我对进针法和补,泻的看法：兼述几点临床经验

我对进针法和补、泻的看法———兼述几点临床经验王碧如郑州市中医院（４５０００７）楚海波整理主题词进针／方法针刺补泻疼痛／针灸疗法晕厥／针灸疗法脱发／治疗水针疗法偏瘫／针灸疗法王碧如，（１９４０～）男，河北省磁县人，１９６４年毕业于河南省中医学徒班，师...     

献血者晕厥产生的情况分析

目的分析献血者晕厥产生的特点，对献血晕厥的原因分析和正确处理，不仅关系到献血者的个人安危，同时关系到《献血法》的持久贯彻和实施。方法封献血时晕厥进行观察比较，搜集有关数据进行统计学分析。结果发现献血晕厥的产生与性别、年龄、献血次数有着明显的关系，为无偿献血的宣传贯彻和采血过程的资讯、护理提供了科学数据。     

倾斜训练联合毕索洛尔治疗血管迷走性晕厥的疗效观察

目的观察倾斜训练联合毕索洛尔治疗血管迷走性晕厥的疗效。方法对23例经舌下含化硝酸甘油倾斜试验阳性的血管迷走性晕厥患者给予倾斜训练,同时口服毕索洛尔10mgd,1个月后复查舌下含化硝酸甘油倾斜试验。结果23例患者晕厥发作时均伴有血压的明显下降和或心率减慢。其中有4例服药后出现心动过缓,2例减为5mgd,2例不能耐受停药,治疗后21例患者重复行舌下含化硝酸甘油倾斜试验,20例转阴,转阴率为95.2%,血压和或心率与平卧位相比无明显下降。结论倾斜试验联合毕索洛尔是治疗血管迷走性晕厥的有效方法。     

领带系出的意外

国华明天要参加学校歌咏比赛,老师要求参赛男生一律穿白衬衫、扎红领带。从未系过领带的他,站在穿衣镜前,一遍又一遍地学着打领带结。12岁的表弟在一旁好奇地瞧着他。     

门诊换药室晕厥病人的预防及护理

晕厥为临床常见症状，因其发病急骤，病因复杂，若不能及时、正确地鉴别和积极有效地救治，就会贻误抢救时机甚至危及生命。门诊换药室经常遇到换药病人发生晕厥。因此，必须引起换药室护士的高度重视。现对我院2003年7月至2005年6月在门诊换药室发生的56例晕厥病人的病因分析和护理体会归纳如下。     

直立倾斜试验对血管迷走性晕厥的诊断价值

目的：探讨直立倾斜试验对血管迷走性晕厥的诊断价值。方法：选择58例有晕厥发作并排除器质性疾病的患者。试验前3d，停用一切影响植物神经功能的药物，试验前4h禁食；检查时，先仰卧5min，记录基础血压、心率、心电图；而后站立于倾斜板床上，直至出现阳性反应或完成45min全程试验；若基础试验阴性则行异丙。肾上腺素激发试验，静滴异丙肾上腺素1μg／min，使心率提高10％，再倾斜10min；期间每5min，记录血压、心率、心电图。结果：阳性23例，占40％。阳性病例中，女20例，占87％。结论：直立倾斜试验对血管迷走性晕厥具有特异性诊断价值。     

A multi-center study of hemodynamic characteristics exhibited by children with unexplained syncope

Background Syncope is common in children and adolescents, with 15% estimated to have had at least one syncopal episode by age 18. In recent years, an increasing number of children, especially girls at their school age, have developed unexplained syncope. The mechanism of an unexplained syncope exhibited by children is incompletely studied; the association between different hemodynamic patterns and clinical features is also not clear. The aim of the study was to investigate the hemodynamic patterns of children with unexplained syncope and to examine the clinical relevance.Methods Two hundred and eight children [87 boys, 121 girls, aged 3－19 years, mean (11.66±2.72) years] were selectively recruited from May 2000 to April 2006 when they presented syncope as their main complaint at the Multi-center Network for Childhood Syncope in Beijing, Hunan Province, Hubei Province, and Shanghai of China. All of the patients underwent head-up tilt tests; data were analyzed using SPSS version 10.0 for Windows. Continuous variables were expressed as the mean±standard deviation. Dichotomous variables were compared through a χ(2) test. A value of P<0.05 (two sided) was regarded as statistically significant.Results The age distribution of children with syncope was approximately normal. Head-up tilt tests was positive in 155 children, and the incidence of positive response of the baseline head-up tilt test for diagnosing unexplained syncope was 50.48%. The sensitivity value and diagnostic value of sublingual nitroglycerin head-up tilt test were both 74.52%. The hemodynamic pattern was normal in 53 children. The 155 children, who were positive in head-up tilt tests, showed signs of postural orthostatic tachycardia syndrome (60, 28.8%), the vasoinhibitory pattern (72, 34.6%), the cardioinhibitory pattern (5, 2.4%), and the mixed pattern (18, 8.7%). The gender distribution between the two age groups (age < 12 years vs age ≥ 12 years) was not different (P>0.05). The distribution of hemodynamic patterns between the children of the two age groups (age < 12 years vs age ≥ 12 years), and the children with different complaints (dizziness vs syncope) was significantly different (P<0.05), while the distribution between the children of different sexes and different lasting time of syncope (≤ 5 minutes vs> 5 minutes) was not significantly different (P>0.05). Different hemodynamic patterns were differentiated by differing syncope inducements, presymptoms, and complicated symptoms during and after syncope.Conclusion The tested girls were more prone when compared with the boys to have unexplained syncope, and the peak age was around twelve years old. The incidence of positive response of head-up tilt tests was also relatively higher for the girls. The distribution of hemodynamic patterns for different ages was different. For children with unexplained syncope, we should use head-up tilttests to distinguish the hemodynamic patterns in order to adopt rational therapeutic measures.     

拔牙患者晕厥的预防和护理体会

拔牙术是口腔科常见的治疗技术之一，许多患者对拔牙手术具有紧张、恐惧心理，害怕手术疼痛和不适，个别患者甚至出现晕厥现象，表现为头晕、心慌、胸闷、面色苍白、出冷汗、短暂意识丧失等。作为口腔科护士，积极配合医生做好晕厥患者的抢救是至关重要的。