Objective To systematically evaluate the influence of PICC (peripherally inserted central catheter) ultrasound guidance on success rates and incidences of complications of elbow catheterization. Methods The Cochrane Library (Issue 3, 2012), Library of JBI evidence-based nursing center, MEDLINE, EMbase, CBM, VIP, CNKI and WanFang Data were searched for relevant studies to influence on success rates of puncture and catheterization and complications from upper arm placement of PICC ultrasound guidance as well as conventional PICC placement from inception to March, 2012. The data were extracted according to the inclusion and exclusion criteria by two reviewers, the quality of included studies was also evaluated. Meta-analysis was conducted using RevMan 5.1, or only descriptive analysis was conducted instead. Results Eleven randomized controlled trials, five clinical controlled trials and four cohort studies were included, involving 4 052 patients. The results of meta-analysis showed that, upper arm placement of PICC ultrasound guidance combined with modified Seldinger technique was associated with significantly higher one-time success rates of puncture and catheterization than conventional PICC placement below the elbow, with significant differences (OR=4.71, 95%CI 1.97 to 11.28, P=0.000 5; OR=8.63, 95%CI 1.92 to 38.82, P=0.005). Conventional elbow catheterization had a significantly higher incidence of phlebitis than catheterization on the elbow that under the guidance of PICC ultrasound and modified Seldinger technique (OR=0.13, 95%CI 0.08 to 0.21, Plt;0.000 01). Conclusion Elbow catheterization under the guidance of PICC ultrasound combined with modified Seldinger technique has an obvious advantage in improving the success rates of puncture and catheterization and reducing the incidence of complications, compared with conventional elbow catheterization.
目的 探讨4种输尿管镜入镜方法的成功率及对输尿管口的损伤。 方法 回顾性分析2008年7月－2011年3月间行输尿管镜手术的患者共553例，按其入镜方法分为4组，分别采用球囊扩张法、灌注泵加压灌注入镜法、内旋法及倒入法进行输尿管镜操作。分析其成功率及对输尿管口的损伤。 结果 气囊扩张法成功率为95%，但对输尿管口的损伤率为100%；灌注泵加压法成功率为67.5%，输尿管口损伤率为87.0%；内旋法的成功率为87.9%，损伤率为50.0%；倒入法成功率91.0%，对输尿管口损伤率为22.2%。4种方法中，灌注泵加压法一次性成功率最低，与其余3种方法比较，差异均有统计学意义（P＜0.008）；其余3种方法间一次性成功率差异无统计学意义（P＞0.008）。对输尿管口的损伤率，4种方法组间两两比较的差异均有统计学意义（P＜0.008），其中气囊扩张法损伤率最高，倒入法最低。 结论 倒入法是4种方法中成功率较高且损伤小的一种方法。
目的:探讨鼻内窥镜在泪囊鼻腔吻合术后的应用。方法:343例436眼实施泪囊鼻腔吻合术,术后结合鼻内窥镜检查。结果:术后随访1～12月,手术治愈好转率为96.33%。结论:鼻内窥镜对泪囊鼻腔吻合术后吻合口行检查及修复,能很好的提高泪囊鼻腔吻合术成功率。
ObjectiveTo explore the effect of comfort care on patients undergoing CT enhanced scan. MethodsSixty patients undergoing CT enhanced scan were enrolled in June 2013, who were randomly divided into general care group (n=30) and comfort care group (n=30). General care group was given the routine care, while patients in the comfort care group accepted comfort care as well as routine care. The success rate of examination and excellent or good imaging rate between the two groups were compared. ResultsIn the general care group, the scan was successful in 21 patients and failed in 9, with a successful scan rate of 70.0% (21/30), and the excellent and good imaging rate was 71.4%. For the comfort care group, the scan examination succeeded in 29 patients and failed in 1 with a success rate of 96.7% (29/30), and the excellent and good imaging rate was 96.6% (28/29). The success rate in the two groups had statistical significance (χ2=7.680, P=0.006), and the excellent and good imaging rate was also significantly different (χ2=7.607, P=0.022). ConclusionComfort care for patients undergoing CT enhanced scan has a good effect in alleviating psychological stress, ensuring comfort and safety, and improving the success rate and excellent and good rate of imaging quality, which reflects its real value of nursing service in CT Department.
ObjectiveTo evaluate the effect of long-term systemic education management program on intervention of chronic obstructive pulmonary disease (COPD). MethodsTwo hundred forty-six stable patients were interviewed face-to-face from March to August in 2013.They were divided into a systemic education group, a follow-up group and a control group according to different management program.The investigation contained general conditions, commonly used medicines, the effects of smoking cessation, the frequency of acute exacerbation in the year before investigation, COPD Assessment Test (CAT) and modified British Medical Research Council (mMRC). ResultsThe success rate for smoking cessation in the systemic education group was 97.6%, which was higher than 81.0% in the follow-up group and 73.8% in the control group(P < 0.01).97.6% of patients in the systemic education group and 93.7% of patients in the follow-up group used bronchodilator.Whereas only 65.5% of patients in the control group inhaled bronchodilator, significantly lower than other two groups (P < 0.01).Mucolytic agents were taken by 14.5% and 19.0% of patients in the systemic education group and the follow-up group, and by 36.9% of patients in the control group (P < 0.01).The frequency of acute exacerbation was 0.9±0.9 both in the systemic education group and the follow-up group, which was lower than 1.2±1.0 in the control group (P < 0.05).CAT and mMRC in the systemic education group (10.2±5.7 and 1.5±1.0) and the follow-up group (11.1±5.8 and 1.5±0.9) were significantly lower than those in the control group (15.0±6.6 and 1.9±1.1, P < 0.01). ConclusionsLong-term systemic education management program can improve success rate for smoking cessation and bronchodilator use, reduce the frequency of acute exacerbation, and improve quality of life effectively in COPD patients.
ObjectiveTo investigate the effect of acoustic earplugs combined with sedative drugs on improving the success rate of MRI examinations in children with epilepsy, and to provide an effective clinical evidence for MRI examination in children with epilepsy for the future.MethodsSeventy-four children with epilepsy who came to the Second Affiliated Hospital of Guangzhou Medical University, between July 2016 and February 2018 were included in this research. To test the effectiveness of acoustic earplugs on children with epilepsy in improving MRI success rates, participants were divided into two groups randomly. The control group only took the drug and withont using the acoustic earplugs. The observation group used both the drug and acoustic earplugs. The comparing the success rate of MRI examination between the two groups.ResultsThe observed group (with the acoustic earplugs) showed a success rate of 97.29% (36/37), the control group (without the acoustic earplugs) showed a success rate of 18.91% (7/37). The success rate of the observed group was higher than the control group (P<0.05) significantly.ConclusionsThe use of acoustic earplugs combined with sedative drugs is effective in improving the success rate of MRI examination in children with epilepsy and can be widely used in clinical practice.