胃管插入速度的探讨

目的 探讨胃管插入速度与一次插管成功及病人反应之间的关系。方法 98例胃管插入病人,按自然排序随机分为两组,分别采用缓速和快速插管法插入胃管,记录插管所需时间,判断一次插管成功与否,观察病人反应。结果 缓速插管法和快速插管法所需时间分别为(25±3.2)s、(12±0.8)s;缓速插管法和快速插管法一次插管成功分别为47例、38例。丽组的插管时间,一次成功率和病人反应经比较P<0.05或P<0.01,有统计学意义。结论 缓速插管法优于快速插管法。     

缓速与快速置胃管方法的效果观察

目的:探讨胃管插入速度与一次插胃管成功及病人反应之间的关系。方法:将88例需插胃管的病人随机分为两组各44例,分别采用缓速和快速插管法插入胃管,记录插管所需时间,判断一次插管成功与否,观察病人反应。结果:缓速插管法与快速插管法所需时间分别为(24.36±3.37)、(20.78±0.86)s;缓速插管法和快速插管法一次插管成功分别为43、32例。两组插管时间、一次插管成功率和病人反应比较,P<0.05,有显著统计学意义。结论:缓速插管法优于快速插管法。     

缓速插管法用于老年男性导尿的临床研究

目的　探讨导尿管插入速度与一次插管成功及病人反应之间的关系。方法　98例老年男性留置尿管病人,按自然排序随机分成2组,分别采用缓速和快速插管法插尿管,记录插尿管所需时间及一次插管成功与否,观察病人反应。结果　缓速插管法和快速插管法所需时间分别为(2 8.0±2 .0 )s、(1 4 .0±2 .2 )s;缓速插管法和快速插管法一次插管成功分别为4 6 ,37例。2组的插管时间、一次成功率和病人反应经比较P <0 .0 5或P <0 .0 1 ,差异有统计学意义。结论　缓速插管法优于快速插管法。     

吞咽温水置胃管52例临床效果观察

目的:探讨在吞咽温水的同时置入胃管的可行性。方法:将104例患者随机分为吞咽组(52例)和对照组(52例)。吞咽组在插胃管时口含温水10～15ml,随吞咽温水动作将胃管插入胃内;对照组按常规法插胃管。结果:吞咽组与对照组一次插管成功率分别为91.7%、59.6%;呕吐发生率分别为4.2%及23.1%;呛咳发生率分别为4.2%及26.90%;插管时间分别为(1.6±1.2)min及(2.1±1.6)min;患者舒适率分别为85.4%和48.1%,两组比较,差异有显著性意义(均P<0.01)。结论:吞咽温水置胃管法能减轻患者痛苦,提高一次量管成功率。     

三种不同插胃管方法在清醒患者中的效果比较

目的：探讨快速插管法、口服温开水插管法及缓慢插管法三种插胃管方法的一次插管成功率及患者舒适度的关系。方法将本院普外科2011年8月至2012年3月的168例插胃管病人随机分为三组，分别采用不同插胃管方法，比较三组患者插胃管一次成功率及患者反应。结果快速插管组与口服温开水组一次成功率及患者反应比较差异均无统计学意义(P>0.05)，两者与缓慢插管组一次成功率及患者反应比较差异均有统计学意义( P<0.05)。结论快速插管法及口服温开水法均优于缓慢插管法。而在实际操作中，快速插管法更优于口服温开水法。     

吞咽温水置胃管52例临床效果观察

目的:探讨在吞咽温水的同时置入胃管的可行性.方法:将104例患者随机分为吞咽组(52例)和对照组(52例).吞咽组在插胃管时口含温水10～15 ml,随吞咽温水动作将胃管插入胃内;对照组按常规法插胃管.结果:吞咽组与对照组一次插管成功率分别为91.7%、59.6%;呕吐发生率分别为4.2%及23.1%;呛咳发生率分别为4.2%及26.90%;插管时间分别为(1.6±1.2)min及(2.1±1.6)min;患者舒适率分别为85.4%和48.1%,两组比较,差异有显著性意义(均P<0.01).结论:吞咽温水置胃管法能减轻患者痛苦,提高一次置管成功率.     

吞咽温水置胃管52例临床效果观察

目的:探讨在吞咽温水的同时置入胃管的可行性.方法:将104例患者随机分为吞咽组(52例)和对照组(52例).吞咽组在插胃管时口含温水10～15 ml,随吞咽温水动作将胃管插入胃内;对照组按常规法插胃管.结果:吞咽组与对照组一次插管成功率分别为91.7%、59.6%;呕吐发生率分别为4.2%及23.1%;呛咳发生率分别为4.2%及26.90%;插管时间分别为(1.6±1.2)min及(2.1±1.6)min;患者舒适率分别为85.4%和48.1%,两组比较,差异有显著性意义(均P<0.01).结论:吞咽温水置胃管法能减轻患者痛苦,提高一次置管成功率.     

探讨改良式插胃管法在临床中的应用效果

目的系统地研究改良式插胃管法的临床价值。方法选取我院2012年3月~2016年3月收治的60例需要插胃管患者。随机分为观察组和对照组各30例。对照组采用传统插胃管方法,观察组采用改良式插胃管方法,对比两组一次插管成功率、插管时间和不良反应的发生情况。结果观察组的一次插管成功率为93.3%,显著高于对照组的76.7%,差异有统计学意义(P0.05);观察组插管时间为3.2±0.9min,显著低于对照组的1.5±0.8min,差异有统计学意义(P0.05);观察不良反应程度显著低于对照组,差异有统计学意义(P0.05)。结论改良式插胃管法能提高一次插管成功率,减少插管时间,减轻不良反应,值得推广。     

喉罩替代气管插管在心肺复苏中的临床应用

目的探讨心肺复苏(CPR)时盲插喉罩通气对复苏成功率的影响。方法将我科2003-06~2007-05所接诊的心跳骤停患者51例作为观察组,应用盲插喉罩通气;另选同期所接诊的心跳骤停患者46例作为对照组,应用气管内插管通气。结果插管所需时间:观察组(28.1±12.6)s;对照组(130±56)s,两组比较差异有统计学意义(P<0.001)。一次插管成功率:观察组盲探下插入喉罩一次成功47例(成功率92%);对照组气管内插管一次成功19例(成功率41.3%),两组比较差异有统计学意义(P<0.01)。复苏成功率:观察组复苏成功25例(成功率49%);对照组复苏成功12例(成功率26%),两组比较差异有统计学意义(P<0.01)。结论在CPR时,盲插喉罩通气具有操作简便、迅速、复苏成功率高的优点,可以代替气管内插管。     

局部喷雾麻醉在喉癌术前鼻胃管置入中的效果评价

目的:比较常规鼻胃管置入法与鼻咽部局部喷雾麻醉后置胃管法对喉癌患者的影响。方法:将需要安置胃管的100例患者随机分成两组,每组50例。实验组行鼻咽部喷雾麻醉,对照组按常规操作,比较两组患者流泪、恶心、呕吐、咳嗽反应,一次成功率及插管所需要时间、插入中暂停次数。结果:实验组一次成功率高,患者反应轻,插管所需时间有显著差异。结论:常规置胃管常因病员难受而中途暂停置管,实验组置胃管前先作鼻咽部局部喷雾麻醉,可明显减轻患者的痛苦,提高插胃管的一次成功率,插管过程中因病员难受暂停次数也明显减少,使临床护理工作时间缩短,对临床护理工作有积极意义。     

静脉留置针单手送管法的应用效果

目的探讨静脉留置针采用单手送管法穿刺的临床应用效果。方法将102例需行静脉留置针治疗的患者按随机数字表法分为2组:试验组51例采用单手送管法穿刺,对照组51例采用传统双手送管法穿刺。比较2组的穿刺成功率及患者疼痛发生率。结果试验组穿刺成功率明显高于对照组(96.1%比90.2%,P<0.05),而患者疼痛发生率显著低于对照组(9.8%比39.2%,P<0.05)。结论单手送管法在提高穿刺成功率的同时能让患者的舒适度得到明显改善,满足了患者安全需要,提高了护理质量。     

Short-Term Thrombosis after Transvenous Permanent Pacemaker Insertion

In order to assess prospectively the incidence and significance of venous thrombosis early after permanent transvenous pacemaker implantation venographic studies were carried out in 40 consecutive patients. The venograms performed between 1 and 6 months (mean 4 months) after the implantation were normal in 31 patients (77%), in six patients (15%) they showed partial venous obstruction and in three patients (8%) total obstruction. Between 6 and 12 months (mean 9 months) the venograms of five patients, that were previously normal, showed partial venous thrombosis. No changes were found in the venograms performed later. Only two of 14 patients with thrombosis of the great veins was clinically symptomatic and developed arm edema, that resolved spontaneously within about a month. No difference in incidence of abnormal venograms was found according to the type of insulation, the polarity of the electrode and the route of entry.     

Doppler Guided Extrathoracic Introducer Insertion

Recent reports have raised concern over the use of standard subclavian puncture for placement of permanent pacing leads. This study reports the initial experience of one implanter in 59 consecutive, unselected patients undergoing implantation of a variety of pacing leads in whom a simple Doppler flow detector was used to guide extrathoracic venipuncture of the lateral subclavian/axillary vein. A total of 100 leads were placed for 48 right- and 11 left-sided systems. Lead insertion by this technique was successful in all patients. One small pneumothorax and two uncomplicated arterial punctures occurred. One patient's leads were revised electively because of unacceptable loss of redundancy when standing. There have been no infections or other late complications. A simple Doppler flow detector appears to be useful in identifying the lateral subclavian/axillary vein for extrathoracic pacemaker lead placement.     

Inadvertent Transarterial Pacemaker Insertion: An Unusual Complication

We describe an unusual complication of pacemaker treatment in a patient who died after a replacement operation. In a difficult situation in which a functioning pacemaker was highly desirable and in which most of the available veins had already been used, the pacemaker electrode was inserted, by mistake, through a small artery. This was not detected by fluoroscopy during surgery. The postoperative X-ray examination seemed to indicate that the electrode tip was located in the coronary sinus, but the subsequent autopsy revealed it to be located in the left ventricle.     

前列腺增生患者插尿管方法的改进效果观察

目的 探讨适合前列腺增生患者的插尿管方法.方法 将98例前列腺增生患者随机分成两组各49例,在尿管插至约16 cm并有阻力时,对照组注入10～15 mL甘油型润滑油后插管,观察组边注入生理盐水边插尿管,观察两组患者插管成功率、插管时疼痛情况和尿道黏膜损伤情况.结果 两组患者的1次插管成功率差异无统计学意义(P＞0.05),但观察组尿道黏膜损伤出血及疼痛发生例数均少于对照组,差异有统计学意义(P<0.05).结论 对前列腺增生患者插尿管时采用边插尿管边注入生理盐水方法可以减少并发症的发生,减轻患者的痛苦,提高患者的舒适度.     

Insertion mechanics of bioinspired needles into soft tissues

Introduction: Most studies to date confirm that any increase in the needle insertion force increases the damage to the tissue. When it comes to brain tissue, even minor damage can cause a long-lasting traumatic brain injury. Thus there is a great demand for innovative minimally invasive needles among the medical community. In our previous studies a novel bioinspired needle design with specially designed barbs was used to perform insertion tests into Polyvinyl chloride (PVC) tissue-mimicking gels, in which it decreased the insertion force by as much as 25%.

Material and methods: In this work, bioinspired needles were designed using a CAD software, and were then manufactured using a 3?D printer. The insertion tests into bovine brain and liver were then performed to further investigate the performance of our bioinspired needles in real tissues.

Results: Our results show that there was a 10-25% decrease in the insertion force for insertions into bovine brain, and a 35-45% reduction in the insertion force for insertions into bovine liver using the proposed bioinspired needles.

Conclusion: The reduction in the insertion force is due to the decrease in the friction force of the bioinspired needle with the bovine tissues, and its results are consistent with our previous results.     

鼓膜置管联合腺样体切除治疗分泌性中耳炎疗效观察

目的:探讨治疗小儿分泌性中耳炎的合理方法。方法:回顾性分析2002~2004年我科12例鼓膜置管联合腺样体切除治疗分泌性中耳炎。结果:术后4天语言频率上升30~40dB,耳科检查:耳道干燥,鼓膜变白,置管无脱落。结论:鼓膜置管联合腺样体切除治疗分泌性中耳炎为小儿分泌性中耳炎的优选治疗方法。     

哺乳期妇女对宫内节育器放置术认知状况的调查

目的调查哺乳期妇女对宫内节育器放置术的认知状况,为制定相应的护理措施提供依据。方法自行设计调查问卷,对2007年6月至2009年6月要求放置宫内节育器的1800名哺乳期妇女进行调查,调查内容包括产后体虚不宜放置宫内节育器、放置宫内节育器会减少乳汁分泌等6项,每项内容根据评分结果分为认知良好、基本认知及认知不良。结果 1800名哺乳期妇女对宫内节育器放置术的认知情况普遍较差,认知良好的人数及百分率最高的为“放置宫内节育器会影响夫妻性生活”,仅为420名（占23.3%）;认知不良的人数及百分率最高的为“哺乳期月经未来不会怀孕”，多达1140名（占63.3%）。结论对哺乳期妇女应加强有关宫内节育器放置术的健康教育,积极做好有效的术前、术中及术后护理,促进其身心尽快康复。