对长期卧床患者应用间歇气压疗法预防下肢静脉血栓形成的护理研究

目的:探讨分析间歇气压疗法对长期卧床患者预防下肢深静脉血栓(DVT)形成的效果.方法:选取102例长期卧床患者为研究对象,按患者意愿分为两组,对照组49例患者采用常规护理措施,观察组53例患者在常规护理的基础上采用间歇气压疗法,比较DVT发生情况.结果:治疗1个疗程后,观察组在下肢疼痛、肿胀、冷感及DVT形成及并发症方面均显著低于对照组,差异有统计学意义(P<0.05),且观察组在满意度方面显著高于对照组.结论:间歇气压疗法具有操作简单、无创、无痛等优点,能够有效预防长期卧床患者下肢深静脉血栓形成,改善下肢肿胀症状.     

护理干预在骨科预防下肢深静脉血栓中的应用

目的评价护理干预对骨科下肢骨折术后深静脉血栓(DVT)形成的预防效果。方法 220例骨科下肢骨折患者随机分为观察组和对照组各110例,观察组在常规护理基础上进行评估,制订预防计划,实施护理干预;对照组仅实施常规护理。观察2组患者深静脉血栓的发生率。结果观察组经护理干预后仅1例出现下肢深静脉血栓的临床表现,发生率为0.91%;对照组出现下肢深静脉血栓临床表现者12例,发生率为10.90%,2组比较差异有统计学意义(P<0.01)。结论对骨科下肢骨折患者实施有效的护理干预,可显著降低下肢深静脉血栓形成的发生率。     

骨科大手术后下肢深静脉血栓形成的循证护理

目的:观察循证护理在骨科大手术后下肢深静脉血栓形成中的作用.方法:将210例骨科大手术后的患者随机分为观察组和对照组,每组各为105例.观察组患者运用循证护理法进行护理,对照组患者进行常规护理,并通过观察分析两组患者下肢深静脉血栓形成相关因素及护理效果.结果:观察组患者中形成下肢深静脉血栓的的有8例(发生率为7.62%),对照组中形成下肢深静脉血栓的有14例(发生率为13.3%),且具有显著性差异(P<0.05).结论:应用循证护理不仅可以为临床提供护理依据、提高护理质量,还可以有效地降低骨科大手术后患者发生下肢深静脉血栓的几率.     

护理干预对预防下肢骨折术后深静脉血栓形成的临床分析

目的：研究护理干预对预防下肢骨折术后深静脉血栓形成的效果。方法：分析2004年1月-2008年6月期间承德市中医院收治的下肢骨折需要手术治疗、术后长期卧床休息、不能自主活动的患者200例,随机分为观察组与对照组,每组各100例,观察组术后进行骨科术后常规护理,同时给予系统护理措施进行干预。进行临床评估,比较两组深静脉血栓的发生情况。结果：结果显示通过系统性护理措施进行干预,可以使患者掌握深静脉血栓形成的基本知识,积极避免容易引起深静脉血栓形成的诱因,降低术后血栓形成的发生率,观察组DVT发生率为4%,对照组DVT发生率为20%,两组比较差异有统计学意义（P〈0.05）。结论：系统护理干预措施对预防下肢骨折术后深静脉血栓形成具有重要的作用。     

骨科大手术下肢深静脉血栓的预防及护理

目的探讨骨科大手术后下肢深静脉血栓形成（DVT）的预防措施及护理方法。方法 70例骨科大手术患者采用硬膜外麻醉38例,气管插管全麻32例。术前、术后实施心理护理、预防措施、饮食护理、机械护理和药物护理。结果通过对70例骨科大手术患者进行预防及护理措施,发生DVT3例,经过治疗和护理后痊愈出院,有效地减少了深静脉血栓并发症的发生。结论下肢深静脉血栓是骨科大手术后的危险并发症,采用基本预防、药物预防结合综合护理可以有效减低DVT的发生率,提高患者的生活质量。     

骨科大手术后预防深静脉血栓形成的护理探析

目的探讨骨科大手术后预防深静脉血栓形成的护理.方法 选取2010年10月—2011年10月期间本院收治的骨科大手术患者156例,随机分成观察组和对照组两组,其中对照组78例给予常规护理干预,观察组78例在常规护理基础上,给予有预防深静脉有针对性护理干预,比较两组患者的深静脉血栓发生率.结果 经分组护理干预后,观察组发生深静脉血栓3例,深静脉血栓发生率为3.85%;对照组发生深静脉血栓14例,深静脉血栓发生率为17.95%.对照组的深静脉血栓发生率明显高于观察组,并具有显著性差异,P<0.05.结论 给予骨科大手术患者在常规护理基础上进行有针对性的深静脉预防护理干预可有效降低术后深静脉血栓的发生率,值得临床推广使用.     

护理干预对骨科老年患者下肢深静脉血栓形成的影响

目的 观察护理干预在预防骨科老年患者深静脉血栓(DVT)形成中的作用,为临床预防下肢深静脉血栓提供依据.方法 将92例老年骨科患者随机分为对照组和干预组,各46例.对照组实行常规护理,干预组在常规护理基础上适时进行功能锻炼和健康教育.结果 干预组患者无DVT发生,对照组患者发生6例DVT,发生率为13％.对照组DVT发生率高于干预组(x2=4.46,P＜0.05).结论 早期健康教育和功能锻炼是预防下肢深静脉血栓形成的有效方法之一.     

骨科大手术后下肢深静脉血栓形成的循证护理

目的观察循证护理在骨科大手术后下肢深静脉血栓形成中的应用及护理。方法将210例骨科大手术后患者随机分为观察组和对照组,各105例;观察组运用循证护理,对照组给予常规护理,观察两组下肢深静脉血栓形成相关因素及护理效果。结果骨科大手术后患者210例,观察组下肢深静脉血栓形成8例,发生率为7．62％;对照组下肢深静脉血栓形成14例,发生率为13．33％,具有显著性差异（P〈0．05）。结论应用循证护理不仅为临床提供护理依据,提高护理质量,还可以有效降低下肢深静脉血栓形成的发生。     

妇科盆腔手术后下肢深静脉血栓形成的预防性护理

目的 研究妇科盆腔手术后下肢深静脉血栓(DVT)形成的预防性护理措施.方法 选取妇科盆腔手术192例患者,分为常规组和预防组各96例,比较围术期行常规护理和预防性护理的术后下肢DVT发生率.结果 预防组术后下肢DVT发生率(3.1%)显著低于常规组(11.5%),差异有统计学意义(P<0.05).结论 加强围术期预防性护理能够有效减少妇科盆腔手术后下肢深静脉血栓的发生率.     

抗血栓压力袜在高龄患者术后预防下肢静脉血栓中的应用研究

目的:观察高龄患者术后使用抗血栓压力袜对预防下肢深静脉血栓的影响.方法:对140例高龄老年患者术后随机分为两组,实验组在术前开始使用抗血栓压力袜,术后联合使用间歇压力泵治疗,直至可自行下床活动,对照组采用术后传统护理.术后(3～8)天行下肢血管彩色多普勒超声,以了解深静脉血栓发生的情况.结果:实验组深静脉血栓(DVT)发生率为2,9%,对照组DVT发生率14.3%,P<0.05,两组高龄患者比较差异有统计学意义.结论:术前开始应用抗血栓压力袜及间歇压力泵治疗,可有效预防高龄患者术后下肢深静脉血栓.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.