静脉输液患者的心理护理

静脉输液是临床上迅速有效的治疗手段 ,在静脉穿刺中对患者进行的心理护理是减轻患者痛苦 ,提高静脉穿刺成功率的重要环节。为了具体掌握静脉穿刺中的心理护理重点 ,笔者在临床工作中作了一些探索并加以总结。现报告如下。1　临床资料和方法　　随机抽出老、幼、中青年静脉输液患者 43例 ,分为无心理护理组 1 7例 ,有心理护理组 2 6例 ,两组对比观察。　　有心理护理组按如下 5种方法对患者进行护理。 (1 )希望法。直接向患者介绍通过输液治疗后的效果 ,尤如在患者眼前展现一条通往康复的希望之路 ,可对患者说些“对你来说 ,输液的效果最好…     

静脉输液反应的护理(附26例报告)

静脉输液是儿科临床最常用、最可靠的给药方法,而输液反应是静脉输液过程中最常见的副反应,其原因很多,与输入致热原、输液时间过长或药物过敏、患儿体质等因素有关,必须引起高度重视,并做好防治工作.本科收治26例输液反应者,均为住院病人,全部治愈出院.     

三级甲等综合医院住院患者静脉输液收费水平分析

目的 反映某省三级甲等综合性医院住院患者静脉输液现状,为《全国医疗服务价格项目规范（2012年版）》静脉输液项目价格调整提供参考。方法 采用调查表的方式对7家三级甲等综合性医院部分科室268位住院患者静脉输液组数及收费水平进行调查。结果 （1）268位住院患者共计住院3456天,静脉输液共计11246次（含续点）,人均静点次数为41.96次,日均静点次数为3.25次;共使用普通输液器4906个,三通788个,人肝素帽32个。（2）268位住院患者静脉输液项目合计日均收费18.45元/日,其中项目本身日均收费12.7元/日,占合计日均收费的68.85%,三种耗材日均收费合计5.75元/日,占合计日均收费的31.15%。讨论 静脉输液项目价格调整应进一步体现护理人员的技术劳务因素;静脉输液项目价格调整应考虑低值易耗品价格因素;兼顾原则性和灵活性,适当考虑对某些特殊专科予以特别考量。     

品管圈在提高静脉输液速度准确率中的应用

目的:通过品管圈活动提高静脉输液速度准确率。方法:成立品管圈活动小组,以提高静脉输液速度准确率为主题展开调查研究,针对要因提出方案并实施。结果:通过品管圈活动前后对比,得出进步率为62.24%,高出预期完成计划。     

注射用完全静脉营养输液

<正> 氨基酸同碳水化合物在静脉营养输液中的应用,已较长时间了,但注射用脂肪加入输液中,要有一定的难度。因为脂肪不溶于水,需经乳化剂作用后形成稳定的乳状液,亦可做静脉注射用,其关键是对乳化剂的选用。对不同乳化剂的使用上,早已被人们所     

门诊静脉输液不良反应的观察与护理干预

静脉输液是一种快速、有效的补液、给药方法,在病人的抢救、治疗和康复中占有重要地位。但静脉输液过程中可偶发不良反应,如晕针、药物过敏反应,甚至过敏性休克,寒颤、发热,恶心、呕吐,出血及血肿,急性肺水肿等,轻者造成患者的痛苦,重者可能危及生命。因此,     

新型排气法与传统排气法在静脉输液中的效果观察

目的观察比较新型排气法与传统排气法在临床护理静脉输液中的应用效果。方法从责任护理组每周一、三、五上午静脉输液患者中抽取80例次为对照组,每周二、四、六上午静脉输液患者中抽取80例次为观察组。对照组静脉输液时采用传统排气法,观察组采用新型排气法。比较两种排气方法一次性排气成功率、排气时间、排气浪费药液情况。结果观察组一次性排气成功率高于对照组,排气时间、排气时浪费的药液损失量低于对照组(P0.05)。结论新型排气法提高了一次性排气成功率,节约了排气时间,提高了护士工作效率,同时也减少了药液损失量,避免潜在的院感发生,提高了患者的满意度。     

浅谈输液过程中易出现的问题及对策

静脉穿刺输液技术为临床患明确诊断,给予治疗及抢救提供了极为方便的途径,但随着医学技术的飞速发展,这一普通的护理技术也有了高标准的要求,现将有关静脉穿刺输液过程中需注意的问题综述如下。     

年老体弱患者手背浅静脉穿刺方法的改进与应用

静脉输液是临床护理工作的基本操作．在护理工作中占仃非常重要的地位,在很大程度上决定着护理人员操作水平的高低及患者的治疗效果。在静脉输液的过程中,尤其是对老年、体弱的病人或应用特殊药物时．运刷常规静脉输液的方法常会出现穿刺失败或引发静脉炎而增加病人的痛苦。     

新生儿静脉输液致静脉炎的原因分析及防治

目的 探讨新生儿静脉输液致静脉炎的防治措施,以减少静脉炎的发生.方法 通过对新生儿静脉输液致静脉炎的原因分析,比较护士培训前后新生儿静脉炎的发生情况.结果 护士经过培训后采用一系列的预防及治疗措施,明显减少了新生儿静脉炎的发生率.结论 提高护士防治静脉炎的意识并实施各项防治措施,可降低新生儿静脉输液所致静脉炎的发生率,提高治愈率.     

Multiple subcutaneous injections of somatostatin induce tachyphylaxis of the suppression of plasma insulin, but not glucagon, in the rat

The time course of pancreatic effects of somatostatin was studied over a period of 2 h in unanesthetized unrestrained rats after administration of the peptide by intravenous infusion and by single and multiple subcutaneous injections. During infusion of 10 and 30 micrograms/kg per min, somatostatin continuously suppressed plasma insulin and plasma glucagon. Plasma glucose was significantly increased at the lower dose, but not affected at the higher dose. Single subcutaneous injections of 0.3 and 3 mg/kg decreased plasma insulin and glucagon dose-dependently for 20-60 min without affecting plasma glucose. Multiple subcutaneous injections of somatostatin (one to four doses of 3 mg/kg, administered at intervals of 30 min) caused an initial decrease of plasma insulin (at 30 min), a rebound-increase at 60 and 90 min, and a final return to control values by 120 min. Plasma glucagon remained continuously suppressed. Plasma glucose increased significantly at 60 and 90 min and tended to return towards control values thereafter. In conclusion, pancreatic B cells - but not A cells - of the rat develop tachyphylaxis to somatostatin within 2 h after multiple subcutaneous injections of the peptide. By this mode of administration, 'selective' suppression of plasma glucagon can be achieved with somatostatin in the rat.     

A novel in vitro pharmacokinetic/pharmacodynamic model based on two-compartment open model used to simulate serum drug concentration-time profiles

An in vitro pharmacokinetic/pharmacodynamic perfusion model that simulates a two-compartment open model of serum drug concentration-time profiles following intravenous bolus injection and infusion was developed and mathematically described. In the present apparatus model, flow was kept in a one-way mode to avoid liquid traffic, and the washout effect seen in dilution models was overcome by embedding the tested bacteria in low melting point agarose gel. The validity of the equations and the reproducibility of the apparatus model were ascertained by simulating the concentration-time profiles of cefazolin and fosfomycin by substitution of their pharmacokinetic parameters obtained from humans for the equations. An empirical regimen 1X(q24h) of 1 g with cefazolin administered by intravenous infusion effectively killed a Staphylococcus aureus strain. The same regimen with fosfomycin produced a marked kill-curve with a fosfomycin-susceptible enterohaemorrhagic Escherichia coli O157:H7, whereas considerable regrowth was observed with a resistant strain. These results indicated that the present model was able to provide a convenient and reliable method for evaluating the efficacy of antimicrobial agents administered by intravenous infusion.     

靶控输注静脉麻醉和腰硬联合麻醉对直肠癌根治术患者免疫功能的影响研究

目的：探讨靶控输注静脉麻醉和腰硬联合麻醉对直肠癌根治术患者免疫功能的影响。方法：选择在我院行直肠癌根治术的72例患者,将其分为观察组和对照组各36例,其中观察组给予靶控输注静脉麻醉,对照组采用腰硬联合麻醉,对两组患者手术时间、术中出血量以及免疫球蛋白水平（IgG、IgA、IgM）、血清白介素-6水平（IL-6）、肿瘤坏死因子α水平（TNF-α）以及T细胞亚群（CD3、CD4）水平进行对比。结果：观察组手术平均时间为（130．5±11．7）min,术中平均出血量为（271.3±37．8）ml,与对照组比较差异均无统计学意义（P〉0．05）;两组IgG、IgA及IgM,在T1、T2、T3及T4时刻水平比较差异均无统计学意义（P〉0．05）;两组IL-6、TNF-α、CD3及CD4在麻醉后较T1时均有明显变化,比较差异均有统计学意义（P〈0．05）,且观察组变化较对照组更为明显,两组比较差异有统计学意义（P〈0．05）。结论：靶控输注静脉麻醉和腰硬联合麻醉对直肠癌根治术患者免疫功能均存在抑制作用,且以抑制细胞免疫功能为主,而腰硬联合麻醉抑制作用较低,值得推广应用。     

靶控输注静脉麻醉和腰硬联合麻醉对直肠癌根治术患者免疫功能的 影响研究

目的：探讨靶控输注静脉麻醉和腰硬联合麻醉对直肠癌根治术患者免疫功能的影响。方法：选择在我院行直肠癌根治术的 72 例患者,将其分为观察组和对照组各36 例,其中观察组给予靶控输注静脉麻醉,对照组采用腰硬联合麻醉,对两组患者手术时 间、术中出血量以及免疫球蛋白水平（IgG、IgA、IgM）、血清白介素-6 水平（IL-6）、肿瘤坏死因子-a 水平（TNF-a）以及T 细胞亚群 （CD3、CD4）水平进行对比。结果：观察组手术平均时间为（130.5± 11.7）min,术中平均出血量为（271.3± 37.8）ml,与对照组比较差 异均无统计学意义（P>0.05）;两组IgG、IgA 及IgM,在T1、T2、T3 及T4 时刻水平比较差异均无统计学意义（P>0.05）;两组IL-6、 TNF-a、CD3 及CD4 在麻醉后较T1 时均有明显变化,比较差异均有统计学意义（P<0.05）,且观察组变化较对照组更为明显,两组 比较差异有统计学意义（P<0.05）。结论：靶控输注静脉麻醉和腰硬联合麻醉对直肠癌根治术患者免疫功能均存在抑制作用,且以 抑制细胞免疫功能为主,而腰硬联合麻醉抑制作用较低,值得推广应用。     

全凭静脉麻醉期间右美托咪定对靶控输注丙泊酚用量及血流动力学的影响

目的：探讨右关托咪定（dexmedetomidine,DEX）对行全凭静脉麻醉患者靶控输注（target controlled infusion,TCI）丙泊酚用量及拔管期间血流动力学的影响。方法：选择拟于全麻下行经鼻蝶窦垂体瘤切除术的患者30例（ASA I～II级）,随机分为两组,每组15例。试验组（D组）给予DEX负荷剂量0．5μg·kg-1,注药时间15rain,继以0．3μg·kg-1·h-1持续输注至修补硬膜时;对照纽（N组）在相同时间给予等容量生理盐水。两组麻醉诱导方法相同,术中以脑电双频指数（bispectral index,BIS）为麻醉深度监测指标,根据BIS值调节丙泊酚血浆靶浓度维持麻醉。记录拔管期间收缩压（SBP）、舒张压（DBP）和心率（HR）,并计算心肌氧耗指数（RPP）;记录丙泊酚平均用量、用药前后BIS值、呼吸恢复时间、睁眼时间、拔管时间及术中不良反应。结果：①D组给予负荷剂量后,BIS值由（95±3）降至（77±11）,差异有统计学意义（P〈0．01）。②与N组相比,D组丙泊酚用量减少28％,差异有统计学意义（P〈0．01）。⑧拔管期间SBP、DBP和HR与入室时比较,D组无明显变化,N组HR显著升高（P〈0．05）;D组拔管期间SBP、DBP、HR和RPP明显低于N组（P〈0．05）;④两组患者呼吸恢复时间、睁眼时间及拔管时间差异均无统计学意义;⑤两组不良反应（心动过缓、高血压、低血压）的发生率无显著性差异。结论：术中持续静脉输注DEX可减少TCI丙泊酚用量,能使BIS值进一步降低,产生良好镇静效应;同时可有效减轻拔管期间循环变化,降低RPP,减少心肌耗氧量,提高拔管质量。     

Subcutaneous implantable infusion device for chronic intravenous pulsatile gonadotropin-releasing hormone treatment

Preliminary data indicate the potential utility of an implantable subcutaneous device that facilitates chronic intravenous infusion of pulsatile gonadotropin-releasing hormone (GnRH) for ovulation induction. GnRH distribution curves were congruent in control monkeys and those with implanted devices. Tissue tolerance was good in this brief trial. These findings suggest that use of this or a similar implantable device be considered for chronic GnRH administration in human pulse therapy.     

静脉输注新型溶瘤腺病毒在体内复制活性与抑瘤的关系*

目的:观察新型溶瘤腺病毒M1在体内代谢的时间及对肿瘤生长的抑制作用。方法:建立人胃癌裸鼠原位移植瘤动物模型,在指定时间点处死动物,观察瘤体大小,分离原发瘤及转移瘤进行病毒滴度测定,采用免疫组化及原位杂交来检测病毒的分布和活性复制。结果:在人胃癌裸鼠原位模型上,M1经静脉输注后不仅分布于胃原发瘤,而且存在于转移灶,但用M1静脉内给药可以减缓肿瘤生长速度。结论:静脉内输注溶瘤腺病毒可以选择性的作用于肿瘤及转移灶,并发挥溶瘤和靶向灭活plk1的双重效应。     

Gonadotropin-releasing hormone infusion interval: importance in pharmacodynamics

Circulating gonadotropin-releasing hormone (GnRH) levels were measured during and after intravenous infusion intervals ranging from 0.08 minutes to 5 minutes and doses ranging from 1 to 25 micrograms per pulse. In all dose groups (1 vs. 5 vs. 25 micrograms), the peak levels of GnRH decreased from the 0.08 minute to the 5 minute infusion interval. Our results suggest that the infusion interval over which GnRH is administered has profound effects on the amount, duration, and pattern of GnRH measured in the peripheral circulation.     

不同胰岛素给药方式救治糖尿病酮症酸中毒临床研究

目的：比较不同胰岛素给药方式治疗糖尿病酮症酸中毒（DKA）的临床疗效。方法：82例DKA患者随机分为胰岛素泵持续皮下输液胰岛素（CSⅡ）组和微量泵持续静脉泵入胰岛素（CXqI）组各41例,分别给予胰岛素泵持续皮下输注胰岛素和小剂量胰岛素持续微量泵静脉泵入不同胰岛素给药方式,观察两组治疗后血糖变化、血糖达标时间、尿酮体变化、pH值变化、胰岛素平均日用量、平均低血糖次数及平均住院时间。结果：两组治疗后空腹血糖、餐后血糖显著下降及血糖达标时间显著缩短差异无统计学意义（P〉0．05）;CSII组尿酮体转阴时间（22．3±7．4）h短于CVII组（32．1±12．1）h（P〈0．01）;CSII组PH值恢复时间（9．4±2．5）h短于CVII组（15．7±3．5）h（P〈0．01）;CSII组平均胰岛素日用量为（47±5）U比CVII组（58＋7）U少（P〈0．01）;CSII组人均低血糖次数为（0．6±O．5）次／人。少于CVII组（1．5±0．8）次／人（P〈O．01）;CSII组住院时间（9．8±1．2）天明显比CVII组（12．5±2．0）天短（P〈0．01）。结论：CSII相较于CVII能更快更有效的纠正代谢紊乱,减少胰岛素日用量,缩短住院时间,从而提高临床疗效。具有较高的安全性及患者依从性。     

Post-ruminal or intravenous infusions of carbohydrates or amino acids to dairy cows 2. Late lactation

The objectives of this study were to compare the effects of post-ruminal and intravenous infusions of wheat starch or glucose (CHO) or a mixture of amino acids (AA) on milk protein yield, nitrogen (N) utilisation, plasma metabolites and mammary extraction rate of dairy cows in late lactation. Eight cow, ruminally fistulated, was assigned to two 4 × 4 Latin squares during 14-day periods, where the last 7 days were for infusions. Infusions were: (1) starch in the abomasum (SP), (2) glucose in the blood (GB), (3) AA in the abomasum (AP), and (4) AA in the blood (AB). The experiment started 165 ± 4 days (mean ± s.e.) post partum (milk yield 22.5 ± 1.1 kg) Daily amounts of nutrients infused were 257, 283, 233, and 260 g for SP, GB, AP and AB, respectively. The cows were fed a basal diet consisting of a concentrate mixture and grass silage (55:45 on a dry-matter (DM) basis), where total dry-matter intake (DMI) was 13.3 kg/day. Milk production was affected by site of infusion within substrate, whereas infusion substrates within infusion site (CHO or AA) were of minor importance. Responses to intravenous infusions (GB or AB) were similar to those in early lactation, but more pronounced. Compared with SP infusion, GB infusion increased ( P < 0.05) milk yield, energy-corrected milk (ECM), protein and lactose yield by 1.4 and 0.9 kg, 38 and 59 g, respectively. The AB infusion had 1.4 and 1.3 kg, 51, 52 and 50 g higher ( P < 0.05) milk yield, ECM, protein, fat and lactose yields than the AP infusion, respectively. N balance data indicated higher losses of metabolic faecal nitrogen (MFN) by abomasal than by intravenous infusions, but the catabolism of AA was lower than in early lactation indicated by no difference ( P < 0.05) in urinary N excretion between treatments. Intravenous AA infusion increased plasma glucose and insulin above that of intravenous glucose infusion. The treatment effects on plasma insulin concentrations were higher in late than in early lactation, suggesting a higher sensitivity in late lactation even at similar negative energy balance. Compared with the SP infusion, GB infusion showed lower ( P < 0.05) concentrations of essential AA (EAA) and branched-chain AA (BCAA) resulting in a higher AA utilisation because of a higher milk protein production. AP infusion increased ( P < 0.05) plasma non-essential AA concentration compared with AB infusion, but infusion site of AA had no effect ( P>0.05) on plasma EAA or BCAA. It is concluded that it is the nutrient supply and not the lactation stage per se that is important for the response in milk production. Nevertheless, stage of lactation affects the N metabolism and the response in plasma hormone concentrations even when cows are in negative energy balance in both lactation stages.