对肝癌介入栓塞术后并发症循证护理的临床应用

目的 探讨肝动脉化疗栓塞(TACE)治疗原发性肝癌术后并发症的护理策略.方法 入选2010年2月-2013年2月进行肝动脉化疗栓塞(TACE)术的原发性肝癌患者98例,分为常规护理组49例和循证护理组49例,给予不同护理措施,观察两组患者并发症情况以及患者对护理服务的满意程度.结果 循证护理措施实施前,两组患者术后各并发症发生率差异均无统计学意义(P＞0.05);实施后,循证护理组并发症发生率明显低于常规护理组(P＜0.05).循证护理组患者满意度明显高于常规护理组,差异具有统计学意义(P＜0.05).结论 循证护理理论应用于原发性肝癌患者介入栓塞术治疗,对并发症预防有积极意义,能够对护理工作进行积极指导,同时提高护理质量,提升护理人员个人素质.     

明胶海绵微粒联合TACE治疗原发性肝癌的护理

目的 探讨新型明胶海绵微粒联合TACE治疗原发性肝癌的护理方法.方法 2009年6月-2011年5月,针对应用明胶海绵微粒行TACE术治疗原发性肝癌患者的99例患者行围手术期护理干预,重点包括术前心理护理、介入术中护理及术后并发症护理,观察和总结此方法治疗原发性肝癌的护理特点.结果 护理干预99例患者,其中包括巨块型肝癌70例,结节型肝癌22例,1例患者术后出现肝脓肿,5例患者出现急性胆囊炎,6个月生存率为90.9％,12个月生存率为82.82％.结论 明胶海绵微粒化疗栓塞原发性肝癌疗效肯定,应用循证护理正确认识和总结该新方法的护理特点对患者的预后尤为重要.     

肝癌介入治疗术中的护理

血管性介入治疗为晚期肝癌及无法手术患者提供了治疗的机会,取得了较好的效果。介入治疗术中的护理是介入治疗的重要环节,其直接影响介入治疗能否顺利进行;防止和减少并发症的发生对介入术后的疗效亦很重要,现将肝癌介入术中的护理及术中并发症的预防     

肝癌肝动脉化疗栓塞术的介入治疗及护理体会

目的:探讨肝癌肝动脉化疗栓塞术介入治疗的护理.方法:对162例肝癌患者行肝癌肝动脉化疗栓塞术治疗,术前宣教,使病人对介入治疗有一定了解,减轻病人心理负担.术中主动与患者沟通,了解术中不适,及时处理.术后对发热、疼痛反应进行对症治疗,注意观察穿刺肢体的血供改变,减少并发症发生.结果:全部病例手术过程顺利,术后没有血栓形成等并发症发生,疗效肯定.结论:术前宣教、术中和术后及时了解患者症状,对症处理及精心护理可改善肝癌肝动脉术介入治疗的副反应,减少并发症发生.     

子宫动脉化疗栓塞术治疗宫颈妊娠23例临床观察及护理

目的 总结子宫动脉化疗栓塞术治疗宫颈妊娠患者的临床观察及护理经验.方法 23例诊断为宫颈妊娠并行子宫动脉造影术及化疗栓塞术的患者在介入治疗全过程中进行精细临床护理干预,包括术前对患者进行心理辅导和支持,介绍介入治疗的重要性、安全性和优越性,缓解患者焦虑、恐惧情绪,以更好地配合手术;术中严密观察生命体征和过敏反应发生情况;术后严密观察并发症症状.结果 22例患者介入术后1个月复查血β-HCG降至正常,B超检查子宫颈恢复正常大小,1例原发性宫颈妊娠而后继发绒毛膜癌,介入治疗后2个月行子宫全切术,术后l周复查β-HCG降至正常.未发生与治疗及护理相关的并发症.结论 对患者进行系统有效的护理取得了良好效果,有效地预防了并发症的发生,子宫动脉栓塞术可把组织出血控制在最小范围,保留了患者的生育能力,提高了生活质量.     

肝移植术后肝动脉狭窄行介入治疗的护理

目的 探讨肝移植术后肝动脉狭窄介入治疗的围手术期护理措施,为减少相关并发症、改善患者预后提供参考.方法 结合患者情况及介入治疗的特殊性,以移植病房20例肝移植术后肝动脉狭窄行介入治疗的患者为样本,从术前准备、术后护理及出院指导3方面对患者进行护理.结果 20例介入治疗患者均无出血倾向及急性血栓形成,症状明显好转.结论 介入治疗对于肝移植术后肝动脉狭窄是一种有效的治疗方法.加强介入治疗后的护理可有效预防与手术相关的并发症的发生、巩同治疗效果.     

介入治疗急症脑动脉瘤破裂出血的护理体会

目的 总结介入治疗急症脑动脉瘤破裂出血的护理经验.方法 回顾性分析过去6年间300例介入治疗急症的破裂出血性脑动脉瘤的术前、术中和术后护理方法.结果 急症介入治疗了所有动脉瘤,无一例发生与护理相关的严重并发症.结论 介入治疗急症破裂出血性脑动脉瘤的科学和规范护理取得了良好效果,保证了患者治疗和康复的顺利进行,有效的预防了并发症的发生.     

肝动脉化疗栓塞和经皮乙酸消融治疗巨块型肝癌的围手术期护理

目的 总结肝动脉栓塞化疗(TACE)和经皮乙酸消融(PAI)双介入治疗巨块型肝癌56例的护理经验.方法 术前对患者进行心理干预和支持,介绍双介入治疗的重要性、安全性和优越性,缓解患者焦虑、恐惧情绪；术前指导患者进行呼吸训练,以更好地配合手术；术中严密观察生命体征和过敏反应发生情况；术后严密观察肝肾功能及腹部疼痛等症状.结果 本组患者治疗后,肿块全部缩小.其中54例缩小1/3,3例缩小1/4,未发生化学性腹膜炎等严重并发症.结论 对患者进行系统有效的护理取得了良好效果,有效地预防了并发症的发生,使患者的生活质量明显提高.     

循证护理在预防神经外科手术并发症的应用

目的：分析循证护理在预防神经外科手术并发症中的应用效果,探讨预防神经外科手术并发症的合理护理措施。方法随机选取治疗的41例神经外科手术患者为对象,应用循证护理对术后常见并发症进行预防,分析患者的护理效果。结果实验中41例患者均未因手术体位摆放而发生任何并发症。结论循证护理能够有效预防神经外科手术因采取俯卧位而发生并发症。     

介入治疗原发性肝癌移植术后复发的价值

目的探讨原发性肝癌肝移植术后复发患者的临床表现及介入治疗价值。 方法2004年3月～2011年6月14例肝移植术后复发的肝癌患者行综合介入治疗,包括肝动脉化疗栓塞32次、肝动脉泵置泵1例、经皮肝穿刺胆道引流1例、经内镜逆行性胰胆管造影术1例,高强度聚焦超声1例。 结果肝癌复发灶呈肝内多发、肝外广泛转移的特点,多为富血供肿瘤,合并血管及胆管并发症者各2例;接受介入治疗后至今存活2例,12例从接受肝移植治疗到死亡平均生存16.1个月。 结论原发性肝癌肝移植术后采用介入治疗可有效抑制肝癌术后复发灶及转移灶的生长,消除移植术并发症对患者的危害,延长患者的生存时间并提高生活质量。     

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.