复方利多卡因乳膏在小儿桡动脉穿刺中的应用

在儿科临床护理工作中,动脉穿刺是一项难度系数较高的操作,采集动脉血标本主要从股动脉、肱动脉、桡动脉、足背动脉穿刺,而以桡动脉穿刺最为方便。为了提高桡动脉穿刺成功率,减轻患儿痛苦,我们采用复方利多卡因乳膏涂抹局部皮肤30min后再行常规方法穿刺,取得了较好的效果,现报告如下。     

复方利多卡因乳膏在血液透析病人动静脉内瘘穿刺中的镇痛效果观察

目的观察复方利多卡因乳膏在血液透析病人动静脉内瘘穿刺中的镇痛效果。方法将64例使用动静脉内瘘行维持性血液透析病人随机分为对照组和观察组,每组各32例。观察组穿刺前60min以穿刺点为中心涂抹复方利多卡因乳膏,对照组采用常规穿刺方法。观察两组病人在内瘘穿刺中的疼痛程度。结果观察组病人在内瘘穿刺中疼痛程度较对照组病人轻,两组比较,Z=-4.239,P〈0.05,差异具有统计学意义。结论在穿刺点涂抹复方利多卡因乳膏可减轻血液透析病人内瘘穿刺时的疼痛。     

复方利多卡因乳膏在妇科手术病人静脉穿刺中的应用

[目的]观察复方利多卡因乳膏在妇科手术病人静脉穿刺中的应用效果。[方法]将89例妇科手术病人随机分为对照组和观察组,观察组44例静脉穿刺前1h手背部涂抹复方利多卡因乳膏,对照组45例采用常规穿刺方法。采用视觉模拟评分法（VAS）,比较两组病人治疗效果。[结果]观察组病人VAS评分低于对照组（P〈0.05）。[结论]静脉穿刺前手背部涂抹复方利多卡因乳膏,可有效减轻妇科手术病人静脉穿刺痛。     

复方利多卡因乳膏在小儿术前留置针穿刺中的应用

目的 研究复方利多卡因乳膏应用于小儿术前静脉留置针穿刺的镇痛效果.方法 随机将92例手术患儿分为对照组和实验组,各46例,实验组于术前1h在穿刺部位涂抹复方利多卡因乳膏,对照组常规消毒穿刺,采用FLACC评分法和观察患儿心率的变化评估小儿疼痛情况.结果 实验组患儿行留置针穿刺时疼痛明显低于对照组.结论 复方利多卡因乳膏...     

肱动脉直接穿刺在维持性血液透析中的应用及护理

目的探讨维持性血液透析患者因各种原因缺乏必要的血管通路而不能进行有效透析时，行肱动脉直接穿刺建立血管通路，进行维持性血液透析的可行性、实用性。方法系统性回顾我院行肱动脉直接穿刺进行维持性血液透析的病例，统计穿刺的成功率及并发症的发生率。结果10例维持性血液透析患者，采取肱动脉直接穿刺建立血管通路，行血液透析共2756例次，穿刺的成功率高，血流量充足，并发症少。结论肱动脉穿刺只要方法得当，可作为维持性血液透析患者的血管通路，保证患者的正常透析，提高患者的生活质量。     

复方利多卡因乳膏在血液透析病人通道建立中的镇痛效果分析及护理

[目的]观察复方利多卡因乳膏在血液透析病人通道建立中的镇痛效果。[方法]将216例血液透析病人随机分为观察组和对照组，各108例。观察组穿刺前30min～60min穿刺点涂抹复方利多卡因乳膏；对照组采用常规穿刺方法。[结果]观察组重度疼痛者明显少于对照组（P〈0．05）。[结论]复方利多卡因乳膏可减轻病人因穿刺带来的疼痛。     

复方利多卡因乳膏在血液透析病人通道建立中的镇痛效果分析及护理

[目的]观察复方利多卡因乳膏在血液透析病人通道建立中的镇痛效果.[方法]将216例血液透析病人随机分为观察组和对照组,各108例.观察组穿刺前30 min～60 min穿刺点涂抹复方利多卡因乳膏;对照组采用常规穿刺方法.[结果]观察组重度疼痛者明显少于对照组(P<0.05).[结论]复方利多卡因乳膏可减轻病人因穿刺带来的疼痛.     

肝素钠乳膏在血液透析扣眼穿刺中的应用

目的 观察肝素钠乳膏在血液透析扣眼穿刺中的应用效果.方法 将63例患者按随机数字表分为对照组31例和观察组32例,对照组采用等渗盐水+常规祛痂法穿刺,观察组采用肝素钠乳膏+常规祛痂法穿刺.观察两组患者疼痛、穿刺成功率、感染发生率、透析中渗血情况.结果 观察组疼痛评分低于对照组(P<0.05);两组患者扣眼感染发生率无统...     

血液透析病人动脉直接穿刺的护理

血液透析病人血管通路一般不选择直接动脉穿刺，因为这样既损伤血管又使血流量不足。但本地区病人经济条件较差，不愿意行双腔静脉置管或造瘘，所以有许多病人要求直接动脉穿刺。为了减少病人的痛苦，保证血液透析治疗，做好动脉直接穿刺的护理非常重要。     

复方利多卡因乳膏在男性患者留置导尿中的应用

目的探讨复方利多卡因乳膏在男性患者留置导尿全身麻醉术后苏醒期躁动的应用效果。方法选择100例在全麻下行胃肠道手术、骨折内固定手术的男性患者,随机分为观察组和对照组,每组各50例,其中观察组在留置导尿前用复方利多卡因乳膏3~4 ml涂抹导尿管前段15 cm,对照组采用石蜡油3~4 ml涂抹导尿管前段15 cm。手术结束后送回麻醉恢复室观察清醒过程中患者的心理状态,观察并记录患者的心率、血压及患者躁动程度。结果两组患者在留置导尿时收缩压、舒张压及心率比较差异无统计学意义(P0.05),在拔出气管插管即刻和拔出气管插管后10 min患者的舒张压、收缩压及心率对照组患者明显高于观察组,差异有统计学意义(P0.05)。结论男性手术患者在全身麻醉中留置导尿管时涂抹复方利多卡因乳膏对其苏醒有非常良好的预防作用,符合舒适化护理的现代临床要求。对患者术后手术切口的恢复和心理状态有较好的促进作用,可减少术后并发症的发生。     

心理干预对子宫肌瘤手术患者焦虑程度的影响

目的:探讨子宫肌瘤手术患者心理变化及护理对策。方法:选择子宫肌瘤手术患者70例分为实验组35例和对照组35例,采用汉密顿焦虑量表进行焦虑程度比较。结果:入院时两组患者焦虑程度比较差异无显著性(P>0.05);两组患者手术后焦虑程度比较差异有显著性(P<0.05)。结论:应针对引起患者焦虑的心理问题,给予正确及时的心理护理。     

Factors physical therapists use to make career decisions

The purpose of this study was to investigate the factors physical therapists use to make career choices. A questionnaire was sent to a random sample of 500 clinicians. The results of this study indicate that salary was the most important factor cited by clinicians for selecting their present position and for remaining in their present position, as well as the principal motivator that would induce them to consider leaving their present position. Unless salaries are raised in academe and in the traditional settings of acute care hospitals and rehabilitation centers, recruitment of clinicians in the future will be difficult.     

长期机械通气患者的气管插管护理

目的:总结机械通气患者气管插管的护理经验,降低机械通气患者治疗时间,减少非计划性拔管的发生。方法:对386例气管插管患者实施气管插管配合、吸痰、气囊放气、机械通气预防感染护理。结果:气管插管接呼吸机通气患者感染率5%,发音障碍一例,因护理不当致口腔感染7例,形成痰痂而发生气道堵塞3例,肺部感染(原发病除外)3例,吸痰致低氧血症1例,非计划性拔管2例。结论:保持呼吸道通畅,保证氧气正常供给。有效预防意外脱管发生,减少脱管后并发症发生率。     

Medicines use reviews: what they are for and how to make use of them

Many people are not able to take their medication as it has been prescribed, for many reasons. Medicines Use Reviews (MURs), introduced as part of the 2005 Community Pharmacist Contract, provide the opportunity for pharmacists to offer NHS consultations, held privately, to discuss their customers' medication with them. The MUR can help to identify any side-effects or reasons why the medication might be ineffective or simply not taken, and agree an action plan which will then be shared with the general practitioner and other significant people involved in their care. This article highlights what this process entails, and how MURs offer an opportunity for even greater multi-disciplinary working, enhancing communication and ensuring best use of NHS resources.     

一种可固定腹腔引流管腹带的制作和使用

腹部手术后留置腹腔引流管,目的是引流出手术后腹腔内存积的渗血、渗液,同时有利于观察病情,及早发现有无腹腔出血及术后吻合口瘘等并发症[1].术后活动或牵拉易引起引流管移位及脱落,从而导致逆行感染、堵管和患者疼痛等[2],因此,有效固定腹腔引流管十分重要.腹部手术后患者常使用腹带,以降低手术切口的张力,减轻术后疼痛.但目前...     

Cardiologists use pulmonary artery catheter information to make homogenous treatment decisions

Medical intensivists make heterogenous decisions using pulmonary artery catheter (PAC) data in medical intensive care unit patients. The object was to determine if cardiologists given PAC data from critically ill cardiology patients make uniform management choices. A survey questionnaire containing 3 coronary care unit (CCU) clinical vignettes was designed and mailed to board-certified cardiologists who are members of the American College of Cardiology. Twenty board-certified medical intensivists were also asked to complete the vignettes. Each vignette contained PAC data and one-half of the surveys contained echocardiographic (ECHO) information. Every respondent was asked to select 1 of 6 interventions for each vignette. In 2 of 3 vignettes 1 intervention was selected by more than 70% of cardiologists. In the third vignette, 1 intervention was selected by more than 50% of cardiologists. For each vignette, 1 intervention was selected by at least 75% of medical intensivists. There was no significant difference in the distribution of management choices between the ECHO and the non-ECHO subgroups. There is relative homogeneity in selecting an intervention based on PAC data among cardiologists and medical intensivists in CCU patients and is probably due to patient-related factors. The presence of ECHO information did not change the intervention selected. Cardiology patients may represent an ideal group in which to evaluate PAC efficacy.     

心脏瓣膜置换术病人的健康教育

心脏瓣膜置换术是瓣膜病变严重,经内科治疗效果不明显,而选择的一种外科治疗方法。患者由于病程长,长期受疾病折磨对手术预后有较重心理负担,表现为焦虑、恐惧。因此,做好患者的健康教育,使患者顺利度过手术期和手术后恢复具有重要意义[1]。1临床资料本组49例,男19例,女30例,年龄16~64岁,平均40岁。均为风湿性心脏病,均行机械瓣膜置换术,其中二尖瓣置换术39例,主动脉瓣置换术7例,双瓣(主动脉瓣、二尖瓣)置换术3例。2健康教育形式2.1口头宣教这种方法适用于不同层次的患者,文化程度较高的患者可适当使用医学术语,文化程度较低的患者宜采用通…