共查询到19条相似文献,搜索用时 78 毫秒
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经桡动脉行冠状动脉造影/介入治疗因并发症少、痛苦小而广泛应用于临床.因穿刺易损伤桡动脉,且术后使用抗凝药物,若穿刺点处理不当,穿刺部位易出现渗血、前臂血肿,给患者带来心理压力,影响治疗效果. 相似文献
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目的:比较两种方法用于介入治疗先心痛手术压迫止血的效果及护理.方法:选取住院行介入治疗的先心病患者100例作为对象,将50例患者介入治疗后使用止血敷井壳聚糖分为观察组,介入治疗后使用传统压迫止血的50例患者设为对照组.通过护士观察,比较2组患者术后伤口表面覆料的渗、出血情况及患者制动期间的耐受差异、全身夏穿刺肢体的并发症的情况.结果:止血敷料壳聚糖组术中止血操作、术后伤口覆料的渗血及患者穿刺侧肢体的制动时间明王少于对照组(p<0.001),同时,壳聚糖组出现全身及穿刺侧肢体的并发症的几率少于对照组.结论:介入治疗先心病手术后辅助应用止血敷料壳聚糖,可明显缩短患者介入术后的穿刺点的渗血及穿刺侧肢体的被动制动时间,减少了术后并发症的发生几率,易于被患者家属所接受,也有利于提高护理工作的效率. 相似文献
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经桡动脉行冠状动脉造影/介入治疗因并发症少、痛苦小而广泛应用于临床。因穿刺易损伤桡动脉,且术后使用抗凝药物,若穿刺点处理不当,穿刺部位易出现渗血、前臂血肿。给患者带来心理压力,影响治疗效果。2008年1~12月我科将橡皮擦用于566例经桡动脉行冠状动脉介入治疗患者,以预防穿刺部位出血,效果较好,介绍如下。 相似文献
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目的 探讨不同穿刺点止血方案对于脑血管内支架植入术后血管并发症的作用.方法 收集2019年1月至2020年10月在海军军医大学第二附属医院接受经皮血管内支架成形术(PTAS)治疗的缺血性脑血管病(ICVD)患者的临床资料,并根据压迫方式不同分为常规组(采用常规压迫止血方案)和观察组(采用短时指压止血方案),各39例.比... 相似文献
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目的系统评价经股动脉穿刺后血管闭合器、血管压迫器、弹力绷带加压法3种止血方式的安全性及效果。方法选取2019年2月至2021年1月首都医科大学附属北京康复医院收治的121例行周围血管介入术的非下肢动脉病变患者,按照住院顺序号将患者分为血管闭合器组(n=42,应用血管闭合器进行股动脉穿刺部位止血)、血管压迫器组(n=40,应用股动脉电子压迫止血器进行股动脉穿刺部位止血)与弹力绷带压迫组(n=39,应用弹力绷带压迫进行股动脉穿刺部位止血)。比较3组患者术前、术后1 d及术后3个月手术穿刺部位及周围3 cm内股动脉最小内径及收缩期峰值血流速度,并观察其术后1 d轻度和严重并发症的发生情况。结果术后1 d,血管闭合器组患者的穿刺部位及周围3 cm内股动脉最小内径小于血管压迫器组和弹力绷带压迫组患者,且血管压迫器组患者的穿刺部位及周围3 cm内股动脉最小内径小于弹力绷带压迫组患者(P<0.05)。术后1 d,血管闭合器组、血管压迫器组患者穿刺处范围内最小内径处的收缩期峰值血流速度均低于弹力绷带压迫组患者(P<0.05)。术后3个月,血管闭合器组患者的穿刺部位及周围3 cm内股动脉最小内径小于弹力绷带压迫组患者;血管闭合器组患者穿刺处范围内最小内径处的收缩期峰值血流速度低于血管压迫器组、弹力绷带压迫组患者,且血管压迫器组患者穿刺处范围内最小内径处的收缩期峰值血流速度低于弹力绷带压迫组患者(P<0.05)。术后1 d,3组患者的轻度及严重并发症总发生率比较,差异均无统计学意义(P>0.05)。结论经股动脉穿刺后3种止血方式均影响穿刺部位附近的血管内径及收缩期峰值血流速度。血管闭合器对患者术后3个月预后情况的影响最大,其次是血管压迫器,弹力绷带加压法对患者术后3个月预后的影响最小。 相似文献
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目的 探讨经股动脉介入治疗术后有效、安全的压迫止血方法。方法 将86例经股动脉介入治疗术后患者随机分为传统组(50例)与改进组(36例)。传统组采用常规压迫止血法,改进组采用一次性股动(静)脉气囊压迫止血带进行压力递减压迫止血。观察两组术肢制动时间、血管并发症及不良反应。结果改进组术肢制动时间厦血管并发症,腰酸、腹胀发生率显著低于传统组(P〈0.01,P〈0.05)。结论经股动脉介入治疗术后通过压力递减法进行压迫止血。既可达到有效压迫止血的目的,又能减少传统压迫止血所致的不良反应。 相似文献
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目的 探讨组合式压迫止血器在经肱动脉路径行冠脉动脉介入治疗压迫止血的效果。方法 将经肱动脉路径行冠状动脉介入治疗患者60例分成两组各30例。对照组采用3M弹力绷带加压包扎的常规止血方法,观察组采用组合式压迫止血器压迫止血。比较两组压迫止血即刻,术后2 h、4 h、6 h出血发生率、局部肿胀程度及疼痛评分;压迫24 h局部压力性损伤发生率。结果 观察组不同时段局部肿胀程度及疼痛评分显著低于对照组,总出血发生率和压力性损伤发生率显著低于对照组(均P<0.05)。结论 组合式肱动脉止血器应用于经肱动脉路径行冠状动脉介入治疗压迫止血效果良好,操作安全且能减轻患者疼痛,预防压力性损伤发生。 相似文献
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目的提高脑血管病介入术患者健康教育效果和满意度。方法将行脑血管病介入术的84例患者按时间段分为对照组与观察组各42例。对照组采取口头宣教加发放小卡片方式实施健康教育;观察组在常规健康教育基础上开展微视频教育。于术后24 h评价效果。结果干预后,观察组脑血管病介入术知识得分、诊疗依从性及健康教育满意度显著高于对照组(P<0.05,P<0.01)。结论微视频扫码用于脑血管病介入术患者健康教育可有效提高患者知识掌握程度,从而提高诊疗依从性和健康教育满意度。 相似文献
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实施护理专案降低脑血管介入术后穿刺部位渗血发生率 总被引:1,自引:0,他引:1
目的通过护理专案改善活动降低脑血管介入术后穿刺部位渗血发生率。方法成立护理专案小组,通过对160例患者的现况分析,确立"降低脑血管介入术后穿刺部位渗血发生率"为活动主题,对现况进行要因分析,确定问题,设定目标,制定对策及组织实施于150例患者。结果脑血管介入术后穿刺部位渗血发生率由专案改善活动前的8.8%降低至2.0%,护理缺漏率由专案改善活动前的9.1%降低至2.7%(均P0.01)。结论针对脑血管介入术后穿刺部位渗血问题采取护理专案活动,有效降低了渗血率,提高了护理质量。 相似文献
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T Aoki Y Tabata Y Azuma H Nakahashi N Iwamoto N Yamamoto T Ono 《Hinyokika kiyo. Acta urologica Japonica》1987,33(6):915-919
This is a report of blood access puncture point pseudoaneurysms which occurred in two hemodialysis patients. Case 1: A 58-year-old male had been undergoing hemodialysis treatment since June, 1975. In January, 1981 a subcutaneous mass had developed at the blood access puncture point above the previously superficialized left femoral artery. An operation was performed in February, 1981 and the mass was dissected. The same artery has been used since the operation for blood access without any problems. The dimensions of the egg-shaped dissected mass were 3.5 X 4 X 2.5 cm. A histological diagnosis of the wall of the mass showed that it was a pseudoaneurysm. Case 2: A 48-year-old female had been undergoing hemodialysis treatment since September, 1983. The left basilic vein, connected to the brachial artery, has been used for blood access. In April, 1984, a subcutaneous mass had developed at the blood access puncture point and an operation was performed within a few days. Operative findings revealed that the mass was a capsulized infected hematoma with a smooth but extremely thin and easily ruptured surface, and the section of the basilic vein surrounded by the mass showed evidence of necrotic change due to compression. The brachial artery was resutured at the region where it was previously connected to the basilic vein without disturbance of arterial blood flow. In July, 1985, an operation was performed in which a new blood access was constructed in the left thigh by superficializing the femoral artery and connecting its side to the end of the saphenous vein.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
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背景与目的:尽管大量的动物实验已证实远隔缺血预处理(RIPC)可显著改善肝切除术后残余肝早期的组织灌注和氧合作用,减少肝缺血-再灌注损伤(HIRI),改善手术预后,提高生存率。然而,在临床研究中关于RIPC减少HIRI的作用仍存在争议。因此,本研究通过Meta分析评价RIPC在肝切除术中的有效性和安全性,为临床提供循证参考。方法:检索多个国内外文献数据库,收集评估RIPC策略有效性和安全性的随机对照试验(RCT),检索时间段为建库至2022年5月。对纳入的RCT进行质量评价,采用Revman 5.3统计软件进行分析。主要评价指标为术后肝功能指标、手术时间、术中出血量、住院时间、主要手术并发症。结果:共纳入11项RCT,包含851例患者,其中RIPC组422例,对照组429例。Meta分析结果显示,两组术前各项肝功能指标差异均无统计学意义(均P>0.05);术后第1天,RIPC组的丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)水平明显低于对照组(WMD=-74.92,95%CI=-126.18~-23.67,P=0.004;WMD=-66.37,95%CI=-106.4... 相似文献
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《Best Practice & Research: Clinical Anaesthesiology》2000,14(1):125-141
Surgery for cerebrovascular disease (cerebral aneurysms, arteriovenous malformations and stenosis of the internal carotid artery) is a relatively common procedure. A detailed knowledge of cerebral (patho-) physiology and of the accompanying diseases in these different groups of patients is required for anaesthesia of patients undergoing aneurysm clipping, obliteration of arteriovenous malformations or carotid endarterectomy. In all three subgroups of cerebrovascular disease, the protection of cerebral function is the main goal of peri-operative anaesthesia care. Cardiovascular diseases such as coronary vascular disease, arterial hypertension and cardiac dysrhythmias play an important role in the management of these patients. In this chapter, the evaluation of patients, pre- and intraoperative management and anaesthetic techniques for cerebrovascular surgery will be described. Intraoperative cerebroprotection is also briefly discussed. No large, prospective, randomized study has yet determined the best mode of anaesthesia for any of these procedures. Therefore, methods based on relevant animal experiments, on indications from reliable human studies and on clinical experience with a large number of patients will also be described. 相似文献
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Pei-Ching Chen Jia-Ling Sun Hsiu-Chuang Hsu Yao-Hui Lai Yu-Chien Liao Pei-Ying Chen Hui-Chen Chang 《Seminars in dialysis》2023,36(6):454-461
Introduction: Arteriovenous fistula or arteriovenous graft is essential to long-term survival and quality of life in patients receiving hemodialysis. To date, no research has examined the clinical impacts of different puncture methods. This study compared the rope ladder and area puncture techniques in terms of vascular patency, pain, and quality of life among patients receiving hemodialysis. Methods: A prospective longitudinal study was performed with 6-month follow-up. A total of 98 participants recruited from a hemodialysis center in Taiwan were randomly assigned to receive the rope ladder technique (experimental group) or the area puncture technique (control group). Vascular patency was assessed by examining access flow and percutaneous transluminal angioplasty rate. Pain and quality of life were measured using the Numerical Pain Rating Scale (NPRS) and Kidney Disease Quality of Life Instrument (KDQOL-36™), respectively. All outcome variables were measured repeatedly and analyzed using a generalized estimating equation. Results: Overall, quality of life was significantly better for the experimental group than for the control group (β = 47.23, p < 0.001). The percutaneous transluminal angioplasty rate was lower for the experimental group than for the control group (12.0% vs. 18.8%). However, no significant differences were found in access flow and pain level between the two groups over time. Conclusion: Hemodialysis patients who received the rope ladder puncture technique had a lower percutaneous angioplasty rate and better quality of life than patients who received the area puncture technique, suggesting that the rope ladder technique could be implemented as a routine cannulation method in hemodialysis clinics. 相似文献
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在外科临床工作中,常常面临伴有脑血管疾病的患者罹患需行手术干预的腹部疾病。如何兼顾在腹部外科围手术期对并发脑血管疾病的患者进行正确的处理,避免因手术进一步加重脑血管并发症或因脑血管疾病而影响外科手术的效果,防止顾此失彼,已日益成为外科医生关注的问题之一。本文针对此类问题,从围腹部手术期患者伴有脑血管并发病的种类及特点、围手术期处理、诱发因素及相关并发症防治等方面加以探讨分析,提高重视程度,正确制定治疗方案,力求达到双赢的满意治疗效果。 相似文献
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Both the radiology and surgery literature mention "popcorn calcification" as a diagnostic aid in identifying pulmonary hamartomas. Nineteen patients underwent resection of pulmonary hamartomas at North Carolina Memorial Hospital between January 1969 and February 1983, representing 1.9 per cent of all thoracotomies performed for pulmonary disease. Of the 19 patients, there were 12 men (63%) and 7 women (37%), and most were asymptomatic. Chest x-ray demonstrated 12 right-sided and 7 left-sided lesions. All masses were located peripherally in the lung parenchyma and in no instance was calcification present. Fourteen wedge resections and 5 lobectomies were performed. Pathologic examination confirmed the absence of calcification; however, in two cases (11%) an associated malignancy was present. There were no operative deaths and only minor postoperative complications. All problems resolved without difficulty. These data show that pulmonary hamartomas are not commonly associated with calcification, and there may be an increased association with carcinoma of the lung. Excision can be performed with minimal morbidity and is necessary to distinguish hamartomas from malignant lesions. 相似文献