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Objective To evaluate the effect of fluid resuscitation with early external jugular vein access on prognosis of sepsis patients.Methods One hundred and twenty patients with sepsis,admitted to emergency intensive care unit (EICU) and the general intensive care units (ICU) were randomly divided into two groups,external jugular vein group (n=60) and deep-vein group (e.g.internal jugular vein,subclavian vein,femoral vein,n=60).The time elapsed from admission to initial application of norepinephrine,the time required for getting the early goal directed therapy (EGDT) after standard procedure,the length of time needed for subsequent use of vasoactive agents during the entire course of resuscitation serum lactate level at3 h and 6 h after resuscitation,lactate clearance rate,SOFA scores were documented.The mortality rates of 14 days and 28 days were observed after treatment.Results Compared with deep vein access,the time elapsed from admission to the initial application of norepinephrine and the time required for getting EGDT were significantly shortened [(20.78±5.03) vs.(6.12±2.58),P＜0.01;(6.15±2.03)vs.(5.35±2.21),P＜0.05],and the serum level of lactate was significantly decreased[(6.88±1.71)vs.(6.28±1.51),P＜0.05] at 3 h after resuscitation,and lactate clearance rate in percentage was significantly increased at 3 h after resuscitation,and SOFA at 6 h was decreased[(25.8±9.2) vs.(31.2±13.3),P＜0.05],and SOFA at 6 h was distinctly reduced [(5.78±1.19) vs.(5.38±0.96),P＜0.05],and.the mortality rates of 14 days decreased significantly in the external jugular vein group(33.3％ vs.16.7％,P＜0.05).Conclusions Early external jugular vein access can more significantly save time,improve the effect of fluid resuscitation,promote recovery of important organ.It is helpful for improving prognosis in sepsis patients.
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Objective: To explore a method that is effective and at the same time friendly to all types of patients, as digital medical records now being applied widely and wireless network universalized. Methods: In 2009, our hospital started using mobile systems for ward rounds, making sure of the data collection and transmission. Results: The application of this mobile system improved the efficiency of clinical medical nursing and service quality. Conclusion:The mobile system has brought historical revolution to traditional model of clinical medical treatment, nursing and hospital management, etc. It has prominent value for improving the hospital’s business and service quality, controlling the inefficiency and improving benefits of both economy and social.
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@# Objective To investigate the relationship between pulsed radiofrequency voltage and therapeutic effect on idiopathic trigeminalneuralgia. Methods 22 idiopathic trigeminal neuralgia patients treated with standard pulsed radiofrequency ineffectively and other 22 patientswith satisfactory effect were included. The pulsed radiofrequency voltage, electric resistance, stimulating voltage and postoperativecomplications were compared. Results Pulsed radiofrequency voltage in the effective group was more than that in ineffective group (P<0.01). More patients suffered from mild numbness in the pulsed radiofrequency effective group (P<0.01). Conclusion The pulsed radiofrequencyvoltage is an important factor affecting the therapeutic effect.
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Objective The care requirements and the waiting time of infusion outpatients in emergency department were evaluated to innovate the mode of outpatient and emergency infusion management. Methods 400 infusion outpatients were randomly assessed with the care requirements assessment form which were designed by ourselves. Results The accurate, timely medication treatment and care, a quiet, comfortable environment and the sharply puncture technique were wanted by most outpatients. Conclusions Information management mode-wireless mobile outpatient infusion management system, provides a technologically advanced, safe, reliable, practical solutions for emergency fluid management.
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@#Objective To explore a modality of ambulatory nursing care applied to the elderly patients with severe trigeminal neuralgia treated by radiofrequency thermocoagulation.Methods42 patients were equally assigned into 2 groups: group A(n=21) aged from 40～60, and group B(n=21) aged from 80～92. Pertinent nursing measures were assessed for risks of ambulatory surgery, including psychological care before surgery and intensive observation during surgery. The pain was assessed with Visual Analogue Scale (VAS) between the groups and before and after surgery, as well as complications.ResultsNo significant difference of the VAS scores was found between the groups before and 2 weeks after surgery (P>0.05), while the score of VAS decreased in two groups 2 weeks after surgery(P<0.01). No severe complication occured in the groups after surgery.ConclusionIt is safe and effective to apply the modality of ambulatory nursing care for the elderly patients with severe trigeminal neuralgia treated by radiofrequency thermocoagulation.
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@#Objective To investigate the efficacy and safety of radiofrequency thermocoagulation guided by spiral CT on severe trigeminal neuralgia in the oldest old patients. Methods 21 patients above 80 with severe idiopathic trigeminal neuralgia were treated with radiofrequency thermocoagulation guided by spiral CT. They were assessed with numeric rating scales (NRS) and the complication were observed. Results The scores of NRS decreased significantly after treatment (P<0.01). No serious complication was observed after treatment. One patient recurred 23 months after operation, and the pain released after radiofrequency thermocoagulation once again. Conclusion Radiofrequency thermocoagulation guided by spiral CT is effective and safe for severe trigeminal neuralgia in the oldest old patients.