration in severe shock. Wedged pulmonary artery pressures monitor the left heart but may be misleading if taken alone. Central venous pressure gives a delayed response to fluid overload.     

Effect of positive end-expiratory pressure on intra-abdominal pressure

Massive elevation of intra-abdominal pressure (IAP) causes renal, cardiovascular, and respiratory dysfunction. Positive end-expiratory pressure (PEEP) markedly increases the detrimental effect of IAP on the cardiovascular system. The purpose of this study was to determine the effect of PEEP on IAP. In 15 patients requiring mechanical ventilation, IAP was measured, after 15-minute equilibration intervals, at PEEP levels of 0, 5, 10, and 15 cm H2O. Parametric analysis with multiple paired t tests and nonparametric analysis with Spearman's rho and Kendall's tau tests were used to determine correlation between PEEP and IAP. All patients were male. The mean age was 39 years (range, 18-77). Ten patients had just had laparotomy. No correlation was found between PEEP and IAP. We conclude that PEEP of 15 cm H2O or less has no effect on IAP, and we discuss the clinical implications.