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Objective:To investigate and analyze the risk factors of pulmonary infection in hemodialysis patients with diabetes nephropathy (DN), and explore the effect of different antibiotic application methods on the efficacy of DN patients with pulmonary infection.Methods:337 inpatients with DN who were admitted to Lishui Central Hospital from August 2021 to April 2022 were selected as the study subjects, and the proportion of pathogenic bacteria in patients with pulmonary infection caused by hemodialysis was analyzed, and the influencing factors of pulmonary infection were analyzed by single factor and multiple factor logistic regression models. DN patients with pulmonary infection were treated with single or multiple antibiotics, and their curative effects were analyzed and compared.Results:Among 337 hospitalized patients with DN in this study, the rate of pulmonary infection caused by hemodialysis was 24.04%(81/337). 87 strains of pathogenic bacteria were cultivated, and the main pathogens of the infected individuals were Klebsiella pneumoniae (36.78%, 32/87), Staphylococcus aureus (17.24%, 15/87), and Acinetobacter baumannii (16.09%, 14/87). The results of univariate analysis showed that patient age, dialysis time, hospital stay, hemoglobin, postprandial blood glucose, malnutrition (blood albumin level<35 g/L), renal function, and volume load were the influencing factors for pulmonary infection in DN patients undergoing hemodialysis (all P<0.05). Multivariate logistic regression model analysis showed that dialysis time, hemoglobin, postprandial, blood glucose malnutrition, renal function, and volume load were risk factors for pulmonary infection caused by hemodialysis (all P<0.05). After treatment, the levels of white blood cells, neutrophils, and hypersensitive reactive protein in patients with pulmonary infection were significantly reduced compared to before treatment (all P<0.05). The effective rate of multi antibiotic therapy (97.44%, 38/39) was higher than that of single antibiotic therapy (80.95%, 34/42) (χ 2=5.563, P=0.018). Conclusions:There are many independent risk factors for pulmonary infection during hemodialysis in DN patients. The infection rate should be reduced through adequate dialysis, blood glucose control, nutrition supplementation, anemia correction and other measures, and the infected can be treated timely with antibiotics according to the situation.
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Objective To investigate the effect of continuous hemofiltration in patients with acute renal injury induced by rhabdomyolysis and summarize the nursing experience.Methods Ten patients with acute kidney injury induced by rhabdomyolysis were managed with continuous hemofiltration,corresponding nursing care performed.Results After treatment,the renal function of 7 patients resumed normal,the function of 2 were improved,and only 1 needed long-term hemodialysis.After treatment,the levels of serum creatine phosphokinase(CPK),myoglobin(Mb),blood urea nitrogen(BUN),creatinine(Scr),aspartate aminotransferase(AST) were gradually decreased,K+resumed normal and urine volume increased to normal level,with significant difference as compared to those before treatment(P<0.05).Conclusions Continuous hemofiltration together with pertinent nursing measures can ensure the curative effect.It is of great significance for improving the prognosis of rhabdomyolysis.
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Objective To observe the effect of lidocaine gargle,gentamicin,dexamethasone mixture on degree and cure time of oral mucositis caused by paraquat poisoning.Methods 61 patients with paraquat poisoning were randomly divided into the experimental group (31 cases) and the control group (30 cases); the experimental group was given lidocaine,gentamicin,dexamethasone mixture gargle,the control group was given dexamethasone dilution as gargle.The degree of oral mucositis and healing time were compared between two groups.Results There was significant difference in degree of oral mucositis and healing time between the experimental group and the control group.Conclusions Lidocaine gargle,gentamicin,dexamethasone mixture gargle can reduce degree of oral mucositis and hasten healing in patients with paraquat poisoning.It can alleviate the suffering of patients,and is worthy of clinical application.
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Objective To explore the application value of improved B-Lynch suture in the treatment of cesarean section refractory hemorrhage.Methods To analyze retrospectively the information of cesarean section refractory hemorrhage patients who have taken conventional treatment or improved B-Lynch suture treatment in our hospital,taken the conventional treatment.the uterus was remove when it's invalid.the improved B-Lynch suture treatment was taken.Results In the improved B-Lynch suture treatment group,the patients have apprently little blood loss,shorter time in the cesarean section operation(t =8.58,6.38,P ＜ 0.05).And none of the cases took the hysterectomy or occured DIC.In the conventional treatment group,the blood loss was more,the operation time was longer,and 6 cases took the hysterectomy,5 cases occured DIC.The two groups were significantly different(x2 =6.98,4.59,all P ＜0.05).Conclusion In the cesarean section,if refractory hemorrhage happen and the conventional measures does not work,the improved B-Lynch suture should be taken into consideration.It has good hemostatic effect.