论著

环泊酚应用于老年患者无痛胃肠镜的临床研究

Clinical study on the application of ciprofol in elderly patients undergoing painless gastroenteroscopy

:406-410
 
目的 观察环泊酚在老年患者无痛胃肠镜检查中的麻醉效果和不良反应。方法 选择80例65岁以上行无痛胃肠镜检查的老年患者,将患者随机分为环泊酚组(C组)40例和丙泊酚组(P组)40例。每例患者均静脉注射舒芬太尼0.08 μg/kg,30 s后C组给予环泊酚0.3 mg/kg、P组给予丙泊酚1.5 mg/kg。记录2组患者麻醉前(T0)、睫毛反射消失时(T1)、置入胃镜后即刻(T2)和操作结束时(T3)的心率(HR)和平均动脉压(MAP);记录2组患者检查操作时间、清醒时间、追加药物次数及静脉注射痛、呼吸抑制、呛咳、体动等不良反应发生情况。结果 2组患者行胃肠镜检查操作时间、麻醉清醒时间和追加药物次数比较差异无统计学意义(P>0.05)。与T0时间点(102.6±14.1 mmHg)比较,P组患者的MAP在T1(86.0±12.5 mmHg)、T2(86.1±13.2 mmHg)、T3(92.8±12.6 mmHg)时间点明显下降,差异有统计学意义(P<0.05);与C组T1(95.9±10.8 mmHg)、T2(96.3±9.6 mmHg)时间点比较,P组的MAP在T1(86.0±12.5 mmHg)、T2(86.1±13.2 mmHg)时均明显降低(P<0.05)。C组患者静脉注射痛、呼吸抑制的发生率明显低于P组(P<0.05);2组体动和呛咳的发生率比较差异无统计学意义(P>0.05)。结论 环泊酚0.3 mg/kg在老年患者胃肠镜检查中能提供和丙泊酚1.5 mg/kg相似的麻醉效果,环泊酚组的老年患者发生注射痛、血压下降、呼吸抑制的比例更低。
Objective To observe the effect of ciprofol and propofol in painless gastroenteroscopy in elderly patients.Methods A total of 80 elderly patients aged 65 or above who underwent painless gastroenteroscopy were randomly divided into a group of 40 patients receiving ciprofol(Group C)and a group of 40 patients receiving propofol(Group P).All patients were given sufentanil 0.08 μg/kg,and group C was given ciprofol 0.3 mg/kg,group P was given propofol 1.5 mg/kg after 30 seconds.The heart rate(HR)and mean arterial pressure(MAP)of two groups of patients before anesthesia(T0),at the disappearance of eyelash reflex(T1),after gastroscopy insertion(T2),and at the end of the procedure(T3)were recorded.The operating time,anesthesia awakening time,number of additional medications and the adverse reactions such as injection pain,respiratory depression,cough,body movements were also recorded.Results There were no significant differences(P>0.05)in the gastroenteroscopy operating time,recovery time and number of additional medications between the two groups.Compared with T0 time point(102.6±14.1 mmHg),the MAP of group P patients significantly decreased at T1(86.0±12.5 mmHg),T2(86.1±13.2 mmHg)and T3(92.8±12.6 mmHg)time points(P<0.05).Compared with Group C at T1(95.9±10.8 mmHg),T2(96.3±9.6 mmHg)time points,the MAP of Group P decreased significantly at T1(86.0±12.5 mmHg)and T2(86.1±13.2 mmHg)time points(P<0.05).The incidences of injection pain and respiratory depression in group C were significantly lower than those in group P(P<0.05).There was no statistically significant difference in the incidences of body movements and cough between the two groups(P>0.05).Conclusions Ciprofol 0.3 mg/kg combined with sufentanil can provide anesthesia effect similar to that of propofol 1.5 mg/kg combined with sufentanil in gastroenteroscopy of elderly patients.The proportions of injection pain,blood pressure decreasing and respiratory depression in elderly patients in the ciprofol group were lower.
论著

纳布啡联合环泊酚或丙泊酚在老年患者无痛胃肠镜中应用效果分析

Application effect of nalbuphine combined with ciprofol or propofol in painless gastroscopy in elderly patients

:1152-1158
 
目的 对比纳布啡联合环泊酚、纳布啡联合丙泊酚应用于老年患者无痛胃镜中的效果。方法 选取厦门市中医院2021年10月至2022年10月收治的180例老年患者(均行无痛胃肠镜检查)为研究对象,按照随机数表法分组,其中A组90例患者给予纳布啡联合环泊酚,B组90例患者给予纳布啡联合丙泊酚,对比两组患者麻醉相关指标、血流动力学、围术期不良反应。结果 两组患者诱导量、诱导时间、追加次数、总追加量、苏醒时间、恢复室停留时间对比差异均无统计学意义(t=1.486、0.830、1.157、0.941、0.906、1.403,均P>0.05);重复测量方差分析结果显示,分组因素间收缩压(SBP)(F=30.019,P<0.001)、心率(HR)(F=282.057,P<0.001)、SpO2(F=64.518,P<0.001)、;时间因素SBP(F=21.780,P<0.001)、HR(F=345.118,P<0.001)、SpO2(F=41.762,P<0.001);分组与时间交互时间因素SBP(F=12.941,P<0.001)、HR(F=193.295,P<0.001)、SpO2(F=13.546,P<0.001),差异均有统计学意义。折线图直观显示,A组患者SBP、HR、SpO2、较B组低。;A组患者围术期不良反应发生率(20.00%)低于B组患者(56.67%)(χ2=25.593,P<0.001)。结论 两种麻醉方案应用于老年无痛胃肠镜,麻醉效果相近,环泊酚复合纳布啡血流动力学更稳定,且围术期不良反应的发生率较低。
Objective To compare the effects of nalbuphine combined with ciprofol and nalbuphine combined with propofol on painless gastroscopy in elderly patients. Methods A total of 180 elderly patients(all underwent painless gastroscopy)admitted to Xiamen Traditional Chinese Medicine Hospital from October 2021 to October 2022 were selected as the study subjects.They were randomly divided into groups using a random number table method.Among them,90 patients in Group A were given a combination of nalbuphine and ciprofol,while 90 patients in Group B were given a combination of nalbuphine and propofol.Anesthesia related indicators,hemodynamics,and perioperative adverse reactions were compared between the two groups.There was no statistically significant difference in the induction amount,induction time,number of additional times,total additional amount,awakening time,and recovery room stay time between the two groups of patients(t=1.486,0.830,1.157,0.941,0.906,1.403,all P>0.05).The results of repeated measures analysis of variance showed that there were statistically significant differences among the grouping factors,including SBP(F=30.019,P<0.001),HR(F=282.057,P<0.001),SpO2(F=64.518,P<0.001),time factors SBP(F=21.780,P<0.001),HR(F=345.118,P<0.001),SpO2(F=41.762,P<0.001),and interaction factors SBP(F=12.941,P<0.001),HR(F=193.295,P<0.001),and SpO2(F=13.546,P<0.001).The line chart visually shows that the SBP,HR,SpO2 of Group A patients were lower than those of Group B.The incidence of perioperative adverse reactions in Group A patients(20.00%)was lower than that in Group B patients(56.67%)(χ2=25.593,P<0.001). Conclusions The two anesthesia regimens used for elderly painless gastroscopy have similar anesthesia effects,with more stable hemodynamics of ciprofol combined with nalbuphine,and a lower incidence of perioperative adverse reactions.
新冠病毒感染专题

肺部超声在老年新型冠状病毒肺部感染的应用价值

Application value of lung ultrasound in elderly patients with COVID-19

:21-24
 
目的 探讨肺部超声(LUS)在高龄(≥75 岁)感染新型冠状病毒肺炎(COVID-19)患者中的应用及后续对病程的监测及诊断价值。方法 回顾性分析2022年11月1日—2023年1月15日本院内科收治的25例COVID-19高龄患者进行病例归纳总结,除临床资料外,动态监测肺部超声检查情况,并与肺CT结果对比,观察检查结果,以及对病程转归的预判及影响。结果 LUS检查提示患者出现不同程度肺间质损伤,包括离散型B线(间质渗出)或融合型B线(渗入肺泡)以及肺实变(肺泡萎陷)。随着病情好转,LUS可见肺实变范围缩小,B线逐步稀疏到消散,A 线出现。结论 LUS与同期胸部CT结果一致性良好。LUS检查安全简便,重复性好,可实时动态监测,即可作为初筛手段,亦可运用于特殊人群,协助临床治疗决策。
Objective To explore the application and follow-up monitoring and diagnostic value of lung ultrasound (LUS) in elderly patients(≥75y) with novel coronavirus pneumonia (COVID-19). Methods Data of 25 COVID-19 elderly patients admitted to the Department of Internal Medicine from November 1, 2022 to January 15, 2023 were retrospectively analyzed and summarized. In addition to clinical data, dynamic monitoring of LUS was performed, and the results were compared with lung CT results. The examination results, as well as the prediction and impact on the course of disease were observed. Results LUS imaging indicated that patients had different degrees of interstitial lung injury, including discrete type B line (interstitial exudation) or fusion type B line (alveolar infiltration) and lung consolidation (alveolar collapse). With the improvement of the disease, the range of lung consolidation seen in LUS was reduced, the B-line was gradually sparse to dissipate, and the A-line appeared. Conclusions The results of LUS and chest CT in the same period are consistent. LUS examination is safe, simple, reproducible, and can be monitored dynamically in real time. It can be used as a primary screening method, and also be used in special patients to assist clinical treatment decision-making.
论著

尿液PSA预测老年良性前列腺增生发生急性尿潴留的临床研究

Clinical study of urinary PSA in predicting acute urinary retention in elderly patients with benign prostatic hyperplasia

:21-24
 
目的 探讨尿液前列腺特异性抗原(u-PSA)预测老年良性前列腺增生(BPH)发生急性尿潴留(AUR)的价值。方法 选取东莞市中医院100例老年BPH患者(2020年1月—2021年4月)进行回顾性研究,均口服盐酸坦索罗辛+非那雄胺片治疗,随访1年,记录AUR发生情况,据此分为AUR组、非AUR组。比较2组一般资料,Logistic回归模型分析老年BPH发生AUR的危险因素,受试者工作特征(ROC)分析前列腺体积(PV)、u-PSA对老年BPH发生AUR的预测价值。结果 100例老年BPH患者AUR发生率为26%;AUR组u-PSA水平高于非AUR组,PV大于非AUR组(P<0.05);Logistic回归模型分析,u-PSA水平及PV增高是老年BPH患者发生AUR的独立危险因素(P<0.05);ROC曲线分析,u-PSA预测AUR的AUC=0.897,高于AUCPV(P<0.05)。结论 u-PSA可作为老年BPH继发AUR的量化评估指标,有利于临床早期筛查、诊断,采取针对性干预措施,改善预后。
Objective To investigate the value of urinary prostate-specific antigen(u-PSA)in predicting acute urinary retention(AUR)in elderly patients with benign prostatic hyperplasia(BPH).Methods A total of 100 elderly patients with BPH in our hospital(from January 2020 to April 2021)were selected for a retrospective study,all of whom were treated with oral tamsulosin hydrochloride + finasteride tablets,followed up for 1 year,and the occurrence of AUR was recorded.The patients were divided into AUR group and non-AUR group.The general data of the two groups were compared.Logistic regression model was used to analyze the risk factors of AUR in elderly BPH patients,and receiver operating characteristic(ROC)was used to analyze the predictive value of prostate volume(PV)and u-PSA for AUR occurrence.Results The incidence of AUR in 100 elderly patients with BPH was 26%;the level of u-PSA in the AUR group was higher than that in the non-AUR group,and the PV was greater than that in the non-AUR group(P<0.05).Increased PV was an independent risk factor for AUR in elderly patients with BPH(P<0.05).ROC curve analysis showed that the AUC of u-PSA for predicting AUR was 0.897,which was higher than that of PV(P<0.05).Conclusions u-PSA can be used as a quantitative evaluation index for AUR secondary to BPH in the elderly,which is conducive to early clinical screening and diagnosing,and taking targeted intervention measures to improve prognosis.
论著

术前控制营养状态评分在老年胃癌患者术后短期并发症中的应用价值

Application value of controlling nutritional status score in short-term postoperative complications of elderly patients with gastric cancer

:28-35
 
目的 探讨术前控制营养状态评分在老年胃癌患者术后短期并发症中的应用价值。方法 回顾分析统计2015年1月—2020年12月在江苏大学附属医院接受治疗的确诊胃癌患者,根据纳入标准和排除标准,选择入组患者,收集纳入研究患者一般资料、术前实验室检测数据和术后并发症情况,计算控制营养状况(CONUT)评分,统计分析CONUT营养评分在老年胃癌患者接受胃癌D2根治术术后短期并发症的价值。结果 共223例患者纳入研究,CONUT评分的截断值为2.5,肿瘤直径的截断值为2.75 cm。CONUT评分>2.5组的平均年龄高于CONUT评分<2.5组(P=0.005 3),且2组性别构成存在差异,男性患者多于女性(P=0.037 0)。CONUT评分>2.5组患者的肿瘤直径较大(P=0.039 4)。在术后并发症方面,CONUT评分>2.5组的术后并发症多于CONUT评分<2.5组(P=0.008 3)。单因素Logistic回归分析,年龄(OR=1.127;95%CI:1.028~1.236;P=0.011)、CONUT评分(OR=0.339;95%CI:0.151~0.764;P=0.009)是患者发生短期并发症的危险因素。多因素Logistic回归分析显示年龄(OR=1.115;95%CI:1.008~1.233;P=0.035)、CONUT评分(OR=0.414;95%CI:0.175~0.982;P=0.045)是患者发生短期并发症的危险因素。结论 CONUT评分作为老年胃癌患者术前营养评估项目可以有效预测患者术后短期并发症,进而提前进行营养干预,降低术后并发症发生率。
Objective To explore the value of controlling nutritional status score in short-term postoperative complications of elderly patients with gastric cancer.Methods The data of patients who confirmed gastric cancer and treated in the Affiliated Hospital of Jiangsu University from January 2015 to December 2020 were reviewed and analyzed.Patients were selected according to the inclusion criteria and exclusion criteria,the general data,preoperative laboratory test data and postoperative complications of the included patients were collected,and the controlling nutritional status(CONUT)score was calculated.The value of CONUT score in the short-term complications of elderly gastric cancer patients undergoing D2 radical gastrectomy for gastric cancer was evaluated.Results A total of 223 patients were included in this study.The cut-off value of CONUT score was 2.5 and the cut-off value of tumor diameter was 2.75 centimeter.The average age of the group with CONUT score > 2.5 was significantly higher than that of the group with CONUT score < 2.5(P=0.005 3).Moreover,there was significant difference between the sex ratio of the two groups,with male more than female(P=0.037 0).The tumor diameter was significantly larger in the group with CONUT score > 2.5(P=0.039 4).In terms of postoperative complications,there was significantly more postoperative complications in the group with CONUT score > 2.5 than in the group with CONUT score < 2.5(P=0.008 3).Univariate logistic regression analysis showed that age(OR=1.127;95% CI:1.028-1.236;P=0.011)and CONUT score(OR=0.339;95% CI:0.151-0.764;P=0.009)were the risk factors for short-term complications.Multivariate logistic regression analysis showed that age(OR=1.115;95% CI:1.008-1.233;P=0.035)and CONUT score(OR=0.414;95% CI:0.175-0.982;P=0.045)were the risk factors for short-term complications.Conclusions As a preoperative nutritional evaluation item for elderly patients with gastric cancer,CONUT score can effectively predict the short-term postoperative complications of patients,and then carry out nutritional intervention in advance to reduce the incidence of postoperative complications.
综述

穴位刺激预防与治疗老年人骨折术后谵妄的临床研究进展

Clinical progress of acupoint stimulation therapy in preventing and treating elderly patients with delirium after fracture operation

:110-116
 
本文综述近10年中医传统疗法中通过穴位刺激预防与治疗老年患者骨折术后谵妄的研究概况。术后谵妄是老年患者骨折术后常见的并发症,不仅延长患者住院时间、增加经济负担,同时与骨折术后死亡并发症的发生密切相关。但是本病机制尚未明确,在临床治疗上难以达成共识。针灸等穴位刺激是中医药治疗脑病的独具特色的疗法,近年来有关穴位刺激防治老年骨折术后谵妄的报道越来越多,本文主要探讨不同的穴位刺激方法干预对骨折术后谵妄发生率的影响,包括传统刺激方式如毫针、电针、穴位注射、穴位敷贴和新针疗法如耳针、头针等,认为穴位刺激能够较好预防骨折术后谵妄发生,在治疗上也有较好疗效。以期为进一步临床研究与应用提供参考。
This article summarized the research of acupoint stimulation in preventing delirium after fracture surgery in elderly patients in recent 10 years.Postoperative delirium is a common complication in elderly patients after fracture surgery, which affects life extremely and increases economic burden.However, the mechanism of this disease haven't been revealed, and it is difficult to reach consensus on clinical treatment.Acupoint stimulation, like acupuncture, is a unique treatment of encephalopathy with traditional Chinese medicine.In recent years, there are more and more reports on acupoint stimulation therapy to prevent and treat delirium after fracture surgery in the elderly.This article mainly study the influence of different acupoint stimulation therapy on treatment of delirium after fracture surgery, including electroacupuncture, auriculotherapy, scalp acupuncture, acupoint injection and acupoint application, etc.It is believed that acupoint stimulation can prevent delirium after fracture surgery, so as to provide reference for further clinical research and application.
论著

老年髋部骨折患者围术期隐性失血的影响因素及护理措施分析

Analysis of influencing factors and nursing measures for perioperative hidden blood loss in elderly patients with geriatric hip fractures

:85-90
 
目的 探讨老年髋部骨折(GHF)患者围术期隐性失血的影响因素及护理措施。方法 回顾性分析2020年3月—2023年3月我院收治的86例老年GHF患者,所有患者均采取手术治疗,计算所有患者围术期失血量,并收集所有患者的一般资料及围术期相关治疗情况,分析不同一般资料患者围术期隐性失血情况,不同手术方式及麻醉方式围术期隐性失血情况,不同术后处理方式围术期隐性失血情况,随后采取Logistic回归分析老年GHF患者围术期隐性失血的影响因素,最后针对结果制定老年GHF隐性失血的护理措施。结果 不同性别和是否合并冠状动脉粥样硬化、高血压患者围术期隐性失血量比较差异无统计学意义(P>0.05),不同年龄、合并糖尿病、骨折类型患者围术期隐性失血量比较差异有统计学意义(P<0.05);不同手术方式、麻醉方式患者围术期隐性失血量比较差异有统计学意义(P<0.05);不同术后引流、使用肝素情况患者围术期隐性失血量比较差异有统计学意义(P<0.05);Logistic回归分析结果表明:年龄、合并糖尿病、手术方式、麻醉方式、术后引流、使用肝素都是造成GHF老年患者围术期隐性失血的影响因素(P<0.05)。患者经相关护理后,恢复较佳。结论 老年GHF患者围术期会存在大量隐性失血情况,同时年龄、合并糖尿病、手术方式、麻醉方式、术后引流、使用肝素与围术期隐性失血量密切相关,临床上可采取针对性措施减少GHF患者隐性失血。
Objective To explore the influencing factors and nursing measures of perioperative hidden blood loss in elderly patients with geriatric hip fractures(GHF).Methods From March 2020 to March 2023,86 elderly patients with GHF admitted to our hospital were selected as the study objects for retrospective analysis.All patients were treated with surgery.The perioperative blood loss of all patients was calculated,general information and perioperative treatment status of all patients were collected,the hidden blood loss of patients with different general information,different surgical and anesthesia methods and different postoperative treatment methods were analyzed.Logistic regression analysis was used to analyze the influencing factors of hidden blood loss of elderly GHF patients during the perioperative period.Nursing measures for hidden blood loss in elderly hip fractures were developed based on the results.Results There was no statistical difference in the amount of perioperative hidden blood loss among patients with different gender,complicated with coronary heart disease and hypertension or not(P>0.05),but there was statistical difference in the amount of perioperative hidden blood loss among patients with different ages,complicated with diabetes and fracture types(P<0.05).There was statistically significant difference in the amount of hidden blood loss during the perioperative period among patients with different surgical and anesthesia methods(P<0.05).There was statistically significant difference in the amount of hidden blood loss during the perioperative period among patients with different postoperative drainage and use of heparin(P<0.05).The results of Logistic regression analysis showed that age,complicated with diabetes,operation methods,anesthesia methods,postoperative drainage and heparin use were independent risk factors for perioperative hidden blood loss in elderly patients with GHF(P<0.05).Conclusions There will be a lot of hidden blood loss in the perioperative period of elderly patients with GHF.At the same time,age,complicated with diabetes,operation methods,anesthesia methods,postoperative drainage and heparin use are closely related to the amount of hidden blood loss in the perioperative period.Targeted measures can be taken clinically to reduce the hidden blood loss in patients with GHF.
论著

非重症监护室护士对住院卧床老年患者肺康复知信行的调查研究

A study of non-ICU nurses'knowledge,attitude and practice about pulmonary rehabilitation in hospitalized bedridden elderly patients

:79-84
 
目的 调查非重症监护室护士对住院卧床老年患者肺康复的知信行现状,探讨其影响因素。方法 采用自行设计的卧床老年患者肺康复知信行现状调查问卷,对广州市第一人民医院的555 名非重症监护室护理人员进行调查。结果 共回收有效问卷513份。调查对象肺康复知信行总分为(76.01±12.27)分,知识维度、态度维度、行为维度得分分别为(14.09±3.25)、(21.89±3.38)、(40.03±9.87)分。多元回归分析显示,主要影响护士对住院老年卧床患者实施肺康复知信行的因素为护龄、是否参加过肺康复相关培训及科室是否已开展肺康复(P<0.05)。结论 非重症监护室护士对卧床老年患者肺康复的态度积极,行为良好,但知识有待提升。建议开展卧床老年人相关肺康复培训,激励护士主动学习肺康复新理念的积极性和主动性,强化理论联系临床实践,从而提高临床护理质量。
Objective To investigate the knowledge,attitude and practice of non-intensive care unit(ICU)nurses about pulmonary rehabilitation of hospitalized bedridden elderly patients,and to explore the influencing factors.Methods A self-designed questionnaire on the status of knowledge,attitude and practice about pulmonary rehabilitation of bedridden elderly patients was used to investigate 555 non-ICU nurses in our hospital.Results A total of 513 valid questionnaires were collected.The total score of pulmonary rehabilitation was(76.01±12.27),and the scores of knowledge,attitude and practice were(14.09±3.25),(21.89±3.38)and(40.03±9.87),respectively.Multiple regression analysis showed that the main factors affecting nurses' knowledge,attitude and practice in implementing pulmonary rehabilitation for hospitalized elderly bedridden patients were nursing age,whether they had participated in training related to pulmonary rehabilitation and whether pulmonary rehabilitation had been carried out in the unit(P<0.05).Conclusions Non-ICU nurses have positive attitudes and good practice toward pulmonary rehabilitation for bedridden elderly patients,but their knowledge needs to be improved.It is recommended that training on pulmonary rehabilitation for the bedridden elderly be carried out to motivate nurses to learn new concepts of pulmonary rehabilitation,strengthen the link between theory and clinical practice,and improve the quality of clinical care.
论著

药物服务干预对老年高血压患者的治疗及用药安全性的影响

Influence of drug service intervention on the treatment and drug safety of elderly patients with hypertension

:49-54
 
目的 探讨药物服务干预对老年高血压患者的治疗及用药安全性的影响。方法 选取2020年6月—2021年12月潮州市中医药研究所门诊部和潮州市中医医院高血压患者90例为研究对象,采用随机数字表法分为观察组45例(给予药物服务干预),对照组45例(给予常规用药指导)。比较干预后血压控制水平、健康知识认知、治疗依从性、自我管理行为、生活质量及药物不良反应等情况。结果 干预后,观察组舒张压、收缩压、不良反应发生率均低于对照组(P<0.05)。干预后,观察组健康知识认知水平、治疗依从率、自我管理行为评分、生活质量评分均高于对照组(P<0.05)。结论 采用药物服务干预的方式能够较好控制老年高血压患者血压水平,提升其健康知识认知水平与治疗依从性,改善自我管理行为状况,提高生活质量。
Objective To investigate the effect of drug service intervention on the treatment and drug safety of elderly patients with hypertension.Methods From June 2020 to December 2021,a total of 90 patients with hypertension from Chaozhou Institute of traditional Chinese Medicine and Chaozhou Hospital of Traditional Chinese Medicine were selected as the study objects,and were divided into observation group(45 cases,given drug service intervention)and control group(45 cases,given routine drug guidance)by random number table method.The blood pressure control level,health knowledge cognition level,treatment compliance,self-management behavior,quality of life and adverse drug reactions of elderly patients with hypertension were compared after intervention.Results After intervention,the incidence of diastolic blood pressure,systolic blood pressure and adverse drug reactions in the observation group were lower(P<0.05).After intervention,the health knowledge cognition level,treatment compliance rate,self-management behavior score and quality of life score of the observation group were higher(P<0.05).Conclusions The use of drug service intervention can better control the blood pressure level of elderly patients with hypertension,improve their health knowledge cognition and treatment compliance,improve self-management behavior and improve quality of life.
论著

超声引导下外周静脉置入中心静脉导管老年患者常见并发症的预防与护理

Preventing and nursing of common complications in elderly patients with ultrasound-guided PICC catheterization

:72-76
 
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.
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