穴位按摩联合艾灸降低妇科腹腔镜术后并发症的护理研究

[目的]探讨穴位按摩联合艾灸减轻妇科腹腔镜术后常见并发症的效果.[方法]将200例妇科腹腔镜手术病人随机分为干预组和对照组,每组100例.对照组给予常规术后护理干预,干预组则在执行常规术后护理干预基础上配合内关穴、足三里穴、中脘穴穴位按摩联合艾灸治疗,评价两组并发症发生情况及术后肛门排气时间.[结果]干预组术后不同时间常见并发症较对照组轻(P＜0.05);肛门排气时间早于对照组(P＜0.05).[结论]穴位按摩联合艾灸能有效缓解妇科腹腔镜术后病人的常见并发症,缩短术后首次肛门排气的时间.     

穴位按摩联合艾灸降低妇科腹腔镜术后并发症的护理研究

[目的]探讨穴位按摩联合艾灸减轻妇科腹腔镜术后常见并发症的效果。[方法]将200例妇科腹腔镜手术病人随机分为干预组和对照组,每组100例。对照组给予常规术后护理干预,干预组则在执行常规术后护理干预基础上配合内关穴、足三里穴、中脘穴穴位按摩联合艾灸治疗,评价两组并发症发生情况及术后肛门排气时间。[结果]干预组术后不同时间常见并发症较对照组轻（P〈0.05）;肛门排气时间早于对照组（P〈0.05）。[结论]穴位按摩联合艾灸能有效缓解妇科腹腔镜术后病人的常见并发症,缩短术后首次肛门排气的时间。     

穴位敷贴联合耳穴埋豆按压对预防妇科患者术后恶心呕吐的效果

目的 探讨中药穴位贴敷配合耳穴埋豆对预防妇科患者术后恶心、呕吐的效果。方法 将2016年3月-2017年2月我科收治52例妇科手术患者设为对照组,2017年3月-2018年3月收治的44例妇科手术患者设为观察组。对照组采用妇科术后常规护理措施,观察组在对照组基础上增加双侧内关穴敷贴联合双侧耳穴埋豆按压进行干预。比较2组患者术后24h内发生恶心、呕吐的情况。结果 观察组发生恶心、呕吐的症状明显轻于对照组(Z=-2.965,P=0.003)。 结论 对行妇科手术的患者实施耳穴埋豆联合中药穴位贴敷进行干预,可以有效减轻患者术后恶心、呕吐症状,且该干预操作简单,患者接受度高,可在临床上推广应用。     

中药穴位敷贴对妇科手术后肠蠕动恢复的影响研究

选取我院2014年6月~9月收治的100例进行妇科手术患者,随机分为两组,对照组采用妇科腹部手术后常规护理,试验组在对照组基础上配合中药穴位敷贴进行干预。结果试验组采用中药穴位敷贴的总有效为90.0%,对照组采用常规护理的总有效为70.0%。且试验组术后首次肛门排气、排便时间明显短于对照组,两组差距较明显,具有统计学意义(P<0.05)。中药穴位敷贴可促进妇科手术后肠蠕动的恢复,效果良好。     

足三里穴位注射新斯的明治疗腹腔镜术后腹胀的疗效观察

目的观察足三里穴位注射新斯的明治疗妇科腹腔镜术后腹胀的临床疗效。方法 106例妇科腹腔镜术后腹胀患者随机分为观察组和对照组,各53例。对照组常规护理并给予足三里穴位按摩,观察组在对照组基础上给予足三里穴位注射新斯的明联合足三里穴位按摩。比较2组肠鸣音恢复时间和术后肛门排气时间。结果观察组肠鸣音恢复时间和术后肛门排气时间均早于对照组,差异有统计学意义(P0.05)。结论足三里穴位注射新斯的明能有效缓解腹腔镜术后腹胀。     

口服山蜡梅叶配合穴位按摩促进妇科开腹术后患者胃肠功能恢复

目的 观察口服山蜡梅叶配合穴位按摩对妇科开腹术后患者胃肠功能恢复的影响.方法 随机将妇科开腹术后68例患者分为观察组和对照组.观察组38例术后患者在妇科常规护理及指导基础上,于术后6 h开始口服山蜡梅叶配合手法按摩躯干两侧足三里穴位;对照组38例给予术后常规护理及指导.两组均术后定时记录肠蠕动开始时间及肛门排气的时间....     

热敷背腧穴合并穴位敷贴对术后腹胀的疗效

目的观察穴位敷贴联合热敷背腧穴对妇科腹部手术后腹胀的疗效。方法选择80例妇科腹部手术后出现腹胀的患者随机分为联合组(41例)和对照组(39例),联合组采用热敷腰骶部背腧穴联合穴位敷贴治疗,对照组只采用穴位敷贴治疗,观察两组患者术后肠鸣音恢复时间、术后排气时间、术后排便时间。结果联合组的术后肠鸣音恢复时间、术后排气时间、术后排便时间均比对照组短,差异有统计学意义(P0.05)。结论热敷腰骶部背腧穴联合穴位敷贴治疗能促进妇科腹部手术后胃肠功能的恢复。     

专项护理对妇科术后患者复苏期间恶心呕吐发生情况的影响

目的 探讨专项护理对妇科术后患者复苏期间恶心呕吐发生情况的影响。方法 选取2019年1月～2020年1月我院收治的妇科手术患者80例,随机分为对照组和研究组各40例。对照组给予常规护理,在此基础上研究组给予复苏期专项护理干预。比较两组患者干预后胃肠蠕动时间、肛门排气时间、肛门自行排便时间;比较两组患者复苏期间恶心呕吐发生率。结果 研究组患者胃肠蠕动时间、肛门排气时间、肛门自行排便时间均短于对照组(P0.05);研究组患者恶心呕吐发生率为67.50%,显著低于对照组的90.00%(P0.05)。结论 对妇科术后患者施行复苏期间专项护理干预,能够缩短患者胃肠蠕动时间、肛门排气时间、肛门自行排便时间,有效改善患者复苏期间恶心呕吐发生率,提高了护理质量。     

快速康复护理策略结合疼痛护理干预对妇科腹腔镜围术期患者的影响

目的 分析快速康复护理策略结合疼痛护理干预对妇科腹腔镜围术期患者术后疼痛、心理应激及术后恢复的影响。方法 选 取 2019 年 12 月至 2021 年 12 月本院收治的 200 例妇科腹腔镜手术患者为研究对象。随机分为对照组和干预组,每组各 100 例。 对照组给予快速康复护理,干预组给予快速康复护理策略结合疼痛护理。分析比较两组的疼痛情况、心理应激水平以及术后恢 复情况。结果 干预组术后 12h、24h、48h 以及 72h 的 VAS 评分均明显低于对照组（P<0.05）。干预后,干预组的 SAS 评分、 SDS 评分均明显低于对照组（P<0.05）。干预组肛门恢复排气时间、下床活动时间以及住院时间均明显短于对照组（P<0.05）。 干预组使用药物镇痛的例数显著少于对照组（P<0.05）。结论 快速康复护理策略结合疼痛护理干预,能缓解妇科腹腔镜围术期 患者的术后疼痛,减轻患者心理应激,促进患者术后康复。     

穴位贴敷对腹腔镜胆囊切除术后患者恶心呕吐的影响及满意度分析

目的 探讨穴位贴敷应用于腹腔镜胆囊切除术后患者对其恶心呕吐的改善效果及满意度的影响。方法 回顾性分析2021年1月至2022年8月我院收治的腹腔镜胆囊切除术后患者40例,按护理方法不同分为观察组和对照组各20例。对照组给予术后常规护理,观察组在对照组基础上给予穴位敷贴干预。比较两组患者鸣音恢复时间、肛门排便时间、肛门排气时间、首次下床活动时间、住院时间,术后24 h内恶心呕吐的发生情况,干预前后的中医症状积分及干预后的满意度。结果 观察组肠鸣音恢复时间、肛门排便时间、肛门排气时间、首次下床活动时间、住院时间均短于对照组（P<0.05）;术后24 h内观察组患者恶心呕吐症状Ⅱ～Ⅳ级的发生率低于对照组（P<0.05）;干预后,两组患者恶心呕吐、口干口苦、疼痛拒按评分均低于干预前,且观察组低于对照组（P<0.05）;干预后,观察组患者总满意度高于对照组（（P<0.05））。结论 穴位贴敷应用于腹腔镜胆囊切除术后患者可有效改善临床症状,缩短术后恢复时间,减少恶心呕吐的发生,提高干预满意度。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.