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1.
目的探讨基于量化评估下的早期循序渐进康复训练对ICU机械通气患者预后的影响。方法选取2019年1月-2020年12月ICU机械通气患者96例,将2019年1月-12月48例患者设为对照组,将2020年1月-12月48例患者设为观察组。对照组行ICU常规护理,观察组在对照组的基础上实施基于量化评估下的早期循序渐进康复训练。比较两组干预前、干预后1个月神经肌肉功能、肌力、并发症发生及预后情况。结果观察组干预后神经肌肉功能总分及各维度评分、肌力评分显著高于对照组(P<0.05)。观察组机械通气时间、入住ICU时间、总住院时间显著短于对照组(P<0.05),观察组ICU获得性肌无力、呼吸机相关性肺炎、压疮发生率显著低于对照组(P<0.05)。结论基于量化评估下的早期循序渐进康复训练能有效改善机械通气患者神经肌肉功能,降低ICU获得性肌无力、呼吸机相关性肺炎及压疮发生率,有利于患者预后及康复。 相似文献
2.
近年来,无创通气在儿童呼吸支持领域有了较快发展。无创通气无需气管插管,操作简便,对部分呼吸道疾病有较为满意的疗效。但是,无创通气不能完全替代有创机械通气。在有些疾病无创通气不仅有着较高的失败率,而且会因气管插管的延误导致病情恶化,增加患儿的病死率。在行无创通气之前需评估患儿是否适宜进行无创通气治疗。对于进行无创通气治疗的患儿需严密监护,动态观察生理指标和监测数据的变化,掌握好气管插管的时机,以免造成有创机械通气治疗的延误。 相似文献
3.
《Journal of endodontics》2022,48(11):1407-1413
IntroductionInformation on the type of vesicular glutamate transporter (VGLUT) that is expressed in the Piezo2-positive (Piezo2+) neurons in the trigeminal ganglion (TG) and on the type of Piezo2+ axons and their distribution in the dental pulp is important for understanding dental pain elicited by mechanical stimuli and developing new therapeutic strategies.MethodsWe examined the expression of Piezo2 and its coexpression with VGLUT1 and VGLUT2 in rat TG, the sensory root, and human dental pulp using light and electron microscopic immunohistochemistry and quantitative analysis.ResultsVGLUT1 and VGLUT2 were expressed in the TG neurons. Piezo2 was expressed in axons of all types but primarily in small myelinated (Aδ) axons in the sensory root. In the dental pulp, Piezo2 was expressed densely in the numerous axons that form a plexus in the peripheral pulp. Piezo2+ axons in the peripheral pulp were mostly unmyelinated, and Piezo2 immunoreactivity was often concentrated near the axolemma, suggesting that it may represent functional receptors.ConclusionsThese findings suggest that VGLUT1 and VGLUT2 are involved in the glutamate signaling in Piezo2+ neurons, Piezo2 may be primarily activated by noxious mechanical stimuli, and Piezo2-mediated dental mechanotransduction may be primarily elicited in the peripheral pulp. 相似文献
4.
圆锥角膜是一种以角膜进行性变薄前突为特征的角膜扩张性疾病。其发病机制尚不清楚。体外实验表明力学刺激可能通过升高氧化应激水平和炎症因子浓度而损伤角膜基质细胞,造成角膜细胞外基质降解等一系列变化。大量临床研究证实揉眼、由睡姿引起的眼球压迫等力学因素可能在圆锥角膜发生发展的过程中起重要作用。它们可能通过增加泪液炎症因子水平、造成眼压变化、改变角膜生物力学性能以及机械摩擦直接损伤角膜组织、升高角膜上皮温度等机制对角膜造成影响。本文就力学因素对角膜基质细胞、角膜组织的影响及其在圆锥角膜发病机制中可能的作用进行阐述,以期为预防和管理圆锥角膜提供参考。 相似文献
5.
目的评价不同消毒方法对清洁用具和地面洁净程度的影响。方法清洁用具分别采用化学消毒剂浸泡和机械热力消毒,用ATP拭子对消毒前后的清洁用具和病房地面采样,使用ATP荧光检测仪进行分析,比较不同消毒方法的效果。结果地面清洁消毒前拖把表面RLU值为137.00±20.98,地巾表面RLU值为1.20±0.84,地巾表面RLU值水平低于拖把表面,差异具有统计学意义(Z=-2.63,P<0.001)。清洁后拖把组地面平均RLU值减少24.78%,地巾组地面平均RLU值减少55.52%,差异具有统计学意义(Z=-6.03,P<0.001)。结论机械热力消毒处理的地巾比化学消毒剂浸泡的拖把洁净程度更高,采用机械热力消毒后的地巾清洁的地面也更干净。 相似文献
6.
Clinical feature and predictive factor analysis for spontaneous regression of retinopathy of prematurity in a Chinese population 下载免费PDF全文
AIM: To investigate the ratio of spontaneous regression of retinopathy of prematurity (ROP) and to explore the possible relevant predictive factors.
METHODS: A retrospective review of 405 infants who were diagnosed with ROP and mother during pregnancy were collected. Stage, zone, and duration of ROP were recorded. Statistical analysis was performed on 51 possible predictive factors.
RESULTS: Totally 356 infants showed spontaneous regression. The incidence was 100%, 95.3%, and 22.7% in stage 1, 2, and 3, respectively. The 13.4% of the ROP with plus disease eventually resolved spontaneously. All affected eyes of aggressive posterior retinopathy of prematurity (AP-ROP) failed to spontaneously regress. The mean duration of ROP was 7.2wk in patients with spontaneous resolution of ROP. Days of mechanical ventilation (OR=0.981, 95%CI, 0.965-0.997, P=0.021), retinal hemorrhage (OR=0.173, 95%CI, 0.064-0.470, P=0.001), delivery pattern (OR=2.750, 95%CI, 1.132-6.681, P=0.025), maternal anemia in pregnancy (OR=0.142, 95%CI, 0.036-0.563, P=0.005), the stages (at initial diagnosis OR=0.183, 95%CI, 0.041-0.816, P=0.026; at final diagnosis OR=0.031, 95%CI, 0.006-0.167, P<0.001), and with plus disease or not (OR=0.005, 95%CI, 0.001-0.031, P<0.001) were independent predictive factors of the spontaneous regression of ROP.
CONCLUSION: Most mild ROP can spontaneously resolve. Active treatment is still recommended for stage 3 ROP, zone I ROP, AP-ROP, and ROP with plus disease. Prolonged mechanical ventilation and concurrent retinal hemorrhage reduce the likelihood of spontaneous ROP resolution. The pattern of delivery and the mother’s anemia during pregnancy can also affect the prognosis of ROP. 相似文献
7.
目的:调查心脏机械瓣膜置换术(mechanical heart valve replacement,MHVR)术后长期抗凝治疗病人的满意度,并分析其影响因素,为临床治疗提供依据。方法:采用方便抽样的方法选取贵州省某三级甲等医院MHVR术后146例病人为研究对象,采用中文版抗凝治疗满意度量表(Anti-Clot Treatment Scale,ACTS)对其抗凝治疗满意度进行调查,采用单因素、多元逐步回归分析对抗凝治疗满意度的影响因素进行分析。结果:多元逐步回归分析结果显示,影响MHVR术后病人抗凝治疗满意度的因素从大到小依次为出院后并发症发生情况、出院时长、医生能否调华法林剂量、出院后是否再次住院以及每次复查费用,可以解释满意度总变异的58.7%。标准化回归方程为满意度得分=0.262×出院时长-0.347×出院后并发症发生情况+0.239×医生能否调华法林剂量-0.219×出院后是否再次住院-0.130×每次复查费用。结论:对MHVR术后病人进行延续性护理时,应重点加强华法林用药的教育,提高用药依从性,严禁病人随意加量或减量,指导病人观察出血、血栓形成的信号,学会应对措施,同时及时告知医生,减少并发症的发生。 相似文献
8.
王金玲 《中国医疗器械信息》2022,(1)
目的:比较手工清洗法和机械清洗法在腹腔镜手术器械清洗和灭菌中的应用价值。方法:选取2019年6月~2020年12月本院消毒供应中心接收并进行清洗、灭菌处理的腹腔镜手术器械5283件,根据其清洗、灭菌方法分为观察组和对照组,观察组包括2636件腔镜手术器械,对照组包括2647件腔镜手术器械。对照组2647件腹腔镜手术器械使用手工清洗法进行清洗和灭菌,观察组2636件腹腔镜手术器械使用机械清洗法进行清洗和灭菌。结果:观察组腹腔镜手术器械的清洗质量合格率和灭菌质量合格率均显著高于对照组,P<0.05,比较差异有统计学意义。医护人员对观察组的腹腔镜手术器械的满意度评分显著高于对照组,P<0.05,比较差异有统计学意义。结论:相比手工清洗法,机械清洗法能够显著提高腹腔镜手术器械的清洗和灭菌质量,从而显著提高其清洗质量合格率和灭菌质量合格率。 相似文献
9.
《The Journal of thoracic and cardiovascular surgery》2023,165(2):634-644.e5
BackgroundProsthetic choice for mitral valve replacement is generally driven by patient age and patient and surgeon preference, and current guidelines do not discriminate between different etiologies of mitral valve disease. Our objective was to assess and compare short- and long-term outcomes after mitral valve replacement among patients with biological or mechanical prostheses in the setting of severe ischemic mitral regurgitation.MethodsBetween 2000 and 2016, 424 patients underwent mitral valve replacement for severe ischemic mitral regurgitation at our institution, using biological prosthesis in 188 (44%) and mechanical prosthesis in 236 (56%). A 1:1 propensity score match (n = 126 per group) and inverse probability of treatment weighting were used to compare groups. Short-term outcomes included in-hospital mortality and other cardiovascular adverse events. Long-term outcomes included survival and hospital readmission for cardiovascular causes, stroke, and major bleeding.ResultsIn-hospital mortality and early postoperative adverse events were similar between groups in the propensity score match and inverse probability of treatment weighting cohorts. Overall long-term survival was similar at 5 and 9 years, but mechanical prosthesis recipients were more frequently readmitted to hospital for cardiovascular causes, including stroke and non-neurological bleeding in propensity score matching and inverse probability of treatment weighting analyses (all P values < .004). Type of prosthesis did not independently influence all-cause mortality (hazard ratio, 1.01; 95% confidence interval, 0.71-1.43; P = .959), but placement of a mechanical prosthesis was associated with increased risk of readmission for cardiovascular events (hazard ratio, 1.65; 95% confidence interval, 1.17-2.32; P = .004) among matched patients.ConclusionsThe type of prosthesis has no influence on long-term survival among patients with severe ischemic mitral regurgitation undergoing mitral valve replacement. There may be an increased risk of neurologic events and serious bleeding associated with mechanical prostheses. 相似文献
10.
《Journal of the American Medical Directors Association》2022,23(9):1608.e1-1608.e8
ObjectiveData on prognostic tools for indicating mechanical ventilation in older people with COVID-19 are still limited. The aim of this research was to evaluate if the Multidimensional Prognostic Index (MPI), based on the Comprehensive Geriatric Assessment (CGA), may help physicians in identifying older hospitalized patients affected by COVID-19 who might benefit from mechanical ventilation.DesignLongitudinal, multicenter study.Settings and Participants502 older people hospitalized for COVID-19 in 10 European hospitals.MethodsMPI was calculated using 8 different domains typical of the CGA. A propensity score, Cox's regression analysis was used for assessing the impact of mechanical ventilation on rehospitalization/mortality for 90 days' follow-up, stratified by MPI = 0.50. The accuracy of MPI in predicting negative outcomes (ie, rehospitalization/mortality) was assessed using the area under the curve (AUC), and the discrimination with several indexes like the Net Reclassification Improvement (NRI) and the Integrated Discrimination Improvement (IDI).ResultsAmong 502 older people hospitalized for COVID-19 (mean age: 80 years), 152 were treated with mechanical ventilation. In the propensity score analysis, during the 90-day follow-up period, there were 44 rehospitalizations and 95 deaths. Mechanical ventilation in patients with MPI values ≥ 0.50, indicating frailer participants, was associated with a higher risk of rehospitalization/mortality (hazard ratio 1.56, 95% CI 1.09-2.23), whereas in participants with MPI values < 0.50 this association was not significant. The accuracy of the model including age, sex, respiratory parameters, and MPI was good (AUC = 0.783) as confirmed by an NRI of 0.2756 (P < .001) and an IDI of 0.1858 (P < .001), suggesting a good discrimination of the model in predicting negative outcomes.Conclusions and ImplicationsMPI could be useful for better individualizing older people hospitalized by COVID-19 who could benefit from mechanical ventilation. 相似文献