RÉSUMÉ
ObjectiveTo study the nursing strategy and high risk factors of critically ill patients complicated with lower respiratory tract infection in department of neurosurgery. Methods672 critically ill patients in department of neurosurgery in our hospital from January 2007 to September 2011 were selected as research object,and the rate of lower respiratory tract infection and high risk factors were studied and analyzed,and they were taken care of with special nursing. Results54 cases of 672 patients were with lower respiratory tract infection,the rate was 8.04％.Infection rate of elderly patients,patients of poor nutrition state,patients with underlying diseases was higher than those of other patients.Infection rate of patients with invasive operation,sputum suction,application of respirator,longer operative time and oxygen inhalation time was higher than those of other patients.Infection rate of patients with longer hospitalization time,emergency operation,application of many antibiotics and complication of preoperative infection of other site was higher than those of other patients,there were significant differences.The infection was well controlled with special nursing and treatment,four patients died of primary diseases. ConclusionsThe high risk factors of critically ill patients complicated with lower respiratory tract infection in department of neurosurgery include personal factors,treatment operation factors and other factors,and it can be controlled by special nursing and treatment.
RÉSUMÉ
ObjectiveTo explore the clinical value of application of metoprolol and nifedipine in the treatment of asymptomatic myocardial ischemia for the elderly.Methods56 cases of elderly patients with silent myocardial ischemia were chosen.They were randomly divideded into the metoprolol group of 28 cases and nifedipine group with 28 cases according to the number table.The incidence of complications during treatment in the metoprolol and nifedipine group were analyzed.The seizure frequency and onset time in the two groups of patients were compared before and after treatment.ResultsThe onset time in the two groups,before treatment had no statistically significant difference[the number of attacks:(19.6±3.2) times/week compared with(18.9±2.8) times/week;attack time:(5131±352)s vs (5130 ± 348 ) s,all ( P ＞ 0.05 ).After treatment,there were statistically significant differences for the number of attacks and attack time [the number of attacks:(4.6 ± 2.1 ) times/week compared with ( 7.4 ± 2.1 )times/week,onset tine:(900 ± 140) s vs ( 1440 ± 240 ) s ( all P ＜ 0.05 ).All patients can tolerate the treatment period,there was no cases of myocardial infarction occurs.ConclusionThe metoprolol and nifedipine for the elderly treatment of silent myocardial ischemia was more secure,and metoprolol was more effective than nifedipine.