外伤性截瘫患者抑郁状况调查及护理对策

目的 为探讨外伤性截瘫患者抑郁状况,调查了解抑郁发病情况并提出护理对策.方法 采用Zung氏抑郁自评量表(SDS)对120例外伤性截瘫患者抑郁状况调查.结果 截瘫患者存在抑郁者114例,发生率95%.其中轻度抑郁15例,中度抑郁88例,重度抑郁11例.结论 外伤性截瘫患者极易产生精神抑郁,对其采用有效的心理支持、康复锻炼和良好的家庭照顾及社会支持,可改善患者抑郁心理,促进患者生理和心理康复.     

益气养阴化瘀法治疗糖尿病胃轻瘫32例

[目的]观察益气养阴化瘀法治疗糖尿病胃轻瘫的临床疗效。[方法]将60例糖尿病胃轻瘫患者随机分为治疗组32例和对照组28例,治疗组采用益气养阴化瘀中药治疗,对照组单服西药治疗,两组均以4周为1个疗程。[结果]治疗组有效率90.62%,对照组78.94%。[结论]治疗组明显优于对照组。     

中药熏洗疗法治疗糖尿病并发症30例

糖尿病周围神经病变属虚实夹杂、本虚标实之证。以气血亏虚为本,瘀血阻络为标。采用温经通脉、活血化瘀法熏洗患肢,治疗30例,显效13例,有效15例,无效2例。     

聚四氟乙烯人造血管动静脉内瘘术后并发症的护理

目的总结聚四氟乙烯(polytetrafluoroethylene,PTFE)人造血管动静脉内瘘术后并发症的护理要点。方法回顾性分析本院2005年1月-2008年12月31例接受PTFE人造血管动静脉内瘘术患者术后并发症的情况,并总结护理经验。结果 16例患者出现术后并发症,其中血栓形成1例,出血1例,感染1例,肢体肿胀3例,假性动脉瘤1例。31例患者随访8-18个月,随访期间出现晚期血栓形成9例。结论血液透析患者行PTFE人造血管动静脉内瘘术后易于出现并发症,护理上应注意观察,做到早发现,早处理,这对延长人造血管的使用具有重要的意义。     

中药封包结合针灸对脑梗死恢复期患者神经功能及生活质量的影响

目的 探讨中药封包结合针灸在脑梗死恢复期患者护理中的应用效果。 方法 将2016年6月-2019年1月收治的脑梗死恢复期患者108例以随机数字表法分为对照组和观察组,各54例,对照组实施常规护理,观察组在对照组基础上加用中药封包与针灸。比较2组干预前、干预4周后神经功能、运动功能、生活活动能力及生活质量。 结果 干预4周后,观察组美国国立卫生研究院卒中量表、改良Rankin量表评分均低于对照组(t=4.648,P<0.001;t=4.446,P<0.001);Fugl-Meyer运动功能评估量表、Barthel 指数、生活质量量表及简明健康调查量表评分均高于对照组(t=4.373,P<0.001;t=4.822,P<0.001;t=3.699,P<0.001;t=4.357,P<0.001)。 结论 应用中药封包结合针灸可改善脑梗死恢复期患者神经功能,减轻功能障碍,提高患者生活质量,值得推广。     

严重创伤失血性休克大剂量输血的并发症及防治对策

目的 探讨严重创伤失血性休克大剂量输血的并发症,并提出防治对策.方法 回顾性分析1997年8月到2006年8月本科收治的24例严重创伤失血性休克大剂量输血患者的临床资料.本组输血量4 200 ml-10 000 ml16例,10 000 ml-12 800 ml 8例;输血成分为红细胞、新鲜冰冻血浆、浓缩血小板、新鲜全血.4种成分血均输的有4例,输前3种的有4例,输前2种的有16例.结果 本组10例并发凝血功能障碍:上消化道出血伴皮肤紫斑、下消化道出血各2例,出现早期DIC3例,出现典型DIC3例.本组生存19例,死亡5例.直接死于创伤失血性休克2例,典型DIC 3例均死亡.并发代谢性酸中毒8例,低钠低氯1例无低血钾,低血钙2例但未出现抽搐,无代碱.结论 大剂量输血可以引起凝血功能障碍,水电解质酸碱平衡紊乱,低体温等并发症.提高麻醉和手术技能,减少出血;避免不合理输血;提倡成分输血;建立早期DIC的概念有望提高治愈率.     

Retrograde migration of the abdominal catheter as a complication of ventriculoperitoneal shunts: the fishhook sign

Three cases of retrograde migration of the distal catheter of ventriculoperitoneal shunts into the subcutaneous fibrous tract of the thoracic wall are reported. To the authors' knowledge this is the first time that this complication of ventriculoperitoneal shunts has been described.     

Taking a Better History for Behavioral Issues Pre‐ and Post‐Deep Brain Stimulation: Issues Missed by Standardized Scales

Objectives: To screen for potentially underreported behavioral changes in patients with idiopathic Parkinson's disease (PD) pre‐ and post‐deep brain stimulation (DBS), a retrospective data base review was performed. Methods: In total, 113 patients who underwent unilateral or bilateral DBS at the University of Florida in either subthalamic nucleus or globus pallidus internus for PD were screened for behavioral issues by asking about the presence or absence of seven neuropsychiatric symptoms (panic, fear, paranoia, anger, suicidal flashes, crying, and laughing). Results: There was a high prevalence of fear (16.3%), panic (14.0%), and anger (11.6%) at baseline in this cohort. In the first six months following DBS implantation, anger (32.6%), fear (26.7%), and uncontrollable crying (26.7%) were the most frequent symptoms reported. Those symptoms also were present following six months of DBS surgery (30.2%, 29.1%, and 19.8%, respectively). New uncontrollable crying occurred more in the acute postoperative stage (less than or equal to six months) (p= 0.033), while new anger occurred more in the chronic postoperative stage (greater than six months) (p= 0.017). The frequency of uncontrollable laughing significantly increased with bilateral DBS (p= 0.033). Conclusions: Many of the neuropsychiatric issues were identified at preoperative baseline and their overall occurrence was more than expected. There was a potential for worsening of these issues post‐DBS. There were subtle differences in time course, and in unilateral vs. bilateral implantations. Clinicians should be aware of these potential behavioral issues that may emerge following DBS therapy, and should consider including screening questions in preoperative and postoperative interviews. Standardized scales may miss the presence or absence of these clinically relevant issues.     

复合手术技术治疗复杂颈动脉狭窄和闭塞性疾病简

目的分析复合手术技术在复杂颈动脉狭窄或闭塞性疾病中的应用,探讨其临床意义。方法回顾分析12例因颈动脉闭塞和颈动脉串联性病变施行复合手术患者之临床资料,初步分析手术安全性和有效性。结果8例颈动脉闭塞患者,7例实现血管再通;4例颈动脉串联性病变患者,均实现血管再通。术后无一例发生脑卒中或死亡。结论采用复合手术技术治疗颈动脉闭塞和串联性病变疗效安全可靠,值得在临床推荐开展。