RESUMO
Objective To explore impact of nursing intervention on the adverse reaction of patient con-trol epidural analgesia (PCEA) after abdominal operation. Methods 258 patients underwent PCEA after ab-dominal operation were selected from 2006 to 2007. The clinical data of 126 patients without nursing interven-tion were analyzed as the control group admitted to our hospital from January to December, 2006 and compared with those of 132 patients receiving nursing intervention as the experimental group from January to December, 2007. The control group was managed by the anesthetists and nurses only conducted routine nursing instruction, while the experimental group was given systematic and normative nursing intervention besides routine nursing instructions, including psychological intervention, behavioral intervention, close observation, of discovery of ad-verse reaction in time and giving early disposal. The incidence of adverse reaction of PCEA of the two groups such as urinary retention, nausea and vomiting, abdominal distension, skin indentation, catheter shedding, skin itching, numbness of lower limbs, respiratory depression was observed. Results Compared with the control group,the incidence of adverse reactions of PCEA in the experimental group such as urinary retention,nansea and vomiting, abdominal distension,skin indentation,catheter shedding was significantly lower. Conclusions The implementation of nursing intervention can reduce the adverse reaction of PCEA after abdominal operation, alle-viate the suffering of patients, and promote functional recovery and the body rehabilitation.
RESUMO
OBJECTIVE: To investigate the changes of the markers of pulmonary vascular endothelial cells (PVECs) after acute lung injury (ALI) induced by bone marrow extract (BME) injection in rabbits. METHODS: Thirty-one rabbits were randomized into control (CG, n=10) and experimental groups (EG, n=21). The rabbits in EG were injected with homogeneous bone marrow extract (0.35 ml/kg, 2 ml/h) at a slow and continuous rate through the jugular vein to establish the model of ALI. At 6 h after the injection, the number of circulating endothelial cells (CECs) in the blood, contents of granule membrane protein-140 (GMP-140), angiotensin converting enzyme (ACE) and endothelin-1 (ET-1) in the plasma and the content of GMP-140 in the pulmonary tissue were determined at various time intervals. Then the animals were killed and routine pathological examination and electron microscopy were performed to observe the changes in the pulmonary tissue. RESULTS: The levels of plasma GMP-140, ACE, ET-1 and CECs were significantly increased in the early stage (0.5 h) and remained higher for 6 h. The marked increase of plasma GMP-140 (3.25 times) in the early stage was negatively correlated to PaO(2), but positively to other parameters. IHC-staining showed that the GMP-140 on the surface of PVECs became weak. CONCLUSIONS: BME injection at slow and continuous rate can establish an acceptable model of ALI. Determination of plasma GMP-140 might be an important measure for the early surveillance and the evaluation of prognosis of ALI in clinical management of serious traffic accidents.
