目的:探讨和总结对消化道恶性肿瘤病人施行125I粒子的手术配合和术后护理要点.方法:对实施125I粒子植入治疗的44例消化道恶性肿瘤病人进行术前健康指导,总结放射性粒子的手术配合及术后护理.结果:本组病人均顺利完成放射性125I粒子植入治疗恶性消化道肿瘤.结论:护理跟进125I粒子植入,是取得该项新开展手术成功的保证.

目的：探讨和总结对消化道恶性肿瘤病人施行125I粒子的手术配合和术后护理要点。方法：对实施125I粒子植入治疗的44例消化道恶性肿瘤病人进行术前健康指导,总结放射性粒子的手术配合及术后护理。结果：本组病人均顺利完成放射性125I粒子植入治疗恶性消化道肿瘤。结论：护理跟进125I粒子植入,是取得该项新开展手术成功的保证。

总结64例关节镜下采用腘绳肌肌腱重建前交叉韧带术患者的术后康复护理。术后1～2周,保持肌力,防止膝关节不能伸直,促进伤口部位肿胀消退,预防血栓,做股四头肌、腘绳肌、髋内收肌等长收缩训练等;术后3～4周,加强肌力练习,进行平衡能力和本体感觉训练,膝关节活动度要求达到90°～120°,拄双拐下地部分或完全负重行走;术后5～12周,指导患者增加灵活性和敏捷性训练,恢复日常生活活动能力,参加轻微体育锻炼;术后4～6个月,全面恢复日常活动,强化肌力和关节稳定训练,开始膝环绕练习、侧向跨跳练习、向前匀速慢跑训练等。术后1年随访,Lysholm膝关节评分从(43.24±1.84)分提高至(89.36±4.72)分,患者膝关节功能得到明显改善。

急性化脓性骨髓炎多见于儿童和青少年(2 ～15岁),具有发病急、病情重的特点,如治疗不及时,可导致慢性骨髓炎,造成不可逆的骨骼损害及畸形,如局部死腔形成、患肢缩短及成角畸形等[1],严重影响患儿的生理及心理发育,给患儿家庭带来沉重的经济负担,对患儿家属也是负性事件.患儿家属多伴有不同程度的焦虑.因此,对患儿家属进行心理干预也是临床护理的重要内容.2001 -03-2010 -03,我们对54例急性化脓性骨髓炎患儿家属进行心理干预,并与单纯常规治疗及护理患儿44例对照,观察对患儿家属焦虑情绪的影响.

<正>临床上普遍采用葡萄糖溶液作为治疗重度窒息新生儿药物的主要溶剂。而重度窒息缺氧不仅损害神经,并可导致糖代谢紊乱,如不严格控制输注葡萄糖速度,可使重度窒息新生儿血糖值进一步升高或降低,直至引起颅内出血等严重合并症,使病死率升高。为探讨重度窒息新生儿输注葡萄糖速度,本文

前交叉韧带损伤是常见的运动损伤,前交叉韧带损伤后出现撕裂或部分断裂,关节镜下重建前交叉韧带以获得膝关节功能的恢复.我院骨科对实施前交叉韧重建术的68例患者,在围手术期给予支具应用和康复锻炼指导,并对术后出现的疼痛、关节积液积血和下肢血栓性并发症采取针对性护理措施,严格康复训练指导,未出现严重的并发症,患者达到了预期目标,伤口甲级愈合,膝关节功能恢复良好,现报道如下.

目的 探讨关节镜下采用腘绳肌肌腱指骨钢板悬吊固定法重建前交叉韧带(ACL)的康复训练效果. 方法对13例前交叉韧带断裂的患者,在关节镜下采用6-8股腘绳肌肌腱进行单束双隧道重建, 4孔指骨钢板对移植物行悬吊式固定术后,进行科学严格的康复训练.术后1 a随访,并按照Lysholm膝关节评分标准评价效果.结果 12例患者(92.31% ) Lachman试验阴性,1例患者Lachman试验阳性, 12例患者轴移试验阴性, 1例患者阳性.按照Lysholm膝关节评分标准,评分从47.77±1.96提高至95.38±4.74,差异有显著性意义(P<0.01).结论对关节镜下采用腘绳肌肌腱指骨钢板悬吊固定重建前交叉韧带的患者进行科学严密的康复训练,是恢复膝关节稳定性的重要环节.

目的探讨关节镜下腘绳肌肌腱重建前交叉韧带术后进行本体感觉康复训练对膝关节功能恢复的影响。方法对56例在关节镜下采用腘绳肌肌腱重建前交叉韧带术的患者进行强化本体感觉训练,术后6个月～1年随访,并按照角度再生试验和单腿弹跳试验标准评价效果。结果 56例患者优良率达91.1%。结论腘绳肌肌腱重建前交叉韧带术后采取一系列旨在促进本体感觉恢复的康复训练程序,有利于膝关节功能的稳定。

临床护理路径(CNP)是跨学科、综合的深化整体护理的诊疗护理工作模式,具有指导护理工作,帮助护理人员判断患者预后,使其获得最佳服务,促进康复,减少术后不良反应等作用.2008年3～8月,我院将CNP用于行膝关节镜手术患者的健康教育评价,并与2007年5～12月未用CNP行膝关节镜手术患者进行比较.现报告如下.

随着放射性粒子植入治疗肿瘤临床应用范围的扩大,对其引起的并发症也越显重要.穿刺恶性肿瘤能否引起针道医源性种植转移尚存争论[1,2].笔者对2005-2006年16例粒子植入患者术中所用植入针涂片行细胞学检查,现将术后随访结果报道如下.

Objective To investigate the pathological changes in normal gastric wall of rabbits receiving 125I brachytherapy.Methods Sixty rabbits were randomly divided into two groups:the Control Group and the Experimental Group.Three 125I seeds were implanted into the muscle layer of rabbit stomach at a triangle arrangement according to the treatment plan defined by the treatment planning system(TPS)in the Experimental Group,with a prescription dose of 120 Gy and a seed activity of 2.96×107Bq.The Control Group was given cold seeds implantation.The two groups were further randomly divided into 6 subgroups respectively,which would be sacrificed on the 7th,14th,30th,60th,120th,and 180th days.The hematologic toxicity,pathological changes,and complications in all subgroups were recorded. Results Assessment of objective responses was completed in all the rabbits.There was no ulcer,perforation,bleeding,or related death in treated rabbits.The seeds losing rate was 8.9%(8/90)in the Experimental Group and 5.6%(5/90)in the Control Group.Pathological findings showed slight inflammation around the seeds in the Control Group while severe inflammation,including degeneration and necrosis around seeds,in the Experimental Group.The severe inflammation area was less than 2 mm around the source and was located in the serous membrane and muscle layer.The severity of these pathological changes was not depended on the exposure time(7～180 d)and the prescription dose(10～120 Gy).The WBC count had no statistical significance between the Experimental Group and the Control Group(P>0.05). Conclusions Pathological changes may occur after interstitial radiotherapy at the dose of 120 Gy,but there are no early irreversible radioactive injuries,such as bleeding and perforation.

To observe the possibility of neoplasm needle track implantation after radioactive seeds implantation and seek preventive measures to avoid it.

<正>患者男,80岁。主因左耳前肿物1.5年,迅速增大伴胀痛1个月入院。入院后查体:KPS80分,周身浅表淋巴结未及肿大。左耳前可见一约7.5cm×4.5cm大小肿物,表面红肿、张力大,质硬、中央囊性感,固定,压痛。腮腺CT平扫示:左侧腮腺区域可见一大小6.5cm×3.5cm肿

患者女,48岁.因右腋窝肿物伴右上肢胀痛10 d入院.7个月前发现甲状腺肿物,术后病理诊断为甲状腺峡部乳头状腺癌、右叶甲状腺腺瘤.查体:甲状腺左叶上极似可触及一黄豆大小结节.右腋窝可触及一5 cm×3 cm质韧、边界尚清、活动欠佳的淋巴结.乳腺钼靶X-线摄影示:双乳腺呈点片状密度增高影,未见明显肿块及砂粒样钙化,皮肤无增厚,乳头无凹陷.考虑:双乳腺增生.颈、胸、乳腺CT扫查:右腋窝淋巴结肿大;肝右叶血管瘤.乳腺、肺未见占位病变.

儿童肱骨髁上骨折如移位严重、易并发神经损伤和肱动脉压迫,采用手术切开复位治疗后,指导患儿早期进行指间关节、掌指关节、腕关节自主运动锻炼及肘关节屈伸练习,可使受损神经和肢体感觉运动功能尽快得到恢复,降低了神经、血管损伤并发症.

为了解CLB消毒片的杀菌性能及其影响因素,以悬液定量杀菌试验对其进行了试验.结果,以其含有效氯250 mg/L溶液对绿脓假单胞菌、白色念珠菌作用5 min,杀灭率为100%;对金黄色葡萄球菌、大肠杆菌、枯草杆菌黑色变种杀灭率达100%所需时间依次为8 min和10 mm;以其含有效氯500 mg/L溶液对以上5种细菌作用5 min,杀灭率均可以达到100%.杀菌效果随菌悬液中有机物的含量增加而降低;含有效氯250mg/L溶液对橡胶制品无明显损坏.

分泌性中耳炎(secretory otitis media,SOM)是一种常见病,小儿及成人均可发生,为小儿常见的致聋原因之一.本病的特点是[1]主要病理改变是咽鼓管功能不良等原因导致中耳腔负压,鼓室内有低度炎症反应,腺体和杯状细胞增生,分泌增多,伴有血浆渗出,形成鼓室积液.鼓膜置管术是治疗SOM有效方法之一[2],鼓室置入通气管后能清除中耳积液,代替咽鼓管部分功能,解除中耳负压状态,改善中耳粘膜的病理变化,鼓室内粘膜上皮逐渐恢复正常,腺体活动减少,纤毛活动恢复正常.我科自1998年1月至2001年1 2月共收治了60例小儿分泌性中耳炎,疗效满意,现报道如下.

The authors in this paper report the nursing of 58 patients with obstructive sleep apnea syndrome (OSAS) treated with uvulopalatopharyn oplasty (UPPP). Their nursing measures are as follows: close observation of the extent of sleep apnea at night before operation; reinforcement of oral nursing, local cold compress to reduce the extent of sore throat; close observation of respiration and hemorrhage to prevent the respiratory tract obstruction, necessary instruction of taking food to abate the dysphagia and countercurrent of the food and the health instruction after operation. The authors conclude the treatment effect of UPPP can be enhanced and the surgical complications of OSAS decreased by intensive and proper nursing.