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1.
冠状动脉介入治疗术后并发症的观察及护理   总被引:4,自引:0,他引:4  
目的 通过观察经皮冠状动脉腔内成形术加冠脉内支架术的术后并发症。探讨其发生的原因及对症护理的方法。方法 分析了494例冠状动脉支架植入术后出现的43例4种不同的并发症,根据其相应护理。从中总结出常见并发症的种类、临床表现、护理要点以及工作体会和经验教训。结果 常见并发症经及时发现和迅速处理后。均顺利度过了术后恢复期。随访半年来见其他并发症,效果满意。结论 应加强医护人员责任心和专科培训。做好术前访视及术后护理。预见潜在的危险因素。才能有针对性、有目的的进行观察及护理。从而减少术后并发症的发生。  相似文献   

2.
经桡动脉途径行冠状动脉介入治疗手部的观察及护理   总被引:6,自引:2,他引:4  
目的 探讨减少经桡动脉途径行冠状动脉介入治疗术后患者不适及严重并发症的护理方法。方法 对105例患者按常规方法进行桡动脉穿刺及冠状动脉造影及介入治疗。术前、术中、术后进行针对性的心理护理及观察术侧上肢的皮肤颜色、血氧饱合度、腕围变化等方面的护理。结果 所有病例均顺利完成介入诊疗手术,术后1例患者发生术侧上肢肿胀明显,经减压、抬高手臂或上举及拆除包扎后得到改善,无一例手部发生缺血性坏死及其他并发症。结论 有针对性地观察和预防性的护理,对于减少经桡动脉途径进行冠状动脉介入治疗术后患者明显不适及防止严重并发症的发生起到了不可缺少的作用,可以提高护理质量。  相似文献   

3.
老年患者经皮冠状动脉介入治疗术后早期护理   总被引:3,自引:0,他引:3  
洪玉芬  黎观梅袁岩 《现代护理》2006,12(13):1211-1213
目的探讨老年患者经皮冠状动脉介入治疗(PCI)术后早期有效的护理方法。方法对118例老年患者PCI术后早期重点加强排尿的护理、心理护理、腰酸背痛的护理及常见并发症的预防与护理。结果85例尿潴留者有77例经诱导排尿后能自行排尿,8例需留置尿管,65例心理障碍者情绪稳定,56例腰酸背痛症状缓解,47例常见并发症经处理后病情缓解。结论对老年患者PCI术后早期加强排尿护理、心理护理及腰酸背痛护理,提高患者舒适度,同时做好常见并发症的预防及护理是确保术后康复的关键。  相似文献   

4.
目的探讨老年患者经皮冠状动脉介入治疗(PCI)术后早期有效的护理方法.方法对118例老年患者PCI术后早期重点加强排尿的护理、心理护理、腰酸背痛的护理及常见并发症的预防与护理.结果85例尿潴留者有77例经诱导排尿后能自行排尿,8例需留置尿管,65例心理障碍者情绪稳定,56例腰酸背痛症状缓解,47例常见并发症经处理后病情缓解.结论对老年患者PCI术后早期加强排尿护理、心理护理及腰酸背痛护理,提高患者舒适度,同时做好常见并发症的预防及护理是确保术后康复的关键.  相似文献   

5.
目的 分析经皮冠状动脉介入治疗术后并发症的防治对策,总结护理干预对减少并发症发生的意义.方法 回顾分析162例行经皮冠状动脉介入治疗患者的临床资料,观察和评估162例经皮冠状动脉介入治疗患者的并发症及其相应的护理措施.结果 本组患者并发症分别表现为急性或亚急性支架血栓形成、低血压、心包填塞、皮下淤血、短阵室速、窦性心动过速、局部出血和血肿、血管内感染等.经相应的对症治疗及护理干预后全部并发症好转或治愈.结论 术前加强心理护理和健康教育,术中严密监测生命体征,术后严密观察切口,正确的护理理可有效地防止冠脉内支架植入术后严重并发症的发生.  相似文献   

6.
经皮冠状动脉腔内成形术后并发症的观察及护理   总被引:11,自引:2,他引:9  
目的:研究冠状动脉腔内成形术(PTCA)术后常见并发症的种类、发生规律及对治疗效果的影响,制定相应的护理措施。方法:了解术前的病理情况手术过程,术后监测血压、心电图、出凝血时间、皮肤粘膜的变化等,及时记录相关内容。结果:PTCA术后常见的并发症主要有急性血管性闭塞、冠脉痉挛、低血压等,经治疗护理均好转。结论:了解PTCA术后并发症的发生规律,制定相应的护理措施可预防术后并发症的发生,提高手术的成功率。  相似文献   

7.
目的 探讨冠状动脉内支架植入患术后康复训练的效果。方法 将106例行冠状动脉内支架植入的住院患随机分为康复训练组和对照组。分别从血栓的预防、伤口出血及血肿的预防、低血压的防治等方面进行护理和术后康复训练。结果 经统计学处理显示两组有明显差异,试验组术后的各种并发症明显少于对照组。结论 通过对冠状动脉内支架植入患进行康复训练减少了其术后并发症的发生、减轻了患的痛苦。  相似文献   

8.
[目的]探讨经皮冠状动脉介入术后并发症发生的原因及相关护理方法.[方法]回顾性分析2006年-2008年56例行冠状动脉支架植入术后病人发生并发症情况,总结有效的护理措施.[结果]发生的并发症有出血或血肿、血管迷走神经反射、胸痛、尿潴留.经治疗和护理后,出血停止,血管迷走神经反射症状好转,心电图、血压恢复正常,胸痛病人通过静脉泵入硝酸甘油及加强抗凝,胸痛在1 h内缓解;尿潴留病人通过诱导排尿,3例无效,后在无菌操作下行导尿术.[结论]护士要了解发生并发症的原因,加强对病人的观察和护理,以减少术后并发症的发生.  相似文献   

9.
目的通过观察内镜逆行行胰胆管造影(ERCP)患者的术后并发症,探讨其护理方法.方法分析了119例ERCP术后出现的并发症,根据其症状给予相应的护理,总结出常见的并发症及临床表现、护理要点.结果常见并发症经及时观察发现并治疗护理后,均能顺利恢复,效果满意.结论加强专科培训和护理人员的工作责任心,做好术前和术后健康教育,预见潜在的危险因素,才能对患者进行有目的、有针对性的观察和护理,减少术后并发症的发生.  相似文献   

10.
吴建华 《护理研究》2010,24(7):1836-1837
[目的]探讨经皮冠状动脉介入术后并发症发生的原因及相关护理方法。[方法]回顾性分析2006年—2008年56例行冠状动脉支架植入术后病人发生并发症情况,总结有效的护理措施。[结果]发生的并发症有出血或血肿、血管迷走神经反射、胸痛、尿潴留。经治疗和护理后,出血停止,血管迷走神经反射症状好转,心电图、血压恢复正常,胸痛病人通过静脉泵入硝酸甘油及加强抗凝,胸痛在1h内缓解;尿潴留病人通过诱导排尿,3例无效,后在无菌操作下行导尿术。[结论]护士要了解发生并发症的原因,加强对病人的观察和护理,以减少术后并发症的发生。  相似文献   

11.
Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.  相似文献   

12.
Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.  相似文献   

13.
This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.  相似文献   

14.
ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.  相似文献   

15.
Ranganath C  Heller AS  Wilding EL 《NeuroImage》2007,35(4):1663-1673
Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.  相似文献   

16.
目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4%(55/72)]明显高于成功组[31.7%(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3%(42/72)]高于成功组[38.1% (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9% (28/72)]高于成功组[23.8%(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大<6 cm、胎头位于坐骨棘上及宫口开大8~10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1%(44/72)]高于成功组[38.9%(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2%(52/72)]明显高于成功组[34.1 %(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.  相似文献   

17.
18.
The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.  相似文献   

19.
20.
目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高<20%视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P<0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P<0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P<0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.  相似文献   

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