电子支气管镜检查患者心理护理干预的效果分析

目的：探讨心理护理干预在电子支气管镜检查中对患者的影响。方法对本科120例住院行电子支气管镜检查的患者,采用对照研究的方法,按先后顺序随机分成观察组与对照组,每组各60例。对照组进行常规护理,观察组在除常规护理外,给予心理护理干预。对比两组患者身心状况,评价观察组患者的干预效果,观察两组患者接受不同护理后进行检查时对检查结果影响。结果观察组干预后焦虑评分和检查后血压、心率的升高幅度均明显低于对照组（P〈0.01）。结论对电子支气管镜检查患者给予心理护理干预,可提高护理效果,改善患者紧张情绪,使检查和治疗顺利完成,值得临床推广应用。     

无张力疝修补术25例临床分析

目的:探讨无张力疝修补术治疗腹股沟疝的临床疗效。方法:应用无张力疝修补术治疗腹股沟疝25例。结果:应用无张力疝修补术治疗腹股沟疝术中损伤小,术后疼痛轻,并发症少,恢复快,随访0.5～1.5年无复发病例。结论:无张力疝修补术效果优越,是治疗腹股沟疝的良好方法,值得临床推广。     

产前盆底肌功能锻炼对阴道分娩结局的影响

目的探讨产前进行盆底肌功能锻炼对阴道分娩结局的影响。方法选择自愿接受盆底肌功能锻炼的孕妇58例作为实验组,未进行功能锻炼的孕妇64例作为对照组。两组孕妇分娩前行盆底肌肉肌张力检测,并记录分娩产程时间和阴道分娩情况。结果实验组孕妇盆底肌肉肌张力强于对照组（P〈0.05）,活跃期、第二产程和总产程时间均短于对照组（P〈0.01）;阴道助产率、会阴侧切率和阴道出血量均低于对照组（P〈0.05）。结论孕妇产前进行盆底肌锻炼能够增强盆底肌张力、缩短产程,并且对于改善阴道分娩结局有积极的作用。     

两种腹股沟疝修复材料的应用比较

目的比较两种腹股沟疝修复材料的应用情况,为临床选择合适的疝修复材料提供依据。方法将符合诊断的腹股沟疝患者随机分为两组,分别采用Bard Perfix Plug及Atrium Proloop网进行无张力修补,对比两组患者的手术时间、术后康复时间、费用、术后患者的感受及复发情况。结果两组患者的手术时间、术后康复时间、费用比较差异无统计学意义,术后患者的自我感受、复发率上两组比较差异有统计学意义,Bard Perfix Plug效果好。结论修复材料的特性与手术及术后恢复关系密切,对于疝环大、Hesselbach三角区薄弱者,Bard补片是较好的腹股沟疝修复材料。     

改良平片无张力疝修补术在腹股沟疝中的应用

目的探讨一种经济实用的腹股沟疝修补方法。方法采用改良的无张力疝修补方法对2010年6月以来收治腹股沟疝患者56例行手术治疗,观察手术效果及并发症情况。结果56例患者无1例复发。并发尿潴留19例,均为腰硬联合麻醉者。阴囊血肿1例,皮下脂肪液化2例,出现低热26例。切口疼痛多能耐受,术后异物感不明显,费用低,住院时间短。结论改良平片无张力疝修补术符合疝修补理念,取得了满意的效果,减轻了患者的经济负担,是一种适合基层医院,相对理想的腹股沟疝修补方法。     

无张力疝修补术治疗40例老年人腹股沟复发疝的临床应用

目的 总结无张力疝修补术治疗老年人腹股沟复发疝的经验.方法回顾性分析无张力疝修补术在治疗40例老年人腹股沟复发疝中的应用.结果 40例患者手术顺利,平均手术时间45 min,平均住院时间70 d.术后并发症：尿潴留6例,阴囊积液3例,对症治疗均痊愈,无切口感染及液化.40例患者均随诊1~4年,无再复发.结论 无张力疝修补术应作为治疗老年人腹股沟复发疝的首选术式.     

2种方法治疗锁骨远端骨折合并肩锁关节脱位的疗效观察

目的观察锁骨钩钢板与克氏针张力带2种方法治疗锁骨远端骨折合并肩锁关节脱位疗效对比,降低再脱位的发生率。方法抽取我院于2009年3月至2010年3月收治的60例锁骨远端骨折合并肩锁关节脱位患者随机分为2组。实验组30例,全麻下行锁骨钩钢板治疗。对照组30例,行克氏针张力带治疗。术后随访1个月～1年,并对疗效结果进行统计。结果实验组术后显效22例,有效6例,无效2例,总有效率(包括显效和有效)为92.8%优于对照组,差异有统计学意义(P<0.05)。结论早期行锁骨钩钢板治疗肩锁关节全脱位符合生物力学要求,并发症少,复位满意,可有效减少再脱位的发生,是治疗肩锁关节脱位和锁骨远端骨折的重要方法,但应注意正确的锁骨钩钢板固定经验及之后规范的功能康复锻炼。     

Neumoencéfalo a tensión,una extraña complicación del uso de oxígeno en neonatos. Descripción de un caso y revisión de la literatura

Tension pneumocephalus is an extremely rare complication of positive-pressure ventilation in neonates, the diagnosis of which requires a high degree of clinical suspicion. We present the case of a preterm newborn, who received high-flow nasal cannula oxygen therapy because of hyaline membrane disease, due to his prematurity, and developed clinical signs of intracranial hypertension. Transfontanellar ultrasound and cranial CT scan revealed significant tension pneumocephalus, which was evacuated with direct needle puncture through the anterior fontanelle.     

Hook plating in patella fractures

PurposeTension band wiring is considered the standard treatment for patella fractures. However, it is limited for fractures with marginal involvement, comminution, and osteoporotic bone. Our experience indicates that these limitations can be overcome with the hook plate. We evaluated the radiographic and clinical outcomes in patients with patella fracture treated with hook plating.MethodsWe enrolled 30 patients who underwent hook plating for patella fracture at two institutions between 2013 and 2017. Fracture classification and surgical options were reviewed. Postoperative fracture gap and time to union as radiographic measurements, and complications, range of motion, and functional outcome with the Lysholm score as clinical outcomes, were evaluated retrospectively.ResultsNine fractures were AO/OTA 34A1, three B1, one B2, two C1, nine C2, and six C3. All were closed fractures. There were 3 cases of revision, 4 with lateral or medial marginal fracture, 9 with isolated inferior pole fracture, and 14 with comminuted fracture. The average postoperative fracture gap was 0.4 (range, 0–2.0) mm, and bone union was achieved without additional intervention. The average time to union was 11.6 (range, 7–24) weeks. There were no complications, and no extension lag except in one case (10°). The average flexion was 138.5° (range, 110–145°). For functional outcomes, the average Lysholm score was 89.5 (range, 74–95), with 13 excellent, 14 good, 3 fair, and no poor cases.ConclusionThis study suggests that hook plating can result in good bone union and restored knee function in marginal or comminuted fractures of the patella.