烧伤换药中利用腕踝针镇痛的疗效观察

创面换药是烧伤治疗中必须采取的一种方法 ,但烧伤创面尤其是Ⅱ度烧伤创面的痛觉敏感。换药时由于更换敷料、清除创面上坏死组织及分泌物时的操作会进一步加重病人的痛苦 ,部分病人甚至因此拒绝接受治疗。目前 ,我国烧伤临床尚未对创面疼痛问题给予足够重视 ,也没有规范的镇痛方法。腕踝针作为中医镇痛的一种方法 ,用于烧伤临床镇痛未见有临床护理操作方法的规范性和可行性报道 ,或对该方法镇痛效果量化的相关报道 ,为此我们进行了以下研究。1　资料与方法1.1　临床资料　选择伤后 3天内入院 ,能够进行正常交流并真实描述主观感受的烧伤病人…     

不同温度膀胱冲洗对患者生命体征的影响

目的探讨常温膀胱冲洗与加温（37～38℃）膀胱冲洗对长期留置尿管患者的生命体征影响。方法随机将120例留置尿管患者分为实验组与对照组,每组60例。两组均采用三腔Folley导尿管形成密闭式膀胱冲洗系统,冲洗液为1∶5000呋喃西林溶液500ml,冲洗速度160滴/min,约45min滴完。实验组冲洗液不加热,室温为（23±2.13）℃;对照组采用HWQ-Ⅱ型人体恒温输液加热器,加热冲洗液至37～38℃。比较冲洗前、中、后两组患者的生命体征。结果实验组与对照组在冲洗前、中、后的各项生命体征比较,差异无统计学意义（均P〉0.05）。结论当室内温度大于21℃时,常温膀胱冲洗对患者生命体征无影响,且更为简便可行。     

术前访视对乳癌患者手术前生命体征的影响

目的:探讨术前访视对乳癌患者手术前生命体征的影响。方法:40例乳腺癌患者根据住院号的先后随机分为两组:实验组和对照组,每组各20例。实验组进行术前访视,对照组未进行术前访视。并观察两组术前的生命体征的变化情况。结果:实验组术前收缩压和脉搏与对照组比较,有显著性差异(P<0.05)。结论:术前访视可减轻手术患者的焦虑和恐惧心理,使患者处于轻度的紧张状态,有利于调动机体的防御机制,使麻醉和手术顺利进行。     

不同侧上臂监测对老年偏瘫患者生命体征的影响

目的探讨老年偏瘫患者在心电监护中健侧与瘫痪侧手臂的体温、脉搏、血压及血氧饱和度是否存在差异。方法60例患者每天测量患侧及健侧手臂体温、脉搏、血压及血氧饱和度值,连续监测30d,比较患侧及健侧手臂体温、脉搏、血压及血氧饱和度监测值。结果60例患者健侧舒张压、脉搏、血氧饱和度与患侧比较,差异均无统计学意义（P〉0．05）;患者健侧的体温及收缩压分别为（36．2±0．2）℃,（142±13．9）mmHg,与患侧的（36．1±0．2）℃,（125±12。2）mmHg比较,差异均有统计学意义（t分别为2．045,11．200;P〈0．05）。结论老年偏瘫患者在心电监护中健侧与瘫痪侧手臂的脉搏、血氧饱和度无差异;而体温、血压存在差异,建议测量体温时用健侧上臂;首次测量血压时先测量双上臂血压,若双上臂血压差值≥10mmHg时,以血压高的一侧上臂为测量肢体。通过对患者生命体征准确的测量,以保证患者及时、正确的治疗与抢救。     

术前访视对手术病人生命体征影响的探讨

目的探讨术前访视的必要性，为手术室开展术前访视提供内容和方法。方法选择80例择期手术病人随机分为观察组和对照组各40例，观察组病人由手术室护士在术前进行手术前环境等情况介绍，对照组无此项干预行为。结果术前观察组的生命体征波动变动低于对照组（P〈0．05）。结论病人进入手术室后因陌生的环境和情景使病人的生命体征波动增大，而术前访视缓冲了手术病人术前的应激反应，有利于手术麻醉的顺利进行，有利于患者的术后康复。     

心肌梗塞患者的生命体征变化及观察要点

心肌梗塞(MI)是冠心病的一种严重表现形式,是引起患者死亡的主要原因。因MI患者的生命体征变化快而复杂,正确识别这些变化的意义不仅对早期发现病情变化,提高抢救成功率,减少病死率有着实际的临床价值,而且对研究MI患者各种临床表现与其病理生理变化的关系也具有重要的科学意义。本文旨在总结MI患者的生命体征变化特点、规律及其临床意义和观察要点,以期为护理同行提供参考。     

860例烧伤门诊换药的护理体会

总结860例烧伤门诊病人创面换药的方法和体会，认为烧伤换药应针对不同的病人采取相应的措施。     

颅脑损伤患者生命体征监测顺序的临床研究

及时准确地监测各项生命体征,是对颅脑损伤患者护理的重点之一。而目前临床上对监测的顺序尚无严格要求,无统一的标准。为了明确不同的监测顺序所得结果有无显著性差异,探索正确的监测顺序,我们对６０例脑损伤患者进行了临床研究。资料与方法１．１．临床资料１９９６年３月至７月间住神经外科监护室的颅脑损伤患者６０例。其中男３９例,女２１例;年龄１７～６９岁,平均３４．５岁;深昏迷者３例,浅昏迷者１５例,昏睡２４例,嗜睡１０例,神志清楚８例。１．２．方法１．２．１．监测顺序　对每１例患者均先后采用两种不同的顺序进…     

术中保温对老年开胸患者生命体征的影响

目的 观察术中保温对老年开胸患者生命体征的影响.方法 将60例行开胸手术老年患者随机分为保温组和对照组,每组30例.保温组患者术中控制室温22～24℃,输入的液体加温至37 ℃,并选用加温至37℃的灌洗液进行胸腔冲洗;对照组患者术中仅控制室温,不采用任何保温措施.测定术前及术后核心体温,比较两组患者围手术期的收缩压、心率、体温变化和寒战发生情况.结果 保温组患者术中体温维持稳定,手术前后体温、收缩压、心率、无明显变化,在人室时、消毒时和手术中1 h及手术结束前差异无统计学意义(P>0.05);对照组患者与术前及保温组比较,术中体温显著下降,收缩压、心率波动明显(P<0.01);而保温组低温(<36℃和<35℃)、寒战发生率显著低于对照组(P<0.01).结论 老年开胸患者术中保温可维持患者体温的稳定,有效预防术中低温和寒战的发生.     

气压式血液循环驱动仪对脑血管病患者血压脉搏呼吸的影响

目的监测气压式血液循环驱动仪对脑血管病患者生命体征的影响,评估气压式血液循环驱动仪在脑血管病患者中使用的安全性和效果。方法纳入106例使用气压式血液循环驱动仪治疗的脑血管病患者,分别监测治疗前15 min、治疗进行15 min时和治疗后15 min 3个时间点患者的收缩压、舒张压、脉搏及呼吸的数值,并比较其差异。结果 106例脑血管患者的收缩压、舒张压、脉搏、呼吸在治疗前15 min、治疗进行15 min时和治疗后15 min 3个时间点比较,差异无统计学意义(P0.05);其中30例合并高血压病的脑血管患者的收缩压、舒张压、脉搏、呼吸在治疗前15 min、治疗进行15 min时和治疗后15 min 3个时间点比较,差异无统计学意义(P0.05)。本组患者使用气压式血液循环驱动仪治疗,住院期间均无下肢深静脉血栓的发生。结论本组患者在使用气压式血液循环驱动仪治疗过程中,收缩压、舒张压、脉搏及呼吸无异常变化,可以有效预防下肢深静脉血栓的发生,适合脑血管病患者使用。     

腕踝针缓解老年腰椎间盘突出症患者疼痛的效果研究

目的：探讨腕踝针对老年腰椎间盘突出症患者疼痛的治疗效果,并且与非甾体抗炎药物以及传统针刺治疗进行对比,比较三种治疗方法对疼痛的治疗效果是否存在差异。方法：选取2019年1月-2021年6月收治的慢性腰椎间盘突出症/腰椎退行性病变伴腰痛急性发作的老年患者90例,随机分为三组,每组各30例,分别给予腕踝针治疗、非甾体抗炎药物治疗、传统针刺治疗,观察评估患者治疗30分钟后的疼痛VAS评分以及评估治疗1疗程（6天）后的腰椎疾患治疗成绩评分。结果：三组治疗后的VAS评分均有降低（P值均＜0.05）,表明三组治疗均可缓解疼痛,并且三组治疗30分钟后VAS评分之间有差异,两两对比后西药组与腕踝针组治疗30分钟后VAS评分无差异,但均低于传统针刺组（P＜0.05）,表明疼痛改善程度较传统针刺组大;三组治疗1个疗程后的腰椎疾患治疗成绩评分有差异,两两对比后传统针刺组与腕踝针组均高于西药组（P＜0.05）,而传统针刺组与腕踝针组之间无差异。结论：本文证实了腕踝针对老年患者腰椎间盘突出症并发急性疼痛有效,并且在即时止痛以及远期镇痛疗效上均有优势。     

不同护理干预方法对新生儿桡动脉采血时疼痛和生命体征的影响

目的 探讨非药物干预,包括非营养性吸吮和葡萄糖糖水口服,对新生儿桡动脉采血时疼痛及生命体征的影响.方法 106例住院新生儿随机分为非营养性吸吮(non-nutritive sucking,NNS)组、糖水组和对照组,分别于采血时给予安慰奶嘴吸吮、10%葡萄糖10～20 ml 口服以及不给予任何干预方法.各组在进行桡动脉穿刺采血时应用"新生儿急性疼痛行为评分量表"进行疼痛评分,并应用多功能监护仪动态记录穿刺前、穿刺中及穿刺后的生命体征和经皮血氧饱和度等指标的变化.结果 在进行桡动脉穿刺采血时,3组新生儿疼痛评分差异有统计学意义(F=47.847,P=0.000),其中对照组明显高于NNS组和糖水组,而NNS组和糖水组之间差异无统计学意义.3组新生儿的生命体征参数变异率差异有统计学意义,其中NNS组和糖水组的变异率均低于对照组(P=0.000),NNS组和糖水组之间无统计学意义.结论 新生儿在进行桡动脉穿刺时,给予非营养性吸吮或喂食糖水可以减轻其疼痛反应,同时减少生命体征的波动.     

音乐疗法对脑性瘫痪患儿针灸中焦虑疼痛生命体征的影响

目的探讨音乐疗法对脑性瘫痪患儿针灸治疗中焦虑、疼痛和生命体征的影响。方法将57例脑性瘫痪患儿随机分成观察组29例,对照组28例。观察组在针灸过程中予聆听音乐,乐曲为患儿所喜爱的儿歌;对照组只予针灸治疗。两组均留针30min,期间不转针。在针刺前、针刺1min、针刺15min,分别记录57例患儿血压、心率和呼吸,并评估患儿的焦虑和疼痛情况。结果观察组针刺15min心率和焦虑得分比对照组下降更明显（P〈0.05）;两组间的平均动脉压、呼吸频率变化差异无统计学意义（P〉0.05）。针刺15min,观察组对疼痛的基本满意率高于对照组（P〈0.05）。结论音乐疗法能缓解脑性瘫痪患儿针灸治疗中的焦虑、疼痛感,使之心率趋于稳定。但由于本研究样本量小,音乐疗法对针灸治疗脑性瘫痪的临床效果的影响有待进一步的研究。     

Dehydration and Orthostatic Vital Signs in Women with Hyperemesis Gravidarum

Objectives: To assess the hydration status of women presenting to an ED with hyperemesis gravidarum and to determine whether clinically relevant changes in orthostatic vital signs occur.
Methods: A convenience sample of 23 pregnant women who had hyperemesis gravidarum, with each patient serving as her own control. The study took place in the ED observation unit of an urban teaching hospital. Women who had pregnancies of ≤16 weeks' gestation who had been vomiting for at least 24 hours were included. Supine and standing pulse rates and blood pressures (BPs) were measured sequentially after 5 minutes in each position. Patient weight and urine specific gravity (SG) also were recorded. After 6 L of lactated Ringer's solution was infused over a 12-hour period, the same measurements were repeated. Pre- and posthydration changes were analyzed using the paired t-test.
Results: The mean treatment weight gain as a percentage of the total body weight was 5.6% ± 2.2% (mean ± SD). The urine SG decreased from 1.027 ± 0.004 to 1.008 ± 0.003 (p < 0.001). The mean change in systolic BP upon assuming the standing position was -8.3 ± 12.7 mm Hg before hydration vs 2.9 ± 7.8 mm Hg after hydration (p < 0.001). The corresponding change in mean diastolic BP was 3.7 ± 10.9 mm Hg before hydration vs 8.6 ± 10.9 mm Hg after hydration (p = 0.12). The mean change in pulse rate upon standing was 26.8 ± 14.5 beats/min before hydration vs 14.5 ± 10.1 beats/min after hydration (p = 0.002).
Conclusions: Women who present to the ED with hyperemesis gravidarum are significantly dehydrated and experience measurable improvement in postural pulse rate and systolic BP changes with rehydration. However, the presenting orthostatic changes lack sufficient sensitivity to be effectively used as quantitative screening tests for dehydration.     

Self-reported Pain Scores in the Emergency Department: Lack of Association with Vital Signs

Background: Some practitioners and investigators have presumed relationships between pain scores and heart rate, blood pressure, or respiratory rate. Previous literature has not adequately addressed the association of pain and vital signs.
Objectives: To identify any association between self-reported pain and heart rate, blood pressure, or respiratory rate.
Methods: In this retrospective, observational study, emergency department patients older than 17 years of age presenting between May 2004 and April 2005 with verifiable painful diagnoses (including nephrolithiasis, myocardial infarction, small bowel obstruction, fracture, burn, crush injury, stab wound, amputation, corneal abrasion, and dislocation) were identified. Data were extracted from the hospital's database, including patients' age, gender, emergency department diagnosis, self-reported pain score, heart rate, blood pressure, and respiratory rate.
Results: Among 1,063 subjects, the most common diagnoses were nephrolithiasis (25%; n = 267) and fracture (23%; n = 249). The mean (± SD) triage pain score was 7 (± 3). The mean (± SD) heart rate was 85 (± 16) beats/min, mean (± SD) systolic blood pressure was 141 (± 23) mm Hg, and mean (± SD) respiratory rate was 19 (± 3) breaths/min. There were no clinically significant differences in mean vital signs across the individual pain scores, as demonstrated by overlapping confidence intervals across pain scores.
Conclusions: No clinically significant associations were identified between self-reported triage pain scores and heart rate, blood pressure, or respiratory rate.     

The Effects of Acupressure on Nausea,Vomiting, and Vital Signs in Patients Undergoing Gynecologic Surgery: A Randomized Controlled Trial

PurposeThis randomized controlled experimental study was conducted to determine the effect of acupressure on nausea, vomiting, and vital signs in patients undergoing gynecologic surgery.DesignA randomized controlled experimental study.MethodsStudy participants consisted of females aged 18 to 65 years who underwent surgery in the gynecology clinic of the related hospital between October 2016 and March 2017. The sample originally consisted of 111 patients: K-K9 group (n = 39), P6 group (n = 37), and control group (n = 35). The point P6 in both wrists was determined, and the patients in that group wore a wristband 1 hour before the operation. The point K-K9 in both hands was determined, and one Black Pepper Seed was fixed on the point with the help of a plaster almost 1 hour before the operation. Once the wristband and the seed were placed, they remained in place for 24 hours. The control group received routine care, with no application of acupressure devices.FindingsFinal sample number was 103 after six were lost to follow-up. Vital signs of the patients showed a difference between the intervention groups and control group after the surgical procedure. The pulse values varied at statistically significant levels according to groups in the first and second measurements. The respiratory values of the K-K9 and P6 groups were statistically lower than those in the control group in the first, second, fourth, and fifth measurements (P < .05). The first measurement of nausea scores varied statistically according to the groups. The K-K9 group nausea scores were statistically lower than those in the control group (P < .05). At the time of the first measurement, the number of those who retched in the P6 group was statistically higher than those in the K-K9 group (P < .05).ConclusionsWe examined the effect of two types of acupressure in the management of postoperative nausea and vomiting in the first 24 hours after gynecologic surgeries. Although some findings of ours did not show a statistically significant difference, these alternative therapies showed promise.