STA麻醉技术和手推注射法在口腔局部浸润麻醉中的临床疗效观察

目的探讨单颗牙齿注射麻醉仪(STA)和手推注射法在口腔局部浸润麻醉中的临床疗效。方法选取2019年1月-2020年1月收治进行单颗拔牙患者100例,根据拔牙中麻醉方式的不同分为对照组(50例)与研究组(50例);对照组予手推注射法,研究组予STA麻醉技术。比较两组患者麻醉过程中疼痛评分、依从性评分与耐受度评分、拔牙出血量、麻醉作用时间、浸润范围与麻醉效果。结果研究组疼痛程度评分明显低于对照组,依从性评分、耐受度评分则明显高于对照组(P<0.05);研究组拔牙出血量、麻醉作用时间、浸润范围与对照组相比,差异无统计学意义(P>0.05);研究组总有效率与对照组相比,差异无统计学意义(P>0.05)。结论口腔局部浸润麻醉中使用STA麻醉技术可有效降低患者麻醉疼痛感,提高治疗依从性,且麻醉效果与手推注射法无明显差异。     

STA牙周膜麻醉在正畸减数牙拔除中的应用体会

目的 比较传统的局部浸润麻醉(骨膜上浸润麻醉)与单颗牙齿麻醉系统(STA)行牙周膜麻醉,在正畸减数牙拔除术前麻醉注射过程中的疼痛程度及麻醉效果.方法 采用自身对照研究的方法,将58例因正畸需要减数拔牙患者的两侧前磨牙随机分为试验侧和对照侧,试验侧(58颗牙)采取STA牙周膜麻醉,对照侧(58颗牙)采取传统的局部浸润麻醉,观察两组在注射过程中的疼痛程度及麻醉效果.结果 试验侧在注射麻醉时疼痛程度明显低于对照侧(x2=18.73,P＜0.05).两种方式的麻醉效果总体上无统计学差异(x2 =1.44,P＞0.05).结论 STA牙周膜注射能有效减轻注射时的疼痛,但麻醉效果与传统的局部浸润麻醉无显著差异.     

护理安全路径应用于肺癌胸腔镜手术围麻醉期的实证研究

目的 制定肺癌胸腔镜手术围麻醉期安全护理路径表,并探讨其应用效果.方法 选取肺癌胸腔镜手术患者120例,随机分为对照组和干预组各60例.对照组采用常规护理,干预组应用安全护理路径护理.比较两组焦虑水平、躁动发生、镇痛评分、舒适度评分有无差异.结果 对照组和干预组在焦虑水平、躁动发生、舒适度评分等方面的差异有统计学意义(均P ＜0.05),在镇痛评分上差异无统计学意义(P＞0.05).结论 肺癌胸腔镜手术围麻醉期安全护理路径表为肺癌胸腔镜手术患者围麻醉期安全护理提供规范方法,能提高患者舒适度,减轻患者焦虑程度及躁动发生.     

臂丛加颈浅丛神经阻滞麻醉在锁骨骨折内固定手术中的效果分析

目的 分析臂丛加颈浅丛神经阻滞麻醉在锁骨骨折内固定手术中的效果.方法 就诊的行锁骨骨折内固定术的患者共44例,采用随机方式,将所选患者均分为对照组及实验组,给予前者单纯臂丛麻醉,给予后者臂丛加颈浅丛神经阻滞麻醉,对两组疗效进行比较.结果 实验组优良率(100.0％)明显高于对照组(77.3％),两组差异显著,具有统计学意义P ＜0.05).实验组HR及MAP明显比对照组低,两组差异具有统计学意义P＜0.05);实验组及对照组在SPO及麻醉持续时间方面没有显著差异,无统计学意义(P＞0.05).结论 与单纯臂丛麻醉相比,臂丛加颈浅丛神经阻滞麻醉可取得满意效果,锁骨骨折内固定手术患者不但生命体征稳定,而且并发症发生率降低,该种麻醉更具安全性、适用性,建议在临床中大力推广.     

分析人性化护理模式对无痛人流手术患者心理状况影响

目的 分析人性化护理模式对无痛人流手术者心理状态产生的影响.方法 资料选自接受无痛人流手术的68例患者,将其随机分为实验组与对照组,每组各34例.给予对照组患者行常规护理,实验组则在此基础上行人性化护理,对比分析两组患者的心理状态.结果 较之对照组患者,实验组患者的护理效果、心理状态明显占优,两组间比较差异具有统计学意义(P＜0.05).结论 针对无痛人流手术者,予以人性化护理,不仅能有效改善患者的焦虑心理与恐惧心理,还能提升患者的整体生活质量,具有显著意义,值得临床推广使用.     

冠心病患者行循证护理后对心绞痛发生率和心理状态的作用效果分析

目的 评价循证护理对冠心病患者心绞痛发生率和心理障碍的缓解效果.方法 选择106例冠心病患者,将其分为对照组和观察组,考察循证护理对冠心痛心绞痛的缓解效果、患者的满意度以及对患者抑郁和焦虑心理状态的改善效果.结果 使用循证护理可以有效降低患者心绞痛的发生率,与对照组相比差异有统计学意义(P＜0.05);能显著降低患者的焦虑和抑郁心理状态,与治疗前和对照组相比差异均有统计学意义(P＜0.05);提高患者对医院患者护理的满意度,与对照组相比差异有统计学意义(P＜0.05).结论 循证护理能有效降低患者心绞痛的发病率和患者抑郁和焦虑的心理状态,提高医院护理水平.     

个体化肠道准备方案在静脉麻醉下老年患者肠镜检查中的应用

 目的 探讨个体化肠道准备方案在老年患者肠镜检查中的应用。方法 选取2021-03至2022-03在解放军总医院第二医学中心消化内镜中心丙泊酚镇静麻醉下、接受无痛肠镜检查的老年患者98例,随机分为对照组与观察组,每组49例。对照组采用常规肠道准备,观察组采用个体化的肠道准备方案下的肠镜检查前肠道准备。对比两组肠道准备清洁度及患者对此肠道准备方案的满意度。结果 观察组波士顿肠道准备量表得分为(7.83±0.35)分,高于对照组的(6.91±0.73)分,差异有统计学意义(P＜0.05);两组患者满意度比较,观察组满意率98.00%高于对照组的79.60%,差异有统计学意义(P＜0.05)。结论 应用个体化肠道准备方案,波士顿评分高,清洁度好,患者满意度更高,值得推广。     

优质护理干预对老年无痛胃肠镜诊疗术患者生命体征、情绪及不良反应的影响

目的探讨优质护理干预在老年无痛胃肠镜诊疗术患者中的应用价值。方法选取2016年4月-2017年9月行无痛胃肠镜诊疗术的老年患者116例,按照检查时间分为两组,各58例。对照组予以常规护理干预,观察组予以优质护理干预,对比两组患者的生命体征、情绪状态及不良反应。结果与对照组相比,观察组患者的SAS评分及不良反应总发生率均较低,差异有统计学意义(P<0.05);与对照组相比,观察组患者的收缩压、舒张压及心率水平均较优,差异有统计学意义(P<0.05);与对照组相比,观察组患者的护理满意度较高,差异有统计学意义(P<0.05)。结论对行无痛胃肠镜诊疗术的老年患者实施优质护理干预,能明显缓解患者诊疗前的焦虑情绪,减轻诊疗中生命体征波动,减少不良反应的发生,有利于提高患者的护理满意度。     

104名骨与关节损伤舰艇官兵的心理护理研究CSCD

目的 通过对骨与关节损伤术后的舰艇官兵患者进行筛查与心理护理干预,并评估其效果,为建立有效的舰艇官兵心理护理干预策略模式提供实验依据.方法 采用事件影响量表（IES-R）、汉密尔顿焦虑量表（HAMA）对接受骨与关节损伤手术的104例舰艇官兵进行心理评估,以其中HAMA总分14分以上且自愿参加研究的80例患者作为研究对象,采用数字表法随机分为实施联合心理护理的实验组和实施基础护理的对照组,每组各40例.护理1周后,分别对实验组及对照组实施IES-R及HAMA测评,进行对比研究,评估联合心理护理的干预效果.结果 （1）实验组IES-R得分,干预前（44.25±3.12）与干预后（20.38±1.69）比较,差异具有统计学意义（P＜0.05）.（2）干预后的IES-R得分,实验组（20.38 ± 1.69）与对照组（40.95 ±2.55）比较,差异具有统计学意义（P＜0.05）.（3）实验组HAMA得分,干预前（18.62 ±2.42）与干预后（6.54±1.55）比较,差异具有统计学意义（P＜0.05）.（4）干预后的HAMA得分,实验组（6.54±1.55）与对照组（15.28 ±1.99）比较,差异具有统计学意义（P＜0.05）.结论 对骨与关节损伤的舰艇官兵实施联合心理护理干预,能够有效纠正、缓解骨与关节损伤术后的应激、焦虑,使其身心得到更好的康复,是进行心理护理干预的有效方法.     

两种麻醉技术在上颌前牙牙周治疗中的应用体会

目的 探讨两种麻醉技术在上颌前牙牙周治疗中的应用体会.方法 将需要在局部麻醉条件下对上颌前牙进行牙周治疗的患者随机分为2组,试验组采用单颗牙麻醉(STA)系统行上牙槽前、中神经麻醉(AMSA),对照组采用传统手推注射法行上颌前牙骨膜上麻醉.注射后,患者均通过视觉模拟评分法(VAS)评定注射时的疼痛程度,在治疗过程中医师评定麻醉效果.结果 试验组与对照组的麻醉效果均较好,统计学检验无显著差异(P＞0.05),试验组注射疼痛的VAS平均值低于对照组(P＜0.01).结论 采用STA系统行AMSA在上颌前牙牙周治疗中的麻醉效果与传统的手推注射法相当,但前者的注射疼痛远较后者小.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）