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脑室引流管的观察及护理 总被引:2,自引:0,他引:2
脑室引流是经颅骨钻孔穿刺侧脑室 ,放置引流管将脑脊液引流至体外 ,其主要目的有 :①抢救因脑脊液循环受阻所致的颅内高压危急状态 ,如 :枕骨大孔疝 ;②进行脑室系统的检查 ,以明确诊断和方位 ;③脑室内手术后安放引流管 ,引流血性脊液 ,减轻脑膜刺激症状及蛛网膜粘连 ,术后早期还可以起到控制颅内压的作用[1] ;④颅内感染经脑室注药冲洗 ,消除颅内炎症。现将我科 43例脑室引流管的护理经验总结如下。1 临床资料本组病例 43例 ,其中女性 16例 ,男性 2 7例 ,最大年龄 75岁 ,最小年龄 8岁 ,其中肿瘤 3 8例 ,外伤 4例 ,寄生虫 1例。2 观察及… 相似文献
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Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1. 相似文献
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颅脑手术后监护室病人经常出现高血压,也就是术后高血压。术后高血压即使只是瞬时发作,也可能会对心血管和颅内产生重大影响。因此,对术后高血压需要进行积极诊断、治疗和护理。1年来,通过对此类病人的临床观察和原因分析,对不同原因的术后高血压病人采取针对性的护理措施,从而取得了较为满意的效果,现将经验介绍如下。 相似文献
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临床上经皮肾穿刺活检是诊断肾脏病的重要方法。我科自 1995年 8月采用B超导向下 1秒钟快速肾穿刺以来 ,并发症明显减少 ,取得良好效果 ,现报道如下。1 资料和方法1.1 病例来源 本组 80 4例 ,为我科 1995年 8月~ 1999年8月住院病人。男 371例 ,女 433例。年龄 15~ 81岁。其中肾功能正常者 6 72例 ,肾功能不全代偿期者 78例 ,失代偿者40例 ,尿毒症状 14例。对肾衰病人凡双肾缩小者未予穿刺。1.2 穿刺操作 肾穿刺活检术是由医生和影像医生共同操作 ,护士配合完成。术前常规检查血小板数量 ,凝血时间及凝血酶原时间 ,高血压者降至 2 1/… 相似文献
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目的 探讨透出液蛋白丢失对连续性非卧床腹膜透析(CAPD)患者营养不良-炎性反应-动脉硬化(MIA)综合征的影响。 方法 对130例无明显水肿和活动性感染的CAPD患者进行横断面的研究。用标准腹膜平衡试验(PET)评估CAPD患者腹膜转运功能。颈动脉彩色超声检测颈动脉内膜中层厚度(IMT)。检测患者血清白蛋白、夜间留腹透出液蛋白和超敏C反应蛋白(hs-CRP)的水平。残余肾功能(rGFR)为24 h尿尿素氮和尿肌酐清除的平均值。 结果 Pearson和Spearman相关分析显示,CAPD透出液蛋白的丢失与年龄、体质量指数(BMI)、夜间腹透液留腹的时间、血糖、4 h透出液肌酐与血肌酐比值(4 h D/Pcr)及hs-CRP水平呈正相关(分别为r = 0.204,P < 0.05;r = 0.314,P < 0.01;r = 0.265,P < 0.01;r = 0.212,P < 0.05;r = 0.401,P < 0.01和r = 0.216,P < 0.05);与舒张压、血清白蛋白、透析液糖浓度及腹膜Kt/V呈负相关(分别为r = -0.209,P < 0.05;r = -0.123,P < 0.05;r = -0.271,P < 0.01;r = -0.212,P < 0.01)。总体上,透出液蛋白丢失量与IMT无相关,但患者rGFR小于1 ml·min-1·(1.73 m2)-1时,透出液蛋白丢失量与IMT呈正相关(r = 0.650,P < 0.01)。 结论 CAPD患者透出液蛋白的丢失与患者腹膜转运类型、营养不良和炎性反应状态密切相关。患者rGFR小于1 ml·min-1·(1.73 m2)-1时,透出液蛋白的丢失是颈动脉动脉硬化的危险因素。 相似文献
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目的探讨持续非卧床腹膜透析患者应对方式和生存质量状况及其相关关系。方法采用医学应对问卷(medical copingmodes questionnaire,MCMQ)及生存质量量表(medical outcomes study 36-item short form survery,SF-36)分别对腹膜透析治疗超过3个月患者进行调查。了解患者应对方式和生存质量状况及其相关关系。结果腹膜透析患者应对方式中的"面对"维度得分为(18.28±3.86)分,低于常模,"回避"与"屈服"维度得分分别为(15.74±2.61)分与(11.10±4.77)分,高于常模,组间比较,差异具有统计学意义(均P〈0.05)。腹膜透析患者生存质量得分低于正常人群,组间比较,差异具有统计学意义(均P〈0.05)。相关性分析表明:生存质量与应对方式中的"面对"维度呈正相关,而与"屈服"维度呈负相关(均P〈0.05)。结论腹膜透析患者倾向于采取"屈服"的应对方式,其生存质量低于正常人群;采用"面对"应对方式者,其生存质量较好,采用"屈服"应对方式,其生存质量较差。教育患者应采用"面对"应对方式,提高其生存质量。 相似文献
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老年糖尿病终末期肾病并发心力衰竭及急性心肌梗塞的腹膜透析治疗 总被引:2,自引:0,他引:2
目的:提高老年糖尿病终末期肾病(DNESRD)患并发心力衰竭、急性心肌梗塞腹膜透析(腹透)的治疗效果。方法:对行腹透的22例老年DNESRD并发心力衰竭、急性心肌梗塞患进行回顾性分析。结果:老年DNESRD并发心力衰竭16例、急性心肌梗塞6例经腹透及血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(AT-Ⅱ)治疗。分别有效15例、5例,在腹透期间未发生其他心脑血管并发症。结论:腹透治疗老年DN ESED并发心力衰竭、急性心肌梗塞效果肯定、安全。合用ACEI或AT-Ⅱ有助于进一步提高疗效。 相似文献
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Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1. 相似文献