重症肺结核合并多器官衰竭抢救体会

重症肺结核常合并多器官功能受损,抢救治疗十分困难,往往因某些脏器衰竭而死亡。我科应用丹参和山莨菪碱(654-2)抢救治疗重症肺结核并多器官衰竭32例,疗效满意,报告如下。 1 资料与方法 1.1 病例选择本组32例均为确诊重症肺结核,即X线上表现为病变范围3个肺野或更     

重型颅脑损伤合并多脏器伤的急救与护理

目的探讨重型颅脑损伤合并多脏器伤患者的抢救及护理。方法对125例重型颅脑外伤合并多脏器伤患者给予积极救治和精心护理。结果认真做好伤情评估,严密观察病情变化,保持呼吸道通畅,加强治疗和护理,预防并发症发生是抢救成功的重要保证。结论熟练的抢救技术,积极有效的护理措施,是提高重型颅脑外伤患者抢救成功率的必要条件。     

新生儿重度窒息100例抢救护理体会

目的：提高新生儿重度窒息复苏抢救的成功率。方法：将100例新生儿重度窒息患儿随机分成两组,即治疗组与对照组各50例,对照组按传统的ABCDE复苏方案进行抢救护理。治疗组按我院综合技术进行抢救护理。观察两组的抢救成功率与并发症。结果：治疗组比对照组抢救成功率明显提高,并发症明显降低。结论：综合技术抢救护理新生儿重度窒息优于传统的ABCDE,它可明显提高抢救的成功率,降低死亡率,减少并发症,降低致残率。     

骨盆骨折的急救与护理

目的探讨临床骨盆骨折患者的急救与治疗过程中的相关护理措施。方法收集2005—2012年期间收治的骨盆骨折病例40例,对临床急诊与治疗的具体护理措施进行回顾性分析与总结。结果所有患者在入院半小时内初步完成检查及评估,急诊骨盆外固定均在外完成,1例患者周严重失血性休克,导致多器官衰竭死亡,其余患者均抢救成功。结论抢救骨盆骨折的患者,通过科学有序的抢救步骤和执行正确护理程序,才能有效杜绝或减少并发症的发生,避免致残及致死率的发生。     

醒脑静与纳洛酮联合治疗急性乙醇中毒34例临床观察

在医院急诊抢救的病例中,因服用药物引起的急性中毒发生率很高,尤其近年来以急性乙醇中毒为多见,治疗方法各异。我们采用醒脑静与纳洛酮联合治疗急性乙醇中毒昏迷者32例,疗效显著,报告如下。     

高压氧舱内昏迷患者常见并发症的护理

在高压氧舱进行抢救与治疗的患者中,昏迷患者占相当的比例,且多由于脑血管病、颅脑损伤、中毒、缺血缺氧性脑病等原因所致.由于自身防御能力降低,生活均不能自理,很容易发生各种并发症,因此在高压氧治疗中,医护人员一定要认真加强病情观察[1],积极预防各种并发症的发生.现将昏迷患者在高压氧舱内抢救治疗中主要并发症的护理总结如下.     

连续性肾脏替代治疗在高原危急重症中的应用时机探讨

目的探索应用连续性肾脏替代治疗（CRRT）抢救高原危急重症病人的治疗时机。方法对伴有急性肾衰（acute renal failure,ARF）及多脏器功能衰竭（multi organ failure,MOF）32例病人,应用CRRT进行治疗,并观察临床各项指标变化。结果早期治疗18例中,8例患者痊愈,6例病情平稳,4例病情恶化;晚期治疗14例中5例痊愈,9例病情恶化死亡。结论CRRT是抢救高原危急重症的有效方法,早期应用能显著提高抢救成功率。     

血液灌流联合血液透析抢救重症中毒患者的护理体会

目的为提高急性重症中毒患者的抢救成功率,探讨血液灌流联合血液透析技术在抢救重症中毒患者中的治疗效果。方法对56例重症中毒患者采用血液灌流联合血液透析的临床资料进行分析。结果血液灌流联合血液透析能有效清除体内有毒物质,本组病例有54例治愈,2例因时间过长引起多脏器功能衰竭而死亡。结论血液灌流联合血液透析是抢救急性重症中毒的快速而有效的重要治疗方法。     

老年严重呼吸衰竭、心力衰竭的抢救与治疗

目的：探讨老年性严重呼吸衰竭和心力衰竭患者的抢救与治疗方法。方法：对6例严重呼吸衰竭与心力衰竭的患者实行机械通气治疗后,给予抗心衰治疗,其中1例安置临时起搏器,观察动脉血气、血流动力学及心功能的变化。结果：人工机械通气后,患者的PaCO2下降,PaO2上升,呼吸性酸中毒得以改善。抗心衰治疗后,PaO2进一步上升,HCO3-下降,心功能得以改善。6例患者全部脱机,好转出院。随访1～8年,6例患者全部存活,且生存质量提高。结论：严重呼吸衰竭合并心力衰竭患者,应行人工机械通气,同时纠正心衰,是改善患者严重状态与脱机的一项重要条件,提示在多脏器功能衰竭的抢救中改善心脏功能是提高抢救成功率及愈后的一个中心环节。     

6例特重烧伤患者的营养支持治疗

营养支持是烧伤患者综合治疗的重要组成部分,尤其是在特重烧伤患者的抢救与治疗中起着重要作用.我们应用营养支持配合临床抢救,治疗了6例特重烧伤患者,效果满意,现报道如下.     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.