悬浮床在治疗大面积烧伤伴毛霉菌感染中的应用研究

目的探讨悬浮床在治疗大面积烧伤病人毛霉菌感染时的特殊作用。方法抽取61例发生毛霉菌感染病例,其中观察组26例卧于悬浮床,对照组35例卧于翻身床,比较悬浮床和翻身床在治疗大面积烧伤伴毛霉菌感染病人的细菌培养结果、换药次数、翻身次数、病人创面愈合情况、消耗卫材及病人住院费用等。结果悬浮床比翻身床在治疗毛霉菌感染时所用时间短,霉菌斑消失快,节约卫材,工作负荷减轻,病人住院费用减少。2组病人观察指标对比具有统计学意义(P<0.05)。结论悬浮床在治疗大面积烧伤毛霉菌感染时具有创面愈合快,降低材质消耗,减轻医护人员工作量,能较大程度上提高救治成功率,明显优于翻身床及其他床单位。     

悬浮床在大面积烧伤治疗中的应用及护理

2000年1月-2006年12月，我们将悬浮床应用于100例大面积烧伤患者的治疗中，经精心护理，效果满意。现报告如下。     

大面积重度烧伤病人应用悬浮烧伤治疗床的体会

目的：是进一步明确悬浮烧伤治疗床的特殊功能及独特性。方法：通过2000年8月至2005年8月使用悬浮烧伤治疗床救治的52例大面积重度烧伤病人与以往应用的普通翻身床相比较。结果：（1）创伤后应激障碍程度减轻，恐惧感减轻，舒适感增强。（2）减少受压，减轻痛苦，避免创面继续加深。（3）保持创面干燥，降低感染的几率。（4）降低护士劳动强度，提高工作质量和工作效率。（5）缩短病程，减少住院天数，减轻病人经济负担，增强了社会效应和经济效益。结论：悬浮烧伤治疗床是值得临床推广应用的。     

悬浮床在治疗大面积烧伤患者中的应用和护理

江苏省苏北人民医院从2001年6月开始应用法国HILL-ROM公司生产的CLINITRON Ⅱ型悬浮床治疗大面积烧伤的患者。     

大面积烧伤患者应用悬浮床的护理体会

目的探讨促进大面积烧伤创面干燥的护理方法。方法应用悬浮床对大面积烧伤患者进行治疗,实施有效的护理。结果大面积烧伤在应用悬浮床治疗中创面得到了有效保护。结论应用悬浮床治疗大面积烧伤,能有效保护创面,使烧伤患者减轻痛苦,减少感染,减少护理工作量。     

大面积烧伤病人应用流体悬浮治疗床的护理

流体悬浮治疗床 (ＣＬＩＩＮＴＲＯＮ11)由美国Ｈｉｕ -Ｒｏｍ公司生产 ,是目前国际上最新的治疗床。美国60年代末发明、应用。 90年代引进我国 ,它是由一个槽内盛装约 50 0ｋｇ的微小细沙 ,复盖坚密滤单构成。通过充气使槽内细沙流动漂浮 ,并且细沙流化形成人工液流 ,内设温热装置 ,可使槽内温度维持在2 8～ 4 0℃ ,再通过风与水双冷却系统保持槽内人工液流的温度恒定 ,温热、流化、漂浮的人工液流、气流而起到治疗作用。在我国主要用于大面积烧伤的病人。流体悬浮治疗床应用于烧伤治疗的优点是避免创面受压 (因压力不超过 1 3ｋＰａ) ,并…     

流体悬浮床治疗大面积烧伤的观察及护理

目的 探讨流体悬浮床对大面积烧伤的疗效。为大面积烧伤患者提供更好的治疗和护理。方法采用随机分组，每组各30例，均采用创面暴露疗法，使用流体悬浮床为治疗组，使用普通翻身床为对照组，观察比较两组烧伤患者的治疗效果及护理。结果使用流体悬浮床治疗组的30例烧伤患者创面成痴快，整个过程病人痛苦少易接受，护理工作明显减少，治疗效果好，全部治愈出院。使用翻身床对照组的30例患者创面潮湿，成痴慢，大部分病人不耐受俯卧住，要很好地实施有很大困难，护理工作量也大大增加，疗效也不理想，特别是烧伤病人处于休克期或严重呼吸道烧伤，心肺功能不好年龄大的烧伤患者，在翻身时易引起心跳呼吸骤停而出现严重后果，本组治愈出院有27例，死亡3例。结论流体悬浮床以其独特的原理，先进的设置良好的性能克服了翻身床的缺点，发挥其避免受压，促进创面干燥成痴，减轻病人痛苦，减少护理工作等作用，流体悬浮床是大面积烧伤患者治疗及护理的理想治疗床。     

悬浮床辅助治疗大面积烧伤患者的安全分析

目的：探讨悬浮床在治疗大面积烧伤患者中的作用,分析患者的安全风险,实施有效的安全护理措施。方法A组大面积烧伤患者22例,应用悬浮床辅助治疗,B组大面积烧伤患者23例,使用翻身床,比较两组患者创面干痂时间、创面愈合时间及并发症的发生率,评估患者坠床风险及心理状态。结果 A组创面干痂时间、愈合时间较B组提前,差异有统计学意义（P＜0．01）;且气管导管意外脱管发生风险降低,并发症的发生差异无统计学意义。结论悬浮床用于大面积烧伤患者的辅助治疗,能保护创面,促进创面愈合,减少风险因素,配合有效的安全防范措施,保证患者的安全。     

大面积烧伤患者悬浮床应用后的呼吸道护理

目的探讨大面积烧伤患者应用悬浮床治疗后呼吸道护理的有效措施。方法在2001年6月～2003年12月及2004年12月～2007年12月期间应用悬浮床治疗大面积烧伤患者61例,按上述时间段分为A组(25例)和B组(36例)。A组按照大面积烧伤、吸入性损伤及悬浮床等护理常规进行护理。B组在A组基础上注重了休克期在监测指标下补液,促进患者痰液的排出及湿化气道,以肺部感染为指标,观察2组肺部感染发生率及肺部感染的愈合时间。结果 B组肺部感染发生率明显低于A组(P<0.05);B组肺部感染的愈合时间较A组明显降低(P<0.05)。结论大面积烧伤患者应用悬浮床治疗后加强呼吸道护理,能降低肺部感染,缩短肺部感染愈合时间。     

烧伤患者应用悬浮床的护理体会

作报道应用悬浮床治疗４０例烧伤患的护理经验。悬浮床应放于单人房,保持空气洁净;针对患臣浮床的矛盾恐惧心理进行耐心解释使其安心治疗;严密监测室温和床温,如室温超过２９℃,应开空调减轻悬浮床的散热负荷,保持床温恒定;喜励患多饮水,或静脉补充水分以及定期监测血浆电解质,预防卧悬浮床患发生脱水现象;设立专人管理和保养悬浮床,每位患用后,对床单元进行全面的消毒灭菌,防止交叉感染。认真做好以上几方     

Diagnosis and treatment of invasive fungal infections in cancer patients

Fungal infections continue to cause major complications in cancer patients. With the increasing use of aggressive chemotherapy causing prolonged granulocytopenia, and the progress made in the prophylaxis and treatment of bacterial infections, the risk of invasive mycoses has increased, particulaly in patients with hematological malignancies. The prognosis of these infections is poor unless they are diagnosed and treated promptly. Early diagnosis, particularly in neutropenic cancer patients, is often difficult and antifungal therapy is frequently unsuccessful because it is not instituted until the infection is in an advanced, fatal phase. In order to reduce the mortality associated with invasive fungal infections, antifungal therapy, usually amphotericin B, has been empirically carried out in neutropenic patients with fever unresponsive to broadspectrum antibacterial therapy. However, the absence of a marker of the fungal infection, the frequent occurrence in these patients of non-infective fever, which does not require any antimicrobial therapy, and the possible toxicity of amphotericin B represent the major limits of empiric antifungal therapy. In view of the above, the study of improved and less toxic antifungal agents, and the evaluation of new clinical and laboratory methods for an early diagnosis, have been the major goals in research on the opportunistic invasive fungal infections in the last years.Presented as an invited lecture at the 4th International Symposium: Supportive Care in Cancer, St. Gallen, Switzerland, 24–27 February 1993     

重度烧伤患者真菌感染34例治疗体会

目的探讨重度烧伤患者真菌感染特点,提高真菌感染的防治效果。方法回顾性分析我科2000～2008年重度烧伤伴真菌感染患者34例的临床资料及治疗情况,总结防治措施。结果本组真菌感染平均出现在伤后12天,主要类型是白色念珠菌26例（76.5%）,其次是热带念珠菌5例（14.7%）、曲霉菌2例（5.9%）、毛霉菌1例（2.9%）;34例真菌感染患者中痊愈31例,死亡3例,治愈率91.2%;抗真菌药物中伊曲康唑组治愈率85.7%,氟康唑组治愈率75.0%。结论重视诱因,早期诊断,早期治疗,综合防治可以提高重度烧伤伴真菌感染的治疗成功率。     

Voriconazole in the treatment of invasive fungal infections

Fungal infections in immunocompromised patients in the Intensive Care Unit (ICU) are a major cause of mortality and morbidity and can lead to extended stays on the ICU. New antifungal drugs have been developed to increase treatment options to improve the clinical outcome. This article reviews the clinical efficacy, side effect profile, dosing and administration schedule of voriconazole, a recently launched second generation triazole. The article also discusses the warnings and precautions associated with the use of this drug. Voriconazole is an effective treatment option in the management of fungal infections.     

Miconazole therapy for treatment of fungal infections in cancer patients.

Selection of resistance to cefamandole has been observed, and the drug has failed to protect animals lethally infected with certain Enterobacteriaceae that appeared to be highly susceptible in vitro. Using spectrophotometric assays, some of these organisms were found to produce beta-lactamases highly active against cefamandole. Cefoxitin, a poor enzyme substrate, was found to be superior to both cephalothin and cefamandole in induction of these enzymes. A simple disk induction test was developed and used to examine 147 Enterobacteriaceae for production of these beta-lactamases. The enzymes were found in 69% of cephalothin-resistant, cefamandole-susceptible strains and in only 3% of strains susceptible to both cephalothin and cefamandole. They were most prevalent among isolates of Enterobacter, indole-positive Proteus, and Serratia. Since selection of resistance and therapeutic failures have occurred most often among these genera, the relationship between presence of inducible enzymes and outcome of therapy should be examined further in humans.     

70例真菌感染病例追踪分析

目的通过对70例真菌感染标本的用药情况进行追踪，说明科学、合理、有效使用抗菌药物的重要性。方法由临床提供病原学标本，检验科按要求进行分离培养，科玛嘉彩板采用郑州安图公司产品。结果70例真菌感染病例与患者年龄和自身抵抗力、医生的不规范用药、过度用药有相互关联。结论认真落实《抗菌药物·临床使用原则》，科学、合理、有效使用抗菌药物是控制真菌感染的有效手段。     

Diagnosing fungal infections in neutropenic patients

Fungal infections are among the most serious complications in neutropenic patients. A major problem that has compromised management of fungal infections is healthcare professionals' inability to recognize the infections when they occur. No adequate diagnostic tools exist to detect many of the fungal infections. Early diagnosis of disseminated candidiasis is a challenge because only 35%-50% of neutropenic patients have positive blood cultures (Bodey, 1997), and radiologic tests have low specificity in that patient population. For example, a routine chest x-ray can be negative, yet a computed tomography (CT) scan of the chest can be positive for pneumonia the next day. Therefore, fungal infections often are advanced before diagnostic confirmation; thus, overall outcomes are poor. A great effort has been invested in developing serologic tests to detect circulating antigens of fungi.     

Preventing fungal infections in immunocompromised patients

The incidence of systemic fungal infections in immunosuppressed patients has increased in the past two decades (Fridkin and Jarvis, 1996). Bone marrow transplant recipients and patients with prolonged neutropenia are most at risk, particularly when environmental factors increase the presence of fungi and fungal spores. Preventive measures include air filtration, handwashing, exclusion of flowers and some foodstuffs and use of chemoprophylaxis. In April 1999, a meeting was held under the auspices of the European Group for Blood and Marrow Transplantation (UK) Nurses and Allied Professionals Group to discuss the role of nurses in the management of patients at risk of systemic fungal infection. Issues discussed included: the need for nurses to recognize risk factors for systemic fungal infection; the role of nurses in giving feedback to patients; and the use of antifungal agents and associated problems, such as non-compliance and side-effects.     

Caspofungin in the treatment of invasive fungal infections.

Caspofungin is a member of a new class of antifungals called Echinocandins and is the first to have marketing authorisation in the United Kingdom. This article reviews the clinical efficacy, side effect profile, dosing and administration schedule of caspofungin. The article also discusses the warnings and precautions associated with the use of this drug. Caspofungin is an effective treatment option in the management of fungal infections.     

悬浮床在治疗重度烧伤患者中的应用和护理

目的观察悬浮床在治疗重度烧伤患者中的作用,总结悬浮床的护理要点。方法64例重度烧伤患者,配对分组,分别使用普通翻身床(A组)和悬浮床(B组),比较两组患者创面干痂时间、创面愈合时间、护理耗时、创面感染情况。结果B组在创面干痂时间、创面愈合时间、翻身耗时及其他操作耗时等方面均比使用普通翻身床的患者短,两者存在统计学差异(P<0.01);两组在创面细菌培养情况上也存在统计学差异(P<0.05),B组的细菌培养阳性率低于A组。结论悬浮床能明显改善重度烧伤患者的创面愈合情况,减轻护理工作量,临床应用前景良好。