神经外科危重患者护理效果观察

目的探讨神经外科危重患者的护理措施。方法用随机抽样的方式,抽取我院外科收治的66例神经外科危重患者的临床护理资料,进行分析探讨。结果 66例神经外科危重患者经过严密监护及精心护理,痊愈48例,好转17例,植物状态1例,无死亡病例。结论对神经外科危重患者进行高效规范的护理,可以有效提高抢救存活率,降低并发症和后遗症。     

神经外科重症管理专家共识(2013版)

一 概述 进入21世纪以来,现代神经外科从理念和设备已经发生了革命性的变化.尽管如此,在神经外科各个领域,尤其在神经外科重症医学(neurosurgical critical care)方面,仍然存在很大差别,诊疗规范各地仍存差异.近30年来,重症医学得到了长足发展,积累了丰富的经验.借鉴重症医学发展的经验和理念,做好神经外科重症方面的工作是未来发展的目标.     

神经外科56例重型患者的监护体会

我院神经外科自 2 0 0 0年 6月～ 2 0 0 1年 4月 10个月间 ,重症监护病房共收治病人 5 6例 ,现将监护情况及护理体会介绍如下 :一、临床资料 :1 监护设备及监护措施 :应用ＳＲＭ 2 0 1型床旁监护仪对患者的心率、血压、呼吸、血氧饱和度等重要指标进行持续监测 ,根据人体生理指标设定报警装置 ,发现异常及时处理。 2 监护对象 :危重及大手术后的病人共 5 6例 ,其中男 38例 ,女 18例 ,平均年龄 34岁。疾病种类主要包括颅内肿瘤、脑出血、脑外伤 (脑干损伤多见 )等。二、结果 :病情好转 ,转为普通病房的 5 4例 ,抢救 2 4例 ,死亡 2例 ,气管切…     

早期滋养型肠内营养在神经外科中老年重症患者中的临床效果

目的 探究早期滋养型肠内营养支持对神经外科中老年重症患者的影响.方法 选择术后或伤后24 h内入住神经外科NICU救治的中老年重症患者48例,采用随机数字表法随机分为早期滋养组与足量喂养组,早期滋养组给予早期滋养型喂养,足量喂养组给予早期足量喂养;观察对比两组胃肠耐受性、血糖代谢指标、生化指标、临床相关指标、新发感染情...     

神经外科重症监护中的应激性溃疡

应激性溃疡是神经外科重症监护（ＩＣＵ）病人的常见并发症，对人体危害极大。有关应激性溃疡的发病机制及防治的文献较多且有争论。文章阐述了应激性溃疡的病理生理、危险因素及常用防治方法，并评价其有效性及其相关因素的影响     

微侵袭神经外科的进展

传统神经外科手术创伤较大，有一定的危险性和并发症，对脑深部及高危险部位病变的治疗亦受到了限制，而微侵袭神经外科（Ｍｉｎｉｍａｌｌｙ　ｉｎｖａｓｉｖｅ　ｎｅａｒｏｓｕｒｇｅｒｙ）显示出美好而广阔的发展前景。１９９２年，德国学者Ｂａuｅｒ和Ｈｅｌｌｗｉｇ首先提出“微侵袭神经外科”的概念。随着神经影像学、微导管技术、立体定向技术、显微外科技术、激光技术、超声技术，放射医学，导航设备和计算机科学等的迅速发展，微侵袭神经外科取得了长足进步，现已成为极具活力的研究热点和发展方向。１ 显微神经外科（Ｍｉｃｒｏｎ…     

中国神经外科创建者的初心与国家情怀

2021年为中国共产党建党100周年.在过去的100年,中国的神经外科专业也获得了长足的发展,值此建党100周年之际,作者对新中国成立之后,赵以成、王忠诚、段国升、涂通今、史玉泉几位中国神经外科专业开拓者在党和国家的领导与支持之下,创建并发展中国神经外科专业的贡献进行回顾.     

浅析神经外科重症监护室护理人员综合能力的培养

目的浅析神经外科重症监护室(NICU)护理人员综合能力培养的方法。方法制定以培养敏锐的观察、分析、应变能力,熟悉专科常见病的临床特点、护理要点和抢救治疗原则,提高护理操作技能,加强基础护理等项目的学习和培训;对培训前后护理人员的综合理论考试、仿真模拟及晨间提问进行对比分析。结果护理人员培训后理论考试、仿真模拟及晨间提问的结果与培训前比较,差异有统计学意义(P<0.01)。结论根据专科护理特点制定培训项目和考核计划是正确指导专科护理人员培养方向和专业护理能力提高的有力保障。     

神经介入配合显微神经外科手术治疗重症动脉瘤性蛛网膜下腔出血的效果观察

目的探讨神经介入配合显微神经外科手术治疗重症动脉瘤性蛛网膜下腔出血的效果。方法选择该院2014-08~2015-09收治的92例重症动脉瘤性蛛网膜下腔出血患者为研究对象,按照随机数字表法分为观察组和对照组,各46例,观察组行神经介入配合显微神经外科手术治疗,对照组行单纯血管内治疗配合常规外科手术治疗,对两组患者疗效及预后进行观察比较。结果观察组术后并发症发生率为6.52%,对照组为34.78%,两组比较差异有统计学意义(P0.01);观察组术后6个月格拉斯哥预后评分(GOS)明显优于对照组,两组比较差异有统计学意义(P0.01)。结论神经介入配合显微神经外科手术治疗重症动脉瘤蛛网膜下腔出血效果满意,可提高手术安全性,降低致残率及致死率,利于患者远期预后,值得推广。     

辽宁医学院附属第一医院神经外科

辽宁医学院附属第一医院神经外科是辽西地区神经外科医疗、教学、科研的中心。于2004年被锦州市卫生局评为市重点专科,2006年被辽宁省卫生厅评为省重点专科。科室拥有经验丰富、技术一流的医护团队,拥有教授3人,副教授     

Current status of radiology in China

INTRODUCTION Radiology has been greatly advanced in China since its founding in 1949 and has been developed faster and further more since China adopted the policy of socioeconomic reform in 1978. It plays an increasingly important role in the medical health care and treatment in the country and has reached the world′s advanced level in certain fields. We now briefly review the history of China′s radiology so as to give a clear picture of its development.     

Interdisciplinary care planning and the written care plan in nursing homes: a critical review

PURPOSE: This article is a critical review the history, research evidence, and state-of-the-art technology in interdisciplinary care planning and the written plan of care in American nursing homes. DESIGN AND METHODS: We reviewed educational and empirical literature. RESULTS: Interdisciplinary care planning and the written care plan are mandated processes that are imbedded in the regulatory fabric and routines of the American nursing home. These processes evolved from the discipline of nursing, where care planning has had a long and controversial history. IMPLICATIONS: Practice implications are provided.     

Development of biliary sludge in patients on intensive care unit: results of a prospective ultrasonographic study.

Biliary sludge may be a precursor of gall stones in man. The aim of this study was to determine the incidence of biliary sludge in a prospective study of 36 patients admitted to the intensive care unit for longer than two days. The presence of biliary sludge was determined by ultrasonography. Biliary sludge developed in 17 patients (47%), after a mean of 5.5 days in the intensive care unit. Patients who developed biliary sludge spent longer in the intensive care unit (14.2 d (1.3)), compared with patients who did not (8.3 d (1.4)); (p = 0.003). Ten of the patients with biliary sludge had a recognised risk factor: total parenteral nutrition (five), abdominal surgery (two), or both (three). All neurosurgical patients (four) who required total parenteral nutrition developed biliary sludge. Seven patients with biliary sludge had no previously recognised risk factor, five of whom had severe head trauma or neurosurgery. In conclusion, biliary sludge develops frequently and rapidly in patients admitted to an intensive care unit. Neurosurgical procedures are associated with biliary sludge formation. (Sludge is commonly associated with the development of cholestatic liver biochemistry.)     

Toward a Core Curriculum for Interdisciplinary Geriatric Care

This paper describes a core curriculum for interdisciplinary geriatric care that was developed by the faculty of the Hunter/Mount Sinai Geriatric Education Center (GEC). The core curriculum encompasses the knowledge, attitudes and skills held in common by the nine health care disciplines that the GEC faculty represent. Each discipline can use the core as a unified base upon which to develop competencies unique to its own practice role and neccessary for implemntation of an interdisciplinary approach to geriatric care. The core curriculum is a first step in the development of basic, advanced and continuing education programs for interdisciplinary geriatric care.     

A content analysis of hiv/aids information in psychology textbooks: implications for education, training, and practice.

Early in the pandemic, psychologists who engaged in HIV/AIDS research and practice or care relied more on their "general" psychological knowledge and training than on HIV/AIDS-specific information or training for combating the disease. In the past two decades much has been gained from the contributions of psychologists working in the areas of HIV/AIDS prevention and intervention. However, little is known regarding how the discipline prepares its students for a career in HIV/AIDS research and practice/care. One important venue for educating future psychologists is college-level textbooks because they are often the students' gateway to the scientific literature in psychology. Therefore, presentation of adequate and accurate information in these texts is critical. The present study involved a review and content analysis of introductory, clinical/counseling, health, human sexuality, and social/community psychology textbooks. It revealed that some level of information regarding HIV/AIDS was found in the majority of most college-level psychology texts that were reviewed. However, many books do not present a comprehensive overview or review of this problem, and do not adequately address the role psychology and behavior change can play in abating it. Implications for education, training, and practices are discussed.     

Contemporary Approaches to the Management of Neurosurgical Complications of Infective Endocarditis

Infective endocarditis can often involve the nervous system, resulting in stroke, intracerebral hemorrhage, infectious aneurysm formation, cerebral abscess, and spinal epidural infection. Many of these problems require neurosurgical attention. Modern advances in neurosurgical critical care, computerization, instrumentation, and radiologic imaging have affected the treatments available to patients with neurosurgical manifestations of infective endocarditis. This paper is a brief overview of the contemporary management of neurosurgical complications of infective endocarditis.     

Stereotactic Neurosurgical Treatment of Drug Addiction

Background: Stereotactic neurosurgery is a well-developed and accepted treatment for movement disorders like Parkinson's disease. Objective: Review use of this neurosurgical intervention to treat drug addiction since the 1960s. Methods: Literature review of case and series reports. Results: Stereotactic neurosurgery has shown promising results in reducing drug addiction, but it has also caused severe side effects. Thus, surgeons have sought to refine the stereotactic lesion procedure and its target over the past 50 years. Conclusions and Significance: Recent developments in stereotactic technique and deep brain stimulation (DBS) may make stereotactic neurosurgery a viable and reversible treatment for drug addiction.     

Pseudo-Outbreak of Ventriculitis in a Neurosurgical ICU

BACKGROUND: Infection is a potentially life-threatening complication of ventriculostomy placement. Placement of ventricular catheters frequently occurs outside the setting of the operating room. We typically detect <10 nosocomial central nervous system infections per year in our neurosurgical ICU. Over a 4–month period (May–August 2003), 19 positive cerebrospinal (CSF) cultures were noted in 10 patients. Organisms included coagulase-negative staphylococci (CNS, 16 cultures in 7 patients), Pseudomonas aeruginosa (4 cultures in 2 patients), and Acinetobacter lwoffi (1 culture in 1 patient).METHODS: An outbreak investigation was performed, including review of the patients' clinical course, laboratory data, ventriculostomy catheter insertion, site care, CSF specimen collection practices, and interviews with all involved staff.RESULTS: Investigation revealed ventriculostomy CSF specimens were collected by a single neurosurgical resident each month. Five (50%) of the patients were determined to have infection. CNS was found in all (10) contaminated cultures. Of 66 cultures obtained in August, 17 (26%) were culture positive, and 9 (14%) of these were contaminated. One resident obtained all cultures in August. Meetings were held between epidemiology department, neurosurgery faculty, and nursing staff. Practice changes were implemented to emphasize hand hygiene, aseptic collection techniques, and exit site care. Inservices were held for nursing staff and neurosurgery residents. Subsequent review of CSF cultures has revealed no further contamination.CONCLUSIONS: Continuing education of medical and nursing staff is required to prevent poor collection technique to prevent contamination of CSF obtained from ventriculostomy catheters. When investigating a potential outbreak, it is important to review all laboratory and clinical data to ensure that positive culture results represent true infection.     

糖尿病未必增加重症监护病房患者的死亡率

近年来一些研究结果显示在发生急性高血糖的重症监护病房(ICU)患者中,糖尿病患者的死亡率低于非糖尿病患者,而且无糖尿病史的患者更能从强化胰岛素治疗中获益.这似提示糖尿病对危重疾病潜在的"保护"作用.可能的"保护"机制包括糖尿病对慢性氧化应激状态的适应性反应、糖尿病患者危重疾病并发症的发生率下降及一些非生物学保护因素.因此对于无糖尿病史高血糖ICU患者的血糖管理应当给予更多的关注.     

糖尿病未必增加重症监护病房患者的死亡率

近年来一些研究结果显示在发生急性高血糖的重症监护病房(ICU)患者中,糖尿病患者的死亡率低于非糖尿病患者,而且无糖尿病史的患者更能从强化胰岛素治疗中获益.这似提示糖尿病对危重疾病潜在的"保护"作用.可能的"保护"机制包括糖尿病对慢性氧化应激状态的适应性反应、糖尿病患者危重疾病并发症的发生率下降及一些非生物学保护因素.因此对于无糖尿病史高血糖ICU患者的血糖管理应当给予更多的关注.