护理干预对极低出生体重儿喂养不耐受的影响

目的探讨护理干预对极低出生体重儿喂养不耐受的影响。方法将出生后出现喂养不耐受的60例极低出生体重儿随机分为两组,均给予保暖,抗感染,小剂量红霉素静脉滴注,静脉营养,插胃管并用生理盐水洗胃,以预防咽下综合征等常规治疗,干预组在此基础上施加抚触疗法及非营养性吸吮并观察干预效果。结果干预组极低出生体重儿残奶量减少,腹胀消退,达到完全经胃肠喂养418.4KJ/（kg·d）时间缩短,与对照组比较,差异有显著性（P〈0.05）。结论护理干预较好地改善极低出生体重儿喂养不耐受,尽快诱导肠胃功能成熟,缩短住院天数,减轻家庭经济负担和心理负担。     

非营养性吸吮联合抚触对早产儿生长发育的影响

目的探讨非营养性吸吮联合抚触对早产儿生长发育的影响。方法将68例需经鼻胃管喂养的早产适于胎龄儿,体质量<2500g,胎龄<35周,随机分为干预组(非营养性吸吮联合抚触)及对照组(单纯予间歇鼻胃管喂养)各34例。干预组在鼻胃管喂养间歇期给予吸吮无孔橡皮奶头8～10min/次,8～10次/d。同时给予全身抚触3次/d,每次15min。对照组单纯给予鼻胃管喂养,两组不足热量给予部分肠外营养。观察胃残留,喂养不耐受情况。肠道营养达418.4kJ(kd·d)时间,恢复出生体质量时间,14d时头围,身高增长情况,平均住院日。结果干预组胃残留、喂养不耐受情况明显低于对照组,达足量肠内营养时间,平均住院日较对照组明显缩短。生后恢复出生体质量时间、头围、身高增长、干预组明显优于对照组。结论非营养吸吮联合抚触,能更好地促使胃肠激素的分泌,刺激胃肠道的生长、发育和成熟,提高经肠道喂养的耐受性,还能加快吸吮反射的成熟,加快体格生长,促进早产儿的生长发育。     

早期喂养干预策略预防极低出生体重儿喂养不耐受的对比研究

目的 探讨以早期微最喂养、非营养性吸吮、温生理盐水灌肠和腹部按摩为主要内容的早期喂养干预策略预防极低出生体重儿(VILBWI)喂养不耐受的效果及其临床意义.方法 将实施早期喂养干预策略的30例VLBWI作为观察组,按照传统方法进行喂养的39例VLBWI作为对照组,记录胃管留置时间、胎粪排完时间和达到全胃肠喂养时间,记录发生喂养不耐受的例数并观察其临床表现;每天测定婴儿体重,计算体重增长速度、体重恢复至出生体重所需时间和体重达到2000g出院标准所需时间;检测婴儿血浆总蛋白、血尿素氮、血清总胆红素、胆固醇的变化.结果 观察组婴儿胃管留置时间、达到全胃肠喂养时间和胎粪排完时间均较对照组明显缩短,喂养不耐受发生率也较对照组明显降低.观察组婴儿体重增长速度明显快于对照组,婴儿体重恢复到出生体重的时间和达到2000克出院体重标准的时间较对照组明显缩短,观察组血清胆红素水平也明显低于对照组.结论 以早期微量喂养、非营养性吸吮、温生理盐水灌肠和腹部按摩为主要内容的早期喂养干预策略可有效降低极低出生体重儿喂养不耐受发生率,值得临床推广应用.     

早期喂养干预策略预防极低出生体重儿喂养不耐受的对比研究

目的探讨以早期微量喂养、非营养性吸吮、温生理盐水灌肠和腹部按摩为主要内容的早期喂养干预策略预防极低出生体重儿（VLBWI）喂养不耐受的效果及其临床意义。方法将实施早期喂养干预策略的30例VLBWI作为观察组,按照传统方法进行喂养的39例VLBWI作为对照组,记录胃管留置时间、胎粪排完时间和达到全胃肠喂养时间,记录发生喂养不耐受的例数并观察其临床表现;每天测定婴儿体重,计算体重增长速度、体重恢复至出生体重所需时间和体重达到2000g出院标准所需时间;检测婴儿血浆总蛋白、血尿素氮、血清总胆红素、胆同醇的变化。结果观察组婴儿胃管留置时间、达到全胃肠喂养时间和胎粪排完时间均较对照组明显缩短,喂养不耐受发生率也较对照组明显降低。观察组婴儿体重增长速度明显快于对照组,婴儿体重恢复到出生体重的时间和达到2000克出院体重标准的时间较对照组明显缩短,观察组血清胆红素水平也明显低于对照组。结论以早期微量喂养、非营养性吸吮、温生理盐水灌肠和腹部按摩为主要内容的早期喂养干预策略可有效降低极低出生体重儿喂养不耐受发生率,值得临床推广应用。     

极低体重儿早期和常规喂养的疗效观察

目的 探讨极低体重儿早期微量喂养的方法 及其喂养效果.方法 将我院收治的56例极低体重儿进行分组喂养,常规喂养组实施经口十二指肠管的喂养方法,早期喂养组在经口十二指肠管喂养基础上,采用腹部按摩、非营养性吸吮及肛管刺激等方法.结果 早期喂养组的患儿达到足量肠内喂养时间及出生体重的恢复时间明显短于常规喂养组,并且早期喂养组患儿并发低血糖的概率明显低于常规喂养组,常规喂养组发生喂养不耐受的机率高.早期喂养组患儿的增加奶量、排便量及排便次数均高于常规喂养组,其残留奶量、平均腹胀次数、胎便排净天数均明显低于常规喂养组.两组间差异均有统计学意义(P＜0.01).结论 早期胃肠喂养能够有效加快极低体重儿的体重增长,缩短静脉营养时间,从而尽快达到足量喂养和出生体重.     

影响极低出生体重儿胃肠喂养不耐受的相关因素及护理

目的 探讨极低出生体重儿（VLBWI）胃肠喂养不耐受的相关因素及护理经验。方法研究极低出生体重儿66例，总结喂养不耐受的相关因素及护理经验。结果66例极低出生体重儿胃肠喂养总的不耐受率为48％（32／66）。胃肠喂养和不耐受组患儿的胎龄、出生体重、开奶日龄、胃肠道营养达418．4KJ·kg^-1·d^-1的日龄、开始经口喂养日龄间差异均有显著性（P〈0．05）。结论VLBWI的胃肠喂养不耐受与患儿的胎龄、出生体重、开奶日龄等因素密切相关，早期、微量喂养、减少光线、疼痛刺激、利用非营养性吸吮，可促进胃肠功能成熟，提高喂养耐受性。     

无菌棉签蘸服糖水在极低出生体质量儿早期喂养中的应用

目的:探讨无菌棉签蘸服糖水对极低出生体质量儿吸吮吞咽及胃肠功能的影响.方法:将36例极低出生体质量儿随机分为观察组(17例)和对照组(19例).在常规治疗的基础上,观察组生后12小时内开始给予间歇鼻胃管喂养,每3小时1次,在每次鼻胃管喂养前用无菌棉签蘸服微量糖水,持续10天;对照组仅单纯给予间歇鼻胃管喂养.观察两组吸吮吞咽功能协调建立时间、恢复出生体质量时间、达足量肠内营养时间、发生喂养不耐受、高胆红素血症、呼吸暂停例次.结果:与对照组比较,观察组吸吮吞咽功能协调建立时间早(P<0.05),恢复出生体质量时间及达足量肠内营养时间快(P<0.05),发生喂养不耐受及高胆红素血症的人数减少(P<0.05).两组发生呼吸暂停例次数差异无统计学意义(P>0.05).结论:极低出生体质量儿在生后早期每次鼻胃管喂养前给予无菌棉签蘸服微量糖水能锻炼吸吮吞咽能力,促进胃肠道功能成熟,改善喂养不耐受,让患儿更易恢复出生体质量与达足量肠内营养,较少发生高胆红素血症.     

早产儿早期微量喂养及非营养性吸吮的疗效观察

目的观察早产儿早期微量喂养及非营养性吸吮的临床疗效。方法将72例早产儿随机分为观察组和对照组各36例,两组患儿入院后均实施常规部分静脉营养,在此基础上,对照组:常规鼻饲,起始奶量2ml/kg,用注射器抽取每次所需奶量,连接胃管,每2h将奶量1次性注到胃内,10～15min注完,每天递增奶量1ml/kg;观察组:起始奶量2ml/kg,以推注式电子输液泵泵入,泵入时间1h,每2h1次,每天递增奶量1ml/kg,同时给予非营养性吸吮,即每次喂养期间吸吮安慰奶嘴3～5min。观察两组早产儿自行吸吮母乳时间、恢复出生体重时间、达足量胃肠喂养时间、胃管留置时间、住院时间及喂养不耐受发生率。结果观察组早产儿自行吸吮母乳时间、恢复出生体重时间、达足量胃肠喂养时间、胃管留置时间及住院时间均比对照组明显缩短(P均<0.001),喂养不耐受发生率也比对照组明显减少(P<0.001)。结论早产儿早期微量喂养及非营养性吸吮干预,可提高早产儿的喂养耐受性,帮助早产儿尽早从肠外营养过渡到经口喂养,促进早产儿体质量的规律性增长,具有广阔的应用前景。     

护理干预对58例极低体重新生儿的影响

目的探讨极低体重儿的有效护理干预方法。方法随机地将116例极低体重儿分为干预组（A组）58例和对照组（B组）58例。观察两组婴儿的存活率、恢复出生体重时间、达足量喂养时间、吸吮吞咽功能建立时间、并发症发生率、住院天数等项目。结果经过护理干预后,A组新生儿在减少并发症发生率、吸吮吞咽功能建立时间、达足量喂养时间、住院天数等方面明显优于B组,差异有统计学意义（P〈0.05）。结论对极低体重儿实施护理干预可促进其体重增长,降低并发症的发生率,值得临床上推广。     

极低出生体重早产儿早期干预的护理体会

国内报道,极低出生体重早产儿的死亡率为63％～74％,国外资料为33％-70％。胎龄越小,体重越低,死亡率越高。本科2007年1月～2009年4月,通过对极低出生体重早产儿进行早期经FI微量喂养的同时给予非营养性吸吮干预治疗和护理手段,有助于早产儿从静脉营养过渡到胃肠营养,减少喂养不耐受等并发症的发生,改善早产儿营养状态,加快早产儿体重增长,缩短住院时间。     

“医”与“法”

2003年8月中,惠氏百宫制药有限公司邀请广东地区各大医院的专家和医院管理人员在广东东莞举行了一场别开生面的研讨会。会议包括两个议题:一是“特治星治疗严重呼吸道感染”的学术研讨;二是“医疗纠纷处理的新规则与新思路”的研讨。会上“热点”不断,台上、台下观点撞击精彩纷呈,这里我们摘录片段与大家共享。     

Laboratory Verification of "heavy" and "light" users of cannabis

For various experimental studies it is often desirable to classify categories of cannabis use. For instance, in a study of the kinetics of δ-9-tetrahydrocannabinol (THC) in man, we wanted to see if there were differences between “heavy” and “light” users of the drug. “Heavy” use was defined as once daily or more, while “light” use was defined as sporadic or occasional, no more frequent than once monthly.Previously, we had found that the 11-oic acid of THC was not only the major metabolite to appear in the urine but also that its appearance in urine was prompt and lasted for at least 72 hours after a single exposure [1]. We decided to use the presence of this material in urine as a marker for heavy and light use; one would expect to find it regularly in heavy users and rarely, if at all, among light users. All subjects entering the study declared their pattern of use and then were asked to provide a spontaneously voided urine, to be used for analysis of THC-11-oic acid.     

以"豆"祛"痘"

虽然早已过了青春期,但我那略显"婴儿肥"的脸上还是会不时地出现些小痘痘.为了消除这些可恶的家伙,我还真是没少折腾,又是吃药、吃保健品,又是用化妆品,可痘痘却大有"野火烧不尽,春风吹又生"之势,看来要消灭它们可不是件容易的事.     

Activity of "reversed" diamidines against Trypanosoma cruzi "in vitro"

Chagas' disease is an important parasitic illness caused by the flagellated protozoan Trypanosoma cruzi. The disease affects nearly 17 million individuals in endemic areas of Latin America and the current chemotherapy is quite unsatisfactory based on nitroheterocyclic agents (nifurtimox and benznidazol). The need for new compounds with different modes of action is clear. Due to the broad-spectrum antimicrobial activity of the aromatic dicationic compounds, this study focused on the activity of four such diamidines (DB811, DB889, DB786, DB702) and a closely related diguanidine (DB711) against bloodstream trypomastigotes as well as intracellular amastigotes of T. cruzi in vitro. Additional studies were also conducted to access the toxicity of the compounds against mammalian cells in vitro. Our data show that the four diamidines compounds presented early and high anti-parasitic activity (IC50 in low-micromolecular range) exhibiting trypanocidal dose-dependent effects against both trypomastigote and amastigote forms of T. cruzi 2h after drug treatment. Most of the diamidines compounds (except the DB702) exerted high anti-parasitic activity and low toxicity to the mammalian cells. Our results show the activity of reversed diamidines against T. cruzi and suggested that the compounds merit in vivo studies.     

"Central" and "peripheral" benzodiazepines and kinetics of lindane-induced toxicity

Because hypothermia and anorexia were previously found to be more sensitive indices of the effects of lindane than were convulsions, these endpoints were used to quantify the ability of benzodiazepines (BDs) and phenytoin either to ameliorate or exacerbate the toxicity of lindane in the rat. After administration of lindane (40 or 50 mg/kg) in oil per os, toxicity was counteracted by phenytoin and the "central" BD agonists diazepam and clonazepam, but was worsened by Ro 5-4864 a "peripheral" BD agonist. Clonazepam and diazepam were each more effective in counteracting lindane-induced anorexia than in stimulating food intake, presumably because the animals had been fasted and probably even controls ate maximally when food was presented. Diazepam alone (3 injections in 1 day) produced withdrawal-induced decreased food intake the following day. Clonazepam and diazepam alone each transiently decreased colonic temperature, yet effectively blocked the more severe hypothermia produced by lindane. Ro 5-4864 by itself did not produce any measurable effects, yet exacerbated all of the effects, including lethal effects, of lindane. The present findings are compatible with other evidence that lindane and Ro 5-4864 act at the picrotoxinin receptor of the GABAA-activated chloride channel and that systemic administration of agents acting at this site may produce a constellation of effects, including seizures, hypothermia and anorexia.