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Objective:To investigate the effects of turning head to the opposite insertion side on catheter heterotopia and degree of comfort among PICC catheter patients.Methods:The inpatients with PICC catheter in Hepatological Surgery of Changzhi People′s Hospital from January 2018 to December 2019 were collected as research object, patients from January to December 2018 was assignment to the control group, patients from January to December 2018 was assignment to the experimental group, with 174 cases in each group. They were catheterized with turning head to the opposite insertion side and turning head to the PICC insertion side, respectively. The incidence of catheter heterotopia, complications as well as degree of comfort during the placement of PICC were compared between the two groups.Results:The successful cases of one-time delivery tube and occurred catheter heterotopia were 97.1% (169/174) and 1.2% (2/174) in the experimental group, the index mentioned above were 91.4% (159/174) and 7.5% (13/174) in the control group, the differences between the two groups were statistically significant ( χ2=5.30, 8.43, both P<0.05). The results from survival curve analysis demonstrated that the occurred of catheter-related venous thrombosis and catheter-related bloodstream infections were significantly lower in the experimental group compared to the control group ( χ2=15.23, 8.76, both P<0.05). The score of comfort during the placement of PICC was (15.00 ± 2.19) in the experimental group, which was significantly lower than (16.86 ± 1.88) points in the control group ( t=8.49, P<0.05). Conclusions:Adopting turning head to the opposite insertion side method can improve the success rate of one-time delivery tube, reduce the incidence of catheter heterotopia and reduce the discomfort of patients during PICC catheterization.
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Objective To study the effect of temporary closure of venous pressure clamp on blood coagulation during duct rinsing in heparin free dialysis.Methods One hundred and forty cases of heparin free dialysis were divided into the control group and observation group according to the singular times dialysis and dual time dialysis,the control group (74 cases with singular times heparin free dialysis) and observation group (66 cases with dual times heparin free dialysis).The rinsing operation of the control group was consistent with the routine dialysis process.In the observation group,the venous pressure clamp was closed before the start of rinsing,and then the venous pressure clamp was opened at the end of this process.The times of alarm,blood pump suspension period,incidence rate and degree of blood coagulation were compared between the two groups to assess the degree of comfort and compliance of all patients during the process.Results The differences between the two groups in terms of times of alarm and blood pump suspension period were statistically significant ((5.7±1.8) times vs.0 times,(9.1±4.0) s vs.0s,P=0.001),the incidence rate of blood coagulation,the degree of blood coagulation above degree Ⅱ and the rate of operation completion ahead of time in the two groups were detected ((70.3% (52/74) vs.7.6% (5/66),21.6% (16/74) vs.0,8.1% (6/74) vs.0).The difference of blood coagulation degree between the two groups was statistically significant (Z=-9.185,P=0.000).Patients in the observation group had a higher grade of comfort degree((4.8±1.0) points vs.(4.2±0.63) points,P=0.001).Conclusion In the operation of heparin free dialysis,the temporary closure of venous pressure clamp can reduce the incidence rate of interruption,prolong the service life of the filter,ensures the dialysis time and treatment effect,and improve the patients' degree of comfort.
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Objective To observe the application effect of homemade polyhedral pillow in endoscopic retrograde cholangiopancreatography operation (ERCP). Methods Using the random number table method, the 160 cases of ERCP patients were divided into traditional group and improvement group on average. Common cotton pillow was used in the traditional group and homemade polyhedral pillow was used in the other. We observed the left facial ministry skin compression of postoperative patients, and a follow-up visit was made about the surgery physician satisfaction and patient comfort. Results The incidence of left facial ministry skin erythema and indentation in improved group patients was 12.50%(10/80), 15.00%(12/80), respectively. The corresponding rate in traditional group was 45.00%(36/80), 48.75%(39/80), respectively. Difference was statistically significant (χ2=20.63, P<0.01; χ2= 20.98, P<0.01). The degree of patient's comfort and Surgery physician satisfaction in improved group patients was 88.5 (70, 95) points, 90.00%(72/80),respectively, which higher than those in traditional group, for about 57.0(51, 83) points,70.00%(56/80), Difference was statistically significant (Z=-6.844, P<0.01; χ2=10.09, P=0.006). Conclusions Intraoperative use of homemade polyhedral pillow in ERCP, can ensure proper head position, reduce the pressure of left facial ministry skin and the occurrence of complications, thus improve the operator and shorten the operation time at the same time, which can also improve the patient′s comfort and the doctor′s degree of satisfaction.