共查询到20条相似文献,搜索用时 140 毫秒
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目的:探讨深静脉置管在重度烧伤患者中的应用及护理方法.方法:回顾性分析11例重度烧伤患者使用深静脉置管的护理资料.结果:本组深静脉置管均成功,补液通畅、及时,为后期治疗赢得了时间.结论:深静脉置管在抢救重度烧伤患者中,能保证及时准确输液和给药,减少患者反复穿刺的痛苦和护士工作量,有效提高抢救成功率,值得临床上推广. 相似文献
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目的对传统颈内静脉长期导管置管术进行改进。方法 72例维持性血液透析患者中34例采用传统的颈内静脉长期导管置管术,38例采用改进的颈内静脉长期导管置管术,传统的颈内静脉长期导管置管术是应用Seldinger技术结合撕脱鞘进行置管。改进的置管方法是采用导引钢丝引导进行导管置入。结果传统置管患者中12例(35.29%)因隧道皮下组织的收缩不能一次性将导管涤纶套放置在所需的位置,9例(26.47%)术中发生10ml以上的出血,10例(29.41%)术后48h内发生明显穿刺点或隧道出口渗血。改进的置管术患者全部一次性将导管涤纶套放置在所需的位置,仅3例(7.89%)发生10ml以上的出血,2例术后48h内(5.26%)出现明显穿刺点或隧道出口出血。改进的置管术患者术中疼痛不适感明显低于传统置管术患者。结论改进的颈内静脉长期导管置管术较传统的颈内静脉长期导管置管术操作更为顺利,难度降低,患者耐受性好,术中及术后出血发生率减少。为一种更安全、方便的置管方法 。 相似文献
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股静脉置管在小儿重度烧伤病人中的应用 总被引:1,自引:1,他引:0
帮助重度烧伤患儿安全渡过休克期 ,关键之一是尽早建立静脉通道行有效抗休克治疗 ,而对大面积烧伤患儿来说 ,建立通畅输液通道既是一个关键问题 ,也是一个较大难题。我科于 1996年 1月~ 2 0 0 0年 12月对 5 8例小儿重度烧伤病人进行了股静脉置管术 ,取得了满意效果。1 临床资 相似文献
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目的:探讨在急诊危重患者抢救过程中,为保证快速有效的输液途径的通畅,保护外周血管和监测中心静脉压,用深静脉置管术代替外周静脉置管术的可行性。方法:对20例危重患者,经颈内静脉或股静脉及锁骨下静脉行深静脉置管术。结果:穿刺置管20次均获成功。结论:对危重患者应多采用深静脉置管,其操作方便,快速,不破坏血管,对提高抢救在功率有较好的作用。 相似文献
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静脉输液在危重患者的救治中起着重要作用.由于中心静脉置管可以快速补液、监测中心静脉压以及输注对静脉刺激强烈的药物,故中心静脉置管术目前已成为危重患者抢救监护、营养支持及肿瘤化疗的重要途径,也是外周静脉通路无法建立时的有效治疗手段. 相似文献
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锁骨下静脉穿刺置管350例 总被引:1,自引:0,他引:1
中心静脉穿刺置管术目前已得到日益广泛的应用,在抢救危重患者的快速输液、中心静脉压监测、长期输液治疗、外周静脉穿刺困难、心脏心内膜起搏术和长期进行血液透析等方面都有重要的作用.我院胸外科于2005年6月至2006年6月所进行锁骨下静脉穿刺术350例,现总结报道如下. 相似文献
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虹吸原理在静脉穿刺中的应用 总被引:6,自引:0,他引:6
目的 :探讨虹吸原理在静脉穿刺中的应用 ,提高静脉穿刺的成功率。方法 :随机将 84例患者分为两组 ,一组用虹吸穿刺法 ,即将输液瓶放置在离穿刺部位 6 0cm左右的下方穿刺 ;一组用常规法。结果 :两组中用虹吸法立即回血占 88 1% ,用常规方法立即回血占 2 1 4 % ,差异有显著性 (P <0 0 5 )。结论 :此法提高了静脉穿刺成功率。 相似文献
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目的探讨全血N末端脑钠肽前体(NT-proBNP)浓度与重度烧伤患者补液量的相关性;评价重度烧伤患者监测NT-proBNP的预警意义。方法选取2012年9月至2015年9月解放军第100医院烧伤科收治的重度烧伤患者53例,入院前均无重大疾病史、遗传史。其中烧伤面积在35%~50%总体表面积(TBSA)或者Ⅲ度10%~20%TBSA共25例为A组,烧伤总面积50%TBSA或Ⅲ度20%TBSA共18例为B组,烧伤总面积90%且复合爆震伤患者共10例为C组;所有患者入院第1~30天监测NT-proBNP浓度用于指导输血及补液。对照组为53例同期年龄相仿的整形美容患者。与补液量计算公式相比,比较NT-proBNP的指导优势。结果此次纳入研究的烧伤患者实际补液量均高于通用补液公式计算出的结果,烧伤越严重,NTproBNP浓度越高,血制品需求量越多;C组与B组、B组与A组间进行比较,NT-proBNP浓度、补液量、MAP输注量、血小板输注量差异均有统计学意义(P0.05)。结论 NT-proBNP浓度改变对重度烧伤患者中长期合理控制输血输液量可能有较高的指导和预警意义。 相似文献
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提高婴幼儿静脉穿刺成功率的探讨 总被引:2,自引:0,他引:2
目的:探讨提高婴幼儿静脉穿刺的成功率.方法:将原静脉注射班单日轮转改为1周负责制;静脉穿刺时采用连接注射器抽吸易见回血法;强化训练静脉穿刺技巧.结果:用新方法为婴幼儿静脉穿刺2 168例次,成功2 138例次,占98.62%,失败30例次,原因包括针头堵塞,患儿不合作,操作技术问题等.对照组成功率为73.08%,差异有显著性(P<0.005).结论:新的静脉注射班1周负责制及易见回血法,提高了服务质量,服务态度满意率明显提高. 相似文献
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目的 探讨同型全血外周动静脉同步置换术治疗重症新生儿高胆红素血症的动态实验室结果及临床疗效观察.方法 对7例危重新生儿高胆红素血症采用外周动静脉同型全血置换.动态监测换血前、后血清总胆红素、非结合胆红素、血红蛋白、血糖、电解质及动脉血气变化情况.结果 换血前、换血后血清总胆红素结果分别为(540.25±76.88)、(282.27±58.58)μmol/L;换血前、后非结合胆红素结果分别为(498.92±84.12)、(256.82±57.16)μmol/L;换血前后实验宣监测患儿血清总胆红素、非结合胆红素结果均明显下降(P<0.01).结论 同型全血外周动静脉换血治疗新生儿重症高胆红素血症安全有效,副作用少. 相似文献
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Over 11 million units of blood are transfused yearly in the United States. Although blood transfusion is common in burns, data are lacking on appropriate transfusion thresholds. The purpose of the study was to identify current burn center physician blood transfusion practices. A 30-question survey of blood transfusion practices was developed and sent to burn center directors. The survey assessed demographics, burn experience, and blood transfusion thresholds. Physicians were asked to list factors affecting their blood transfusion thresholds and then to give their blood transfusion threshold for patients based on age and percent burn. The final section presents three case scenarios with alterations in one physiological parameter to assess the effect on transfusion thresholds. A total of 55 of the 180 surveys (31%) were returned. Mean number of burn beds was 15.7 +/- 1.4, with 264 +/- 25 burn admissions per year. The respondents had been in burn care for 15.9 +/- 1.4 years. Their mean hemoglobin transfusion threshold was 8.12 +/- 1.7 g/dl. The most frequent reasons for transfusion were ongoing blood loss (22%), anemia (20%), hypoxia (13%), and cardiac disease (12%). Inhalation injury influenced the decision to transfuse blood in 34%. The hemoglobin level below which respondents would transfuse blood increased with increasing TBSA burn, history of cardiac disease, acute respiratory distress syndrome, and age. Blood transfusion thresholds in burns vary based on burn percentage, age, and presence of cardiac disease. To date, no standard of care exists for blood transfusions in burns. Future prospective studies are needed to determine the appropriate use of blood in burns. 相似文献
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Hoffman HG Patterson DR Seibel E Soltani M Jewett-Leahy L Sharar SR 《The Clinical journal of pain》2008,24(4):299-304
OBJECTIVE: Most burn-injured patients rate their pain during burn wound debridement as severe to excruciating. We explored the adjunctive use of water-friendly, immersive virtual reality (VR) to distract patients from their pain during burn wound debridement in the hydrotherapy tank (hydrotank). SETTING: This study was conducted on inpatients at a major regional burn center. PATIENTS: Eleven hospitalized inpatients ages 9 to 40 years (mean age, 27 y) had their burn wounds debrided and dressed while partially submerged in the hydrotank. INTERVENTION: Although a nurse debrided the burn wound, each patient spent 3 minutes of wound care with no distraction and 3 minutes of wound care in VR during a single wound care session (within-subject condition order randomized). OUTCOME MEASURES: Three 0 to 10 graphic rating scale pain scores (worst pain, time spent thinking about pain, and pain unpleasantness) for each of the 2 treatment conditions served as the primary dependent variables. RESULTS: Patients reported significantly less pain when distracted with VR [eg, "worst pain" ratings during wound care dropped from "severe" (7.6) to "moderate" (5.1)]. The 6 patients who reported the strongest illusion of "going inside" the virtual world reported the greatest analgesic effect of VR on worst pain ratings, dropping from severe pain (7.2) in the no VR condition to mild pain (3.7) during VR. CONCLUSIONS: Results provide the first available evidence from a controlled study that immersive VR can be an effective nonpharmacologic pain reduction technique for burn patients experiencing severe to excruciating pain during wound care. The potential applications of VR analgesia to other painful procedures (eg, movement or exercise therapy) and other pain populations are discussed. 相似文献
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[目的]探讨腋静脉留置套管针在婴幼儿烧伤输液中的临床应用效果。[方法]对56例大面积烧伤患儿采用腋静脉留置套管针进行静脉输注。[结果]经腋静脉留置时间长,有效地解决了大面积烧伤选血管困难及抗休克的难题,56例患儿成功的渡过了休克期、感染期并康复出院。[结论]腋静脉留置针穿刺输液术大大提高了大面积烧伤患儿的抢救效率及成功率,同时也减轻了护士的护理工作量,提高了患儿家长的满意度。 相似文献