目的 探讨超声引导下外周静脉置入中心静脉导管(PICC)老年患者常见并发症的预防与护理措施。方法 回顾性分析本院2019年12月—2021年1月间收治的116例PICC置管老年患者,根据是否实施超声引导下PICC置管并发症专项预防护理(后简称专项护理)将入选患者分配为实施组及对照组各58例,对比2组患者穿刺效果、并发症发生情况,评估2组患者护理前后的心理状态变化情况,调查患者满意度。结果 实施组一次穿刺成功、头端到位率、头端最佳率均高于对照组,平均穿刺次数、操作时间均少于对照组,差异均有统计学意义(P<0.05);实施组各种并发症总发生率为18.97%,对照组为46.55%,2组差异有统计学意义(P<0.05);置管后2组患者焦虑自评量表、抑郁自评量表评分均低于置管前,且实施组均低于对照组,差异均有统计学意义(P<0.05);实施组患者总满意率为96.55%,对照组为77.59%,实施组高于对照组,差异有统计学意义(P<0.05)。结论 专项预防护理措施能够提高老年患者超声引导下外周静脉置入中心导管的穿刺准确性,降低置管相关并发症发生风险,缓解患者心理压力,提高患者满意度。

Objective To explore the preventing and nursing measures of common complications in elderly patients with ultrasound-guided peripherally inserted central catheter (PICC). Methods The data of 116 elderly patients with PICC catheterization in our hospital from December 2019 to January 2021 were retrospectively analyzed.Patients were divided into implementation group and control group (58 cases each) according to whether they received special preventive nursing for complications of ultrasound-guided PICC catheterization (specialized nursing). The catheterization outcomes and complications of the two groups were compared, the changes in the psychological state were evaluated, and satisfaction rate of the patients was investigated. Results The success rate of the first catheterization, the head-end in place, and ideal placement of the head-end in implementation group were higher than those of the control group, the average number of catheterization and operation time were less than those of the control group, and the differences were statistically significant (P<0.05). The total incidence of various complications in the implementation group was 18.97%, while that in the control group was 46.55%, the difference between two groups was statistically significant (P<0.05). The scores of Self-Rating Anxiety Scale and Self-Rating Depression Scale of the two groups after PICC catheterization were lower than those before catheterization, and the implementation group was lower than the control group, the differences were statistically significant (P<0.05). The total satisfaction rate of patients in the implementation group was 96.55%, and that in the control group was 77.59%, which difference was statistically significant (P<0.05). Conclusion Special preventive nursing measures could improve the catheterization accuracy of ultrasound-guided PICC for elderly patients, reduce the risk of catheter-related complications, relieve the psychological pressure of patients, and improve patients’ satisfaction.

目的 盾叶冠心宁片与复方丹参滴丸治疗冠心病稳定型心绞痛临床疗效比较。方法 选取于2017年10月—2018年10月至延安大学附属医院诊治的120例冠心病稳定型心绞痛患者。随机将所有患者分为2组,观察组患者在常规西药治疗基础上加服盾叶冠心宁片,对照组患者在常规西药治疗基础上加服复方丹参滴丸,比较两组患者治疗6个月后的临床疗效。结果 经过6个月治疗后,观察组患者的治疗有效率为66.7%,对照组患者的治疗有效率为40.0%。观察组与对照组治疗效果相比,差异有统计学意义(P＜0.05)。盾叶冠心宁片治疗冠心病稳定型心绞痛的综合疗效优于复方丹参滴丸。结论 冠心病稳定型心绞痛患者在常规西药治疗不变的基础上加用盾叶冠心宁片,不仅能改善临床心绞痛症状,还能调节血脂异常及降低同型半胱氨酸水平,以及缓解患者情绪及睡眠问题,且安全性高,有较高临床应用价值。

Objective To compare the clinical efficacy of Dunye Guanxinning tablets and Compound Danshen dropping pills in the treatment of stable angina pectoris caused by coronary heart disease. Methods 120 patients with stable angina pectoris were selected from the affiliated hospital of Yan'an University from October 2017 to October 2018.All patients were randomly divided into two groups. The observation group was treated with Dunye Guanxinning tablets on the basis of conventional western medicine, while the control group was treated with Compound Danshen dropping pills on the basis of conventional western medicine. The clinical efficacy of the two groups was compared after 6 months of treatment. Results After 6 months of treatment, the effective rate was 66.7% in the observation group and 40.0% in the control group. The treatment effect of the observation group was statistical different from that of the control group (P<0.05). The comprehensive curative effect of Dunye Guanxinning tablets in treating stable angina pectoris of coronary heart disease is better than that of Compound Danshen dropping pills. Conclusion The use of Dunye Guanxinning tablets in patients with stable angina pectoris after conventional western medicine treatment may not only improve the symptoms of clinical angina pectoris, but also regulate dyslipidemia and reduce homocysteine level, as well as alleviate the patients' emotional and sleep problems. It has high safety and high clinical application value.

目的 探讨硝普钠联合多巴胺治疗心肌梗死后左心衰竭的疗效。方法 选取2018年11月—2019年11月我院收治的心肌梗死后左心衰竭患者148例,应用随机数字法分为两组,对照组应用多巴胺治疗,研究组应用硝普钠联合多巴胺治疗。比较2组治疗效果,心率、呼吸、收缩压及舒张压等心功能指标,头痛、视力模糊、肌肉颤搐等不良反应。结果 经过治疗后,比较2组治疗效果,经研究可知,研究组有效率为97.2%,对照组为87.8%,研究组疗效高于对照组,差异有统计学意义(P＜0.05);治疗后,2组患者心脏功能指标均优于治疗前,且研究组心脏功能指标优于对照组,差异有统计学意义((P＜0.05);经过治疗后,比较2组治疗效果,经研究可知,研究组不良反应为2.8%,对照组为10.8%,研究组不良反应低于对照组,差异有统计学意义(P＜0.05)。结论 在治疗心肌梗死左心衰竭患者,通过使用硝普钠联合多巴胺治疗,治疗效果显著,能够有效改善患者的心率、呼吸等心功能指标,而且患者在用药后出现的不良反应少,提高了患者的生活质量,有助于早日康复出院,值得临床上大力推广应用。