学龄前儿童先天性脊柱侧凸矫形手术围术期输血的相关因素分析——一项单中心回顾性分析

目的回顾性分析学龄前儿童（≤72个月）行先天性脊柱侧凸矫形手术围术期血液管理的临床特点及相关影响因素。方法针对2年以来行先天性脊柱侧凸矫形手术的110例学龄前儿童（≤72个月）相关资料进行回顾性分析,组间比较采用t检验,组内比较采用重复测量的方差分析,多元Logistic回归分析被用来确定异体红细胞输注的独立预测因子。结果共有91例患儿（83％）术中输入异体红细胞,与术中异体红细胞输入量存在明显相关性的因素有患儿的体重、术前Cobb角、融合节段、手术时间、截骨数量、失血量以及术前血红蛋白（hemoglobin,Hb）浓度、红细胞比容（hematocrit,Hct）、血小板（bloodplatelet,Pit）计数,其中独立因素有Cobb角、截骨数量、术前Hb浓度、Hct、Pit计数。输血患儿与未输血患儿比较,术中截骨率、术中出血量和术后24h伤口引流量显著增加,术后住院时间也明显延长。结论可作为围术期输血评估的独立因素有Cobb角、截骨数量、术前Hb浓度、Hct、Plt计数,而与患儿的年龄、体重、融合节段及手术时间无明显相关性,有助于对学龄前儿童先天性脊柱侧凸矫形手术围术期输血需求的早期识别和准确评估,保证患儿的生命安全。     

心胸外科应用物理排痰疗法的体会

护理胸外科病人,呼吸道管理是重点,使痰液顺利排出又是其中的难点,传统方法是鼓励病人咳嗽、拍背或雾化吸入等,由于病情各异,有时效果不佳。1993年3月开始,我们对收治的196例采取听、引、叩、震、排一整套护理技术帮助病人排痰,收到了良好效果,现介绍如下。     

使用维生素K1引起接触性皮炎13例

使用维生素K1引起的13例接触性皮炎中,患有上呼吸道感染伴咳嗽的患者8例,产后围产期出血较多的患者5例;年龄最小的5岁,最大28岁;均为女性.13例均在用维生素K1治疗3～5天后出现皮疹,双侧臀部肌注局部出现手掌大水肿性红斑,边缘清楚,在红斑的基础上可见米粒大丘疱疹、水疱,局部皮温较高.自觉有烧灼感及微痒,追问病史,既往注射其它药物后均未发生过局部皮肤过敏史.     

县级医院护士工作压力源分析与干预

护士作为医院的一线工作人员,其工作性质和时间相对于一般企事业员工来说有更强的不稳定性,而且护士必须经常面对患者及其家属、医生及其他与工作相关的人员,这些因素都会使护士产生工作压力。工作压力不但会影响护士身心健康,还会影响其工作质量。目前国内对三级医院护士所做的工作压力源及工作疲溃感的调查研究较多,但针对县级医院护士的调查不多见。2008年3月,我们向潍坊地区三家二级甲等医院的300名护士发放问卷,调查县级医院护士的工作压力源,并为县级医院的护理管理者提供科学管理的依据。     

金州区医疗机构消毒质量监测结果分析

为了解金州区医疗机构消毒工作状况,加强消毒管理,预防和控制医源性感染,2004-2007年连续4年对辖区内的医疗单位进行消毒质量监测,现将监测结果报告如下.     

传染性软疣误诊为尖锐湿疣二例

<正> 例1女,35岁,汉族,已婚。于1989年12月初自觉会阴部微痒,继之出现针尖大小丘疹,渐增大增多。曾在某医院诊断为“尖锐湿疣”给服中药及外用药(药名不详)治疗两月余无效。皮损波及大腿内侧,来我院就诊。皮肤科情况:会阴部、大小阴唇及双股     

体外循环技术在自体血回输中的应用

2004-2005年。我们采用体外循环技术回收30例患者的术中出血，并给予回输，效果良好。现报告如下。     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.