患者体位对注射时发生晕厥的影响及护理措施

目的：了解不同体位对注射时出现晕厥的影响，提高患者注射时的安全感。方法：对静脉穿刺抽血、静脉注射和肌内注射患者分坐舒组、平卧位组，分别坐在靠背椅子、仰卧或侧卧在床上接受注射或静脉抽血，对每例注射时发生晕厥的患者记录姓名、性别、年龄、体位、使用的药物、主要症状体征等情况，并进行对比。结果：坐位组接受注射或抽血发生晕厥的几率明显高于卧位组，且患者发生晕厥后3min内血压嘲显低于卧位组，有显著性差异（P〈0．01）。结论：对患者采取卧位抽血或注射可有效地减少晕厥发生和减轻晕厥症状。     

患者体位对注射时发生晕厥的影响及护理措施

目的：了解不同体位对注射时出现晕厥的影响，提高患者注射时的安全感。方法：对静脉穿刺抽血、静脉注射和肌内注射患者分坐舒组、平卧位组，分别坐在靠背椅子、仰卧或侧卧在床上接受注射或静脉抽血，对每例注射时发生晕厥的患者记录姓名、性别、年龄、体位、使用的药物、主要症状体征等情况，并进行对比。结果：坐位组接受注射或抽血发生晕厥的几率明显高于卧位组，且患者发生晕厥后3min内血压嘲显低于卧位组，有显著性差异（P〈0．01）。结论：对患者采取卧位抽血或注射可有效地减少晕厥发生和减轻晕厥症状。     

患者体位对注射时发生晕厥的影响及护理措施

目的:了解不同体位对注射时出现晕厥的影响,提高患者注射时的安全感。方法:对静脉穿刺抽血、静脉注射和肌内注射患者分坐位组、平卧位组,分别坐在靠背椅子、仰卧或侧卧在床上接受注射或静脉抽血,对每例注射时发生晕厥的患者记录姓名、性别、年龄、体位、使用的药物、主要症状体征等情况,并进行对比。结果:坐位组接受注射或抽血发生晕厥的几率明显高于卧位组,且患者发生晕厥后3 min内血压明显低于卧位组,有显著性差异(P<0.01)。结论:对患者采取卧位抽血或注射可有效地减少晕厥发生和减轻晕厥症状。     

体位对注射复方氨基比林出现晕厥的影响及护理

目的：为了解不同体位对肌内注射复方氨基比林注射液出现晕厥的影响,方法随机将２４０例肌内注射氨基比林注射液的患分为２组,观察组１２０例采用卧位注射,对照组１２０例采用坐位注射。观察２组晕厥发生情况。结果观察组患无１例出现晕厥,而对照组患出现了３８例晕厥（Ｘ＾２＝４５．１４,Ｐ〈０．０１）,两组晕厥的发生率具有显性差异。结论采用卧位注射复方氮基比林注射液可减少或避免患出现晕厥。     

注射时发生晕厥的原因分析及处理

晕厥是一种突发而短暂的意识丧失,可伴有全身性先驱症状,如头昏、目眩、耳鸣、面色苍白、出冷汗等.在日常工作中,护士在给病人注射时,病人经常会出现晕厥现象.现分析发生晕厥的原因,并提出相应的处理措施. 1 原因     

两种体位肌肉注射安乃近发生晕厥的对比研究

[目的]研究减少肌肉注射安乃近发生晕厥的最佳体位。[方法]将肌肉注射安乃近的病人340例随机分为两组,每组170例,分别坐位和卧位肌肉注射,观察出现晕厥的发生率。[结果]坐位肌肉注射安乃近出现晕厥的发生率为18.82%,卧位肌肉注射出现晕厥的发生率为1.18%。年龄4岁～35岁的病人采用坐位晕厥发生率明显高于卧位(P<0.01或<0.05)。[结论]采用卧位肌肉注射安乃近可减少晕厥的发生。     

婴儿预防接种注射体位的探讨

目的 探讨婴儿预防接种注射的最合适体位，以提高免疫接种质量。方法 将接受预防接种注射的健康婴儿155例，随机分成斜卧位组52例、环抱坐位组52例和传统坐位组51例，采用自制婴儿疼痛程度评估表，比较3种体位注射时婴儿疼痛反应及监护人的舒适认可程度。结果 斜卧位和环抱坐位组注射时，婴儿表现比较安静，不满意程度低，疼痛反应程度轻，监护人容易认可接受。传统坐位组注射时婴儿表现比较紧张、烦躁，不满意程度高，疼痛反应程度重。环抱坐位组、斜卧位组分别与传统坐位组相关指标比较差异有统计学意义（P〈0．01）。结论 斜卧位与环抱坐位可作为婴儿行预防接种注射的合适体位，能减轻注射疼痛对婴儿造成的不良影响。     

门诊注射时晕厥发生原因及护理体会

在门诊注射室晕厥是肌注或静注时常见的一种病发症。由于病人个体差异形式的不同心理，导致极度的心理紧张，刺激迷走神经，使迷走神经兴奋，血管扩张，回心血量减少．使大脑广泛性供血不足所致的短暂的意识丧失。因此分析发生的原因，有助于预防晕厥的发生，及时抢救和护理晕厥病人。     

婴儿预防接种注射体位的探讨

经常持久的疼痛刺激对婴儿的神经系统是有害的,刺激和疼痛能导致应激反应,如果缺乏应激适应能力,就会导致生理失调[1]。长期以来儿童预防接种注射疼痛未引起足够重视,对接种注射疼痛的评估及疼痛处理的相关研究报道甚少。预防接种作为一种必要的伤害性刺激,应该引起关注,如何减     

肌内注射舒适体位的应用研究

目的探讨肌内注射的最舒适体位。方法对410例(共1045例次)肌内注射病人采取自身对照法,每例病人至少注射2次,交替取传统的侧卧位肌内注射体位即侧卧,上腿伸直,下腿弯曲(传统体位)和改进后的体位即侧卧,上腿弯曲,下腿伸直(改良体位),采用简化Mcgil疼痛评分表和自制的卧位舒适评定表进行评定,对比两种不同注射体位注射时病人的疼痛和舒适程度。结果两种体位的疼痛评分无显著性差异(P=0.314),但两种体位的舒适度评分有显著性差异(P<0.0001),病人感觉采取改良体位注射较为舒适。结论上腿弯曲、下腿伸直的侧卧注射体位较传统的上腿伸直、下腿弯曲的体位更加舒适,较易为病人接受。     

The role of tilt training in preventing recurrent syncope in patients with vasovagal syncope: a prospective and randomized study

Background: Recurrent vasovagal syncope (VVS) can be a severely disabling disorder that may lead to an important deterioration of quality of life because of the severity and recurrence of episodes. This study sought to investigate the effectiveness of repeated orthostatic self-training in preventing syncope in patients with recurrent VVS.
Methods: Eighty-two consecutive patients (mean age 41 ± 4 years, 37 males) with recurrent VVS episodes and positive head-up tilt testing (HUT) were enrolled in this study. The patients were then randomized (1:1) to conventional therapy or conventional therapy plus additional tilt training sessions. The patients were followed for spontaneous syncope for one year. Primary end-points were the recurrence of syncope, the number of episodes, and the interval of time to the first recurrence.
Results: There were no significant differences of baseline clinical characteristics and parameters of HUT between the tilt training and control groups. The patients had 4 ± 2/year syncopal episodes prior to the HUT. The mean follow-up after randomization was 12 ± 2 months. Spontaneous syncope recurrence during follow-up was 56% (23 patients) versus 37% (15 patients) in the control and tilt training groups, respectively (P = 0.1). Time to first recurrence was also similar in both groups (70 ± 20 days vs 50 ± 15 days, P = 0.09). The frequency of recurrent syncopes was similar in all types of VVSs while the rate of episodes was significantly higher in control group in patients with vasodepressor type during follow-up period (32% vs 10%, P = 0.04). The mean number of recurrent syncope episodes was also similar in both groups (3 ± 1 vs 2 ± 1, P = 0.4).
Conclusions: Tilt training was unable to influence the spontaneous syncope recurrence for recurrent VVS except for vasodepressor type.     

Swallow syncope

Swallow syncope is a rare disorder caused by hypersensitive vagotonic reflex in response to deglutition. A 26-year-old man complained of recurrent light-headedness and near syncope on swallowing was hospitalized for monitoring and evaluation. Continuous electrocardiographic and invasive arterial pressure monitoring showed ingestion of a solid meal evoked light-headedness and complete AV block without an escape rhythm that lasted for 5.6 seconds. This patient received a Medtronic Kappa (401B) DDDR pacemaker with the rate drop feature. The patient has remained asymptomatic on follow-up for the past 2 years.     

直立倾斜试验对血管迷走性晕厥反复发作的预测价值

目的：探讨直立倾斜试验（HUTT）对血管迷走性晕厥（VVS）反复发作的预测价值。方法：2001年1月-2005年12月在中南大学湘雅二医院晕厥专科门诊就诊或住院的不明原因晕厥患者共429例。根据临床症状分为偶发晕厥组（晕厥发作仅1次，n=112）与反复晕厥组（晕厥发作超过1次，n=317）。HUTT采用基础直立倾斜试验（BHUT）及舌下含服硝酸甘油倾斜试验（SNHUT），观察两组的阳性率与晕厥发作频次的关系。结果：①BHUT＋SNHUT阳性率与晕厥发作频次关系：偶发晕厥组阳性率与反复晕厥组未见差异（36．61％比37．22％），各组男女性别分布亦未见差异（P均〉0.05）。②BHUT或SNHUT阳性率与晕厥发作频次关系：在BHUT时偶发晕厥组阳性率低于反复晕厥组（15．09％比33．33％，P〉0．05），女性〉男性（34．25％比14．15％，P〈0．01）；在SNHUT时偶发晕厥组阳性率亦低于反复晕厥组（10．69％比40．88％，P〉0．05），男女性别未见差异（50．88％比62．35％，P〉0．05）。结论：BHUT和（或）SNHUT与晕厥发作频次无明显关系，HUTT阳性率不能预测VVS反复晕厥发作。     

Clinical characteristics of defecation and micturition syncope compared with common vasovagal syncope

Background: Little is known about the clinical characteristics of patients with situational syncope such as defecation syncope (DS) or micturition syncope (MS) compared with those with common vasovagal syncope (VVS). Methods: Among 680 consecutive patients, who underwent a head‐up tilt test between January 2006 and November 2010, 282 patients (40.4±16.7 years; 48.6% men) diagnosed as DS (n = 38), MS (n = 38), or common VVS (n = 208) were included. Results: Ages at diagnosis (38.7±17.3 vs 48.3±14.1 vs 42.0±13.8, P = 0.004) and the first syncope (33.7±18.4 vs 44.5±15.3 vs 37.5±14.6, P = 0.002) were significantly less in patients with common VVS than those with DS or MS, respectively. The patients with MS were more likely to be men (73.7%, P = 0.036), whereas patients with DS were more commonly women (73.7%). No sexual preference was observed in patients with common VVS. Body mass index was significantly lower (P = 0.047) and syncopal episodes were more recurrent (P = 0.049) in patients with common VVS than those with DS or MS. The frequency of drinking alcoholbefore syncope was significantly higher in patients with MS (39.5%, P < 0.001). Conclusions: DS tended to occur in older women, whereas MS tended to occur in middle‐aged men and drinking alcohol was an important precipitating factor for MS. However, common VVS was observed more in a thin and young population, which was more recurrent compared with those situational syncopes. (PACE 2011;1–7)     

An association between anxiety and neurocardiogenic syncope during head-up tilt table testing

To study the association between anxiety and neurocardiogenic syncope as determined by head-up tilt table testing (HUT) in men and women with presyncope or syncope, patients with unexplained syncope or presyncope undergoing HUT were asked to complete the Burns Anxiety Inventory (BAI), a validated inventory of 33 questions with responses graded from 0 to 3. HUT consisted of a 30-minute tilt to 60 degrees, which if negative, was repeated with an isoproterenol infusion. A positive HUT was defined as symptomatic hypotension and/or bradycardia. Of the 66 patients who completed the BAI and underwent HUT, 33 were men and 33 were women. The mean age was 57 +/- 18 years (17-91 years). Patients with a positive HUT had a higher BAI score than those with a negative HUT (22 +/- 12 vs 14 +/- 13, P = 0.017). This association was stronger in women with a BAI score of 24 +/- 11 in those with a positive HUT versus 13 +/- 8 in those with a negative HUT (P = 0.005). In contrast, the mean BAI score for men with a positive HUT was 19 +/- 13, as compared to 15 +/- 16 for a negative HUT (P = 0.5). In conclusion, the present study demonstrates a statistical association between anxiety (as determined by BAI) and HUT result. Gender-based analysis revealed a more statistically significant relationship between anxiety and HUT outcome for women as compared to men.     

The clinical characteristics of situational syncope in children and adults undergoing head-up tilt testing

ObjectiveSituational syncope is a subtype of neurally mediated syncope and associated with specific circumstances. This paper is to assess the clinical characteristics and underlying causes of situational syncope.MethodsThis is a retrospective study of patients who underwent head-up tilt testing (HUTT). Medical records including age at HUTT, gender, number of syncopal episodes, family history of syncope, triggers before the syncopal episode, position during the syncopal episode and the responses to HUTT were reviewed.ResultsAmong 3140 patients, 354 patients (mean age 28.3 ± 16.6 years old, with 184 males and 170 females) were diagnosed with situational syncope. The causes of situational syncope included micturition (50.85%), defecation (15.82%), bathing (10.45%), swallowing (6.50%), cough (4.80%), post-dinner (3.95%), singing (3.11%), teeth brushing (2.26%), and hair grooming (2.26%). Patients with syncope triggered by micturition, cough, post-dinner were more likely to be men, while those caused by bathing, swallowing, singing, teeth brushing and hair grooming were more likely to be women. 34.75% of patients with situational syncope were between the ages of 10–19 years old, and 20.34% were between the ages of 40–49 years old. 74.01% of situational syncopal events occurred in an upright position. 47.74% of patients had positive responses to HUTT.ConclusionsThese findings show that micturition was the most common cause of situational syncope in both children and adults. There were significant gender and age differences among situational syncope triggered by different causes. Most of situational syncope occurred in the upright position and nearly half of the patients had positive responses to HUTT.     

Situational syncope: response to head-up tilt testing and follow-up: comparison with vasovagal syncope

Among sequential patients with neurally-mediated syncope, we studied the response to head-up tilt test (HUTT) in patients with situational syncope (SS) and their follow-up. Our findings were compared to those in patients with vasovagal syncope (VVS). The response to HUTT in patients with SS has not to date been fully investigated. Additionally, the prognosis of SS patients has not been systematically studied. We studied 162 consecutive patients with recurrent SS or VVS, all free of structural heart disease. Before study inclusion, they underwent an HUTT and were followed up for 12 months. Patients with SS were advised to avoid the trigger event. Patients with VVS were treated with propranolol or fluoxetine. For each patient we compared the number of syncopal spells during the last 12 months before study inclusion with that during follow-up. Among the 162 patients, 36 had SS and 126 had VVS. The response to HUTT and the number of syncopes before and during follow-up were similar in both groups. Among patients with SS, 10 (28%) had also experienced occasional episodes of VVS; however, they had a similar response to HUTT and prognosis to the remaining 26 SS patients without VVS attacks. Patients with SS have a similar response to HUTT and similarly benign clinical course to patients with VVS. The coexistence of occasional VVS episodes in patients with SS is not associated with a higher rate of positive HUTT or worse prognosis.