探讨针尖斜面未完全进入血管内的处理方法

目的 探讨使用一次性头皮针为患者行静脉输液时针尖斜面未完全进入血管内的有效的处理方法.方法 将78例行静脉输液时针尖斜面未完全进入血管内的患者随机分为实验组(将针头斜面倒转向下)和对照组(重新扎上止血带,让患者握拳,再进针少许),比较2种处理方法的效果.结果 实验组总有效率明显高于对照组,差异有统计学意义(P<0.05).结论 输液时针尖斜面未完全进入血管内,采用翻转针尖斜面向下的方法,可提高静脉输液成功率,减少穿刺部位疼痛.     

静脉输液结束两种拔针按压法效果观察

目的:探讨减轻静脉输液患者拔针时疼痛及减少局部淤血、出血的方法,以提高患者满意度及再次穿刺的成功率。方法:对80例住院输液患者采用自身对照比较,即连续2d在患者左右手对称部位静脉输液各1次。第一天采用旧方法:用干棉签按压穿刺点上方,迅速拔出针头(对照组);第二天采用新方法:迅速拔出针头,立即用干棉签纵向按压穿刺点上方(观察组)。结果:无痛率新方法为96%,旧方法为72%,两组比较差异有统计学意义(P<0.05),患者满意度提高。结论:运用新方法拔针可减轻患者的血管损伤程度,缓解紧张,增加舒适感,有利于提高基础护理质量及患者的满意度。     

输液不通畅的处理

静脉输液在护理工作中占有重要地位，但常有输液不通畅的情况。其发生原因是：针头滑出血管外，针头斜面紧贴血管壁，针头阻塞，压力偏低及静脉痉挛。在临床实践中，有时虽然排除了这些原因，但滴流仍然不畅，常给病人造成痛苦和增加工作中的烦恼。现将本人对此问题的处理方法介绍如下：例一是：患者输入“拉克”细胞后，接着输入5％葡萄糖500ml加入维生素C和肌苷；另一例是输入5％葡萄糖250ml，加入先锋必2g，最初液体滴流通畅，40滴／分以上，到后来，滴速减慢，10滴／分左右，用生理盐水冲针头，无阻力，回血良好，但一直滴液不畅。改用…     

一次性输液器常见故障的排除

随着现代医学的发展，医疗用品不断更新，一次性输液器已广泛应用于临床，它不仅轻便、易携、易保存，而且省略了清洗灭菌程序，但也有不足之处。下面主要谈一下使用中易出现的故障及处理方法。1．液体输入不畅：输液速度减慢或不滴，有以下几种可能。①针头斜面紧贴血管壁引起速度减慢或不滴，调整针头位置以及病人输液肢体的位置。②压力过低，抬高输液瓶位置。③输液速度减慢或不满，可能是针头滑出，液体注入皮下组织，则局部肿胀并有疼痛，应另选血管重新穿刺。④针头阻塞：试播橡皮管若无回血，可用注射器抽少许液体，接输液针头用力…     

婴儿背带在静脉输液中的使用探讨

目的探讨使用婴儿背带对婴幼儿静脉输液是否能提高静脉穿刺的成功率,防止静脉输液过程中针头漏出血管外,提高输液过程顺利完成率,为婴幼儿解除再穿刺的痛苦。方法我院儿科注射室抽取静脉输液的3个月～3岁婴幼儿600例,分为实验组和对照组,各300例。实验组婴幼儿使用婴儿背带,观察静脉穿刺的成功率、静脉输液过程中针头漏出血管外的情况。结果实验组和对照组穿刺成功率及针头漏出血管外情况比较,数据经统计学处理,差异有显著性（p〈0．05）,两组穿刺成功率,实验组为99．7％,对照组为91．7％;针头漏出血管外,实验组为0．03％,对照组为8．33％。结论婴幼儿在静脉输液时使用婴儿背带,无论是手、足、头等部位的穿刺,穿刺成功率高,并能有效的减少漏针,减轻患儿及家属的痛苦,避免护患纠纷,提高了护理工作质量及护理工作效率。     

两种不同静脉穿刺进针方法对疼痛的影响

目的 比较在输液中两种不同静脉穿刺进针方法对疼痛的影响.方法 选择清醒的静脉穿刺患者100例,同体左右侧手背部相同部位进行静脉穿刺,专人操作.选取相同头皮针,单日左手(对照组)采用传统静脉穿刺方法即先扎止血带,叮嘱患者握拳,针刺部位常规消毒,输液护士一手拇指在血管远端固定,另一手将针头斜面向上,与针刺部位保持15～30°夹角,从静脉一侧刺入并沿静脉走向刺入静脉,出现回血后将针头稍作推进,最后进行固定.双日右手(观察组),采用自然法于针刺血管上方约6 cm的位置扎止血带,叮嘱患者尽量保持手部放松,手背向上,输液护士将输液针头斜面向左,与皮肤呈20度角从静脉上方刺入皮下,沿静脉走向刺入静脉,出现回血后将针头稍作推进,然后固定.结果 自然法进针比传统法进针成功率高(P<0.05),自然法进针较传统法进针疼痛度低(P<0.01).结论 改进后的自然进针穿刺方法能明显减轻患者的疼痛,提高了穿刺成功率.     

介绍一种固定单翼针头的新方法

在大量的临床静脉输液工作中 ,我们经常会遇到这样一种情况 ,在正常静脉穿刺后 ,松开止血带 ,打开水止 ,液体速度正常滴入 ,而固定针头时 ,液体就会不滴或速度显著变慢。其实 ,这主要是因为针尖的斜面贴在血管内壁上造成的。这时常用的方法是 ,固定完针头后 ,在针翼下方轻垫一个或两个棉签。我们在临床工作中遇到这样的情况 ,并通过大量的实践发现了一种新的固定单翼针头的方法比较好 ,现介绍如下。在打开水止后 ,将要固定针头时如发现液体速度变慢或不滴 ,就以针梗为轴 ,针翼旋转 180度至对侧 ,再贴上胶布 ,固定针头。这样我们不必垫绵签就…     

虹吸负压在小儿头皮静脉穿刺中的应用

小儿输液常选择头皮静脉 ,但因静脉压力低 ,输液针头细 ,穿刺成功后不见回血极为常见 ,因而常需借助注射器抽吸观察回血。在此过程中 ,分离和重新连续输液管与输液针头极易造成空气输入和药液流失。为此 ,我院自１９９９年５月～２０００年１１月应用虹吸负压原理为４０例小儿施行改良式头皮静脉穿刺 ,取得满意效果 ,现介绍如下 :１操作方法１ １按静脉输液法备好物品 ,选择血管、消毒皮肤。１ ２操作重点 :待针头斜面完全进入皮肤后 ,放低输液瓶 ,使瓶内液面低于穿刺点平面１０ｃｍ～２０ｃｍ ,放开调节器 ,应用虹吸原理使输液管内形成负压…     

静脉输液中针头斜面调整的应用探讨

我们在静脉输液工作中,常常会遇到因针头斜面上挑,紧贴血管壁,静脉滴注不畅的问题.我们惯用的办法是,用棉球垫在针柄下,抬高针柄,压低针头,使针头斜面离开血管壁,使滴注顺畅,但由于针柄不能紧贴皮肤,固定不牢,病人稍有活动,会导致渗液或静脉滴注不畅,另外,穿刺处针头和皮肤有夹角,病人有疼痛或不适感,如此等等,致病人反复呼叫,给护士增加了工作量,给病人增添了许多麻烦,也增加了输液成本.在工作实践中,我们发现仅反转针头使斜面向下,可以达到异曲同工之效,自2001年10月,我们对86例患者采用此方法,固定针头,使针头斜面向下固定输液,效果良好,现介绍如下:     

输液相关性静脉炎对动静脉内瘘成形术的影响及临床分析

目的:探讨输液相关性静脉炎对动静脉内瘘成形术的影响,并分析相关原因及预防措施,提高患者动静脉内瘘手术的成功率及远期通畅率。方法:选择2010年1月—2014年12月行动静脉内瘘成形手术的305例尿毒症患者,选出合并输液相关性静脉炎的病例42例,从静脉内膜增生厚度、血管纤维化及狭窄的程度、手术成功率及远期并发症情况进行总结分析。结果:动静脉内瘘成形手术总体成功率为88.1%,术后1年通畅率为73.0%。术后并发症主要有内瘘血流量不足、远期静脉狭窄。结论:输液相关性静脉炎对动静脉内瘘成形术存在显著影响。早期预防输液相关性静脉炎及术前体格检查可最大限度减少静脉炎对动静脉内瘘成形术的影响。     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

Biochemical and molecular characterisation of cubozoan protein toxins

Class Cubozoa includes several species of box jellyfish that are harmful to humans. The venoms of box jellyfish are stored and discharged by nematocysts and contain a variety of bioactive proteins that are cytolytic, cytotoxic, inflammatory or lethal. Although cubozoan venoms generally share similar biological activities, the diverse range and severity of effects caused by different species indicate that their venoms vary in protein composition, activity and potency. To date, few individual venom proteins have been thoroughly characterised, however, accumulating evidence suggests that cubozoan jellyfish produce at least one group of homologous bioactive proteins that are labile, basic, haemolytic and similar in molecular mass (42-46 kDa). The novel box jellyfish toxins are also potentially lethal and the cause of cutaneous pain, inflammation and necrosis, similar to that observed in envenomed humans. Secondary structure analysis and remote protein homology predictions suggest that the box jellyfish toxins may act as α-pore-forming toxins. However, more research is required to elucidate their structures and investigate their mechanism(s) of action. The biological, biochemical and molecular characteristics of cubozoan venoms and their bioactive protein components are reviewed, with particular focus on cubozoan cytolysins and the newly emerging family of box jellyfish toxins.     

Dose tolerability of chronically inhaled voriconazole solution in rodents

Invasive pulmonary aspergillosis (IPA) is a fungal disease of the lung associated with high mortality rates in immunosuppressed patients despite treatment. Targeted drug delivery of aqueous voriconazole solutions has been shown in previous studies to produce high tissue and plasma drug concentrations as well as improved survival in a murine model of IPA. In the present study, rats were exposed to 20 min nebulizations of normal saline (control group) or aerosolized aqueous solutions of voriconazole at 15.625 mg (low dose group) or 31.25 mg (high dose group). Peak voriconazole concentrations in rat lung tissue and plasma after 3 days of twice daily dosing in the high dose group were 0.85 ± 0.63 μg/g wet lung weight and 0.58 ± 0.30 μg/mL, with low dose group lung and plasma concentrations of 0.38 ± 0.01 μg/g wet lung weight and 0.09 ± 0.06 μg/mL, respectively. Trough plasma concentrations were low but demonstrated some drug accumulation over 21 days of inhaled voriconazole administered twice daily. Following multiple inhaled doses, statistically significant but clinically irrelevant abnormalities in laboratory values were observed. Histopathology also revealed an increase in the number of alveolar macrophages but without inflammation or ulceration of the airway, interstitial changes, or edema. Inhaled voriconazole was well tolerated in a rat model of drug inhalation.