重复使用的氧气湿化装置与一次性氧气湿化装置用后的比较研究

目的 重复使用的氧气湿化装置与一次性氧气湿化装置进行使用后细菌学分析.方法 随机抽取老年科6个病区用后的可重复使用的氧气湿化装置与一次性氧气湿化瓶,将吸氧患者随机分为3组,A组用冷开水作为氧气湿化液,B组用蒸馏水作为氧气湿化液,C组用AQUAPAK一次性氧气湿化装置.A组和B组在每周一和周四更换湿化瓶前采样,C组在每瓶一次性氧气湿化装置使用结束后采样,按<医院消毒卫生标准>消毒液的采样方法 采样后送检验科检验.结果 A组61个样本中带菌率为81.97%,B组71个样本中带菌率为47.89%,C组52个样本中带菌率为0.3种湿化瓶使用后的污染率比较差异显著.A,B组间进行比较,A组细菌平均严重等级高于B组,A组革兰阴性菌种类的等级及革兰阳性菌的带菌率均高于B组.结论 无论是用冷开水还是蒸馏水作为氧气湿化液,湿化液均有不同程度的污染,在目前各医疗机构尚无统一湿化液选择标准以及消毒规范的背景下,对长期吸氧的患者,建议选择一次性氧气湿化装置,以期减少患者院内感染的发生率.

Abstract：

Objective To carry out bacteriological analysis between re-used and disposable oxygen humidification devices. Methods Reused oxygen equipment and disposable oxygen moisture bottles from 6 randomly selected elderly wards were collected, patients who used oxygen will be randomized into 3 groups, group A used cold water as the oxygen humidification liquid, group B used distilled water as humidification liquid, group C used AQUAPAK disposable oxygen humidification devices, sample taking in group A and group B happened on every Monday and Thursday before the replacement of sample moisture bottles, sample was taken in group C after the use of disposable oxygen humidification devices, according to "hospital disinfection health standards" (GB5982-1995)sampling method of disinfection liquid sample was taken and sent to test in the disinfectant laboratory. Results Of 61 samples in group A bacteria cartier rate was 81.97%, bacteria carrier rate of 71 samples in group B was 47.89%, of 52 samples in group C the carrier rate was 0. The comparing of bacterial contamination rate of three kinds of oxygen moisture bottles after using was statistically significant. Take group A, B for comparison, the average severity level of bacteria in group A is higher than group B. In group A, the level of the Gram-negative bacteria as well as Gram-positive bacteria colonization was higher than group B. Conclusions Whether use of cold water or distilled water, oxygen humidification liquids have different degrees of pollution. Currently there is no general criteria and norms in the context of sterilization of oxygen humidification, for patients on long-term oxygen using, to choose disposable oxygen humidification device to reduce the incidence of hospital infections is recommended.     

亚低温治疗对心搏骤停心肺复苏患者预后影响

Objective To study clinical effect of moderate hypothennia treatment in patients with cardiac arrest survivors and search a practical monitoring way during moderate hypothennia treatment. Method A total of 40 patients of CPR following the restoration of spontaneous circulation were randomly divided into the hypothermia therapy group ( n= 20) and the routine therapy group ( n= 20), the clinical effect on patient followed for three months is evaluated. At the same time regional cerebral oxygen saturation (rSO2) was detected at different times after moderate hypothennia treatment in two groups. Results The recovery rate were higher and the mutilation rate was lower in hypothermia therapy group than that of the routine therapy group. rSO2 obviously increased after 12 hours of hypothermic treatment, and continuing kept stable level after 24 hours of hypothermic treatment, but it was also higher than routine therapy group (P＜0.01). Conclusions Moderate hypothermia can alleviate the metabolic disorder of the brain tissue and improve the prognosis in patients with cardiac arrest survivors. Noninvasire continuously monitoring of rSO2 has important significance for instructing moderate hypothermia treatment in clinic.     

高压氧对脑梗死患者血浆SOD和CRP的影响及临床意义

Objective To study the effect of hyperbaric oxygenation(HBO) therapy on the activities of serum SOD and CRP of patients with cerebral infarction and its clinical significance. Methods 78 patients with cerebral infarction were randomly divided into hyperbaric oxygen group (HBO Group, 40 cases)and clinical group (38 cases). The clinical group was treated with clinical conventional treatment only. HBO group was treated with HBO combined with clinical conventional treatment. 21 healthy volunteers were assigned to control group. Before and after treatment, the activities of serum SOD and CRP level were measured, and the curative effect were evaluated. Results The pretreatment serum SOD and CRP of the HBO group and clinical group were significantly different from the control group (P＜ 0. 01). Compared with the pretreatment and posttreatment serum level of the HBO group, SOD raised, CRP lowered, the difference was significant(P＜ 0. 01).Compared with clinical group, SOD raised, CRP lowered and the total cure rate of the HBO group were more significant different(P ＜0.01). Conclusion HBO therapy raised the activities of SOD and lower the level of CRP in serum of the patients with cerebral infarction, and improved the free radicals scavenging ability in the body. Therefore, HBO therapy has a good effect for cerebral infarction. The experiment suggests that the activities of SOD and CRP level in serum can be used to judge the curative effect and prognosis of HBO therapy for cerebral infarction.     

护理干预对老年复治肺结核病人预后的影响

Objectiye To enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis by nursing intervention. Methods One hundred and six relapse agedness patients with pulmonary tuberculosis were divided into experimental (n=54) and control groups (n=52). The experimental group was given the whole course nursing intervention and the control group was given universality guidance when they left hospital. The therapy compliance, sputum negative conversion rate and absorbability instance of focus were investigated among the patients of the two groups. Results The therapy compliance,sputum negative conversion rate and absorbabilty instance of focus in the trial group were significant higher than those in the control group (P＜0.05). Conclusions The whole course nursing intervention can enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis.     

护理干预对老年复治肺结核病人预后的影响

Objectiye To enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis by nursing intervention. Methods One hundred and six relapse agedness patients with pulmonary tuberculosis were divided into experimental (n=54) and control groups (n=52). The experimental group was given the whole course nursing intervention and the control group was given universality guidance when they left hospital. The therapy compliance, sputum negative conversion rate and absorbability instance of focus were investigated among the patients of the two groups. Results The therapy compliance,sputum negative conversion rate and absorbabilty instance of focus in the trial group were significant higher than those in the control group (P＜0.05). Conclusions The whole course nursing intervention can enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis.     

局部氧疗促进烧伤患者残余难愈创面修复的有效性研究

Objective In order to know the effective of local oxygen therapy to promoting renovation of residual surface of bums wound.Methods Divided 60 patients with burns into the experimental group and the control group,there were 30 cases in the each group.Routine nursing cares were used in the control group,while the local oxygen therapy was used in the experimental group.Compare the condition of secretion of wound between the two groups.Results The wound healing time of experimental grou was(5.87±3.29)d,which significant shorten than that of in the control group,the kinds of bacteria in the control group was more than in the experimental group.Conclusions The local oxygen therapy can effective promote the healing of residual surface of bums wound,which can reduce the infection rate of bacteria.     

综合干预对青少年精神分裂症患者人格形成作用的对照研究

Objective To explore the influence of synthesis intervenes on the young schizophrenia patients'personality forms,therapy and relapse. And study whether synthesis intervenes can reduce patients ' personality change. Methods Objects were first round schizophrenia patients aged 15 ～ 16. They were randomized into the synthesis intervention group (the study group) and the pure medicine treatment group (the control group) . Follow- up visit lasted to 18 years old. The therapeutic effect with PANSS score, examine the relapse rate and evaluate personality characteristics with EPQ were evaluated. Results The scores of study group were less than those of the control group in relapse rate, PANSS total score and N, P scores; EPQ. The scores of study group were more in P, N and less in E, L than those of the control group. Conclusions Synthesis intervenes may reduce the relapse, enhances the curative effect, reduce and prevent the personality change. Synthesis intervenes acts the positive role to the personality forming.     

综合干预对青少年精神分裂症患者人格形成作用的对照研究

Objective To explore the influence of synthesis intervenes on the young schizophrenia patients'personality forms,therapy and relapse. And study whether synthesis intervenes can reduce patients ' personality change. Methods Objects were first round schizophrenia patients aged 15 ～ 16. They were randomized into the synthesis intervention group (the study group) and the pure medicine treatment group (the control group) . Follow- up visit lasted to 18 years old. The therapeutic effect with PANSS score, examine the relapse rate and evaluate personality characteristics with EPQ were evaluated. Results The scores of study group were less than those of the control group in relapse rate, PANSS total score and N, P scores; EPQ. The scores of study group were more in P, N and less in E, L than those of the control group. Conclusions Synthesis intervenes may reduce the relapse, enhances the curative effect, reduce and prevent the personality change. Synthesis intervenes acts the positive role to the personality forming.     

输氧装置结构改良对氧疗患者舒适度的影响

目的 探讨改良后的输氧装置结构对氧疗患者舒适度的影响.方法 借鉴国外及香港地区改良输氧装置结构,选取需氧疗的患者300例,将150例需低流量吸氧的患者随机分为改良组72例和非改良组78例,150例需中流量吸氧的患者随机分为改良组78例和非改良组72例,改良组使用改良后的输氧装置干燥吸氧,调整病室湿度至80%左右,非改良组使用传统输氧装置湿化吸氧,分别比较改良组与非改良组患者在不同流量吸氧情况下的舒适度.结果 低、中流量吸氧患者分别使用改良与非改良吸氧装置后的舒适度比较,口咽部干燥、鼻黏膜干燥、异味比较差异无统计学意义(P＞0.05),噪音比较差异有统计学意义(P<0.05),改良组吸氧噪音低于非改良组.结论 改良后的输氧装置不会影响低、中流量吸氧患者的舒适度,解决了传统输氧装置的湿化瓶、湿化液、湿化瓶通气管等结构的易污染问题及消毒程序复杂和噪音大的问题.     

心理干预联合高压氧治疗对脑卒中后抑郁患者生命质量的影响

Objective To investigate the effect of the psychological intervention combined with hyperbaric oxygen therapy on the mental status and the quality of life of patients with depression after cerebral stroke.Methods 45 patients with depression after cerebral stroke were randomly divided into the study group (n = 22)and the control group(n = 23). The two groups had the same clinical routine treatments including improving cerebral cirulation, reducing intracranial pressure, drugs to anti-infection, nervous nutrition and corresponding operation for 8 weeks as a course of treatment, and psychological behavior intervention combined with hyperbaric oxygen therapy was added to the study group. The scores of Hamilton depression rating scale (HAMD) on both groups were evaluated before and spitzer' s quality of life index(QL-INDEX) were used and investigated on two groups at the end of 8 weeks. Results There was no significant difference on the scores of HAMD between the two groups before therapy (P ＞ 0. 05). The scores on HAMD of the study group after the treatment notably dropped compared to the control group (P＜ 0. 01). The difference of the scores on group index of quality of life between the study group (8.57 ± 1.94) and the control group (7.30 ± 1.98) had statistical significance (P ＜0. 05). Conclusion Psychological intervention combined with hyperbaric oxygen therapy plays an important role in the treatment of patient with depression after cerebral stroke to improve their mental status, treatment effectiveness and quality of life.     

氧气雾化间歇吸入法应用于心力衰竭合并肺部感染患者的效果观察

目的 观察氧气雾化间歇吸入法应用于心力衰竭合并肺部感染患者的效果.方法 对120例心力衰竭合并肺部感染的患者,随机分为观察组60例和对照组60例,两组在抗炎、止咳、化痰、强心、利尿等药物治疗及常规护理的基础上行氧气雾化吸入,观察组采取氧气雾化间歇吸入法,对照组采取传统的氧气持续雾化吸入法,比较两组的治疗效果.结果 两组患者有效排痰时间、痰鸣音消失时间及感染控制时间比较,差异具有统计学意义(P<0.01);雾化吸入后2 h观察组患者呼吸、心率及血氧饱和度与对照组比较,差异具有统计学意义(P<0.01);两组患者雾化吸人副作用发生情况比较,差异具有统计学意义(均P<0.01).结论 氧气雾化间歇吸入法不仅能稳定心力衰竭合并肺部感染患者的呼吸、心率,明显缩短了患者有效排痰时间、痰鸣音消失时间及感染控制时间,减少副作用的发生,提高了治疗的效果.     

护理干预对学龄期哮喘儿童氧驱动雾化吸入的效果

目的探讨护理干预对学龄期哮喘儿童氧驱动雾化吸入治疗的效果。方法将167例学龄期哮喘儿童随机分为干预组84例和对照组83例。两组患儿遵医嘱给予常规治疗护理的基础上,观察组患儿实施氧驱动雾化吸入治疗过程中给予视听训练、行为训练及氧合疗法护理干预;对照组按传统的氧驱动雾化吸入治疗常规知识宣教,由患儿自行完成氧驱动雾化吸人治疗,分别观察比较两组治疗效果。结果干预组患儿氧驱动雾化吸人后呼吸（18．31±2．32）次／min、心率（91．23±2．65）次／min及血氧饱和度（97．25±2．03）％与对照组（21．27±3．08）次／min、（95．87±3．42）次／min、（95．02±3．17）％。两组比较差异有统计学意义（t分别为7．020,9．807,5．420;P〈0．01）,干预组哮喘日间症状评分（1．05±0．23）分、夜间症状评分（1．03±0．21）分低于对照组（1．77±0．35）分、（1．75±0．32）分,两组比较差异有统计学意义（t分别为15．728,17．209;P〈0．01）;干预组氧驱动雾化吸入治疗依从性和治疗效果显著优于对照组,两组比较差异有统计学意义（x^2分别为34．53,10．92;P〈0．01）。结论全程护理干预提高了患儿治疗的依从性,尽快缓解病情,从而提高氧驱动雾化吸入治疗效果。     

氧气雾化间歇吸入法应用于老年肺部感染的效果

目的探讨氧气雾化间歇吸入法应用于老年肺部感染的效果。方法将120例老年肺部感染患者随机分为观察组和对照组,每组各60例。两组患者在一般药物治疗和常规护理的基础上行氧气雾化吸入,观察组采取氧气雾化间歇吸入法,对照组采取氧气持续雾化吸入法,比较两组患者治疗效果。结果两组患者舒适度得分、有效排痰时间、痰鸣音消失时间及感染控制时间比较,差异有统计学意义（t分别为22．76、6．5、7．52、3．02,P〈0．05）;雾化吸人1h后观察组患者呼吸、血氧饱和度与对照组比较,差异有统计学意义（t分别为4．56、21．12,P〈0．05）;两组患者雾化吸入副作用发生情况比较,差异有统计学意义（χ2=68．76,P〈0．05）。结论氧气雾化间歇吸入法可使老年患者舒适度增加,明显缩短了有效排痰时间、痰鸣爵消失时间及感染控制时间,减少了副作用的发生,提高了老年患者冶疗的效果。     

不同氧流量影响外科患者氧气雾化吸入效果的研究

目的探讨不同流量的氧气雾化吸入对外科术后患者辅助治疗的效果。方法对90例外科术后行氧驱动雾化吸入的患者进行实验观察,患者随机分为3组,每组30例,3组均行氧气雾化吸入1周,3次/d,15 min/次。各组雾化吸入时氧气驱动的流量分别是≤4 L、6 L、≥8 L,比较3组患者雾化时心率、呼吸、血氧饱和度、主观感觉以及雾化后首次排痰量、肺部痰鸣音消失时间和住院时间。结果 3组间雾化吸入时的心率、呼吸、血氧饱和度、氧流量等4个指标差异无统计学意义,P>0.05。对雾化吸入后的首次排痰量、肺部痰鸣音消失时间、住院时间等3个指标差异有统计学意义,P<0.01或P<0.05。结论氧流量稳定在6 L/min时,雾量适中、吸入合理,患者接受程度高,能达到氧气雾化吸入治疗最佳效果。     

鼻导管吸氧法导管插入深度的临床研究

为探讨鼻导管吸氧时导管的适宜插入深度 ,将鼻导管分别插入1.5cm、2cm、3cm及5cm ,观察记录吸氧前后的血氧饱和度、心率、血压 ,吸氧 8h后导管前端分泌物粘附情况及病人的感受 ,并分别与传统组进行对照。结果显示 :各实验组与对照组在血氧饱和度及其他生命体征方面无统计学意义 (P >0 .10 ) ,而在导管分泌物粘附方面存在统计学差异 (P <0 .0 1)。提示 :采用鼻导管吸氧时导管插入深度以2cm左右为宜。     

早期氧气面罩雾化给氧对纠正重型颅脑损伤患者低氧血症的影响效果观察

目的探讨氧气面罩雾化给氧方式对重型颅脑损伤患者低氧血症的可行性及安全性,以促进患者早日康复。方法将收治98例重型颅脑损伤患者随机分为观察组48例和对照组50例,在常规治疗的同时,观察组采用氧气面罩接雾化器给氧方式进行给氧;对照组采用鼻塞导管湿纱布覆盖口鼻进行给氧。结果观察组其动脉血氧饱和度、氧分压明显提高。2组病死率比较差异明显,而2组患者的心率、血压、pH、PaCO2比较差异不明显。结论氧气面罩雾化器给氧能快速、有效纠正重型颅脑损伤患者缺氧状态,纠正低氧血症。     

早期氧气面罩雾化给氧对纠正重型颅脑损伤患者低氧血症的影响效果观察

目的 探讨氧气面罩雾化给氧方式对重型颅脑损伤患者低氧血症的可行性及安全性,以促进患者早日康复.方法 将收治98例重型颅脑损伤患者随机分为观察组48例和对照组50例,在常规治疗的同时,观察组采用氧气面罩接雾化器给氧方式进行给氧;对照组采用鼻塞导管湿纱布覆盖口鼻进行给氧.结果 观察组其动脉血氧饱和度、氧分压明显提高.2组病死率比较差异明显,而2组患者的心率、血压、pH、PaCO2比较差异不明显.结论 氧气面罩雾化器给氧能快速、有效纠正重型颅脑损伤患者缺氧状态,纠正低氧血症.     

不同给氧方法在脑肿瘤术后气管切开患者氧疗中的应用

目的探讨脑肿瘤术后气管切开患者氧疗中实施不同给氧方法的效果。方法选取脑肿瘤术后气管切开患者60例,按照随机数字法分为鼻导管组、人工鼻组、面罩组各20例,分别实施鼻导管吸氧、人工鼻吸氧及面罩法吸氧。观察3组患者氧疗前、氧疗1 h、氧疗24 h时的血氧饱和度、痰液黏稠度(Ⅲ度)以及并发症(肺部感染与切口感染)发生情况并进行统计学分析。结果 3组患者在吸氧1 h、吸氧24 h时的血氧饱和度均比吸氧前有显著提高(P0.05),但面罩组提高幅度显著更高(P0.05);鼻导管组与面罩组吸氧1 h、吸氧24 h时的痰液黏稠(Ⅲ度)率相比吸氧前显著下降(P0.05),优于人工鼻组(P0.05);面罩组与人工鼻组的肺部感染与切口处感染发生率差异无统计学意义(P0.05),均显著低于鼻导管组(P0.05)。结论面罩吸氧应用在脑肿瘤术后气管切开患者中有良好效果,不仅可快速平稳改善血氧饱和度,而且能降低痰液黏稠度以及肺部感染与切口感染的发生率,值得借鉴。     

两种不同雾化方式对老年患者术后血氧含量影响的研究

目的探讨两种不同雾化方式对老年患者插管全麻术后血氧含量的影响,从而选择最佳的雾化方式,防止术后肺部感染等并发症。方法采用自身对照研究,患者分别采用A、B两种不同雾化方式。A方式采用电动超声雾化吸入;B方式采用高频有氧射流雾化吸入,动态记录两组雾化吸入前、后的血氧饱和度变化及测定其血气分析的变化。结果两种雾化方式血气分析比较,在PO2、STO2、SPO2、pH方面P<0.05,差异有显著性意义。结论采用高频有氧射流雾化吸入可有效提高患者的血氧饱和度和PO2,减少老年患者术后肺及心脑血管并发症的发生。     

急性阻塞性肺疾病的雾化吸入选择及其护理研究

目的　探讨不同雾化吸入疗法辅助治疗阻塞性肺疾病 (AOPD)时的利弊和护理特点 ,提高其疗效和安全性。方法　选择住院 2岁以内的AOPD患儿 2 40例 ,分为重症组和轻症组 ,每组又分为氧气雾化吸入组和超声雾化吸入组 ,并以氧饱和度 (SaO2 )、心率、呼吸频率为观察参数进行对比研究。结果　氧气雾化时各观察参数均无明显的变化 ,但超声雾化吸入组的重症组 ,其SaO2 显著低下 (P <0 .0 5 ) ,其他参数均见较大波动。结论　氧气雾化吸入比超声雾化吸入更适于AOPD患儿。