胃、十二指肠溃疡患者采用心理干预护理的效果探讨

目的分析和探讨应用心理干预护理方法对胃、十二指肠溃疡患者进行护理的临床效果。方法选取2015年4月~2015年5月期间在本院接受治疗的胃、十二指肠溃疡患者180例。随机分成两组,其中,对照组90例,对患者进行常规护理,观察组90例,在常规护理的基础上对患者进行心理干预护理。对比两组患者的临床症状变化。结果对照组患者的护理有效率为63.3%,临床恢复时间为(10.4±3.3)d,观察组患者的护理有效率为91.1%,临床恢复时间为(7.6±2.3)d,相较于对照组,观察组患者的护理效果明显更佳,差异有统计学意义(P0.05)。结论心理干预护理方法的有效应用,能够使胃、十二指肠溃疡患者的临床症状得到有效缓解,具有良好的临床实用价值。     

护理干预在胃十二指肠溃疡出血患者中的应用

目的:探讨护理干预在胃十二指肠溃疡出血患者中的应用效果。方法:将118例胃十二指肠溃疡出血患者依据护理手段的不同随机分为观察组60例和对照组58例。对照组给予常规护理,观察组给予护理干预。比较两组患者住院时间、溃疡愈合情况及对护理满意度情况。结果:观察组住院时间和痊愈率与对照组比较差异均有统计学意义(P<0.05),观察组对护理满意度高于对照组(P<0.05)。结论:对胃十二指肠溃疡出血患者实施病症、心理、宣教等方面的护理干预,对患者病症的恢复有明显的积极作用。     

胃十二指肠溃疡穿孔术的干预性护理

目的探讨胃十二指肠溃疡穿孔术的干预性护理及效果。方法将本院胃十二指肠溃疡穿孔患者80例随机分为常规组和干预组各40例,常规组给予常规护理方式,干预组开展干预性护理方式。比较2组护理满意度、胃十二指肠溃疡穿孔手术实施时间、胃十二指肠溃疡穿孔术后住院时间、溃疡穿孔愈合时间、护理前后汉密尔顿焦虑量表评分、生活质量QOL评分、手术后腹胀、便秘、出血发生率。结果干预组满意度显著高于常规组(P 0. 05),汉密尔顿焦虑量表评分显著低于常规组(P 0. 05),生活质量QOL评分显著高于常规组(P 0. 05);干预组胃十二指肠溃疡穿孔手术实施的时间、胃十二指肠溃疡穿孔术后住院时间显著短于常规组(P 0. 05);干预组溃疡穿孔愈合时间显著短于常规组(P 0. 05),手术后腹胀、便秘、出血发生率低于常规组(P 0. 05)。结论胃十二指肠溃疡穿孔患者实施干预性护理方式效果确切,可减轻患者的焦虑情绪,并缩短手术的时间,减少术后的相关并发症,改善患者术后生活质量,提高胃十二指肠溃疡穿孔患者的满意度。     

系统性红斑狼疮致口腔黏膜溃疡40例护理干预

目的:探讨护理干预对系统性红斑狼疮(SLE)致口腔黏膜溃疡治疗效果的影响.方法:将80例SLE致口腔黏膜溃疡患者随机分为实验组和对照组各40例.对照组给予常规护理及常规药物治疗,实验组在此基础上给予护理干预,即加强心理护理、生活护理、饮食指导、健康教育等.结果:实验组痊愈26例,显效14例,无效0例;对照组痊愈13例,显效17例,无效10例.两组疗效比较有极显著性差异(P<0.01).结论:护理干预可明显提高系统性红斑狼疮致口腔黏膜溃疡患者的治疗效果.     

大剂量甲氨喋呤化疗诱发口腔黏膜溃疡护理干预临床效果分析

目的:探讨护理干预对防治骨肉瘤患者应用大剂量甲氨喋呤化疗所致口腔黏膜溃疡的效果.方法:将52例患者随机分为两组各26例,对照组仅给予常规药物治疗,实验组在此基础上给予护理干预,即用药前后加强心理护理、卫生教育、饮食指导等.结果:实验组口腔黏膜溃疡发生率、程度、痊愈时间明显低于对照组(P＜0.05).结论:护理干预与药物联合应用可明显降低大剂量甲氨喋呤化疗致口腔黏膜溃疡程度.     

基于循证逻辑下的护理行动策略在十二指肠球部溃疡患者中的应用

目的:探讨基于循证逻辑下的护理行动策略在十二指肠球部溃疡患者中的应用效果。方法:将2017年2月1日～2019年12月31日收治的84例十二指肠球部溃疡患者按照来院就诊患者病历号末尾数奇偶数情况随机分为研究组和对照组各42例。对照组采用常规护理干预,研究组实施基于循证逻辑下的护理行动策略。比较两组干预效果。结果:干预后研究组患者知识储备能力优于对照组(P<0.05);干预后研究组自我管理能力高于对照组(P<0.05)。结论:基于循证逻辑下的护理行动策略应用于十二指肠球部溃疡患者,能完善患者的知识储备,提高患者自我管理能力,值得临床进一步推广。     

护理干预对青年战士十二指肠球部溃疡治疗效果的影响

目的 探讨护理干预对青年战士十二指肠球部溃疡治疗效果的影响.方法 对106例十二指肠球部溃疡患者进行随机分组,对照组50例采用抗溃疡治疗和常规护理,干预组56例在此基础上实施护理干预.2组患者均采用症状自评量表(SCL-90)、Zung焦虑自评量表(SAS)、Zung抑郁自评量表(SDS)评定,对评定结果进行比较.结果 2组患者的SCL-90、SAS、SDS有显著性差异(P＜0.05),治疗效果有显著性差异(P＜0.05).结论 护理干预可促进患者身心健康,提高治疗效果.     

护理干预在胃十二指肠溃疡穿孔术后的应用效果分析

目的探讨实施护理干预对于胃十二指肠溃疡穿孔术后患者的护理效果。方法选择2009年5月至2011年5月山东省泰山医学院附属莱芜市人民医院收治的84例胃十二指肠溃疡穿孔术患者,随机将患者分为对照组和观察组两个组别,各42例。对照组患者实施常规护理,对观察组患者实施护理干预。同时,比较两组患者的住院时间、满意度、生命质量评分、健康知识掌握情况以及术后并发症的发生情况。结果观察组患者住院时间与对照组患者相比较明显下降,差异具有统计学意义（P＜0．05）;观察组患者的生命质量评分、满意度以及健康知识掌握情况与对照组相比较明显上升,差异具有统计学意义（P＜0．05）;并且,实施护理干预以后,术后并发症的发生概率明显下降,观察组术后并发症的发生率为4．8％,对照组为19．0％,差异具有统计学意义（ P＜0．05）。结论对胃十二指肠溃疡穿孔术后患者实施综合的护理干预措施,可以促进病情的康复,值得临床应用和推广。     

综合护理干预对慢性胃炎及消化性溃疡患者的效果观察

目的探讨综合护理干预在慢性胃炎及消化道溃疡患者中的临床护理效果。方法选取90例慢性胃炎及消化道溃疡患者作为研究对象,采用随机数字法分成对照组与实验组,实验组采用综合护理干预方法,对照组采用常规护理方法。结果对照组患者临床护理满意度为73.33%,研究组患者为97.78%,研究组显著优于对照组(P0.05)。结论综合护理干预应用在慢性胃炎及消化道溃疡患者中,可有效提升患者临床护理满意度以及生活质量,减轻焦虑。     

综合性心理干预应用于腹部手术后胃瘫综合征患者的效果评价

目的 探讨综合性心理干预对促进腹部手术后胃瘫综合征(PGS)患者恢复的效果.方法 将70例腹部手术后发生胃瘫综合征的患者按单双序号随机分为实验组和对照组各35例.对照组采用传统的常规治疗:留置三腔胃管、禁食、胃肠外营养+肠内营养(PN+EN),以及常规护理、健康指导等.实验组在对照组实施措施的基础上辅以综合性心理干预.采用抑郁量表(center for epidemiological survey depression scale,CES-D)对2组干预前、干预后不同时间进行测评,并进行胃肠功能恢复的评定.结果 实验组患者抑郁程度的改善明显高于对照组,实验组患者症状(恶心、呕吐、腹胀)消失时间、胃管拔出时间、进食恢复时间明显短于对照组;胃液＞ 800 ml/d引流的天数明显缩短;PGS的恢复时间和住院天数明显缩短;住院费用明显减少.结论 对腹部手术后胃瘫综合征患者实施综合性心理干预可以改善患者的负性情绪,能缩短患者的恢复时间.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.