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颅脑损伤合并胸腹部损伤的诊疗分析 总被引:5,自引:0,他引:5
目的 探讨颅脑损伤合并胸、腹部损伤的诊断和治疗。方法回顾性分析1996-2004年我院收治的颅脑损伤合并胸、腹部损伤患76例。结果76例患中恢复良好44例(57.9%),中残5例(6.6%),重残2例(2.6%),植物生存状态1例(1.3%)。死亡24例(31.6%)。结论诊治胸、腹部创伤的同时,应重视颅脑外伤的早期诊断,并应根据伤情的主次选择术中及术后的治疗方案。 相似文献
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Leyla Baysan Arabaci Gul Dikec Ayse Buyukbayram Gulcin Uzunoglu Erol Ozan 《Archives of Psychiatric Nursing》2018,32(4):568-573
The aim of this study was to examine the traumatic mental growth and psychological resilience status of females who were receiving inpatient treatment at a district mental health hospital and had a history of being subjected to violence. One hundred-twenty female patients with a history of exposure to violence participated in the study. An introductory information form, the Traumatic Growth Inventory (TGI) and the Psychological Resilience Scale for Adults (PRSA) were used for data collection. This study found that all the participants were subjected to emotional violence, 65.8% to physical violence, 30.8% to sexual violence, and 94.2% to verbal violence at some point in their lives. Their TGI mean score (60.96?±?11.91) was above average, while their PRSA mean score (97.90?±?9.18) was below average. The participants' mean scores on the TGI and PRSA did not vary significantly by the type of violence (p?>?0.05) to which the women were exposed. Moreover, no statistically significant relationship was found between the TGI and the PRSA total scale and subscale mean scores (p?>?0.05). This study found that the posttraumatic growth of females who had a history of physical or emotional or sexual abuse was positive, and that their psychological resilience levels were inadequate. 相似文献
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《Journal of biomedical informatics》2013,46(5):905-913
Integration of clinical decision support services (CDSS) into electronic health records (EHRs) may be integral to widespread dissemination and use of clinical prediction rules in the emergency department (ED). However, the best way to design such services to maximize their usefulness in such a complex setting is poorly understood. We conducted a multi-site cross-sectional qualitative study whose aim was to describe the sociotechnical environment in the ED to inform the design of a CDSS intervention to implement the Pediatric Emergency Care Applied Research Network (PECARN) clinical prediction rules for children with minor blunt head trauma. Informed by a sociotechnical model consisting of eight dimensions, we conducted focus groups, individual interviews and workflow observations in 11 EDs, of which 5 were located in academic medical centers and 6 were in community hospitals. A total of 126 ED clinicians, information technology specialists, and administrators participated. We clustered data into 19 categories of sociotechnical factors through a process of thematic analysis and subsequently organized the categories into a sociotechnical matrix consisting of three high-level sociotechnical dimensions (workflow and communication, organizational factors, human factors) and three themes (interdisciplinary assessment processes, clinical practices related to prediction rules, EHR as a decision support tool). Design challenges that emerged from the analysis included the need to use structured data fields to support data capture and re-use while maintaining efficient care processes, supporting interdisciplinary communication, and facilitating family-clinician interaction for decision-making. 相似文献
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Maria Martin-Saez Joe Deakins Rachel Winson Peter Watson 《Neuropsychological rehabilitation》2013,23(6):769-783
In 2003 Wilson, Scott, Evans, and Emslie published a report of a new healthcare resource; a paging system designed to reduce the everyday problems of people with neurological deficits who experience memory and/or planning problems. The system was established following several research studies carried out to evaluate its effectiveness. Information was collected on the first 40 clients recruited to the service. The purpose of the present study is to determine how the service might have changed over a 10-year period. The most recent users of the service (N?=?40) have been compared with the original cohort of 40 clients. In addition, in 2007 clients were given the opportunity to use their mobile telephones to receive messages; 17 chose to do so. There was no difference in age between the telephone users compared to the pager users, but those using a pager were less likely to have sustained a traumatic brain injury (TBI) and were more likely to be longer post-insult. There were no significant differences in the gender or ages of the people using the pager compared with those using the telephone service. However, the mean overall time since injury for the last 40 referrals was 9.48 years compared to 4.56 years for the original cohort. Both cohorts comprised several diagnostic groups; clients with TBI formed the largest subgroup, followed by those with stroke. This is typical of patients seen for rehabilitation, with other diagnostic groups forming a smaller percentage. We wanted to determine whether the range of diagnoses was similar over the 10-year period. Despite slight differences, we found a similar range of patients referred. In both cohorts the most frequent messages sent each week related to medication (27.9% in the first compared to 28.6% in the second). More messages were sent regarding mood management in the second cohort. No such messages were sent to the first 40 clients, whereas over 27 per week were sent to the last 40. Fewer health authorities (N?=?21) were referring after 10 years in comparison with 26 referrers for the first cohort. 相似文献
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目的考察中西结合护理手段对创伤性截瘫患者术后尿潴留的临床护理效果,为患者提供安全、经济、高效的护理方法。方法收集河北省怀安县人口和计划生育局2008年3月~2012年5月间收治的90名创伤性截瘫患者为研究对象,分为A、B两组。在脊髓休克期与脊髓功能恢复期分别使用不同的中西结合护理手段对创伤性截瘫患者进行护理,治疗一定时间后对护理效果进行考察。结果脊髓休克期内的患者接受间歇导尿与中药利尿饮的护理治疗后,患者经导尿后的尿残余量与护理前相比,有明显下降,泌尿道感染率接近零。A组护理前残余尿量为(336.42±51.21)mL,2、4周后,护理后残余尿量分别为(163.46±39.81)、(336.42±51.21)mL;B组护理前残余尿量为(340.17±47.26)mL,护理后残余尿量分别为(103.24±25.49)、(89.64±31.69)mL,且数据间差异有高度统计学意义(P〈0.01)。脊髓功能恢复期内的A、B两组患者,经过中西结合护理后,2周与1个月后患者自行排尿后尿残余量与护理前相比均有显著下降,A组下降为(103.11±23。57)、(91.83±29.13)mL,B组下降为(103.24±25.49)、(89.64±31.69)mL,且数据间差异有高度统计学意义(P〈0.01),膀胱功能改善的总有效率为100%。结论中西结合的护理手段对创伤性截瘫患者的尿潴留症状具有较好的临床护理效果,且有安全、高效、经济等优点,值得临床推广应用。 相似文献
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目的探讨经颅手术修补外伤性脑脊液漏的术前定位、手术方法及疗效。方法对2009年1月至2011年9月间18例外伤性脑脊液漏患者资料进行回顾性分析;包括术前检查、手术方式、术后疗效及随访情况。结果急诊手术一期修补12例,术后脑脊液立即停止漏出6例,术后明显减少且2~4 d内停止漏出5例,术后死亡1例;延迟性脑脊液漏修补6例,术后漏出全部停止;所有出院患者随访均无复发。结论术前准确定位漏口,选择合适的手术方法可使外伤性脑脊液漏的修补获得较好的临床疗效。 相似文献