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find Author "杨佳" 6 results
  • 老年谵妄患者的循证护理

    目的为1例老年谵妄患者制定护理方案,检索当前最佳证据,使谵妄症状消失,促进患者早日康复。 方法2015年4月13日收治1例老年患者,入院诊断:①肺部感染,Ⅰ型呼吸衰竭;②原发性高血压3级,极高危;③意识障碍原因待查;④低蛋白血症。患者有原因不明的意识障碍,护士全面评估病情后,确定患者存在谵妄。针对患者的谵妄问题,检索数据库获得循证医学证据,制定最佳护理方案,住院始末均全面实施该方案,评价护理结局。 结果检索纳入循证指南2篇,系统评价4篇,在对老年谵妄患者进行护理时,针对谵妄的危险因素提前进行预防,采用多学科合作的非药物干预手段,可以使老年患者的谵妄症状消失,改善护理质量。 结论通过循证方法护理老年谵妄患者,更具有科学性和有效性。

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  • CT肠道三维重建薄层扫描检查的护理配合

    目的 讨论CT肠道三维重建薄层扫描(CTE)检查的护理及配合。 方法 对2011年1月-2012年2月34例行CTE检查患者予以详尽的宣传教育和充分的肠道准备,使患者顺利完成检查事项。 结果 34例患者都获得较为满意的检测图像及诊断数据,为疾患的诊断和治疗提供了可靠、有效的依据。 结论 CTE检查安全方便,良好的护理配合是检查成功的保证;检查前肠道清洁,口服甘露醇充盈小肠可有效改善CT图像质量,提高检查成功率和诊断准确率。

    Release date:2016-09-07 02:38 Export PDF Favorites Scan
  • Clinical and CT findings of coronavirus disease 2019

    ObjectiveTo investigate the clinical and CT findings in patients with coronavirus disease 2019 (COVID-19).MethodsThe epidemiological data and clinical manifestations of 83 COVID-19 patients admitted to Chongqing Public Health Medical Center from January 24, 2020 to February 4, 2020 were analyzed retrospectively. According to the clinical classification, they were divided into four groups: mild group 8 patients, common group 62 patients, severe group 10 patients, and critically severe group 3 patients. The CT characteristics and their relationship with clinical classification were analyzed.ResultsThe average age of 70 mild patients was (43.7±15.0) years, 13 severe patients was (57.4±11.8) years. The average age of mild patients was lower than that of severe patients (Z=–3.185, P=0.001). The average course of mild disease was (5.5±4.2) days, lower than that of severe disease (11.8±5.0) days (Z=–3.978, P=0.000). The clinical manifestations were fever in 72 patients, cough in 60 patients, expectoration in 34 patients, asthenia in 25 patients and shortness of breath in 19 patients. Basic diseases were complicated in 16 patients. CT findings: Both lung lobes were affected in 70 patients (93.3%), pure right lung lobe was affected in 3 patients (4.0%), pure left lung lobe was affected in 2 patients (2.7%), and there was no focus in 8 patients. The total number of affected lung segments was 203 in severe type, with an average of 15.6±5.4 and 530 in the common type, with an average of 9.6±5.3. The number of the severe type was more than that in the common type (Z=–3.456, P=0.001). The focus was mainly in the posterior part, 62 in the dorsal and 65 in the posterior basal segments, 41 in the anterior part of the upper lobe, and less in the common type (P<0.05). The main lesions were ground-glass opacities in 74 patients, patchy shadow in 72 patients, piece shadow in 46 patients, strip shadows in 51 patients and consolidation in 34 patients. Among them, the common CT showed patchy shadow in 34 patients (54.8%), less than severe patients in 12 patients (92.3%) (χ2=4.880, P=0.027). There was no significant difference between the mild CT and the severe patients (P>0.05).ConclusionsThere are some radiographic characteristics in COVID-19. Chest CT is helpful for the diagnosis and the judgement of the disease.

    Release date:2020-05-26 09:32 Export PDF Favorites Scan
  • CEMENTLESS TOTAL HIP ARTHROPLASTY FOR TREATMENT OF Crowe TYPE Ⅲ DEVELOPMENTAL DYSPLASIA OF HIP IN ADULTS

    ObjectiveTo investigate the value of cementless total hip arthroplasty (THA) for the treatment of Crowe type Ⅲ developmental dysplasia of hip (DDH) in adults. MethodsBetween September 2013 and September 2015, 50 patients (51 hips) with Crowe type Ⅲ DDH were treated. There were 20 males (20 hips) and 30 females (31 hips), with the average age of 39 years (range, 19-55 years). The left side was involved in 34 cases, the right side in 15 cases, and both sides in 1 case. All patients had the symptoms of limp walking and hip pain. The disease duration was 10-47 months (mean, 26 months). The sign of "4" number test and Trendenleburg sign were positive; the Harris score was 38.9±7.1. The bilateral lower extremities discrepancy was 2.5-4.0 cm (mean, 3.3 cm) before operation. All the patients underwent cementless THA, and acetabulum by structural femoral head autograft was performed in 28 cases (28 hips). ResultsAfter operation, the incision healed by first intention. Only 2 patients (2 hips) had femoral nerve palsy, and 7 patients (7 hips) had leg swelling, which were cured after symptomatic treatment. All the patients were followed up 6-18 months (mean, 10 months). The sign of limp walking was improved after operation, hip pain was relieved in 46 patients (46 hips) and only 4 patients (5 hips) still had mild pain. The X-ray films showed bony healing at 3-6 months (mean, 5 months) after operation. At last follow-up, the patients had equal limb length with the discrepancy less than 1 cm (mean, 0.4 cm). At last follow-up, the Harris score was significantly increased to 91.2±2.8 (t=-79.77, P=0.00). ConclusionThe cementless THA is an effective method to treat Crowe type Ⅲ DDH in adults.

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  • Correlation of choroidal thickness and visual function in retinitis pigmentosa patients

    ObjectiveTo analyze the subfoveal choroidal thickness in retinitis pigmentosa (RP) patients and to evaluate the correlation between the subfoveal choroidal thickness (SCT) and visual function. MethodsTotally 42 RP patients (84 eyes) and 49 age and diopter-matched normal controls (98 eyes) were enrolled in this study. All the patients were taken the enhanced depth imaging technique of optical coherence tomography (EDI-OCT) examination for the measurement of the SCT. The covariate analysis was used to analyze the interaction effect between age and group. Then the SCT was amended. The RP patients were examined by 30°visual field test (T32 or LVC program) and electroretinogram (ERG) test. 32 eyes examined by T32 program, 52 eyes examined by LVC program. The waveform of ERG, mean sensitivity (MS) and mean defect (MD) were recorded. The relationship of SCT, MS and MD were analyzed by Pearson correlation analysis. ResultsThe SCT of RP patients and controls were (223.12±69.59), (288.29±52.36) μm. The covariate analysis of covariance with different age group interaction was not statistically significant (F=1.619, P=0.205), as amended SCT of RP patients and controls were (217.34±6.60), (293.20±6.00) μm, respectively. The SCT was decreased in RP patients (t=7.042, P < 0.001). Among 84 eyes, bright cone response weaken in 35 eyes, scotopic rod response weaken in 31 eyes. The difference of SCT in different ERG waveform was not significant (t=-0.976, -1.584; P=0.332, 0.117). The MS and MD of 32 eyes using T32 program were (9.05±6.42), (18.84±6.30) dB, the SCT was (209.83±71.48) μm; the MS and SCT of 52 eyes using LVC program were (7.14±5.03) dB and (228.32±66.32) μm. The SCT was related to MS (r=0.494, P=0.003) and MD (r=-0.448, P=0.009) in eyes using T32 program. There was no correlation between SCT and MD in eyes using LVC program (r=-0.232, P=0.095). ConclusionsThe SCT of RP patients is thinner than that of normal controls. The SCT of RP patients is related to MS and MD of T32 program, but not correlated to ERG waveform and MS of LVC program.

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  • Clinical effect of histidine-tryptophan-ketoglutarate solution versus University of Wisconsin solution for liver transplantation: a systematic review and meta-analysis

    ObjectiveTo compare the clinical effects of two commonly used organ preservation solutions University of Wisconsin (UW) solution and histidine-tryptophan-ketoglutarate (HTK) solution in liver transplantation.MethodsThe PubMed, Embase, Cochrane Library, CNKI, CBM, VIP, and Wanfang Data were searched to collect the comparative studies of the UW solution and HTK solution in the liver transplantation. The data were extracted and evaluated by the RevMan 5.3 software.ResultsFinally, 16 articles with a total of 35 024 patients were included. The meta-analysis results showed that the HTK solution group had a lower incidence of postoperative biliary complications [RR=1.30, 95%CI (1.07 1.58), P=0.008] and lower aspartate aminotransferase peak level within 7 d after operation [MD=112.45, 95%CI (93.34, 131.56), P<0.01] as compared with the UW solution group. No significant differences were found in terms of the incidence of primary non-function [RR=1.07, 95%CI (0.52, 2.18), P=0.86], survival rates of patient and graft in different time points (P>0.05), incidence of retransplantation [RR=0.83, 95%CI (0.48, 1.45), P=0.51], incidence of acute rejection [RR=1.27, 95%CI (0.96, 1.68), P=0.33], alanine aminotransferase peak level within 7 d [MD=31.79, 95%CI (–161.84, 225.42), P=0.75] after operation, total bilirubin [MD=19.42, 95%CI (–10.83, 49.67), P=0.21], and prothrombin time [MD=1.75, 95%CI (0.01, 3.49), P=0.84] between these two groups.ConclusionsHTK solution is safe and effective for liver transplantation, and has similar effects as UW solution. Regarding effect of both on long-term survival rates of patient and graft, large-sample and high-quality RCT is still needed for systematic evaluation.

    Release date:2020-06-04 02:30 Export PDF Favorites Scan
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