心脏衰竭患者静脉泵入硝酸甘油时回血的干预研究

目的 探讨解决心脏衰竭（心衰）患者在静脉泵入硝酸甘油时出现的静脉血反流或回血的方法。方法 在静脉泵入硝酸甘油的同时，以一定的速度从同一静脉通路输入生理盐水或5％葡萄糖至硝酸甘油泵完，观察回血情况及能阻止静脉血反流的最慢滴速，并观察额外输液．对患者心功能的影响。结果 静脉泵入硝酸甘油的速度〈5ml／h时出现回血，以5次／min的速度维持输液即可阻止同血。与无回血未施干预的对照组相比，观察组患者在泵入硝酸甘油时伴随的额外输液对患着的心功能未产生明显的影响。结论 静脉泵入硝酸甘油的同时以一定的速度从同一通路缓慢滴入生理盐水或5％葡萄糖即可以阻止回血．同时额外增加的输液并不增加心衰患者心脏负担。     

埋入式导管药盒系统用于动脉灌注化疗的护理

目的：探讨埋入式导管药盒系统用于恶性肿瘤病人长期动脉灌注化疗这一新途径的临床应用及护理。方法：对40例恶性肝、颅内肿瘤病人采用埋入式导管药盒系统进行长期动脉灌注化疗的效果观察及护理。结果：80％上病人采用该技术在动脉内建立化疗灌注通道长达2～3月。结论：术前、术中、术后及并发症的观察，药盒的正确处理至关重要。     

Infusion tomography and ultrasonography of the gallbladder in the diagnosis of acute cholecystitis

Sixty-three patients with the clinical suspicion of acute cholecystitis were examined with infusion tomography of the gallbladder. Ultrasonography was performed in 51 of these cases. The technique and diagnostic principles of both methods are discussed. The diagnostic value of the two methods when used in combination is stressed. Thus in a case of gangrenous cholecystitis when opacification of the gallbladder wall may not appear at infusion tomography, ultrasonography may demonstrate signs of gallbladder disease. Infusion tomography, on the other hand, may be of great value if ultrasonography is not informative.     

Retrospective chart review of severe infusion reactions with rituximab,cetuximab, and bevacizumab in community oncology practices: assessment of clinical consequences

GOALS OF WORK: Monoclonal antibody (MoAb) treatments can result in severe infusion reactions. Managing infusion reactions in the outpatient setting introduces clinical and resource challenges for patients and providers, but there is little information regarding prevention, management, or outcomes of severe infusion reactions. This study represents one of the first attempts to describe the clinical consequences of severe infusion reactions associated with MoAb treatment. MATERIALS AND METHODS: Clinic staff identified adults treated with rituximab, cetuximab, or bevacizumab who experienced a grade 3 or higher (severe) infusion reaction. Chart reviews from 19 oncology practice sites across the USA captured patient demographics, infusion reaction management procedures, and clinical outcomes. MAIN RESULTS: With an average age of 62 years, the sample comprised of 76 patients who experienced a severe infusion reaction while receiving rituximab (n = 47), cetuximab (n = 24), and bevacizumab (n = 5). The most common pretreatment medications were acetaminophen and antihistamine in the rituximab group and corticosteroids (42%) in the cetuximab group. All cetuximab and the majority of rituximab severe infusion reactions occurred during the first cycle of therapy. Postinfusion reaction management typically included corticosteroids, oxygen, and intravenous fluids. Overall, 22% were hospitalized for a mean of 4 days (range = 2.0 to 6.0 days). Permanent discontinuation of MoAb therapy occurred after the majority of cetuximab (79 to 100%) related severe infusion reactions. CONCLUSIONS: Severe infusion reactions are intensive events that present a serious challenge to patients and oncology practices. Efforts to prevent or reduce such reactions could be of great benefit.     

肿瘤晚期患者使用PICC-电子镇痛泵的疗效观察及护理

目的总结PICC-电子镇痛泵应用过程中的护理经验,使肿瘤晚期患者应用镇痛泵时减轻疼痛,提高生活质量。方法经PICC连接电子镇痛泵,应用麻醉性镇痛药。结果24例患者均达到良好的镇痛效果,并针对不同程度的便秘、恶心等副作用采取了相应的措施。结论经PICC使用电子镇痛泵,治疗肿瘤晚期疼痛,方法简单有效,改善了患者的生活质量。     

输液泵输注甘露醇的可行性研究

目的:探讨输液泵输注甘露醇的可行性.方法:随机将输注甘露醇的病人1620例次分为两组,每组810例次,观察组用输液泵输注,对照组采用重力法输入,观察两组外渗发生例次和面积以及外渗的血管部位.结果:两组外渗发生例次和面积差异有统计学意义(P<0.01),观察组的外渗例次多于对照组,外渗面积大于对照组;两组外渗的发生均与选择静脉的直径呈负相关.结论:输液泵不能用于加压输注甘露醇,但在重力法输液的流速能达到甘露醇使用要求时,可用输液泵恒速输入.     

外科侧卧位手术输液部位选择对比分析

目的:探讨外科侧卧位手术输液部位的选择对手术的影响。方法:随机选择480例侧卧位手术患者,分试验组和对照组。试验组选择侧卧位下侧上肢输液,对照组选择上侧上肢输液,并对结果进行比较分析。结果:外科侧卧位手术中选择下侧上肢输液明显比上侧上肢输液速度快,同时可间接反映下侧上肢静脉回流受阻情况,观察腋枕是否放置妥当,术中测量血压,肢体避免长时间受压。结论:外科侧卧位手术中选择下侧上肢输液能满足手术和麻醉的需要,保证手术的顺利进行。     

肝乐冲剂治疗乙型肝炎肝郁脾虚型60例临床观察

[目的]探讨肝乐冲剂治疗乙型肝炎肝郁脾虚型的疗效。[方法]采用随机对照方法,将60例病人分为治疗组(肝乐冲剂)与对照组(甘力欣胶囊),观察治疗前后各项相关指标的变化及临床疗效。[结果]治疗组疗效指数为93.3%,对照组的66.7%,肝功能改善情况及血清乙肝病毒指标转阴率,治疗组优于对照组,两组比较有显著性差异(P0.05)。[结论]肝乐冲剂治疗慢性乙型肝炎肝郁脾虚型疗效明显。     

推注与泵注舒芬太尼在腹腔镜胆囊切除术中的应用

随着腹腔镜下胆囊切除(LC)技术的不断提高,手术时间越来越短,手术连台情况越来越多,这就要求患者在停止给药后尽快苏醒。因此,寻求安全有效的药物和给药方式显得尤为重要。本研究将间断推注舒芬太尼和持续泵注舒芬太尼用于LC术,以观察两种方法对患者术中血流动力学和麻醉恢复的影响,从而为临床工作提供参考。     

临床静脉输液反应的主要原因及防预对策

目的分析发生输液反应的原因,查找预防措施,减少临床输液反应的发生.方法观察我院2009年4月-2012年4月已确认输液反应的病例135例,进行分析、总结.结果发生输液反应的原因有药物因素、操作因素、输液器具、季节及个体差异等.结论注意药物配伍及输注速度,严格无菌操作规程,加强输液观察,提高护理管理水平,把握好药品及输液器具的采购渠道及质量关等,才能够减少输液反应的发生.