护理干预在多层螺旋CT增强检查急症主动脉夹层中的应用

[目的]探讨护理干预在多层螺旋CT增强检查急症主动脉夹层中的作用。[方法]对50例病人行急症主动脉夹层多层螺旋CT增强检查,检查过程中给予有效的护理干预,严密观察病情,积极控制血压,给予止痛治疗等。[结果]50例病人经临床与CT室医护人员共同配合,严密监护,44例顺利完成平扫及增强扫描。无意外情况发生或不合作而中断检查,影像显示满足诊断要求。6例因胸前区剧烈疼痛,配合不理想,经镇静、镇痛、屏气训练、心理暗示及安慰等护理干预后,顺利完成检查。[结论]多层螺旋CT增强对急症主动脉夹层的明确诊断具有独特的优越性,实施正确的护理干预是取得检查成功的关键。

胫骨高位截骨术与腓骨近端截骨术治疗膝关节内侧间室骨关节炎疗效比较

膝骨关节炎(KOA)是一种以膝关节软骨退变和骨质增生为特征的慢性退行性疾病,临床主要表现为膝关节肿胀、疼痛、变形、功能活动受限等,多发于50岁以上中老年女性人群,且以膝关节内侧间室骨关节炎最为常见,其发病趋势不断攀升,严重影响患者生活质量[1]。目前临床治疗KOA方法多样,常见的手术方式有膝关节镜清理术。

The effect of five-knee-point acupuncture combined with herbal package warm compress for knee osteoarthritis

Objective:To observe the therapeutic effect differences among five-knee-point acupuncture combined with Chinese medication package warm compress therapy of Shēntòng Zhúyū Decoction(身痛逐瘀汤 generalized pain stasis-expelling decoction),simple five-knee-point acupuncture and simple Chinese medication package warm compress therapy of Shēntòng Zhúyū Decoction in treating knee osteoarthritis(KOA).Methods:A total of 126 KOA patients were randomized into a five-knee-point acupuncture combined with Chinese medication package warm compress therapy group(combined treatment group),where there were 42 cases,including 28 cases of unilateral KOA and 14 cases of bilateral KOA,totally 56 affected knees involved,a Chinese medication package warm compress therapy group(medication package group,42 cases,including 22 cases of unilateral KOA,20 cases of bilateral KOA,totally 62 affected knees involved)and a five-knee-point acupuncture group(five-knee-point group,42 cases,including 27 cases of unilateral KOA,15 cases of bilateral KOA,totally 57 affected knees involved).The basic health education was provided in all of the groups.Additionally,in the combined treatment group,acupuncture was applied to the five knee points on the affected side for 30 min.The warm compress with herbal package of Shēntòng Zhúyū Decoction was given for 10 to 15 min.In the medication package group,the warm compress with Shēntòng Zhúyū Decoction was exerted on the affected area for 10 to 15 min.In the fiveknee-point group,acupuncture was applied to SP 10,ST 34,EX-LE 2,EX-LE 4 and ST 35 and the needles were retained for 30 min.The treatment in each group was given once a day,consecutively for 2 weeks.Before and after treatment,the visual analogue scale(VAS)and Lysholm knee scale were adopted to evaluate the pain degree and knee joint motor function in KOA patients.The clinical therapeutic effects were evaluated too.Results:A total of 121 cases accomplished the final observation and 5 cases were dropped out in the three groups,in which,2 cases(2 affected knees)were dropped out in the combined treatment group,1 case(2 affected knees)in the medication package group and 2 cases(3 affected knees)in the fiveknee-point group.VAS scores after treatment were all lower than those before treatment in the three groups and the scores of Lysholm knee scale were all higher than those before treatment,indicating the significant differences(all P<0.05).The total effective rate was 98.1%(53/54)in the combined treatment group,which was higher than 86.7%(52/60)in the medication package group and 92.6%(50/54)in the five-knee-point group,indicating the significant differences(all P<0.05).After treatment,VAS score(2.24±1.24)in the combined medication group was lower than(2.48±1.08)in the medication package group and(2.63 ± 1.44)in the five-knee-point group,presenting the significant difference(all P<0.05).The score of Lysholm knee scale was(60.50±13.76)in the combined medication group,higher than(52.23±11.65)in the medication package group and(52.14±11.77)in the five-knee-point group,indicting the significant differences(all P<0.05).Conclusion:Compared with the simple application of Chinese medication package warm compress therapy of Shēntòng Zhúyū Decoction or the five-knee-point acupuncture therapy,five-knee-point acupuncture combined with Shēntòng Zhúyū Decoction relieves the clinical symptoms of KOA patients more effectively and achieves a better clinical therapeutic effect.

高龄股骨粗隆间骨折的微创手术治疗

目的探讨高龄股骨粗隆间骨折微创治疗效果。方法收治80岁以上股骨粗隆间骨折174例,对骨折类型、术前原发病、手术方法、术后并发症等方面进行分析。骨折均以微创内固定治疗,方法有DHS和Gamma钉、PFN。结果本组140例不同种类和不同程度的内科疾病,平均患病2.5种,123例获得随访,功能评价优良率87%。结论术前充分评估并治疗术前疾病,采用微创内固定治疗高龄股骨粗隆间骨折疗效优良。