术中不同物理干预预防对妇科肿瘤患者术后下肢深静脉血栓发生的影响

目的:探讨术中不同物理干预对妇科肿瘤患者术后下肢深静脉血栓（DVT）发生的影响。方法:采用便利抽样法,选取2020年1—12月在山西省人民医院行手术治疗的79例妇科肿瘤患者为研究对象,按照随机数字表法分将其分为观察组（ n=40）和对照组（ n=39）。对照组患者术中采用梯度压力弹力袜（GCS）...     

一种充气加压装置预防妇科腹腔镜手术中皮下气肿的效果观察

目的:探讨一种充气加压装置对妇科腹腔镜手术中皮下气肿的预防效果。方法:将80例全麻下腹腔镜宫颈癌根治术患者随机分为观察组和对照组各40例,对照组采用临床上常规皮下气肿预防方法,观察组在此基础上使用自制充气加压装置,比较两组皮下气肿发生率、呼吸循环参数、麻醉医生干预次数。结果:观察组皮下气肿发生率低于对照组(P0.05),PaCO_2、PetCO_2水平低于对照组(P0.05),麻醉干预次数少于对照组(P0.05)。结论:在妇科腹腔镜手术中使用充气加压装置可有效降低皮下气肿的发生率,减少术中麻醉干预次数,改善PaCO_2、PetCO_2指标。     

踝泵运动与间歇性充气加压泵对妇科肿瘤术后患者血栓形成的干预效果比较

目的：比较踝泵运动与间歇性充气加压泵(IPC)对妇科肿瘤术后患者血栓形成的干预效果。方法：选取2019年3月1日～2021年6月30日接受妇科肿瘤手术的136例患者为研究对象,随机分为对照组70例和观察组66例;对照组实施踝泵运动干预,观察组实施IPC干预。比较两组术前与术后1、7、30 d凝血功能指标[包括血小板计数(PLT)、凝血酶原时间(PT)、部分活化凝血酶原时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)等],手术前后静脉血管管径与流速(包括髂外静脉、股静脉、股深静脉、腘静脉)及术后下肢深静脉血栓形成(LEDVT)发生率。结果：两组凝血指标、静脉血管流速均改善(P<0.05),且观察组优于对照组(P<0.05);两组静脉血管管径比较差异无统计学意义(P>0.05);观察组术后LEDVT总发生率低于对照组(P<0.05)。结论：IPC干预方法可进一步减少妇科肿瘤术后患者血栓形成风险。     

早期运动干预联合间歇充气加压泵对预防妇科手术患者下肢深静脉血栓形成的影响

目的探讨早期运动干预联合间歇充气加压泵对预防妇科手术患者下肢深静脉血栓形成(DVT)的影响。方法选取妇科手术患者120例,按随机数字表法分为对照组和观察组,各60例。对照组给予常规护理。观察组在对照组的基础上给予早期运动干预联合间歇充气加压泵治疗。比较两组血流动力学指标,皮肤温度升高,下肢疼痛、肿胀及DVT发生率。结果术后观察组血流峰速度、血流平均速度及血流量显著高于对照组,两组比较有显著性差异(P0.05)。观察组皮肤温度升高、下肢疼痛、肿胀及DVT发生率显著低于对照组,两组比较有显著性差异(P0.05)。结论采用早期运动干预联合间歇充气加压泵可有效改善血流动力学,预防妇科术后DVT。     

预防性护理在减少妇科腹腔镜手术并发症中作用的研究

目的：研究预防性护理在减少腹腔镜妇科手术并发症中的作用。方法将我院2012年1月至2013年12月收治的530例妇科腹腔镜手术病人随机分为预防性护理干预组（干预组）及对照组,其中对照组采取常规护理,干预组在常规护理的基础上对术中术后可能出现的并发症进行预防性的护理干预,比较两组术后病人并发症的产生及治疗结果。结果干预组的术中术后并发症发生率及痊愈时间均明显低于对照组（ P＜0.05）。结论实行预防性护理可明显降低妇科腹腔镜手术患者术中术后并发症的发生率,缩短痊愈时间,有利于病人康复。     

护理干预对预防妇科肿瘤术后下肢静脉血栓形成的效果分析

【目的】探讨妇科肿瘤术后预防下肢深静脉血栓形成的护理措施。【方法】选择2010年11月至2011年10月本院妇科诊断为妇科肿瘤并行剖腹手术的患者326例,按时间先后分为对照组（n=160）和干预组（n=166）。对照组采用传统妇科围手术期护理,干预组在此基础上增加预防下肢静脉血栓形成的护理干预措施,包括针对性健康教育、体位护理和肢体活动等。比较两组术后10d内下肢肿胀及疼痛、下肢深静脉血栓和肺栓塞的发生率。【结果】术后10d内,干预组深静脉血栓、下肢肿胀及疼痛的发生率明显低于对照组（P〈0．05）。对照组发生肺栓塞1例,干预组未发生肺栓塞,两组患者均无围手术期死亡。【结论】针对性的护理干预措施能有效降低妇科肿瘤术后下肢静脉血栓的发生率。     

3D打印技术辅助空心加压螺钉治疗Andersonll A型齿状突骨折

目的 研究3D打印技术辅助空心加压螺钉治疗Andersonll A型齿状突骨折的临床疗效。 方法 选取我院2014年1月~2017年1月收治的AndersonⅡA型齿状突骨折患者40例,按随机数字表法分为观察组（n=21,行3D打印辅助空心加压螺钉治疗）和对照组（n=19,行单纯空心加压螺钉治疗）。比较两组手术相关指标（手术成功率、手术时间、术中出血量、透视次数、置钉次数）,骨折临床愈合时间和螺钉松动断裂发生率,术前和术后1月日本骨科学会评分（JOA）,颈椎活动度（CROM）,美国脊髓损伤学会评分(ASIA）。 结果 两组手术成功率均为100%,观察组相比于对照组,手术时间更短、术中出血量更少、透视次数更少、置钉次数更少,差异具有统计学意义（P<0.05）。观察组骨折临床愈合时间短于对照组,螺钉松动断裂发生率低于对照组,差异具有统计学意义（P<0.05）。两组术前JOA、CROM、ASIA差异无统计学意义（P>0.05）。两组术后1月JOA、CROM、ASIA评分高于术前,差异具有统计学意义（P<0.05）。两组术后1月JOA、CROM、ASIA评分差异无统计学意义（P>0.05）。 结论 3D打印技术辅助空心加压螺钉能减少手术时间、术中出血量、透视次数和置钉次数,骨愈合快,螺钉松动断裂少。       

全程护理干预对妇科肿瘤患者腹腔镜手术效果的影响

目的探讨全程护理干预对妇科肿瘤患者腹腔镜手术康复的效果。方法将115例经腹腔镜手术的妇科肿瘤患者随机分为干预组58例,对照组57例。两组患者遵医嘱实施腹腔镜手术前后常规护理的基础上,即干预组实施术前认知行为干预,术后疼痛干预及出院后随访干预为一体的全程个体化护理干预模式;对照组患者按传统式腹腔镜手术前后常规护理。分别观察比较两组干预效果。结果干预组术后不同时间段疼痛视觉模拟评分（VAS）明显低于对照组,其中干预组术后72h VAS评分为（1．35±1．02）分,对照组为（2．76±1．20）分,组间比较差异具有统计学意义（t=6．79,P〈0．01）;观察组患者住院时间（7．15±2．15）d,对照组患者住院时间为（9．89±2．18）d,组间比较差异具有统计学意义（t=6．79,P〈0．01）;观察组术后1年内复发率为1．72％,对照组为14．03％,组间比较差异具有统计学意义（χ^2=4．45,P〈0．05）。结论妇科肿瘤患者实施全程个体化护理干预模式,促进了患者早日康复,改善了术后生活质量,提高了腹腔镜手术治疗效果。     

腹股沟疝术后使用弹性腹带及毛巾加压包扎切口的效果观察

目的 观察腹股沟疝术后使用弹性腹带+毛巾加压包扎切口的效果。方法 选择南通市第三人民医院2016年1月至2017年12月收治的89例行手术治疗的腹股沟疝患者为观察对象。普外科二区（实验组）45例术后切口处使用弹性腹带+毛巾加压包扎法;普外科一区（对照组）44例术后切口仍使用传统的砂袋压迫法。比较两组患者术后切口渗血量、疼痛程度和舒适度的情况。结果 与对照组相比,实验组患者术后切口出血较少,切口疼痛程度较轻,术后舒适度更高,两组比较差异有统计学意义（P＜0.05）。结论 弹性腹带+毛巾加压包扎法可增加腹股沟疝术后患者的舒适度、减少切口出血量、减轻切口疼痛。     

临床护理路径在妇科手术病人中的应用

目的探讨临床护理路径在妇科手术病人中的应用效果。方法选择本院2011年1月~2013年1月进行妇科手术的300例患者作为研究对象,随机分为2组,每组150例。观察组患者采用临床护理路径表进行护理干预,对照组患者给予常规护理干预。对2组患者护理满意度、住院时间、住院费用以及并发症发生率进行对比分析。结果采用临床护理路径后,观察组患者的护理满意度、住院时间、住院费用以及并发症发生率分别为98.6%、（5.4±1.4）d、（4582.5±492.4）元、1.4%,显著少于对照组的93.3%、（7.1±1.8）d、（5824.6±814.7）元、3.3%,比较差异具有统计学意义（P〈0.05）。结论在妇科手术患者术后采用临床护理路径进行干预,有利于患者早日康复。     

Radiological assessment of the adult chest: implications for chest compressions

The recommended depth for chest compression during adult cardiopulmonary resuscitation (CPR) is 4-5 cm, and for children one-third the anterior-posterior (AP) chest diameter. A compression depth of one-third of the AP chest diameter has also been suggested for adult CPR. We have assessed chest CT scans to measure what proportion of the adult AP chest diameter is compressed during CPR. Measurements of AP diameter of chest CT scans were taken from the skin anteriorly at the middle of the lower half of the sternum, perpendicularly to the skin on the posterior thorax. The anatomical structure that would be compressed at this level was also noted. One hundred consecutive CT scans were examined (66 males and 34 females). The age (mean +/- S.D.) was 68+/-12 years. AP chest diameter was 253 +/- 27 mm for males and 235 +/- 30 mm for females. The proportion of total AP chest diameter compressed with current compressions is 15.8-19.8% for males and 17.0-21.3% for females. The commonest anatomical structures that would be compressed are the ascending aorta (38%) and the top of the left atrium (36%). There is also a wide anatomical variation in the shape of the adult chest. A chest compression depth of 4-5 cm in adults equates to approximately one-fifth of the AP diameter of the adult chest.     

音叉震动觉在脊髓压迫症定位诊断中的地位

【目的】探讨音叉震动觉检查在急慢性脊髓压迫症初步定位诊断中的价值及方法。【方法】对临床可疑患者用128Hz音叉从踝骨开始依次向上检查骨突部位,以音叉震动觉时间≤5s为异常,以上下脊髓节段支配区音叉震动觉时间相差1倍以上处为中心行MRI检查。【结果】慢性胸椎压缩性骨折3例,颈部黄韧带骨化5例,胸椎黄韧带骨化19例,颈椎间盘突出1例．腰椎间盘突出10例均得到准确定位诊断。【结论】音叉震动觉异常可作为脊髓压迫症初步定位诊断的依据,尤其是对无感觉障碍平面的患者有重要价值。     

Force and depth of mechanical chest compressions and their relation to chest height and gender in an out-of-hospital setting

IntroductionThe LUCAS 2 device stores technical data that documents the chest compression process. We analyzed chest wall dimensions and mechanics stored during chest compressions on humans using data gathered with the LUCAS 2 device.MethodsData from LUCAS 2 devices used in out-of-hospital cardiac arrest were downloaded with dedicated proprietary software and matched to the corresponding patient data. Cases were included only if the suction cup was placed correctly, if it was not realigned during the first 5 min of chest compressions, and if no other anomaly in device use was noted. Trauma cases were excluded.ResultsNinety-five patients were included. All patients received manual cardiopulmonary resuscitation prior to the application of the device. The mean (SD) chest height was 232 (25) mm for males and 209 (26) mm for females (P < 0.001). The mean (min–max) compression depth in patients with chest height >185 mm was 53 (50–55) mm, corresponding with 19–28% of the chest diameter. The mean force required to achieve the compression depth of 53 mm ranged between 219 and 568 N. No correlation was found between chest height and force to reach 53 mm depth (females: R² = 0.001, males: R² = 0.007).ConclusionThere was a large variation of the required force to achieve a compression depth of 53 mm. No correlation was seen between chest height and maximum force required to compress the chest 53 mm.     

Mechanical cardiopulmonary resuscitation for patients with cardiac arrest

BACKGROUND:

Although modern cardiopulmonary resuscitation (CPR) substantially decreases the mortality induced by cardiac arrest, cardiac arrest still accounts for over 50% of deaths caused by cardiovascular diseases. In this article, we address the current use of mechanical devices during CPR, and also compare the CPR quality between manual and mechanical chest compression.

METHODS:

We compared the quality and survival rate between manual and mechanical CPR, and then reviewed the mechanical CPR in special circumstance, such as percutaneous coronary intervention, transportation, and other fields.

RESULTS:

Compared with manual compression, mechanical compression can often be done correctly, and thus can compromise survival; can provide high quality chest compressions in a moving ambulance; enhance the flow of blood back to the heart via a rhythmic constriction of the veins; allow ventilation and CPR to be performed simultaneously.

CONCLUSION:

Mechanical devices will be widely used in clinical practice so as to improve the quality of CPR in patients with cardiac arrest.KEY WORDS: Cardiopulmonary resuscitation, Manual compression, Mechanical compressionCardiopulmonary resuscitation (CPR), also called basic life support, is an emergency medical procedure performed to restore blood flow (circulation) and breathing. The goal of CPR is to provide oxygen quickly to the brain, heart, lungs, and other organs until normal function of the heart and lung is restored. CPR can help prevent brain damage and death in children.[1] It is reported that approximately 600 000 individuals suffer from cardiac arrest and receive cardiopulmonary resuscitation in the United States and Europe each year.[2,3] Although modern CPR substantially decreases the mortality induced by cardiac arrest, cardiac arrest still accounts for over 50% of deaths caused by cardiovascular diseases.[4]The success rate of CPR ranging widely from 5% to 10% is based on many factors such as (1) causes of cardiac or respiratory arrest; (2) underlying health conditions of victims; (3) time elapse between arrest and CPR; and (4) techniques for CPR.[5,6] The survival rate is affected not only by CPR but more importantly by its quality. Effective CPR can contribute more blood flow to the brain, heart and other organs, and thus increase the survival rate of patients with cardiac arrest.[7] In November 2005 the AHA revised CPR guidelines to emphasize chest compression and its effect on blood pressure.[8] Studies[7,9,10] showed that by taking fewer breaks between compressions, rescuers can keep blood pressure higher, which helps to pump blood to the brain and other vital organs. However, during CPR even with the best manual chest compressions, cardiac output is approximately 20% to 30% of normal value, and performer''s fatigue may also reduce the quality of the compressions. Besides, chest compressions can not be performed during the transportation of patients, which prolong the time between the arrest and CPR, and also increase the difficulty of resuscitation.[11,12] Therefore, to avoid or reduce these negative factors and to improve the CPR quality, mechanical devices are frequently used.In this article we address the current use of mechanical devices during CPR, and also compare the CPR quality between manual and mechanical chest compression.

Comparison of quality between manual and mechanical CPR

In 1961, Harrison-Paul[13] applied the electric pneumatic device clinically, and then Kouwenhoven et al[14] introduced closed chest cardiac massage for CPR in 1969. The Kouwenhoven technique has been shown repeatedly its clinically inefficacy. Although this technique can clearly save lives, its inherent inefficiency and the challenges related to teaching and retaining the skills needed to perform the technique correctly have limited its overall effectiveness. This has prompted us to develop new life-saving CPR techniques and devices.At present, the most commonly used mechanical chest-compression devices include LUCASTM, Autopluse, Lifebelt, Thumper and Brunswick-TM HLR R30. Compared with manual compression, mechanical compression can: (1) often be done correctly, and thus can compromise survival; (2) potentially improve the quality of chest compression with automatic mechanical devices, which can potentially apply compression more consistently than manually; (3) can provide high quality chest compressions in a moving ambulance, which is very difficult to accomplish with manual CPR; (4) allow a reduction in a number of emergency medical systems (EMS) personnel needed to perform resuscitation;[15] (5) allow ventilation and CPR to be performed simultaneously; (6) enhance the flow of blood back to the heart via a rhythmic constriction of the veins.[16]Autopulse can markedly increase the mean systolic blood pressure from 72 mmHg to 106 mmHg, and the average diastolic blood pressure from 17 mmHg to 23 mmHg as compared with manual compression (P<0.05). In addition, Autopulse can obviously improve coronary perfusion, and generate approximately 36% of the normal blood flow, which is much higher than that generated by manual compression (13%).[17] But before and after use of Autopulse, there is no significant difference in the pressure of end tidal carbon dioxide (PETCO₂), which serves as an important parameter for evaluating cardiac output and pulmonary blood flow.[18] Axelsson et al[5] reported that in 126 patients who participated in the study, 64 were enrolled in a mechanical chest compression group and 62 in a control group. The group receiving mechanical ACD-CPR showed highest PETCO₂ values in contrast to the average (P=0.04), initial (P=0.01) and minimum (P=0.01) values. There was no significant difference in the maximum values between the two groups. This indicated that chest compression can increase blood supply to the heart and lung.

Comparison of survival rate

Although mechanical CPR can increase cardiac output, coronary and cerebral blood flow, arterial blood pressure, and PETCO₂, whether mechanical CPR can increase the survival rate of patients with cardiac arrest is still in debate. Skogvoll et al[19] reported that there were no significant differences between mechanical and manual CPR compression (survival rates 13% vs. 12%) in 302 patients with cardiac arrest. Another prospective trial showed that the survival rate of patients after hospitalization for 24, 48, and 72 hours and the number of patients who had reestablished spontaneous circulation was increased in the mechanical compression group, but no differences were observed between the mechanical and manual CPR compression groups.[18] In a prospective randomized trial conducted by Kouwenhoven[14], 1410 patients received mechanical CPR and 1456 received manual CPR. The survival rate of the mechanical CPR group was significantly higher than that of the manual CPR group (23.8% vs. 20.6%, P< 0.05). Ong et al[17] also reported that mechanical CPR increased the survival rate of patients. But Skogvoll et al[19] described in their randomized clinical trial that mechanical CPR increased the mortality of patients. Thus further clinical studies or animal experiments are needed to confirm this finding.

Mechanical CPR in special circumstance

Percutaneous coronary intervention (PCI)

In most cases, cardiopulmonary arrest is derived from the heart. Myocardial ischemia caused by acute coronary occlusion can lead to the development of ventricular fibrillation. PCI was thought to be useful in patients with acute ST elevation myocardial infarction (STEMI),[20,21] and it was also beneficial to patients after recovery of spontaneous circulation.[22] Sunde et al[23,24] found that the mortality of patients treated with PCI (n=12) was significantly lower than that of patients treated conservatively (n=20) (17% vs. 70%). However, PCI is seldom used in patients with cardiac arrest.[25] CPR is still required to perform PCI during cardiac arrest, but it is very difficult to simultaneously perform manual CPR and PCI. Mechanical chest compression allows for continued PCI despite ongoing cardiac or circulatory arrest with artificially sustained circulation. A study[25] reported that in 3058 patients treated with PCI for ST-elevation myocardial infarction (STEMI), 118 were in cardiogenic shock and 81 required defibrillation. LUCAS was used in 38 patients, 1 underwent a successful pericardiocentesis, and 36 were treated with PCI. Eleven of these patients were discharged alive in good neurological conditions. Similarly, other studies have shown that that it is feasible to perform mechanical CPR during PCI.[26–29]

Transportation

During ambulance transport to hospital, it may not be possible to perform manual CPR, while mechanical devices may play an important role in maintaining circulation.

Other fields

Mechanical devices have been used in imaging diagnosis. Agostoni et al[30] evaluated both CT image quality in a phantom study and feasibility in an initial case series using automated chest compression (A-CC) devices for cardiopulmonary resuscitation (CPR), and they found under CPR conditions multidetector CT diagnostics supports either focused treatment or the decision to terminate efforts.

Limitations of mechanical CPR

Delayed time-elapse between arrest and CPR

Device use may delay the time-elapse between arrest and CPR. Ong et al[31] reported that LUCAS device delayed CPR for 2.9±2.1 minutes when compared with manual compression. Another study showed that the median no-flow time, defined as the sum of all pauses between compressions longer than 1.5 seconds, during the first 5 minutes of resuscitation, was manual CPR 85 seconds (interquartile range [IQR] 45 to 112 seconds) versus mechanical CPR 104 seconds (IQR 69 to 151 seconds). The mean no-flow ratio, defined as no-flow time divided by segment length, was manual 0.28 versus mechanical CPR 0.40 (difference=−0.12; 95% confidence interval −0.22 to −0.02). However, from 5 to 10 minutes into the resuscitation, the median no-flow time was manual 85 seconds (IQR 59 to 151 seconds) versus mechanical CPR 52 seconds (IQR 34 to 82 seconds) and the mean no-flow ratio manual 0.34 versus mechanical CPR 0.21 (difference=0.13; 95% confidence interval 0.02 to 0.24). The average time to apply mechanical CPR during this period was 152 seconds. This suggests that in the first 5 minutes, the quality of manual CPR is higher than that of mechanical CPR; while during 5-10 minutes, the quality of mechanical CPR was improved. Hallstrom et al[19] reported that use of an automated LDB-CPR device as used in this study was associated with worse neurological outcomes and a trend toward worse survival than manual CPR. These factors might partly explain the varied outcomes treated with mechanical CPR.

Injuries associated with mechanical CPR

Mechanical chest compression can also cause injuries in patients. Hallstrom et al[32,33] reported that fracture was present in 10/47 in the manual group and in 11/38 in the LUCAS group (P=0.46), and there were multiple rib fractures (> or =3 fractures) in 13/47 in the manual group and in 17/38 in the LUCAS group (P=0.12). Bleeding in the ventral mediastinum was noted in 2/47 and 3/38 in the manual and LUCAS groups respectively (P=0.65), retrosternal bleeding in 1/47 and 3/38 (P=0.32), epicardial bleeding in 1/47 and 4/38 (P=0.17), and hemopericardium in 4/47 and 3/38 (P=1.0), respectively. This finding indicates that mechanical chest compression with the LUCAS device appears to be associated with the same variety and incidence of injuries as manual chest compression. For the injuries caused by mechanical CPR, we still need further clinical studies.In conclusion, mechanical devices will be widely used in clinical practice so as to improve the quality of CPR in patients with cardiac arrest.     

动脉压迫止血器在冠状动脉造影术后的应用

目的评价经股动脉冠状动脉造影术（coronary arteriography,CAG）后股动脉穿刺部位应用YM-GU-1229型股动脉压迫器的止血效果和安全性。方法经股动脉途径行CAG的195例患者随机分为两组,观察组术后采用天津怡美医疗器械有限公司生产的YM-GU-1229型动脉压迫器压迫止血105例,对照组采用传统人工压迫止血法90例,比较两组止血时间、制动时间和血管并发症发生率。结果两组止血方法进行比较,其中止血时间观察组为（3.0±1.5）min,对照组为（20.0±4.5）min;下肢制动时间观察组为（8.5±2.5）h,对照组为（22.0±2.0）h,两组比较观察组止血时间及下肢制动时间均显著缩短（P〈0.05）。观察组血管并发症的发生率为6.7%,人工压迫组为12.2%,两组比较,观察组发生率明显减少（P〈0.05）;止血成功率两组间无明显差异（P〉0.05）。结论 YM-GU-1229型动脉压迫止血器压迫止血可有效缩短止血时间及下肢制动时间,操作简便,适用性广,血管并发症明显低于传统人工压迫止血法,值得临床推广。     

压力带与抗栓泵联合使用预防妇科盆腔手术患者下肢深静脉血栓的研究

目的探讨压力带与抗栓泵对妇科盆腔手术后患者下肢深静脉血栓形成的预防作用。方法将150例妇科盆腔手术患者随机分为对照组、观察组和肝素组,每组各50例,对照组采取踝泵运动等常规下肢深静脉血栓形成干预措施;观察组在常规干预的基础上加用抗栓泵及压力带;肝素组在常规干预措施的基础上加用抗栓泵及低分子肝素。结果观察组术后凝血功能各项指标均在正常范围,肝素组术后凝血酶原时间及活化部分凝血酶时间显著延长并超出正常高值。观察组、肝素组预防下肢深静脉血栓形成效果优于对照组（P〈0．01）。结论压力带与抗栓泵联合使用可增加下肢静脉回心血流量,改善血液高凝状态,可减少妇科盆腔手术患者下肢深静脉血栓的发生,并且肝素组无潜在的出血风险,值得临床推广使用。     

压力梯度长袜联合间歇压力充气装置预防妇科肿瘤淋巴清扫术后下肢淋巴水肿的效果研究

[目的]探讨压力梯度长袜联合间歇压力充气装置预防妇科肿瘤淋巴清扫术后下肢淋巴水肿的效果。[方法]按照随机数字表法将2017年6月—2018年12月无锡市某三级甲等医院收治的89例妇科肿瘤病人分为对照组47例和观察组42例,对照组病人采用常规治疗,观察组病人采取压力梯度长袜联合间歇压力充气装置治疗。观察两组病人术前1 d、术后第7天静脉血流平均速度;比较术后引流量、尿管留置时间和白蛋白水平;术后6个月下肢淋巴水肿情况、下肢淋巴水肿相关症状情况。[结果]两组病人术前1 d静脉血流平均速度、术后6个月活动受限情况比较差异无统计学意义(P>0.05);观察组病人术后第7天静脉血流平均速度、术后血清清蛋白水平、术后6个月下肢淋巴水肿治疗总有效率高于对照组(P<0.05);观察组病人术后引流量、术后6个月下肢出现疼痛、麻木情况低于对照组,术后尿管留置时间短于对照组(P<0.05)。[结论]压力梯度长袜联合间歇压力充气装置可以有效预防妇科肿瘤淋巴清扫术后下肢淋巴水肿,提高病人术后生活质量。     

The relationship between rate of chest compression and compression:relaxation ratio

One of the arguments put forward in support of a relatively fast rate of chest compression during CPR, is that it facilitates the achievement of a high compression:relaxation ratio. This has been shown to increase blood flow. In this study a group of volunteers carried out chest compression at the rate that each felt was correct and comfortable. There was no significant relationship between compression rate and compression:relaxation ratio. In a second study volunteers carried out chest compression on a manikin at rates of 40/min; 60/min; 80/min and 100/min. There was no significant rate related difference in the compression:relaxation ratios recorded. The ability to achieve a high compression duration is not related to compression rate, and should not be a consideration when guidelines on CPR are revised.     

Lossless Compression of Otoneurological Eye Movement Signals

We studied the performance of several lossless compression algorithms on eye movement signals recorded in otoneurological balance and other physiological laboratories. Despite the wide use of these signals their compression has not been studied prior to our research. The compression methods were based on the common model of using a predictor to decorrelate the input and using an entropy coder to encode the residual. We found that these eye movement signals recorded at 400 Hz and with 13 bit amplitude resolution could losslessly be compressed with a compression ratio of about 2.7.