网络成瘾综合征患者的持续综合护理干预

目的 探讨持续综合护理干预对网络成瘾综合征（IAD）患者生存质量及心理状态的影响.方法 将IAD患者随机分为对照组和观察组各50例.对照组采用常规治疗护理的方法进行干预;观察组在此基础上采用持续综合护理干预方法,包括角色体验感悟式教育、开设护理点评课堂、系统健康教育、建立个人档案、定期随访.结果 干预3个月后,两组家庭亲密度与适应性各维度、SCL-90各因子分（除精神病性外）及生存质量得分比较,差异有统计学意义（P＜0.05,P＜0.01）.结论 持续综合护理干预能明显改善IAD患者的生理、心理状况,显著提高其生活质量.     

综合护理干预在肝癌介入治疗中的应用体会

目的探讨综合护理干预在肝癌实入治疗中的应用体会。方法按照入院时间将100例接受介入治疗的肝癌患者分为2组,每组50例。对照组给予常规护理,干预组采用心理、健康教育等综合护理干预措施。观察2组治疗效果。结果干预组各项生活质量指标评分明显优于对照组,2组比较,差异均有统计学意义(P0.05)。结论综合护理干预能有效提高患者的生存质量。     

护理干预对慢性阻塞性肺疾病患者生存质量的影响

将56例慢性阻塞性肺疾病(COPD)患者随机分为对照组和观察组各28例。对照组采用常规护理方法,观察 组在此基础上增加护理干预措施,于5周后采用生存质量测评表(QOL)进行评估。结果观察组日常生活能力、社 会活动情况、抑郁心理状况、焦虑心理症状及QOL总分显著优于对照组(均P<0.05)。提出护理干预能改变不良 的生活方式,预防疾病复发,提高COPD患者的生存质量。     

综合护理干预对术后下肢深静脉血栓形成患者焦虑抑郁情绪、遵医行为及生活质量的影响

目的探讨综合护理干预对术后下肢深静脉血栓形成(DVT)患者焦虑抑郁情绪、遵医行为及生活质量的影响。方法选取2015-01—2019-01间郑州大学第一附属医院(郑东院区)大血管外科收治的84例术后下肢DVT患者,随机分为2组,各42例。对照组实施常规护理,观察组在常规护理基础上采取心理护理和健康教育等综合护理干预。比较2组患者的焦虑、抑郁(HAD)评分,遵医行为及生活质量。结果综合护理干预后,观察组患者的HAD评分、遵医行为及生活质量均优于对照组,差异有统计学意义(P0.05)。结论在常规护理的基础上,给予心理护理和健康教育等综合护理干预,可显著改善下肢DVT患者的焦虑、抑郁情绪,提升其遵医行为和生活质量。     

延续护理对舌癌手术患者生活质量的影响

目的探讨延续护理对舌癌手术患者出院后生活质量的影响。方法将84例舌癌手术患者于出院前分为对照组及观察组各42例。对照组出院后给予常规护理指导,观察组在此基础上实施延续护理干预,具体包括成立延续护理小组、发放语音康复训练手册,安排心理咨询师心理辅导、电话回访等。实施护理干预6个月后采用欧洲癌症研究和治疗组织生存质量头颈部癌特异量表(EORTC QLQ-HN35)评价效果。结果干预后观察组EORTC QLQ-HN35多维度得分显著高于对照组(P0.05,P0.01)。结论对舌癌手术患者出院后实施延续护理干预,增强了患者生活信心,提高了患者生活质量。     

护理干预对减轻外科患者术后疼痛的疗效观察

目的探讨护理干预对减轻外科患者术后疼痛的疗效。方法将88例外科手术患者随机分为对照组和观察组,各44例。对照组实施常规护理,观察组在常规护理的基础上实施综合护理干预,包括心理护理、健康教育、疼痛护理等,采用线性视觉模拟评分法比较两组患者术后疼痛情况。结果观察组总有效率(97.73%)明显高于对照组总有效率(81.82%),差异有统计学意义。(x2=6.0647,P0.05)。观察组患者及家属满意率(90.91%)明显高于对照组(70.45%),差异有统计学意义(x2=5.9056,P0.05)。结论外科手术术后综合护理干预可以有效减轻患者的疼痛,提高外科护理质量,有利于患者及早康复,值得在临床上广泛推广。     

中药灌肠结合综合护理干预治疗慢性溃疡性结肠炎的疗效观察

目的:分析中药灌肠结合综合护理干预治疗慢性溃疡性结肠炎(UC)的临床疗效。方法:选取2020年3月至2021年12月,本院收治的60例UC患者,使用单双号分发法随机分为观察组和对照组,每组各30例。对照组采用中药灌肠干预,观察组在此基础上增加综合护理干预。比较2组患者心理状态及生活质量等指标,分析中药灌肠结合综合护理干预的应用效果。结果:干预后,2组焦虑和抑郁评分均明显下降,且观察组评分低于对照组(P<0.05);观察组患者的生活质量评分明显优于对照组(P<0.05)。结论:UC患者采用中药灌肠结合综合护理干预,可以有效改善患者心理状态,提升其生活质量,临床效果显著,值得推广应用。     

2型糖尿病伴阻塞性睡眠呼吸暂停低通气综合征患者的延续护理

目的探讨延续护理对2型糖尿病伴阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者干预效果及生存质量的影响。方法将100例2型糖尿病伴OSAHS患者按照随机数字表法分为观察组和对照组各50例。对照组给予常规出院健康指导,观察组在此基础上实施为期6个月的延续护理。分别在干预前、干预后3个月及6个月测量患者的糖化血红蛋白水平(HbA1c)、呼吸暂停低通气指数(AHI),并采用糖尿病特异性生存质量量表(DSQL)及Epworth嗜睡量表(ESS)进行调查。结果 82例患者完成研究,干预3个月后,观察组HbA1c、DSQL总得分及心理功能、社会关系2个维度得分显著低于对照组(P0.05,P0.01);干预6个月后,观察组HbA1c、呼吸暂停低通气程度、白天嗜睡程度、DSQL总得分及各个维度得分显著低于对照组(P0.05,P0.01)。结论长期有效的延续护理可以提高2型糖尿病伴OSAHS患者的治疗效果,改善其生存质量。     

改进护理干预对老年冠心病患者健康行为及生活质量的影响

目的探讨改进护理干预对老年冠心病患者健康行为及生存质量的影响。方法将95例冠心病患者根据住院时间段分为观察组(n=47)和对照组(n=48),对照组给予常规护理,观察组给予改进护理干预,干预后12个月采用中国心血管病人生活质量评定问卷(CQQC)和健康行为量表(HPL)评估干预效果。结果观察组干预后12个月生活质量总分及各维度评分、健康行为总分及各维度评分显著高于对照组(均P0.05)。结论改进护理干预可有效提高冠心病患者的健康行为及生活质量。     

人性化护理措施对提高乳腺癌患者术后生活质量的疗效观察

目的探讨人性化护理干预对乳腺癌患者术后生活质量的效果。方法将80例乳腺癌术后患者随机分为2组,各40例。对照组给予常规护理,观察组常规护理基础上实施心理、健康教育等人性化护理干预。依据乳腺癌患者生活质量评定表对2组进行比较分析。结果观察组患者的身体、心理、角色功能等生活质量指标明显优于对照组,比较差异有统计学意义(P0.05)。结论人性化护理干预可有效缓解乳腺癌患者心理及生理压力,增强患者的治疗依从性,改善护理质量和预后。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.