成批烧伤患者的急救与护理管理

目的:总结成批烧伤患者的救治经验及组织管理措施,提高抢救成功率.方法:由护理部统一指挥,统筹安排,建立快速有效地应急护理管理机制.结果:10批80例患者抢救成功率为93.75%.结论:科学有效地护理组织与管理,是提高成批烧伤患者抢救成功率的重要保证.     

急诊胸痛患者抢救时应用优化急诊护理流程的价值

目的：系统分析急诊胸痛患者抢救时应用优化急诊护理流程的价值。方法：遴选本院68例急诊胸痛患者展开回顾性研究,选取时间范围是2021年3月～2022年3月,依据“护理方式的不同”将其分成对照组与观察组,且每组收入患者34例,对照组患者以常规护理模式,观察组行优化急诊护理流程模式,系统分析两组的抢救成功率、各抢救环节耗费时间。结果：护理后,对比于对照组,观察组的抢救成功率显著较高,P<0.05;护理后,对比于对照组,观察组的接诊环节、分诊评估环节、抢救前准备环节与抢救环节显著较短,P<0.05。结论：急诊胸痛患者行优化急诊护理流程模式可显著提升其抢救成功率,缩短各抢救环节耗费时间,建议临床积极学习、推广。     

优化急诊护理路径对急性脑卒中患者的影响

目的 探究优化急诊护理路径对急性脑卒中患者抢救效率的影响。方法 分析2020年01月-2022年01月急诊科收治的急性脑卒中患者资料,合计256例患者,根据优化急诊护理路径应用时间分为对照组(传统急诊流程护理,128例)及优化组(优化急诊护理路径,128例)。观察两组患者抢救效率、急救时间、不良事件发生率、预后及患者护理满意度。结果 优化组抢救效率、Fugl-Meter评分、Barthel指数、患者及其家属护理满意度显著高于对照组,差异具有统计学意义(P<0.05);优化组入院至接诊时间,入院至确诊时间,转运时间、入院至溶栓时间、不良事件发生率、NIHSS评分均显著低于对照组(P<0.05)。结论 优化急诊护理路径能有效缩短急性脑卒中患者抢救时间,提高患者抢救效率并减少不良事件,改善患者预后且能提高患者满意度。     

多科协作创伤救治模式探索

目的 探讨在创伤救治中的多科协作模式.方法 回顾总结我院创伤救治中心成立以来多科协作模式的运行方式和救治流程,创伤患者救治的时间节点与创伤中心成立前作比较.结果 对照组收治955例,抢救成功823例,占86.18%;本组2 670例,抢救成功2 618例,成功率98.05%.两组比较统计学有显著差异(P<0.01).结论 多科协作模式是提高创伤救治成功率的有效途径.创伤中心的设立、成套的创伤救治体系建立、高素质专业人员培养及由创伤中心医师组织多科协作的实施,开展急诊手术尽早修复损伤器官、消除致死致残因素、重视重症监护与治疗是提高救治成功率的关键.     

高原地区道路交通伤2100例急诊救治体会

目的分析西藏高原地区道路交通伤的临床特点和急诊救治措施。方法回顾分析2年来我院急诊救治2100例道路交通伤患者的临床资料。结果本组2100例患者中,1145例行急诊手术,急诊抢救治愈1102例,抢救成功率96．2％,术中、术后死亡40例。结论快速进行伤情评估,准确拟定诊疗计划,有效进行血容量维持,合理进行急诊规范化救治,能最大限度地提高道路交通伤的救治成功率。     

院前急救护理对急诊昏迷患者预后影响临床分析

目的探讨院前急诊护理干预在对急诊昏迷患者抢救中的效果及意义。方法选取急诊科自2012年4月~2014年4月收治的昏迷患者98例作为研究对象,将其依据入院方式分为两组:对照组(42例):患者由家属送入医院即未进行院前急诊护理;观察组(56例):患者由120接入医院并均进行了院前急诊护理。对比分析两组的介入急救时间、抢救成功率、致残率、并发症发生率以及死亡率。结果观察组介入急救时间明显短于对照组,二者差异有统计学意义(P<0.05);观察组抢救成功率高于对照组,致残率、并发症发生率及死亡率低于对照组,两组比较差异有统计学意义(P<0.05)。结论院前急诊干预护理可以有效的缩短介入急救时间,提高昏迷患者的抢救成功率,降低致残率、并发症发生率及死亡率,值得临床的重视。     

滇南地区102例烧伤患者长途转运中的护理体会

威胁生命的大面积烧伤大多发生在院外,入院前处理不当和入院不及时是造成救治失败的重要原因[1].滇南地区地处边疆,山高路险,大多数路况较差,给伤员长途转运带来较大的挑战.为提高烧伤患者长途转运护理质量,我科从2006年6月~2010年12月,对急诊出诊的烧伤病人采取启动转运预案、转运前准备、转运中护理及注意事项、信息沟通、转运交接等5条措施,确保烧伤病人院前专业治疗护理的连续性,取得了良好的效果,现总结如下.     

成批大面积烧伤救治的临床经验

目的 :通过对烧伤早期的正规治疗 ,提高成批大面积烧伤救治成功率。方法 :对 1994年～1998年与 1998～ 2 0 0 2年前后两个阶段的成批大面积烧伤救治成功率的比较 ,前者为B组 ,后者为A组 ,验证早期实施湿性医疗技术与综合抢救治疗的疗效。结果 :A组在烧伤早期予以湿性医疗技术及综合正规治疗明显提高了成批大面积烧伤治愈率 ,与B组相比 ,P <0 0 1。结论 :大面积成批烧伤的抢救治疗应建立院前急救机制 ,进行网络化管理 ,湿性医疗技术和综合治疗措施结合可提高治愈率     

急救绿色通道模式下204例严重创伤患者的救治

目的 探讨急诊绿色通道模式下严重创伤患者的救治.方法 回顾分析了2006年1月~2010年12月进入"严重创伤急救绿色通道"的204例患者资料,记录了各环节的救治情况.结果 伤后至入院时间平均为207min,入院至确定性治疗时间为64.34min;死亡19例,抢救成功率92.87%.结论 急诊绿色通道加快严重创伤患者确...     

重症时机理论关怀护理对急诊重症多发伤患者抢救成功率及Porter评分的影响

目的 探讨重症时机理论关怀护理对急诊重症多发伤患者抢救成功率及Porter评分的影响。方法 选取2020年01月-2022年12月期间收治的80例急诊重症多发伤患者为对象,随机分为对照组、观察组,各40例。对照组以常规护理干预,观察组增加重症时机理论关怀护理干预。评估比较两组患者的抢救成功率、急诊用时指标、Porter评分、护理满意度等。结果 观察组抢救成功率为95.00%(38/40),高于对照组患者为77.50%(31/40)(P<0.05)。干预后,观察组患者的急诊科停留时间、影像学检查时间、急诊运送至手术室时间、入院至手术时间均低于对照组(P<0.05)。干预后,观察组各静脉处Porter评分均低于对照组(P<0.05)。观察组护理满意度为92.50%(37/40),高于对照组患者为75.00%(30/40)(P<0.05)。结论 重症时机理论关怀护理干预对急诊重症多发伤患者干预效果良好,能够提高患者的抢救成功率,缩短患者的抢救时间,改善患者的血管通畅程度,提高患者的护理满意度,可在护理实践中推广应用。     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

新疆石河子地区奶牛隐性乳房炎的调查与分析

采用LMT法对新疆石河子地区三个规模化奶牛场泌乳牛群进行了隐性乳房炎检测,共检测994头泌乳牛3976个乳区.结果表明:奶牛隐性乳房炎阳性率为81.9%,乳区阳性率为49.1%.数据分析表明,不同年龄、胎次以及有无卧床奶牛的隐性乳房炎阳性率差异显著(P<0.05),后乳区的隐性乳房炎感染率显著高于前乳区感染率(P<0.05),隐性乳房炎乳区发生数也明显影响当日产奶量(P<0.05).     

Sex differences in neuromuscular fatigability in response to load carriage in the field in British Army recruits

Objectives

Women are resistant to neuromuscular fatigue compared to men in response to a range of exercise tasks. The sex differences in the neuromuscular responses to load carriage have yet to be investigated.

Decrease in eccentric hamstring strength in runners in the Tirol Speed Marathon

Background

The local muscular endurance of knee flexors, during eccentric work in particular, is important in preventing or delaying kinematic changes associated with fatigue during treadmill running. This result, however, may not be transferable to overground running.

Objective

To test the hypothesis that overground running is associated with eccentric hamstring fatigue.

Methods

Thirteen runners (12 male and one female) performed an isokinetic muscle test three to four days before and 18 hours after a marathon. Both legs were tested. The testing protocol consisted of concentric and eccentric quadriceps and hamstring contractions.

Results

There were no significant differences between peak torque before and after the race, except that eccentric peak hamstring torque (both thighs) was reduced.

Conclusion

Overground running (running a marathon) is associated with eccentric hamstring fatigue. Eccentric hamstring fatigue may be a potential risk factor for knee and soft tissue injuries during running. Eccentric hamstring training should therefore be introduced as an integral part of the training programme of runners.     

肺心病慢性呼吸性酸中毒合并代谢性酸碱失衡判断方法探讨(附80例次血气分析)

目的：对42例肺心病慢性呼吸性酸中毒患者的80例次血气测定结果。方法：用不同的酸碱图（卡）及代偿公式进行酸碱类型的初步差别分析。结果：结合临床表现、各种影响因素与治疗反应等作出综合判定。结论：比较二种判定的差异，并提出较为实用、可靠的判断建议，以助于复合型呼吸性酸碱失衡的临床诊断与处理。     

Oxalosis in primary hyperoxaluria in infancy

Primary hyperoxaluria (PH1) is a rare inborn autosomal recessive metabolic disorder due to the deficiency of hepatic alanine-glyoxylate-aminotransferase. This deficiency results in excessive synthesis and urinary excretion of oxalate, inducing renal stone formation and deposition of calcium oxalate in the kidney, bone, myocardium, and vessels (systemic oxalosis, SO) in the most severely affected individuals. We report renal and skeletal changes in a 3-month-old girl with PH1 and SO. Intense cortico-medullary hyperechogenicity and increased homogeneous radiopacity of normal-sized kidneys suggested the diagnosis of SO. Skeletal survey showed osteopenia and characteristic symmetrical metaphyseal transverse bands in long bones, progressively becoming more dense and migrating towards the diaphysis. Multiple pathological and slowly healing fractures of the limbs occurred at the dense band level. A radiopaque rim was then observed in flat bones, epiphyseal nuclei, and vertebral bodies. Inflammatory granulomatous reaction, induced by the presence of oxalate crystals in the marrow spaces, coexisted with progressively evident radiological signs of secondary hyperparathyroidism, with partially overlapping features. The patient was treated by peritoneal dialysis and hemodialysis until combined liver–kidney transplantation. There are no previous reports of infants treated with hemodialysis for more than 2 years.     

Interventional radiology in oncology in private practice

Interventional oncology in private practice requires expert training and can be performed in a stand-alone facility for type 1 procedures in a hospital setting for type 2 and 3 procedures where subspecialized radiologists, state-of-the-art equipment, and postprocedure hospital monitoring are available. A multidisciplinary effort with oncologists, internal medicine physicians and anesthesiologists is necessary. The practice of interventional oncology requires around the clock availability, meticulous and established protocols and procedures and a financial investment. On the other hand, it is professionally gratifying because of constant technical advances and the impact on patients.