股静脉体表投影点穿刺法联合一次性采血针在危重患者采血中的应用

目的：探讨危重患者股静脉体表投影点穿刺法联合一次性采血针采血的效果。方法将危重患者124例随机分为对照组和观察组,对照组患者采用传统的股静脉定位穿刺方法及注射器采血,观察组患者采用股静脉体表投影点穿刺法联合一次性采血针采血。结果观察组穿刺时间、局部瘀斑、血肿,标本溶血、凝血发生率低于对照组,其差异有统计学意义（P＜0.05）。一次性穿刺采血成功率高于对照组（P＜0.05）。结论股静脉体表投影点穿刺法联合一次性采血针采血较传统的定位穿刺方法及注射器采血法具有优越性。     

股静脉体表投影点穿刺法在危重病人股静脉采血中的应用

目的 提高危重病人股静脉采血成功率,以减少并发症的发生.方法 将222例需股静脉采血的危重患者随机分为对照组106例.观察组116例.对照组采用传统方法穿刺采血,观察组采用股静脉体表投影点垂直穿刺法.结果 观察组一次采血成功率显著高于对照组,穿刺时间及误抽动脉血、局部瘀斑、血肿、感染发生率等显著低于对照组.结论 股静脉体表投影点穿刺法较直观,可提高采血成功率,并能减少许多并发症.     

真空管采血法在小儿股静脉穿刺中的应用观察

目的提高小儿股静脉穿刺成功率,减少并发症.方法选择80例年龄1～180天住院的患儿,随机分成A组、B组,A组40例采用真空管采血法抽取血标本,B组40例采用注射器采血法抽取血标本,比较2组一次穿刺成功率、局部瘀斑等并发症发生率.结果A组一次穿刺成功率明显高于B组,并发症发生率低,经统计学处理,p＜0.05.结论真空管采血法一次穿刺成功率高,并发症少,一定程度上简化了小儿股静脉穿刺,值得临床推广应用.     

提高新生儿股静脉采血成功方法的研究

目的　探讨提高新生儿股静脉采血一次成功率的方法。方法　对 1 5 6例新生儿按股动脉搏动明显与否 ,分成2组 ,采用 3种不同的方法进行采血 ,对股动脉搏动明显的 1 3 2例新生儿 ,采用传统的垂直穿刺法和改进法———斜角穿刺法采血 ;对股动脉搏动不明显的 2 4例新生儿 ,采用新方法———引垂线斜角穿刺法采血。结果　斜角穿刺法和引垂线斜角穿刺法在新生儿股静脉采血时 ,一次成功率明显高于传统的垂直穿刺法。     

新穿刺法应用于婴幼儿股静脉采血的效果分析

目的:探讨婴幼儿股静脉采血的穿刺方法。方法:选择1 d～24个月的门诊患儿120例,随机分为观察组和对照组各60例,观察组采用体表定位触摸斜角穿刺法采血,对照组采用常规垂直穿刺法采血。结果:观察组的1次穿刺成功率明显高于对照组(P0.01);穿刺点血肿、瘀斑发生率低于对照组;患儿家属满意率高于对照组(P0.05)。结论:体表定位触摸斜角穿刺法采血成功率高,并发症少,值得推荐。     

大隐静脉真空采血在婴幼儿中的应用

目的：探讨经大隐静脉真空管采血和股静脉采血2种不同部位,采取不同的进针方式,进行婴幼儿静脉采血效果的比较。方法：385例静脉采血的婴幼儿随机分为实验组（采用一次性采血针和真空管进行大隐静脉采血）和对照组（采用5 ml一次性注射器直接垂直进针,行股静脉采血）,观察比较两组穿刺成功率,平均采血时间以及局部皮肤情况。结果：实验组一次采血成功率和平均采血时间显著优于对照组（P〈0.01）,出现局部瘀血者两组比较差异无统计学意义（P〉0.05）。结论：婴幼儿采用一次性采血针和真空采血管行大隐静脉采血具有自动定量、安全可靠、准确高效、操作方便、节省时间等优点,值得推广。     

连线定位法在婴儿股静脉穿刺采血中的应用效果观察

[目的]观察连线定位法在婴儿股静脉穿刺采血中的应用效果。[方法]将180例行股静脉穿刺采血的婴儿随机分为观察组90例和对照组90例,观察组采用连线定位股静脉穿刺采血,对照组采用触摸法股静脉穿刺采血。观察及比较两种方法股静脉穿刺采血一次穿刺成功率、采血时间、穿刺点血肿及家属满意度。[结果]对照组采血时间为9.6min±1.03min,一次穿刺成功率为88.89%,穿刺点血肿发生率8.89%,家属满意度85.56%,观察组采血时间为7.8min±0.8min,一次穿刺成功率为97.78%,穿刺点血肿发生率1.11%,家属满意度96.67%,两组比较差异有统计学意义。[结论]连线定位法行婴儿股静脉穿刺采血优于触摸法,操作方法简单,安全性高,且并发症少。     

新生儿桡动脉采血与股静脉采血的对比研究

目的探讨桡动脉采血与股静脉采血的成功率与副作用的差异。方法将102例新生儿随机分为A组50例和B组52例。A组采用桡动脉采血,B组采用股静脉采血,并对两组采血成功率、穿刺采血损伤程度及操作时间进行比较。结果与股静脉采血比较,桡动脉采血可显著提高采血成功率,减少穿刺部位血肿发生率,缩短采血时间（P〈0.05,P〈0.01）。结论对新生儿行桡动脉采血有利于提高穿刺成功率,减轻损伤程度,缩短采血时间。     

应用蝶翼针行小儿股静脉采血的效果评价

目的：应用蝶翼针行股静脉采血，提高小儿股静脉采血的成功率，减少并发症的发生。方法：选择160例年龄2天～3岁的患儿行股静脉穿刺术抽取血标本，80例采用注射器垂直穿刺法，另80例采用蝶翼针斜角穿刺法，两种方法比较。结果：蝶翼针斜角穿刺法的一针成功率与注射器垂直穿刺法无明显差别，但血肿或瘀血的发生率，二者比较有明显差异性，且蝶翼针斜角穿刺法发生率低于注射器垂直穿刺法。结论：蝶翼针穿刺技术类似于外周静脉穿刺方法，受其它因素影响较少，穿刺成功率高，并发症少。     

联线定位法在婴幼儿股静脉穿刺采血中的应用

目的探讨提高股静脉穿刺采血成功率及减轻患儿痛苦的有效方法。方法将104例行股静脉穿刺患儿随机分为两组，对照组54例采用传统方法，观察组50例采用联线定位法。结果观察组一次穿刺成功率，标本合格率显著高于对照组（P〈0．05），平均采血时间明显缩短（P〈0．01）。结论联线定位法定位准确，可提高穿刺成功率，减轻患儿痛苦。     

Use of crystepin in combination with obsidan in patients with diabetes mellitus with arterial hypertension

Examination included 70 patients with diabetes mellitus in combination with arterial hypertension of different origin (II stage essential hypertension and symptomatic renal arterial hypertension). Crystepin (2-3 tablets per 24 h) in combination with beta-adrenoblocker obsidan (40-80 mg/24 h) was used for treatment. Basic hemodynamic parameters and the state of the renin-aldosterone system were determined. The hemodynamic hypotensive effects in these patients due to the influence of the above therapy are uniform and depend on the form of attendant arterial hypertension. The hypotensive effect of crystepin used in combination with obsidan was more pronounced in patients with diabetes and II stage essential hypertension than that in those with diabetes and renal hypertension. The concentration of aldosterone and renin activity of blood plasma in patients with diabetes and arterial hypertension during treatment with crystepin and obsidan had no regular connection with the hemodynamic parameters.     

高血压病人高尿酸血症与冠心病发生的关系

目的　探讨原发性高血压病人高尿酸血症与冠心病发生的关系。方法　经临床诊断的病人 6 8例 ,6 2例献血员及健康查体者设为对照。测定以上两组人员血中尿酸、肌酐、总胆固醇、低密度脂蛋白胆固醇。结果　冠心病组与高血压组比较血清尿酸、肌酐间有非常显著性差异 (P <0 0 1) ,低密度脂蛋白胆固醇亦有显著差异 (P <0 0 5 )。高血压患者血尿酸低密度脂蛋白胆固醇水平显著高于对照组 (P <0 0 5 )。结论　合并冠心病高血压患者血尿酸显著增高 ,高尿酸血症的高血压病人与冠心病的发生有很直接的关系 ,可能是致冠心病的危险因素之一。     

氨溴索联合人免疫球蛋白静脉滴注治疗小儿重症肺炎的疗效观察

目的：观察氨溴索联合人免疫球蛋白静脉滴注治疗小儿重症肺炎的疗效。方法选择153例重症肺炎患儿,随机分为对照组、单用组、联用组各51例,对照组予利巴韦林治疗,单用组在对照组基础上行氨溴索雾化吸入治疗,联用组在单用组基础上行静脉滴注人免疫球蛋白治疗。记录并比较3组患儿的疗效、症状缓解时间、住院时间、并发症发生情况。结果单用组和联用组的总有效率分别为84％、86％,均明显高于对照组的66％（P＜0.017）。单用组和联用组的音消失、止咳、退热、平喘等症状缓解时间及住院时间均比对照组明显缩短（P＜0.05）。联用组的并发症发生率明显低于对照组（P＜0.017）。结论氨溴索联合人免疫球蛋白静脉滴注治疗小儿重症肺炎疗效良好,且安全性高。     

Effectiveness of long-term treatment with pantethine in patients with dyslipidemia

A one-year clinical trial with pantethine was conducted in 24 patients with established dyslipidemia of Fredrickson's types II A, II B, and IV, alone or associated with diabetes mellitus. The treatment was well tolerated by all patients with no subjective complaints or detectable side effects. Blood lipid assays repeated after 1, 3, 6, 9, and 12 months of treatment revealed consistent and statistically significant reductions of all atherogenic lipid fractions (total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B) with parallel increases of high-density lipoprotein cholesterol and apolipoprotein A. The results were equally good in patients with uncomplicated dyslipidemia and in those with associated diabetes mellitus. The authors conclude that pantethine (a drug entity related to the natural compound, pantetheine) represents a valid therapeutic support for patients with dyslipidemia not amenable to satisfactory correction of blood lipids by diet alone.     

Association of fluconazole pharmacodynamics with mortality in patients with candidemia

Recent studies of nonneutropenic patients with candidemia or candidiasis suggest that fluconazole pharmacodynamic parameters correlate with clinical outcomes; however, additional data of correlation to mortality in patients with candidemia would be valuable. We assessed the impact of MICs for Candida, fluconazole pharmacodynamics, and patient characteristics on all-cause mortality with use of a prospective cohort of 96 hospitalized patients with candidemia. Among 84 patients for whom Candida isolates were available for testing, the most frequent Candida species isolated were Candida albicans (44%), followed by Candida parapsilosis (20.2%), and Candida glabrata (20.2%). Fluconazole resistance (MIC of ≥64 μg/ml) was present in 7 (8.3%) to 10 (11.9%) of 84 isolates, depending on the MIC endpoint determination method (50% or 80% inhibition read at 24 or 48 h). Overall mortality occurred in 27 (28.1%) of 96 patients, and nonsurvivors were more likely to have fluconazole-resistant isolates (25% versus 6.7%; P = 0.02). Multivariable analysis demonstrated an association between fluconazole resistance and mortality, but it did not reach statistical significance (odds ratio, 5.3; 95% confidence interval, 0.8 to 33.4; P = 0.08). By pharmacodynamic analysis, a fluconazole area under the concentration-time curve/MIC of <11.5 or MIC of ≥64 was associated with increased patient mortality (P ≤ 0.09). These data support previous findings of an antifungal exposure-response relationship to mortality in patients with candidemia. In addition, similar MICs were obtained using a 24- or 48-h MIC endpoint determination, thus providing the opportunity to assess earlier the impact of isolate susceptibility on therapy.     

肝硬化患者肝移植前后心电图改变的分析

目的研究肝硬化患者肝移植术前及术后心电图改变,从而探讨肝移植对心电生理的影响。方法选取2007～2010年住院行肝移植术的患者37例,对其心电图结果进行分析;另设健康体检者60例为对照组。结果肝移植患者术前组与对照组心电图异常率比较,差异有统计学意义(P<0.01);肝移植术后围手术期组与术后其他组比较,差异有统计学意义(P<0.01);术前组与术后≤6个月组比较差异有统计学意义(P<0.05);术前组与术后>6个月组比较差异有统计学意义(P<0.01);肝功能A级、B级、C级术后组QTc间期分别与对照组比较,差异有统计学意义(P<0.01)。结论肝硬化患者心电图异常率明显升高,主要表现为QTc间期延长,且随肝损害严重程度加重而延长;肝移植术后,心电图异常率下降,QTc间期较术前缩短,心电生理得到改善;围手术期心电图异常率增高,临床医师应密切注意肝移植患者围手术期心电图的变化,及时治疗心脏并发症。