输液时调节器的位置与回血关系的研究

将一次性输液器的调节器分别夹闭于距接头处15cm、30cm、45cm、60cm等4个位置,对88例输液患者进行每人各4次静脉穿刺,观察其回血情况,将所得数据用美国SAS程序进行随机区组方差分析处理。结果表明:使用一次性输液器时,调节器位置对回血有影响,调节器距针头越远回血率越高,头皮针管内回血长度越长。故调节器夹闭的位置不宜过低,至少应距离接头60cm以上。     

一次性输液器调节器位置的观察

将一次性输液器调节器位置的观察将一次性输液器的调节器分别夹于距接头20、40、60、80cm4个位置，观察了98例输液患者(每人各4次)静脉穿刺的血液回流(回血)情况。结果表明：使用一次性输液器时，调节器距接头40cm以上时回血阳性率明显增高，调节器距接头越远，穿刺针内回血长度越长。由此可见，调节器夹闭的位置不宜过低，至少应距接头40cm以上，以60cm位置为佳。调节器不直接与患者接触，防止交叉感染，便于观察，效果满意，值得推广。     

输液时调节器的位置与回血关系的研究

笔者将一次性输液器的调节器分别夹闭于距接头处15cm、30cm、45cm、60cm等4个位置,对88例输液患者进行每人各4次静脉穿刺,观察其回血情况,将所得数据用美国SAS程序进行随机区组方差分析处理,结果表明:使用一次性输液器时,调节器位置对回血有影响,调节器距针头越远回血率越高,头皮针管内回血长度越长,故调节器夹闭的位置至少应距离接头60cm以上,且经统计学检验回血量与年龄无相关性,对任何年龄均适用。     

输液管调节器的位置对头皮针静脉回血影响的研究

目的 :探讨输液管调节器的位置对头皮针静脉回血的影响。方法 :根据输液管调节器位置的高低 ,随机将1 5 7例 1 2 0 0例次静脉输液患者分为以下几组 :A组 :输液管调节器距输液管乳头 5cm ;B组 :输液管调节器距输液管乳头 1 5cm ;C组 :输液管调节器距输液管乳头 2 5cm ;D组 :输液管调节器距输液管乳头 3 5cm ;E组 :输液管调节器距输液管乳头 45cm ;F组 :输液管调节器距输液管乳头 5 5cm。结果 :A、B、C、D、E、F组头皮针静脉即刻回血率分别为3 2 .5 %、49.0 %、85 .5 %、91 .0 %、93 .5 %、92 .0 % ,C、D、E、F组明显高于A、B组 (P均 <0 .0 0 1 )。结论 :输液管调节器的位置对头皮针静脉回血有影响 ,从头皮针静脉即刻回血率与操作的方便性双重考虑 ,认为输液管调节器应放置于距输液管乳头约 2 5～ 3 5cm的位置最佳     

巧用一次性闭光输液器

临床工作中静脉输注氟罗沙星、硝普钠等药物时，为了保证该药的疗效，常用一次性闭光输液器。一次性闭光输液器管壁颜色为深棕色，在静脉输液操作中，常常遇到许多静脉输液穿刺成功后无回血或回血不畅的情况。这时操作者判断针头是否进入血管只能依靠针头刺入血管腔的感觉来判断，具有一定的盲目性。采用负压进针法进行穿刺，利用负压原理可有利于静脉回血，一次性闭光输液器头皮针前端管型颜色明显加深，操作者可准确判断。现介绍如下。     

改良一次性输液器临床应用观察

静脉输液时 ,经常遇到针头刺入血管而不见回血现象 ,仅凭着经验和手感判断针头是否在血管内 ,具有一定的盲目性。1999年 12月— 2 0 0 0年 10月 ,作者对一次性输液器上的调节器位置进行了改进 ,并观察穿刺时回血情况。现将应用情况总结如下 :1　临床资料1.1　一般资料　血液科 1999年 12月— 2 0 0 0年 10月收治病人2 0 0例 ,将其随机分为观察组和对照组 ,两组病人在性别、年龄、病程、临床表现以及血管充盈方面 ,经统计学处理均无统计学意义 (Ｐ >0 .0 5 )。1.2　方法　以手背浅静脉为穿刺点 ,观察穿刺时一次性输液器不同部位夹闭后的回血…     

调节器预设高度与手臂下垂后扎止血带对手背静脉穿刺的影响

在临床输液操作中，输液管调节器的位置对静脉回血有较大影响，调节器距输液管乳头上1／3处位置最佳。为提高手背静脉穿刺效果，我们将调节器设置在距输液管乳头80cm处，分别采用常规法和手臂下垂法对150例病人600例次静脉输液进行观察，以研究其对静脉穿刺的影响。现报道如下。     

使用一次性输液器的小窍门

一次性输液器已使用多年，但在临床操作时常见到穿刺针进入血管不易见回血。特别是细小血管或血容量不足的血管，常常外头已进人血管内，却无法判断仍在盲目的穿刺或退出重新穿刺，结果穿刺失败，给病人造成不必要痛苦。我们分析了静脉穿刺不易见回血的原因，主要在于输液器内液体压力的大小。穿刺时只有输液器内液体压力低于静脉内血液的压力，才能出现回血现象，对于这种情况我们在工作中对静脉输液的操作进行了简单的改进，使穿刺成功率得到了明显提高。具体做法：排净输液器管内空气，关紧调节器。操作时把调节器下面的胶管反折用持针的…     

静脉输液时液体静压对回血的影响

目的研究静脉输液时液体的静压对回血的影响。方法共100例输液患者,每位患者连续3 d输液,输液调节器均夹闭在据输液管乳头80 cm处,3次输液时调节器距离穿刺静脉的垂直高度分别为0、408、0 cm处,见有回血3 s记录每次输液时的回血长度。结果输液调节器的高度越高回血越短,高度越低回血越长（P〈0.05）。结论即调节器的高度（调节器下面输液管内液体的静压）越高,回血越少。     

提高一次性输液器静脉穿刺成功率方法介绍

一次性输液器应用临床后,通过大量使用也存在一定的缺点,特别是一次输液器较之乳胶管输液器相比,管腔细,内径小,管腔内压大,在进行静脉穿刺时,头皮针进入血管后往往回血量小,有时甚至看不到回血,对穿刺成功与否,极不易判断,严重影响了静脉穿刺的成功率。笔者经过临床观察、实践,总结出一简便易行的方法用以判断一次性输液器静脉穿刺后未见回     

Diagnosis of portal vein tumor thrombus by pulsed Doppler ultrasonography.

The blood flow of portal vein thrombus was studied by pulsed Doppler ultrasonography in 21 patients with tumor thrombus and 14 with blood clot thrombus. Pulsatile waves were observed in 19 of the 21 with tumor thrombus, with backward continuous waves in 3, and forward/backward continuous waves in 2. In contrast, forward continuous waves were observed in 2 of the 14 with blood clot thrombus. By color imaging, the blood flow could be observed in 9 of 14 with tumor thrombus, but in 1 of 7 with blood clot thrombus. Pulsatile and backward continuous waves were characteristic of tumor thrombus.     

大角度静脉穿刺术的临床与实验研究

目的 验证大角度静脉穿刺术的临床应用价值。方法 将大角度一胸脉穿刺术与常规静脉穿刺术各行８１５例次临床应用,观察静脉穿刺的速度与质量,以及两种静脉穿刺术对兔耳静脉穿刺后局部病理组织改变的影响。结果 临床对比应用表明,大角度静脉穿刺组回血时间缩短１．２４ｓ,一针成功率提高４．１１％,皮下瘀血率减少０．７１％,各项指标皆有显著性差异,Ｐ值均〈０．０１动物实验提示,大角度静脉穿刺组静脉管壁周围组织损伤程     

血小板抗原与抗体的研究及其应用

血小板抗原与抗体的研究,在各类免疫性血小板减少症的诊断和治疗中具有重要作用.与红细胞血型遗传和免疫血液学技术相比,血小板抗原、抗体的基础研究和免疫检测技术相对落后,尤其是国内,在新的种族特异性血小板抗原的发现、血小板抗体特异性鉴定、血小板输注同种免疫问题等方面,亟需加大研究力度,以推动我国血小板免疫学研究和临床应用的发展.     

Changes in cerebral blood flow during forward and backward walking with speed misperception generated by virtual reality

[Purpose] The purpose of this study was to investigate the effect of speed misperception on brain activity, created by a speed difference between actual walking and virtual reality walking videos. [Participants and Methods] The participants were 20 healthy young people. The walking speed in the video was set to 3 km/h to induce an error, while the actual walking speed was 1 km/h. Cerebral blood flow was measured using an optical imaging brain function measurement device. Left and right prefrontal cortices were analyzed using two channels and oxyhemoglobin level change from rest was used as a cerebral blood flow index. A t-test compared the cerebral blood flow dynamics before, during, and after the virtual reality video viewing under forward and backward walking conditions. [Results] Regarding changes in oxyhemoglobin levels during walking after watching the virtual reality video, cerebral blood flow increased especially in the backward walking state, where the difference was large in the right prefrontal cortex. [Conclusion] The backward walking that caused misperception by virtual reality is an extraordinary movement compared to forward walking. Thus, it is necessary to voluntarily adjust the movement by the cerebral cortex, and it is thought that activation of the prefrontal cortex occurs.     

Changes in cerebral blood flow before,during, and after forward and backward walking in stroke patients trained using virtual reality walking videos with deliberately induced inaccuracies in walking speed estimations

[Purpose] The aim of this study was to examine the effects of virtual reality (VR) training, with deliberately induced inaccuracies in walking speed estimations, on brain activity. [Participants and Methods] The study participants were 21 stroke patients, and the walking tasks involved forward and backward walking. While the VR walking speed was set at 3 km/h, estimation errors were induced by using an actual walking speed of 1 km/h during the walking tasks. Cerebral blood flow was measured using two functional near-infrared spectroscopy (fNIRS) channels located over the left and right prefrontal cortices, to determine changes in oxyhemoglobin levels from the resting state. Cerebral hemodynamics were compared during and after the VR training. [Results] The backward walking task induced a significant increase in cerebral blood flow in the right prefrontal cortex during and after the VR training. No significant changes were observed during the forward walking task. [Conclusion] In the backward walking condition, greater activation of the right prefrontal cortex was observed during and immediately after the VR training. Watching VR may have led to inaccurate walking-speed estimations, necessitating postural control (which may be attributed to the activation of the prefrontal cortex) during walking.     

Complex flow patterns in the great vessels: a review

The article reviews the applications of magnetic resonance velocity mapping based on phase shifts in the protons to quantify blood flow velocity and blood flow volume. The method can be used to study normal physiology of blood flow in the aorta and its major branches, including forward and backward flow, to measure the aortic valve function in aortic valvular disease, stenosis and regurgitation, as well as pulmonary artery flow velocities in pulmonic insufficiency and regurgitation. Superior vena cava flows, pulmonary vein flows, left-to-right shunts, atrial and ventricular pulmonary conduit flows can also be measured. Two- and three-directional velocity mapping is reviewed and can be used to study three- or four-D flows in the aorta and the major arteries in great detail.     

生理性返流产生机制及影响因素

通过临床观察、动物实验、模拟试验等方面的超声心动图检查、声学造影多普勒观测，对生理性返流的产生机制和影响因素进行了研究。结论说明，生理性返流是前进的血流碰到逆向关闭瓣膜的结果；后散射较弱，返流速较慢，检查部位离探头较远，均影响生理性返流的检出率；左心压力较高，但因室壁较厚，乳头肌对二尖瓣牵拉力较大，因而二尖瓣关闭速度比三尖瓣关闭速度要慢，是影响二尖瓣生理性返流检出率较低的原因之一。主动脉和肺动脉因几何图形不同，血流束和所撞管壁夹角大小不同，影响了反作用力的大小，根据所测气泡流线的速度，肺动脉折返流线大于主动脉，这对主、肺动脉瓣生理性返流检出率也有一定影响。     

The clinical laboratory evaluation of accuracy of portable glucometers "Satellite Express" and "Satellite Express mini"

The portable glucometers "Satellite Express" and "Satellite Express mini" were applied during 35 days to analyze 200 blood samples of patients with diabetes mellitus type I and II and of healthy people. The results were compared with the data of reference analyzer The results of clinical laboratory trials revealed that these glucometers have enough degree of accuracy detection of glucose in capillary blood - 100% of results are within the permissible limits as directed by ISO 15197:2003. Furthermore, 98.3% of results are within the limits of +/- 15% from reference analyzer results. Thereby, the glucometers "Satellite Express" and "Satellite Express mini" can be recommended to detect the glucose concentration in capillary blood for the purpose of glycaemia level self-control by patients with diabetes mellitus. The devices can also be used by medical personnel for express diagnostics in case of emergency care.     

Abnormalities in aortic properties: a potential link between left ventricular diastolic function and ventricular—aortic coupling in sickle cell disease

Left ventricular (LV) diastolic dysfunction in patients with sickle cell disease (SCD) is associated with increased mortality. However, its mechanisms are not well known, preventing the development of effective therapies. We hypothesized that patients with SCD have altered aortic properties despite normal blood pressure, which may contribute towards the development of diastolic dysfunction. We studied 31 stable adult patients with SCD (32 ± 7 years) and 12 healthy controls of similar age (29 ± 10 years) who underwent echocardiography and cardiovascular magnetic resonance (CMR) imaging on the same day. Echocardiographic measurements of mitral inflow and mitral annulus velocities were used to evaluate LV diastolic function. CMR imaging included standard LV function evaluation and myocardial tissue characterization as well as velocity-encoded images of the ascending aorta to measure aortic diastolic cross-sectional area, distensibility, as well as peaks and volumes of the global, forward and backward blood flow rate. Compared to controls, SCD patients had increased aortic diastolic area, global stroke volume, and both forward and backward flow, while aortic distensibility and peripheral blood pressure were similar. Furthermore, peak backward flow rate and volume were able to discriminate between patients with and without diastolic dysfunction. Our findings show that some aortic properties are altered in SCD patients and may be associated with diastolic dysfunction despite normal systolic blood pressure. If confirmed in larger studies, these aortic changes could be a novel therapeutic target to prevent or delay the development of LV diastolic dysfunction in SCD and thus potentially improve outcomes in these patients.     

"Naturally-occurring" anti-K1: possible association with mycobacterium infection

We report a case of "naturally-occurring" (nonred blood cell stimulated) anti-K1. The patient had never received a blood transfusion. Red blood cell antibody screening panels showed agglutination with K:1 red blood cells at room temperature and not in the anti-globulin test. Testing with 2-mercaptoethanol showed the antibody to be IgM. The antibody is "naturally-occurring" and may be associated with pulmonary tuberculosis.