贝复剂喷雾加特定电磁波照射治疗Ⅱ期及Ⅲ期褥疮的疗效观察

褥疮一词源于拉丁文Decub，该词意为“躺下”，因此容易使人误解为“褥疮是由躺卧引起的溃疡”，事实上躺卧和褥疮之间并没有必然的联系，引起褥疮最基本、最重要的原因是压迫而造成的局部组织缺血，故曾有人建议称之为压力性溃疡(pressure ulcers)似更妥。引起褥疮的原因是多方面的，但在骨科，病人常常因骨折需长期卧床、长时间坐轮椅、夹板内压垫放置不当、石膏内不平整或有渣屑等原因引起。另外，年老体弱、消瘦、瘫痪、水肿、大手术后、营养不良亦属于褥疮的高危人群。我科自1996年10月-2003年7月对54例带褥疮入院的病人进行贝复剂喷雾加特定电磁波(TDP)照射治疗，并与采用常规治疗和护理的54例进行比较，发现此法明显优于常规法。现报告如下。     

褥疮的新认识及其护理近展

褥疮(Decubitus wlcer)是临床上常见的并发症,也是护理工作的一大难题。近年来有关国内外文献资料对褥疮的病因及护理提出了一些新的看法,试摘要综述如下。一、有关概念的几个问题 1.“褥疮”一词,命名不当褥疮,来源于拉丁字decub,意为“躺下”。易使人简单地误解为“躺卧引起的溃疡”,而忽视了最基本的病因——压迫。实际上褥疮亦能发生于长期坐位(如轮椅)的病人,并非一定由躺卧引起。因此,褥疮一词实属命名不当,采用压力性溃荡(Pressure ulcer)较妥,体现了形成褥疮的主要原因。     

一例骶尾部及双下肢多处褥疮患者护理体会

压疮（亦称褥疮）是由于局部组织长期受压，发生持续缺血、缺氧、营养不良而致组织溃烂坏死，压疮最早称为褥疮．来源于拉丁文“decub”意为“躺下”，因此容易使人误解为压疮是“由躺卧引起的溃疡”。实际上，压疮可发生于长期卧床的患者．也可发生于无法站立而长久坐位（如坐轮椅）的患者。引起压疮最基本、最重要的因素是压力，故目前倾向于将压疮改称为“压力性溃疡”。     

褥疮的发生与预防

褥疮(Decubotus ulcer)一词来源于拉丁字,decub意为“躺下”,但实际上褥疮也发生于长期坐位(如轮椅)的病人,而并非一定由躺卧引起,所以应用“压力性溃疡”(Pressure ulcers,Pu)更为准确,它既强调了形成溃疡的主要原因:压迫,又可代表其病理生理。一、Pu的发生导致Pu发生的原因有很多,起决定作用的有四种:压力、剪力、摩擦力和潮湿。其中压力是主要因素,在骨突起部增加压力,可引起宽阔的三维压力梯度。Landis研究发现在动脉枝处平均压力为32mmHg,Houle认为任何超过32mmHg的压力传导给组织作用于毛细血管壁将导致循环阻塞和产生局部缺血,如果持续下去,将产生溃疡。压力超过     

压疮护理研究新进展

压疮是身体局部组织长期受压，血液循环障碍，组织营养缺乏，致使皮肤失去正常功能而引起的组织破损和坏死。压疮最早称为压疮（bedsores），来源于拉丁文“dccub”，意为“躺下”。因此容易使人误解为压疮是“由躺卧引起的溃疡”。长期卧床患者皮肤出现的最严重问题是发生压疮（pressure sores）。压疮是临床常见的并发症，可发生于躺卧或长期坐位（如轮椅）的患者，而并非仅由躺卧引起。引起压疮最基本、最重要的因素是由于压迫而造成的局部组织缺血、缺氧，故称为“压力性溃疡”更妥当，即强调了形成溃疡的主要原因。     

褥疮的护理

褥疮的发生率在专科医院和福利性医院中达到２３%～２７．５%［５］,如何预防褥疮的发生是一项重要课题。现就人们熟知的褥疮概念与临床护理研究作一概述。１“褥疮”（ＤｅｃｕｂｉｔｕｓＷｌｅｅｒ）的命名根据文献所示,褥疮来源于拉丁文Ｄｅｅｕｂ,意为“躺下”,它易使人们简单地误解为“久卧引起的溃疡”,俗称褥疮。事实上,褥疮决不仅仅是久卧所致,也可发生于长期坐位如长期坐轮椅生活的病人,国内倪杏芳认为采用“压力性溃疡（Ｐｒｅｓｓｕｒｅｕｌｃｅｒ）”似更妥,即强调了形成溃疡的主要原因。还有人建议用“营养性溃疡”更确切些。…     

褥疮发病因素的研究现状

褥疮是常见的临床并发症 ,是临床护理工作棘手的问题 ,由于对褥疮的概念存在较多的模糊认识 ,在护理管理方面存在着偏见 ,因而影响着褥疮护理的进展。本文就褥疮的定义、褥疮的发生机制及对发生褥疮的认识综述如下。1　褥疮的命名与定义1.1　久卧床引起的溃疡　根据相关文献所示 ,褥疮来源于拉丁文Ｄｅｃｕｂ ,意为“躺下” ,因此使人误解“久卧床引起的溃疡”[1] ,事实上 ,褥疮不仅仅是久卧所致 ,也可发生于长期坐位 ,如长期在轮椅上生活的病人。1.2　压力性溃疡、压疮　“压力性溃疡”主要强调了“压力所致”[2 ] ,但压力并非是形成褥疮的…     

自制锌氯泥霜治疗溃疡期褥疮效果观察

褥疮多由局部组织长期受压，发生持续缺血、缺氧、营养不良而致组织溃烂坏死，是难以避免的临床护理并发症。为了探讨治疗褥疮更有效的方法，从2002年1月-2003年10月自制锌氯泥霜在我市两所二甲医院对不同原因引起的褥疮病人进行了治疗，效果较好。总结如下。     

肺炎、脑梗死、深静脉血栓合并压疮护理1例

压疮或压力性溃疡来源于“褥疮”一词，意为“躺下”，自1590年开始使用。祖国医学称之为“席疮”，因久着席褥而得名。在实践中人们发现，这种溃疡不仅发生于卧位，也可发生于坐位，并非仅仅发生在“躺卧引起的溃疡”。Cinsdule提出，在9．3kPa压力下组织持续受压2h以上，就能引起组织不可逆损伤。事实证明，只要施加足够的压力，并有足够长的时间，任何部位均可发生压疮。2007年3月我科收治1例脑梗死、深静脉血栓合并多发压疮的肺炎患者，经过72d的精心治疗和护理，压疮治愈出院。     

致压疮的原因——压力分析及预防

压疮中医俗称为席疮。Hildnaus等1590年开始使用褥疮（decubitus ulcer）一词，并指出褥疮是由于压力和剪切力引起的皮肤损害。近年来，褥疮一词逐渐被废弃，因为Decubitus来源于拉丁文，意为“躺下”，而褥疮不仅发生于卧床病人，也发生于坐位。现多采用压疮（pressure sore）一词，从病理和病因上可以反映出是由于受压而引起的病理学改变。压疮临床治疗棘手，一旦发生感染，不仅增加病人痛苦，严重者引发败血症危及病人生命。近年来广大护理工作者对压疮作了很多的临床研究。现将引起压疮的原因——压力分析及预防介绍如下。     

与1例失语病人的交流

语言在人类进化过程中已成为重要的交往工具和联络手段[1] 。脑梗死病人 ,由于大脑皮质语言功能区病损 ,发音肌肉瘫痪 ,使其说话、阅读和书写能力残缺 ,不能表达其思想 ,影响了人际间交往 ,给治疗、护理工作带来了很大困难。我院于 2 0 0 2年10月 9日收治 1例多发性脑梗死病人     

Bullous Eruption Associated With Dihydropyridines With Cross Reactivity

The spectrum of cutaneous eruptions associated with dihydropyridines is extensive, varying from exanthemas to severe adverse events. We report a case of bullous eruption, one month after starting nicardipine and lercanidipine. The same symptoms recurred few days after taking nitrendipine.     

Factors Associated With Self-Concept in Children With Asthma

PURPOSE: To investigate the relationship of demographic asthma, family, and child factors with self-concept in children with asthma. METHODS: Data were collected twice approximately 4 years apart from both the affected children and their mothers (N = 134) via interviews and self-report questionnaire. FINDINGS: Children who demonstrated more negative attitudes toward their illness, had less satisfaction with family relationships, and used more negative coping behaviors had the poorest self-concepts. Over time, the greatest improvement in self-concept occurred in children whose attitudes and satisfaction with family relationships improved and whose use of negative coping behaviors decreased. CONCLUSIONS: Results suggest that some children with asthma, especially girls with severe asthma, appear to be at risk for poor self-concept.     

Factors Associated With Home Discharge Among Veterans With Stroke

Objective

To determine which patient-, treatment-, and facility-level characteristics were associated with home discharge among patients hospitalized for stroke within the Department of Veterans Affairs.

Design

Retrospective observational study.

Setting

Veterans Affairs facilities nationwide.

Participants

Veterans hospitalized for stroke during fiscal year 2007 to fiscal year 2008 (N=12,565).

Intervention

Not applicable.

Main Outcome Measure

Discharge location after hospitalization.

Results

There were 10,130 (80.6%) veterans discharged home after hospitalization for acute stroke. Married veterans were more likely than nonmarried veterans to be discharged home (odds ratio [OR]=1.23; 95% confidence interval [CI]=1.11–1.35). Compared with veterans admitted to the hospital from home, patients admitted from extended care were less likely to be discharged home (OR=.04; 95% CI=.03–.07). Compared with those with occlusion of cerebral arteries, patients with intracerebral hemorrhage (OR=.61; 95% CI=.50–.74) or other central nervous system hemorrhage (OR=.78; 95% CI=.63–.96) were less likely to be discharged home, whereas patients with occlusion of precerebral arteries (OR=1.36; 95% CI=1.07–1.73) were more likely to return home. Evidence of congestive heart failure (OR=.85; 95% CI=.76–.95), fluid and electrolyte disorders (OR=.86; 95% CI=.77–.96), internal organ procedures and diagnostics (OR=.87; 95% CI=.78–.97), and serious nutritional compromise (OR=.49; 95% CI=.40–.62) during hospitalization remained independently associated with lower odds of home discharge. Longer hospitalizations and receipt of rehabilitation services while hospitalized acutely were negatively associated, whereas treatment on more bed sections and rehabilitation accreditation of the facility were positively associated with home discharge. Region exerted a statistically significant effect on home discharge.

Conclusions

We found sociological, clinical, and facility-level factors associated with home discharge after hospitalization for acute stroke. Findings document the importance of considering a broad range of characteristics rather than focusing only on a few specific traits during discharge planning.