Analysis of the Necessity of Stellate Ganglion Block after Anesthesia to Reduce the Risk of Cardiovascular Accidents in Coronary Heart Disease

Objective:To adjust the sympathetic nervous system through preoperative ultrasound-guided stellate ganglion block and to explore and analyze the situation and necessity of postanesthesia stellate ganglion block to reduce the risk of cardiovascular accidents in coronary heart disease.Methods:80 patients with cardiovascular risk factors in Songshan Hospital of Chifeng were selected,and the time span would cover from October 2022 to June 2024,with 80 cases of elective surgery and combined coronary heart disease.They will be randomly divided into blocked groups and conventional groups,40 cases each.Conventional block was performed after anesthesia in patients in the conventional group,and planetary ganglion block was performed after anesthesia in patients in the blocked group.The cardiovascular responses of patients in the two groups were observed,and the number of intraoperative cardiovascular active drugs and the occurrence of cardiovascular adverse events were recorded in patients in the two groups.Results:Analysis of the mean arterial pressure(MAP)and heart rate(HR)values of the two groups of patients at the time points before anesthesia(T0),the moment of tracheal intubation(T1),the moment of surgical skin cutting(T2),the end of the operation(T3),and the 6h postoperative period(T4)showed that the MAP and HR of the blocked group were lower than those of the conventional group at the time points of T1 to T4,and the differences in MAP and HR values of the two groups in different time points compared with the T0 time point were statistically significant(P<0.05)and the differences in cardiovascular response(P<0.05)were statistically significant(P<0.05).significance(P<0.05).The number of intraoperative cardiovascular active drugs used in the blocked group was shorter than that in the conventional group,and the incidence of cardiovascular adverse events was lower than that in the conventional group,with a statistically significant difference(P<0.05).Conclusion:By implementing preoperative ultrasound-guided stellate ganglion block in patients with cardiovascular risk factors,the frequency and degree of coronary heart disease symptoms will be reduced,thus reducing the risk of patients,which is worth promoting.

南京市臭氧短期暴露人群急性健康效应研究

目的探讨南京市臭氧(O3)短期暴露对人群的急性健康影响。方法整理2013—2015年南京市气象数据、O_3与PM(2.5)监测数据及人群非意外死亡等数据,采用Possion分布广义相加模型(GAM),分析O3短期暴露水平(O3每日最大1h浓度,O_(3 1h-max))与人群非意外死亡风险之间的相关性。结果单污染物模型中,O3 1h-max多日移动平均滞后效应强于单日滞后,且在lag03时最强。O_(3 1h-max)浓度(lag03)每升高10μg/m^3,人群非意外死亡风险增加0.79%(95%CI:0.50%~1.09%),心血管疾病死亡风险增加1.25%(95%CI:0.78%~1.72%);其中女性非意外死亡风险增加0.97%(95%CI:0.53%~1.41%),男性增加0.66%(95%CI:0.27%~1.05%);≥65岁人群增加0.90%(95%CI:0.57%~1.23%)。双污染物模型中,调整了共存污染物PM2.5的影响后,非意外死亡风险和心血管疾病死亡风险分别降至0.42%(95%CI:0.22%~0.63%)、1.19%(95%CI:0.72%~1.67%)。结论南京市O3短期暴露能增加人群非意外死亡、心血管系统疾病死亡的风险,女性和65岁以上老年人为暴露的敏感人群。

2017-2018年闽近地面臭氧污染对人群健康的影响

目的探讨闽近地面臭氧污染对人群健康的影响。方法选取2017—2018年福建50个代表性监测点,运用泊松广义相加模型时间序列方法分析O3暴露对闽人群各死因的健康风险及置信区间95%CI。结果2017—2018年近地面O3浓度升高(lag2)10μg/m^3研究区域人群非意外总死亡和心脑血管疾病死亡风险分别增加0.57%[95%CI(0.40%,0.74%)]和0.55%[95%CI(0.28%,0.83%)],调整PM10共存污染物的影响后分别降至0.47%[95%CI(0.28%,0.66%)]和0.35%[95%CI(0.04%,0.66%)],仍有统计学意义;全省冬季风险最高,但区域之间存在效应异质性(P=0.043和P=0.008),体现在沿海的效应明显,分别为0.87%[95%CI(0.32%,1.42%)]和1.23%[95%CI(0.18%,2.27%)],而山区则无统计学意义;全省秋季和夏季效应都无统计学意义。脑血管疾病和呼吸系统疾病死亡风险在调整PM10共存污染物的影响后都失去统计学意义。结论2017—2018年近地面O3暴露与福建人群非意外总死亡和心脑血管疾病死亡风险增加密切相关,沿海冬季O3浓度升高滞后2天效应显著。

坠床/跌倒高危评估在心内科患者安全管理中的应用

目的探讨在心内科应用坠床/跌倒高危评估对患者的安全管理。方法对2008年11月～2011年4月心内科收治的5311例患者进行了高危坠床/跌倒评估。结果通过坠床/跌倒高危评估在患者安全管理中的应用,减少并防范了院内坠床/跌倒发生,保证了心内科住院患者的安全,达到了安全目标。结论通过介绍坠床/跌倒高危评估在患者安全管理中的应用,提出建立高危坠床/跌倒评估体系,制定相应有效的护理措施,实施三级质量控制,减少了住院患者坠床/跌倒的发生,提高了护士的安全管理意识,融洽了护患关系,提高了患者对护理服务的满意度。

上海市日平均气温对居民死亡数的滞后效应研究

目的了解上海市日均气温对居民每日非意外死亡、心血管疾病死亡和呼吸系统疾病死亡的关系。方法根据上海市2001年1月1日至2008年12月31日每日居民死亡资料和同期气象指标及大气污染指标，采用非线性分布滞后模型，在控制长期趋势、季节趋势和其他混杂因素后，研究日均气温与日非意外死亡数、心血管疾病死亡数和呼吸系统疾病死亡数之间的关系。结果上海市日均气温对非意外死亡、心血管疾病死亡和呼吸系统疾病死亡效应曲线均为J形。冷效应具有延迟性，在滞后1d开始出现，4d达到最高，持续14～30d。热效应表现为急性效应，以当天最高，持续2d，呈现出明显的收获效应。结论高温和低温均是上海市居民每日死亡的危险因素，存在滞后效应，且低温效应的滞后时间长于高温。

气温对2007～2013年济南市人群慢性非传染性疾病死亡的归因风险研究

目的采用归因风险评估分析气温与健康结局之间的关系,补充公共卫生学方面的证据。方法收集济南市2007~2013年逐日气温与非意外死亡、心血管疾病死亡和呼吸系统疾病死亡的逐日死亡数据,采用分布滞后非线性模型的归因风险评估方法,分析气温暴露造成人群死亡的归因风险,并进一步探索气温对敏感人群的风险。结果济南市日均气温与非意外死亡/心血管疾病死亡/呼吸系统疾病死亡的累积暴露-反应关系曲线近似呈U型;由气温导致的归因风险比例分别为13.2%(95%CI:9.6~16.8)/17.0%(95%CI:12.6~20.8)/27.8%(95%CI:-2.5~50.5)。低温对女性、老年人和教育水平较低者影响较大。结论高温或低温均可增加人群不同疾病死亡风险,但是低温效应的归因比例高于高温的作用。