基于表面肌电图分析靳三针结合镜像疗法治疗脑梗死下肢功能障碍的效果研究

背景脑梗死常导致患者下肢功能障碍,降低生活质量。研究显示针刺结合镜像疗法可改善脑梗死患者下肢功能障碍,但研究尚少,且评价方法有待补充。目的 基于表面肌电图(sEMG)分析靳三针结合镜像疗法对脑梗死患者下肢功能障碍的影响。方法 选取2022年7—12月南方医科大学深圳医院康复医学科、神经内科住院部的90例脑梗死下肢功能障碍患者为研究对象,依据随机数字表法将其分为靳三针组、镜像组、靳三针+镜像组,每组30例。三组患者均给予基础治疗,靳三针组在基础治疗上增加靳三针治疗,镜像组在基础治疗上增加膝关节镜像训练,靳三针+镜像组则在基础治疗上增加靳三针治疗和膝关节镜像训练。三组均治疗1次/d,5次/周,共治疗4周。采用s EMG评估治疗前后患侧下肢肌肉神经系统功能,包括时域指标[均方根值(RMS)]和频域指标[中位频率(MF)];采用简化Fugl-Meyer量表中的下肢部分(FMA-LE)评分评估下肢运动功能。结果 镜像组与靳三针组患者患侧股二头肌、胫骨前肌、股直肌、腓肠肌治疗4周后RMS、MF比较,差异无统计学意义(P>0.05);靳三针+镜像组患者患侧股二头肌、胫骨前肌、股直肌、腓肠肌治疗...     

浅析"嗅三针"疗法治疗痴呆的理论基础

"嗅三针"疗法是刘智斌教授和牛文民教授在长期的针灸临床实践中探索总结出来的一种针刺治疗方法。该针法在临床中治疗痴呆取得较好的疗效,本文从中医基础、神经解剖学基础、脑功能磁共振成像基础及临床疗效基础等方面展开研究,对"嗅三针"疗法的理论基础做一浅析及思考。     

Implementing AORN Recommended Practices for Sharps Safety

Prevention of percutaneous sharps injuries in perioperative settings remains a challenge. Occupational transmission of bloodborne pathogens, not only from patients to health care providers but also from health care providers to patients, is a significant concern. Legislation and position statements geared toward ensuring the safety of patients and health care workers have not resulted in significantly reduced sharps injuries in perioperative settings. Awareness and understanding of the types of percutaneous injuries that occur in perioperative settings is fundamental to developing an effective sharps injury prevention program. The AORN “Recommended practices for sharps safety” clearly delineates evidence-based recommendations for sharps injury prevention. Perioperative RNs can lead efforts to change practice for the safety of patients and perioperative team members by promoting the elimination of sharps hazards; the use of engineering, work practice, and administrative controls; and the proper use of personal protective equipment, including double gloving.     

胰岛素笔一次性针头重复使用现状及安全性分析

目的 通过对住院糖尿病患者胰岛素笔一次性针头被重复使用现状的调查,观察其重复使用的安全性,为糖尿病患者正确使用胰岛素笔,医务人员进行健康宣教提供依据.方法 自行设计《胰岛素笔一次性针头使用情况调查表》,对附属医院消化内分泌科纳入标准的80名糖尿病患者进行调查.结果 糖尿病患者胰岛素笔一次性针头重复使用现象较普遍,95％患者存在重复使用现象,35％患者重复使用达6次以上.针头贵是其主要原因.重复使用次数(n＜6或n≥7)对皮肤的损害程度差异有统计学意义(x12=5.78,P1＜0.05),但重复使用2～6次与7次以上对皮肤影响差别不大,差异无统计学意义(x22=0.10,P2＞ 0.05).结论 目前糖尿病住院患者胰岛素笔针头重复使用现象普遍,经济原因及缺乏有效的健康教育和指导是其重要因素.加强对糖尿病患者规范使用胰岛素笔的教育,预防不良反应发生,势在必行.     

Intraoperative Loss of a Surgical Needle: A Laparoscopic Dilemma

Background:

Increasing awareness around patient safety and efforts to reduce medical errors has become a priority in the modern health care system. Losing needles during laparoscopic procedures is an uncommon occurrence; however, it poses a significant dilemma for the operating surgeon because retrieval can be a major challenge even for highly skilled and experienced operators.

Objective:

The objective of this paper was to review the current literature and highlight this potentially serious issue and suggest a method of dealing with this uncommon occurrence.

Methods:

A comprehensive literature search was conducted using several Internet search engines including PubMed, Google Scholar, and ScienceDirect.

Conclusions:

The risks associated with retained small foreign bodies remains unknown, and there are few reports and little consensus on how surgeons should manage retained needles or other small foreign bodies during laparoscopic surgery. We propose an algorithm that may be implemented as a standard operating procedure in surgical theatres when a surgeon is faced with such a dilemma.     

输液敷贴与棉签按压拔针效果观察

目的：比较输液敷帖与棉签两种材质按压拔针的效果。方法对98例住院患者同体左右手静脉输液后分别采取输液贴按压法拔针和棉签按压法拔针,观察拔针后止血效果。结果棉签按压法拔针后产生疼痛的发生率为79．6％、皮下瘀斑发生率为5．1％,输液敷贴法分别为35．7％、0,棉签按压法拔针后产生疼痛及皮下瘀斑的发生率显著高于输液敷贴按压法（ P＜0．05或0．01）。结论输液敷贴按压拔针能有效减少静脉输液拔针后疼痛及皮下瘀斑的发生。     

无痛技术在儿科外周静脉留置针中的应用

目的 探讨无痛技术在儿科患儿留置外周静脉留置针中的应用效果。方法 选取2017年1~6月在神经内科住院的828例患儿为研究对象,按随机数字表法选择尾数为奇数的402名患儿为对照组,采用常规方法留置外周静脉留置针;选择尾数为偶数的426名的患儿为实验组,采用无痛技术留置外周静脉留置针,比较2组患儿的疼痛反应、配合度、一次性穿刺成功率和对护理工作的满意度。 结果 实验组患儿的疼痛程度明显轻于对照组(Z=-16.374,P<0.001)、配合度及一次性穿刺成功率均明显高于对照组(χ²=89.229,P<0.001; χ²=12.838,P<0.001);患儿及家属对护理工作的满意度均优于对照组(Z=-4.370,P<0.001)。 结论 将无痛技术应用于儿科外周静脉留置针中,能减轻患儿的疼痛反应,缓解其恐惧心理,提高配合度和一次性穿刺成功率,提升患儿及其家属对护理工作的满意度,且方法简单,便于临床应用。