Carto三维标测系统指导下射频消融治疗心房颤动患者的护理

目的 探讨Carto三维标测系统指导下射频消融治疗心房颤动患者的护理.方法 对34例Carto三维标测系统指导下射频消融治疗心房颤动患者进行术前准备、术中配合、术后观察与护理.结果 88.2%以上患者转为窦性心律,患者临床症状明显减轻,生活质量明显提高.结论 术前严谨的告知制度,充分的术前准备,必要的心理支持;术中注重心理护理,熟练配合;术后严密的监护和观察,是减少并发症、提高手术成功率的重要保证,对提高护理质量及促进患者的康复起到非常重要的作用.     

腔内射频消融术治疗单纯性大隐静脉曲张的手术护理

目的：探讨射频消融术治疗单纯性大隐静脉曲张的手术护理。方法选择2011年1月至2013年4月重庆市第五人民医院行射频消融术治疗下肢静脉曲张手术的66例患者为研究对象,术前给予心理护理及认知干预,术中充分准备与配合,术后重视健康教育,总结围术期护理要点。结果患者均Ⅰ期愈合,无手术并发症发生。结论手术室护士做好围术期护理,与医生密切配合,是减少并发症,缩短手术时间,保证手术成功的关键。     

射频消融术围手术期心理干预

目的探讨射频消融术(RFCA)患者围手术期的心理特点及原因,为适当的心理干预提供理论依据.方法采用问卷法评估射频消融术患者围手术期的心理反应,对其进行心理干预,并评估效果.结果30例患者均有不同程度躯体症状、抑郁、焦虑,经适当的心理干预,术后抑郁、焦虑较术前明显缓解.结论对射频消融术患者进行围手术期心理干预,具有很强的实用性,能有效地降低患者术后的抑郁、焦虑.     

三维标测系统指导下射频消融治疗室性早搏的护理

目的 探讨在(CARTO)三维标测系统指导下进行射频消融治疗室性早搏的护理方法.方法 对28例行射频消融术治疗的室性早搏患者进行观察和护理.术前做好准备和心理护理,术后密切观察患者的生命体征,加强并发症的观察和护理.结果 28例均完成了射频消融治疗.随访2～20个月,治愈率92.9％.结论 Carto三维标测系统指导下行射频消融治疗室性早搏安全有效.合理、细致的护理,可消除患者的恐惧心理,提高手术耐受性,且能及早发现和防治并发症,增加手术的安全性.     

Carto标测系统指导下射频消融治疗心房颤动的护理

目的:探讨房颤患者在Carto标测系统指导下射频消融治疗心房颤动的护理体会。方法:对35例患者在Carto标测系统指导下行射频消融术。结果:32例患者手术一次成功3,例患者一次射频消融未成功,3个月后再次行射频消融术后成功。结论:通过加强术前术后护理,有效减少及预防了疾病并发症,促进了患者的康复。     

腹腔镜下肾脏肿瘤射频消融术患者的护理体会

目的探讨腹腔镜下肾脏肿瘤射频消融术的护理特点。方法总结12例腹腔镜下肾脏肿瘤射频消融术的围术期护理措施。结果所有患者均能积极配合治疗和护理,手术均获成功,未出现护理并发症。结论腹腔镜下肾脏肿瘤射频消融术具创伤小、术后患者康复快的特点。术前准确完成各项准备工作,认真做好心理护理;术后严密观察患者生命体征,做好各引流管的护理及并发症的观察等,对腹腔镜下肾脏肿瘤射频消融术的成功和术后的恢复有着重要的意义。     

Carto标测系统指导下射频消融治疗心房颤动患者的术中配合与护理

目的 探讨Carto标测系统指导下射频消融治疗房颤的术中配合经验及护理措施.方法 对13例实施Carto标测系统指导下射频消融的房颤患者进行手术,配合要点包括术前探访,进入导管室后的心理干预,特殊设备仪器的连接使用,术中及时提供专用器械,全过程严密监护,根据手术进程密切配合医生操作及时提供有效信息,对发生的异常情况进行分析并迅速采取护理措施.结果 13例患者手术成功率100%,术中发生并发症3例,其中呼吸、心脏骤停1例,因疼痛致迷走神经反射出现血压降低、心率减慢、恶心呕吐2例,经积极治疗护理后均转危为安.结论 术中注重患者心理护理,准备完善,熟练配合,严密监护和观察是手术顺利进行,减少并发症和提高手术成功率的重要保证.     

CARTO系统引导下导管射频消融术治疗房颤的护理体会

目的探讨CARTO系统引导下导管射频消融术治疗心房颤动(房颤)围术期间护理配合及其对并发症的发现及处理措施。方法收集192例经导管消融术治疗的房颤患者临床资料,术前制定围手术期针对性护理方案,包括术前心理辅导,完善术前器械和仪器,拟定意外抢救备案,术中术后密切监测病情,预防并发症的发生。结果 192例患者手术均顺利完成,无严重并发症发生。结论严格执行围术期护理要求和加强并发症监测是导管射频消融术顺利完成的保障,对改善患者预后至关重要。     

CARTO指导下心房颤动射频消融术17例的围手术期护理

本文总结了17例三维电解剖标测系统(CARTO)指导行心房颤动(房颤)射频消融术患者的围手术期护理经验。护理要点包括完善术前准备,做好心理护理;术中严密监测;术后做好心电监测、穿刺部位和并发症的观察,指导患者合理饮食。CARTO指导下房颤射频消融术围手术期间,根据患者病程长、反复发作、焦虑、担心手术效果等特点,实施规范的围手术期管理,早期识别并发症,促进患者康复。     

射频消融术围手术期心理干预

目的:探讨射频消融术(RFCA)患者围手术期的心理特点及原因,为适当的心理干预提供理论依据。方法:采用问卷法评估射频消融术患者围手术期的心理反应,对其进行心理干预,并评估效果。结果:30例患者均有不同程度躯体症状、抑郁、焦虑,经适当的心理干预,术后抑郁、焦虑较术前明显缓解。结论:对射频消融术患者进行围手术期心理干预,具有很强的实用性,能有效地降低患者术后的抑郁、焦虑。     

Intérêt du Télos dans l'évaluation de la laxité chronique antérieure du genou en pré- et en postopératoire

The objective of our work is to clarify the contribution of knee arthrometer in the diagnosis of the anterior laxity of the knee, to look for the factors of escalation of this pathology, to estimate the objective results and outcomes following of the anterior cruciate ligament surgery. It is about a retrospective study which concerned 78 patients presenting the anterior chronic laxity of the knee, investigated, treated and followed in the M.-T.-Kassab Institute of Orthopaedics over a period of 10 years. The average age of our patients was of 27.6 years with a male ascendancy. The anterior cruciate ligament surgery was realized according to the technique of Kenneth-Jones under arthroscopy. The arthrometer has been used to determine the outcome 6 months after the surgery. Before the surgery, the average anterior translation of the tibia was 15.3 mm, 95% of the patients had 8 mm previous absolute laxity, while the differential was about 4 mm in 87% of the cases in which comparative study could be made. There was a statistically significant correlation between the Lachman's test, the internal meniscus injuries and the delay accident — surgery with the anterior knee laxity in the arthrometer. The postoperative average laxity was bout 8.2 mm and earning was proportional to the importance of the initial tibial translation. The present study demonstrates that arthrometer tests may be an objective complement for the clinical exam, with a diagnostic, previous and therapeutic purpose.     

宫颈高度鳞状上皮内瘤变的“即诊即治”策略

目的探讨宫颈高度鳞状上皮内瘤变应用＂即诊即治＂策略的价值。方法选取宫颈细胞学检查为高度鳞状上皮内瘤变（HSIL）,并经阴道镜检查、镜下活检及宫颈电圈切除术（LEEP）治疗的患者76例,按阴道镜RCI评分分成高评分组、低评分组,对组织病理结果及过度治疗率进行回顾性分析。结果 RCI高评分组CINⅡ、Ⅲ及以上病变比例为97.4%,低评分组59.5%,高评分组过度治疗率2.6%,低评分组40.5%（P〈0.001）,不同RCI评分组的过度治疗率差异有统计学意义,高评分组过度治疗率显著低于低评分组。结论对于细胞学为HSIL,经阴道镜检查RCI高评分,提示高度病变的患者,采取＂即诊即治＂策略快速而有效地进行诊治,是较为适宜的;而细胞学检查HISL、RCI低评分者,仍以传统三阶梯方案进行筛查诊治为宜。     

Place du traitement médicamenteux et des infiltrations dans la prise en charge médicale des lésions de la coiffe des rotateurs

One of the main objectives of medical treatment of rotator cuff lesions is to attenuate or totally relieve pain and allow the patient to access the next phase of functional rehabilitation. Relative rest is desirable. Harmful sports movement should be avoided. Strict immobilization is never indicated. The question is raised as to whether wider use of analgesics would be warranted. The inflammatory nature of rotator cuff tendiopathies remains to be clearly demonstrated and the efficacy of analgesics in this indication would be related more to their intrinsic pain killer action. Analgesics should thus be prescribed prudently and limited to a few days, particularly because of the potential adverse effects. Theoretically, steroidal anti-inflammatory drugs should not be used for tendonitis. Myorelaxing agents could be used in the event of associated muscle contracture. If the patient requires further relief, corticosteroid injections could be considered, taking care to avoid contraindications for intra-articular injections and avoiding any risk of contamination while keeping in mind the possible adverse effects.     

Instabilité antérieure récidivante de l'épaule chez le rugbyman. Résultats d'une série de 85 épaules opérées par la technique de Latarjet avec un recul moyen de sept ans

The stabilization of an unstable chronic shoulder is a difficult challenge in the contact sportsman especially the rugby player. We report our experience of the modified Latarjet procedure with a retrospective series of 85 shoulders (79 rugbymen at 75 months follow-up). It acted all young men with a prevalence of dominant shoulder, occupying all the stations (over-representation of the third lines). Eighty percent presented osseous lesions; the first luxation was traumatic during a tackle. We describe our technique and our postoperative protocol. Seven percent experienced recurrence of their instability after a new traumatism and 67% returned to rugby within 8 months by keeping for some of them a sport practice functional embarrassment (16 patients). Only two mechanical complications were observed, 93% of the patients were satisfied with their intervention.     

Analysis of older adults visiting the emergency department with fever as a suspected Covid-19 vaccine-related adverse reaction: A retrospective multicenter study

IntroductionAfter COVID-19 vaccination was initiated, the number of patients visiting the emergency department (ED) with vaccine-related adverse reactions increased. We investigated the clinical features of older adults (aged 65 years and older) visiting the ED with self-reported COVID-19 postvaccination fever.MethodsWe conducted a retrospective observational study at three EDs between March 2021 and September 2021. Patients who reported adverse reactions, fever (≥37.5 °C) and/or febrile sensation or rigors following COVID-19 vaccination were included. The demographic and clinical data of these patients were collected by reviewing their medical records.ResultsA total of 562 patients were selected, and 396 (70.5%) were female. The older adult group included 155 (27.6%) patients, and the median age was 75 (69–79 years). The older adults less frequently had a fever (≥37.5 °C) upon ED presentation (75.5% vs. 85.7%, respectively), used more emergency medical services (43.9% vs. 18.7%, respectively), and visited an ED more frequently during early hours (00:00–06:00) (31% vs. 20.1%, respectively) compared to the younger adults (p = 0.004, p < 0.001 and p = 0.036). Fewer older adults visited an ED within 2 days of fever onset (73.5% vs. 84%) (p = 0.012), and more older adults were admitted for medical conditions other than vaccine-related adverse reactions (32.9% vs. 4.2%) (p < 0.001). Older adults received more thorough testing (laboratory and imaging tests). Among the older adults, the admission rate was associated with age (p = 0.003).ConclusionOlder adults presenting with fever as an adverse reaction following COVID-19 vaccination less frequently had a fever upon visiting the ED, required more ED testing, and had higher admission rates for non-vaccination-related medical conditions.     

Épicondylites : « les nouveautés en 2007 »

What news for 2007 concerning sportsmen lateral epicondylitis? Concerning biomechanics, we will evaluate the role of the supinatus at the same time we will talk about the complex characteristics of the functionnel unit. An anatomic work has showed in some cases, the involvment of ligment structure that could explain the atypical side of the pain and sometime the failure of the treatment. As for rehabilitation, we will insist on the importance of excentric work. The braces conserve a certain importance. We insist on new therapeutics and mostly on the interest of trinitrine patches. Botulinium toxic is still discussed and the recent study of Hayton does not show any significant difference with placebo injection. An original autologue blood injection in the epicondylitis tendon demonstrates good results and specially in the cases that resist to the corticoid therapeutics. We will talk about our experience. Considering corticoide injections a Crowther publication reveals a significant result compared to choc waves therapy. At last, we will criticize the Smidt study because we believe that the use of fluorite corticoid induce iatrogenic effects. We will conclude this article by our 2007 propositions about the local corticoid indication.     

Spécificités de la pratique du rugby chez l'enfant

The knowledge of the specificity of the child compared to the adult and his reactions regarding the exercise will make it possible to answer parents questions as well as possible and to accompany the child and the teenager in their sporting practice. Five essential concepts govern the practice of Rugby in the child: 1) the child is not an adult in miniature. It is an organization in constant evolution towards its physical and psychic statute of adult. He has a free will depending on the others; 2) Rugby must remain for him a ludic space, where the motivation must be the first condition; 3) the child is a mosaic of growth cartilages. Traumatic pathology is preferentially a pathology of this structure in the acute traumatisms (epiphysium separation rather than distorsion, muscular apophyse avulsion rather than tear) and under the effect of chronic microtraumatisms (osteochondrosis rather than tendinitis); 4) overtraining will result in a disturbance of one of the factors of the general balance of the organization which it acts of a pain, of against performance, an abnormal tiredness, of a demotivation, a relational disorder (mood, affectivity), of lower school output of which it will be necessary to establish a relationship to the sporting practice; 5) the execution of a sporting gesture must always be modulated as of the appearance of a pain, true alarm.