抚触配合穴位按摩对新生儿黄疸影响的研究

[目的 ]探讨抚触配合穴位按摩对新生儿黄疸的影响。 [方法 ]选取足月分娩新生儿 2 10例 ,随机分成对照组、抚触组和穴位按摩抚触组各 70例。对照组予以新生儿常规护理 ,抚触组在常规护理基础上给予传统正规的标准抚触方法 ;穴位按摩抚触组除给予新生儿常规护理外 ,将穴位按摩手法融入标准抚触方法中进行按摩 ,观察并记录新生儿出生后 7d内的经皮胆红素变化及高胆红素血症发生率。 [结果 ]在降低黄疸指数和新生儿高胆红素血症发生方面 ,穴位按摩抚触组与抚触组有统计学意义(P <0 .0 1) ,抚触组与对照组有统计学意义 (P <0 .0 1)。 [结论 ]抚触有降低新生儿黄疸指数和新生儿高胆红素血症的作用 ,抚触配合穴位按摩效果更优于单纯抚触法。     

新生儿抚触体位和顺序的临床研究

[目的 ]探讨新生儿抚触的最佳体位和顺序。 [方法 ]将 160例足月分娩正常新生儿在抚触中随机分为两组 ,对照组按正规国际抚触标准法进行 ,观察组先俯卧位抚触背部 ,再侧卧位抚触四肢 ,最后仰卧位抚触胸部、腹部、头部 ,观察新生儿抚触中是否哭闹不安、四肢屈曲紧张伴拥抱反射等症状。 [结果 ]观察组紧张哭闹明显少于对照组 ,两组比较有统计学意义 ( χ2 =65 .2 8,P <0 .0 1)。[结论 ]采用先俯卧再侧卧后仰卧的抚触体位与顺序 ,新生儿更感安全舒适 ,有利于父母建立抚触信心     

抚触配合穴位按摩对新生儿生长影响的研究

目的　观察抚触和抚触配合穴位按摩对新生儿生长发育的影响。方法　随机将足月分娩的新生儿 2 10例 ,分成对照组、抚触组和穴位按摩抚触组 3组 ,每组各 70例。对照组予以新生儿常规护理 ,抚触组除给予新生儿常规护理外给予标准抚触 ;穴位按摩抚触组除给予新生儿常规护理外 ,将穴位按摩手法融入标准抚触方法进行按摩 ;1次 /d ,每次 2 0～ 2 5min。分别观察、测量并记录新生儿出生时、出生后第 3天和出生后第 7天的头围、胸围、腹围、身长和体重。结果　出生后第 7天 ,按摩穴位组抚触新生儿的头围、胸围、身长和体重 ,分别与对照组、抚触组比较有统计学意义 (P <0 .0 5 )。结论　抚触配合穴位按摩 ,有利于促进新生儿生长发育     

新生儿抚触体位的临床观察

为了探讨新生儿抚触的最佳体位,我们对新生儿最初几次抚触时体位的舒适度进行了比较观察,结果是观察组抚触头部、躯体新生儿哭闹状态明显少于对照组.观察组新生儿哭闹状态需平均抚触次数明显少于对照组,而对照组新生儿安静状态需平均抚触次数明显多于观察组.不同分娩方式的新生儿,顺产新生儿对先俯卧位后仰卧位抚触耐受力比剖宫产新生儿好.     

抚触对新生儿健康的影响

目的　研究抚触对新生儿健康的影响。方法　将 80 0例新生儿随机分为抚触组 4 2 0例和对照组 380例。抚触组新生儿自出生后第 1天至生后 4 2d接受抚触 ,3次 /d。对照组未给予抚触 ,洗澡 1次 /d。于出生后第 5天及第 4 2天对新生儿进行摄奶量、身长、体重、头围测量。结果　抚触组新生儿安静、易入睡 ,且睡眠时间长 ;出生后 4 2d ,抚触组摄奶量、身长、体重均大于对照组 (P <0 0 5 )。结论　抚触能使新生儿情绪稳定 ,增加食欲和体重 ,有益于新生儿健康     

抚触促进新生儿生理性黄疸消退的临床观察

目的探讨新生儿抚触对生理性黄疸的影响.方法将60例正常新生儿分为抚触组和对照组,观察新生儿生理性黄疸消退情况.结果抚触组新生儿生理性黄疸消退较明显.结论抚触是一种简单实用的护理技术,值得推广.     

有效抚触对新生儿体重的影响

目的 :评价有效抚触对新生儿体重的影响。方法 :随机将 6 0例正常足月且评分在 8分以上的新生儿分成两组 ,实验组通过指导母亲抚触达到有效要求 ,对照组采用常规护理。结果 :实验组新生儿体重与对照组差异有显著性 (P <0 0 5 )。结论 :有效抚触可明显增加新生儿体重。     

抚触对促进新生儿生长发育的效果评价

目的:探讨抚触对新生儿身长、体重的影响。方法:将120例足月新生儿分为抚触组和对照组各60例,抚触组新生儿进行抚触活动2次/d,15m in次/;对照组按常规护理,不予抚触。测定两组出生时及出生42d时身长、体重的变化。结果:抚触组新生儿身长、体重增加明显,与对照组相比有显著性差异(P<0.05)。结论:抚触可促进新生儿生长发育,是一项安全、简便、实用的护理技术。     

抚触对新生儿生理行为及生长发育的效果分析

目的：观察抚触手法对新生儿生理行为及生长发育的影响,并与常规护理新生儿对比.方法：选择2003-06/2004-12在焦作煤业集团中央医院总院、一分院妇产科出生的足月正常儿300例.按出生的先后顺序分为2组,抚触组150例,对照组150例.①抚触组于新生儿出生后第2天开始进行抚触,2次/d,15 min/次.操作者抚触前温暖双手,抚触次序从头部、胸部、腹部、四肢至背部.头颈及背部应用指揉法按摩,四肢应用捏揉法.新生儿住院期间由专职抚触师操作,出院后继续由母亲或家属抚触.②由责任护士和家长记录其睡眠和觉醒时间、哭闹时间及睡眠惊醒次数,每例记录5 d;并分别记录出生时和42 d时的体质量,以及出生第10天、第60天的平均摄入奶量.对照组按新生儿常规护理,观察指标与抚触组相同.定期随访,60 d后全部返院进行各项指标复测评估.结果：①两组新生儿睡眠、觉醒、哭吵时间及惊醒次数比较：抚触组新生儿的睡眠时间显著长于对照组（t=7.10,P＜0.01）,而觉醒、哭吵时间显著短于对照组（t=10.91,17.14,P＜0.01）,惊醒次数也显著少于对照组（t=20.83,P＜0.01）.②两组新生儿第42天时体质量比较：抚触组新生儿的体质量显著高于对照组[（5 506.2&;#177;442.0）g,（5 154.4&;#177;387.4）g（t=7.33,P＜0.01）].③两组新生儿出生后第10天、第60天平均摄入奶量比较：出生后第10天两组新生儿的平均摄入奶量相比差异无显著性意义[520 mL,480 mL（P＞0.05）].出生后第60天抚触组新生儿平均摄入奶量显著高于对照组[1 100mL,920 mL（t=2.81,P＜0.01）].结论：接受过抚触的新生儿食量增加,睡眠时间延长且有规律,体质量增长较快且情绪稳定,因此抚触能有效地促进新生儿的生长发育和心理行为发育.     

抚触对新生儿血糖及体重的影响

目的为探讨抚触对新生儿健康的影响;方法将80例足月正常新生儿分为抚触组与对照组,对40例新生儿(抚触组)进行正规的抚触活动,观察两组在不同时间血糖、体重的变化;结果抚触后的新生儿血糖明显降低,体重明显增加.结论抚触是一种安全、简便的促进新生儿生长发育的方法之一.     

Clinical Trial Updates and Hotline Sessions presented at the Scientific Session 2007 of the American heart association

This article provides information and commentaries on trials which were presented at Clinical Trial Updates and Hotline Sessions presented at the Scientific Sessions 2007 of the American Heart Association in Orlando, Florida. The comprehensive summaries have been generated from the oral presentations and the webcasts of the American Heart Association. Most reports have not been published as full papers and therefore have to be considered as preliminary data, as the analysis may change in the final publications. The following papers are discussed: TRITON TIMI-38, EVA-AMI, BRIEF-PCI, RACE, MASS Stent, HF-ART, STITCH, CORONA, ILLUMINATE, CORE-64, OAT Substudy, AFCHF, MASCOT, RETHINQ, MASTER I, POISE, COUMA-GEN, HIJ-CREATE, PROVIDENCE I, CAUSMIC, IC-BMC, IC/IM BMCs.     

Caring as a slave morality: Nietzschean themes in nursing ethics

BACKGROUND: Sceptical arguments about 'caring' can be divided into three categories. First, it is suggested that, while caring is no doubt an admirable thing in itself, it is just one ideal among others. Secondly, it is claimed that caring is not really a virtue at all, and that it should be regarded as more of a vice, because it promotes favouritism, injustice, and self-deception. Thirdly, there is a worry that caring is not politically realistic, and that its advocates underestimate the powerful organizational and social structures which conspire to subvert nursing. AIM: This paper outlines a fourth, and more radical, type of scepticism, which explains why caring is subject to these drawbacks. In doing so, it considers the relation between caring, phenomenology and holism in nursing discourse, and the way in which all three fit together to form the 'caring paradigm'. METHODS: The paper adopts a genealogical approach, borrowed directly from Nietzsche's Genealogy of Morality. That book argues that the values associated with caring are the expression of a profound resentment, harboured by the slaves (weak, powerless, timorous) against the nobles (strong, powerful, self-confident). Caring represents an inversion, a sort of 'fantasy revenge', in which the nobles can be portrayed as 'evil', while the slaves portray their own weakness as 'good'. Taking its cue from Nietzsche, the paper shows that the Genealogy narrative can be transposed into a modern health care context, with nurses as the 'slaves' and the medical profession as the 'nobles'. CONCLUSIONS: The ideology of caring is, in the Genealogy's terms, a slave morality. It represents an attack on the 'medical-scientific model', motivated by resentment, and designed to establish nursing's superiority. Its effects have been debilitating, and it has prevented nursing from becoming a 'noble' (that is, a properly scientific) discipline.     

Recent advances in plant hepatoprotectives: a chemical and biological profile of some important leads

Medicinal plants have been traditionally used for treating liver diseases since centuries. Several leads from plant sources have been found as potential hepatoprotective agents with diverse chemical structures. Although, a big list of hepatoprotective phytomolecules was reported in the scientific literature, only a few were potent against various types of liver damages. Of which, silymarin, andrographolide, neoandrographolide, curcumin, picroside, kutkoside, phyllanthin, hypophyllanthin, and glycyrrhizin have largely attracted the scientific community. This review focuses discussion on the chemistry, biological activity, mode of action, toxicity, and future prospects of these leads.     

吞咽障碍患者服药管理的最佳证据总结

目的检索、评价和总结吞咽障碍患者服药管理的最佳证据。方法运用循证护理的方法,针对吞咽障碍患者服药管理提出问题,系统检索UpToDate、BMJ、乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)图书馆、Cochrane Library、加拿大安大略注册护士协会网站、英国国家临床医学研究所指南库、苏格兰学院间指南网、美国国立指南网、国际网络指南网、加拿大医学会临床实践指南、美国心脏/脑卒中协会网站、PubMed、CINAHL、英国NEWT网站、中国生物医学文献数据库、医脉通、中国知网等数据库或网站,检索时限为建库至2021年1月,文献类型涵盖临床决策、临床实践指南、证据总结、系统评价、专家共识。由3名研究者对检索到的文献进行评价和证据提取。结果共纳入12篇文献,其中临床决策2篇、指南2篇、证据总结6篇、专家共识2篇。总结了8个方面的最佳证据,包括医护人员教育和培训、用药前筛查和评估、多学科合作、代偿性方法、口服固体剂型的选择、碾碎药物的管理、胃肠营养管用药、用药效果监测和记录。结论该研究针对吞咽障碍患者服药管理进行证据总结,为建立吞咽障碍患者服药规范流程、实践...     

慢性病和功能障碍老年人身体活动的健康效果：系统综述的系统综述

目的 基于世界卫生组织国际分类家族(WHO-FICs)构建身体活动对慢性病和功能障碍老年人健康及健康相关状况的干预效果范畴及架构。方法 运用《国际疾病分类第十一次修订本》(ICD-11)和《国际功能、残疾和健康分类》(ICF)对老年人的健康及健康状况进行系统分析。检索PubMed、CBM、Scopus、Web of Science、Embase、中国知网、维普、万方等数据库,收集建库至2022年8月8日关于身体活动干预对慢性病和功能障碍老年人健康及健康相关状况康复效果的系统综述进行综述。结果 最终纳入系统综述11篇,来自6个国家,共涉及316项相关随机对照试验和28 169名参与者,主要包括老龄化、公共健康、康复、身体锻炼等领域。与老年人健康状况相关的疾病主要集中于痴呆、帕金森病、精神分裂症、抑郁症、认知障碍,骨质疏松症、关节炎、肌少症,慢性心力衰竭、冠心病、高血压、脑卒中,2型糖尿病,慢性肺病。干预方案中,活动形式有平衡、功能和耐力训练、灵活性训练,步行、伸展、上下肢训练、瑜伽、气功、太极拳等,活动频率每周1～7次,活动强度为中度,活动持续时间4周～10年。健康结局涉及降低疾病风险,...     

Integrative Medicine in the Oncology Setting,What Does the Research Show?

Most oncology patients are using some form of complementary alternative medicine (CAM). These can include acupuncture, massage, yoga, homeopathy, energy work, spiritual healers, vitamins and supplements, mind-body interventions, diets, and many other modalities. Although many of these interventions are safe and beneficial, some of them can be harmful. Unfortunately, because of time constraints, knowledge deficits, and the acuity of our patients, assessment of the use of CAM is often overlooked. As nurse practitioners, we must educate ourselves about the evidence for safety and efficacy of these interventions.     

四维面积应变评价不同左心室构型高血压患者的左心室功能

目的评价四维应变成像技术面积应变（4D-area strain）检测高血压不同左心室构型患者左心室收缩功能的价值。 方法收集2015年2月至8月浙江省杭州市余杭中医院确诊的原发性高血压患者125例,根据Ganan分类法分为：正常构型组45例（A组）、向心性重构组25例（B组）、向心性肥厚组25例（C组）及离心性肥厚组30例（D组）。另选取本院体检中心40名健康人作为健康对照组（N组）。采用4D-area strain检测各组与健康对照组常规左心室收缩功能指标与整体面积应变（GAS）、节段面积应变（RAS）值,进行相互比较。组间整体面积应变与对应的节段面积应变比较采用多样本均数方差分析,多个均数间的两两比较采用LSD-t检验。 结果（1）常规心功能：A、B、C、D及N组左心室舒张末期容积（EDV）、心搏量（SV）及心输出量（CO）测值比较,差异均无统计学意义（F =0.679、3.829、0.600,P均>0.05）,收缩末期容积（ESV）、射血分数（EF）、球形指数（Spl）、舒张末期重量（EDMass）测值比较,差异均有统计学意义（F=3.829、6.596、2.653、2.604,P均<0.05）;D组ESV测值与N、A、B、C组比较,差异有统计学意义（t =2.011、2.244、3.685、2.278,P均<0.05）;B组ESV测值与N组比较,差异有统计学意义（t=2.170,P<0.05）;B组EF测值与N、A、D组比较,差异有统计学意义（t =2.452、3.514、4.949,P均<0.05）;D组EF测值与N、C组比较,差异有统计学意义（t=2.849、3.486,P均<0.05）;D组SpI测值与N、A、B、C组比较,差异有统计学意义（t =2.854、2.941、3.200、2.979,P均<0.05）;C组EDMass测值与N、A组比较,差异有统计学意义（t=2.170、2.087,P均<0.05）;D组EDMass测值与A、B、N组比较,差异有统计学意义（t=2.668、2.081、3.762,P均<0.05）。（2）GAS：A、B、C、D各组与N组GAS测值比较,差异均有统计学意义（t=7.950、7.361、8.959、11.277,P均<0.01）,且随左心室重构程度加重差异更为明显;A、B组GAS测值分别与D组比较,差异均有统计学意义（t =3.332、2.102,P均<0.05）,A组GAS测值与C组比较,差异有统计学意义（t=3.134,P<0.05）。（3）RAS：D组所有节段与N组比较,差异均有统计学意义（第1~17节段,t分别为2.967、3.793、4.896、4.001、2.375、4.169、4.077、2.137、4.652、4.016、5.230、6.267、5.735、2.143、2.353、5.429、4.128,P均<0.05）;A、B、C 3组与N组比较,基底段的前间隔壁、后间隔壁、前侧壁,中间段的前侧壁,心尖段的前壁、侧壁、心尖帽,差异均有统计学意义（A-N：t=2.667、3.084、3.574、4.771、3.182、4.806、3.567,P均<0.05;B-N：t=2.702、2.868、2.179、3.130、3.302、3.203、3.093,P均<0.05;C-N：t=4.927、5.600、4.276、6.577、6.198、5.190、5.441,P均<0.05）;A、B、C 3组与N组心尖间隔段比较,差异均无统计学意义（t=0.934、1.562、1.879,P均>0.05）。 结论4D-area strain为不同左心室构型高血压患者左心室收缩功能的检测提供一种新方法,尤其是对早期收缩功能的检测更为敏感。     

Overview of Lymphedema for Physicians and Other Clinicians: A Review of Fundamental Concepts

Lymphedema has historically been underrated in clinical practice, education, and scholarship to the detriment of many patients with this chronic, debilitating condition. The mechanical insufficiency of the lymphatic system causes the abnormal accumulation of protein-rich fluid in the interstitium, which triggers a cascade of adverse consequences such as fat deposition and fibrosis. As the condition progresses, patients present with extremity heaviness, itchiness, skin infections, and, in later stages, dermal fibrosis, skin papillomas, acanthosis, and other trophic skin changes. Correspondingly, lymphedema results in psychological morbidity, including anxiety, depression, social avoidance, and a decreased quality of life, encompassing emotional, functional, physical, and social domains. For this review, we conducted a literature search using PubMed and EMBASE and herein summarize the evidence related to the fundamental concepts of lymphedema. This article aims to raise awareness of this serious condition and outline and review the fundamental concepts of lymphedema.     

Sitting biomechanics part I: review of the literature

OBJECTIVE: To develop a new sitting spinal model and an optimal driver's seat by using review of the literature of seated positions of the head. spine, pelvis, and lower extremities. DATA SELECTION: Searches included MEDLINE for scientific journals, engineering standards, and textbooks. Key terms included sitting ergonomics, sitting posture, spine model, seat design, sitting lordosis, sitting electromyography, seated vibration, and sitting and biomechanics. DATA SYNTHESIS: In part I, papers were selected if (1) they contained a first occurrence of a sitting topic, (2) were reviews of the literature, (3) corrected errors in previous studies, or (4) had improved study designs compared with previous papers. In part II, we separated information pertaining to sitting dynamics and drivers of automobiles from part 1. RESULTS: Sitting causes the pelvis to rotate backward and causes reduction in lumbar lordosis, trunk-thigh angle, and knee angle and an increase in muscle effort and disc pressure. Seated posture is affected by seat-back angle, seat-bottom angle and foam density, height above floor, and presence of armrests. CONCLUSION: The configuration of the spine, postural position, and weight transfer is different in the 3 types of sitting: anterior, middle, and posterior. Lumbar lordosis is affected by the trunk-thigh angle and the knee angle. Subjects in seats with backrest inclinations of 110 to 130 degrees, with concomitant lumbar support, have the lowest disc pressures and lowest electromyography recordings from spinal muscles. A seat-bottom posterior inclination of 5 degrees and armrests can further reduce lumbar disc pressures and electromyography readings while seated. To reduce forward translated head postures, a seat-back inclination of 110 degrees is preferable over higher inclinations. Work objects, such as video monitors, are optimum at eye level. Forward-tilting, seat-bottom inclines can increase lordosis, but subjects give high comfort ratings to adjustable chairs, which allow changes in position.     

Hospital Management of Acute Iron Ingestion

Abstract

This overview summarizes the major and minor side effects and drug interactions of fluoxetine. The adverse reactions include the “serotonin syndrome”, cardiovascular complications, extrapyramidal side effects such as akathisia, dyskinesias, and parkinsonian-like syndromes and an apparently increased risk of suicidality. Fluoxetine-induced mania and hypomania, seizures and sexual disorders are evaluated along with minor symptoms of allergic reactions, stuttering, hematological changes, psoriasis, and inappropriate secretion of the antidiuretic hormone. The major fluoxetine-drug interactions involve the amino acids L-dopa and L-tryptophan, anorexiants, anticonvulsants, antidepressants, anxiolytics, calcium channel blockers, cyproheptadine, lithium salts, and drugs of abuse. The underlying mechanism and the paradoxical effects of fluoxetine are addressed.