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简介:摘要目的分析管道标识在ICU护理安全中的临床应用效果。方法选取2012年12月~2014年12月我院收治的使用管道标识护理的ICU重症患者84例为观察组,同时随机选择使用管道标识前的ICU重症患者84例为对照组,对两组患者给药差错、更换管道差错等护理差错和对护理服务的满意程度等情况进行对比分析。结果观察组患者给药差错、更换管道差错等护理差错的发生率和患者、家属对护理服务的满意程度等情况均明显优于对照组,具有统计学意义(p<0.05)。结论在对ICU重症患者实施护理服务的过程中,管道标识的运用可以有效的提高护理人员风险防范的意识,减少了护理缺陷和给药差错、更换管道差错等护理差错的发生,更好的体现出“以人为本”的护理理念,具有显著安全性和效果,值得临床应用和推广。
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简介:ObjectivesToreportauthors'experiencesinthediagnosisandtreatmentsofcongenitalfirstbranchialfistula(congenitalauriculocervicalfistula).MaterialsandMethodsTwelvecasesofcongenitalfirstbranchialfistulawerereviewed.Ofthese,8underwentfistulectomywithfacialnervedissectionandpartialparotidectomyand4underwentsimplefistulectomy.ResultsTheinneropenings(upperopening)offistulaelayinthefollowingsites:inferioposteriorwallatthejunctionofcartilaginousandbonysegmentsoftheauricularcanalandinferiorwallofcartilaginousauricularcanal.Theouteropenings(loweropening)layalongtheanteriorborderofuppersternocleidomastoidmuscle,atthemastoidtipandposteriortothemandibularangle.Completefistulaeresectionwasachievedinallbutonecase.Elevencaseswerefollowedfor5yearwithnorecurrence.Recurrenceoccurredin1case6monthsaftertheprimarysurgeryandrevisionsurgerywasperformed.ConclusionsPre-operativeradiographyforthelocationandcourseofthefistulaiscrucialforsuccessfulfistularesection,especiallyincaseswithpastinfections.Facialnervedissectionshouldbedoneroutinelyfordeeplylocatedfistulae.
简介:目的:通过对线粒体DNA1555/1494突变耳聋文献病例进行分析,总结患者听力学特点,探讨影响耳聋程度的相关因素。方法以“线粒体DNA1555/1494突变”和“感音神经性聋”为主题词,检索中文CNKI、万方、维普数据库,英文PubMed数据库,进行文献回顾。对线粒体DNA1555/1494突变耳聋患者病例进行基本信息和听力学相关信息统计,按照性别、基因突变信息、是否应用氨基糖甙类抗生素、用药年龄、用药情况、发病间隔、发病年龄、单倍型、突变异质率以及耳聋程度等相关项目编辑excel表格,按需要导入SPSS19.0软件分析。结果共收集到符合要求的文献39篇,资料完整的线粒体DNAA1555G和C1494T突变携带者324例。线粒体DNAA1555G突变共285例,华裔254例,其他亚裔18例,非亚裔13例,线粒体DNAC1494T突变39例均为华裔。明确使用氨基糖甙类抗生素致聋230例,无氨基糖甙类抗生素使用发生耳聋92例。2例应用氨基糖甙类抗生素药物1年听力正常。统计分析发现用药患者的耳聋程度较未用药患者重(X2=25.414,P<0.05)。无论是否用药,发病年龄与耳聋程度有显著的负相关,而用药后发病间隔与耳聋程度无相关(R=0.054,P>0.05)。另外,线粒体DNA1555/1494突变异质率与耳聋程度显著正相关(R=0.823,P<0.05)。结论多种因素影响mtDNAA1555G/C1494T携带者的临床表现。对于线粒体DNAA1555G/C1494T相关耳聋进行早期耳聋基因诊断有重要的临床意义。对突变携带者,严禁使用氨基糖甙类抗生素。
简介:ObjectiveChronictinnitusisahighlyprevalentconditionandhasbeenhypothesizedtoresultfromaninnatedisturbanceincentralnervousserotonergictransmission.Giventhefrequentcomorbiditywithmajordepressionandanxiety,wearguethatcandidategenesforthesedisordersarelikelytooverlap.Thepresentstudyaddressesthegeneencodingforthe5-HT1Areceptorasaputativeriskfactorfortinnitus.MethodsIn88subjectswithadiagnosisofchronicsubjectivetinnituswhounderwentadetailedneurootologicalexamination,theentire5-HT1AgenewasamplifiedusingoverlappingPCRproducts.Ampliconswerecustomsequencedbidirectionallyandwerescreenedforvariantsinmultiplealignmentsagainstthehumangenomereference.ResultsWeidentifiedasynonymousC>Texchangeatresidue184(Pro)in7/88subjects,butdetectednomissensevariantsinthepopulationunderstudy.Specifically,thefollowingresidueswerefullyconserved:16(Pro),22(Gly),28(Ile),98(Val),220(Arg),267(Val),273(Gly),and418(Asn).DiscussionThepresentdatacountagainstthecausationofchronictinnitusbyachangeinthe5-HT1Areceptor'saminoacidsequence.However,theallelefrequencyforthe184Prominorallele(0.04)reachedtwicethefrequencyreportedincontrolcohortsfromthesameethnicity.Additionalinvestigationsareinvitedtoclarifytheroleofthe5-HT1Apolymorphisminlargersamples,andtocontrolforcomorbidaffectivedisorders.