静脉留置针的临床护理进展

静脉穿刺留置套管针输液作为一种新的护理技术，早在60年代就被欧美等发达国家作为头皮针的替代物而普及使用，成为临床输液的主要工具，具有减少血管穿刺次数、减少液体外渗，对血管的刺激性小，有利于临床用药和紧急抢救，减轻护士的工作量等优点。在国内目前已广泛应用于临床，作为一项普遍的护理操作技术，现从留置针和穿刺血管的选择及置管技巧、留置时间、给药的管理、封管药液及封管方法的选择及穿刺部位的护理对静脉留置针的应用作一综述。     

使用静脉留置针的护理体会

随着护理科学的不断进步，静脉留置针的应用越来越广泛。静脉留置针其优越性在于：减轻患者反复穿刺的疼痛感，保持患者良好的心态；维持血管通路，利于紧急抢救；减少护士穿刺操作次数，提高工作效率。静脉留置针又称套管针，作为头皮针的换代产品以其操作简单、套管柔软、套管在静脉内留置时间长且不易穿破血管等特点被广泛应用于临床。近年来，临床上静脉留置针的应用越来越广泛。其优点是：静脉留置针能减少反复穿刺的痛苦，对血管刺激性小，并且可随血管形状弯曲，不易脱出血管，便于肢体活动，为输血、输液提供了方便，保留了一条开放的静脉通道，利于患者的抢救工作，同时提高了医护人员的工作效率。现将使用静脉留置针的护理体会介绍如下。     

静脉留置针留置时间的临床护理研究进展

近年来,静脉穿刺留置针技术的临床应用已日趋广泛,本文对静脉留置针技术在临床应用中,从影响静脉留置针留置时间的相关因素及并发症,临床护理研究进展等进行了综述。在进行静脉穿刺留置针操作时,应根据患者的病情、治疗目的、输入药液的性质、患者静脉血管的状况和对治疗的依从性等进行综合分析。选择合适的穿刺血管和部位;去除影响静脉留置针留置时间的因素和降低留置针的并发症;掌握好封管药液种类、剂量并保持正压封管;加强留置针留置期间的护理。从而减少静脉留置针的并发症,最大限度地发挥留置针持续留置的优点,使所有接受静脉留置针技术进行治疗的患者能得到安全和舒适护理。     

静脉留置针应用问题及对策

静脉留置针又称套管针，作为头皮针的换代产品，具有减少血管穿刺次数、减少液体外渗，对血管的刺激性小，有利于临床用药和紧急抢救，减轻护士的工作量等优点。近年，我国许多医院都将静脉留置针作为临床输液治疗的主要工具。作为一项普遍的护理操作技术，针对其相关的操作及易发生的相关问题经过临床观察及查阅有关资料，对相关问题整理如下。     

静脉留置套管针的应用和护理

静脉留置针自60年代被欧美国家作为头皮针的替代物而普及使用以来，已在临床上得到越来越广泛的应用。使用静脉留置针，既能免除临床上长期输液病人每日反复静脉穿刺带来的痛苦，又能减少穿刺对病人血管的破坏，再加上它的简单易学，所以，在临床上十分受广大护理工作者的欢迎。     

静脉留置针在手术室中的应用

浅静脉穿刺是临床最基本的护理操作技术之一，也是医院治疗抢救病人的一个重要手段。近年来，随着社会的发展，卫生事业条件的改进，静脉留置针作为头皮针的换代产品，具有减少血管穿刺次数，减少液体外漏，对血管的刺激性小，有利于临床用药和紧急抢救，减轻护士的工作量等优点，我国许多医院都将静脉留置针作为临床输液治疗的主要工作，作为一种普遍的护理操作技术。作者通过多年临床实践，通过对我院半年来786例手术病人使用静脉留置针的观察，发现其较大地摒弃了传统的静脉穿刺针的弊端，对手术病人的静脉穿刺及术中抢救病人起到了极大的作用。     

浅谈静脉留置针的临床应用及护理体会

静脉留置针又称套管针,是临床上最常见的诊疗技术之一,在以往静脉输液技术中穿刺往往会给病人带来疼痛不适,特别是护理人员操作不当或病人自身不接受配合等因素给病人带来诸多不良反应,影响病情恢复,因此,作为头皮针的换代产品,具有减少血管穿刺次数,对血管的刺激性小,减少液体外渗,不易脱出血管,减少患者对输液的心理压力,可随时进行输液治疗,有利于危重患者的抢救和提高护理工作效率,减轻护士的工作量等优点。留置针的诸多优点已越来越被广大患者及护理人员所接受。静脉留置针作为一项护理新技术正日益广泛地应用于临床护理工作。许多医院都将静脉留置针作为临床输液治疗的主要工具。     

血液透析患者使用静脉留置针封管液的选择

静脉留置针又称套管针,作为普通静脉输液针的换代产品,目前广泛应用于临床护理工作,使用目的在减少血管穿刺次数,降低液体外渗的机率,减少外周静脉穿刺困难患者的心理压力,以及危重病人抢救时使用等优点。血液透析患者因其皮肤水肿,病情危重,大量使用利尿剂等原因,临床采用静脉留置针途径给药。     

静脉留置针的临床使用心得

静脉留置针又称套管针,由先进的生物材料制成,管壁光滑平稳,且在血管内有较好的柔软性,因此不易损坏血管而引起渗漏。作为头皮针的替代产品,目前已广泛应用于临床输液患者。在临床护理工作中可以发现,相比较头皮针,静脉留置针具有相当多的优点，例如：操作简便，使用方便，对血管的刺激性小能减少反复穿刺的痛苦，保护血管，     

静脉留置针常见并发症预防及护理体会

<正>随着护理科学的不断进步,静脉留置针的应用越来越广泛。静脉留置针又称套管针,作为头皮针的换代产品以其操作简单、套管柔软、套管在静脉内留置时间长且不易穿破血管特点被广泛应用于临床。其优越性在于:减轻患者反复穿刺的疼痛感,保持患者良好的心态;维持血管通路,利于紧急抢救,减少护士穿刺操作次数,提高工作效率。近年来,静脉留置针的临床应用范围不断扩大,既解决了     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.