两种不同静脉穿刺进针方法对疼痛的影响

目的 比较在输液中两种不同静脉穿刺进针方法对疼痛的影响.方法 选择清醒的静脉穿刺患者100例,同体左右侧手背部相同部位进行静脉穿刺,专人操作.选取相同头皮针,单日左手(对照组)采用传统静脉穿刺方法即先扎止血带,叮嘱患者握拳,针刺部位常规消毒,输液护士一手拇指在血管远端固定,另一手将针头斜面向上,与针刺部位保持15～30°夹角,从静脉一侧刺入并沿静脉走向刺入静脉,出现回血后将针头稍作推进,最后进行固定.双日右手(观察组),采用自然法于针刺血管上方约6 cm的位置扎止血带,叮嘱患者尽量保持手部放松,手背向上,输液护士将输液针头斜面向左,与皮肤呈20度角从静脉上方刺入皮下,沿静脉走向刺入静脉,出现回血后将针头稍作推进,然后固定.结果 自然法进针比传统法进针成功率高(P<0.05),自然法进针较传统法进针疼痛度低(P<0.01).结论 改进后的自然进针穿刺方法能明显减轻患者的疼痛,提高了穿刺成功率.     

提高静脉穿刺成功率的操作体会

静脉穿刺术是门诊急诊科护士必须熟练掌握的护理技术操作之一 ,快、稳、准地完成静脉穿刺 ,不仅为急危重症患者的抢救争取时间 ,也为常规输液治疗的患者减轻不必要的痛苦。1　穿刺方法1.1　直接刺入法　即针尖通过皮肤直接刺入静脉。针尖不在真皮内潜行 ,与皮肤成 2 0°～ 4 0°角 ,在静脉上方直接刺入静脉。这种方法很少刺激真皮内的游离神经末梢 ,减轻了进针时的痛感。而且针尖刺入皮下后 ,直接压迫被穿刺静脉 ,使之不易滑动 ,穿刺成功率高 ,患者也乐于接受 ,较常用。1.2　潜行刺入法　在欲穿刺的静脉旁 0 .5～ 1cm处 ,针尖与皮肤成 10°…     

两种静脉穿刺方法疼痛程度的比较与分析

目的：探讨在静脉输液中两种不同的穿刺方法对患者疼痛程度的影响。方法：267例接受静脉穿刺的患者采用自身对照法。奇数日为对照组,采用传统法,针头与皮肤间约成传统的30°进针,针头在皮下潜行后刺入血管;偶数日为实验组,采用改良法,穿刺针头在血管上方与皮肤成40°～60°快速进针直刺血管。评价患者疼痛程度,进行比较。结果：实验组的疼痛明显轻于对照组,两组比较,差异有统计学意义,P〈0.01。结论：采用改良40°～60°直刺血管法进行静脉穿刺,可减轻患者的痛苦,增加其舒适度。     

静脉输液外渗的预防及处理

为了避免和解除静脉渗漏造成的不良后果,在临床工作中应积极采取预防及处理措施.现就此探讨如下. 1 静脉外渗的预防 1.1 熟练掌握穿刺技术:穿刺时避开关键部位,选择合适型号的静脉穿刺针头,进针前对比针体与血管长度以决定进针长短,穿刺时患者不用握拳,采取自然放松法,操作者以左手拇指绷紧皮肤,固定血管下端,减少血管滑动,对血管充盈度好的患者,可加大进针角度,以35°快速刺入皮下后稍放平针头,针尖压住血管时,针体角度再抬高25°快速刺入血管,见回血后放平针体徐徐进入少许,用胶布固定.     

Outcomes of ultrasound-guided axillary vein puncture

目的 评价超声引导下腋静脉穿刺置管的效果.方法 用超声对胸前区腋静脉段及伴行腋动脉进行测量.采用超声实时引导和平面内技术行腋静脉穿刺置管.结果 腋静脉第二段区域位于锁骨下缘中点外1-3 cm处.在锁骨下缘中点外3cm纵线上,穿刺点至锁骨距离为(5.22±0.43) cm,向锁骨中点内1cm处进针,平均进针角度(42±4)度,平均进针深度(4.6±0.6)cm,平均穿刺次数(1.00±0.86)次.随访评价满意.结论 采用超声实时引导可成功完成腋静脉穿刺置管.     

喜辽妥预防小儿PICC致机械性静脉炎的疗效观察

目的 探讨喜辽妥涂敷在预防小儿PICC致机械性静脉炎方面的临床效果.方法 将156例PICC术后患儿随机分为治疗组与对照组,治疗组于PICC置管24 h后,从静脉穿刺点上方 3～4 cm 处沿血管走向连续7 d预防性涂敷喜辽妥,而对照组不使用,观察两组患儿机械性静脉炎的发病率.结果 治疗组机械性静脉炎的发病率为2.6%,对照组的发生率为12.8%.结论 PICC置管后预防性使用喜辽妥涂敷可有效降低小儿PICC致机械性静脉炎的发生率.     

快速穿刺进针角度增大在CT影像中的应用

目的 探索静脉置针穿刺角度以减轻疼痛、提高穿刺成功率.方法 随机选择CT增强扫描患者,分对照组和观察组各350例.两组均按无菌注射技术操作要求选择血管及消毒,对照组按传统的穿刺方法,入针角度为15°～ 30°,观察组则对入针角度增大,即直接在血管上方60°～90°快速进针穿刺.评价两组患者对进针的痛感程度及穿刺成功率.结果 观察组一次穿刺置管率99.1％,对照组一次穿刺置管率88.9％,观察组显著高于对照组(x 2=6.825,P＜0.05).观察组患者0～1级疼痛反应占95.7％,2级疼痛反应占3.1％,3～4级疼痛反应占1.1％;对照组患者0～1级疼痛反应占86.3％,2级疼痛反应占9.4％,3～4级疼痛反应占4.3％;观察组显著优于对照组(x 2=25.72,P＜0.001).结论 穿刺快速进针角度为60°～ 90°的静脉留置方法能减轻患者进针疼痛感,一次穿刺率高,能适应高压注射器以3～5 ml/s的注射而减少造影剂碘海醇外渗的发生,保证显影质量,值得推广应用.     

超声引导下腋静脉穿刺术的效果

目的评价超声引导下腋静脉穿刺置管的效果。方法用超声对胸前区腋静脉段及伴行腋动脉进行测量。采用超声实时引导和平面内技术行腋静脉穿刺置管。结果腋静脉第二段区域位于锁骨下缘中点外1-3cm处。在锁骨下缘中点外3cm纵线上,穿刺点至锁骨距离为(5.22±0.43)cm,向锁骨中点内1cm处进针,平均进针角度(42±4)度,平均进针深度(4.6±0.6)cm,平均穿刺次数(1.00±0.86)次。随访评价满意。结论采用超声实时引导可成功完成腋静脉穿刺置管。     

外周静脉穿刺置入中心静脉导管穿刺处渗血与输注化疗药物的时机相关性分析

目的:通过观察外周静脉穿刺置入中心静脉导管(PICC)换药次数多少,论证PICC置管7 d后再行化疗穿刺点的渗血发生率是否减少。方法:将拟行PICC置管的患者随机分为两组,PICC置管7 d后再行化疗的患者为观察组,置管当天化疗的患者为对照组。比较两组患者的渗血发生率、换药次数等。结果:PICC置管7 d后再行化疗,穿刺点的渗血率和换药次数明显减少,两组比较差异有统计学意义(P<0.05)。结论:置管7 d后再行化疗,穿刺点渗血明显减少。     

静脉进针时间与外涂利多卡因红花液相关分析

目的:探讨静脉穿刺进针时间与外涂利多卡因红花液的相关性因素。方法:选取我院门诊静脉输液2次以上并同意参加试验的100例患者为研究对象,采用自身对照的类实验性研究方法,即将第1次静脉输液设置为实验组(2%利多卡因50ml加红花饮片10g),第2次静脉输液设置为对照组(2%利多卡因),比较两组患者静脉穿刺时的进针时间,以评价利多卡因和红花混合液外用在浅静脉穿刺中缩短进针时间的效果,减轻患者恐惧心理及疼痛,从而提高工作效率。结果:观察组进针时间显著短于对照组(P<0.01)。结论:利多卡因红花液外用能显著缩短静脉穿刺时的进针时间。     

Role of the liver in the disposition of intravenous nitroglycerin in the rat

Previous studies have indicated that the liver is the main site of nitroglycerin (NTG) elimination when the drug is systematically infused. To examine this hypothesis, we measured the apparent systemic clearance (Cls) of nitroglycerin in anesthesized rats receiving a constant intravenous infusion at a dose of 100 micrograms per kg per min. Animals were divided into shunt and sham groups; the former had undergone a portal vein ligation 10 days prior to the study, while the latter was subjected to a sham operation. On the study day, half of the animals of each group also received probenecid at 200 mg/kg, i.v., a drug previously reported to inhibit organic nitrate ester reductase (ONER) activity in rat liver. Arterial NTG samples were obtained at 41, 43 and 45 min of infusion in all four experimental groups; Cls was 439 +/- 32 ml per kg per min (mean +/- S.E.) in sham, 460 +/- 44 in sham and probenecid, 477 +/- 39 in shunt, and 461 +/- 34 in shunt and probenecid animals. During NTG infusion, hepatic blood flow (measured with a constant infusion of indocyanine green) was decreased markedly in shunted rats as was liver/body weight, indicating hepatic atrophy. The specific activity of hepatic ONER was similar in all four groups. In spite of marked differences in hepatic blood flow and hepatic mass, the Cls was similar in all four groups. The liver does not appear to be a major site for the elimination of systemic nitroglycerin as hitherto assumed.     

半导体激光治疗老年人压疮疗效观察

目的探讨半导体激光局部照射治疗老年人压疮疗效.方法:收集2012年1月-2015年6月48例压疮患者,分为半导体组和常规组各24例.常规组采用常规治疗,半导体组采用半导体激光加常规治疗,10 d为1个疗程,不超过3个疗程.疗程结束后比较两组疗效.结果:半导体组压疮愈显率为83.33％,创面愈合时间为(12.75±5.51)d,常规组分别为54.17％和(19.63±8.65)d,组间差异有统计学意义(P＜0.05),两组均未见不良反应.结论:半导体激光加常规治疗压疮效果肯定,无明显不良反应,且操作简便.     

Nifedipine in the treatment of hypertension in the elderly

The effect of nifedipine monotherapy, retard tablets, 20 mg bid, was evaluated in 23 hypertensive patients, mean age, 79 +/- 2 years. Twenty-one patients completed an eight-week study. Blood pressure (BP) decreased to 160/90 mm Hg in 15 patients; in four additional patients diastolic BP dropped by 15% to 28%. In a subset of five patients with isolated systolic hypertension, a significant reduction in systolic BP was noted. Side effects were relatively mild and only two patients discontinued the study. The results suggest that nifedipine monotherapy offers an alternative, logic, therapeutic approach to hypertension in the elderly.     

HACCP在学校集体食堂卫生管理中的应用研究

目的 通过HACCP在学校集体食堂管理中的应用,提高食品卫生水平,保障学生的身体健康。方法 HACCP原则。结果 食品卫生达到较高水平,极大地减少了食物中毒的发生。结论 提示HACCP原则可在学校集体食堂的卫生管理中发挥有效作用。     

The role of the gut flora in the reduction of sulphinpyrazone in the rat

Sulphinpyrazone underwent both reduction to a sulphide and oxidation to a sulphone after parenteral administration to normal Wistar rats. Oral administration was associated with a bioavailability of about 75% and with a 3-fold greater formation of the sulphide. However, no sulphide was detected in the plasma after oral administration of sulphinpyrazone to germ-free (BD/X) rats or normal rats treated with oral antibiotics. In vitro studies showed that the major site of reduction of sulphinpyrazone was the contents of the hind gut with little activity detected in the liver or other tissues. The sulphide was oxidised in vivo to sulphinpyrazone and small amounts of sulphone, while the latter underwent only slight reduction to sulphinpyrazone, but did not give detectable levels of the sulphide. These data suggest that the gut microflora are the main site of reduction of sulphinpyrazone in the rat in vivo.     

Pharmacological analysis of the participation of the catecholaminergic system in the development of the abstinence syndrome in rats

The behavioural activity of rats in "the open field" was studied. It was revealed that rats alcoholized for 8 months do not practically differ in their behavioural indicators from the intact ones. After the discontinuation of alcohol marked disturbances appear in their behaviour, that are arrested by apomorphine (0,1 mg/kg). In intact animals dopamine (50 mkg into the brain ventricles) induces behavioural disorders similar to those in rats during abstinence. Noradrenaline does not induce similar disorders. A conclusion is made on the dopaminergic nature of disorders in the behaviour of rats in the state of alcohol abstinence.     

Problems in the evaluation of hypnosis in the treatment of alcoholism

Although hypnotherapy has been applied to alcoholism for over a century and is accepted by the AMA as a medically valid technique, the effectiveness of hypnosis in treating alcoholics remains controversial. Systematic evaluation has been hampered by the unique role of hypnosis as a cultural artifact, by problems in defining and verifying hypnotic intervention, by individual and situational variation in hypnotizability, and by difficulty in separating hypnosis from the therapies to which it is applied. Clinicians using hypnosis are likely to continue to base their claims for its effectiveness on intuition, especially since no study has demonstrated that hypnotherapy is contraindicated for patients requesting its use.