ACS患者深静脉留置导管两种封管液的效果比较

目的比较已接受阿司匹林、氯比格雷和低分子肝素钙三联抗凝一周以上的急性冠脉综合征（acute coronary syndrome,ACS）患者深静脉留置导管2种封管液的封管效果,以选择更有效的封管液封管。方法将108例患者按随机抽样的方法分为对照组和实验组,每组均54例,对照组用生理盐水5 ml封管,实验组用肝素盐水（50 U/ml）5 ml封管,两组均采用正压封管方法,进行留置效果比较。结果实验组封管次数、留置时间、堵管和血流不足的发生率与对照组比较差异无统计学意义;实验组感染、出血的发生率高于对照组,组间比较差异有统计学意义（P〈0.05）。结论对于充分抗凝的ACS患者,使用生理盐水封管有效率等同于肝素盐水,但能减少感染、出血的发生率。     

心脑血管病人浅静脉留置针输液封管液探讨

目的:探讨心脑血管病人浅静脉留置针输液封管的效果.方法:106例患者随机分成2组,观察组54例,每天输液结束时封管1次,先用10ml生理盐水缓慢推注,再用1ml肝素液(每ml含肝素250u)封管,次日输液时,先从留置针内抽出肝素液(约0.3ml),直至抽出回血,再接液体.对照组52例,用5ml肝素液(每ml含肝素25u)封管,每隔8小时封管一次,次日消毒后接上液体.结果:两组堵管率比较观察组明显低于对照组(P＜0.01);平均留置天数观察组多于对照组(P＜0.05);平均每天封管次数观察组低于对照组(P＜0.05).结论:心脑血管病人浅静脉留置针输液封管采用高浓度肝素液较低浓度肝素液其堵管发生率低,留置天数长,且每天只需封管1次.     

重度慢阻肺病人静脉留置针封管液浓度的选择

目的研究不同剂量肝素在重度慢阻肺病人静脉留置针的封管效果。方法300例重度慢阻肺病人随机分为对照组实验组，各150例，在每次治疗结束后均用3mL肝素盐水正压封管，浓度分别为62．5U／mL、125U／mL。观察并比较2组病人堵管及出血发生情况。结果肝素封管液堵塞的发生率实验组与对照组比较差异有统计学意义（P〈0．01）；实验组与对照组在发生出血情况上差异无统计学意义（P〉0．05）。结论重度慢阻肺病人静脉留置针使用3mL肝素盐水（125U／mL）封管既可减少堵管发生又安全。     

静脉留置针两种封管方法的效果观察

目的对使用肝素盐水封管前是否用生理盐水先冲管达到的封管效果的比较。方法将180例采用常规静脉留置针输液的患者随机分为观察组和对照组各90例,观察组先用生理盐水冲管后用的肝素生理盐水封管。对照组用肝素生理盐水封管。对静脉留置时间、堵管、红肿、外渗及静脉炎发生率进行比较。结果两组静脉留置针的留置时间、堵管、红肿、外渗及静脉炎发生率比较有统计学差异(P0.05)。结论用肝素盐水封管前先用适量生理盐水冲管比单纯用肝素盐水封管效果更好,值得临床推广。     

静脉留置针封管液的观察

目的为了减少外周静脉留置针由于封管液选用不当而致堵管的发生,探讨合理有效的封管液进行封管护理。方法对560例在该院肿瘤科住院治疗的患者进行2种封管液的效果比较,将输液结束后用肝素钠盐水封管的患者设为实验组(A组),将输液结束用无菌生理盐水封管患者设为对照组(B组),2组均采用正压脉冲式封管方法,以观察次日管道通畅情况,并进行统计学分析。结果 A组和B组间2组封管效果差异具有统计学意义(P=0.001),肝素盐水封管组明显优于生理盐水组。结论对外周静脉留置针而言,主张用肝素钠稀释液封管。     

成人浅静脉留置针不同封管方法的效果观察

目的探讨不同封管方法的封管效果.方法将500例行浅静脉留置针的患者随机分为2组,Ⅰ组分为2个亚组,Ⅱ组分为3个亚组.观察对比留置针小开关不同关闭位置堵管发率和使用不同封管液,以及不使用任何封管液直接封管对堵管发生率的影响.结果在延长管远端封管组堵管8例,在延长管起始部封管组堵管2例,生理盐水封管组堵管26例,留置天数3±d,肝素液封管组及无封管液直接封管组堵管均为5例,留置时间均为5±d.结论封管时小开关关闭位置靠近留置针延长管起始处,封管效果可靠.肝素盐水封管效果优于生理盐水,不采用任何封管液直接封管效果可靠,与肝素盐水封管相比较其堵管发生率无显著差异性.     

封管液对保持静脉留置针通畅的差异性研究对比

目的:研究探讨封管液对保持静脉留置针通畅的差异性。方法:选取我院收治的使用浅静脉留置针的患者160例作为研究对象,将其随机分为两大组,A组采用5ml封管液,B组采用10ml封管液,A、B两组组内又根据封管液含不含肝素各分为两小组,A1、B1组采用生理盐水,A2、B2组每毫升中肝素50U,对四小组患者的留置针通畅程度的差异性进行比较。结果:采用10m1封管液的B组患者通畅率(93.8%)显著高于A组患者(53.8%),且比较有统计学差异(P0.05)。但A、B两组组内不同封管液患者的留置针通畅程度的比较无统计学差异(P0.05)。结论:剂量为10m1的生理盐水封管液用于保持静脉留置针通畅性的效果最好,封管操作简便,节约费用,安全性好,值得临床推广使用。     

封管液对保持静脉留置针通畅的差异性研究对比

目的:研究探讨封管液对保持静脉留置针通畅的差异性。方法:选取我院收治的使用浅静脉留置针的患者160例作为研究对象,将其随机分为两大组,A组采用5ml封管液,B组采用10ml封管液,A、B两组组内又根据封管液含不含肝素各分为两小组,A1、B1组采用生理盐水,A2、B2组每毫升中肝素50U,对四小组患者的留置针通畅程度的差异性进行比较。结果:采用10m1封管液的B组患者通畅率(93.8%)显著高于A组患者(53.8%),且比较有统计学差异(P0.05)。但A、B两组组内不同封管液患者的留置针通畅程度的比较无统计学差异(P0.05)。结论:剂量为10m1的生理盐水封管液用于保持静脉留置针通畅性的效果最好,封管操作简便,节约费用,安全性好,值得临床推广使用。     

新生儿静脉留置针封管效果的观察

目的比较使用静脉留置针时,采用不同剂量以及不同种类封管液在新生儿科输液中封管的效果。方法将2010年7—12月在该科住院治疗使用静脉留置针的162例新生儿,随机分为A、B、C三组,分别采用2mL12.5U/mL肝素盐水,5mL12.5U/mL肝素盐水,0.9%生理盐水对留置针封管进行比较。结果其堵管结果经统计学χ2检验:A组与B组比较P>0.05,无显著性差异,A组和B组分别与C组比较P<0.01,有显著性差异。结论在新生儿使用静脉留置针时,用2mL的12.5U/mL肝素盐水封管,留置针的留置时间能延长,和5mL12.5U/mL肝素盐水封管效果等同,比0.9%生理盐水封管的效果好,同时也不会给患儿血管中注入无关治疗的液体,值得临床中推广应用。     

脉冲式封管与普通式封管对于深静脉置管的应用比较

目的比较脉冲式封管与普通式封管对于有效防止深静脉置管封管后再次应用时输液不畅的效果。方法观察组用10ml稀释肝素液（125U／ml）脉冲式封管（推一下停一下）,每推注0．2ml,暂停1S,再推注0．2ml,如此反复进行至完成封管。对照组用10ml稀释肝素液缓慢推注封管。两组在封管时均采用边推注封管液边退针的正压封管。将活塞夹闭在深静脉置管的近端。比较两组封管的效果。结果两组封管结果,观察组深静脉置管针的堵管发生牢远远小于对照组,而输液速度快于对照组。结论脉冲式封管对保护深静脉置管在输液中的应用效果明显好于普通式封管。     

静脉留置针2种封管液的效果比对

静脉留置针在临床使用过程中存在静脉炎、静脉血栓、导管堵塞等许多相关的问题,但导管堵塞是最常见、最容易发生的问题,这一问题与我们平常使用的静脉留置针封管液及封管方法息息相关.正确使用肝素封管液封管的效果比正确使用生理盐水封管的效果优越的多,发生导管堵塞的几率也很小.     

三种封管液用于静脉留置针封管效果的观察

目的:寻找一种简便有效的静脉留置套管针封管方法。方法:将90例使用静脉留置针的病人随机分为Ⅰ、Ⅱ、Ⅲ三组,每组30例,Ⅰ组用5ml肝素稀释液,Ⅱ组用5ml生理盐水,Ⅲ组使用原液进行正压封管,观察静脉留置针阻塞、外渗和静脉炎的发生率。结果:Ⅰ组、Ⅱ组、Ⅲ组静脉留置针阻塞、外渗和静脉炎的发生率无显著性差异。结论:使用原液进行封管具有安全有效、操作简便、节省资源等优点。     

离心温度对惰性分离胶真空促凝管的影响

目的观察离心温度对惰性分离胶促凝管分离血清的影响。方法分别使用普通离心机和低温离心机对惰性分离胶促凝管进行离心分离血清,观察两种离心方式分离管中血清出现油珠的比率,并应用追溯性方法观察两种离心方式对仪器的影响及对一些生化项目结果的影响。结果室温应用普通离心机分离的惰性分离胶促凝管血清清晰,但有15%～20%的样品中出现了大小不一的油性小珠,而用低温离心机离心的试管分离出的血清,未发现油性小珠。仪器在受到分离胶干扰时及排除干扰后血清部分生化结果的对比,显示总蛋白、白蛋白受到的影响较大。结论离心温度对惰性分离胶促凝管分离血清有显著的影响,温度超过分离胶管要求的贮存温度时,惰性分离胶将溶解在血清中,不但对生化仪样品针及反应杯产生堵塞及污染,而且将对一些生化测定结果产生比较大的影响。     

离心温度对惰性分离胶真空促凝管的影响

目的观察离心温度对惰性分离胶促凝管分离血清的影响。方法分别使用普通离心机和低温离心机对惰性分离胶促凝管进行离心分离血清,观察两种离心方式分离管中血清出现油珠的比率,并应用追溯性方法观察两种离心方式对仪器的影响及对一些生化项目结果的影响。结果室温应用普通离心机分离的惰性分离胶促凝管血清清晰．但有15％～20％的样品中出现了大小不一的油性小殊,而用低温离心机离心的试管分离出的血清．未发现油性小珠。仪器在受到分离胶干扰时及排除干扰后血清部分生化结果的对比。显示总蛋白、白蛋白受到的影响较大。结论离心温度对惰性分离胶促凝管分离血清有显著的影响,温度超过分离胶管要求的贮存温度时,惰性分离胶将溶解在血清中,不但对生化仪样品针及反应杯产生堵塞及污染,而且将对一些生化测定结果产生比较大的影响。     

试管类型及标本储存方式对血液甲状旁腺激素的影响

目的比较不同类型试管以及不同标本储存方式对人体血液中全段甲状旁腺激素(intact parathormone,iPTH)检测结果的影响。方法选取2019年1月5日-2月28日于医院就诊的30例门诊及住院患者,采集其清晨空腹静脉血,分装于5种真空试管中,包括无添加剂管、促凝剂管、分离胶管、肝素锂抗凝剂管、EDTA-K3抗凝管,每管5 mL,分离血清、血浆,分别在室温2 h内(即刻)、4 h、8 h及2~8℃冷藏24 h、48 h、72 h检测血中全段甲状旁腺激素的浓度,分析检测结果的差异。结果对于即刻iPTH浓度,分离胶采血管与EDTA-K3抗凝剂管比较,差异具有统计学意义(P<0.05),Bland-Altman分析,双侧置信区间检测,超过25%允许范围;EDTA-K3室温4 h、8 h的iPTH浓度在允许范围内,2~8℃24 h、48 h、72 h的检测结果均超过允许的范围;肝素锂抗凝管室温放置4 h的检测结果在25%允许误差范围内,而8 h、2~8℃24 h、48 h、72 h的iPTH浓度均超过允许范围。促凝剂采血管、无添加剂试管在室温4 h、8 h、2~8℃24 h、48 h、72 h的iPTH浓度均超过允许范围。结论分离胶采血管不适用于iPTH检测,肝素锂、无添加剂管、促凝剂管需即刻进行检测,EDTA-K3抗凝剂管室温放置8 h仍稳定,是血液全段甲状旁腺激素检测的最佳采血管。     

46例脑外伤患者术后合并上消化道出血的护理

目的探讨46例脑外伤术后并发上消化道应激性出血的影响因素。方法46例患者随机分为观察组26例,患者立即经胃管注入3％冰盐水250～300ml,6h／次,4～5d;对照组20例,患者仅插胃管用于胃肠减压观察,比较两组上消化道出血的影响因素。结果观察组26例患者中并发上消化道出血8例（30．6％）,对照组20例患者并发上消化道出血12例（60％）。观察组脑出血患者并发上消化道出血发生率比对照组显著降低（P〈0．05）。结论脑外伤术后患者冰盐水胃管注入治疗,对预防上消化道出血发生有重要意义。     

Chromosome survey of seals in the Baltic Sea in 1988–1992

The populations of grey seals (Halichoerus grypus) and ringed seals (Phoca hispida botnica) in the Baltic Sea have decreased very much, especially during the last decades. Environmental pollution has been seen as an important cause. As top predators, the seals accumulate pollutants from their environment. High concentrations of chlorinated hydrocarbons and heavy metals have been found in seals from the Baltic Sea. In the present study the possible mutagenic effects of environmental pollutants on the seals have been studied by screening cultured lymphocytes for chromosome aberrations.Blood samples were taken from grey seal pups before weaning in March–April, and from adult ringed seals at the end of April during 1988–1992. Blood cells were cultured for 48 h for screening for chromosome aberrations, and for 61 h with bromodeoxyuridine for the study of sister chromatid exchange (SCE).The types of aberrations found were chromosome and chromatid breaks, gaps, and fragmentations. More complicated rearrangements were rare. Blood samples from a total of 47 grey seal pups and from ten adult ringed seals were analysed. The mean frequency of cells with chromosome aberrations from the grey seals was 5.7% (SD ±5.3). The median was 4, because the distribution was skewed with some animals having a considerably higher frequency of aberrations than the average. Some cells with several aberrations and fragmentation of the chromosomes were observed among the lymphocytes from these animals. The frequencies of SCEs were not markedly higher than those normally found in humans. The frequencies of aberrations found in the adult ringed seals were lower than those found in the grey seal pups. The chromosome aberrations are probably caused by chemical pollutants.     

Enteral feeding tube guidewire—another factor in the retrograde contamination of enteral feeding systems?

Background: In vitro enteral feeding systems were used to investigate the effect that withdrawal of the guidewire from the feeding tube has on bacteria ascending from a patients’ stomach or intestine via the feeding tube to the giving set and nutrient container of the feeding system. Methods: Enteral feeding systems were assembled with the feeding tube running into nutrient broth contaminated with Klebsiella aerogenes. The enteral feeding tubes were held in different orientations (horizontal and vertical) to examine the effect in both prostrate and ambulant patients. The guidewire was removed either prior to or after the enteral feeding tube had been inserted into the K. aerogenes broth. Feed was then run through the systems for 24 h, with feed samples being collected from the distal (patient) end of the giving set at 0 and 24 h. Results: After 24 h, 10^3–108 c.f.u. (colony forming units) K. aerogenes/ml were detected in feed samples taken from the distal end of the giving set in systems where the guidewire had been removed after the enteral feeding tube had been inserted into the contaminated broth (both orientations), but K. aerogenes was not detected in samples from systems in which the guidewire had been removed before the end of the tube was inserted into the broth (both orientations). However, when the latter feed samples were enriched (i.e. incubated at 37 °C for a further 24 h to detect if very low levels of bacteria were present in the original sample), 40% of samples from systems with horizontally orientated tubes, and 20% from systems with vertically orientated tubes were positive for the test organism. K. aerogenes was not detected in any samples of feed taken from the nutrient container or just below the drip chamber. Conclusion: The results demonstrate: (i) that bacteria ascend the feeding tube over a 24-h period (retrograde contamination) and (ii) removal of the guidewire can contribute to the colonization of the lumen of the feeding tube and distal end of the giving set with bacteria from a patients’ own flora.