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目标导向性液体治疗对围术期高凝患者凝血功能的影响 被引量:9
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作者 赵若光 陈彦青 +3 位作者 邹聪华 林莹 缪丽艳 龚赞辉 《福建医科大学学报》 北大核心 2016年第6期411-414,共4页
目的探讨目标导向性液体治疗(GDFT)与传统输液治疗对围术期血液高凝患者凝血功能的影响。方法选择ASAⅠ-Ⅲ级需行胃肠道肿瘤手术且入手术室后(输液前)第1次血栓弹力图结果为高凝(CI〉3)的中老年患者60例,随机分为2组(n=30),Ⅰ... 目的探讨目标导向性液体治疗(GDFT)与传统输液治疗对围术期血液高凝患者凝血功能的影响。方法选择ASAⅠ-Ⅲ级需行胃肠道肿瘤手术且入手术室后(输液前)第1次血栓弹力图结果为高凝(CI〉3)的中老年患者60例,随机分为2组(n=30),Ⅰ组采用中心静脉压(CVP)指导围术期输液即为CVP组,Ⅱ组采用每搏变异度(SVV)指导围术期输液即SVV组。CVP组根据CVP指导输液,维持CVP在9-15mmHg(1.2-2kPa);Ⅱ组采用SVV指导围术期输液,维持SVV〈10%;记录2组患者输液前(T0)、麻醉开始后3h(T2)、手术后24h(T3)血栓弹力图的凝血情况,包括反应时间(R)、凝固时间(K)、angle、血栓形成的最大幅度(MA)、综合凝血指数(CI),低凝发生率;记录2组患者输液前(T0)、麻醉诱导后即刻(T1)、麻醉诱导后3h(T2)的平均动脉压(MAP)、心率(HR)、手术时间、麻醉时间、麻醉诱导后3h的总输液量、总出血量、尿量、血管活性药使用情况、手术后至手术后24h的总出血量、术后大出血的发生率、术后7d内血栓性事件的发生率。结果与Ⅰ组比较,Ⅱ组患者T0血栓弹力图结果无明显差别(P〉0.05);2组患者T2,T3时的凝血因子功能和纤维蛋白原功能明显减弱(P〈0.05),而血小板功能和综合凝血功能无差别(P〉0.05)。与Ⅰ组比较,Ⅱ组T2时的凝血因子功能较强(P〈0.05);综合凝血功能较强(P〈0.05);低凝的发生率明显减少,差别有统计学意义(P〈0.05);T3的R,K,angle及MA差别无统计学意义(P〉0.05);T0,T1及T2的MAP,HR,麻醉诱导后3h内的总出血量及血管活性药使用量差别无统计学意义(P〉0.05);麻醉诱导后3h内的总输液量、尿量明显减少,差别有统计学意义(P〈0.05);手术结束后24h的总出血量差别无统计学意义(P〉0.05)。2组患者术后7d内均无血栓事件发生。结论 GDFT与传统输液治疗比较,可较好的纠正围术期血液高凝患者的凝血状态。 展开更多
关键词 *补液疗法 手术 *围手术期护理 *血液凝固障碍 血液凝固
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Perioperative care in older adults 被引量:3
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作者 Giselle A Baquero Michael W Rich 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2015年第5期465-469,共5页
1 Background Over the last 20 years, the number of older adults requiring surgical interventions has substantially increased and will continue to escalate as the population ages. Perioperative management of older pati... 1 Background Over the last 20 years, the number of older adults requiring surgical interventions has substantially increased and will continue to escalate as the population ages. Perioperative management of older patients poses challenges not encountered in younger individuals. People over 70 years of age are more likely to have multiple comorbidities, physical and cognitive impairments, and reduced cardiac, pulmonary, and renal reserve. These factors predispose older patients to increased risk for perioperative complications and prolonged length of hospital stay, which in turn increase risk for iatrogenesis, nosocomial infections, and perioperative mortality. 展开更多
关键词 AGING Cardiovascular disease Perioperative care SURGERY The elderly
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Operating room nurses’lived experiences of ethical codes:A phenomenological study in Iran 被引量:1
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作者 Fateme Aghamohammadi Behzad Imani Mahnaz Moghadari Koosha 《International Journal of Nursing Sciences》 CSCD 2021年第3期332-338,I0007,共8页
Objective:Operating room nurses,as essential members of health care teams,often face ethical challenges in the operating room.By using the ethical experiences of operating room nurses,a better understanding of ethics ... Objective:Operating room nurses,as essential members of health care teams,often face ethical challenges in the operating room.By using the ethical experiences of operating room nurses,a better understanding of ethics in the operating room can be achieved,which can lead to better nursing decisions in the face of these challenges.Therefore,this study was conducted to investigate operating room nurses’lived experiences of ethical codes.Methods:A hermeneutic phenomenological study was performed in Hamadan(Iran)from February 2019 to November 2020.Ten operating room nurses were selected as participants by purposive sampling.Data were collected through in-depth and semi-structured interviews.Data analysis was performed based on Van Manen methodology.Results:Data analysis revealed three main themes and 11 sub-themes representing the operating room nurses experience of the ethical code.The main themes were;adherence to professional commitments,preserving patient dignity,and respect to colleagues.Conclusion:The results underlined ethics and ethical values in the operating room.Due to the intense interactions between operating room nurses with the patient and surgical team,commitment to ethics by nurses can lead to improving quality of care and interactions among members of the surgical team.It is suggested that using these codes as a guideline and a framework could be developed to improve the ethical and professional performance of operating room nurses. 展开更多
关键词 Ethical codes Qualitative study Phenomenology Iran Operating room nursing Perioperative nursing
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