急诊低钾性周期性麻痹72例临床分析

本文报告我院1995～2004年低钾性周期性麻痹72例,分析如下. 1临床资料 1.1一般资料 72例患者,男64例,女8例,男女比例为8:1,发病年龄为18～30岁58例(81%),30～40岁10例,40～50岁4例.一次肌无力持续时间最短的4 h,最长5 d.72例患者中,主要诱因是受凉、上感和腹泻,其次是饱餐、酗酒、剧烈活动和大量食糖.甲亢患者8例,肾脏病3例,肝硬化1例.     

急性心血管事件院前急救的应急策略及流程探讨

Objective To study the strategy and process of out-hospital emergency care of acute cardiovascular events. Methods One hundred and eighty-three patients in the Second Affiliated Hospital of Baotou Medical College were prospectively studied. The patients were divided into two groups according to the different ways of out-hospital care, one group consisted of patients who received first-aid care after calling " 120" (94 cases), another was self-aid group consisting of patients sent to hospital by relatives (89 cases). The proportion of persons with higher than high school education and better knowledge for emergency care of patients with heart disease in first-aid group was higher than self-aid group (50. 0% vs. 29. 2%, 83.0% vs. 60. 7%, both P<0. 05). When the patients were brought to the emergency room, they were all treated according to our standard procedure and then registered. All patients were followed up at the end of first and third month after illness. Results Cardiovascular events were mainly myocardial infarction (61.7%) among 183 patients. There were statistically significant differences between two groups in self-aid response time, first disposal time and out-hospital rescuing time [(32.3 ± 5.6) minutes vs. (89.6±8.4) minutes, (47.3±7.3) minutes vs. (149.8±13.5) minutes, (61.7±8.3) minutes vs. [(149.8±13.5) minutes, all P<0. 01], but no difference was found in in-hospital rescuing time [(29. 9±5.3) minutes vs. (31.1±4.5) minutes, P>0. 05]. Morbidity rate was lower in first-aid group than self-aid group in 1st and 3rd month, respectively (2.1% vs. 9. 0%, 4. 2% vs. 12.4%, both P<0. 05). Conclusion Excellent emergency system and procedure can shorten initial disposal time and out-hospital rescuing time, thus improve patients' prognosis. The education level and health knowledge of patients and their raletives directly affect their mode of arriving hospital and prognosis.     

急性心血管事件院前急救的应急策略及流程探讨

Objective To study the strategy and process of out-hospital emergency care of acute cardiovascular events. Methods One hundred and eighty-three patients in the Second Affiliated Hospital of Baotou Medical College were prospectively studied. The patients were divided into two groups according to the different ways of out-hospital care, one group consisted of patients who received first-aid care after calling " 120" (94 cases), another was self-aid group consisting of patients sent to hospital by relatives (89 cases). The proportion of persons with higher than high school education and better knowledge for emergency care of patients with heart disease in first-aid group was higher than self-aid group (50. 0% vs. 29. 2%, 83.0% vs. 60. 7%, both P<0. 05). When the patients were brought to the emergency room, they were all treated according to our standard procedure and then registered. All patients were followed up at the end of first and third month after illness. Results Cardiovascular events were mainly myocardial infarction (61.7%) among 183 patients. There were statistically significant differences between two groups in self-aid response time, first disposal time and out-hospital rescuing time [(32.3 ± 5.6) minutes vs. (89.6±8.4) minutes, (47.3±7.3) minutes vs. (149.8±13.5) minutes, (61.7±8.3) minutes vs. [(149.8±13.5) minutes, all P<0. 01], but no difference was found in in-hospital rescuing time [(29. 9±5.3) minutes vs. (31.1±4.5) minutes, P>0. 05]. Morbidity rate was lower in first-aid group than self-aid group in 1st and 3rd month, respectively (2.1% vs. 9. 0%, 4. 2% vs. 12.4%, both P<0. 05). Conclusion Excellent emergency system and procedure can shorten initial disposal time and out-hospital rescuing time, thus improve patients' prognosis. The education level and health knowledge of patients and their raletives directly affect their mode of arriving hospital and prognosis.     

急诊护理教学方法改革

护理临床教学是医学护理教育的重要组成部分,是课堂的深化,是学生由学校走向社会的重要过渡阶段。急诊作为急救体系中的重要环节,其工作与其他专科护理相比,有着其独特性[1]。根据急诊科的工作特点,我们规范了教学管理方法,采用科学的引导、施教,把培养护理学生观察能力、应急能力、动手能力、沟通能力作为实习带教的重点内容,指导护理学生进一步提高急救技能,     

EAM－1型耳膜按摩机疗效观察（附110例报告）

ＥＡＭ－１型耳膜按摩机疗效观察（附１１０例报告）张靖寅，崔刚关键词：鼓膜；按摩我科从１９９３年６月至１９９４年６月进行鼓膜按摩１１０例，疗效观察如下。１临床资料一般资料：１１０例病人中男４５例，女６５例；年龄最大的７６岁，最小的９岁。病种及症状：①因...     

急性盐酸多塞平中毒抢救1例分析

盐酸多塞平属于三环类抗抑郁药,多塞平中毒临床较少见,现将重度多塞平中毒病例分析如下. 1 病历摘要 女,35岁.因生气空腹口服盐酸多塞平100片3 h后就诊,无呕吐,间断抽搐.当时查体:BP 50/40 mm Hg,R 6～8次/min,P 40次/min,深昏迷状,呼吸浅表,口唇发绀,双侧瞳孔散大约5 mm,对光反射迟钝,口腔鼻腔无异常分泌物.双肺呼吸爵弱,心音低钝,律齐,生理反射消失,病理反射未引出.     

急性心血管事件院前急救的应急策略及流程探讨

Objective To study the strategy and process of out-hospital emergency care of acute cardiovascular events. Methods One hundred and eighty-three patients in the Second Affiliated Hospital of Baotou Medical College were prospectively studied. The patients were divided into two groups according to the different ways of out-hospital care, one group consisted of patients who received first-aid care after calling " 120" (94 cases), another was self-aid group consisting of patients sent to hospital by relatives (89 cases). The proportion of persons with higher than high school education and better knowledge for emergency care of patients with heart disease in first-aid group was higher than self-aid group (50. 0% vs. 29. 2%, 83.0% vs. 60. 7%, both P<0. 05). When the patients were brought to the emergency room, they were all treated according to our standard procedure and then registered. All patients were followed up at the end of first and third month after illness. Results Cardiovascular events were mainly myocardial infarction (61.7%) among 183 patients. There were statistically significant differences between two groups in self-aid response time, first disposal time and out-hospital rescuing time [(32.3 ± 5.6) minutes vs. (89.6±8.4) minutes, (47.3±7.3) minutes vs. (149.8±13.5) minutes, (61.7±8.3) minutes vs. [(149.8±13.5) minutes, all P<0. 01], but no difference was found in in-hospital rescuing time [(29. 9±5.3) minutes vs. (31.1±4.5) minutes, P>0. 05]. Morbidity rate was lower in first-aid group than self-aid group in 1st and 3rd month, respectively (2.1% vs. 9. 0%, 4. 2% vs. 12.4%, both P<0. 05). Conclusion Excellent emergency system and procedure can shorten initial disposal time and out-hospital rescuing time, thus improve patients' prognosis. The education level and health knowledge of patients and their raletives directly affect their mode of arriving hospital and prognosis.     

连续性血液净化在急危重症患者治疗中的应用

目的 探讨连续血液净化(CBP)辅助治疗48例急危重症患者的疗效及其影响因素.方法 回顾性分析2008年6月至2009年12月我院急诊科和ICU病房接受CBP治疗48例急危重症患者的临床资料,根据患者预后分为存活组和死亡组各24例,对其接受CBP治疗前的全身状况、原发疾病种类和CBP治疗病因等进行比较.结果 原发疾病分布情况:存活组重症急性胰腺炎13例(54.2%),无脑出血、重度颅脑损伤患者;死亡组重症急性胰腺炎、脑出血、重度颅脑损伤分别为3例(12.5%)、6例(25.0%)、5例(20.8%),组间差异有统计学意义(P＜0.05或＜0.01).接受CBP治疗原因分布:存活组MODS 6例(25.0%),均未合并急性肾衰竭(ARF);死亡组16例(66.7%),其中合并ARF 12例(50.0%),组间差异有统计学意义(P均＜0.01).48例患者中2个脏器功能不全者2例,均存活;3个脏器功能不全者3例,死亡1例;4个脏器功能不全者6例,死亡4例;5个脏器功能不全者6例,6个脏器功能不全者5例,均死亡.与存活组比较,死亡组年龄更大[(60.5±14.4)、(40.7±14.6)岁,t=4.233,P＜0.01],死亡组治疗前心率(HR)、急性生理学与慢性健康状况(APACHEⅡ)评分、血肌酐和尿素氮均比存活组高(t值分别为2.49、10.58、3.81、6.15,P＜0.05或＜0.01),治疗后虽然比治疗前明显下降,但仍高于存活组(t值分别为5.21、7.46、4.85、6.10,P均＜0.01);死亡组平均动脉压(MAP)治疗前明显低于存活组(t=2.23,P＜0.05),治疗后虽有明显升高,但仍低于存活组(t=3.17,P＜0.01),末梢血氧饱和度(Sp02)2组治疗前差异无统计学意义(t=1.03,P＞0.05),治疗后均有明显升高(t值分别为6.59、6.66,P＜0.01),死亡组仍低于存活组(t=2.10,P＜0.01).结论 CBP可以短期减轻患者的病情,为进一步治疗争取时间,但患者的预后取决于疾病的严重程度和原发病能否得到有效控制等.     

血清T_3和T_4在危重病患者治疗前后的临床研究

近年来,甲状腺功能正常性病变综合征(ESS)~([1,2])越来越受到重视,各种危重病、严重创伤应激时机体甲状腺激素减低.本文通过分析57例危重病患者血清甲状腺激素的变化来探讨其与疾病和预后的关系.     

急性心血管事件院前急救的应急策略及流程探讨

目的 探讨急性心血管事件院前急救的应急策略及流程.方法 采用前瞻性研究方法 ,连续登记本院急诊科收治的新发心血管疾病患者183例.按不同就诊模式分为拨打"120"就诊的救护组(94例)和由家人护送来院就诊的自救组(89例).救护组高中以上文化程度者及了解心血管急救知识的比例均较自救组高(50.0%比29.2%,83.0%比60.7%,P均<0.05),救护组院外给予各种应急治疗,自救组院外未进行正规治疗;到院后两组均按绿色通道救治方案及流程处理.1、3个月末对所有患者进行盲法随访.结果 183例患者中心血管事件构成以心肌梗死为主(占61.7%).救护组自救反应时间、第一处置时间、院外救治时间均较自救组短[(32.34±5.6)min比(89.6±8.4)min,(47.3±7.3)min比(149.8±13.5)min,(61.7±8.3)min比(149.8±13.5)min,P均<0.01];而两组院内急救时间比较差异无统计学意义C(29.9±5.3)min比(31.1±4.5)min,P>0.05].救护组1、3个月病死率较自救组低(2.1%比9.0%,4.2%比12.4%,P均<0.05).结论 完善的急救体系及路径能明显缩短患者第一处置时间和院外急救时间,改善患者预后;患者及家属的文化程度及健康知识直接影响就诊模式和预后.