护理质量敏感指标在结肠镜诊疗患者肠道准备中的应用

目的 探讨护理质量敏感指标在结肠镜诊疗患者肠道准备中的应用效果；方法 选取2021年10月至12月消化内科病房行结肠镜检查且需行肠道准备的患者286例为对照组，2022年5月至7月消化内科病房行结肠镜检查且需行肠道准备的患者245例为观察组，通过应用护理质量敏感指标，对结肠镜诊疗患者肠道准备进行督查和改进，比较两组患者结肠镜诊疗肠道准备的合格率。结果 观察组的结肠镜诊疗患者肠道准备的合格率明显高于对照组；护理人员对于结肠镜诊疗患者肠道准备护理质量敏感指标相关知识的掌握度明显提高。（P<0.05）结论 运用护理质量敏感指标可以提高结肠镜诊疗患者肠道准备合格率。     

肠道准备临床应用及评价研究进展

<正>肠道准备是指通过口服导泻剂或灌肠等方式来清除肠道内粪便、减少肠道内细菌数量和术后并发症的一种方法[1-2]。肠道准备广泛用于肠道手术、结肠镜、小肠镜、胶囊内镜诊疗和影像学检查前[3],是肠镜检查和肠道手术成功的关键[4]。理想的肠道准备应具备以下特点:能短时间内排空肠内容物;不引起肠黏膜的改变;不会导致水电解质紊乱;经济实用;操作简便[3,5]。目前临床中已有的肠道准备方法多样,但常常难以达     

综合护理干预在结肠镜诊疗前肠道准备中的应用研究

[目的]探讨综合护理干预在改善结肠镜诊疗前肠道准备中的作用。[方法]将消化内科住院并行结肠镜诊疗的291例病人分为对照组和观察组,对照组给予常规护理,观察组给予综合护理干预,比较两组病人肠道准备合格率。[结果]对照组结肠镜诊疗前肠道准备合格率为56.8%,观察组为89.6%,经比较差异有统计学意义(P0.05)。[结论]合理护理措施能有效提高结肠镜诊疗前肠道准备合格率。     

首次肠镜诊疗患者采用图片与模具进行健康教育的效果评价

目的探讨首次肠镜诊疗患者采用图片与模具进行健康教育的效果。方法将2015年9月至2016年2月首次进行肠镜诊疗的住院患者220例,采用随机数字表法分为观察组112例和对照组108例。对照组采用口述式教育方法,观察组采用图片与模具健康教育法。比较两组肠道清洁度、肠镜诊疗知识掌握的程度、健康教育的满意度。结果两组肠道清洁度、肠镜诊疗知识掌握的程度、健康教育的满意度差异有统计学意义(P0.01)。观察组肠道清洁度、肠镜诊疗知识掌握的程度、健康教育的满意度均高于对照组。结论采用图片与模具进行健康教育可提高首次肠镜诊疗患者肠道清洁度以及肠镜诊疗知识掌握的程度、健康教育的满意度。     

个体化护理干预在胶囊内镜检查患者中的应用

目的:探讨分析个体化护理干预对胶囊内镜检查前肠道准备的影响。方法:选取2012年3月～2013年9月我院收治的60例首次行胶囊内镜检查需行肠道准备者为研究对象,随机等分为对照组和观察组,对照组采用传统护理方法,观察组实施个性化护理干预。观察比较两组患者肠道清洁度、病变检查效果以及患者满意度情况。结果:观察组的肠道清洁度、病变检查效果以及护理满意度均高于对照组,两组比较差异有统计学意义(P0.05)。结论:个性化护理干预有效提高了患者肠道清洁度和病变检出率,对胶囊内镜检查提供了良好的肠道准备环境。     

25例结肠胶囊内镜检查的护理

[目的]总结结肠胶囊内镜检查的护理。[方法]对25例行结肠胶囊内镜检查,同时加强护理,主要对病人宣教检查前注意事项及进行肠道准备,观察病人胶囊胃、小肠通过时间、结肠检查时间、胶囊排出率、肠道清洁度、检查过程中副反应。[结果]25例检查者均顺利完成结肠胶囊内镜检查,90.4%检查者胶囊在480min内排出;结肠检查时间360min±85min,胃通过时间85min±43min,小肠通过时间为142min±83min;肠道清洁度良好为95%,检查过程中未出现严重不良反应。[结论]对结肠胶囊内镜检查病人行护理指导可使检查者顺利完成检查,使结肠胶囊内镜用于肠道疾病临床筛查和诊断。     

硫酸镁用于基层医院结肠镜诊疗前肠道清洁准备的临床效果分析

【目的】探索一种在基层医院大肠镜诊疗中,费用低、安全实用、依从性好、满意度高的肠道清洁准备方法,以利于开展大肠镜下诊疗项目。【方法】对100例患者采用大肠镜诊疗前1d进食少渣半流质食物,检查当天服25％硫酸镁200mL、5％葡萄糖水500mL、生理盐水500mL。观察患者服药后肠道清洁程度。依据结肠镜检查中改良后肠道清洁度（1～4级）评价肠道清洁效果,并记录不良反应。【结果】肠道准备符合要求者95％、患者无不良反应,术后患者满意度达100％。【结论】口服25％硫酸镁200mL、5％葡萄糖500mL、生理盐水500mL结肠镜诊疗前清洁肠道,肠道清洁程度理想,患者满意度高。     

电话随访对门诊结肠镜诊疗患者肠道准备依从性的影响

目的 探讨电话随访对门诊结肠镜诊疗患者肠道准备依从性及肠道清洁效果的影响.方法 将400例门诊结肠镜诊疗患者随机分为随访组(200例)和对照组(200例),两组患者均在预约时给予常规口头及书面肠道准备的健康教育,随访组在饮食准备和药物清洁肠道时还接受电话随访健康教育,且患者可随时咨询预约护士.通过术前问卷调查,对患者饮食和服药依从性进行评价,术后由内镜医师单盲法判定肠道清洁度.结果 两组患者饮食和服药依从性、肠道清洁度比较,差异均有显著意义(P＜0.00l),随访组优于对照组.结论 对门诊结肠镜诊疗患者实施电话随访,延续健康教育,有助于提高患者肠道准备依从性及肠道清洁度,从而有效提高结肠镜诊疗的成功率,减少并发症.     

3种方法在胶囊内镜肠道准备中的清洁效果比较

目的比较3种肠道准备方法在胶囊内镜检查中的清洁效果。方法将实施胶囊内镜检查的90例患者随机分为A组(磷酸钠盐组)、B组(复方聚乙二醇组)、C组(硫酸镁组),每组各30例,检查前分别给予磷酸钠盐、复方聚乙二醇、硫酸镁进行肠道准备。根据胶囊内镜检查所见视野清晰度,评价3种肠道准备方法的效果及患者耐受程度。结果 A组、C组患者肠道清洁效果明显优于B组;A组、B组患者耐受程度明显优于C组,组间比较,均P<0.0167,差异具有统计学意义。结论 综合视野清晰度、患者耐受程度,口服磷酸钠盐是比较理想的胶囊内镜检查术前的肠道准备方法,但是价格较高。     

不同护理健康教育方式对肠镜诊疗前肠道准备效果的影响

目的探讨不同护理健康教育方式对肠镜诊疗前患者肠道准备依从性及肠道清洁效果的影响。方法将300例首次接受肠镜诊疗的门诊患者依预约时间分为对照组和观察组,各150例。对照组采用常规健康教育方式。观察组采用录音讲解加电话访谈健康教育方式。通过术前问卷调查对两组患者依从性进行评价,术后由内镜医师单盲法判断肠道清洁程度。结果两组患者肠道准备的依从性及肠道清洁效果比较,有显著性差异(P<0.01)。结论录音讲解加电话访谈健康教育方式能明显提高患者肠道准备依从性及肠道清洁效果,从而间接有效地提高肠镜诊疗的成功率及预防和减少相关并发症的发生。     

多功能颅脑导向定位装置的临床应用

目的:自行研制简易多功能颅脑导向定位装置并用于临床。方法:采用自制简易多功能颅脑导向定位装置及头皮标记定位仪,根据颅内病灶和头皮标记物的关系,计算CT最大病灶在头皮标记定位仪的位置,将其标记在头皮上对应的部位,依据两点一线的原理,头颅两侧分别设置穿刺点和瞄准点。两点连线恰通过颅内靶点中心,控制穿刺针深度并沿此线运行,能准确抵达靶点。结果:(1)穿刺精确度的模拟试验,在人体颅骨标本基底节区埋置椭圆形"十字"标记橡皮泥块,以中心为靶点,行CT扫描后用定位仪确定穿刺点,垂直及改选穿刺点穿刺,总平均误差在5mm以内。(2)穿刺针损伤模拟试验,选择不同的曲度骨面进行钻孔试验,YL-1型微创穿刺针表面与限位孔摩擦仅有轻微螺旋压痕,无明显损伤及变形。经模拟试验后应用该装置与目测导向穿刺治疗高血压脑出血,对临床资料完整并得到随访的79例进行对比分析,治疗前后血肿清除两组比较差异有显著性(P<0.05),生存质量观察组优于对照组(P<0.05)。结论:应用该导向定位装置将YL-1型微创穿刺针和引流套管集定位穿刺多功能于一体,能满足目前国内多数医院进行的颅内血肿微创治疗、囊肿等定位穿刺及引流的需要;避免了目测导向的误差带来的医源性损害,穿刺成功率达100%,符合微侵袭神经外科原则,结构简单,操作方便,适宜临床推广。     

A system for portable sleep apnea diagnosis using an embedded data capturing module

Sleep apnea (SA) is a very common disease with serious health consequences, yet is very under-diagnosed, partially because of the high cost and limited accessibility of in-laboratory polysomnography (PSG). The purpose of this work is to introduce a newly developed portable system for the diagnosis of SA at home that is both reliable and easy to use. The system includes personal devices for recording breath sounds and airflow during sleep and diagnostic algorithms to process the recorded data. The data capturing device consists of a wearable face frame with an embedded electronic module featuring a unidirectional microphone, a differential microphone preamplifier, a microcontroller with an onboard differential analogue to digital converter, and a microSD memory card. The device provides continuous data capturing for 8 h. Upon completion of the recording session, the memory card is returned to a location for acoustic analysis. We recruited 49 subjects who used the device independently at home, after which each subject answered a usability questionnaire. Random data samples were selected to measure the signal-to-noise ratio (SNR) as a gauge of hardware functionality. A subset of 11 subjects used the device on 2 different nights and their results were compared to examine diagnostic reproducibility. Independent of those, system’s performance was evaluated against PSG in the lab environment in 32 subject. The overall success rate of applying the device in un-attended settings was 94 % and the overall rating for ease-of-use was ‘excellent’. Signal examination showed excellent capturing of breath sounds with an average SNR of 31.7 dB. Nine of the 11 (82 %) subjects had equivalent results on both nights, which is consistent with reported inter-night variability. The system showed 96 % correlation with simultaneously performed in-lab PSG. Conclusion: Our results suggest excellent usability and performance of this system and provide a strong rationale to further improve it and test its robustness in a larger study.     

Test method for empirically determining inertial properties of manual wheelchairs

The iMachine is a spring-loaded turntable used to measure inertial properties of irregularly shaped rigid bodies, specifically manual wheelchairs. We used a Newton-Euler approach to calculate wheelchair mass and center of mass (CM) location from static force measurements using load cells. We determined the moment of inertia about the vertical axis from the natural frequency of the system in simple harmonic motion. The device was calibrated to eliminate the effects of platform components on measurement error. For objects with known inertial properties, the average relative error of the mass and the CM coordinates (x and y) were 0.76%, 0.89%, and 1.99%, respectively. The resolution of the moment of inertia calculation depends on the ratio of test piece inertia to system inertia, such that the higher the ratio, the more accurate the measurements. We conducted a Gage Repeatability and Reproducibility (Gage R&R) test using three manual wheelchairs measured three times by three operators; the results showed that over 90% of the variance in inertia was caused by differences in the wheelchairs being measured. Gage R&R analysis indicated that measurement system operation was acceptable using criteria from the Automobile Industry Action Group for both inertia and mass measurements.     

A system for standardized evaluation of patient-controlled analgesia devices: Design,construction, and engineering aspects

Objective. Our objective was to design, construct, and assess an automated system to perform standardized evaluation of patient-controlled analgesia (PCA) devices.Methods. We developed a computer-controlled test station. The computer activates the PCA device under test through a purpose-built serial interface device. The dose delivered is weighed on an electronic balance; then, at a predetermined interval, the computer interrogates the balance via the serial interface device to determine the weight gain. A robotic digit simulates patient button presses for four commonly used demand mechanisms. Software programs were written to test three types of patient-demand profile.Results. The automated system is sufficiently accurate for evaluating PCA devices and has been successfully used to perform and evaluate several thousand demands on six different models of PCA device.Conclusions. The test station has proved to be simple to use and extremely reliable, and has enabled the successful evaluation of several types of PCA device. The authors would like to thank Mr. R.R.L. Fronsko for practical assistance in the development of the testing station and Dr. David J. Hawkins for help with a prototype system.     

A method of residual limb stiffness distribution measurement

A method of recording a residual limb indentation stiffness map was developed for possible use as an aid in calculating prosthetic socket rectifications. The method was tested to determine the level of repeatability attainable. A hand-held, pencil-like device was used, with an air-driven piston that indented the tissue 10 times per second. The indentor tip contained an electromagnetic digitizer element that sensed position and orientation 120 times per second. The examiner moved the device around the limb; sampling was variable in density, and typically concentrated on critical areas. An interactive visual display of sampled data quality was used to guide sampling. The indentation maps typically contained approximately 4,000 locations, in a cylindrical coordinate system, with sampling locations spaced every 3.2 mm vertically, and every 0.087 radians tangentially. The behavior of the system was characterized using six test subjects on whom recorded indentations ranged from 1.5 to 21 mm. The largest range of indentations (i.e., worst disagreement) recorded at a single location was 5.4 mm. The average standard deviation on repeated measurement ranged from 7 to 15%, and averaged 0.67 mm in absolute terms. Many of the structurally significant anatomical features of the limbs were visible, including the patella and patellar tendon, fibular head, shin, biceps femoris tendon, semitendinosus, and popliteal area.     

Quantitative evaluation of stance balance performance in the clinic using a novel measurement device

This study was undertaken to test the clinical applicability of a novel device for measurement of stance balance performance. Samples were taken from hemiparetic patients (n = 27, age range 60-80) and of three groups of healthy subjects (24 subjects at ages 64-81, 13 at ages 27-50 and 24 aging 20-24 years). Stance was evaluated in six different positions incorporating two perturbing effects: visual deprivation and movements--linear and angular--of the base of support. Three variables were measured: sway and the values of the X and Y coordinates of the Center of Pressure. Concurrent validity of the system was assessed by comparing results with data of other works that tested comparable variables in similar populations and with already well established instrumentation. Repeatability of measurements was checked by performing all tests twice and comparing their results, as well as by calculating test retest reliability. The findings pointed to significant effects of vision and of movement of the base of support on sway, and to a significant difference between sway of hemiparetic patients and healthy subjects. The location of the COP in both the X and Y coordinates was not substantially influenced by the above effects. The agreement of the findings with existent knowledge indicates that the system is credible for measurement of body sway and of the location of the COP in various stance positions.     

Early pacemaker battery depletion caused by a current leak in the output circuitry: rectification not exchange

Malfunction of a dual chamber system pacemaker due to a current leak in the output circuitry leading to a rapid decline in battery longevity is described. Serial pulse amplitude alterations in defined device configurations enabled location of the defect in the 2.5-V output voltage level; the current leak disappeared in the 5-V output voltage level, and recurred in the 7.5-V output voltage level which combines both 2.5-V and 5-V output circuitries. Reprogramming of pulse amplitudes rectified device malfunction. Circuitry reprogramming of pacemakers with faulty unexplained high battery current can circumvent early replacement in management of device malfunction.     

Accuracy of an electromagnetic three-dimensional ultrasound system for carotid artery imaging.

Freehand, three-dimensional (3-D) ultrasound (US) systems, which incorporate an electromagnetic tracking device to register the 3-D spatial location of images acquired using a standard linear array scan-probe, are a flexible and cost-effective solution for many clinical applications. The reconstruction accuracy of one such system was investigated by using a precision-made phantom. The error in 3-D distance measurements, under conditions appropriate to US investigations of the carotid arteries, was found to be -0.45 +/- 1.30 mm, equivalent to -0.53 +/- 3.39% (mean +/- SD). The results are relevant to data acquired using a single sweep scan and for distances in the range 25.00 to 79.06 mm. Both the overall accuracy and precision in point-target location were found to be relatively unaffected by scan depth, and the precision of point-target location was found to be poorest in the elevational direction. In conclusion, the system tested in our laboratory performed with high accuracy, adopting a setup and scan-sweep identical to that used for imaging of the carotid arteries in 3-D.     

局灶性脑梗死模型大鼠予全植入式低强度皮质电刺激的安全和可行性

背景：近10年来使用皮质电刺激治疗脑卒中的动物和临床试验均得到了比较肯定的结果。 目的：观察全植入式皮质电刺激器长时间、低强度、变频皮质电刺激对大鼠局灶性脑梗死后神经功能恢复的影响。 方法：成年雄性SD大鼠60只,线栓法制作大脑中动脉阻塞的脑梗死模型。选取Bederson评分为1-3分的大鼠40只进行MRI扫描,筛选出有皮质梗死的大鼠（n=23）,MRI测定梗死灶周边皮质的位点,确定接受皮质电刺激治疗的靶点,大脑中动脉阻塞后第6天植入电刺激器。将23只大鼠随机分为2组：皮质电刺激组（n=13）大鼠每天进行皮质电刺激治疗2次/d,每次持续30 min,电刺激频率10 s内在50,20和5 Hz之间变动并重复循环。无刺激组（n=10）仅植入电刺激器,无电刺激输出。在植入电刺激器后第2天和第16天,两组大鼠进行前肢使用不对称、足失误测试,第16天最后一次行为学评价完成后,取出电刺激器进行检测,常规苏木精-伊红染色观察大鼠梗死灶周围皮质结构及细胞形态。 结果与结论：23个电刺激器取出后,仅发现1个皮质电刺激组电刺激器不能正常工作,其余各电刺激器性能均保持良好。除1只大鼠在电刺激器植入部位的皮肤有破溃,愈合稍差,其余大鼠皮肤切口均愈合良好。苏木精-伊红染色可见脑梗死电极植入处皮质组织结构清晰完整,神经细胞排列整齐,神经元胞浆丰富,核仁清楚,正常胶质细胞结构完整,细胞周围间隙致密无水肿。足失误和前肢使用不对称测试结果均显示第16天皮质电刺激组大鼠神经功能恢复显著优于较无刺激组。结果表明采用了一套用于大鼠脑梗死模型的全植入式皮质电刺激器,建立了安全的植入方式及刺激模式,并证明低强度、长时间、变频的脉冲式电刺激模式是安全的,且有助于促进大脑局灶性脑梗死后的神?     

A simple acoustically coupled calibrator

An acoustically coupled device is described which is designed to calibrate the electronic caliper systems of diagnostic ultrasound machines. The device is intended primarily for use with linear array machines where electrical interconnection of test equipment is not possible. The transmitter pulse from the linear array machine is detected by a single element transducer held in contact with its probe and used by the calibrator to initiate the injection of accurately timed markers back into the real time probe via the same transducer. The real time caliper system may be calibrated to 1540 or 1600 ms^?1 using markers thus displayed on the real time machine. The device is compact and convenient to use.