1.Application of emergency deep venous catheterization outside the operation room
Yijun ZHU ; Weizheng FENG ; Dongping SHI
Clinical Medicine of China 2007;23(z1):61-62
Objective To evaluate the advantages and disadvantages of inserted internal jugular vein cathe-ters and femoral vein catheters in emergency patients outside the operation room.Methods 206 patients received right internal vein catheterization(group J,n=110)and right femoral vein catheterization(group F,n=96).Suc-cessful rates of puncture,operation time,incidence of complications were observed and compared between the two groups.SAS6.04 software was used to analyze the data of the two groups.Results Emergency deep venous catheter-ization was accomplished in all the patients.There were no severe complication in two groups,such as pneumothorax and cardiac arrest.The rate of successful puncture in group J was 88%(97/110),however,100%(96/96)in group F.There was statistical significant difference between two groups(P<0.05).Mean time needed in group J (21.5±8.4)m was more than that in group F(12.5±5.3)min(P<0.05).The cases of puncturing into artery or serious arrhythmia in group F(2 cases)were less than that in group J(7 cases including hematoma in 4 cases)(P<0.05).6 cases were found to have arrhythmia in group J but there was not arrhythmia in group F(P<0.05).Con-chsion Different ways of emergency deep venous catheterization should be selected according to different condi-tions of patients outside the operation room.For critically ill patients,femoral vein puncture is more safe,with high rate of Success and less complication.
2.Application of emergency deep venous catheterization outside the operation room
Yijun ZHU ; Weizheng FENG ; Dongping SHI
Clinical Medicine of China 2007;23(13):61-62
Objective To evaluate the advantages and disadvantages of inserted internal jugular vein cathe-ters and femoral vein catheters in emergency patients outside the operation room.Methods 206 patients received right internal vein catheterization(group J,n=110)and right femoral vein catheterization(group F,n=96).Suc-cessful rates of puncture,operation time,incidence of complications were observed and compared between the two groups.SAS6.04 software was used to analyze the data of the two groups.Results Emergency deep venous catheter-ization was accomplished in all the patients.There were no severe complication in two groups,such as pneumothorax and cardiac arrest.The rate of successful puncture in group J was 88%(97/110),however,100%(96/96)in group F.There was statistical significant difference between two groups(P<0.05).Mean time needed in group J (21.5±8.4)m was more than that in group F(12.5±5.3)min(P<0.05).The cases of puncturing into artery or serious arrhythmia in group F(2 cases)were less than that in group J(7 cases including hematoma in 4 cases)(P<0.05).6 cases were found to have arrhythmia in group J but there was not arrhythmia in group F(P<0.05).Con-chsion Different ways of emergency deep venous catheterization should be selected according to different condi-tions of patients outside the operation room.For critically ill patients,femoral vein puncture is more safe,with high rate of Success and less complication.
3.Surveys of nutrition risk and risk factors in patients with chronic pancreatitis
Guoying ZHU ; Dongping HUANG ; Jianwei HUANG ; Fengshang ZHU
Parenteral & Enteral Nutrition 2017;24(1):33-36
Objective:To evaluate the nutritional risk and its risk factors in patients with chronic pancreatitis (CP).Methods:Using nutritional risk screening 2012,a retrospective study was performed to analyze nutritional risk in 156 CP patients.Conditional logistic regression model was applied to identify the risk factors from fourteen clinical features that potentially influen cenutritional risk.Results:Proportion of patients with nutritional risk was significantly higher than malnutrition patients (44.9% vs 25.6%,x2 =12.64,P =0.000 4).Univariate analysis indicated the following seven factors,gender,concomitant diabetes mellitus,intervention by endoscope or surgery,pancreatic enzyme replacement therapy,anxiety depression,insufficient eating and nutritional support for less than 3 months were associated with higher nutritional risk in CP patients (P < 0.01).The result of multivariate analysis showed that anxiety depression,insufficient eating and nutritional support for less than 3 months werethe risk factors for malnutrition CP patients.Conclusion:There are higher nutritional risks in CP patients and early psychotherapy,sufficient eating and timely parenteral or enteral nutrition support should be undertaken for patients with chronic pancreatitis.
4.Effects of sufentanil, remifentanil or fentanyl on cardiac output of elder patients during induction of general anesthesia
Yijun ZHU ; Guo RAN ; Chenxia LIU ; Yang BAO ; Dongping SHI
Chinese Journal of Primary Medicine and Pharmacy 2013;20(19):2893-2895
Objective To compare the effects of equivalent dose sufentanil,remifentanil or fentanyl on hemodynamic and cardiac output in the elderly patients during induction of general anesthesia.Methods Ninety elderly patients(ASA Ⅰ ~ Ⅱ) undergoing elective abdominal surgery under general anesthesia were randomly divided into sufentanil group(group S),remifentanil group(group R) and fentanyl group(group F),30 patients in each group.Patients in group S,group R and group F received sufentanil 0.2μg/kg,remifentanil 2μg/kg and fentanyl 2μg/kg Ⅳ,respectively,using an blind method before intubation.SBP,DBP,MAP,HR,CO,CI and SVR were recorded before of anesthesia (T0),immediately after induction (T1),1,3 minutes after tracheal intubation (T2,T3).Changes of SBP and HR during observation were also recorded.Results The MAP and HR in three groups at T1 were significantly lower than those at T0 and decreased significantly in group R than those in group F and S(P <0.05).The MAP and HR in group F significantly increased at T1 than T0.The MAP and HR in group R were significantly decreased after tracheal intubation.Compared with the baseline,the MAP and HR in group S at T1,T2,remained unchanged.In group R,there were two patients whose HR were under 50 bpm.In group F,the MAP at T1,T2 were significantly higher than those at T.In group S,there were no significant changes in CO,CI,SVR which were all within normal range (P > 0.05).Conclusion Both sufentanil and remifentanil effectively inhibit the stress response during induction of general anesthesia.At the same time,sufentanil has better hemodynamic stability.
5.Sharp Instrument Injuries in Nursing:Analysis and Prevention
Meirong WANG ; Xiulan ZHU ; Dongping FANG ; Xiange LIN
Chinese Journal of Nosocomiology 2006;0(09):-
OBJECTIVE To explore the incidence of sharp instrument injuries among nurses from the various classes of medical institutions and to analyze the cause and investigate the preventive countermeasures.METHODS To survey the sharp instrument injuries in nursing among 1050 nurses from 50 medical institutions.From 1050 questionaires,1028 were performed.RESULTS Among 1028 nurses from 50 medical institutions,903 nurses suffered different degrees of sharp instrument injuries with 87.84%,of which 40.75% and 31.12% were caused respectively in working age of 6-10 years and 11-15 years.All injury cases added up to 7059,with average of 7.80 times per person and 287(31.78%) cases were with over 10 times.Injuries for ampule in dispensing and clearance of instruments accounted for 70.63% and 15.54%,with the times of 4986 and 1097.Degrees of injury:the light injury of skin accounted for 57.69% with 4076 cases.CONCLUSIONS It is suggested to reform the craft of ampules and safety of instruments continually.Instrument cleaner is recommended if necessary.The key point is to strengthen the education of awareness on occupational protection and do self-protection best,which is sharply important to reduce the incidence of injuries.
6.The impact of early whole course patient controlled epidural analgesia on the fetus and neonate
Lindong YANG ; Yuanzhe WU ; Sihai ZHU ; Dongping RAO
Journal of Medical Postgraduates 2003;0(05):-
0.05),while the difference of dynamic HCO3-,BE in the umbilical blood gas analysis was significant statistically in the three groups(P
7.Current status of occupational protection awareness and behavior among medical interns
Siyan DING ; Xiaoqing SHAO ; Yiping MAO ; Dongping ZHU
Chinese Journal of Infection Control 2016;15(10):796-799
Objective To understand current status of occupational protection awareness and behavior among dif-ferent professional medical interns,and provide basis for strengthening the education about occupational protection among medical interns .Methods Questionnaire survey was used to survey medical interns at the end of their clini-cal internship.Results A total of 385 cases of occupational exposure occurred during internship period,occupation-al exposure rate was 42.31 % (385/910),occupational exposure mainly occurred in nursing interns (n =190).358 (39.34%)medical interns understood self-protective antibody (hepatitis B surface antibody);difference in occupa-tional exposure rates and awareness of self-protective antibody among different professional medical interns was sta-tistically significant (all P <0.05);222 (57.66%)medical interns sustained occupational exposure more than once, 45.45% of occupational exposure occurred during the process of diagnostic and therapeutic procedure,exposure mainly occurred in the wards (32.21 %).After occupational exposure,46.75% of medical interns felt nervous, 35.06% were worried,18.18% appeared serious psychological reaction,only 14.03% sought support and help from others.Conclusion Awareness of occupational protection among medical interns is insufficient,education and awareness of occupational protection should be intensified,psychological behavioral after occupational exposure should be paid attention among medical students.
8.Subject service in hospital library
Zhenchun CHEN ; Dongping ZHU ; Yongzeng HUANG ; Ming ZHANG
Chinese Journal of Medical Library and Information Science 2015;24(12):66-67
Measures to carry out subject service in hospital library were analyzed according to its human resources, information resources, subject librarian literacy, established systems, and service objectives.
9.Analysis of the complication of transvaginal hysterectomy of patients with non-prolapsed uterus
Xian HU ; Dongping LIU ; Rui ZHAO ; Xiaoli ZHU ; Yifei XUAN
Clinical Medicine of China 2011;27(12):1330-1333
Objective To explore the advantages and disadvantages of transvaginal hysterectomy for patients with non-prolapsed uterus,and explore the cause and preventive measurements of the complications of transvaginal hysterectomy.Methods The complications of transvaginal hysterectomy ( group TVH ) in 110 patients with non-prolapsed uterus and of transabdominal hysterectomy ( group TAH ) in 120 patients were compared with each other.These patients were chosen randomly from June 2006 to April 2010.Results In the TVH group,rectum hurt occurred in one patient,prolapse of fallopian tube in one patient and celiac internal bleeding in one patient.The preoperative diagnosis were not consistent with the postoperative diagnosis in four patients.Two patients encountered with postoperative residual end bleeding and four patients with vaginal residual end polyps.In the TAH group,three patients had postoperative diagnosis inconsistent with their preoperative diagnosis.In addition,there were four abdominal wall incision liquefaction ( including two phase suture in two patients),three postoperative bronchial lung infection and two residual end polyps.No celiac internal bleeding and visceral injury occurred in this group.Conclusion TVH has a higher risk of visceral injury and postoperative bleeding than TAH.These complications should be avoided when treating the patients with TVH technique.
10.Appropriate dose of remifentanil combined with propofol for painless artificial abortion
Weizheng FENG ; Yijun ZHU ; Dongping SHI ; Renlong ZHOU ; Yannan HANG
Clinical Medicine of China 2009;25(3):269-272
Objective To compare different dose of remifentanil combined with propofol for painless abortion and approach to an appropriate dose of remifentanil.Methods Ninety pregnant women with ASA 1 were randomly divided into three groups(n=30)before administrating remifetanil,a bolus midazolam 1 mg was injected inminutes later.These two drugs did not stop administration until three minutes before the end of negative suction.MAP,HR,SpO2,BIS,RR,VT,PET CO2 were monitored.The onset,operation and recovery time,sedation score and adverse reaction were recorded.Results Sedation scores were significantly different between group A and C [(3.90±0.97)and(4.90±0.85),t=4.24,P<0.01].Three cases in group A were found moving.MAP,HR,BIS decreased as compared witll baseline.HR reduced significantly in group C(P<0.05,P<0.01).Respiratory movement was lower and shallower.RR,VT decreased compared to preoperative one.PET C02 increased gradually (P<0.05,P<0.01).There were two cases of respiratory depressing in group A,four cases in group B and ten cases in group C(five cases apnea more than three minutes).All patients used oxygen mask to maintain SpO2>95%.Incidence of adverse reactions such as chest titanic,nausea and vomiting,itching were of no difference among three groups(P>0.05).All patients were satisfied with anesthesia.Conclusion The appropriate infusing dose of remifetory devices such as oxygen mask and monitoring life signs are very important to prevent respiratory depress and bradycardia during operation.