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Research and Application of Bedside Rhetorical Teaching Method in Teaching Nursing Interns
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作者 Rui Cao 《Journal of Contemporary Educational Research》 2024年第4期226-229,共4页
Objective:To observe and analyze the application of the bedside rhetorical teaching method in teaching nursing interns.Methods:A total of 64 nursing interns in the gastroenterology department of our hospital from July... Objective:To observe and analyze the application of the bedside rhetorical teaching method in teaching nursing interns.Methods:A total of 64 nursing interns in the gastroenterology department of our hospital from July 2022 to May 2023 were randomly divided into two groups,32 cases in the control group and 32 cases in the intervention group.The control group was given conventional teaching methods,and the intervention group was given the bedside rhetorical teaching method on the basis of the conventional teaching.The differences in the methods of teaching between the two groups were compared after the end of the internship,and there was a statistically significant difference with P<0.05.Results:The scores of the interns in the intervention group were significantly better than those of the control group in theoretical knowledge,communication skills,and case analysis items(P<0.05).Conclusion:The bedside rhetorical teaching method transforms classroom education into bedside teaching,which enables the interns to apply the theoretical knowledge to clinical practice,and has a higher improvement in the three aspects of disease knowledge,communication skills,and case analysis,cultivates the interns’comprehensive clinical skills,and lays a good foundation for the future entry into the nursing field. 展开更多
关键词 bedside rhetorical teaching method Nursing interns teaching Application research
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Bedside ultrasound in the diagnosis of nonalcoholic fatty liver disease 被引量:12
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作者 Nancy Khov Amol Sharma Thomas R Riley 《World Journal of Gastroenterology》 SCIE CAS 2014年第22期6821-6825,共5页
Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease in the United States.While the American Association for the Study of Liver Diseases guidelines define NAFLD as hepatic steatosis detected either... Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease in the United States.While the American Association for the Study of Liver Diseases guidelines define NAFLD as hepatic steatosis detected either on histology or imaging without a secondary cause of abnormal hepatic fat accumulation,no imaging modality is recommended as standard of care for screening or diagnosis.Bedside ultrasound has been evaluated as a non-invasive method of diagnosing NAFLD with the presence of characteristic sonographic findings.Prior studies suggest characteristic sonographic findings for NAFLD include bright hepatic echoes,increased hepatorenal echogenicity,vascular blurring of portal or hepatic vein and subcutaneous tissue thickness.These sonographic characteristics have not been shown to aid bedside clinicians easily identify potential cases of NAFLD.While sonographic findings such as attenuation of image,diffuse echogenicity,uniform heterogeneous liver,thick subcutaneous depth,and enlarged liver filling of the entire field could be identifiedby clinicians from bedside ultrasound.The accessibility,ease of use,and low-side effect profile of ultrasound make bedside ultrasound an appealing imaging modality in the detection of hepatic steatosis.When used with appropriate clinical risk factors and steatosis involves greater than 33%of the liver,ultrasound can reliably diagnose NAFLD.Despite the ability of ultrasound in detecting moderate hepatic steatosis,it cannot replace liver biopsy in staging the degree of fibrosis.The purpose of this review is to examine the diagnostic accuracy,utility,and limitations of ultrasound in the diagnosis of NAFLD and its potential use by clinicians in routine practices. 展开更多
关键词 Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Liver fibrosis Liver biopsy Liver disease Liver cirrhosis STEATOSIS bedside ultrasound
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Application of scoring systems with point-of-care ultrasonography for bedside diagnosis of appendicitis 被引量:2
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作者 Erden Erol Unluer Rifat Urnal +5 位作者 Utku Eser Serkan Bilgin Mehmet Haciyanh Orhan Oyar Haldun Akoglu Arif Karagoz 《World Journal of Emergency Medicine》 CAS 2016年第2期124-129,共6页
BACKGROUND: Appendicitis is a common disease requiring surgery. Bedside ultrasound(BUS) is a core technique for emergency medicine(EM). The Alvarado score is a well-studied diagnostic tool for appendicitis. This study... BACKGROUND: Appendicitis is a common disease requiring surgery. Bedside ultrasound(BUS) is a core technique for emergency medicine(EM). The Alvarado score is a well-studied diagnostic tool for appendicitis. This study aimed to investigate the relationship between patients' symptoms, Alvarado score and ultrasound(US) findings, as performed by emergency physicians(EPs) and radiologists, of patients with suspected appendicitis.METHODS: Three EM specialists underwent the BUS course and core course for appendicitis assessment. Patients suspected of having appendicitis were selected and their Alvarado and modif ied(m) Alvarado scores calculated. The specialists performed the BUS. Then, patients were given a formal US and surgery consultation if necessary. Preliminary diagnoses, admission or discharge from the emergency department(ED) and fi nal diagnosis were documented. The patients were also followed up after discharge from the hospital.RESULTS: The determined cut-off value was 2 for Alvarado and 3 for m Alvarado scores. The sensitivities of the two scores were 100%. Each score was used to rule out appendicitis. The results of EP-performed BUS were as follows: accuracy 70%, sensitivity 0.733, specifi city 0.673, + LR 2.24, and – LR 0.40(95%CI). Radiologists were better than EPs at diagnosing appendicitis and radiologists and EPs were equally strong at ruling out appendicitis by US. When US was combined with Alvarado and m Alvarado scores, EP US+Alvarado/m Alvarado scores ≤3 and radiology US+Alvarado/m Alvarado scores ≤4 perfectly ruled out appendicitis.CONCLUSION: BUS performed by EPs is moderately useful in detecting appendicitis. Combined with scoring systems, BUS may be a perfect tool for ruling out decisions in EDs. 展开更多
关键词 bedside ultrasound Alvarado score APPENDICITIS
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A feasibility study to determine if minimally trained medical students can identify markers of chronic parasitic infection using bedside ultrasound in rural Tanzania 被引量:1
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作者 Maria Barsky Lauren Kushner +6 位作者 Megan Ansbro Kate Bowman Michael Sassounian Kevin Gustafson Shadi Lahham Linda Joseph John C Fox 《World Journal of Emergency Medicine》 CAS 2015年第4期293-298,共6页
BACKGROUND: Parasitic infections pose a significant health risk in developing nations and are a major cause of morbidity and mortality worldwide. In the Republic of Tanzania, the CDC estimates that 51.5% of the popula... BACKGROUND: Parasitic infections pose a significant health risk in developing nations and are a major cause of morbidity and mortality worldwide. In the Republic of Tanzania, the CDC estimates that 51.5% of the population is infected with one or more intestinal parasites. If diagnosed early, the consequences of chronic parasitic infection can potentially be avoided.METHODS: Six first-year medical students were recruited to enroll patients in the study. They underwent ten hours of formal, hands-on, ultrasound which included basic cardiac, hepatobiliary, renal, pulmonary and FAST scan ultrasound. A World Health Organization protocol with published grading scales was adapted and used to assess for pathology in each patient's liver, bladder, kidneys, and spleen.RESULTS: A total of 59 patients were enrolled in the study. Students reported a sensitivity of 96% and specificity of 100% for the presence of a dome shaped bladder, a sensitivity and specificity of 100% for bladder thickening, a sensitivity and specificity of 100% for portal hypertension and ascites. The sensitivity was 81% with a specificity of 100% for presence of portal vein distention. The sensitivity was 100% with a specificity of 90% for dilated bowel.CONCLUSIONS: Ultrasound has shown a promise at helping to identify pathology in rural communities with limited resources such as Tanzania. Our data suggest that minimally trained first year medical students are able to perform basic ultrasound scans that can identify ultrasonographic markers of parasitic infections. 展开更多
关键词 Parasitic infection bedside ultrasound Computed tomography Tanzania
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The Observation on Risk of Ventilator Failure Weaning by Ultrasound bedside Monitoring of Inferior Vena Cava and Lung B Line
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作者 Zhangshun Shen Qian Zhao +2 位作者 Hongming Pan Yangjuan Jia Jianguo Li 《Open Journal of Preventive Medicine》 2020年第10期267-275,共9页
<strong>Objective:</strong> This study was designed to investigate risk of ventilator weaning by ultrasound bedside monitoring of the width of inferior vena cava (IVC) and the number of lung B-lines (B-lin... <strong>Objective:</strong> This study was designed to investigate risk of ventilator weaning by ultrasound bedside monitoring of the width of inferior vena cava (IVC) and the number of lung B-lines (B-lines). <strong>Methods:</strong> This study was conducted on 106 patients from January 2019 to January 2020 who had mechanical ventilation for more than 48 hours in an emergency care unit. They were clinically stable and had the criteria for weaning from the ventilator. Before Spontaneous Breathing Test (SBT) and 30 min or 120 min after SBT, the width of IVC and the number of B-lines in patients were monitored via bedside ultrasound. There were 87 cases of successful weaning as a control group and 19 cases of ventilator failure weaning as a study group. Changes of the width of IVC and the number of B-lines were compared in the different stages of SBT. <strong>Results:</strong> A total of 106 patients were included in this study. There were 87 cases of ventilator successful weaning and 19 cases failure weaning. The weaning success rate was 82.08%. The width of IVC and the number of B-lines in the study group were higher than those in the control group in same stage of SBT, the difference was statistically significant (P < 0.05), and which increased significantly with time. There was no significant difference in the width of IVC and the number of B-lines on the different stage of SBT in the control group (P > 0.05), and significant difference in the study group. <strong>Conclusion:</strong> The width of IVC and the number of B-lines monitored by bedside ultrasound can assess the risk of ventilator weaning, it may be caused by cardiopulmonary interaction. 展开更多
关键词 Ventilator Weaning Cardiopulmonary Interaction bedside Ultrasound IVC The Lung B Line (B-Lines) SBT
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Value of Real-Time Bedside Ultrasonography in the Etiologic Diagnosis of Acute Dyspnea
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作者 Ning Xu Zhangshun Shen +5 位作者 Chang Lv Qian Zhao Hui Guo Huiling Zhang Zhichao Ma Jianguo Li 《International Journal of Clinical Medicine》 2021年第10期441-450,共10页
<strong>Objective: </strong>To explore the value of real-time bedside ultrasonography in the etiologic diagnosis of acute dyspnea.<strong> Methods:</strong> Sixty-two patients with acute dyspne... <strong>Objective: </strong>To explore the value of real-time bedside ultrasonography in the etiologic diagnosis of acute dyspnea.<strong> Methods:</strong> Sixty-two patients with acute dyspnea who were treated in our hospital from January 2016 to December 2020 were randomly selected and their clinical data were retrospectively analyzed. All patients were randomly divided into a control group for routine examinations (n = 31) and an observation group for real-time beside ultrasonography (n = 31). The costs of medical examinations, examination duration, and diagnostic results of severe pneumonia, acute cardiogenic pulmonary edema, pulmonary embolism, chronic obstructive pulmonary disease, and pneumothorax (including sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy) of the two groups of patients were compared and analyzed. <strong>Results:</strong> Compared with the control group, the observation group had significantly shorter examinations (P < 0.05). Although the cost of medical examinations of the observation group tended to be higher, the difference between groups was not significant (P > 0.05). Moreover, there were no significant differences in left ventricular ejection fraction, left ventricular end-diastolic diameter, or brain natriuretic peptide between the two groups (P > 0.05). Comparison of the etiologic diagnosis results between the two groups showed that the observation group had significantly higher diagnostic sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for various causes compared with the control group (P < 0.05). <strong>Conclusion:</strong> Real-time bedside ultrasonography for the etiologic diagnosis of patients with acute dyspnea was quicker and had higher diagnostic accuracy;thus providing accurate guidance for the disease treatment, and having a higher promotional value in clinical practice compared with routine examinations. 展开更多
关键词 Real-Time bedside Ultrasonography Acute Dyspnea Etiological Diagnosis Clinical Diagnosis
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The Role of Bedside Troponin T Test for Identification of High Risk Patients With Acute Chest Pain
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作者 郭晓碧 冯建章 郭衡山 《South China Journal of Cardiology》 CAS 2005年第2期90-94,133,共6页
Objectives Evaluation of patients with acute chest pain when they admitted is time-consuming. We prospectively investigated the role of bedside troponin T test for predicting the risk of death and acute heart failure ... Objectives Evaluation of patients with acute chest pain when they admitted is time-consuming. We prospectively investigated the role of bedside troponin T test for predicting the risk of death and acute heart failure of patients with acute chest pain.Methods and Results 502 consecutive patients with chest pain for less than 24 hours were determined by troponin T test at bedside and quantitative troponin I test in lab. For bedside troponin T tests, there were 160 patients in positive and 323 in negative. During 30 days of followed-up. Myocardial infarction evolved in 139 patients among 160 patients in positive troponin T test, only 7 patients in negative one. Acute heart failure occurred in 51 patients among the positive group, but 37 occurred it at negative group. The odds ratio of acute heart failure of positive group vs. negative group was 3.6. Patients died 39 in positive group, 15 in negative group, the all-cause death odds ratio of positive group vs. negative group was 6.7; 31 patients died with cardiac event in positive group, 5 in negative group only. Conclusions Bedside Troponin T test is a powerful and independent predictor of death and acute heart failure for patients with acute chest pain. 展开更多
关键词 Acute chest pain bedside Troponin T Risk stratification Heart failure Diagnosis
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Implementing the First-Aid Education into the College Curriculum in China: The Efficacy Study of the First-Aid Workshop at Wenzhou-Kean University
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作者 Bowen Cao Jiaqi Lang +4 位作者 Jiayi Chen Jinze Yu Liping Tan Yu Meng Fangfang Cai 《Journal of Biosciences and Medicines》 2018年第12期79-87,共9页
In the event of an emergency, the timely and appropriate first-aid operations provided by non-medical personnel at the scene of accident before the arrival of medical professionals are crucial to help minimize the fre... In the event of an emergency, the timely and appropriate first-aid operations provided by non-medical personnel at the scene of accident before the arrival of medical professionals are crucial to help minimize the frequency in accidental induced deaths and injuries. Thus, it is essential to provide the effective first-aid training to the public. College students are considered to be the ideal candidates due to their excellent learning ability, maturity as well as the strong adaptability. Not as in most advanced countries, little education on the first aid is currently offered in Chinese universities especially those non-medical institutes. To determine the feasibility of introducing the first-aid education into the school curriculum, here we reported the study on the efficacy of the one-day first-aid training at Wenzhou-Kean University (WKU), an American-Chinese joint education institute. The general survey was initially conducted among all the freshman (n = 620) students at WKU to identify their interests as well as demand for the first-aid education. Along with the one-day first aid workshop which included both the lecture and the operation sessions, the pre-post study was performed to evaluate the efficacy of the workshop. The first-aid knowledge and skills as well as social awareness were judged before and after the training among the participants (Pre: n = 95;Post: n = 85). Results demonstrated that more than 95% of students appreciate the importance of first-aid training in universities indicating an extremely high demand. More than 40% students prefer to have the first-aid education as part of their curriculum. It also revealed that students lack professional knowledge towards the key first-aid skills such as cardiopulmonary resuscitation (CPR). The pre-post efficacy study suggested that participants’ knowledge as well as skills have been significantly improved after the workshop. The correctness rate of objective questions for CPR was raised from 68.4% to almost 100%;For Heimlich method, the accuracy rate was elevated about 2.4 fold. We also surveyed the social awareness among the participants. The ratio of people who are willing to take a leading role in emergency rescue at the accidental site with the absence of medical professionals increased from 11.5% to 23.2%. To conclude, our study indicates that the one-day first-aid workshop not only significantly improved students’ skills and knowledge, but also raised their social awareness. Therefore, there is an urgent need to implement first-aid education into the curriculum of WKU and other Chinese Universities. 展开更多
关键词 first-aid EDUCATION UNIVERSITY CURRICULUM
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Study on the Treatment Strategy of Batches of the Wounded and Partial First-Aid Procedures in Public Emergencies in Tertiary General Hospitals
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作者 Chenyu Wang Xiantao Huang +4 位作者 Xueping Zhao Limin Pan Yumei Jia Tian Tian Lijun Gao 《Open Journal of Emergency Medicine》 2021年第2期25-31,共7页
<strong>Objective: </strong>The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. &l... <strong>Objective: </strong>The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. <strong>Methods: </strong>This study analyzed the emergency treatment case that we participated in. In this case, we used various means to start the emergency plan, run the emergency procedures, optimize diagnosis, treatment, and rescue procedures, mobilize medical rescue resources, provide a reference for emergency command decisions, formulate a set of coping strategies of tertiary general hospitals on public emergencies. <strong>Results:</strong> Through the scientific and effective management of our hospital, 20 wounded have been discharged from the hospital and achieved the ideal effect of zero deaths in the hospital. <strong>Conclusions:</strong> The new mode of first-aid and health emergency management on the scene of modern disaster needs to find ways to minimize the loss of life and property brought by public emergencies, integrate the various sections of modern disaster medicine, integrate a large number of international and domestic basic and clinical research achievements of disaster first-aid, and upgrade to information, digital system. 展开更多
关键词 Public Emergency Batches of the Wounded Treatment Strategy first-aid Procedure
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风险管理联合细节干预对行床旁气管镜检查肺结核患者并发症的影响 被引量:1
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作者 徐霞 李慧 张慧 《河北医药》 CAS 2024年第4期630-633,共4页
目的探讨风险管理联合细节干预对行床旁气管镜检查肺结核患者并发症的影响。方法选择2019年7月至2020年12月接诊的80例行床旁气管镜技术检查的肺结核患者为研究对象,将其随机分为对照组和观察组,每组40例。对照组患者给予常规干预,观察... 目的探讨风险管理联合细节干预对行床旁气管镜检查肺结核患者并发症的影响。方法选择2019年7月至2020年12月接诊的80例行床旁气管镜技术检查的肺结核患者为研究对象,将其随机分为对照组和观察组,每组40例。对照组患者给予常规干预,观察组患者给予风险管理联合细节干预措施,比较2组患者的干预效果。结果观察组护理技能、文书书写、健康教育和服务态度等临床干预服务质量评分高于对照组(P<0.05)。观察组物质生活、生理健康、社会功能和心理状态等的生活质量评分优于对照组(P<0.05)。观察组的自我护理能力实施量表(ESCA)评分高于对照组(P<0.05)。观察组的护理满意度、治疗依从性高于对照组(P<0.05)。结论风险管理联合细节干预能有效降低行床旁气管镜技术检查肺结核患者的并发症发生率,提高临床服务质量。 展开更多
关键词 风险管理 细节干预 床旁气管镜技术 肺结核
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床旁超声评估早期新生儿的脊髓和椎管发育 被引量:1
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作者 徐鑫 刘玉芹 +1 位作者 魏柯香 胥萍 《西部医学》 2024年第4期575-579,共5页
目的探讨床旁超声在早期新生儿脊髓和椎管发育中的临床价值。方法收集2022年1月—8月兰州大学第二医院125例新生儿的临床资料,包括母亲的分娩次数、分娩方式、新生儿的胎龄、性别、出生天数、身高、体重、头围、胸围,并用床旁超声测量... 目的探讨床旁超声在早期新生儿脊髓和椎管发育中的临床价值。方法收集2022年1月—8月兰州大学第二医院125例新生儿的临床资料,包括母亲的分娩次数、分娩方式、新生儿的胎龄、性别、出生天数、身高、体重、头围、胸围,并用床旁超声测量颈、胸、腰椎脊髓和椎管前后径。按其胎龄分为早产儿组(32~36^(+6)周,30例)、早期足月儿组(37~38^(+6)周,39例)和完全足月儿组(39~40^(+6)周,56例)。比较脊髓和椎管前后径的组间差异及与临床资料的相关性,进一步观察脊髓和椎管前后径随胎龄变化的规律。结果完全足月儿组、早期足月儿组的脊髓和椎管前后径均大于早产儿组(P<0.05)。早期新生儿的脊髓和椎管前后径与胎龄、身高、体重、头围、胸围呈正相关,尤其早产儿组与胎龄明显相关(P<0.05)。脊髓和椎管发育无性别差异。结论床旁超声可以显示早期新生儿的脊髓和椎管前后径随胎龄而变化,其参考值将有助于评估新生儿的脊髓损伤。 展开更多
关键词 床旁超声 新生儿 脊髓 椎管 发育
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床旁健康教育视频联合PDCA循环健康教育在经皮肾镜取石术患者中的应用效果及对治疗依从性的影响 被引量:1
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作者 白静 郑亮 +4 位作者 胡小剑 胡敏 许珊 许晓梅 蔡杨萍 《临床医学研究与实践》 2024年第7期150-153,共4页
目的探讨床旁健康教育视频联合PDCA循环健康教育在经皮肾镜取石术(PCNL)患者中的应用效果及对治疗依从性的影响。方法选取2021年6月至9月行PCNL的46例肾结石患者为参考组,另选择同年10月至12月行PCNL的46例肾结石患者为干预组。参考组... 目的探讨床旁健康教育视频联合PDCA循环健康教育在经皮肾镜取石术(PCNL)患者中的应用效果及对治疗依从性的影响。方法选取2021年6月至9月行PCNL的46例肾结石患者为参考组,另选择同年10月至12月行PCNL的46例肾结石患者为干预组。参考组予以常规健康教育,干预组予以床旁健康教育视频联合PDCA循环健康教育。比较两组的干预效果。结果干预组的首次下床时间、肛门排气时间、住院时间短于参考组,术后不良事件总发生率低于参考组,差异具有统计学意义(P<0.05)。干预组的术后饮食、术后服药、术后下床活动依从率高于参考组,结石复发率低于参考组,差异具有统计学意义(P<0.05)。干预组的中文版威斯康星州肾结石生活质量量表(WISQOL)各维度评分均高于参考组,差异具有统计学意义(P<0.05)。结论床旁健康教育视频联合PDCA循环健康教育能够提高PCNL患者的治疗依从性,加速术后康复,降低结石复发率,提高生活质量。 展开更多
关键词 床旁健康教育视频 PDCA循环健康教育 经皮肾镜取石术
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急诊床旁超声心动图在反向型Takotsubo综合征诊治中的应用价值
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作者 郭朝锋 王晓静 +3 位作者 李爱菊 王红宇 孙广信 王玲 《中国中西医结合急救杂志》 CAS CSCD 2024年第2期162-166,共5页
目的探讨急诊床旁超声心动图(EB-Echo)在反向型Takotsubo综合征(r-TTS)诊治中的临床应用价值。方法采用回顾性研究方法,选择2014年1月至2021年12月郑州人民医院重症医学科收治的10例已确诊为r-TTS患者的EB-Echo影像学资料及临床资料作为... 目的探讨急诊床旁超声心动图(EB-Echo)在反向型Takotsubo综合征(r-TTS)诊治中的临床应用价值。方法采用回顾性研究方法,选择2014年1月至2021年12月郑州人民医院重症医学科收治的10例已确诊为r-TTS患者的EB-Echo影像学资料及临床资料作为r-TTS组;选择同期收治的33例经典型TTS患者的临床资料作为经典型TTS组。比较两组患者EB-Echo检出率、EB-Echo诊断时间、心脏功能指标〔左室射血分数(LVEF)、左心室每搏量(LVSV)〕、血容量指标〔下腔静脉直径(IVCD)、下腔静脉塌陷度(cIVC)〕及并发症〔急性左室流出道梗阻(ALVOTO)、急性二尖瓣反流(AMR)、肺动脉高压(PH)〕发生率及预后的差异。结果r-TTS组EB-Echo检出率明显高于经典型TTS组〔100.0%(10/10)比66.7%(22/33),P<0.05〕,且诊断时间较经典型TTS组明显缩短(min:26.80±3.77比41.18±6.61,P<0.05)。在心脏功能指标方面,r-TTS组LVEF和LVSV均明显低于经典型TTS组〔LVEF:0.36±0.05比0.41±0.04,LVSV(mL):36.43±4.30比40.65±5.09,均P<0.05〕,而r-TTS组和经典型TTS组容量指标(IVCD和cIVC)比较差异无统计学意义〔IVCD(mm):15.02±1.88比14.94±1.75,cIVC:(0.43±0.06)%比(0.44±0.07)%,均P>0.05〕。并发症方面,r-TTS组ALVOTO发生率略低于经典型TTS组〔0%(0/10)比21.2%(7/33),P>0.05〕,AMR和PH发生率与经典型TTS组相近〔AMR发生率:40.0%(4/10)比24.2%(8/33),PH发生率:30.0%(3/10)比18.2%(6/33),均P>0.05〕。随访6个月至3年,r-TTS组无死亡病例,经典型TTS组死亡1例,两组病死率比较差异无统计学意义。结论EB-Echo在r-TTS早期诊断、指导治疗、改善预后方面有重要的临床应用价值。 展开更多
关键词 急诊 床旁超声心动图 反向型Takotsubo综合征
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胃窦运动指数对ICU肠内营养病人喂养不耐受的预测价值
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作者 付红 倪秀梅 +1 位作者 宋云凤 周月琴 《蚌埠医学院学报》 CAS 2024年第7期953-956,共4页
目的:探讨床旁超声监测胃窦运动指数(MI)在预测ICU肠内营养(EN)病人喂养不耐受中的应用价值。方法:选取ICU经鼻胃管实施EN病人82例,采用床旁超声于EN喂养第1、2、3天分别测量病人MI,并评估病人喂养不耐受发生情况。通过logistics多因素... 目的:探讨床旁超声监测胃窦运动指数(MI)在预测ICU肠内营养(EN)病人喂养不耐受中的应用价值。方法:选取ICU经鼻胃管实施EN病人82例,采用床旁超声于EN喂养第1、2、3天分别测量病人MI,并评估病人喂养不耐受发生情况。通过logistics多因素回归分析EN病人喂养不耐受发生的危险因素,绘制ROC曲线分析MI对喂养不耐受的预测价值。结果:ICU病人在EN实施第1、2、3天喂养不耐受发生率分别为20.73%(17/82)、24.39%(20/82)、31.71%(26/82)。单因素分析显示,机械通气、EN启动时间、镇静镇痛药物、MI、急性生理与慢性健康评分Ⅱ是喂养不耐受发生的影响因素(P<0.05~P<0.01);多因素分析显示,机械通气、EN启动时间和MI均为喂养不耐受发生的独立影响因素(P<0.05~P<0.01)。MI预测喂养不耐受AUC为0.856,最佳截断值为0.556,敏感度为0.765,特异度为0.782。结论:ICU病人喂养不耐受发生率较高,机械通气、EN启动时间延迟及低MI是喂养不耐受发生的高危因素,监测MI值有助于预测喂养不耐受发生。 展开更多
关键词 肠内营养 胃窦运动指数 床旁超声 喂养不耐受
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床旁超声联合镇静躁动评分对ICU机械通气患者撤机的指导作用
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作者 曾金华 刘志伟 +3 位作者 刘琳 马渤键 李映笑 高坤华 《中外医学研究》 2024年第9期111-114,共4页
目的:分析床旁超声联合镇静躁动评分对ICU机械通气患者撤机的指导作用。方法:选取2022年4月—2023年3月东莞市黄江医院收治的52例ICU机械通气患者。随机将其分为对照组和观察组,各26例。对照组根据常规方式进行撤机,观察组根据床旁超声... 目的:分析床旁超声联合镇静躁动评分对ICU机械通气患者撤机的指导作用。方法:选取2022年4月—2023年3月东莞市黄江医院收治的52例ICU机械通气患者。随机将其分为对照组和观察组,各26例。对照组根据常规方式进行撤机,观察组根据床旁超声联合镇静躁动评分进行撤机。比较两组撤机成功率,临床指标,不良事件。结果:观察组撤机成功率高于对照组,差异有统计学意义(P<0.05)。观察组机械通气时间、ICU住院时间均短于对照组,死亡率低于对照组,差异有统计学意义(P<0.05)。观察组不良事件发生率低于对照组,差异有统计学意义(P<0.05)。结论:床旁超声联合镇静躁动评分在ICU机械通气患者撤机中的指导作用突出,能够保证撤机成功率,降低死亡率,缩短机械通气时间和ICU住院时间,降低不良事件发生率。 展开更多
关键词 床旁超声 镇静躁动评分 机械通气 撤机
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床旁超声在儿童脓毒性休克液体复苏中的应用价值
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作者 史海燕 刘帅 +5 位作者 耿文锦 岳燕科 许笑雷 郭莎 刘岩 徐梅先 《河北医药》 CAS 2024年第2期214-218,共5页
目的探讨床旁超声在脓毒性休克患儿液体复苏中的临床价值。方法选取2021年12月至2023年1月收治河北医科大学附属河北省儿童医院重症医学一科诊断为脓毒性休克的患儿50例,采用随机数字表法分为常规组和超声组,每组25例。患儿入院后均给... 目的探讨床旁超声在脓毒性休克患儿液体复苏中的临床价值。方法选取2021年12月至2023年1月收治河北医科大学附属河北省儿童医院重症医学一科诊断为脓毒性休克的患儿50例,采用随机数字表法分为常规组和超声组,每组25例。患儿入院后均给予抗感染、呼吸支持等对症治疗。2组均给予初始液体复苏(20 mL/kg醋酸钠林格液)。常规组在初始液体复苏后按照指南(早期目标导向治疗6 h目标)继续液体复苏;超声组在初始液体复苏后根据超声测下腔静脉内径及肺部超声检查指导后续液体复苏。比较2组液体复苏6、12 h后心率、平均动血压(mean arterial pressure,MAP)及中心静脉血氧饱和度(Systemic central venous oxygen saturation,ScvO_(2))指标变化,并比较2组患儿24 h液体入量及血管药物评分、液体复苏12、24、48 h氧合指数变化、肺水肿发生例数及28 d病死率。结果液体复苏6、12后2组患儿的心率、MAP、ScvO_(2)指标比较,差异无统计学意义(P>0.05)。超声组24 h液体总入量少于常规组,差异有统计学意义(P<0.05),24 h血管活性药物评分低于常规组,但差异无统计学意义(P>0.05)。液体复苏12 h超声组氧合指数高于常规组,但差异无统计学意义(P>0.05),液体复苏24、48 h超声组患儿的氧合指数明显高于常规组,差异有统计学意义(P<0.05)。超声组液体复苏期间发生肺水肿的例数少于常规组,差异有统计学意义(P<0.05);2组患儿的28 d病死率比较,差异无统计学意义(P>0.05)。结论床旁超声测下腔静脉内径联合肺部超声可以指导儿童脓毒性休克的液体管理,减少液体入量,优化容量状态,改善血流动力指标,降低肺水肿发生的风险,因超声具有无创性,在儿科临床应用更广泛,益于儿童。 展开更多
关键词 床旁超声 下腔静脉内径 肺部超声 儿童脓毒性休克 液体复苏
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颈总动脉流速对创伤合并休克患者容量反应性的评价
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作者 秦龙 万健 +3 位作者 张黔 陈嵩 樊聪慧 郝怿隆 《创伤外科杂志》 2024年第1期56-60,共5页
目的探讨颈总动脉呼气末及吸气末流速对评估创伤合并休克患者容量反应性的意义。方法前瞻性研究2017年7月—2019年1月上海市浦东新区人民医院重症监护室收治需要机械通气控制呼吸的创伤合并休克患者60例,根据液体复苏后是否具有容量反应... 目的探讨颈总动脉呼气末及吸气末流速对评估创伤合并休克患者容量反应性的意义。方法前瞻性研究2017年7月—2019年1月上海市浦东新区人民医院重症监护室收治需要机械通气控制呼吸的创伤合并休克患者60例,根据液体复苏后是否具有容量反应性(VR)且扩容前后心输出量(CO)变化是否≥15%将患者分为有反应(VR+组)及无反应(VR-组),各30例。VR+组男性23例,女性7例;年龄18~86岁,平均46.9岁。VR-组男性21例,女性9例;年龄18~90岁,平均46.1岁;采用迈瑞M9便携式多普勒超声取右颈总动脉长轴方向上测量两组患者呼气末最大血流速度(ex-Vmax)、吸气末最大血流速度(in-Vmax)与呼气末平均血流流速(ex-TAmax)、吸气末平均血流流速(in-TAmax),并计算出各自的变异度值:颈总动脉吸呼气末最大血流速度变异度(△Vmax)、吸呼气末平均血流速度变异度(△TAmax),分析不同组别上述数值的变化;绘制受试者工作特征(ROC)曲线,分析以上各项指标在容量反应性评估方面的价值。结果VR+组与VR-组in-Vmax[(71.72±18.67)cm/s vs.(79.47±24.04)cm/s]、in-TAmax[(40.67±11.44)cm/svs.(46.44±15.84)cm/s]比较无明显差异,但ex-Vmax[(61.00±17.84)cm/s vs.(76.86±25.28)cm/s]、ex-TAmax[(34.83±11.01)cm/s vs.(44.66±15.43)cm/s]比较差异有统计学意义(P<0.05)。VR+组与VR-组△Vmax(19.42%±14.18%vs.5.09%±13.59%)、△TAmax(18.19%±11.63%vs.4.29%±7.57%)比较差异有统计学意义(P<0.001)。ex-Vmax与ex-TAmax对创伤合并休克患者容量评估的ROC曲线下面积分别为0.695和0.678,而△Vmax与△TAmax的ROC曲线下面积均>0.800,分别是0.803和0.863,提示△Vmax、△TAmax对于创伤合并休克患者容量的评估更敏感。结论呼气末颈总动脉最大血流流速及平均血流流速、吸呼气末最大血流流速差异度及平均血流流速变异度均可用来评估机械通气创伤合并休克患者的容量反应性,且吸呼气末最大血流流速变异度及平均血流流速变异度对容量反应性的评估效果更佳。 展开更多
关键词 休克 床旁超声 颈总动脉血流流速 容量反应性
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母婴床旁及延续护理促进产妇康复效果的实证研究
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作者 谭维玉 罗蔓 +3 位作者 黄婉婷 刘文蓉 赖玉娥 卢丽佩 《中国当代医药》 CAS 2024年第7期182-188,共7页
目的探讨母婴床旁及延续护理对产妇康复的应用效果。方法选取2021年4月1日至5月27日到广西壮族自治区妇幼保健院厢竹院区产科一区收治的280例顺产、单胎的初产妇为研究对象,按照随机数字表法将其分为对照组(n=140)与试验组(n=140),对照... 目的探讨母婴床旁及延续护理对产妇康复的应用效果。方法选取2021年4月1日至5月27日到广西壮族自治区妇幼保健院厢竹院区产科一区收治的280例顺产、单胎的初产妇为研究对象,按照随机数字表法将其分为对照组(n=140)与试验组(n=140),对照组予常规护理+延续护理,试验组予母婴床旁护理+延续护理。对照组与试验组产妇及家属出院后开展电话随访、建立QQ群等延续母婴护理指导。比较两组产妇的母婴护理知识及技能、自我护理能力(ESCA)、中文版育儿胜任感(C-PSOC)、中文版压力知觉(CPSS)的评分。结果干预后,试验组产妇的母婴护理知识及技能掌握程度优于对照组,ESCA、C-PSOC评分均高于对照组,CPSS低于对照组,差异有统计学意义(P<0.05)。结论母婴床旁及延续护理指导,提高产妇母婴护理知识及技能、产妇自我护理能力、育儿胜任感,降低产妇压力感知,促进产妇康复,值得推广应用。 展开更多
关键词 家庭参与式 母婴床旁护理 延续护理 产后康复
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教育数字化转型背景下针灸学案例教学法+床边教学的教学模式研究与实践
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作者 杨春辉 张瀚元 +1 位作者 李鑫 李健睿 《中国当代医药》 CAS 2024年第32期127-131,共5页
目的探讨教育数字化转型背景下针灸学案例教学法(CBL)+床边教学的教学模式效果。方法选取2023年7月至2024年1月长春中医药大学轮转针灸科的2019级中西医临床医学专业56名学生为研究对象,将其纳入观察组,在教育数字化转型背景下对其实施C... 目的探讨教育数字化转型背景下针灸学案例教学法(CBL)+床边教学的教学模式效果。方法选取2023年7月至2024年1月长春中医药大学轮转针灸科的2019级中西医临床医学专业56名学生为研究对象,将其纳入观察组,在教育数字化转型背景下对其实施CBL+床边教学的教学模式,另选取2022年7月至2023年5月轮转针灸科的2018级中西医临床医学专业56名学生,将其纳入对照组,实施传统教学模式,比较两组学生出科成绩、综合能力提升情况、学习能力评分情况及满意度评价结果。结果观察组学生出科成绩高于对照组,差异有统计学意义(P<0.05);观察组自主学习能力、医患沟通能力、团队协作能力、解决问题能力及中医思维能力等方面综合能力提升高于对照组,差异有统计学意义(P<0.05);观察组学习能力评分均高于对照组,差异有统计学意义(P<0.05);观察组学生总满意度高于对照组,差异有统计学意义(P<0.05)。结论在教育数字化转型背景下将CBL+床边教学的教学模式用于针灸学中,有助于提高学生的成绩及学习能力,并使其综合能力得以全面提升,学生满意度高。 展开更多
关键词 针灸学 案例教学法 床边教学 综合能力 学习能力
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床旁脉冲预处理对流产吸引管清洗质量的影响
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作者 刘燕梅 李莲英 +3 位作者 徐娟兰 黄小霞 桂华明 李丽冰 《中国当代医药》 CAS 2024年第25期133-136,共4页
目的通过对流产吸引管预处理方法进行改进,探索预处理时机与方法对管腔器械清洗质量的影响。方法选取2020年7月至2022年7月梧州市红十字会医院使用的600件流产吸引管为研究对象,按照抽签分组法分为A组(n=200)、B1组(n=200)和B2组(n=200)... 目的通过对流产吸引管预处理方法进行改进,探索预处理时机与方法对管腔器械清洗质量的影响。方法选取2020年7月至2022年7月梧州市红十字会医院使用的600件流产吸引管为研究对象,按照抽签分组法分为A组(n=200)、B1组(n=200)和B2组(n=200)。A组预处理采用在流产吸引管使用后马上床旁使用负压吸引恒温多酶清洗剂进行脉冲冲洗管腔内壁方式进行处理;B1组和B2组预处理采用在流产吸引管使用后马上采用流动水下冲洗管腔内壁进行处理。经预处理的器械均放置3 h后集中回收到供应室进行进一步处理,A组直接放入超声波清洗机超声清洗5 min;B1组在常温多酶洗剂内浸泡20 min后再放入超声波清洗机超声清洗5 min;B2组在常温多酶清洗剂内浸泡15 min后用毛刷在液面下贯通管腔来回刷洗5次后再放入超声波清洗机超声清洗5 min。比较三组器械清洗质量。结果A组残留蛋白检测合格率、隐血试验合格率、白色通条检查合格率、带光源放大镜检查合格率均高于B1组和B2组,差异有统计学意义(P<0.001)。结论改进预处理方法将器械有效预处理的地点前移至使用科室,预处理时间前移至术后即时,既践行行业标准,又改进预处理方法,抓住污染管腔器械最佳处理时间以及酶洗剂最强效果,利用脉冲原理使污物从管腔内壁剥离达到理想的预处理效果,进而提高器械清洗质量。 展开更多
关键词 床旁脉冲预处理 管腔器械 清洗质量 消毒供应室
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