手助腹腔镜改良网袋肾捆绑术结合独一味治疗肾破裂

目的：探讨手助腹腔镜下改良网袋肾捆绑术结合独一味胶囊内服在肾破裂保肾手术中的应用价值。方法：将50例肾破裂患者分为3组,A组采取非手术治疗结合独一味内服;B组采用手助腹腔镜下改良丝线网袋肾捆绑术治疗结合独一味内服;C组采用单纯手助腹腔镜下改良丝线网袋肾捆绑术治疗。结果：A组有11例非手术治疗成功,成功率39.3%,延期肾切除率40%,近、远期并发症46.4%,远期肾功能损害14.3%;B组11例手术成功,成功率91.7%;C组手术均成功。B组在术后症状减轻时间、术后血尿消失时间、腰部引流量等方面明显优于A、C两组。结论：手助腹腔镜下改良网袋肾捆绑术结合独一味胶囊内服治疗肾破裂,不失为一种较好的保肾方法。     

Study of Influence of Atmospheric Conditions on the Thermal Properties of Sleeping Bags

The thermal properties of clothing products are influenced by external environmental parameters, such as temperature, humidity, air flow and parameters related to the user’s body, which mainly include temperature and humidity. Depending on the type of raw material, its thickness and the material manufacturing technique, clothing products are characterised by certain insulating properties to protect the human body from external factors. A multilayer system made of different material groups can change the thermal insulating capacity significantly, which cannot be determined by the testing of individual layers used in the production. In order to determine the influence of weather conditions on thermal insulation and air permeability, tests were carried out for two types of sleeping bags (summer and autumn) produced by the same manufacturer, differing in insulation thickness. Simulations were carried out using SolidWorks and verified using a Newton thermal mannequin. During tests, both the temperature (range from −20 °C to 20 °C) and humidity values were changed (range 40–80% humidity). For sleeping bags, the effective thermal insulation decreases along with the increase of temperature and decrease of humidity. It can be observed, for the autumn sleeping bags, that for a temperature of 20 °C and humidity of 60%, the thermal insulation is 1.063 m²·K·W⁻¹, while for a temperature of −20 °C and humidity of 60% thermal insulation increases significantly and amounts to 1.111 m²·K·W⁻¹. A similar situation occurs for the effective thermal insulation of a summer sleeping bag (20 °C/60% thermal insulation is 0.794 m²·K·W⁻¹, while for −20 °C/60%—0.851 m²·K·W⁻¹. During the tests, the humidity and temperature between the layers of the clothing system were also controlled, in order to learn more about the influence of these parameters on the thermal insulation properties of the sleeping bags.     

低位水囊在足月妊娠引产中的临床研究

目的 研究低位水囊引产用于足月妊娠引产的临床效果.方法 将180例单胎、头位、足月妊娠初产妇随机分成2组:水囊组110例,催产素组70例,观察比较其临床效果.结果 水囊组引产总有效率明显高于催产素组(P＜0.05),水囊组引产到临产时间明显缩短(P＜0.05).结论 对宫颈未成熟的孕妇采用水囊引产安全,经济,有效,可靠,在一定范围内可作为促宫颈成熟的一种有效方法.     

输液加压袋＋输血器在宫腔镜检查中膨宫的可行性研究

目的探讨输液加压袋联合输血器在宫腔镜检查中膨宫的可行性及安全性。方法 194例进行宫腔镜检查患者,随机分为两组,观察组100例采用输液加压袋＋输血器进行膨宫检查,对照组94例采用液体膨宫机进行膨宫检查。观察两种方法在宫腔镜检查中是否存在差异,进而推论输液加压袋＋输血器在宫腔镜检查中膨宫是否可行及值得推广。结果两种方法均能提供良好恒定的宫腔压力,可清楚观察整个宫腔形态及双侧输卵管开口情况,无一例出现不良反应。在检查时间方面无明显差异,膨宫用液量方面对照组浪费较多,且液体膨宫机价格昂贵,在基层医院难以购买多台,而观察组的输液加压袋＋输血器价格便宜,且操作简单。结论输液加压袋＋输血器在宫腔镜检查中膨宫是可行及安全的,值得推广。     

家庭延续式造口护理在膀胱全切回肠膀胱术后患者中的应用价值

目的探讨家庭延续式造口护理在膀胱全切回肠膀胱术后患者中应用的重要性及价值。方法选取2013年9月~2017年9月接受膀胱全切+回肠膀胱术的患者36例,随机分为常规护理组和家庭延续式护理组,常规护理组:进行常规围术期健康教育,术后床旁进行造口护理,出院后1周随访1次。家庭延续式护理组:在常规护理措施的基础上实施延续性护理。评价术后6个月时两组患者在生活质量、造口并发症及患者满意度方面的差异。结果家庭延续式护理组患者在生活质量相关的各项评分均显著高于常规护理组(P0.05),延续式护理组的造口并发症发生率更低(16.7% vs 44.4%),患者满意度更高(83.3% vs 61.1%)。结论家庭延续式造口护理显著改善了患者生活质量,降低并发症,提高患者满意度,具有重要的价值及实用性。     

Blobbing injury patterns

Introduction“Blobbing” is a modern outdoor activity where a participant sits on the end of a partially inflated air bag (“blobber”) and is launched into the water when another participant jumps onto the air bag from a platform on the opposite side (“jumper”). This is the first study to evaluate the injury patterns associated with blobbing.Patients and methodsA retrospective data analysis was conducted based on 86 patients who sustained blobbing injuries between January 2011 and December 2016.The date of birth, gender, day of injury, diagnosis, body region of trauma, and treatment were recorded for the patients. Treatment was subclassified into conservative or surgical treatment. The position of the participant was recorded as either a jumper or a blobber.ResultsOne-third of the patients sustained a spine injury, which was the most common body part injured. The most frequent type of injury was cervical spine distortion. All shoulder (n = 9), elbow (n = 3), hand (n = 2), knee (n = 3), and foot (n = 12) injuries occurred in jumpers, whereas all ear (n = 6) and lung (n = 5) injuries occurred in blobbers. Head (n = 5) and spine (n = 33) injuries were distributed in jumpers and blobbers. Sixty-nine patients were treated with conservative treatment. Three ankle fractures and two spine fractures were treated with immediate surgical treatment. Twelve patients were treated with conservative treatment but were referred for potential surgery at their hospital at home.ConclusionBoth jumpers and blobbers were prone to injuries. More severe injuries with the potential for surgical treatment occurred in jumpers, presumably because of bad landings. This analysis of the injury patterns in blobbers might lead to the introduction of protective gear and changes in the behavior of participants in order to reduce the risk of injury.     

水囊新法打输尿管隧道在宫颈癌根治术中的应用分析

目的探讨水囊新法打输尿管隧道在宫颈癌根治术中的应用价值。方法回顾分析2018年6～12月在我院确诊的宫颈癌患者临床资料,其中用水囊新法处理输尿管16例(A组)、输尿管导管处理输尿管21例(B组)。比较两组患者手术时间、术中出血量、术后尿管拔除时间、尿潴留发生率、输尿管损伤率、术后发热率、尿路感染发生率等。结果 A组手术时间明显短于B组,但差异无统计学意义(P0.05);两组患者术中出血量、术后住院时间、术后尿管拔除时间、术后尿潴留发生率比较差异无统计学意义(P0.05)。A组术后抗生素使用时间明显短于B组,术后发热、尿路感染、术后血尿发生率明显低于B组,差异均有统计学意义(P均0.05)。两组患者术中、术后均未发生输尿管损伤。术后3个月随访过程中,B组患者中4例出现尿路感染,1例出现肾积水,A组患者无尿路感染或泌尿系统损伤的发生。结论在行广泛子宫切除手术时,为避免术中输尿管损伤,术中水囊新法打输尿管隧道是可行的,可有效避免术中输尿管的损伤,不增加患者经济负担,且不增加术后并发症的发生,具有临床推广价值。     

气囊仿生助产技术联合分娩球在产妇助产中的应用价值分析Analysis of the application value of balloon bionic assisted birth technique combined with delivery ball in maternal midwifery 顾彩琴

目的：观察产妇助产应用气囊仿生助产技术联合分娩球的临床价值。方法：选取2021年3月到2022年3月收治的87例产妇进行研究,对照组采取常规助产技术,观察组采取气囊仿生助产技术联合分娩球。结果：观察组第一、第二、第三产程时间以及总产程时间、产后出血量、疼痛评分、新生儿窒息、羊水污染发生率均低于对照组,新生儿APgar评分、自然分娩率、护理满意度高于对照组(P＜0.05)。结论：通过采取气囊仿生助产技术联合分娩球,完成助产,能够提高产妇自然分娩率,可帮助产妇缩短产程,有利于改善产妇疼痛情况,减少出血量,有利于确保新生儿安全,使产妇更加满意。     

《2020版WCET®国际造口指南》(第二版)解读

世界造口治疗师协会(World Council of Enterostomal Therapists? ,WCET?)成立于1978年,是一家在英国注册的慈善结构,其使命是引领造口、伤口、失禁专科化职业化护理的全球发展。最初,WCET?仅涉及造口护理专业,进过多年的发展,伤口和失禁护理也被纳入实践领域。2022年12月WCET?发布了《2020版WCET?国际造口指南》(第二版),该指南旨在为即将进行或已经进行造口手术的患者提供循证护理的建议。以2014年第一版WCET?国际造口指南为基础,对自2014年指南发布以来发表的研究和文献进行了更新评估。2020版国际造口指南适用于在各国/地区的各种护理环境之下接受护理服务的所有造口人士,包含与全球范围内的造口患者护理有关的文化、宗教和/或种族资料,将帮助护理人员根据适当的文化、宗教和种族考虑因素制定护理计划。本文主要从指南发布的背景、指南的目标、指南推荐、指南推荐和证据评估、指南实施,WCET?成员的文化、宗教和社会考虑因素、附录、术语和定义等方面进行要点解读,以期能让造口护理相关领域的专业人员、组织以及造口患者和照顾者更好地了解本指南的核心内容,为进一步提高造口护理质量,改善造口患者的生活质量提供参考。