Un-cross-matched blood for emergency transfusion. One year's experience in a civilian setting.

One year's experience (56 cases) in the use of un-cross-matched blood for emergency transfusion in a large civilian teaching hospital showed that 49 transfusions were given as un-cross-matched, group-specific (ABO and Rh) blood in emergencies. Seventy-seven percent (43) of blood requests were for patients with trauma, unexpected massive intraoperative hemorrhage, or ruptured aneurysm. The indications for emergency transfusion were questionable in ten cases. There were no adverse effects noted even though complete serologic testing had not been done. While the use of un-cross-matched blood is usually safe, the potential for serious reaction exists. Overuse should be discouraged.     

Extracorporeal shock-wave lithotripsy for upper urinary tract calculi. One year's experience at a single center

Four hundred sixty-seven patients with symptomatic upper urinary tract calculi underwent extracorporeal shock-wave lithotripsy (ESWL) at The New York Hospital-Cornell Medical Center during the first year. Ninety-five percent of stones were completely treated with one ESWL session. An analysis of 300 treatments revealed that the overall stone-free rate (success) three months after treatment was 75%. The stone-free rate for patients with renal pelvic calculi less than or equal to 20 mm in diameter was 91%. Individual patient stone-free rates depended on stone size (burden), position, composition, and quality of disintegration. Two percent of treatments failed to disintegrate the targeted stone. Complications were minimal. Seven percent of treatments were followed by a secondary endoscopic procedure to facilitate complete stone passage, and 23% of treatments were preceded by cystoscopy with ureteral stent placement of manipulation of stones. Combined therapy utilizing percutaneous surgery or multiple sequential ESWL treatments is necessary for complex stones, and ureteroscopy or basket extraction remains the treatment of choice for distal ureteral calculi.     

无创式呼吸在治疗慢性阻塞性肺病合并呼吸衰竭患者的护理体会

目的 探讨了无创式呼吸在治疗COPD合并呼吸衰竭患者的护理体会.方法 对2010年1月至2012年5月我院收治的COPD合并呼吸衰竭患者的临床资料进行了统计分析,并对其采用无创呼吸机对患者进行辅助治疗,给予患者精心护理.结果 本组全部患者无1例死亡,29例患者的效果满意,1例患者由于病情危重,改为有创机械通气.结论 无创呼吸机是一种有效的治疗COPD合并呼吸衰竭的方法,配合精心护理和医务人员熟练操作,取得了满意的治疗效果,提高患者的生活质量.     

中期照护模式对老年慢性阻塞性肺疾病患者生活质量的效果观察

目的评估中期照护多学科管理模式对老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者生活质量的效果。方法选取2018年6月至2019年5月北京老年医院住院治疗的老年慢性阻塞性肺疾病急性加重(acute exacerbate of chronic obstructive pulmonary disease, AECOPD)患者160例,采用随机数字表法分为观察组和对照组。观察组给予中期照护多学科干预+常规治疗;对照组仅给予常规治疗。在入组时、中期照护8周及随访6个月、12个月时分别对两组进行日常生活能力量表(activity of daily living scale, ADL)、简易精神状况检查表(mini-mentalstate examination, MMSE)、简版老年抑郁量表(geriatric depression scale-15, GDS-15)、跌倒风险评估工具(fall riskassessment tool, FRA)、微型营养评估(mini nutritional assessment, MNA)等评分...     

AIDS and related conditions. One year's experience in St. Vincent's Hospital, Sydney

Fifty-six patients were referred in 1983 for assessment in connection with AIDS and related disorders. Clinical and immunological classification of patients was carried out according to the NHMRC criteria. The presence of antibodies to an AIDS-associated retrovirus (ARV) was determined in some patients. Of the 32 patients who could be categorized, three patients had AIDS, and all three had serum antibodies to ARV. Fifteen patients had lymphadenopathy syndrome with impaired T-cell immunity. Ten of 12 patients tested had antibodies to ARV. Symptomatic illnesses resembling lymphadenopathy syndrome, but without immune defects, occurred in nine patients. By contrast, five patients who had no symptoms had impaired immunity, and in seven patients no clinical and immunological abnormalities were found. The classification proposed by the NHMRC was found to be useful in delineating several major clinical and immunological patterns of response to infection with the AIDS-associated retrovirus.     

One year experience of neonatal mortality and morbidity in a state level neonatal intensive care unit and its comparison with national neonatal-perinatal database

Neonatal mortality is still the leading group among the infant mortality in India. Poor infrastructure, home delivery and lack of facility, trained personnel in rural hospital are the major determining factors leading to neonatal mortality and morbidity including perinatal asphyxia. The data, which is gathered from a tertiary neonatal intensive care unit (NICU) of West Bengal and its statistical interpretation, has thrown light upon the current state of neonatal care in our county. Encouragement for institutional delivery, routine use of blood culture and sensitivity and standard antibiotic policy should lead to a far better outcome.     

儿科重症监护室患儿并发肺部感染的临床护理经验探析

目的 探讨儿科重症监护室(PICU)患儿并发肺部感染的临床护理方法及效果.方法 选取中国医科大学附属盛京医院PICU收治的127例并发肺部感染的患儿作为研究对象,按照护理方法分为观察组和对照组,观察组65例,分析导致并发肺部感染的因素,实施具有针对性的综合护理干预;对照组62例,实施常规护理.观察2组患儿肺部感染相关临床指标、住院时间、心理状态、重返PICU率、护理满意率等.结果 干预后观察组患儿各项指标明显优于干预前和对照组,差异有统计学意义(P＜0.05);观察组住院时间、心理紊乱综合征持续时间及发生率、重返PICU率、各项护理满意度评分均显著优于对照组,差异有统计学意义(P＜0.05).结论 分析PICU患儿并发肺部感染的相关因素并给予有效的临床护理干预,可有效改善患儿肺部感染,具有促进患儿恢复、保障护理安全及构建护患和谐关系等积极意义.     

Indications for admission to a coronary care unit in patients with unstable angina.

One hundred cases with an admission diagnosis of acute coronary insufficiency or unstable angina were reviewed to establish criteria for admission to a coronary care unit. Myocardial infarction was subsequently diagnosed in 20 of the patients. Ventricular tachycardia occurred in 16 patients and ventricular fibrillation in 1 patient. Clinical features found to predict an increased risk of myocardial infarction included chest pain for more than 30 minutes within 24 hours prior to admission, new nonspecific electrocardiographic abnormalities consistent with ischemia, and diaphoresis. All patients with ventricular tachydysrhythmias had presented with both prolonged chest pain prior to admission and new electrocardiographic changes. The sensitivity, specificity and predictive value of various clinical criteria for identifying patients likely to have a myocardial infarction were calculated, and criteria with very high (greater than 90%) sensitivity were identified. These could be used to establish which patients are at increased risk of myocardial infarction and therefore require admission to a coronary care unit.     

对急性肺栓塞中危患者溶栓疗法的建议

在美国, 静脉血栓栓塞症(VTE)是仅次于心肌梗死和卒中的第3位常见的心血管疾病, 急性肺栓塞3个月内的病死率超过心肌梗死, 在15%以上.1971年Miller等[1]首次报道急性大块肺栓塞链激酶溶栓.1990年我国以尿激酶进行首例急性肺栓塞溶栓成功[2].其后, 肺栓塞溶栓治疗虽取得一些进展, 但并未像急性心肌梗死溶栓疗法那样成熟与规范.     

105例肺栓塞患者的护理体会

目的探讨肺栓塞患者的护理体会;方法收集自2005-2009年我院收治的105例肺栓塞患者,经抗凝、溶栓、介入、外科手术等不同的治疗方法及相应的护理措施;结果60例患者除一例死亡外均恢复良好;结论肺栓塞患者经合理的治疗及及时、有效的护理,均能取得满意的疗效,减少并发症的发生。     

1例中毒性表皮坏死松解症的护理体会

通过对1例中毒性表皮坏死松解症(TEN)患者的护理,在专科创面护理的基础上,结合合理营养,预防和控制感染,严密观察病情变化,加强皮肤黏膜护理、基础护理、生活护理、心理护理等,治愈出院。