择期开颅手术患者围术期抑郁焦虑评价分析

目的探讨择期开颅手术患者围术期抑郁焦虑状况。方法于入院时、术前1d和术后3d对109例择期开颅手术患者采用SAS和SDS量表评价其自身抑郁焦虑状况，同期由5名经过培训的护士采用HAMA和HAMD量表评价患者抑郁焦虑状况。结果患者SAS和SDS自评分与HAMA和HAMD他评分时间主效应比较，均P〈0．05，且SAS和HAMA、SDS和HAMD评分呈正相关（均P〈0．05）。结论开颅手术患者围术期存在抑郁焦虑情绪，应根据不同时期的心理需求采取相应的护理措施。经过培训的护士可以对患者进行心理状况评价。     

维、汉族心血管病住院患者抑郁焦虑状况调查分析

目的 了解新疆地区维、汉族心血管病患者抑郁、焦虑状况,使临床心理护理更具有针对性.方法 采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)对维、汉族心血管病住院患者各100例进行调查.结果 汉族患者SAS、SDS、HAMA、HAMD评分显著高于维族患者(均P＜0.01).结论 新疆地区汉族心血管病住院患者抑郁、焦虑状况显著高于维族患者,应根据民族差异实施针对性的心理护理.     

维、汉族心血管病住院患者抑郁焦虑状况调查分析

目的了解新疆地区维、汉族心血管病患者抑郁、焦虑状况，使临床心理护理更具有针对性。方法 采用焦虑自评量表（SAS）、抑郁自评量表（SDS）、汉密顿焦虑量表（HAMA）、汉密顿抑郁量表（HAMD）对雏、汉族心血管病住院患者各100例进行调查。结果汉族患者SAS、SDS、HAMA、HAMD评分显著高于维族患者（均P〈0．01）。结论 新疆地区汉族心血管病住院患者抑郁、焦虑状况显著高于维族患者，应根据民族差异实施针对性的心理护理。     

整形美容患者行围手术期心理干预护理的临床研究

目的:通过对整形美容手术患者围手术期的综合心理干预,探讨整形美容患者的心理健康状况,评估心理干预对整形美容手术的重要作用。方法:对70例整形美容手术患者在围手术期进行心理干预,干预前后采用Zung焦虑自评量表(SAS)与抑郁自评量表(SDS)对患者心理状况进行评定。结果:手术后患者的SAS评分和SDS评分明显低于术前,整形美容的就诊者术后的焦虑与抑郁状况较术前有明显缓解。结论:在整形美容患者的手术治疗中,综合心理干预能够更好的改善患者的心理健康状况,对整形美容患者围手术期实施综合心理干预具有重要意义。     

贝克认知疗法在恶性骨肿瘤保肢术患者心理护理中的应用

目的探讨贝克认知疗法在骨科恶性肿瘤保肢术患者心理护理中的应用效果。方法将186例恶性骨肿瘤保肢术患者按随机数字表法分为观察组和对照组各93例。对照组给予骨科围术期常规心理护理,观察组在常规心理护理基础上进行贝克认知疗法,干预前后分别采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评价患者心理状况。结果干预后观察组HAMD和HAMA评分显著低于对照组(均P0.01)。结论贝克认知疗法能够降低恶性骨肿瘤保肢术患者围术期的焦虑和抑郁程度,有利于缓解患者不良情绪。     

腰椎间盘突出症围手术期心理干预效果观察

目的探讨围手术期心理干预对腰椎间盘突出症(LDH)患者心理状态和手术疗效的影响。方法将2014年1月至2015年12月广州市番禺区中医院拟行腰椎后路椎板切除+髓核摘除+神经根减压+椎弓根钉内固定+椎间植骨融合术的62例LDH患者作为研究对象。按住院号随机分为对照组(30例)和观察组(32例),对照组采用脊柱专科常规处理,观察组在此基础上强化围手术期心理干预。观察两组患者入院及术后7 d焦虑自评量表(SAS)、抑郁自评量表(SDS)及疼痛数字评价量表(NRS)评分的变化。结果两组患者术后7 d SAS、SDS、NRS评分均较入院时下降(P0.05),其中观察组术后7 d SAS、SDS、NRS评分均较对照组明显下降(P0.05)。结论围手术期心理干预能改善LDH患者的焦虑和抑郁状态,增强对疼痛的耐受能力,提高手术疗效。     

心理护理干预对择期骨科手术患者焦虑、抑郁情绪的影响效果观察

目的探讨心理护理干预对择期骨科手术患者焦虑、抑郁情绪的影响效果。方法选取2014-12—2016-02间收治的76例择期骨科手术患者,随机分为观察组和对照组,每组38例。对照组实施常规护理措施,观察组在实施常规护理的基础上联合应用心理护理措施。采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评价并比较2组患者干预前后焦虑、抑郁程度的改善情况。结果 2组患者干预前的SAS评分、SDS评分比较,差异均无统计学意义(P0.05)。干预后2组患者的SAS评分、SDS评分均优于干预前;而且观察组患者的SAS评分、SDS评分均显著优于对照组,差异均有统计学意义(P0.05)。结论对择期骨科手术患者加强心理护理,可有效改善患者焦虑、抑郁情绪,促进患者术后恢复进程。     

早期运动联合心理干预对冠脉搭桥患者术后焦虑抑郁状况的影响

目的 探讨运动疗法联合心理干预对非体外循环冠脉搭桥患者术后焦虑抑郁状况的影响.方法 将53例患者随机分成联合组(26例)和对照组(27例),对照组在围术期按常规治疗护理,联合组在常规治疗护理的基础上实施以步行为主的运动疗法联合以谈话式、认知行为疗法为主的心理干预.连续12 d后评价效果.结果 两组术后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分较术前均有下降(均P＜0.05);联合组术后SAS、SDS评分显著低于对照组(均P＜0.01).结论 联合运动疗法及心理干预能有效减轻非体外循环冠脉搭桥患者术后焦虑、抑郁情绪,促进术后康复.     

甲状腺手术围术期心理和疼痛护理的效果分析

目的分析甲状腺手术围术期心理和疼痛护理的效果。方法依据围术期不同护理方法将76例接受甲状腺手术的患者分为2组,各38例。对照组围术期行常规护理,观察组在对照组基础上加强心理和疼痛护理干预。应用抑郁自评量表(SDS)和焦虑自评量表(SAS)评价2组患者护理前后抑郁、焦虑改善情况。根据视觉模拟评分标准(VAS)比较2组患者术后的疼痛程度和镇痛措施应用率。结果 2组患者干预前的SAS评分、SDS评分差异无统计学意义(P>0.05);干预结束后2组患者的SAS评分、SDS评分均优于干预前,且观察组的SAS评分、SDS评分优于对照组。差异均有统计学意义(P<0.05)。观察组术后24 h、48 h的VAS评分及镇痛措施应用率均低于对照组,差异有统计学意义(P<0.05)。结论围术期对甲状腺手术患者实施心理、疼痛护理干预,有助于改善不良情绪和缓解疼痛程度。     

乳腺癌改良根治术围术期心理护理对改善患者焦虑和抑郁情绪的效果

目的探讨乳腺癌改良根治术围术期心理护理对改善患者焦虑和抑郁情绪的效果。方法随机将48例接受乳腺癌改良根治术的乳腺癌患者分为2组,各24例。对照组行围术期常规护理,观察组行常规护理联合心理护理。采用焦虑自评量表(SAS)和抑郁自评量表(SDS),比较护理前后2组患者焦虑和抑郁状态的改善情况。结果入院时2组患者的SAS和SDS评分差异无统计学意义(P0.05)。护理后,2组患者的SAS和SDS评分均较护理前降低,观察组SAS和SDS的降低幅度均显著大于对照组,差异均有统计学意义(P0.05)。结论对实施乳腺癌改良根治术的患者围术期实施常规护理联合心理护理,可有效改善其焦虑和抑郁情绪,使其顺利完成手术和术后的综合治疗,有利于提高治疗效果和患者的生活质量。     

Tracheal constriction by morphine and by fentanyl in man

The effects of morphine and fentanyl on tracheal smooth muscle tone were studied in 38 patients during induction of anesthesia. Endotracheal tube cuff pressure was used to measure tracheal tone. Anesthesia was maintained with nitrous oxide, 70 per cent in oxygen, and pancuronium and ventilation was controlled with a respirator. Morphine, 0.5 mg/kg, produced a biphasic response, initially causing tracheal dilatation and then tracheal constriction. Ten minutes after morphine injection, cuff pressure increased to significantly (21 +/- 8 per cent) above control. Morphine-induced tracheal constriction could be completely blocked by the prior administration of atropine, 0.5 mg. Fentanyl, 0.006 mg/kg, also produced significant tracheal constriction, cuff pressures increasing to 44 +/- 11 per cent above control at 10 min. Fentanyl-induced tracheal constriction could be blocked by pretreatment with droperidol, 0.25 mg/kg. At equianalgesic doses, morphine and fentanyl produced similar tracheal constriction.     

Lower extremity lengthening by Wagner's method and by callus distraction

Fifty-three patients underwent 64 lengthenings of the femur or tibia by the Wagner technique or by the callus distraction method. Thirty-six femoral and 28 tibial segments were lengthened. Simultaneous lengthening of the femur and tibia was performed in seven limbs. Three segments underwent repeat lengthenings. The average length gained by the Wagner method was 5.1 cm in the femur and 5.4 cm in the tibia. Length gains by callus distraction were 4.9 cm in the femur and 4.5 cm in the tibia. Complication rates were fewer and less severe with callus distraction. The number of operations, days of hospitalization, and length of total treatment were less in patients operated on with the callus distraction method than in those who underwent the Wagner technique.     

Tarsal tunnel syndrome caused by synovial cysts and by neurilemmoma

Summary The tarsal tunnel syndrome is the least frequent nerve entrapment of the peripheral nerves. Its etiology is varied and sometimes difficult to determine. The anamnestic data are very important in the initial diagnosis. Clinical data should always be supported by electromyography. We report two typical cases caused by synovial cysts and neurilemmoma. In these case histories we think it necessary to perform MRI as it gives valuable information on the morphology that the surgeon will have to deal with and provides visual confirmation of the diagnosis. Analyzing the results, we specified the constant need for a routine prevention of cicatricial fibrosis.     

Enhancement by hyponatremia and hyperkalemia of ventricular conduction and rhythm disorders caused by bupivacaine

Intraventricular conduction disorders and reentrant arrhythmias in dogs can be produced by high plasma bupivacaine concentrations. The authors' aim was to determine if these conduction disturbances also occurred at moderate plasma bupivacaine concentrations (2.2-3.7 micrograms/ml) when in association with other factors which affect intracardiac conduction, such as hyponatremia and hyperkalemia. Thus, duration of the QRS complex, ventricular conduction time, and effective refractory period (ERP) was measured during ventricular pacing at 180 beats per min in 46 anesthetized, closed-chest dogs separated into five treatment groups as follows: group I, an iv bolus of 4 mg/kg of bupivacaine plus an infusion of 0.1 mg.kg-1.min-1 of bupivacaine followed in 50-60 min by 10 ml.kg-1.min-1 of 1.5% glycine iv to produce dilutional hyponatremia; group II, 1.5% glycine alone, as above; group III, bupivacaine, as above, followed in 50-60 min by 0.05 mmol.kg-1.min-1 of KCl iv to produce hyperkalemia; group IV, KCl alone, as above; and group V, bupivacaine, as above, except that the duration of infusion was 90 min. QRS duration and ventricular conduction time, which were prolonged approximately 33% and 61%, respectively, by bupivacaine alone were additionally prolonged 29% and 44%, respectively, when serum sodium concentration was lowered to 114 mmol/l and potassium concentration was raised to 7.7 mmol/l. The combinations of bupivacaine and hyponatremia, and bupivacaine and hyperkalemia tended to increase ERP more than did bupivacaine alone, although these changes were not statistically significant. Wave burst arrhythmias and episodes of ventricular tachycardia occurred spontaneously or were triggered by pacing in those dogs in which conduction time was most prolonged.(ABSTRACT TRUNCATED AT 250 WORDS)     

电化学发光法测定HBV标志物与荧光定量PCR-HBV-DNA结果的分析比较

目的探讨HBV标志物与HBV-DNA的相关性,更加准确地了解患者HBV感染、病毒复制和传染性情况,为临床制定合理的治疗方案、疗效观察和预后评估提供依据。方法用电化学发光法测定HBV标志物,用实时荧光定量PCR方法检测HBV-DNA。结果 HBV标志物模式1～5均有HBV-DNA阳性检出,其中模式4的检出率最高（81.7%）,而且DNA含量也最高;模式6～9均为DNA阴性。在乙肝五项指标中,HBeAg的定量结果与HBV-DNA含量相关性最大（r=0.713）。结论 HBV标志物和HBV-DNA既相关又有所不同,应将两者结合起来并相互补充才能更好的反映患者HBV病毒复制和传染性情况。