浅谈褥疮预防及护理

目的 探讨卧床病人预防褥疮的有效护理措施,并寻找理想的治疗方法.方法通过对20例卧床病人褥疮的预防和10例不同原因所致溃疡期褥疮,采用克林霉素治疗.结果 有效降低了卧床病人褥疮的发生,采用克林霉素治疗溃疡期褥疮10例,痊愈7例,3例好转后自动出院,总有效率达100%.结论 正确有效的护理可减少卧床病人褥疮的发生,采用克林霉素治疗溃疡期褥疮方法简便,疗效显著.     

褥疮护理与治疗

目的：观察并研究褥疮的护理以及治疗方法。方法选择我院120例长期卧床患者为研究对象，给予褥疮预防护理服务，严密观察褥疮的发生情况。并对发生褥疮的4例患者进行冲洗、氧疗、外用药物等临床治疗。结果本组患者中，有4例患者发生了褥疮，在经过治疗后，病情得到了痊愈，未出现复发的情况。结论对长期卧床的患者进行规范、优质的护理，能有效降低发生褥疮的概率。在治疗褥疮的过程中，采用冲洗、氧疗、外用药物等方法，治疗效果显著，大大改善了患者的生活质量，值得推广和使用。     

浅谈褥疮合并绿脓杆菌感染8例的护理体会

褥疮又称压迫性溃疡,褥疮是临床最常见的并发症之一,高危人群为老年人,长期卧床的偏瘫患者,年老体弱,瘫痪,大小便失禁,营养不良等均是褥疮形成的主要个体因素,特别是合并绿脓杆菌感染的褥疮,其护理非常棘手,我院于2003年3月～2009年12月间共收治褥疮合并绿脓杆菌感染8例患者,现将护理方法总结如下.     

骨折病人预防褥疮的护理体会

褥疮是局部组织长期受压而致血液循环障碍所引起的软组织坏死.在骨科病区中有80%的患者需要卧床,所以加强褥疮的护理显为重要.     

浅谈褥疮合并绿脓杆菌感染8例的护理体会

褥疮又称压迫性溃疡,褥疮是临床最常见的并发症之一,高危人群为老年人,长期卧床的偏瘫患者,年老体弱,瘫痪,大小便失禁,营养不良等均是褥疮形成的主要个体因素,特别是合并绿脓杆菌感染的褥疮，其护理非常棘手，我院于2003年3月～2009年12月间共收治褥疮合并绿脓杆菌感染8例患者，现将护理方法总结如下。     

踝足矫形器人机耦合仿真刚度对步态生物力学影响的评价方法

目的 为更好评价踝足矫形器(ankle-foot orthosis, AFO)的人机工效,提出一种 AFO 人机耦合仿真刚度对步态生物力学影响的评价方法。 方法 首先,评测两种 AFO 的力学特性并量化其刚度;其次,采集 30 名受试者在正常与穿戴两种不同刚度 AFO 行走条件下的运动学及动力学数据;最后,通过仿真计算,定量对比分析 AFO 刚度对 行走中下肢关节角度、关节力矩与肌肉力的影响。 结果 在穿戴两种刚度 AFO 情况下,支撑相踝关节背屈峰值角度、膝关节屈曲峰值角度和髋关节伸展峰值角度均显著增加(P<0. 05),比目鱼肌与腓肠肌峰值肌肉力呈现增加趋势。 踝关节跖屈峰值角度、髋关节屈曲峰值角度与髋关节屈曲峰值力矩均显著降低(P<0. 05)。 结论 本文所提出的 AFO 人机耦合仿真方法可以有效实现不同刚度对步态生物力学影响的定量评估,该方法同样也适用于评估和优化其他辅助器具的人机工效,可以为 AFO 的选配、适配、优化设计提供方法指导。     

绳索并联驱动下肢康复机器人的设计与分析

下肢运动障碍患者对下肢康复器械的需求日益增大.基于刚性连杆康复机器人的局限,本研究设计了一款绳索并联驱动的下肢康复机器人.通过对人体步态运动规律的分析,建立了人机运动学模型,利用数值法对运动学正逆解进行了验证,得到了绳索长度、速度、加速度变化规律,并进行了工作空间的研究.最后将模型导入Adams软件进行仿真,其下肢各关...     

基于AVR的防褥疮气垫控制器设计

目的针对防褥疮气垫工作模式单一、故障报警措施缺乏、操作界面呆板等不足,本文提出基于 AVR单片机的防褥疮气垫微控制器设计方案.方法该微控制器以 Atmega16为核心,外设电路包括压力传感器、气压检测电路、液晶显示电路、气泵驱动电路等,可根据体重、周期、工作时间参数设置不同,控制气泵使气垫产生幅度、周期、时间可调的波动式翻滚达到防治褥疮的作用.连接气泵对气垫充气测试,设置不同的工作参数,观察并比较测试结果.结果测试结果表明控制器运行稳定,可使气垫产生规律的波动式翻滚,符合防治褥疮的要求.结论基于该微控制器的防褥疮气垫操作界面友好,工作模式多样,并且工作安全可靠,成本低廉.     

旋转臀大肌肌皮瓣治疗重度褥疮的护理体会

骨科、泌尿外科、脑外科综合病房,长期卧床病人约占60％以上,一旦发生褥疮,将给治疗带来严重影响,因此我们对长期卧床的病人在褥疮的预防和治疗上积累了一些经验。在褥疮的预防上我们主要做到五勤:勤翻身、勤擦洗、勤按摩、勤整理、勤更换,通过加强护理,杜绝了褥疮的发生。对于入院时已经发生Ⅰ°、Ⅱ°褥疮的病人主要采用局部烤电、换药、定时翻身的治疗措施。对于Ⅳ°褥疮的患者,我们通过采用旋转臀大肌肌皮瓣手术,术后严密观察皮瓣血运和防止感染,使创面一期愈合,疗程短,减轻了病人的痛苦并且挽救了病人生命,现介绍如下。     

褥疮的预防及护理探讨

褥疮的发生与患者年龄、营养状况、所患疾病、局部皮肤清洁及创口处理、医疗环境舒适程度、护理质量有极大关系,尤其是护理质量.褥疮的护理应以预防为主,治疗为辅,未病先防,已病防止恶化,忌单一护理局部褥疮,忌单一护理方法.通过阅读大量相关资料,联系临床实践,吸取先进经验.从而了解褥疮发生的原因、诱因、易发人群,总结褥疮的防治方法,以减少褥疮发生率和减轻患者痛苦.     

An intriguing design concept to enhance the pulsatile fatigue life of self-expanding stents

Intravascular stenting has emerged as the primary treatment for vascular diseases and has received great attention from the medical community since its introduction two decades ago. The endovascular self-expanding stent is used to treat peripheral artery diseases; however, once implanted, these stents suffer from various cyclic motions caused by pulsatile blood pressure and daily activities. Due to this challenging environment, fatigue performance has become a critical issue for stent design. In this paper, a simple yet intriguing concept of stent design aimed at enhancing pulsatile fatigue life is investigated. The concept of this design is to shift the highly concentrated stresses/strains away from the crown and re-distribute them along the stress-free bar arm by tapering its strut width. Finite element models were developed to evaluate the mechanical integrity and pulsatile fatigue resistance of the stent to various loading conditions. Results show that the fatigue safety factor jumped to 2.5–3.0 times that of the standard stent with constant strut width. This is astonishing considering that the stent profile and scaffolding were not compromised. The findings of this paper provide an excellent approach to the optimization of future stent design to greatly improve stent fatigue performance.     

Mechanical design of an intracranial stent for treating cerebral aneurysms

Endovascular treatment of cerebral aneurysms using stents has advanced markedly in recent years. Mechanically, a cerebrovascular stent must be very flexible longitudinally and have low radial stiffness. However, no study has examined the stress distribution and deformation of cerebrovascular stents using the finite element method (FEM) and experiments. Stents can have open- and closed-cell structures, and open-cell stents are used clinically in the cerebrovasculature because of their high flexibility. However, the open-cell structure confers a risk of in-stent stenosis due to protrusion of stent struts into the normal parent artery. Therefore, a flexible stent with a closed-cell structure is required. To design a clinically useful, highly flexible, closed-cell stent, one must examine the mechanical properties of the closed-cell structure. In this study, we investigated the relationship between mesh patterns and the mechanical properties of closed-cell stents. Several mesh patterns were designed and their characteristics were studied using numerical simulation. The results showed that the bending stiffness of a closed-cell stent depends on the geometric configuration of the stent cell. It decreases when the stent cell is stretched in the circumferential direction. Mechanical flexibility equal to an open-cell structure was obtained in a closed-cell structure by varying the geometric configuration of the stent cell.     

Fabrication of self-expandable NiTi thin film devices with micro-electrode array for bioelectric sensing,stimulation and ablation

Self-expandable medical devices provide mechanical functionality at a specific location of the human body and are viable for minimal invasive procedures. Besides radiopaque markers and drug-eluting coatings, next generation self-expandable devices can be equipped with additional functionality, such as conductive and flexible electrodes, which enables chronic recording of bioelectrical signals, stimulating or ablating tissue. This promises new therapeutic options in various medical fields, among them in particular neuromodulation (e.g. deep brain stimulation), BioMEMS, radio frequency ablation, mapping or denervation. However, the fabrication of such multi-functional devices is challenging. For this study we have realized a 35 μm thick, superelastic NiTi thin film stent structure with six isolated electrodes on the outer circumference, each electrode connected to a contact pad at the end of the stent structure, using magnetron sputtering, UV lithography and wet chemical etching. Mechanical and electrical properties of the device during typical loading conditions, i.e. crimping, simulated pulsatile and electrochemical testing, were characterized and reveal promising results. For the fabrication of future multifunctional, minimal invasive medical devices, such as electroceuticals or other intelligent implants, NiTi thin film technology is therefore a versatile alternative to conventional fabrication routes.     

气道支架力学设计与数值模拟研究进展

气道狭窄是一种先天性或由感染、肿瘤、外伤、结核等疾病引起的临床常见疾病,国内常见的病因有气管支气管结核、良性或恶性肿瘤等,植入气道支架已经成为介入治疗气道狭窄的主要方式。气道支架由硅酮支架到激光雕刻、编织支架,其材料与构型一直在不断更替改进。气道支架植入后仍然存在支架发生移位、气管出现肉芽肿、再狭窄等问题未解决,这些问题往往与支架植入后对气管组织整体产生的力学作用相关。本文总结归纳气道支架的力学性能以及支架与气管的典型数值模拟研究。力学性能包括支架的径向力、扭结阻力与屈服应力,其常受支架材质、构型设计、制作工艺等综合影响;而数值模拟方法能高效地对支架研发提供技术支持,为支架材料选取、设计改进与制造工作提供参考。     

基于激光雷达的嵌入式护理床自动对接系统

针对目前失能患者自主移动困难及传统护理搬运易造成二次伤害,本研究设计了一种基于激光雷达的嵌入式护理床自动对接系统.实现可分离式护理床的对接,要获取轮椅与床体精准的相对位姿.床椅对接分为局部定位和精准对接两步.前期利用智能轮椅自主导航移动至床体框架前部目标区域,到达目标点,后向激光雷达对预置的床体人工标志进行特征提取与局...     

Mechanical properties, drug eluting characteristics and in vivo performance of a genipin-crosslinked chitosan polymeric stent

A limitation with the use of polymers as stent matrices is their inherent mechanical weakness. In this study, a polymeric stent, made from chitosan-based films fixed by genipin which has a cyclic molecular structure, was developed (the genipin stent). The mechanical properties of the genipin stent were investigated; its counterpart fixed by a linear epoxy compound (the epoxy stent) and a commercially available metallic stent were used as controls. The results indicated that the cyclic crosslinking structures formed within the genipin stent matrix were beneficiary to the improvement of its mechanical property. Additionally, the tolerable compression load of the genipin stent was superior to that of the control metallic stent. The cytotoxicity of the genipin stent was significantly lower than the epoxy stent. The deployment of the genipin stent in rabbit infrarenal abdominal aortas was performed using a French sheath. At 3 months postoperatively, the retrieved arteries remained patent; no thrombosis was observed. A nearly intact layer of endothelial cells was seen on the stent-implanted vessel wall. To evaluate its possibility as a drug delivery vehicle, sirolimus (an anti-proliferative drug) was loaded in the genipin stent. It was found that the genipin stent with heparin coating exhibited a linear sustained-release profile and the released sirolimus still possessed its original activity in inhibiting smooth muscle cell proliferation. These findings suggest that the genipin stent with enhanced mechanical strength can be used as an attractive stent platform for local drug delivery.     

不同形状血管中医用支架扩张力学行为的研究进展

血管支架介入术由于其微创性和高效性已经成为目前治疗由血管狭窄所引发的冠心病的主要治疗手段,但支架内再狭窄却是影响支架远期效果的最大障碍,严重制约了其实际疗效。首先从支架内再狭窄的形成机制出发,从固体力学角度回顾力学环境对再狭窄的影响,并主要阐述近年来支架在圆直、锥形、分叉、弯曲4种不同形状血管内扩张的研究进展,特别是从支架扩张对血管应力及血管形状的改变与再狭窄的相关关系方面进行综述。最后,针对不同血管形状对支架扩张的影响,提出一个旨在提高支架扩张性能及减少支架内再狭窄的血管支架多目标优化设计方法。     

床体因素对于放疗剂量的影响

目的：了解多种床体结构及其连接部分对于放射治疗剂量的衰减率,予以指导临床应用中不同机架角度配合使用相应治疗床,降低床体衰减对于射束的影响,提高放疗剂量的精确性。方法：测量参考剂量,有机玻璃体遮挡下剂量,有机玻璃体金属边框最厚部分剂量,网状碳纤维床体剂量,网状碳纤维床体边缘最厚部分剂量,延长板遮挡下剂量,延长板底面连接最厚部分剂量,相同条件下机架180°时金属支架与有机玻璃体遮挡下剂量。分别计算其衰减率。结果：有机玻璃体对于射线的衰减率最小为4.49%,有机玻璃体金属边框最厚部分衰减率最大值为36.2%,网状碳纤维床体衰减率最小值为0.74%,其边缘最厚部分碳纤维床体衰减率最小值为6.26%,延长板遮挡衰减率最小值为4.77%,延长板连接部分最高衰减率为63.78%,当机架180°时,金属支架与有机玻璃体共同遮挡所造成剂量衰减率最小值为31.21%。不同结构之间金属支架连接衰减率过大且不均匀,实际应用中须避开各部分之间连接区域,而在使用有机玻璃体床体、网状碳纤维床体以及延长板时也应根据其衰减率影响选择适合机架角度进行治疗。结论：临床应用中应选择适合床板配合治疗,考虑不同结构相互之间的衰减并在制定计划时避开相应区域,选择最佳治疗方案,以保证放疗方案的最优化。     

A Novel Carotid Covered Stent Design: In Vitro Evaluation of Performance and Influence on the Blood Flow Regime at the Carotid Artery Bifurcation

In the present study, a novel carotid covered stent design has been developed. Prototypes of different geometrical design parameters have been fabricated and their performance has been evaluated in vitro under physiological pulsatile flow condition, utilizing flow visualization (dye injection), and particle image velocimetry techniques. These evaluations include the assessment of emboli prevention capability, side-branch flow preservation, and influence on the branch flow pattern and velocity field. The novel covered stents demonstrated significantly higher emboli prevention capability than the corresponding bare metal stent, while preserving more than 83% of the original flow of the external carotid artery (ECA). Flow in the ECA through these covered stents was uniform without evidence of undesirable flow recirculation and reversed flow that might predispose the vessel wall to post-stenting intimal thickening and atherosclerotic plaque formation. This study demonstrated the potential of these novel covered stent designs for the treatment of carotid atherosclerotic stenosis. However, further computational and in vivo investigations of hemodynamics, biological effects, and mechanical performance of this covered stent design is warranted.