直接气管内吸痰在婴幼儿心脏术后预防肺不张的应用

肺不张是婴幼儿心脏术常见的并发症,婴幼儿不能有效的咳嗽及排痰,使痰液积聚在气管及支气管内,造成呼吸道阻塞,形成肺不张。应用直接气管内吸痰可有效清除痰液,保持呼吸道通畅,预防肺不张的发生。我科在临床通过对35例术后婴幼儿实施此项护理并配以拍背、雾化吸氧等均得到满意疗效。本文主要介绍了直接气管内吸痰的方法、适应症及护理要点。     

应用脂肪抽吸术治疗巨大脂肪瘤的护理

手术切除治疗脂肪瘤 ,术后遗留瘢痕 ,影响体表皮肤的外观美 ,用脂肪抽吸法治疗脂肪瘤可弥补手术之不足。总结了应用脂肪抽吸术治疗巨大脂肪瘤 3例患者的护理体会 ,着重于脂肪瘤患者的心理特点及护理和预防血肿发生的护理     

Autologous suction blister grafting for chronic leg ulcers

Background Non‐healing leg ulcers represent a treatment problem. Objective Investigate grafting of autologous suction blister roofs as treatment. Methods Twenty‐nine chronic, non‐healing leg ulcers of various aetiologies in 18 inpatients were treated by autologous epidermal grafting using the roofs of suction blisters. Results 55% of ulcers completely healed 2 to 6 weeks after grafting. A 50–90% reduction in size was documented in 34% and no change was observed in 11% of ulcers. Twelve weeks after grafting, 89% of ulcers were healed completely. In most ulcers, we observed a stimulation of reepithelialization from the wound edge (‘edge effect’) and an accelerated formation of healthy granulation tissue. During a follow‐up period of 12 months, 90% of the ulcers remained healed. Conclusion Grafting of autologous suction blister roofs is an effective treatment option for non‐healing leg ulcers. The advantages of the method are its lack of pain, low costs and immediate availability.     

Psoralen-ultraviolet A-induced erythema: sensitivity correlates with the concentrations of psoralen in suction blister fluid

Since the advent of psoralen-ultraviolet A (PUVA) therapy, the value of plasma 8-methoxypsoralen (8-MOP) concentrations to predict PUVA-induced erythema has been widely investigated. Plasma 8-MOP concentrations have not been proportional to, and cannot alone predict, the degree of PUVA-induced erythema. We assumed that PUVA-induced erythema was related more closely to psoralen concentrations in the skin tissue rather than those within blood vessels. This study was designed to investigate the correlations between the 8-MOP concentrations in suction blister fluid (SBF) and in plasma, with the degree of PUVA-induced erythema. 8-MOP concentrations in plasma and SBF were measured in 15 vitiligo patients and 11 volunteers. Blood and SBF samples were collected 2 h after taking 8-MOP, and 8-MOP concentrations in plasma and SBF were quantified using reverse-phase high-performance liquid chromatography. Eleven volunteers were phototested using a series of doses of ultraviolet A at the time of sampling. The erythema responses were estimated visually to determine the minimal phototoxic dose (MPD). SBF 8-MOP concentrations showed a weak positive correlation with plasma 8-MOP concentrations, which means that we could not predict the exact SBF 8-MOP concentrations using the plasma 8-MOP concentrations. The MPD showed a better correlation with the log of the SBF 8-MOP concentration than with that of the plasma 8-MOP concentration. These results show that plasma 8-MOP concentration cannot represent the exact SBF 8-MOP concentration, and that SBF 8-MOP concentrations, which are representative of the skin tissue 8-MOP level, are more closely related to the erythemal sensitivity during PUVA therapy.     

规范化双腔支气管导管插管及其就位判定方法的临床应用

目的：评价规范化双腔支气管插管法的临床应用，以及吸痰管通畅试验联合听诊法在插管位置判定中的作用。方法：60例择期行胸外科手术的病人，在麻醉诱导完全后，行规范化双腔支气管插管，并采用吸痰管通畅试验复合听诊法判断双腔管的就位情况。在双腔管就位满意后，再以纤支镜下的准确定位为判定双腔支气管的位置。结果：纤支镜定位双腔支气管导管满意就位率96．6％，无一例发生与双腔管就位不良有关的并发症。结论：吸痰管通试验复合听诊法判断双腔管满意就位的方法简单、可靠，可反复用于术中患者体位变动后对双腔管满意就位状态的判断，且不增加损伤机会，是临床上一个很好的方法。     

ICU护士为机械通气患者安全吸痰的临床观察

机械通气是救治呼吸衰竭的重要措施。正压机械通气妨碍纤毛运动,气管内插管阻止痰液的排出。因此,吸痰是护理机械通气患者的主要技术操作。吸痰方法不当可造成多种不良后果,甚至危及生命。所以,掌握正确的吸痰方法是安全吸痰、保持呼吸道通畅的关键。     

Performance Comparison of Geodrain Drainage and Gravel Drainage Layers Embedded in a Horizontal Plane

Drainage materials are widely used, among other uses, in the construction of landfills. Regulations require a drainage layer in the base and a covering for the landfill. The implementation of a gravel drain requires a lot of material and financial outlays. New geocomposite materials are an alternative, and facilitate construction. The aim of the research was to compare the drainage properties of the Pozidrain 7S250D/NW8 geocomposite and gravel drainage. The model test was performed on a specially prepared test stand. The research was carried out for model #1, in which the gravel drainage was built. Model #2 had a drainage geocomposite built into it. The test results show the values of the volumetric flow rate for geodrains, with a maximum value of 40 dm³·min⁻¹. For the gravel layer, values of up to 140 dm³·min⁻¹ were recorded. Another parameter recorded during the damming of water by the embankment was the speed of water suction by the geosynthetic and gravel drainage; the values were 0.067 and 0.024 m³·s⁻¹, respectively. The efficiency of water drainage through the geocomposite was sufficient. It is possible to use the slopes of the landfill for drainage, which will reduce material and financial outlays.     

简易腹水还纳输注探讨

目的　肝硬变腹水是一常见病 ,治疗处理需要探讨。方法　根据现在对其病因的新认识 ,提出“三原则两辅助处理”规则 ,而辅助之一是腹水还纳注射 ,试探一次抽出腹水分次静脉回输。结果　观察 1115例肝硬变并发腹水患者 ,12 2例 (10 .9% )在三原则治疗下辅助腹水还纳 ,腹水均获消退。结论　简易腹水还纳对特大量和顽固性腹水有甚好辅助治疗作用 ,简便易行 ,且安全     

一次性吸痰器在儿童重症监护室患儿留取痰培养标本中的应用

目的 探讨一次性吸痰器在儿童重症监护室(pediatric intensive care unit,PICU)患儿留取痰培养标本中的应用效果。方法 选取2019年10月-2020年9月入住PICU首次留取痰培养标本的患儿作为研究对象。按照入住病区将其分为观察组302例和对照组318例,观察组采取一次性吸痰器配合一次性吸痰管留取痰培养标本;对照组仅采用一次性吸痰管留取痰培养标本。比较2组痰培养标本质量、留取痰培养标本所需时间。结果 观察组痰培养标本质量好于对照组(Z=-4.571,P<0.001),留取痰培养标本所需时间短于对照组(t=-32.600,P<0.001)。结论 PICU患儿采取一次性吸痰器留取痰培养标本,可大大提高痰培养标本采集质量,缩短标本留取时间,节约人力,避免交叉感染。     

Composite Behavior of Insulated Concrete Sandwich Wall Panels Subjected to Wind Pressure and Suction

A full-scale experimental test was conducted to analyze the composite behavior of insulated concrete sandwich wall panels (ICSWPs) subjected to wind pressure and suction. The experimental program was composed of three groups of ICSWP specimens, each with a different type of insulation and number of glass-fiber-reinforced polymer (GFRP) shear grids. The degree of composite action of each specimen was analyzed according to the load direction, type of the insulation, and number of GFRP shear grids by comparing the theoretical and experimental values. The failure modes of the ICSWPs were compared to investigate the effect of bonds according to the load direction and type of insulation. Bonds based on insulation absorptiveness were effective to result in the composite behavior of ICSWP under positive loading tests only, while bonds based on insulation surface roughness were effective under both positive and negative loading tests. Therefore, the composite behavior based on surface roughness can be applied to the calculation of the design strength of ICSWPs with continuous GFRP shear connectors.