负压引流防治腮腺术后涎瘘112例

目的 探讨负压引流技术作为防治腮腺术后涎瘘方案的可行性。 方法 腮腺良性疾病患者112例,手术后放置负压引流管引流3 d,拔管后短时间加压包扎3 d,观察涎瘘情况并对症治疗。 结果 104例切口一期愈合; 7 例发生轻度涎瘘,局部搔刮后加压包扎1周后治愈;1例术后术腔积血并Ⅲ级涎瘘,术后3 d发现,经处理后术后2周治愈。 结论 负压引流可以预防腮腺涎瘘发生,缩短加压包扎时间,传统加压包扎对术后涎瘘治疗作用肯定。     

PRELIMINARY REPORT ON THE MECHANISM OF HEAT AND BANDAGE TREATMENT FOR LYMPHEDEMA

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自制气切固定绷带在ICU患者中的应用

正气管切开已成为ICU抢救患者重要手段之一,气切系带的使用不合理或者选择不合适都会给患者带来痛苦,如颈部皮肤潮湿性皮炎、水泡、溃疡的发生。笔者科室之前用棉布带固定气管切开套管,据统计2014年下半年至2015年上半年我科气管切开套管气囊意外剪断率达3.2%。气囊的意外剪断会造成患者的误吸,增加肺部感染的发生率,增加患者痛苦和经济负担。为此科室对现有棉布系带的不足进行改良,研制了新型的气切绷带。并应用于临床,取得较好     

An investigation of the ability to produce a defined ‘target pressure’ using the PressCise compression bandage

Compression therapy is the cornerstone in the prevention and treatment of leg ulcers related to chronic venous insufficiency. The application of optimal high pressure is essential for a successful outcome, but the literature has reported difficulty applying the intended pressure, even among highly skilled nurses. The PressCise bandage has a novel design, with both longitudinal and horizontal reference points for correct application. In the current experimental study, the results for the general linear model, where the data set is treated optimally, showed that all 95% confidence intervals of the expected values for pressure were, at most, 5 mmHg from the target value of 50 mmHg, independent of the position on the leg and the state of activity. Moreover, even nurses with limited experience were consistently able to reach the targeted pressure goal. Future studies are needed to determine how well the bandage works on legs of different shapes, the optimal way of using the bandage (day only or both day and night) and whether the bandage should be combined with an outer bandage layer. In addition, special attention should be paid to subjective patient experiences in relation to the treatment as pain, discomfort and bulk are factors that can compromise patients' willingness to adhere to the treatment protocol and thereby prolong the healing process.     

对外科患者换药疼痛的心理护理措施分析

在外科各种手术、创伤、感染等伤口的换药处理过程当中，由于换药场所的环境的陌生或者医患之间的关系等等原因，都会对病人的心理产生一定的影响，从而导致其过分重视疼痛感而加重换药过程中痛疼的敏感性，严重时患者会因剧烈的疼痛感而导致换药达不到理想效果。针对患者这一心理特点，在换药过程中如何进行有效的心理护理措施，减轻患者心理负担降低疼痛，是换药过程中的重要环节之一。     

自黏性弹力绷带在隐匿性阴茎矫正术患儿中的应用

目的探讨自黏性弹力绷带在隐匿性阴茎矫正术患儿中的应用效果。方法选择2011年6月至2013年6月在第二军医大学长海医院整形外科行隐匿性阴茎矫正术的患儿260例,按入院先后将其分为观察组和对照组各130例,两组患儿术后均先用无菌纱布自切口缠绕阴茎至根部,观察组采用环氧乙烷灭菌自黏性弹力绷带缠绕固定,适当加压;对照组选用普通胶布缠绕固定。评价并比较两组患儿术后7d的换药次数、血肿及水肿发生情况、患儿家长的满意率。结果观察组患儿术后7d的换药次数、血肿及水肿发生情况均少于对照组,患儿家长满意率高于对照组,差异均有统计学意义(P0.05或0.01)。结论自黏性弹力绷带应用于隐匿性阴茎矫正术患儿的术后包扎,有利于减轻患儿的术后不适,减少并发症的发生,促进患儿尽快康复。     

Lateral epicondylalgia: a structured programme better than corticosteroids and NSAID

Abstract

Aim: To evaluate whether patients with lateral epicondylalgia had less pain or function loss two years following treatment by a structured programme and if the number of recurrent episodes and sick leave days differed compared with a control group. Subjects: All of the patients were diagnosed by a physician with the diagnosis code M77.1 (lateral epicondylitis). The intervention group (n = 103) was treated by a physiotherapist and an occupational therapist with a home training programme that included ergonomic advice. Wrist supports and/or night bandages were also available. Controls (n = 194) were diversely treated by different professionals. Major findings: In the total study group (n = 297), 54% of the patients experienced pain and 55% experienced function loss after two years. The intervention group had less pain than patients treated with corticosteroid injections (p < 0.0001) or NSAIDs (p = 0.048) and experienced better function than those treated with corticosteroid injections (p = 0.002). The intervention group had a lower recurrence (p < 0.0001) and fewer sick leave days at the time of the visit to the health care centre (p = 0.005). Principal conclusions: A structured treatment programme was more effective than corticosteroid injections and NSAIDs. Patients did not require additional treatment or sick leave and had learned self-treatment of the disorder.