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Leber病一家四例報告

標識管理在開顱手術多液路中的應用

目的 探討標識管理方法在開顱手術中多液路輸液中的應用效果。 方法 選取 2015 年 3 月—4 月行開顱手術且建立 3 組及以上液體管路的手術患者，采用隨機數字法分為干預組和對照組。干預組術中在常規輸液護理的基礎上，再加上應用不同顏色的標識條對多個液體的輸液管路分別進行標記；對照組術中給予常規輸液護理。比較兩組在給藥時定位管路的正確率、正確定位管路的速度、麻醉師和護士滿意度的差異。 結果 共納入患者 100 例，干預組和對照組各 50 例。在給藥時定位管路的正確率方面，干預組為 96.0%，優于對照組的 44.0%；在正確定位管路的速度方面，干預組為（3.94±1.35）s，快于對照組的（30.24±21.25）s；在醫護人員的滿意度方面，干預組為 83%（83/100），亦優于對照組的 18%（18/100）；兩組比較差異均有統計學意義（P<0.05）。 結論 術中多液路輸液時應用規范醒目的護理標識，可正確定位要給藥的管路，縮短定位時間，提高工作效率，增進醫護人員的滿意度，確保護理安全。

顱內原發性惡性黑色素瘤并蛛網膜下腔播散一例

An immunohistochemical study of Il-6,TNF-α in epiretinal membreanes.

Purpose To investigate the expression of the interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-alpha;) in epiretinal membranes(ERM) of eyes with proliferative vitreoretinopathy(PVR). Methods Nineteen epiretinal membranes were obtained form eyes undergoing vitrectomy for retinal detachment complicated with PVR and observed by immunohistochemical methods. Results Expression of IL-6 and TNF-alpha; were observed in 12 and 15 membranes respectively with positive staining mostly in extracellular matrix of epiretinal membranes.Only one membrane showed positive to IL-6 intracellularly,and expression for IL-6 and TNF-alpha; simultaneously in membranes. Conclusion The findings indicate that IL-6、and TNF-alpha;might be involved in the development of PVR. (Chin J Ocul Fundus Dis,1998,14:219-221)

氣道內超聲協助診斷呼吸道受累復發性多軟骨炎一例及文獻復習

目的提高對呼吸道受累的復發性多軟骨炎(RP)的臨床認識,以及氣道內超聲對氣道壁疾病的診斷價值。 方法對1例呼吸道受累的RP患者氣道內超聲協助臨床診療過程進行分析,并結合文獻復習。 結果首發呼吸道癥狀有聲嘶、咳嗽、咳痰、喘息、呼吸困難等,CT檢查有氣管、支氣管狹窄、氣管軟骨變形等,支氣管鏡表現有不同程度的聲帶水腫、聲門下環狀軟骨塌陷、聲帶麻痹、喉腔狹窄和主氣道、左右支氣管及其分支彌漫或局限狹窄、充血水腫、軟骨結構消失。氣道內超聲顯示氣道壁分層模糊,軟骨層破壞增厚、形狀不規則。 結論呼吸道受累的RP臨床容易誤診,氣道內超聲對氣道壁疾病具有潛在的診斷價值。

支氣管內活瓣置入治療重度肺氣腫一例

Effect of pain management by anesthesia nurses on labor analgesia

Objective To explore the effect of pain management by anesthesia nurses on labor analgesia. Methods A total of 100 parturient women in the Affiliated Hospital of North China University of Science and Technology between July and August 2015 were randomly divided into two groups: analgesia group and control group with 50 in each. Both two groups accepted labor analgesia routine maternity nursing. Analgesia group accepted maternal perinatal term pain management in addition to the routine nursing. Then we compared degree of pain during the production process, labor time and perineal injury between the two groups of women. Results The number of women with a labor pain degree of 0-Ⅲ in the analgesia group was respectively 36 (72%), 12 (24%), 2 (4%) and 0 (0%), and the number in the control group was respectively 23 (46%), 17 (34%), 8 (16%), and 2 (4%). The above difference between the two groups was statistically significant (Z=–2.908, P =0.004). The number of women with intact perineum, perineal injury of lateral and median cut, and Ⅰ-Ⅲ degree laceration in the analgesia group was respectively 31 (62%), 7 (14%), 8 (16%), 4 (8%) and 0 (0%); and the number in the control group was respectively 21 (42%), 12 (24%), 10 (20%), 7 (14%) and 0 (0%), also with significant difference between the two groups (Z =–2.028, P =0.043). The first and second labor stage of the analgesia group was (462.32±101.27) and (63.58±10.38) minutes, and was (568.27±113.28) and (76.92±11.24) minutes in the control group, with significant differences between the two groups (P<0.001). There was no statistically significant difference between the two groups in the third labor stage (5.78±3.02) and (5.97±2.96) minutes, (P=0.654). Conclusions The implementation of pain management by anesthesia nurses on labor analgesia can significantly reduce maternal labor pain, shorten the time of labor, and the condition of the perineal injury is mild and easily acceptable. It is worthy of clinical promotion.