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71.
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目的:探讨单用依托咪酯或丙泊酚诱导气管插管在急诊危重患者中的可行性和安全性。方法:回顾性分析单用依托咪酯或丙泊酚诱导气管插管的首次成功率、反流误吸发生率、诱导后低血压和心律失常发生率、气管插管后药物的使用情况。结果:所有患者在诱导插管过程中都无反流误吸发生。与丙泊酚诱导比较,依托咪酯诱导低血压与心律失常发生率更低,插管后升压药物使用率更低(P<0.05)。首次成功率和降压药使用率差异无统计学意义。结论:急诊危重病患者单用依托咪酯或丙泊酚诱导气管插管都具有良好可行性,但用依托咪酯诱导插管更安全。 相似文献
73.
Objective
Compare the impact of two interventions, a web-based support and a folder support, for young persons who care for people who suffer from mental illness.Methods
This study was a randomized control trial, following the CONSORT statements, which compared the impact of two interventions. Primary outcome variable was stress, and secondary outcome variables were caring situation, general self-efficacy, well-being, health, and quality of life of young informal carers (N = 241). Data were collected in June 2010 to April 2011, with self-assessment questionnaires, comparing the two interventions and also to detect changes.Results
The stress levels were high in both groups at baseline, but decreased in the folder group. The folder group had improvement in their caring situation (also different from the web group), general self-efficacy, well-being, and quality of life. The web group showed increase in well-being.Conclusion
Young informal carers who take on the responsibility for people close to them; suffer consequences on their own health. They live in a life-situation characterized by high stress and low well-being. This signals a need for support.Practice implications
The non-significant differences show that each intervention can be effective, and that it depends upon the individual's preferences. This highlights the importance of adopting person-centered approach, in which young persons can themselves choose support strategy. 相似文献74.
Purpose
Mentally disabled patients show different recovery profiles compared to normal patients after general anesthesia. However, the relationship of dose-recovery profiles of mentally disabled patients has never been compared to that of normal patients.Materials and Methods
Twenty patients (10 mentally disabled patients and 10 mentally intact patients) scheduled to dental surgery under general anesthesia was recruited. Sevoflurane was administered to maintain anesthesia during dental treatment. At the end of the surgery, sevoflurane was discontinued. End-tidal sevoflurane and recovery of consciousness (ROC) were recorded after sevoflurane discontinuation. The pharmacodynamic relation between the probability of ROC and end-tidal sevoflurane concentration was analyzed using NONMEM software (version VII).Results
End-tidal sevoflurane concentration associated with 50% probability of ROC (C50) and γ value were lower in the mentally disabled patients (C50=0.37 vol %, γ=16.5 in mentally intact patients, C50=0.19 vol %, γ=4.58 in mentally disabled patients). Mentality was a significant covariate of C50 for ROC and γ value to pharmacodynamic model.Conclusion
A sigmoid Emanx model explains the pharmacodynamic relationship between end-tidal sevoflurane concentration and ROC. Mentally disabled patients may recover slower from anesthesia at lower sevoflurane concentration at ROC an compared to normal patients. 相似文献75.
目的 观察两类达标血糖控制对急危重患者预后的影响. 方法 选取2011年1月至2013年9月我院急诊重症监护室(EICU)急性生理学与慢性健康评分(APACHEⅡ)>15分且合并高血糖的危重患者200例,分为胰岛素强化治疗(IIT)组和常规控制(CIT)组,比较两组近期死亡率、3d及7d后APACHEⅡ、严重并发症、低血糖、院内感染发生率、住院时间和费用等指标. 结果 IIT组住院时间和费用、院内感染发生率、呼吸衰竭、心功能不全、3d及7d后APACHEⅡ较CIT组低(P<0.05).两组低血糖总发生率比较差异有统计学意义(29% vs 13%,P<0.01),严重低血糖发生率、死亡率比较差异无统计学意义. 结论 IIT可能为临床带来较多益处,但增加急危重患者低血糖风险,对降低总死亡率可能无明显影响. 相似文献
76.
Yvonne M. Drewes MD Rosalinde K. E. Poortvliet MD Jeanet W. Blom MD PhD Wouter de Ruijter MD PhD Rudi G. J. Westendorp MD PhD David J. Stott MD PhD Henk J. Blom PhD Ian Ford PhD Naveed Sattar MD PhD J. Wouter Jukema MD PhD Willem J. J. Assendelft MD PhD Anton J. M. de Craen PhD Jacobijn Gussekloo PhD 《Journal of the American Geriatrics Society》2014,62(2):213-221
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78.
Patients suffering from primary sclerosing cholangitis (PSC) show considerable differences regarding clinical manifestations (i.e. large duct versus small-duct PSC, presence or absence of concomitant inflammatory bowel disease), disease progression, risk for malignancy and response to therapy, raising the question whether PSC may represent a mixed bag of diseases of different aetiologies. The growing list of secondary causes and diseases 'mimicking' or even overlapping with PSC (e.g. IgG4-associated sclerosing cholangitis), which frequently causes problems in clear-cut discrimination from classic PSC and the emerging knowledge about potential disease modifier genes (e.g. variants of CFTR, TGR5 and MDR3) support such a conceptual view. In addition, PSC in children differs significantly from PSC in adults in several aspects resulting in distinct therapeutic concepts. From a clinical perspective, appropriate categorization and careful differential diagnosis are essential for the management of concerned patients. Therefore, the aim of the current review is to summarize current and evolving pathophysiological concepts and to provide up-to-date perspectives including future treatment strategies for PSC. 相似文献
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80.
《Nordic journal of psychiatry》2013,67(5):435-442
Nordentoft M. Deinstitutionalization and homelessness among the mentally ill – a historical review.The number of psychiatric beds has decreased dramatically in the Western world during the past three decades. At the same time there has been a shift in psychiatric care from being mainly custodial in big asylums to a more active, often psychotherapeutically oriented treatment in the psychiatric departments of general hospitals or in community mental health centers. This development has benefited many psychiatric patients, but during the same period severely ill psychiatric patients, mostly schizophrenics, have dropped out of psychiatric care and are now in increasing numbers to be found in jails, in board-and-care homes, or homeless in the streets. It is stressed that there is a need for analysis of the cause of homelessness among psychotic patients and of development of aid programs that can be accepted by this specific group of patients. 相似文献