介绍一种防止皮下淤血的静脉拔针法

静脉输液是临床常用的一种治疗手段，也是一项基础性的护理技术操作，由于拔针方法不同，常致患者拔针后出现皮下淤血，疼痛加重。经过临床护理观察和实践，笔者采用平行直压拔针法，效果满意，介绍如下。     

静脉输液后新式拔针法效果观察

目的 探讨静脉输液后新式拔针法的临床效果。方法 对500例静脉输液患者按单、双日输液顺序，单日患者行新式拔针法，输液毕，护士不关闭输液调节器开关，不提前按压穿刺点，即用左手将无菌干棉签沿血管走向轻放于穿刺点上方，以拇指固定，右手拔针并反折针头软管，以防液体漏出，拔针后用左手拇指迅速按压穿刺点上方3min；双日患者行常规拔针法。结果 新拔针方法其疼痛程度、针头回血率低于常规拔针法（均P〈0．01）。结论 新拔针方法能显著减轻患者疼痛，提高患者舒适度。     

静脉输液后新式拔针法效果观察

目的 探讨静脉输液后新式拔针法的临床效果.方法 对500例静脉输液患者按单、双日输液顺序,单日患者行新式拔针法,输液毕,护士不关闭输液调节器开关,不提前按压穿刺点,即用左手将无茵干棉签沿血管走向轻放于穿刺点上方,以拇指固定,右手拔针并反折针头软管,以防液体漏出,拔针后用左手拇指迅速按压穿刺点上方3 min;双日患者行常规拔针法.结果 新拔针方法其疼痛程度、针头回血率低于常规拔针法(均P＜0.01).结论 新拔针方法能显著减轻患者疼痛,提高患者舒适度.     

静脉穿刺无痛拔针方法

笔者总结一种静脉穿刺无痛拔针法即先慢后快法，介绍如下。方法：拔针前在针两侧绷紧皮肤，顺血管纵轴平行，向外缓慢拔针，当针头即将拔出血管壁时再快速拔出体外，并立即用棉球平行于静脉压住穿刺点(棉球压于静脉穿孔处而不是皮肤穿孔处)，然后抬高患肢少许即可。折起输液管，以防回血及药液污染被褥和地面。     

介绍一种防止皮下淤血的静脉拔针法

静脉输液是临床常用的一种治疗手段,也是一项基础性的护理技术操作,由于拔针方法不同,常致患者拔针后出现皮下淤血疼痛加重.经过临床护理观察和实践,笔者采用平行直压拔针法,效果满意,介绍如下.     

静脉穿刺拔针方法的改进

为了减轻静脉穿刺拔针所致的疼痛 ,我们对拔针方法进行了改进 ,效果较好。报告如下。资料 :选择 2 0 0 1年 3～ 6月外科住院病人 135例 (行静脉穿刺 10 0 0次 ) ,男 75例 (6 2 8次 )、女 6 0例 (372次 )。年龄2 1～ 4 5岁 ,平均 32 4岁。静脉输液 94 6次 ,静脉推注 5 4次。方法 :采用单、双日自身对照法各 5 0 0次 ,对拔针方法进行观察比较。单日采用常规法 ,当病人输液 (或静脉推注 )毕 ,即用于棉签按压针孔 ,迅速拔出针头 ,按压片刻[1] 。双日用改进法 ,即用干棉签横形置于针孔处 ,向拔针反方向轻柔地推针孔处组织 (不加压 ) ,迅速拔出针…     

浅静脉穿刺两种不同握拳法的对比观察

对 5 0 0例浅静脉充盈不佳需行静脉穿刺的病人采用自身对照的方法 ,即双日采取常规扎止血带后反复用力握拳运动 6次 ,单日采取常规扎止血带握拳 1次即行静脉穿刺。结果反复握拳法病人静脉充盈度及静脉穿刺成功率均优于单次握拳法 (均P <0 .0 1)。提示静脉穿刺前反复用力握拳 ,能明显改善静脉充盈度 ,提高静脉穿刺成功率     

老年人静脉穿刺拔针后皮下瘀血原因分析及防治

临床工作中经常遇到静脉穿刺拔针后皮下瘀血现象,特别是老年人更常见.老年人的静脉血管多有硬化,管壁厚而无弹性,腔隙窄,脆性大,缺乏皮下脂肪,皮肤松弛,又加之所用某些药物可降低血液粘稠度,稀释血液,使血管渗透性增高,又因经验缺乏、错误操作等原因,致静脉穿刺拔针后,血液渗入皮下组织,造成皮下瘀血,给病人造成恐慌、痛苦,给下一步的静脉用药造成穿刺困难,掌握老年人血管特点,掌握拔针后止血要领,熟悉所用药物的药理作用是预防皮下瘀血的重要措施.     

静脉输液后两种拔针方法效果比较

目的比较静脉输液后2种拔针方法的效果。方法将400例静脉输液患者随机分为观察组和对照组各200例．对照组采用常规拔针法．观察组行缓慢拔针法。结果观察组患者拔针后疼痛、皮下瘀血发生率少于对照组（均P〈0．01）。结论缓慢拔针按压方法可减轻患者的痛苦．利于再次静脉穿刺。     

Painless Venipuncture. A Clinical Trial of Iontophoresis of Lidocaine for Venipuncture in Blood Donors

Discomfort or frank pain at venipuncture may be a reason for abstaining from giving blood. In an attempt to offer a painless alternative, a method for iontophoretic application of local anaesthetics was developed. Its effectiveness in producing anaesthesia for venipuncture was tested in a double-blind trial in 47 blood donors. A positive result was obtained in 89%, as against 28% in the placebo group.     

二黄补白方治疗气血失调型白癜风临床疗效观察

目的：观察二黄补白方治疗气血失调型白癜风的临床疗效。方法：将95例白癜风患者分为治疗组和对照组。治疗组46例,口服二黄补白方,每天1付,分2次服;对照组49例,口服祛白糖浆,每次20ml,2次/天;两组患者均外用祛白酊,1次/天。结果：经过3个月的治疗,治疗组总有效率76.09%,与对照组53.06%比较,差异有统计学意义,P〈0.05。结论：二黄补白方治疗白癜风可以改变白斑的色素,减少皮损面积,疗效确切。     

Long-Term Outcome of Early Steroid Withdrawal After Kidney Transplantation in African American Recipients Monitored by Surveillance Biopsy

Generally chronic steroid therapy is standard care for African American (AA) kidney recipients because of their higher incidence of rejections and lower long-term graft survival. This prospective study evaluated the long-term safety and efficacy of early steroid withdrawal (ESW) in AA recipients. A total of 206 recipients were studied; 103 AA and 103 non-AA recipients monitored by serial surveillance biopsies from 1 to 60 months posttransplantation to evaluate subclinical acute rejections (SCAR) and chronic allograft injury (CAI). Biopsy-proven clinical acute rejections (BPAR) and SCAR were treated. Primary end point was BPAR and secondary end points were 5-year SCAR, CAI and survival. Incidences of BPAR was 16% versus 14% (p = 1.0), prevalence of CAI due to hypertension was 48% versus 30% (p = 0.05) and interstitial fibrosis/tubular atrophy was 47% versus 32% (p = 0.05) and the mean serum creatinine levels were 2.1 versus 1.8 mg/dL (p = 0.05) at 5-years in AA versus non-AA recipients. The incidence of SCAR was 23% versus 11% at 1 month (p = 0.04), 12% versus 3% at 3 years (p = 0.04) and 10% versus 1% at 5 years (p = 0.04) in AA and non-AA recipients, respectively. Five-year patient survivals were 81% and 88% (p = 0.09) and graft survivals were 71% and 73%(p = 0.19) in AA and non-AA groups, respectively. After early steroid withdrawal AA kidney recipients have significantly lower renal function and higher SCAR and CAI but 5-year graft survival are comparable to non-AA recipients.     

两种术式治疗混合痔的疗效比较

为探讨自动痔疮套扎术（RPH）联合外痔切除术与外剥内扎术治疗Ⅱ、Ⅲ期内痔为主的混合痔的临床疗效,采用RPH联合外痔切除术治疗该类混合痔65例（观察组）,与同期单纯采用外剥内扎术治疗55例（对照组）进行比较,在平均单个痔手术时间、住院时间、创口愈合时间、水肿发生例数、术后出血评分、术后尿潴留例数、疼痛评分、术后1年复发例数方面评价两组的治疗效果。结果显示,观察组可缩短单个痔手术时间、住院时间及创口愈合时间,且可明显减轻术后疼痛、创缘水肿及术后出血,优于对照组（P〈0．05）。而术后1年复发率、术后尿潴留情况两组比较无统计学意义（P〉0．05）。结果表明,在治疗Ⅱ、Ⅲ期内痔为主的混合痔时可优先选择RPH联合外痔切除术,以加快患者术后恢复,减轻术后并发症。     

Calcineurin Inhibitor Withdrawal After Renal Transplantation with Alemtuzumab: Clinical Outcomes and Effect on T-Regulatory Cells

To address the results of calcineurin inhibitor (CNI) withdrawal after alemtuzumab induction relative to CNI continuation, we performed a pilot randomized clinical trial in renal allograft recipients on CNI, a mycophenolic acid derivative and steroids after the first 2 months posttransplantation. Forty patients were randomized to taper off CNI or to maintain it, and followed for at least 1 year. Four patients in the withdrawal group were treated for acute rejection while no patient received antirejection treatment in the control group. Two control patients withdrew CNI due to nephrotoxicity. Estimated GFR was similar in both groups after 1 year. Flow cytometry of CD4⁺CD25⁺CTLA-4⁺FoxP3⁺ regulatory T cells (Treg) demonstrated a significant increase in Treg percentages in the peripheral blood of alemtuzumab-treated patients on CNI early postransplant. Furthermore, the increased Treg percentages in the withdrawal cohort were unchanged at month 6 postenrollment, whereas they decreased significantly in those patients maintained on CNI. Patients withdrawn from CNI after alemtuzumab trend toward a higher rejection rate, but most patients can be weaned from a CNI using this regimen. With the exception of maintaining increased Treg levels, the benefits are not appreciable in this short follow-up, and a larger randomized trial is justified.     

中医辨证配合穴位埋线治疗肥胖症患者的疗效观察

目的:观察中医辨证配合耳针穴位埋线治疗肥胖症患者的疗效。方法:将我院116例肥胖症患者随机分为两组。对照组:患者常规性针灸治疗,治疗组采用中医辨证配合耳针穴位埋线治疗。7天为1个疗程,治疗2个疗程后对比临床效果。结果:治疗组总有效率为93.1%,对照组70.7%,疗效比较有显著性差异(P0.05)。两组患者在治疗过程中均未出现不良反应,患者的体重与体重指数对比存在较大差异性,且差异具有统计学意义(P0.05)。结论:中医辨证配合耳针穴位埋线治疗肥胖症患者疗效高于常规性针灸治疗,且治疗全面、有效,减少了并发症的发生,安全性较高。     

塞来昔布联合督脉灸、揿针治疗活动期强直性脊柱炎25例临床观察

目的:观察塞来昔布联合督脉灸、揿针治疗活动期强直性脊柱炎患者的临床疗效.方法:将50例强直性脊柱炎患者随机分为治疗组和对照组,每组25例.对照组给予塞来昔布口服联合督脉灸(每次30 min,每日1次)治疗;治疗组在对照组治疗基础上联合揿针(每次6 h,每日1次)治疗.2组均以2周为1个疗程.观察2组临床疗效,以及治疗前...     

陈旧性肛裂手术两种麻醉方法效果比较

为了为陈旧性肛裂手术患者寻求一种安全有效的麻醉方法,对122例陈旧性肛裂患者分别在骶管麻醉（治疗组,62例）或局部麻醉（对照组,60例）下行手术治疗,跟踪观察麻醉止痛效果和肛门松弛效果。结果显示,（1）麻醉止痛效果：治疗组显效59例（95．2％）,有效3例（4．8％）,无效0例;对照组显效21例（35．0％）,有效39例（65．0%）,无效0例;治疗组显效率明显高于对照组,P〈0．05。（2）麻醉后肛门松弛效果：治疗组显效59例（95．2％）,有效3例（4．8％）,无效0例;对照组显效15例（25．0％）,有效39例（65．0％）,无效6例（10．0％）;治疗组显效率明显高于对照组,P〈0．05。结果表明,陈旧性肛裂患者骶管麻醉下手术安全可靠,止痛效果和肛门松弛效果好。     

壮医针挑疗法联合常规西药治疗类风湿关节炎30例临床观察

目的:观察壮医针挑疗法联合常规西药治疗类风湿关节炎的临床疗效.方法:将60例类风湿关节炎患者随机分为治疗组和对照组,每组30例.对照组给予双氯芬酸钠双释放肠溶胶囊、甲氨蝶呤口服治疗,治疗组在对照组的基础上加用壮医针挑疗法.2组均以4周为1个疗程.观察2组临床疗效、ACR20缓解率,以及治疗前后28个关节的疾病活动度评分...     

新铍针治疗原发性骨质疏松性膝痛的临床疗效观察

目的:探讨新铍针治疗原发性骨质疏松性膝痛的临床疗效。方法:选取2017年3月—2019年3月天津中医药大学第一附属医院骨伤科收治的原发性骨质疏松伴有膝关节疼痛患者60例,随机分为对照组和观察组,各30例。对照组予以碳酸钙D3片、骨化三醇胶丸、鲑降钙素鼻喷雾剂。观察组在对照组的基础上采用新铍针结合拔罐治疗,两组均连续治4周。分别于治疗前后比较两组的VAS评分、BPI评分、Lequesne评分、患肢红外热成像温度的变化情况,并依据WOMAC骨关节炎指数进行疗效评价。结果:治疗后观察组和对照组VAS评分、BPI评分和Lequesne评分较治疗前降低,治疗后观察组VAS评分、BPI评分和Lequesne指数分别为3.03±0.72、23.50±1.20、5.63±0.96,显著低于对照组的5.20±0.76、37.77±1.17、7.73±0.83,差异有统计学意义(P0.001)。观察组的WOMAC指数疗效改善率为93.33%,高于对照组的73.33%,差异有统计学意义(P0.05)。患肢红外热成像温度临床疗效明显优于对照组,差异有统计学意义(P0.05)。结论:新铍针治疗原发性骨质疏松性膝痛的疗效显著,操作简便,安全可行。