口腔种植牙患者的围手术期护理

目的：探讨口腔种植牙患者的围手术期护理的意义。方法：医护人员对牙种植患者术前、术中、术后三个阶段实施术前准备、健康教育、心理护理。结果：短期随访未发现种植体松动失败病倒，无医疗纠纷发生。结论：良好的口腔种植牙患者的围手术期治疗和护理可提高种植成功率，减少医疗纠纷。     

上颌窦提升同期xive种植体植入围手术期护理及手术配合

目的探讨上颌窦提升同期xive种植体植入围手术期护理及手术配合。方法通过对18例（24颗牙缺失）患者进行上颌窦提升同期xive种植体植入手术，术前做好器械消毒准备、患者的心理护理、术中密切配合医生、术后指导患者。结果18例患者（24颗）随访6个月至3年，均形成良好的骨结合。结论正确的围手术期护理及手术配合是上颌窦提升同期人工种植牙获得种植成功的重要保障。     

小钛板内固定治疗下颌骨骨折684例的护理

目的 观察小钛板内固定治疗下颌骨骨折的疗效及护理效果.方法 选择下颌骨骨折患者684例,将骨折解剖复住后,用1～2块小钛板行骨折端坚固内固定,其中582例多发性或粉碎性骨折辅以1～2周颌间固定牵引,观察骨折段复位、咬合关系、颌面形态恢复情况.结果 684例患者术后均无感染,术后3个月X线检查,骨折端复位良好,骨痂形成,颌面外形满意,咬合功能良好.结论 小钛板内固定治疗下颌骨骨折疗效可靠,采用整体的术前术后护理措施,是较为理想的颌骨骨折治疗方法.     

组合式外固定支架治疗胫腓骨开放性骨折的临床护理

目的 探讨胫腓骨开放性骨折患者组合式外固定支架固定围手术期的护理方法与疗效.方法 对32例胫腓骨开放性骨折组合式外固定支架治疗患者,围手术期进行精心护理.结果 本组经积极治疗与精心护理,肢体恢复功能优18例,良12例,中2例,优良率90.9％.骨折平均愈合时间为10-32周,无骨不连或再骨折发生,无针道感染,无固定针松动.结论 组合式外固定支架治疗胫腓骨开放骨折效果满意,认真做好术前护理、术前准备、术后护理、功能锻炼、出院指导,不仅有利于关节功能的恢复,也有利于骨折端血运重建,可促进切口愈合骨折愈合,降低并发症,使患者早日康复.     

自制下颌骨骨折复位牵引器在坚固内固定术中的应用

目的评价自制下颌骨骨折复位牵引器在下颌骨骨折手术中的应用价值。方法采用自行研制的获国家专利的下颌骨骨折复位牵引器应用在进行坚固内固定手术的68例下颌骨骨折患者。结果68例患者术后切口无感染，均Ⅰ期愈合。全部病例恢复到术前咬合关系。68例术后X线复查未见骨折愈合不良或假关节形成。结论在下颌骨骨折坚固内固定手术中应用自制下颌骨骨折复位牵引器能够使骨折复位更加接近于伤前的解剖形态，避免出现骨折线过紧或过松而发生铪干扰问题。具有操作简便、固定可靠、疗效确切、患者痛苦小、恢复快等优点，值得临床推广应用。     

冠状动脉旁路移植同期行瓣膜置换术患者的围术期护理

目的总结冠状动脉旁路移植同期行瓣膜置换术患者的围术期护理。方法对20例冠状动脉旁路移植同期行瓣膜置换术的患者进行精心的术前、术中、术后护理。结果本组患者均顺利完成手术,围术期均无并发症发生,切El愈合良好,心功能恢复,均康复出院。结论高质量的围术期护理是冠状动脉旁路移植同期行瓣膜置换术成功的重要保证。     

高龄患者髋部骨折的围术期护理

目的 探讨高龄髋部骨折患者的围术期护理要点,减少并发症的发生.方法 回顾性分析56例髋部骨折术前术后实行各种相关护理,包括术前心理护理、术前评估、术后护理及病情观察、饮食调控、各种并发症预防及术后功能训练指导.结果 本组发生深静脉血栓1例、应激性溃疡1例,无褥疮、泌尿系感染.骨折愈合良好,68.5%患者能生活自理.结论 术后通过配合医生的治疗,恰当的围术期护理,可以减少和预防并发症的发生,促进患者的早期康复.     

口内途径坚强内固定治疗下颌骨骨折60例临床分析

目的 评价口内隐蔽切口微小型钛板坚强内固定在下颌骨骨折中的临床应用和疗效.方法 对60例下颌骨骨折采用口内切口行微小型钛板行坚强内固定术.对患者术后的咬牙合关系,骨折复位,骨折愈合及伤口愈合等情况进行观察.结果 60例患者手术切口均一期愈合,术后3～6个月X线片示骨折线对位良好,骨生长良好,咬牙合关系正常.结论 下颌骨骨折口内切口行钛板坚强内固定术具有创口隐蔽,美观,愈合良好等优点,是一种优于传统口外切口治疗下颌骨折的理想的固定方法.     

高龄骨折合并糖尿病病人的围术期护理研究

目的:高龄骨折合并糖尿病病人围术期的护理研究.方法:结合多年、多例高龄骨折合并糖尿病病人的围术期所呈现的健康问题如:伤口愈合不良、压疮、肺部及尿路感染等一系列问题,进行分析,归纳和总结出一些有效的预防并发症及术后感染的一些方法.应用于70例年龄在65岁以上的骨折合并糖尿病的患者,让他们了解控制及预防并发症发生的方法.结果:大大降低了术后患者压疮并发症的发生.使患者积极地面对疾病.结论:加强高龄骨折合并糖尿病病人围术期的护理,对于病人的心理健康有很大帮助,并且减少了术后感染和术后并发症的发生,围术期的护理是非常重要的.     

手术治疗成人下颌骨髁状突骨折的临床研究

目的 分析评价成人踝状突骨折的手术方法及效果.方法 对焦作市人民医院口腔领面外科2006年至2011年间43例髁状突骨折成人患者行手术切开复位微型钛板内固定.术后观察骨折复位愈合,张口度,咬合关系等情况.结果 全部病例手术切口均Ⅰ期愈合,咬合关系恢复良好.结论 手术治疗成人下颌骨踝状突骨折,疗效确切.     

A retrospective study on the approach to the tooth in the fracture line of the mandible

The presence of a tooth in the fracture line constitutes a specific problem in mandibular fractures. Therefore, our objective was to characterize the approach to teeth in the fracture line used in the Department of Maxillofacial Surgery, Plovdiv, by retrospectively investigating the association between various preoperative factors and the decision to extract or preserve the tooth. MATERIAL AND METHODS: The following variables were studied based on data from available hospital records: 1) gender and age of patients; 2) local preoperative infections; 3) time from trauma to treatment; 4) degree of fracture displacement; 5) relationship between tooth and fracture line; 6) periapical pathology; 7) periodontal diseases; 8) type of tooth in the fracture line; 9) degree of eruption; 10) method of treatment. RESULTS: 593 fractures with a tooth in the fracture line were included in the study. The tooth was preserved in 69.90 +/- 0.14% of the cases, it was extracted in 29.30 +/- 1.91% and exarticulated in 0.80 +/- 0.38% of all fracture lines. The results demonstrated the existing association between the studied variables and the decision to extract or preserve the tooth. Extraction was generally preferred in the following cases: if a local preoperative infection was present; the time from trauma to treatment was more than 72 hours; there was a significant displacement of the fracture; the dental root was fractured; periapical pathology or periodontal disease was present; the tooth was multi-rooted; or treatment consisted of open reduction and internal fixation. CONCLUSIONS: Making a decision to extract or preserve the tooth in the fracture line is a complex process. Each case, therefore, should be approached individually.     

术前快速口腔护理对急诊全麻病人肺部感染的影响

目的探讨普外科急诊全麻病人术前快速口腔护理对预防肺部并发症的影响。方法普外科急诊全麻病人90例,随机分为2组,每组45例。观察组用口腔宝含漱液口腔护理,对照组用生理盐水口腔护理。结果 90例普外科急诊全麻病人术前快速口腔护理,其中观察组45例肺部感染8例占17.8%,对照组45例肺部感染26例,占57.8%。结论手术前使用口腔宝含漱液进行手术前口腔干预,可起到局部抑菌杀菌的作用,对预防全麻手术患者肺部感染起到良好效果。     

200例全身麻醉患者麻醉复苏期特殊护理体会

目的探讨全身麻醉患者麻醉复苏期特殊安全护理措施。方法对200例全身麻醉患者术前、术后实施相关的特殊护理措施进行随访,并对其麻醉恢复期潜在的安全问题进行总结。结果在全身麻醉复苏期实施特殊安全护理的患者病情恢复顺利,无护理并发症发生。结论对全身麻醉患者术前及术后麻醉复苏期采取针对性、精细化护理措施,可促进患者早日康复,减少术后并发症。     

内镜辅助开放手术治疗髁突-下颌支联合体骨折

目的　探讨内镜技术在手术切开复位内固定治疗髁突-下颌支联合体骨折中的应用.方法16例(18侧)髁突-下颌支联合体骨折患者中,2侧髁颈部骨折,11侧髁颈下骨折,5侧下颌支骨折;6侧髁突骨折段无明显移位,10侧髁突骨折段有明显移位,2侧髁突骨折段脱位.术中经口外入路或经口内入路,在内镜监视下复位移位的骨折段,并利用穿刺套管完成内固定.结果所有患者手术顺利,患者恢复原有的咬合关系,骨折段复位;术后随访12～36个月,关节功能良好、骨折固定稳固、无严重并发症.结论经口内入路或经口外入路内镜辅助手术复位内固定治疗髁突-下颌支联合体骨折具备可行性;该手术方式具有微创和美观等优点.     

GSS-Ⅱ型椎弓根钉系统治疗胸腰椎骨折的临床分析

目的探讨采用通用脊柱内固定系统GSS-Ⅱ型椎弓根钉复位固定治疗胸腰椎骨折的临床疗效。方法采用通用脊柱内固定系统GSS-Ⅱ型椎弓根钉复位固定治疗胸腰椎骨折47例,术前、术后及随访期间摄X光片,测量术前、术后椎体前缘高度、椎体后缘高度、后凸Cobb角,了解术后骨折复位情况以及随访期间有无失败和复位丢失情况。采用Frankel评分评价神经损伤的恢复情况。结果通过手术复位固定,椎体前缘高度、椎体后凸Cobb角与术前相比均明显改善,术后平均随访18.5个月,测量以上结果与术后相比无明显变化,无一例发生内固定失败。神经功能按Frankel分级除2例A级无恢复外,其余均有1级以上的恢复,无神经损伤加重的病例。结论采用GSS-Ⅱ型椎弓根钉复位内固定治疗胸腰椎骨折可有效的使骨折复位,防止脊柱骨折复位丢失和后突畸形,改善神经功能,是治疗胸腰椎骨折较理想的方法。     

Impact of Dental Referral Prior to Elective Surgery on Postoperative Outcomes

ObjectivesOral bacteria may contribute to postoperative infectious complications including postoperative pneumonia or surgical site infection. The aim of this study was to investigate the impact of preoperative dental care on postoperative outcomes among surgical patients under general anesthesia.DesignRetrospective cohort study.Setting and ParticipantsWe analyzed clinical records of major surgical patients at a university hospital between 2016 and 2018. Subjects were categorized into either the preoperative dental care group, those being referred to dentists by their surgeons based on an individual surgeon's judgment for dental care before surgery, or the control group.MethodsThe primary outcome was postoperative infectious complications. Secondary outcomes were postoperative inflammation markers (C-reactive protein and fever), and economic outcomes (postoperative length of hospital stay and medical expenses). As the main analysis, the average treatment effects of the preoperative dental care were obtained from the augmented inverse-probability weighting (AIPW) method with consideration of demographics and perioperative risk factors to estimate causal effect of the intervention from the observational data. Then, stratified analyses by age and surgical sites were conducted with the inverse-probability weighting and linear regression methods, respectively.ResultsIn the AIPW estimation, compared with the control group, the care group saw a significantly lower rate of postoperative infection (average treatment effect ?3.02) and shorter fever duration (?2.79 days). The stratified analysis by age revealed significant positive impact of dental care in all age groups, including the highest treatment effects observed among patients younger than 60. Also, treatment effect was observed in wider surgical sites than previously known.Conclusion/ImplicationsThis study indicates a significant impact of preoperative dental care on preventing postoperative infection and inflammation. Along with old age or certain types of surgeries in which advantages of dental referral have been already known, preoperative dental referral could be beneficial for broader types of patients.     

全麻下小儿斜视矫正术的护理

目的探讨护理在全麻下小儿斜视矫正术中的作用。方法回顾性研究2010年2月至2010年12月宜昌市中心人民医院眼科29例全麻术下斜视矫正手术患者的临床资料,总结该组患者的术后效果及并发症。结果本组29例斜视患者,均获得预期的手术效果,其中仅有1例患儿发生呕吐,无窒息,其余患儿术中平稳,术后恢复好。结论优质的术前、术中及术后护理对于全麻下小儿斜视矫正手术的成功起着至关重要的作用。     

Pelvic Fracture Rates in Community-Living People With and Without Disability and in Residents of Nursing Homes

ObjectivesThere are limited data on the epidemiology of pelvic fractures. The purpose of this study was to calculate incidence rates of pelvic fractures leading to hospital admission and to compare incidence rates between residents of nursing homes and community-dwelling persons with and without care need.MethodsData were retrieved from a database of the largest health insurance company in Bavaria, Germany. Between 2004 and 2009, 10,170 pelvic fractures were observed in 751,101 women and 491,098 men. Age- and gender-specific incidence rates were calculated. Incidence rates were further stratified by setting (nursing home versus community) and functional status (no care need versus care need for those in the community). In addition, the average cumulative risk for a pelvic fracture at different ages was calculated.ResultsThe incidence rate increased from 0.54 and 0.38 per 1000 person-years in women and men aged 65 to 69 years to 9.35 and 4.45 per 1000 person-years in women and men aged 90 years and older, respectively. Persons living in a nursing home or living at home with care need had considerably higher incidence rates than community-dwelling older persons without care need. The average cumulative risk at the age of 65 years for an incident pelvic fracture until the age of 90 years was 6.9% in women and 2.8% in men.ConclusionThe incidence of pelvic fractures leading to hospital admission is higher in women than in men and rises dramatically with increasing age. Persons with care need have a particularly high risk for pelvic fracture.     

双腔支气管导管用于肺癌手术全麻30例的护理体会

目的:探讨双腔支气管导管(DLT)插管用于肺癌手术全麻的护理体会。方法:结合临床护理实践,对麻醉诱导插管、手术体位、手术中注意事项、拔管及换管、运送患者等方面的护理配合进行探讨。结果:30例患者均插管成功,其中2例因单肺通气时出现低氧血症,给予双肺通气,患者血氧饱和度恢复,其余麻醉过程顺利,未发生严重并发症。结论:加强麻醉过程各环节的护理,能提高双腔支气管导管插管成功率、减少相关并发症的发生。