【摘要】 目的 评价抚触对硬膜外麻醉穿刺疼痛的影响及效果。 方法 2009年1-12月，将485例行硬膜外麻醉穿刺患者随机分为抚触组（术中行抚触干预）和对照组（常规护理），观察两组患者的穿刺程度、穿刺时间。 结果 抚触组患者疼痛程度、穿刺时间较对照组有明显改善，且差异有统计学意义（Plt;0.01）。 结论 抚触可降低应激引起的硬膜外麻醉穿刺患者的疼痛程度，保持穿刺体位从而缩短穿刺时间，有利于麻醉操作顺利进行。【Abstract】 Objective To evaluate the effect of touching on alleviating the pain in patients undergoing epidural anesthesia puncture. Methods A total of 485 patients who underwent epidural puncture from January to December 2009 were randomly divided into two groups: 259 in touching group and 226 in control group. In the touching group, the patients were touched and consoled while undergoing epidural puncture. The pain extent and time of puncture were observed and recorded. Results The level of pain and time of puncture were obviously alleviated and shortened in the touching group and the difference between the two groups was statistically significant. Conclusion Touching could reduce the stress and pain caused by epidural puncture, which may lead to maintain the puncture position and thereby shorten the puncture time. It helps to finish the narcotic operation favorably.
目的:通过对严重腹部损伤患者实施损伤控制性手术策略和方法,提高创伤的抢救成功率。方法:回顾分析8 例严重腹部损伤 (ISSgt;16)患者应用损伤控制性手术的策略进行救治的情况,8例患者入院后在积极抗休克急救处理的同时进行急诊剖腹探查手术,初期均采用大纱垫填塞的方法控制出血后关腹,ICU 内复苏后,所有患者都进行了Ⅱ期计划性手术。结果:经过损伤控制性手术救治的严重损伤复苏过程较平稳,腹部并发症得到有效控制。痊愈6 例,死亡2例。术后出现膈下感染1例,胆瘘1例,经引流治疗痊愈。结论:对于符合DCO 指征的严重腹部损伤的患者要尽早、尽快地实施DCO,提高综合治疗水平,根据腹部损伤的部位和程度,采取适宜的再次确定手术的方式,可以有效地降低严重腹部损伤病死率。