附送水胃镜与普通胃镜临床应用价值的对比研究

目的对附送水内镜与普通胃镜在临床中的应用价值进行对比研究。方法随机选取2018-02至2018-09于解放军总医院第三医学中心消化内科行胃镜检查的患者100例作为研究对象,按随机数字表法分为研究组和对照组,各50例。检查中发现消化道黏膜被粘液或泡沫等污物遮盖时,研究组应用附送水内镜的附送水通道对黏膜进行冲洗,对照组采用常规手推注射器的方法对黏膜进行冲洗,记录相关指标。结果两组患者黏膜冲洗前内镜下清晰度评分比较,差异无统计学意义(P>0.05)。但研究组患者达到清晰效果所需注水量少于对照组,并且研究组的内镜检查操作时间明显短于对照组,研究组浅表性胃炎检出率明显高于对照组,研究组医护人员满意度及患者耐受度均高于对照组,差异均有统计学意义(P<0.05)。结论应用附送水内镜进行胃镜检查,具有省时、省力的优势,能够显著提高工作效率,值得在临床中推广应用。     

延续性护理干预在小儿支气管哮喘护理中的应用研究

目的观察延续性护理干预对小儿支气管哮喘患者哮喘控制情况的影响。方法选取2016-01至2017-12期间住院的小儿支气管哮喘患者86例,随机分为2组:观察组(n=43)和对照组(n=43)。出院后,观察组采用延续性护理干预,对照组不进行护理干预。结果出院12个月后,观察组患者的第一秒用力呼气量占预计值百分比(forced expiratory volume in the first second,FEV1%)和最大呼气量占正常预计值百分比(peak expiratory flow,PEF)较对照组显著提高,差异有统计学意义(P<0.05)。同时,观察组患者的哮喘控制率较对照组明显改善(P<0.05)。结论延续性护理干预有助于改善患儿的呼吸功能,控制哮喘。     

疑似或确诊新型冠状病毒肺炎患者相关手术室感染防控建议

根据新型冠状病毒肺炎的流行病学特点,结合国家近期印发的有关该疾病的相关防控方案、指引和感染防控的相关法律、法规,结合手术室工作特点,组织我省手术室护理专家制订首版-该疾病患者手术在手术室过程的感染防控指引,内容包括手术间准备、用物准备、手术人员准备、患者转运、手术中和手术后的管理等各个环节,以预防和控制新型冠状病毒肺炎手术患者在手术过程中造成交叉感染,并供全国各地医院手术室参考。     

Cervical intervertebral disc degeneration and dizziness

Clinical studies have found that patients withcervical degenerative disease are usually accompanied by dizziness. Anterior cervical surgery can eliminate not only chronic neck pain, cervical radiculopathy or myelopathy, but also dizziness. Immunohistochemical studies show that a large number of mechanoreceptors, especially Ruffini corpuscles, are present in degenerated cervical discs. The available evidence suggests a key role of Ruffini corpuscles in the pathogenesis of dizziness caused by cervical degenerative disease (i.e. cervical discogenic dizziness). Disc degeneration is characterized by an elevation of inflammatory cytokines, which stimulates the mechanoreceptors in degenerated discs and results in peripheral sensitization. Abnormal cervical proprioceptive inputs from the mechanoreceptors are transmitted to the central nervous system, resulting in sensory mismatches with vestibular and visual information and leads to dizziness. In addition, neck pain caused by cervical disc degeneration can play a key role in cervical discogenic dizziness by increasing the sensitivity of muscle spindles. Like cervical discogenic pain, the diagnosis of cervical discogenic dizziness can be challenging and can be made only after other potential causes of dizziness have been ruled out. Conservative treatment is effective for the majority of patients. Existing basic and clinical studies have shown that cervical intervertebral disc degeneration can lead to dizziness.     

Chinese expert consensus on interventional diagnosis and management of acquired digestive-respiratory tract fistulas (second edition)

Acquired digestive-respiratory tract fistulas occur with abnormal communication between the respiratory tract and digestive tract caused by a variety of benign or malignant diseases, leading to the alimentary canal contents in the respiratory tract. Although various departments have been actively exploring advanced fistula closure techniques, including surgical methods and multimodal therapy, some of which have gotten good clinical effects, there are few large-scale evidence-based medical data to guide clinical diagnosis and treatment. The guidelines update the etiology, classification, pathogenesis, diagnosis, and management of acquired digestive-respiratory tract fistulas. It has been proved that the implantation of the respiratory and digestive stent is the most important and best treatment for acquired digestive-respiratory tract fistulas. The guidelines conduct an in-depth review of the current evidence and introduce in detail the selection of stents, implantation methods, postoperative management and efficacy evaluation.