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Approach to Paroxysmal Atrial Fibrillation Type Arrhythmia in a Cardiology Service: A Case Report 认领
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作者 Miriam Viviane Baron Luis Manuel Ley Dominguez +16 位作者 Carolina Paz Mohamad Isa Gabriela Di Lorenzo Garcia Scherer Michele Paula dos Santos Vitória Pereira Itaquy Talia Guimarã es dos Santos Julia Braga da Silveira Paulo Ricardo Martins Amanda Corrêa dos Santos Marcus Vinicius de Mello Pinto Janine Koepp Daiana Klein Weber Carissimi Joice Nedel Ott Carolina Gon?alves Pinheiro Nathália Ken Pereira Iketani Gabriela Feltez Bartira Ercília Pinheiro da Costa 《炎症(英文)》 2020年第2期9-17,共9页
Atrial fibrillation is a cardiac arrhythmia of high prevalence in the population, especially in the elderly. Its main electrical characteristics are the interval between two successive irregular R waves, absence of P ... Atrial fibrillation is a cardiac arrhythmia of high prevalence in the population, especially in the elderly. Its main electrical characteristics are the interval between two successive irregular R waves, absence of P waves and presence of f waves between QRS complexes. The most common symptoms of atrial fibrillation are irregular palpitations associated with dyspnea, dizziness, feeling tired, fatigue and general malaise, but not all patients have any symptoms. The present report presents the history of an elderly patient who arrived at the hospital’s emergency department with irregular heart rhythm and palpitations. The patient’s symptoms, associated with the electrocardiogram results, indicated paroxysmal atrial fibrillation. Electrical cardioversion was performed, and after, cardiac ablation via the femoral vein at the hospital’s cardiology service. There were no complications during the procedure. As a routine imaging exam after ablation, control esophagogastroduodenoscopy was requested to verify that there was no formation of atrio-esophageal fistula developed by the invasive ablation procedure and electrocardiogram, which showed normal sinus rhythm. The patient remained in the cardiac intensive care unit for observation for 24 hours. After the electrical cardioversion and catheter ablation procedures, the patient improved his clinical picture of atrial fibrillation and was discharged after 24 hours of hospitalization. He received treatment to perform at home, to reduce acid reflux into the esophagus and to prevent thrombosis. He did not present pulmonary thromboembolism after hospital discharge. It is believed, therefore, that this form of treatment and management of paroxysmal atrial fibrillation is effective for the solution of the proposed problem and can also serve as a reference for other professionals within the cardiology service. 展开更多
关键词 Atrial FIBRILLATION Electrical CARDIOVERSION CATHETER Ablation Hypertension OBSTRUCTIVE Sleep APNEA Syndrome
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静脉输注利多卡因与右美托咪啶防治CRBD临床效果的对照分析 认领
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作者 张帮健 杨小燕 +1 位作者 薛强 沈娟 《海南医学院学报》 CAS 2020年第6期454-457,462共5页
目的:探讨静脉输注利多卡因与右美托咪啶在全麻后留置尿管的男性患者导尿管源性膀胱不适(catheter-related bladder discomfort,CRBD)的临床效果。方法:选取本院行择期全麻手术的男性患者210例,随机分为利多卡因组(麻醉诱导时静滴利多卡... 目的:探讨静脉输注利多卡因与右美托咪啶在全麻后留置尿管的男性患者导尿管源性膀胱不适(catheter-related bladder discomfort,CRBD)的临床效果。方法:选取本院行择期全麻手术的男性患者210例,随机分为利多卡因组(麻醉诱导时静滴利多卡因1.5 mg/kg,插管后持续静脉输注利多卡因2 mg·kg-1·h-1)、右美托咪啶组(麻醉诱导时采取10~15 min恒速泵注右美托咪啶0.5μg/kg,插管后持续静脉输注右美托咪啶0.4μg·kg-1·h-1)、对照组(麻醉诱导时静滴生理盐水,插管后持续静脉输注等量生理盐水)各70例,3组均采用16F的舒适导尿管经石蜡油润滑后置入膀胱,对比各组术中舒芬太尼用量、术后舒芬太尼用量以及拔管后不同时间点的CRBD评分、视觉模拟疼痛程度评分(VAS)、心率(HR)、收缩压(SBP)。结果:T1~T4时刻,利多卡因组CRBD评分均低于右美托咪啶组和对照组,利多卡因组的VAS评分均低于对照组,右美托咪啶组的CRBD评分、VAS评分均低于对照组,差异均具有统计学意义(P<0.05);在T0~T4时刻,各组HR、SBP比较,差异无统计学意义(P>0.05)。结论:利多卡因能减轻全麻后留置尿管男性患者CRBD的发生程度。 展开更多
关键词 全麻手术 导尿管 利多卡因 导尿管源性膀胱不适
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导尿管引流裤的设计及应用 认领
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作者 黄锦华 《中外医学研究》 2020年第8期172-175,共4页
目的:探讨改进后的导尿管引流裤在泌尿外科带导尿管及引流管的住院患者中的应用.方法:收集笔者所在医院泌尿外科2016年10月-2017年7月使用导尿管引流裤的816例患者,与2015年12月-2016年9月使用普通病人裤的785例患者进行比较.结果:2016... 目的:探讨改进后的导尿管引流裤在泌尿外科带导尿管及引流管的住院患者中的应用.方法:收集笔者所在医院泌尿外科2016年10月-2017年7月使用导尿管引流裤的816例患者,与2015年12月-2016年9月使用普通病人裤的785例患者进行比较.结果:2016年10月-2017年7月穿着导尿管引流裤的患者的非计划脱管率为1.2%,导管相关的尿路感染(CAUTI)率为7.4%,与2015年12月-2016年9月穿着普通病人裤患者的非计划拔管率3.1%及CAUTI率10.4%相比较,差异有统计学意义(P<0.05);2016年10月-2017年7月,医护人员对导尿管引流裤使用评价,平均同意率为99.3%;家属对导尿管引流裤使用评价,平均同意率为98.1%.结论:导尿管引流裤的使用,可以减少患者导尿管的非计划脱管率及CAUTI,医护人员及患者家属对其评价好,具有临床应用及推广价值. 展开更多
关键词 泌尿外科 导尿管 引流管 引流裤
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Non-Infectious Complications of Peritoneal Dialysis in Senegal 认领
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作者 Ahmed Tall Lemrabott Maria Faye +12 位作者 Moustapha Faye Abdoul Hassane Sanlé Traoré Mouhamadou Moustapha Cissé Khodia Fall Yaya Kane Zeinabou Maiga Moussa Tondi Mansour Mbengue Bacary Ba Niakhalee Keita Seynabou Diagne Abdou Niang Boucar Diouf El Hadji Fary Ka 《肾脏病(英文)》 2020年第1期43-49,共7页
Introduction: Senegal has pioneered the implementation of peritoneal dialysis (PD) in West Africa, practicing it since 2004. Non-infectious complications are a significant cause of failure of this technique and the tr... Introduction: Senegal has pioneered the implementation of peritoneal dialysis (PD) in West Africa, practicing it since 2004. Non-infectious complications are a significant cause of failure of this technique and the transfer of patients to haemodialysis. The aim of this study was to determine the prevalence and the different types of non-infectious complications in our context. Patients and Methods: This was a 5-year, descriptive, retrospective study of patients on chronic peritoneal dialysis for more than 3 months. Results: During the study period, 75 patients were included. The prevalence of non-infectious complications was 88%, including 45.3% mechanical complications and 76% metabolic complications. Catheter migration was the most common mechanical complication (55.9%), followed by catheter blockage (23.5%). Metabolic complications were dominated by hypoalbuminemia (76.3%). Dyslipidaemia and hypokalaemia affected more than 50% of patients, occurring in 59.3% and 56.9% of cases, respectively. Conclusion: In our study, non-infectious complications related to PD were frequent and varied. They remain a significant cause of technical failure. Mechanical complications are often the cause of permanent transfer to haemodialysis. 展开更多
关键词 PERITONEAL DIALYSIS NON-INFECTIOUS COMPLICATIONS CATHETER Migration HYPOALBUMINEMIA Hypokalaemia
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Clinical control effect analysis of intravenous infusion of lidocaine and dexmedetomidine for prevention and treatment of CRBD 认领
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作者 Bang-Jian Zhang Xiao-Yan Yang +1 位作者 Qiang Xue Juan Shen 《海南医科大学学报:英文版》 2020年第6期50-53,共4页
Objective To investigate the clinical value of intravenous lidocaine in reducing CRBD in male patients who need catheterization after general anesthesia.Methods A total of 210 male patients who underwent elective gene... Objective To investigate the clinical value of intravenous lidocaine in reducing CRBD in male patients who need catheterization after general anesthesia.Methods A total of 210 male patients who underwent elective general anesthesia in our hospital from May 2017 to April 2018 were selected.Random number table method was used to divide into the lidocaine group(1.5 mg?kg-1 of intravenous lidocaine infusion during anesthesia induction,and continuous intravenous infusion of lidocaine 2 mg?kg-1?h-1 after intubation),Dexmedetomidine group(0.5μg?kg-1 of dexmedetomidine intravenously during anesthesia induction,continuous intravenous infusion of dexmedetomidine 0.4μg?kg-1?h-1 after intubation).Control group(intravenous saline infusion during anesthesia induction,continuous intravenous infusion of the same amount of saline after intubation),70 cases in each group.All three groups were placed in the bladder with a 16F comfortable urethral catheter lubricated with paraffin oil.The amount of sufentanil used during the operation,the amount of sufentanil used after surgery,and the CRBD score and VAS at different time points after extubation were compared.Scoring,HR,SBP.Results T1 to T4,the CRBD scores of the lidocaine group were lower than those of the dexmedetomidine group and the control group(P<0.05).The VAS scores of the lidocaine group were lower than those of the control group(P<0.05),the CRBD score and VAS score of the dexmedetomidine group were lower than those of the control group(P<0.05);From T0 to T4,the differences in HR and SBP between the three groups were not statistically significant(P>0.05).Conclusion Lidocaine administration in male patients requiring catheterization after general anesthesia can significantly reduce the incidence of CRBD. 展开更多
关键词 General ANESTHESIA CATHETER LIDOCAINE Catheter-induced bladder DISCOMFORT
文章速递Computed Tomography-Guided Virtual Stereotactic Puncture and Catheter Drainage for a Brainstem Pontine Hemorrhage: A Case Report 认领
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作者 Chenbing Wang 《临床医学病理报告(英文)》 2020年第8期223-227,共5页
<strong>Background: </strong>Patients with severe hypertensive brainstem hemorrhages have poor prognoses if they only receive conservative medical management. In contrast, aggressive operative intervention... <strong>Background: </strong>Patients with severe hypertensive brainstem hemorrhages have poor prognoses if they only receive conservative medical management. In contrast, aggressive operative interventions may decrease the morbidity and mortality in such patients. These operative treatments include craniotomy for evacuation of the hematoma, stereotactic positioning, and neuronavigational-guided hemorrhage puncture and drainage. Here, we report a novel and relatively simple procedure to achieve satisfactory outcomes in a patient with a brainstem pontine hemorrhage.<strong> Case Presentation:</strong> A 53-year-old man who was diagnosed with brainstem pontine hemorrhage. On hospital day 6, he underwent CT-guided, virtual stereotactic puncture and catheter drainage of this brainstem pontine hemorrhage. Medical treatments were continued after this procedure. On postoperative day 16 (hospital day 22), the patient was discharged from the hospital, awake and able to answer questions appropriately. Muscle strengths were grades V and IV for the left and right extremities, respectively. The patient was continued with active rehabilitation and achieved a Barthel index of 85 points at one month after the percutaneous drainage procedure. <strong>Conclusion:</strong> CT-guided, virtual stereotactic percutaneous transcranial puncture and catheter drainage for brainstem pontine hemorrhages has obvious potential advantages and offers a possible alternative to achieve the best outcomes with minimal operative trauma compared to open microcraniotomy. 展开更多
关键词 Computed Tomography-Guided Stereotactic Catheter Drainage Pontine Hemorrhage
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文章速递A Retrospective Analysis for Different Routes of Administration in Mice-Percutaneous Retro-Orbital, Jugular Catheter, Tail Vein and Femoral Cut Down Injections 认领
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作者 Priyanka Prathipati Cristian Rodriguez-Aguayo +4 位作者 Brian L Walton Anil K. Sood Jamieson Greaver Christopher F. Janssen Gabriel Lopez-Berestein 《生物科学与医学(英文)》 2020年第9期131-141,共11页
Liposomes effectively transport fatty proteins to targeted tissues. Laboratory experiments use multiple methods to administer liposomes, but comparison of these methods is not available. In this retrospective study, w... Liposomes effectively transport fatty proteins to targeted tissues. Laboratory experiments use multiple methods to administer liposomes, but comparison of these methods is not available. In this retrospective study, we characterized and compared four intravenous administration routes (tail vein, jugular catheter, femoral vein and percutaneous retro-orbital injections) in murine models. ApoE<sup>-/-</sup> mice were used to compare administration routes. Results indicate that the jugular catheter route delivered the highest amount of liposomes to tissues due to longer period of injections compared to other routes;however, this route failed to remain patent for 8/10 animals. Delivery via tail vein, femoral vein and percutaneous retro-orbital injections resulted in similar accumulation in the organs. When including technical difficulty and expense, percutaneous retro-orbital injections of liposomes are the most convenient and efficacious approach. 展开更多
关键词 Femoral Vein Jugular Catheter Liposomes Retro-Orbital Tail Vein
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呼吸器辅助声门下分泌物引流导管对机械通气时气囊滞留物清除的临床研究 认领
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作者 王爱贞 郑兰华 +1 位作者 王秀 魏静 《中国医学装备》 2020年第3期96-99,共4页
目的:探讨简易呼吸器辅助声门下分泌物引流(SSD)导管对接受机械通气(MV)患者行气囊滞留物清除的临床效果。方法:选取在医院治疗的84例经口气管插管应用MV治疗的患者资料,采用随机数表法将其分为观察组和对照组,每组42例。两组呼吸机治... 目的:探讨简易呼吸器辅助声门下分泌物引流(SSD)导管对接受机械通气(MV)患者行气囊滞留物清除的临床效果。方法:选取在医院治疗的84例经口气管插管应用MV治疗的患者资料,采用随机数表法将其分为观察组和对照组,每组42例。两组呼吸机治疗时均执行常规人工气道标准管理;对照组使用SSD导管,以76~113 mmHg负压值行SSD法间歇性吸引;观察组除采用SSD法行间断声门下吸引外,将简易呼吸器与患者的气管插管相连,加用气流冲击法,以加大气囊上滞留物的清除效果。比较两组每日声门下分泌物吸引总量、MV治疗时间及入住重症监护室(ICU)天数,评估两组不同气囊管理模式下对呼吸机相关性肺炎(VAP)的影响。结果:观察组声门下滞留物总吸引量增加,与对照组比较差异有统计学意义(t=-7.143,P<0.05);观察组MV治疗时间和入住ICU天数均低于对照组,其差异均有统计学意义(t=-4.075,t=-8.291;P<0.05);观察组VAP发生率为9.52%(4/42),对照组VAP发生率为14.28%(6/42),两组比较差异有统计学意义(χ^2=3.971,P<0.05)。结论:在提供有效SSD法间断声门下吸引的基础上联合简易呼吸器气流冲击法,可有效提高机械通气患者气囊上滞留物清除效果,对预防控制VAP发生具有重要临床意义。 展开更多
关键词 简易呼吸器 声门下分泌物引流(SSD) 导管 气囊滞留物
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脉冲式膀胱冲洗在尿路感染干预中的应用研究 认领
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作者 黄巧玲 张耿红 熊慧英 《中外医学研究》 2020年第14期90-91,共2页
目的:观察脉冲式膀胱冲洗在尿路感染干预中的应用效果。方法:随机选择2018年7月-2019年6月普宁市人民医院就诊的长期留置尿管并发尿路感染患者160例,随机数字表法分为观察组(80例)和对照组(80例),对照组采用常规冲洗法进行护理,观察组... 目的:观察脉冲式膀胱冲洗在尿路感染干预中的应用效果。方法:随机选择2018年7月-2019年6月普宁市人民医院就诊的长期留置尿管并发尿路感染患者160例,随机数字表法分为观察组(80例)和对照组(80例),对照组采用常规冲洗法进行护理,观察组使用脉冲式冲洗进行护理,于膀胱冲洗第3、5、7天晨取中段尿进行尿常规检查,比较两组临床效果。结果:经不同方法冲洗后,治疗第7天后治疗观察组总有效率高于对照组,差异有统计学意义(P<0.05);观察组患者治疗第3、5、7天细菌计数超过10~5 cfu/ml率及24 h尿沉渣检查白细胞计数>39个/μl率显著高于对照组,差异有统计学意义(P<0.05)。结论:脉冲式膀胱冲洗可有效降低导尿管相关尿路感染率,临床效果更佳。 展开更多
关键词 脉冲式膀胱冲洗 尿路感染 导尿管 临床效果
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机器人辅助腹腔镜下根治性前列腺切除术后早期拔除导尿管的临床疗效 认领
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作者 王岩 费笑晨 +6 位作者 樊连城 王艳青 沙建军 潘家骅 董柏君 朱寅杰 薛蔚 《现代泌尿外科杂志》 CAS 2020年第9期806-809,共4页
目的总结机器人辅助腹腔镜下根治性前列腺切除术(RALP)后早期拔除导尿管的临床疗效。方法回顾性分析2016年12月至2018年1月期间157例接受RALP的前列腺癌患者的临床资料,分为术后7d拔除导尿管组(n=55)和术后14d拔除导尿管组(n=102)。术... 目的总结机器人辅助腹腔镜下根治性前列腺切除术(RALP)后早期拔除导尿管的临床疗效。方法回顾性分析2016年12月至2018年1月期间157例接受RALP的前列腺癌患者的临床资料,分为术后7d拔除导尿管组(n=55)和术后14d拔除导尿管组(n=102)。术后7d拔除组中位年龄68(63~72)岁;术后14d拔除组中位年龄68(63~72)岁。临床分期T2aN0M0~T4N0M0期,其中T2a期36例,T2b期24例,T2c期64例,T3a期18例,T3b期10例,T4期8例。Gleason评分6~10分,其中<7分35例,7分75例,>7分47例。记录患者拔除导尿管后有无发生尿潴留、即刻漏尿量、疼痛评分(VAS)、术后1个月和3个月尿控恢复情况。结果两组均没有发生尿潴留。术后7d拔除组、术后14d拔除组拔管后即刻漏尿量中位数分别为5(5~15)、10(5~16.25)mL(P=0.118);术后1个月尿控恢复分别为18.18%(10/55)、20.59%(21/102)(P=0.923);术后3个月尿控恢复分别为40.38%(21/55)、42.16%(43/102)(P=0.63);差异均无显著性统计学意义。拔管当天VAS评分术后7d拔除组显著优于术后14d组,差异具有显著统计学差异(P<0.001)。结论RALP术后早期拔除导尿管在无法行膀胱造影的前提下仍然安全、有效,可以有效减轻患者疼痛症状,不影响近期尿控恢复。 展开更多
关键词 机器人 腹腔镜 前列腺肿瘤 前列腺切除术 早期拔除 导尿管
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X线引导下恶性肿瘤患者胸壁输液港植入的临床分析 认领
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作者 李冬霖 陈卢峰 +1 位作者 李荣宾 蔡旭东 《中国卫生标准管理》 2020年第18期38-40,共3页
目的探讨X线引导下胸壁输液港植入过程中导丝、导管异位及其他并发症。方法回顾性分析2016年1月—2018年7月在X线引导下行中心静脉输液港植入术的1 141例恶性肿瘤患者,评估穿刺过程中导丝及导管异位、导管通畅率、术后并发症情况。结果... 目的探讨X线引导下胸壁输液港植入过程中导丝、导管异位及其他并发症。方法回顾性分析2016年1月—2018年7月在X线引导下行中心静脉输液港植入术的1 141例恶性肿瘤患者,评估穿刺过程中导丝及导管异位、导管通畅率、术后并发症情况。结果各穿刺入路的导丝异位50例,不同穿刺入路的导丝异位率比较差异有统计学意义(P <0.001);导管异位2例,感染1例,气胸1例,导管堵塞3例,术区疼痛2例,血肿2例。结论输液港对肿瘤患者是安全、有效的静脉通路,X线下行中心静脉输液港植入术的安全性较好。 展开更多
关键词 静脉输液港植入 X线 恶性肿瘤 导丝 导管 异位 并发症
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妇科腹部术后短期留置尿管夹闭训练必要性的循证实践 认领
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作者 文希 贺海霞 +5 位作者 桂屏 刘牡丹 陈适达 杨晴 魏琳 黄绮华 《按摩与康复医学》 2020年第4期69-72,共4页
目的:通过腹部手术短期留置尿管夹闭训练的最佳证据应用,建立妇科腹部术后短期留置导尿管夹闭训练必要性的统一标准。方法:通过对导尿管拔除及夹闭相关主题的文章进行系统检索及质量评价,总结2条最佳证据,并结合临床情景和专业判断,制订... 目的:通过腹部手术短期留置尿管夹闭训练的最佳证据应用,建立妇科腹部术后短期留置导尿管夹闭训练必要性的统一标准。方法:通过对导尿管拔除及夹闭相关主题的文章进行系统检索及质量评价,总结2条最佳证据,并结合临床情景和专业判断,制订了1条基于证据的质量审查标准,在妇科病房开展质量审查。结果:与改善前夹闭相比,改善后非夹必训练后拔管前下腹部坠胀感(Z=-3.086,P=0.002)减轻,疼痛感减轻(Z=-2.351,P=0.019);首次下床活动时间提前(t=-7.349,P=0.000),首次排尿量差异无统计学意义(P>0.05);对本次改善措施的满意度方面,改善前后护士及患者的满意度均有提高,且差异有统计学意义(P<0.05)。结论:基于证据的应用,妇科腹部术后短期留置尿管不进行夹管训练,直接拔除可减轻患者拔管时的不适症状,缩短患者首次下次时间,加速患者术后康复,同时提高护患的满意度。 展开更多
关键词 腹部手术 短期 导尿管 留置 夹管训练
弹射座椅导管渗透检测技术研究 认领
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作者 李玫 田家洋 赵文 《航空维修与工程》 2020年第6期110-112,共3页
某型飞机弹射座椅导管裂纹为多发故障,采取水洗型荧光渗透检测时存在漏检情况。为解决该问题,首先对缺陷进行金相分析以确定缺陷类型,再分析导管水洗型荧光渗透检测全流程,最终确定应重点控制渗透、去除、观察等环节。实践结果表明,改... 某型飞机弹射座椅导管裂纹为多发故障,采取水洗型荧光渗透检测时存在漏检情况。为解决该问题,首先对缺陷进行金相分析以确定缺陷类型,再分析导管水洗型荧光渗透检测全流程,最终确定应重点控制渗透、去除、观察等环节。实践结果表明,改进后的检测技术有效提高了检测准确度,对保障导管修理质量具有重要作用。 展开更多
关键词 导管 荧光渗透检测 裂纹
膀胱造瘘管在机器人辅助腹腔镜下根治性前列腺切除术后老年病人中的应用效果 认领
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作者 陆炳燕 金萍 +1 位作者 黄媛媛 张青 《护理研究》 北大核心 2020年第3期494-496,共3页
[目的]比较膀胱造瘘管与导尿管在机器人辅助腹腔镜下根治性前列腺切除术后老年病人中的应用效果。[方法]选取2016年10月-2018年10月我院收治的行机器人辅助腹腔镜下根治性前列腺切除术后的老年病人96例,随机分为对照组和观察组各48例。... [目的]比较膀胱造瘘管与导尿管在机器人辅助腹腔镜下根治性前列腺切除术后老年病人中的应用效果。[方法]选取2016年10月-2018年10月我院收治的行机器人辅助腹腔镜下根治性前列腺切除术后的老年病人96例,随机分为对照组和观察组各48例。对照组留置导尿管,观察组使用膀胱造瘘管。比较两组导管相关并发症发生率、疼痛程度及睡眠质量。[结果]观察组干预1周后导管相关并发症发生率、疼痛程度低于对照组,睡眠质量高于对照组(P<0.05)。[结论]在机器人辅助腹腔镜下根治性前列腺切除术后老年病人应用膀胱造瘘管可以有效降低病人导管相关并发症发生率,减轻其疼痛程度,改善睡眠质量。 展开更多
关键词 膀胱造瘘管 导尿管 机器人 腹腔镜 根治性前列腺切除术 并发症 疼痛程度
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应用耐高压注射型导管致造血干细胞移植老年患者穿刺点局部感染的研究 认领
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作者 杨学青 祝成红 +5 位作者 张铮 郑燕芳 党照华 郭宇飞 柳彦君 王承竹 《中华老年医学杂志》 CAS CSCD 北大核心 2020年第8期910-913,共4页
目的分析造血干细胞移植老年患者应用耐高压注射型经外周中心静脉置管(PICC)导管致穿刺点局部感染的相关原因和对策。方法回顾性分析我院自2017年11月至2019年11月收治的应用耐高压注射型PICC导管操作的造血干细胞移植患者75例的临床资... 目的分析造血干细胞移植老年患者应用耐高压注射型经外周中心静脉置管(PICC)导管致穿刺点局部感染的相关原因和对策。方法回顾性分析我院自2017年11月至2019年11月收治的应用耐高压注射型PICC导管操作的造血干细胞移植患者75例的临床资料,按照是否出现导管致穿刺点局部感染分为感染组(26例)与未感染组(49例),分析感染组的细菌培养结果,探讨注射型PICC导管致穿刺点局部感染的相关因素,针对这些高危因素制定有效的对策,同时探讨不同程度局部感染患者的治疗频次、治疗效果以及治愈时间。结果感染组共26例患者,PICC导管相关感染细菌的类型比例由高到低如下:金黄色葡萄球菌(46.51%)、肺炎克雷伯杆菌(30.77%)、微小棒状菌(15.38%)、其他(7.69%)。与未感染组的材料因素、置管季节、换药时间、置管时间、一次性置管成功率、贴膜情况相比差异有统计学意义(t=5.5、4.9、5.0、13.6、9.4、6.2,均P<0.05)。Logistic多因素分析发现,非"U"形固定、延期换药、置管时间长、一次性置管成功率低、贴膜松脱可作为引起PICC导管相关感染高危因素(OR=2.78、2.42、3.16、2.66、2.32,均P<0.05)。重度分别相比于中度、轻度相比,中度与轻度相比治疗频次较高,总有效率较低,治愈时间较长,组间差异具有统计学意义(F=10.353、8.775、12.341,均P<0.05)。结论材料因素、换药时间、置管时间、一次性置管成功率、贴膜情况均能够作为引起造血干细胞移植患者应用耐高压注射型PICC导管致穿刺点局部感染的高危因素,临床工作者通过制定有效的临床干预对策能够辅助控制局部感染的发生。 展开更多
关键词 造血干细胞移植 导管 感染
Left atrial appendage aneurysm: A case report 认领
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作者 Dmitry Vladimirovich Belov Vladimir Ivanovich Moskalev +1 位作者 Dmitry Victorovich Garbuzenko Nikolay Olegovich Arefyev 《世界临床病例杂志》 SCIE 2020年第19期4443-4449,共7页
BACKGROUND An aneurysm of the left atrial appendage is one of the rare but potentially hazardous heart defects.The risk of lethal complications grows with its size.To date,about 150 cases of this defect have been desc... BACKGROUND An aneurysm of the left atrial appendage is one of the rare but potentially hazardous heart defects.The risk of lethal complications grows with its size.To date,about 150 cases of this defect have been described in the literature.We present a case of left atrial appendage aneurysm with the deformation of the mitral valve and the left main coronary and circumflex artery,which required mitral valve annuloplasty and bifurcation stenting.CASE SUMMARY A 58-year-old man presented to our hospital complaining of shortness of breath,general weakness,dizziness during physical exertion,and fatigue.Based on the results of echocardiography,an aneurysm of the left atrium was suspected.A free-breathing real-time cine magnetic resonance imaging with electrocardiograph synchronization confirmed the diagnosis of left atrial appendage aneurysm.The patient underwent an aneurysmectomy via a median sternotomy with cardiopulmonary bypass.Intraoperative transesophageal echocardiography revealed relative mitral insufficiency that was corrected with an annuloplasty ring.Intraoperative coronary angiogram showed impaired blood flow in the left main coronary and circumflex artery and 60%stenosis.For this reason,bifurcation stenting was performed.The patient had an uneventful postoperative clinical course and was discharged from the hospital on the 10th day in a satisfactory condition.CONCLUSION Left atrial appendage aneurysm is a rare and dangerous heart pathology that requires surgery to prevent related complications. 展开更多
关键词 Atrial appendage ANEURYSM Mitral valve insufficiency Coronary stenosis Catheter ablation Case report
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基于加速康复外科理念腹腔镜胃癌患者术后拔除尿管时机的探讨 认领
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作者 刘鹏 徐丽群 魏玉哲 《中国实用护理杂志》 2020年第19期1457-1462,共6页
目的探讨加速康复外科理念在腹腔镜胃癌患者术后不同时期拔除导尿管的安全性与可行性。方法选取2017年12月至2019年1月在哈尔滨医科大学附属肿瘤医院行腹腔镜胃癌根治术的患者219例为研究对象,将所有患者按照随机数字表法分为A、B、C 3... 目的探讨加速康复外科理念在腹腔镜胃癌患者术后不同时期拔除导尿管的安全性与可行性。方法选取2017年12月至2019年1月在哈尔滨医科大学附属肿瘤医院行腹腔镜胃癌根治术的患者219例为研究对象,将所有患者按照随机数字表法分为A、B、C 3组各73例,每组脱落1例,最终每组72例完成研究。A组术后12 h拔除尿管,B组术后24 h拔除尿管,C组术后48 h拔除尿管。比较3组患者排尿相关指标和康复指标。结果首次拔除尿管后自行排尿例数、尿潴留重新置管例数、尿路刺激症例数、尿常规异常例数、排尿疼痛评分比较差异无统计学意义(P>0.05);A组患者下床活动时间、首次通气时间、术后住院天数、总住院天数、住院治疗总费用分别为(10.26±4.51)h、(28.74±8.04)h、(4.94±1.73)d、(6.68±1.93)d、(7.19±0.31)万元,B组分别为(16.37±5.13)h、(39.16±11.52)h、(5.27±1.97)d、(7.83±1.88)d、(7.51±0.36)万元,C组分别为(24.19±5.77)h、(54.37±17.49)h、(6.48±1.73)d、(8.16±1.81)d、(7.98±0.42)万元,3组比较差异有统计学意义(F值为12.376~131.721,均P<0.01)。结论加速康复外科理念下腹腔镜胃癌患者术后早期拔除导尿管是安全可行的,能促进患者早期康复,减少住院时间,降低患者的总体经济负担。 展开更多
关键词 ERAS 腹腔镜 胃肿瘤 导尿管 护理
集束化护理对泌尿外科患者术后尿路感染及导尿管留置时间的影响 认领
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作者 廖莹 周翌婷 《医药高职教育与现代护理》 2020年第5期354-356,共3页
目的探讨集束化护理对泌尿外科手术患者术后尿路感染发生率及导尿管留置时长的影响。方法采用简单抽样法,选取铜陵市立医院2018年5月至12月符合纳入标准的泌尿外科患者112例作为研究对象,将其随机分为对照组和试验组,每组各56例。对照... 目的探讨集束化护理对泌尿外科手术患者术后尿路感染发生率及导尿管留置时长的影响。方法采用简单抽样法,选取铜陵市立医院2018年5月至12月符合纳入标准的泌尿外科患者112例作为研究对象,将其随机分为对照组和试验组,每组各56例。对照组采取泌尿外科术后导尿管常规护理措施,试验组采取集束化护理,评估并比较两组患者术后尿路感染发生情况及导尿管留置时间。结果试验组患者的尿路感染发生率为5.36%,平均尿管留置时间为(3.43±1.48)d,对照组患者的尿路感染发生率为19.64%,平均尿管留置时间为(5.67±1.21)d,两组比较差异均有统计学意义(均P<0.05)。结论将集束化护理干预引入泌尿外科术后患者导尿管护理工作中,可有效降低患者泌尿系统感染的发生率,缩短导尿管留置时长,值得推广使用。 展开更多
关键词 泌尿外科 导尿管 集束化护理 尿路感染
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血液净化股静脉无涤纶套导管感染的危险因素分析 认领
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作者 安娜 曾丽花 +5 位作者 陈汝满 贺纪清 白亚飞 徐明芝 王春莉 李洪 《临床肾脏病杂志》 2020年第7期532-536,共5页
目的探讨血液净化治疗行股静脉无涤纶套导管置管术患者发生导管相关感染(catheter related infection,CRI)的危险因素。方法研究分析海南省人民医院2015年4月至2017年2月经皮股静脉留置双腔导管行血液净化治疗的252例患者的基本信息资料... 目的探讨血液净化治疗行股静脉无涤纶套导管置管术患者发生导管相关感染(catheter related infection,CRI)的危险因素。方法研究分析海南省人民医院2015年4月至2017年2月经皮股静脉留置双腔导管行血液净化治疗的252例患者的基本信息资料,依据导管感染程度分为无感染组、局部感染组(出现导管细菌定植或导管出口感染)、导管相关血流感染组,对CRI发生的相关因素进行单因素分析和多因素Logistic回归分析。结果在252例患者中发生导管相关血流感染18例(7.1%)、导管出口感染10例(4%)、导管细菌定植21例(8.3%)。在单因素分析中,三组患者在慢性肾脏病5期及急性肾损伤比例方面,差异存在统计学意义(P<0.05);三组患者的白蛋白水平差异存在统计学意义(P<0.05);三组在性别方面差异有统计学意义(P<0.05),男性的CRI发生率高于女性;三组患者在病程中是否使用抗生素方面的差异有统计学意义(P<0.05),因其他部位感染,在置管前或带管期间使用抗生素的患者其CRI发生率较低。多因素Logistic回归分析结果提示男性(OR=2.71,95%CI 1.218~6.033,P<0.05)和病程中没有使用抗生素(OR=2.22,95%CI 1.086~4.540,P<0.05)是CRI的发生的危险因素。结论改善患者营养状态,合理使用抗生素,重视导管集束化管理,可减少股静脉无涤纶套导管相关感染的发生。 展开更多
关键词 血液净化 导管 感染 细菌定植
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Skeletal muscle-derived cells repair peripheral nerve defects in mice 认领
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作者 Zi-Xiang Chen Hai-Bin Lu +3 位作者 Xiao-Lei Jin Wei-Feng Feng Xiao-Nan Yang Zuo-Liang Qi 《中国神经再生研究:英文版》 SCIE CAS CSCD 2020年第1期152-161,共10页
Skeletal muscle-derived cells have strong secretory function,while skeletal muscle-derived stem cells,which are included in muscle-derived cells,can differentiate into Schwann cell-like cells and other cell types.Howe... Skeletal muscle-derived cells have strong secretory function,while skeletal muscle-derived stem cells,which are included in muscle-derived cells,can differentiate into Schwann cell-like cells and other cell types.However,the effect of muscle-derived cells on peripheral nerve defects has not been reported.In this study,5-mm-long nerve defects were created in the right sciatic nerves of mice to construct a peripheral nerve defect model.Adult female C57BL/6 mice were randomly divided into four groups.For the muscle-derived cell group,muscle-derived cells were injected into the catheter after the cut nerve ends were bridged with a polyurethane catheter.For external oblique muscle-fabricated nerve conduit and polyurethane groups,an external oblique muscle-fabricated nerve conduit or polyurethane catheter was used to bridge the cut nerve ends,respectively.For the sham group,the sciatic nerves on the right side were separated but not excised.At 8 and 12 weeks post-surgery,distributions of axons and myelin sheaths were observed,and the nerve diameter was calculated using immunofluorescence staining.The number,diameter,and thickness of myelinated nerve fibers were detected by toluidine blue staining and transmission electron microscopy.Muscle fiber area ratios were calculated by Masson’s trichrome staining of gastrocnemius muscle sections.Sciatic functional index was recorded using walking footprint analysis at 4,8,and 12 weeks after operation.The results showed that,at 8 and 12 weeks after surgery,myelin sheaths and axons of regenerating nerves were evenly distributed in the muscle-derived cell group.The number,diameter,and myelin sheath thickness of myelinated nerve fibers,as well as gastrocnemius muscle wet weight and muscle area ratio,were significantly higher in the muscle-derived cell group compared with the polyurethane group.At 4,8,and 12 weeks post-surgery,sciatic functional index was notably increased in the muscle-derived cell group compared with the polyurethane group.These criteria of the muscle-derived cel 展开更多
关键词 MUSCLE NERVE conduit myokine NERVE REGENERATION NERVE REPAIR peripheral NERVE REGENERATION polyurethane catheter seed CELLS SKELETAL MUSCLE SKELETAL muscle-derived CELLS tissue-engineered NERVE
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