循证护理在预防透析低血压中的应用

循证护理（evidence—haced nuring，EBN）是指护士慎重、准确和明智地应用当前所能获得的最好研究证据，结合护理专业技能和多年临床经验，同时考虑患者的价值和愿望，将三者完美地结合，制订护理措施。血液透析（HD）中最常见的急性并发症是低血压，我院血液净化中心为了患者能安全、舒适地完成每次HD，提高生存质量，于2005年3—7月对22例有低血压倾向的患者进行了EBN，取得了良好的效果。现报道如下。     

不同高压氧治疗方案对急性一氧化碳中毒受损心肌的疗效分析

目的 探讨不同高压氧(hyperbaric oxygen,HBO)治疗方案对急性一氧化碳(carbon monoxide,CO)中毒受损心肌的影响.方法 对2006年10月至2010年3月收治的155例重症CO中毒患者进行HBO常规治疗(常规组,75例)和HBO改进治疗(改进组,80例).(1)常规组治疗方案:治疗压力0.25 MPa,加压20 min,稳压后吸氧2次,每次30 min,中间间歇10 min,减压20 min出舱.每日1次,12次为1个疗程,治疗9-68次.(2)改进组方案:前5 d采用HBO常规治疗,以后采用减小治疗压力、缩短吸氧时间、增加吸氧间隔、间歇给氧的治疗方案,治疗压力0.20 MPa,稳压吸氧4次,每次10min,中间间歇5 min,减压20 min出舱.连续治疗3 d后间隔1 d,10 d为1个疗程.2组患者使用相同的药物治疗方案.统计分析常规组和改进组ST-T变化及血清心肌酶变化.结果 改进组与常规组相比ST-T恢复率(56%,28%)明显升高(P＜0.05),HBO治疗第3天和第6天ST-T加重率(第3天21%、25%.第6天16%、27%)明显降低(P＜0.01);2组血清心肌酶恢复率和加重率比较差异有统计学意义(P＜0.05.P＜0.01).结论 HBO改进方案对CO中毒患者受损心肌疗效较好.

Abstract：

Objective To investigate the effects of different hyperbaric oxygen ( HBO) treatment profiles on damaged myocardium induced by acute carbon monoxide poisoning. Methods One hundred and fifty-five serious cases of acute carbon monoxide ( CO) poisoning admitted into the hospital for treatment from October 2006 to March 2010 were randomly divided into the routine HBO treatment group (the routine group,75 cases) and the improved HBO treatment group (the improved group,80 cases). The treatment profile of the routine HBO treatment group: the patients were compressed for 20 min to the treatment pressure of 0.25 Mpa. Following stabilization at the said pressure, the patients breathed oxygen twice for 30 min plus 10 min, once a day. The whole treatment course consisted of 12 sessions, with the patients receiving HBO treatments from 9 to 68 times. The treatment profile of the improved HBO treatment group: the patients were given routine HBO treatment in the first 5 days, then, received improved HBO treatment, with a treatment profile of lower pressure (0.20 Mpa) , shorter oxygen-breathing time, lengthening of oxygen-breathing intervals and intermittent oxygen breathing. Total oxygen-breathing time was 4 times, each for 10 min plus 3 times each for 5 min. Then, the patients were decompressed to the surface following 20-min oxygen-breathing decompression. The patients received treatment for a succession of 3 days, then, had 1-day interval, and the whole treatment course consisted of 10 sessions. Changes in ST-T and myocardial enzymes of both the routine HBO treatment group and the improved HBO treatment group were measured and analyzed. Results ST-T recovery rate of the improved HBO treatment group increased (56% ,28% ) obviously, when compared with that of the routine HBO treatment group(P ＜ 0. 05). ST-T worse rate decreased significantly following HBO treatment on the 3rd and 6th days (21% and 25% on the 3rd day, 16% and 27% on the 6th day) respectively (P＜0.01). Statistical differences could be seen in the myocardial recovery rate and worse rate, when a comparison was made between them (P＜0. 05, P＜0. 01). Conclusions The improved HBO treatment profile showed better therapeutic effect on damaged myocardium induced by CO poisoning. This treatment profile should be used instead of other treatment profiles.     

不同高压氧治疗方案对急性一氧化碳中毒受损心肌的疗效分析

Objective To investigate the effects of different hyperbaric oxygen ( HBO) treatment profiles on damaged myocardium induced by acute carbon monoxide poisoning. Methods One hundred and fifty-five serious cases of acute carbon monoxide ( CO) poisoning admitted into the hospital for treatment from October 2006 to March 2010 were randomly divided into the routine HBO treatment group (the routine group,75 cases) and the improved HBO treatment group (the improved group,80 cases). The treatment profile of the routine HBO treatment group: the patients were compressed for 20 min to the treatment pressure of 0.25 Mpa. Following stabilization at the said pressure, the patients breathed oxygen twice for 30 min plus 10 min, once a day. The whole treatment course consisted of 12 sessions, with the patients receiving HBO treatments from 9 to 68 times. The treatment profile of the improved HBO treatment group: the patients were given routine HBO treatment in the first 5 days, then, received improved HBO treatment, with a treatment profile of lower pressure (0.20 Mpa) , shorter oxygen-breathing time, lengthening of oxygen-breathing intervals and intermittent oxygen breathing. Total oxygen-breathing time was 4 times, each for 10 min plus 3 times each for 5 min. Then, the patients were decompressed to the surface following 20-min oxygen-breathing decompression. The patients received treatment for a succession of 3 days, then, had 1-day interval, and the whole treatment course consisted of 10 sessions. Changes in ST-T and myocardial enzymes of both the routine HBO treatment group and the improved HBO treatment group were measured and analyzed. Results ST-T recovery rate of the improved HBO treatment group increased (56% ,28% ) obviously, when compared with that of the routine HBO treatment group(P ＜ 0. 05). ST-T worse rate decreased significantly following HBO treatment on the 3rd and 6th days (21% and 25% on the 3rd day, 16% and 27% on the 6th day) respectively (P＜0.01). Statistical differences could be seen in the myocardial recovery rate and worse rate, when a comparison was made between them (P＜0. 05, P＜0. 01). Conclusions The improved HBO treatment profile showed better therapeutic effect on damaged myocardium induced by CO poisoning. This treatment profile should be used instead of other treatment profiles.     

结肠癌根治术围手术期成分输血的分析及护理体会

目的：探究结肠癌根治术围手术期成分输血的基本情况和护理方法。方法：对该院2013年1月至2015年12月间接收的62例患者成分输血治疗，探究成分输血的基本情况，并针对患者情况进行护理，探究有效的护理方法。结果：输入血液成分为红细胞的患者住院时间相对较短，且患者所花费用相对较少；输入全血的患者不良反应明显高于输入红细胞和血浆的患者，相比差异明显（P ＜0.05）。结论：结肠癌根治术围手术期成分输血中红细胞效果较好，可推广使用，但须在使用过程中对患者进行严密观察，减少不良反应。     

一次性纸垫在直肠癌腹壁造口护理中的应用

直肠癌腹壁造口术后,常规配戴造口袋。在开放早期,由于肠道功能尚未恢复,大脑皮层尚未形成定时排便兴奋灶,大便次数多且不成形,造口袋配戴与皮肤间隙存在着密闭性能差,难以防止肠液、稀便从其间隙外溢,引起造口周围皮肤感染和污染时有发生。于1995年2月-2005年8月我们对28例直肠癌腹壁造口患者在使用造口袋护理中应用一次性纸垫,能够避免造口袋配戴密闭不严所引起的并发症,收到了满意的效果,现报告如下。     

高压氧舱安全型排氧的应用

介绍了高压氧舱排氧设备的改造升级,应用了排氧流量显示、排氧浓度监控、自动通风换气、排氧汇流管回旋式设计、立井式排氧通道等多项技术措施,解决了排氧阻力大、舱内氧浓度高等问题,保障了高压氧舱设备的安全运行。     

痰涂片与结核抗体检验在诊断肺结核中的应用效果

目的分析痰涂片与结核抗体检验在诊断肺结核患者中应用效果。方法总结我公司2017年7月-2018年12月间已明确诊断进行肺结核相关检查的168例标本,根据标本类型和检验方式不同分为A、B两组各84例,A组患者取清晨痰或夜间痰,进行痰涂片抗酸杆菌检测,B组患者采集清晨空腹静脉血,进行血清结核菌抗体检测,比较两组标本检验相关性。结果B组标本诊断符合率(88.09%)显著高于A组(76.19%),且B组特异度、敏感度均明显高于A组,对比P<0.05。结论相对于痰涂片抗酸杆菌检验,血清结核菌抗体检验在肺结核诊断中阳性率较高,临床应用价值更显著。     

循证护理在预防透析低血压中的应用

循证护理(evidence-baced nuring,EBN)是指护士慎重、准确和明智地应用当前所能获得的最好研究证据,结合护理专业技能和多年临床经验,同时考虑患者的价值和愿望,将三者完美地结合,制订护理措施[1]。血液透析(HD)中最常见的急性并发症是低血压[2],我院血液净化中心为了患者能安全、舒适地完成每次HD,提高生存质量,于2005年3-7月对22例有低血压倾向的患者进行了EBN,取得了良好的效果,现报道如下。临床资料1.一般资料。选取我院2005年3-7月维持性HD患者22例,男13例,女9例,年龄17~75岁。均有透析中低血压经常发作史。其中慢性肾炎9例,高血…     

一种高压氧舱自动通风换气装置

目的 研究高压氧舱的自动通风换气系统，解决手动控制的各种弊端。方法 自动通风换气系统由2个电动调节阀、1个交流接触器、1个开关、1台测氧仪、少量无缝钢管组成。结果和结论 该系统结构简单，安装方便，通风效果良好。