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经阴道穿刺取卵术中不同方法镇痛效果比较
随着不孕症发病率的增加和体外受精-胚胎移植(in vitro fertilizatioa-embryo transfer,IVF-ET)技术的不断成熟,通过IVF-ET技术成功妊娠的病人日益增多.经阴道穿刺取卵术作为IVF-ET过程中重要的一环,同时也是病人承受痛苦大的一环.如何在取卵术中减轻病人痛苦,减少副反应的发生,是医务工作者的职责.目前,国内应用较多的有静脉麻醉、宫颈麻醉、哌替啶肌肉注射等方法.哌替啶镇痛因费用低廉、镇痛效果好、无需麻醉师参与等优势在经阴道穿刺取卵术中应用广泛.近年来,双氯芬酸钠栓因镇痛效果好、价格低廉、副反应少且使用方便被广泛应用于临床镇痛治疗.2010年1月-2010年12月,我院在经阴道穿刺取卵术中应用哌替啶肌肉注射及双氯芬酸钠栓直肠用药两种方式镇痛,比较两种方案镇痛效果及副反应发生情况.现报道如下.
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中心静脉导管两种固定方法的对照研究
随着临床外科学的发展和手术适应证的不断拓宽,中心静脉置管已广泛应用于肿瘤病人化疗、围术期输液、静脉营养支持、中心静脉压监测和危重病人的抢救等临床实践中[1-3].我科自1987年开展中心静脉置管以来,大量的临床病例置管后均采用缝针固定,以防导管脱落及意外拔出.思乐扣是一种新型固定粘贴材料,在经外周静脉置入中心静脉导管(PICC)中得到广泛的应用.自2010年5月以来,我科中心静脉置管后采用思乐扣固定取得了良好的效果.现报告如下.
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两种固定气管导管方法的效果比较
机械通气是呼吸衰竭病人维持有效通气的重要手段,在各医院重症监护室和手术麻醉科均得到广泛运用.危重症病人机械通气一般时间较长,其气管导管的固定护理尤为重要,特别是不合作的儿童,时有非计划性拔管(unplanned extubation,UEX)的情况发生,严重威胁患儿的安全.为此,我科于2008年7月在传统气管导管固定方法基础上进行改进,采用倒"工"字形胶布固定法,临床效果良好.现介绍如下.
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两种不同清洁灌肠方法的对比研究
探讨改良清洁灌肠方法对灌肠次数、肠腔清洁效果、病人腹部疼痛、便意感程度的影响.因此,选择需清洁灌肠做直肠、结肠检查的100例病人进行对比研究.
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不同膀胱功能训练法对宫颈癌术后尿潴留的影响
宫颈癌根治术是治疗早期宫颈癌的首选方法,术后常见的并发症是尿潴留[1],其发生率为28%.20%左右的病人需要再次导尿,既增加病人的痛苦又增加尿路感染的机会[1].目前,国内外对宫颈癌术后恢复自主排尿方面有许多研究,如留置尿管方式及时间的改变,术后盆底肌肉的锻炼,预防泌尿道感染,个体化放尿、排尿,物理疗法及心理护理等措施[2].但对于这方面的文献报道各说己见.本研究旨在探索有效预防措施,进行有意识的会阴部、盆底肌肉及腹壁肌肉的收缩锻炼、使支配膀胱的神经得到一定的恢复, 阻止膀胱肌肉的萎缩,加强尿道括约肌的作用, 促进自主排尿功能的恢复.为此,我科于2009年1月起对宫颈癌根治术术后采用常规护理加腹肌盆底肌膀胱肌锻炼的主动膀胱功能训练法,对拔除尿管后排尿时间和排尿成功情况进行临床观察,效果明显.现报道如下.
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基层医院手术室人性化管理的思路与方法
基层医院手术室普遍存在人员编制不足、手术量多、危重手术病人多、急诊手术多的特点,护士劳动强度不断加大,得不到应有的各种保障, 受到影响.
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改革《护理研究》实验课方法培养护生科研能力
护理科研是推动护理学科发展,提高护理质量的重要手段[1].目前,我国对本科生科研训练的作用及地位还未提高到相当的认识高度,国内许多研究型大学仅将其看作是一种辅助性的培养手段,认识上的差异是非常明显的[2].任何学科发展和进步均以科学研究为基础.科研能力作为衡量高级护理专业人才的一个重要指标越来越受到重视.<护理研究>课旨在培养和提高学生的科研能力和科学素养,系统阐述科研选题、信息查询、科研设计和统计方法等护理科研基本方法,是高等护理教育不可缺少的组成部分.我们在<护理研究>实验课教学中,改革教学方法,培养学生的科研意识,训练学生科研能力,使其具备护理科研的基本能力.
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破伤风抗毒素皮试配制方法的对比研究
为预防破伤风的发生,对外伤、烧伤、动物咬伤常规注射破伤风抗毒素.破伤风抗毒素是经胃酶消化的马破伤风免疫球蛋白,具有抗原性,注射后易出现过敏反应.
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放射性核素静脉注射方法的对比观察
静脉注射放射性核素(示踪剂、显像剂、治疗剂)是核医学科进行脏器功能测定、核素显像和放射性核素治疗的主要给药方法[1].传统的注射方法是直接静脉穿刺,在实践中发现该方法弊端较多,故对静脉给药的操作方法进行了改进.现将改进方法总结如下.
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《健康评估》课程多种教学方法的探讨
<健康评估>是一门涉及多相关专业知识的学科,是为临床护理专业课程的学习奠定基础.如何针对不同的教学内容选择佳教学方法,是摆在我们面前值得探讨和研究的课题.随着教学科研、教学改革的不断深化.现代化教学手段不断完善,护理教学方法也不断改革、创新和灵活多样,以培养学生自主学习和终身学习的能力[1].
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经络穴位导平结合现代康复技术治疗脑性瘫痪68例报告
BACKGROUND:In our country,inducing of channel,collateral and acupoint,acupuncture and moxibustion,massage,Chinese herbs are therapeutic methods of traditional Chinese medicine on cerebral paralysis and function training is the method of western medicine such as Tian therapy.According to the correlation channel and collateral theory of traditional Chinese medicine and neural physiology,there are complementary actions when these two methods are combined.
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针刺治疗再发性面神经麻痹7例报告
Background:The relapsed facial paralysis is the relapse of facial paralysis on the same or the other side in patients after the first facial paralysis. Such patients are rate in clinical practice(about 0.5% ) and most of them are of Bell's paralysis. Objective:To investigate the treating methods of the relapsed facial paralysis through treating 7 cases of relapsed facial paralysis.
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脑血管意外非知识型老年人康复指导的难点及对策
1 Rehabilitative instructions for ignorant elder patients Due to their ignorance,ignorant elder patients often can't understand and accept rehabilitation knowledge,and consider health knowledge is difficult to absorb.They may show impatience for rehablilitation instructions.Thus,the reulsts of rehabilitative education are not satisfying. 2 Rehabilitation instructions for ignorant elder patients based on their characteristics
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腰康胶囊减轻淤血性腰椎间盘突出症痛痛的疗效观察
Background:The prolapse of the lower back intervertebral disc is a common clinical disease,the national research of recent years found that non-operation methods were important in treating the prolapse of the intervertebral discs,especially the Chinese medicine has significant effects.Yaokang capsule is made from 7 herbs as Earth worm, Frankincense and Myrrh etc it used on blood clotting prolapse of lower back intervertebral disc and satisfactory effects were achieved. Objective:To discuss the treating effects of Yaokang capsule to decrease pain caused by blood clotting prolapse of lower back intervertebral disc. Design:100 cases of prolapse of lower back intervertebral disc were randomly divided into treating group and control group.There was no difference of ages,sexes and complications between the two groups(P< 0.05).The treating effects were determined according to the scoring methods of Chinese medicine and related standards, Chi-squared test was used in statistics. Unit: Anyang District Hospital of Puyang City.
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早期应用特异性iRNA对防治烧伤患者感染的作用及机理研究
Objective To explore the effect and mechanism of early using specific immune RNA (iRNA) for preventing burn infection.Method 129 patients with serious burn were randomly divided into two groups by double blind method. The control group (n=64) was treated with routine method; The therapeutic group(n= 65) was given specific iRNA in addition to the routine therapy. The incidence of infection in two groups were investigated; Meantime, with the methods of monoclonal antibody (McAb) APAAP, 3H- TdR incorporation and MTT colorimetery, the various immune functions of patients were determined. Result (1) the incidences of wound infection and bacteriemia after burn in the therapeutic group were markedly lower than those of the control group; (2) the therapeutic group was also superior to the control group in the general condition and time of the wound healing; (3) on the l0th day postburn, the various immune founction tested in the therapeutio group have approximately restored to the normal levels, while those in the control group were still in low levels. The difference between the two groups was statistically significant (P<0.01). Conclusion Specific iRNA, which, when used early after burn, can reduce the incidence of postburn infection, and improve immune functions of burned patients.
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经鼻气管插管患者2种置胃管方法的对比观察
临床急救工作中经常遇到已经施行了气管插管辅助呼吸的患者需行胃肠减压或鼻饲而插胃管,但由于气管导管、气囊压迫了食管造成插胃管时胃管易弯曲而插入困难.我科2002年10月-2005年11月对90例行经鼻气管插管患者使用2种不同的方法置胃管,并对效果进行了比较,现报道如下.
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几种检测肾小球功能的方法及评价
肾小球的主要功能是滤过血浆,生成原尿.肾小球滤过率(GFR)是反映其滤过功能的直接、客观的指标,是肾功能分期的主要依据.另外,在监测肾毒性药物的使用、移植肾功能状况的评价等方面也具有重要意义.GFR为单位时间(min)内从肾小球滤过的血浆总量.
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贯彻《母婴保健法实施办法》加快生殖保健中心建设拓宽妇幼保健服务市场
1994年世界卫生组织(WHO)通过了正式的生殖健康的定义.1994年国际人口与发展大会号召各国政府在2015年达到"人人享有生殖保健服务"的目标.今年6月公布的<母婴保健法实施办法>把生殖保健作为母婴保健工作的目的,明确了要依法开展生殖保健工作,依法维护生殖健康,以期实现提高出生人口素质的的基本国策.这给我们妇幼保健工作者既提出了挑战又带来了机遇.我们应该如何面对,笔者从以下几个方面进行了思考和探索.
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OBJECTIVE To study the structural and preliminary functional characterization of the hepatitis B virus(HBV) enhancer Ⅰ in patients with chronic hepatitis B treated with interferon (IFN). METHODS The characteristics of the HBV enhancer Ⅰ in 12chronic carrier who were treated with alpha interferon was detected by the methods of molecular biology including PCR, cloning of PCR products, sequencing and cell culture.RESULTS Four of 6 patients cleared viral DNA; all 6 in this group also seroconverted from e antigen to antibody. Prior to therapy, the HBV enhancer Ⅰ region demonstrated many point mutations in all 6 patients who became nonresponders, compared to patients who responded to interferon. The mutated sequences, many of which were within regions of transcription factor binding, were significantly more active than the corresponding wild type sequences in reporter gene assays. CONCLUSION These results imply that the mutations found in nonresponders appear to render the virus less sensitive to interferon.
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中西医结合治疗冠心病的创新之路
编者按:大量临床实践的经验积累对临床医师的医术提高至关重要.然而,紧密结合临床需要,坚持以扎实的基础理论研究与科学的临床思维总结分析临床难点,才会有学术创新,有质的飞跃.戴瑞鸿与范维琥教授的评述鲜明地展示:几十年如一日,坚持中西医结合,以现代先进的医学技术揭示中西医结合治疗冠心病深奥机理的理念很值得我们借鉴.