[ABATRACT]Objective:To evaluate the inlfuences of three ways of tracheal intubation, Macincosh direct laryngoscope, video laryngoscope and laryngeal mask (number 4) on haemodynamics under same anesthesia depth (BIS=40). Methods:60 cases non laparoscopic selective operation patients were randomly divided into 3 groups (n=20):Macincosh direct laryngoscope (DL group), video laryngoscope group (VL group) and laryngeal mask (number 4) group (F4 group). The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) of patients before anesthesia (T0), after induction (T1), at intubation (T2), 3 minutes after intubation (T3) and 5 minutes after intubation (T4) were recorded respectively. Results:The SBP, DBP and HR at T1 of patients in 3 groups were all obviously lower than that before anesthesia (P<0.05);The SBP, DBP and HR at T2 of patients in 3 groups were all obviously higher than that before anesthesia (P<0.05);There wasnostatisticallysigniifcantdifferenceaboutSBP,DBPandHRatT3andT4comparedwiththatbeforeanesthesia(P>0.05). There was no statistically signiifcant difference about SBP, DBP and HR at T0, T1, T3, T4 between DL group, VL group and F4 group (P>0.05). At T2, The SBP, DBP and HR of patients in DL group were obviously higher than VL group and F4 group (P<0.05). Conclusions:Compared with direct laryngoscope, the inlfuences of video laryngoscope and laryngeal mask on haemodynamics are small, which are suitable for clinical application.
目的:观察应用MMSE量表和MoCA量表评估老年病人全麻术后的早期认知功能.方法:老年全麻手术病人66例,分别于术前ld和术后3h、6h、24h、48h应用MMSE量表和MoCA量表评估病人的认知功能.结果:病人术后3h、6h的MMSE、MoCA测试评分最低;术后各时间点的MoCA评分均明显低于MMSE评分(P＜0.05).MMSE量表显示18.18％(12例)的病人术后出现认知功能障碍,MoCA量表显示25.76％(17例)的病人出现认知功能障碍,两种量表评估病人认知障碍发生率比较差异无统计学意义(P＞0.05).结论:MoCA量表可作为评估老年病人全麻术后早期认知功能障碍的首选;MMSE和MoCA两种量表共同评估或MoCA量表较MMSE更适于评估老年病人术后早期的认知功能.
癫痫是大脑神经元异常放电引起的短暂中枢神经功能异常的慢性病变.发作时运动、感觉、意识、行为和自主神经等都有不同程度的障碍,具有突然发作、反复发作的特点.工作和日常生活中常常会因癫痫发作引起意外伤害,其中烧伤占有较大比例,占所有烧伤患者的1.6%-3.7%[1].癫痫患者发作时如接触热源,常导致严重的烧伤,与一般烧伤相比,创面集中,烧伤程度深,多需手术治疗,患者住院时间长.由于其典型的临床特点,癫痫合并烧伤患者的治疗和护理具有其特点,也极为重要.近年我科共收治癫痫发作致意外烧伤患者20例,总结护理体会如下.
负压封闭引流(vaccum sealing drainage VSD)是用内含引流管的聚乙烯酒精水化海藻盐泡沫敷料覆盖或填充皮肤或缺损软组织创面,再用生物半透膜对之进行封闭,使其成为密闭空间,通过连接负压源,利用可控制的负压促进创面愈合的治疗方法,现已广泛应用于临床。我科自2010年8月至2012年2月共计应用VSD技术治疗难愈性创面20例,其中慢性溃疡12例,热压伤2例,压疮6例。患者手术平均次数为1-2次,可保持有效引流5-7天,患者均痊愈出院。
目的:探讨负压封闭引流技术治疗难愈性创面围手术期的护理.方法:术前做好心理护理及常规准备、调试负压装置,术后严密观察患者生命体征、观察引流液的性状、注意无菌操作并应用抗生素预防感染、注意保证负压引流通畅.结果:20例患者均痊愈出院,未发生术后感染等并发症.结论:围手术期病情的密切观察及有效护理、及时发现和解决出现的问题是负压封闭引流技术能够取得良好疗效的关键.
