Objective To investigate the mental status of medical staffs in the orthopedics department during the earthquake, providing evidence for psychological intervention. Methods Choosing 104 staffs in the orthopedics department as eligible subject with convenient sampling; the research tool was Symptom Checklist-90. The questionnaire was done by the participants with the same instruction from psychological professionals; analyze the results. Results The score in somatization, anxiety and phobic anxiety of staffs in the orthopedics department was significantly higher than the national norm. Conclusion There exists disorder in mental health of medical staffs in orthopedics department, it is necessary to implement mental intervention.
目的 探討圍手術期患者靜脈血栓預防的分級護理方法，為靜脈血栓的預防提供實證依據。 方法 2009年5月－2012年1月，以某市級乙等綜合性醫院各科室手術患者為對象，引入量化工具評估患者圍手術期靜脈血栓發生的危險，并根據評估結果采取分級護理方法進行防治，并在患者出院時用彩色多普勒超聲判斷是否存在靜脈血栓，以驗證分級護理防治效果。 結果 納入的318患者經評估均存在發生靜脈血栓的風險，其中低度危險患者65例，中度182例，高度危險71例。經分級護理治療，出院時均未發生靜脈血栓癥狀、肺栓塞。 結論 分級護理方法安全、簡便，可操作性強，便于圍手術期患者靜脈血栓的早期、普遍預防，值得推廣。
目的:了解汶川地震后截肢患者存在的功能障礙及康復需求情況。方法:選取我院骨科2008 年5 月12 日至2008 年6 月1 日收治的19 例截肢患者為研究對象,采用自行設計的調查表,由康復醫師在征得研究對象同意的情況下完成資料的收集。結果:63.2%的患者存在肌力下降,36.8%的患者生活需要幫助,其中生活依賴明顯占31.6%,完全依賴占5.3 ％,幾乎所有患者存在參與功能障礙。 結論:大多數截肢患者存在不同程度的功能障礙,應該引起高度重視其康復鍛煉。
目的 總結大型災害情況下，急診傷員信息收集流程，為制定大型災害救援提供證據支持。 方法 回顧性分析汶川地震（2008年5月12日－6月2日）和玉樹地震（2010年4月14日－5月1日）傷員信息收集方法，總結兩次地震傷員信息收集管理過程中發現的問題及取得的經驗。 結果 通過制作地震傷員登記表、調整病歷收集與管理模式、分診提前、傷員信息登記提前，調整急診功能分區、頭像采集技術的使用、成批傷員信息資料袋和分診信息卡的應用，最大限度地保證了傷員信息收集的完整性。 結論 地震傷員信息資料的準確性、完整性、及時性在傷員的救治、傷員的查找、傷員的轉歸和各類醫療信息的收集，以及制定大型災害事故應急預案等方面起著非常重要的作用。
目的:總結分析25例地震傷致氣性壞疽傷員的救治經驗，探討救治方案，為臨床工作提高參考。方法:回顧性研究25例地震傷致氣性壞疽傷員的早期臨床表現，診斷方法，隔離措施、臨床管理及其預后。結果:共收治25例氣性壞疽傷員，無一例死亡。院外診斷7例，院內診斷18例。截肢18例，開放性截肢12例，非開放性截肢6例；擴創7例。發生急性腎功能衰竭2例，行血液透析治療后腎功能恢復；無院內交叉感染的發生。結論:早期診斷、治療、早期隔離及全面、系統護理可以提高臨床救治水平，改善患者的預后，避免院內交叉感染的發生。
目的:了解汶川地震老年傷員存在的身體結構與功能受損程度及活動、參與能力受限程度,明確其康復護理需求。方法:方便抽樣的方法選取研究對象,采用自行設計的調查表由康復醫師在征得其同意后對其完成資料的收集。結果:共選取研究對象40名。傷員存在多系統多器官的結構和功能受損,存在呼吸道感染者4例(10%),截肢者2例(5%),顱腦損傷導致癱瘓者1例(2.5%),骨折者28例(70%)。傷后早期即出現運動功能的下降,26例(65%)患者存在關節活動受限,26例(65%)肌力下降。疼痛是需要解決的一個重要問題,19例(47.5%)患者存在不同程度的疼痛問題。傷后老年傷員日常活動生活能力下降,生活能基本自理者僅13例(32.5%);參與能力受限也是一個不容忽視的問題,職業能力受限者36例(90%),休閑娛樂能力受限者33例(82.5%),社交能力受限者25例(62.5%)。結論:老年傷員的康復現狀不容樂觀,應該引起重視,康復治療需要及早進行。
Objective To evaluate the safety and efficacy of intermittent pneumatic compression in prevention of deep venous thrombosis after major orthopedic operation. Methods We searched MEDLINE (1966 to January 2008), The Cochrane Library (Issue 2, 2008), CBM (1996 to January 2008), CNKI (1998 to January 2008), VIP (1998 to January 2008), and retrieved clinical controlled trials (CCTs) or randomized controlled trials (RCTs) in which IPC was used as an intervention to prevent DVT, and all the trials were published in English or Chinese. The methodological quality of the included studies was assessed according to the standard of Cochrane systematic review. RevMan 4.2 software was used for meta-analysis. Results Seven RCTs and 1 CCT were included. Their methodological quality was poor. The results of Meta–analyses showed: (1) The incidence of DVT in the IPC group was lower than that in the control group (RR=0.20, 95%CI 0.11 to 0.35, Plt;0.000 01); (2) There was no difference in the incidence of DVT between the IPC group and the LMWH group (RR=0.70, 95%CI 0.28 to 1.74, P=0.44); (3) The incidence of DVT in the IPC plus LMWH group was lower than that in the LMWH-alone group (RR=0.23, 95%CI 0.10 to 0.52, P=0.000 4). Furthermore, the incidence of DVT in the IPC plus LMWH group was lower than that in the GCS plus LMWH group (Plt;0.000 1). No severe adverse reaction of IPC in DVT prevention was reported. Conclusion IPC shows an effective tendency in DVT prevention, but because of the low quality and the small sample of the included studies, this conclusion needs to be verified by protocols of more samples and high quality.
【摘要】 目的 探討口服百草枯中毒患者口腔護理的方法及早期護理的臨床意義。 方法 2009年1月-2010年3月，采用半隨機方法將62例白草枯中毒患者按中毒時間的長短分A組（中毒時間lt;3 d，n=32）、B組（中毒時間gt;3 d，n=3），比較兩組患者口腔潰瘍的治愈率、并發癥發生狀況，分析早期口腔護理的必要性。 結果 A組患者百草枯所致的口腔黏膜損害明顯減輕，并發癥發生率降低，為改善預后提供了條件，顯示了早期加強口腔護理的成效。 結論 重視百草枯早期口腔護理，能夠減輕口腔糜爛潰瘍痛苦，減少并發癥，提高患者生活質量。【Abstract】 Objective To investigate the clinical significance of early oral care for paraquat-poisoned patients. Methods A quasi-randomized controlled trial was used. A total of 62 paraquat-poisoned patients (from January 2009 to March 2010) were divided into experimental group and control group in order to compare the healing rate of oral ulcer, complications and the necessity of early oral care between the two groups. Results The oral mucosa lesions in experimental group obviously alleviated and the complications decreased. The effective early oral care provided the very favorable conditions for better prognosis. Conclusion The early oral care for paraquat-poisoned patients could relieve the pain of oral ulcer, reduce the complications and improve patient′s life quality.
Transcatheter aortic valve replacement (TAVR) can effectively treat symptomatic severe aortic valve stenosis, and its applicable population is gradually expanding. The perioperative and rehabilitation care of TAVR is an important influencing factor for the success of the surgery. The release of the Chinese Expert Consensus on Perioperative Nursing of Transcatheter Aortic Valve Replacement has promoted the homogenization and high-quality care of TAVR patients in China. In order to better understand the key issues of TAVR perioperative nursing and serve clinical practice, this article provides a detailed interpretation of the above consensus based on five key issues of preoperative nursing, intraoperative monitoring, postoperative intensive care nursing, ward nursing, and nutritional assessment.
Objective To observe the efficacy of hydrogel dressings in preventing and treating vein injury of rabbits so as to provide a experimental evidence for cl inical appl ication. Methods Twenty-four healthy large-eared Japanese rabbits (48 ears) were choosen, weighing (2.15 ± 0.15) kg, and divided into 3 groups randomly. The vein injury models were made byintravenously infusing 20% mannite (2.5 mL/kg). The sites of puncture were treated with hydrogel dressings (group A, n=8) and 25%MgSO4 (group B, n=8) 5 minutes after infusion. The sites of puncture were not treated as a blank control (group C, n=8). The tissue specimens were collected from the auricular veins at 24 hours after mannite infusion for histological observation by HE staining. The injury of the vessel wall, hemorrhage around the vessels, infiltration of inflammatory cells, and disturbance of circulation were observed to evaluate the injury degree of vein. Results There existed redness and congestion in the injured veins of each group. HE staining showed that in both groups A and B, the vessel wall was sl ightly injured and hemorrhage around the vessel was mild. There existed infiltration of inflammatory cells in the vessel wall and surrounding tissues. There also existed congestion and thrombus in the vessel lumen in these two groups. While in group C, the injury of vessel wall was severe, and schistic bleeding in the surrounding tissue of the vessel was existed. The severe congestion and thrombus in the vessel lumen was observed. There was no significant difference among three groups in the extent of vein wall injury and hemorrhage around the vessel (P gt; 0.05). The degree of infiltration of inflammatory cells and circulatory disturbance in both groups A and B were significantly less than that of group C (P lt; 0.05); but there was no significant difference between groups A and B (P gt; 0.05). Conclusion Hydrogel dressing is helpful to prevent vein injury of rabbits induced by mannite.