静脉输液后两种拔针方法效果比较

目的比较静脉输液后2种拔针方法的效果。方法将400例静脉输液患者随机分为观察组和对照组各200例,对照组采用常规拔针法,观察组行缓慢拔针法。结果观察组患者拔针后疼痛、皮下瘀血发生率少于对照组(均P<0.01)。结论缓慢拔针按压方法可减轻患者的痛苦,利于再次静脉穿刺。     

静脉输液拔针方法的改进

为了减轻患者输液后拔针的疼痛和出血，笔者于2005年10月至2006年4月．通过对本科182例输液患者的临床实践．探索出一种输液毕采用扩大按压穿刺部位，缓解患者疼痛的方法，效果满意，介绍如下。     

静脉输液后缓慢拔针临床效果观察

目的探讨静脉输液后缓慢拔针法的临床效果。方法对370例行静脉输液患者按首次输液顺序，奇数患者先行缓慢拔针法，偶数患者先行快速拔针法。结果缓慢拔针法疼痛程度、皮下瘀血率均显著低于快速拔针法（均P〈0.01）。结论绷紧皮肤缓慢拔针可减轻疼痛，降低皮下瘀血发生率。     

静脉输液拔针按压方法再探

静脉输液是临床治疗的主要手段之一,也是护士基础护理操作的重要内容。护士在拔针时由于按压不当,常导致皮下出血。曾有护士对拔针按压方法进行探讨,我们借鉴了这些经验,探讨棉签与血管平行直压法的止血效果,介绍如下。1　资料与方法1.1　一般资料1998年4～11月行静脉输液的病人258例,男152例,女106例,共输液1408例次,随机分成两组。观察组131例,男80例,女51例,平均年龄(39.0±12.2)岁;输液726例次,平均5.54例次,对照组127例,男72例,女55例,平均年龄(41.2±15.7)岁,输液682例次,平均5.37例次。年龄在统计学上差异无显著性(t=1.03,P>0.05)。…     

静脉输液拔针方法的改进

为了减轻患者输液后拔针的疼痛和出血,笔者于2005年10月至2006年4月,通过对本科182例输液患者的临床实践,探索出一种输液毕采用扩大按压穿刺部位,缓解患者疼痛的方法,效果满意,介绍如下.     

静脉输液后缓慢拔针临床效果观察

目的探讨静脉输液后缓慢拔针法的临床效果。方法对370例行静脉输液患者按首次输液顺序,奇数患者先行缓慢拔针法,偶数患者先行快速拔针法。结果缓慢拔针法疼痛程度、皮下瘀血率均显著低于快速拔针法(均P<0.01)。结论绷紧皮肤缓慢拔针可减轻疼痛,降低皮下瘀血发生率。     

改变拔针步骤减少儿科静脉输液浪费

静脉输液作为一种主要治疗手段在儿科广泛应用。根据小儿的生理特点，其用药剂量有严格的规定，且用药绝对量较少，但输液本身存在一些“合理”的丢失现象^[1]，使静脉输液实际给药量远少于医嘱用量，影响药物治疗效果。鉴此，2006年5月笔者改变了患儿拔针步骤，有效减少了输液浪费，现报告如下。     

改变拔针步骤减少儿科静脉输液浪费

静脉输液作为一种主要治疗手段在儿科广泛应用.根据小儿的生理特点,其用药剂量有严格的规定,且用药绝对量较少,但输液本身存在一些"合理"的丢失现象[1],使静脉输液实际给药量远少于医嘱用量,影响药物治疗效果.鉴此,2006年5月笔者改变了患儿拔针步骤,有效减少了输液浪费,现报告如下.     

两种按压方式应用于静脉输液拔针后的效果比较

目的:对静脉输液拔针后两种按压方式进行比较.方法:选择2009年2～10月十堰市人民医院心胸外科输液治疗的患者186例,随机分为两组,实验组93例采用改良纵向大面积按压法,对照组93例采用传统横向小面积按压法,比较两组患者出血及皮下淤血的发生率.结果:改良纵向大面积按压法与传统横向小面积按压法相比有显著性差异,P＜0.05.结论:建议今后工作中,从人性化护理出发,注意按压方式,保护静脉血管,减轻患者的痛苦.     

静脉输液后新式拔针法效果观察

目的 探讨静脉输液后新式拔针法的临床效果。方法 对500例静脉输液患者按单、双日输液顺序，单日患者行新式拔针法，输液毕，护士不关闭输液调节器开关，不提前按压穿刺点，即用左手将无菌干棉签沿血管走向轻放于穿刺点上方，以拇指固定，右手拔针并反折针头软管，以防液体漏出，拔针后用左手拇指迅速按压穿刺点上方3min；双日患者行常规拔针法。结果 新拔针方法其疼痛程度、针头回血率低于常规拔针法（均P〈0．01）。结论 新拔针方法能显著减轻患者疼痛，提高患者舒适度。     

静脉输液后新式拔针法效果观察

目的 探讨静脉输液后新式拔针法的临床效果.方法 对500例静脉输液患者按单、双日输液顺序,单日患者行新式拔针法,输液毕,护士不关闭输液调节器开关,不提前按压穿刺点,即用左手将无茵干棉签沿血管走向轻放于穿刺点上方,以拇指固定,右手拔针并反折针头软管,以防液体漏出,拔针后用左手拇指迅速按压穿刺点上方3 min;双日患者行常规拔针法.结果 新拔针方法其疼痛程度、针头回血率低于常规拔针法(均P＜0.01).结论 新拔针方法能显著减轻患者疼痛,提高患者舒适度.     

Efficacy of Two Methods for Reducing Postbypass Afterdrop

Background: Afterdrop, defined as the precipitous reduction in core temperature after cardiopulmonary bypass, results from redistribution of body heat to inadequately warmed peripheral tissues. The authors tested two methods of ameliorating afterdrop: (1) forced-air warming of peripheral tissues and (2) nitroprusside-induced vasodilation.

Methods: Patients were cooled during cardiopulmonary bypass to approximately 32[degrees]C and subsequently rewarmed to a nasopharyngeal temperature near 37[degrees]C and a rectal temperature near 36[degrees]C. Patients in the forced-air protocol (n = 20) were assigned randomly to forced-air warming or passive insulation on the legs. Active heating started with rewarming while undergoing bypass and was continued for the remainder of surgery. Patients in the nitroprusside protocol (n = 30) were assigned randomly to either a control group or sodium nitroprusside administration. Pump flow during rewarming was maintained at 2.5 l [middle dot] m-2 [middle dot] min-1 in the control patients and at 3.0 l [middle dot] m-2 [middle dot] min-1 in those assigned to sodium nitroprusside. Sodium nitroprusside was titrated to maintain a mean arterial pressure near 60 mmHg. In all cases, a nasopharyngeal probe evaluated core (trunk and head) temperature and heat content. Peripheral compartment (arm and leg) temperature and heat content were estimated using fourth-order regressions and integration over volume from 18 intramuscular needle thermocouples, nine skin temperatures, and "deep" hand and foot temperature.

Results: In patients warmed with forced air, peripheral tissue temperature was higher at the end of warming and remained higher until the end of surgery. The core temperature afterdrop was reduced from 1.2 +/- 0.2[degrees]C to 0.5 +/- 0.2[degrees]C by forced-air warming. The duration of afterdrop also was reduced, from 50 +/- 11 to 27 +/- 14 min. In the nitroprusside group, a rectal temperature of 36[degrees]C was reached after 30 +/- 7 min of rewarming. This was only slightly faster than the 40 +/- 13 min necessary in the control group. The afterdrop was 0.8 +/- 0.3[degrees]C with nitroprusside and lasted 34 +/- 10 min which was similar to the 1.1 +/- 0.3[degrees]C afterdrop that lasted 44 +/- 13 min in the control group.     

Portal Vein Thrombosis After Hepatectomy

Background

Although various complications after hepatectomy have been reported, there have been no large studies on postoperative portal vein thrombosis (PVT) as a complication. This study evaluated the incidence, risk factors, and clinical outcomes of PVT after hepatectomy.

Methods

The preoperative and postoperative clinical characteristics of patients who underwent hepatectomy were retrospectively analyzed.

Results

A total of 208 patients were reviewed. The incidence of PVT after hepatectomy was 9.1 % (n = 19), including main portal vein (MPV) thrombosis (n = 7) and peripheral portal vein (PPV) thrombosis (n = 12). Patients with MPV thrombosis had a significantly higher incidence of right hepatectomy (p < 0.001), larger resection volume (p = 0.003), and longer operation time (p = 0.021) than patients without PVT (n = 189). Multivariate analysis identified right hepatectomy as a significant independent risk factor for MPV thrombosis (odds ratio 108.9; p < 0.001). Patients with PPV thrombosis had a significantly longer duration of Pringle maneuver than patients without PVT (p = 0.002). Among patients who underwent right hepatectomy, those with PVT (n = 6) had a significantly lower early liver regeneration rate than those without PVT (n = 13; p = 0.040), and those with PVT had deterioration of liver function on postoperative day 7. In all patients with MPV thrombosis who received anticoagulation therapy, PVT subsequently resolved.

Conclusions

Postoperative PVT after hepatectomy is not rare. It is closely related to delayed recovery of liver function and delayed liver regeneration.     

静脉穿刺后两种拔针法临床对比观察

目的 观察病人对两种不同拔针法的疼痛反应及针眼出血和皮下瘀血情况。方法 对100例住院输液病人进行同体双侧手背同部位静脉穿刺后拔针对比观察,专人操作。左侧采用旧拔针法(对照组,用无菌干棉签按压穿刺点上方,迅速拔出针头);右侧采用新拔针法(观察组,迅速拔出针头,用无菌干棉签按压穿刺点上方)。结果 对照组疼痛反应发生率明显高于观察组(P<0.01);两组均能达到止血效果。结论 新拔针法能显著减轻病人的疼痛。     

Portal Vein Thrombosis After Laparoscopic Cholecystectomy

Introduction:

Portal vein thrombosis (PVT) is a relatively uncommon complication after abdominal surgery.

Case Report:

We report an even more unusual case of PVT 10 days after an uncomplicated laparoscopic cholecystectomy, believed to be only the fourth reported case in the literature of this rare complication.

Conclusion:

Albeit extremely rare, PVT should be included in the differential diagnosis for abdominal symptoms and/or elevated hepatic function tests after laparoscopic cholecystectomy.