OBJECTIVE: Through preoperative temporary balloon occlusion of internal carotid artery and monitoring of carotid artery stump pressure variation, in order to further predict the risk of carotid artery ligation and resection, evaluation operative risk and provides the reference for the choice of surgical approach. METHOD: Continuous monitoring and recording the carotid artery stump return pressure,before clamping and in the process of blocking, close observation the patients mental state and the nervous systemof all kinds of signs, in the process of blocking, to understand the dynamic change of stump artery pressure return in patients and whether can the smooth passage of carotid artery balloon occlusion test. RESULT: Of the 19 patients, 4 cases were positive, 15 negative cases, Blocking immediate the positive patients and negative patients with stump pressure drop was (57. 35 ± 1. 89) % and (38. 99 ± 12. 23) %, with statistical significance between the two, in the process of blocking, the mean stump pressure of the positive patients and the negative patients was (37. 29 ± 3. 15) mmHg and (61. 36 ± 14. 69) mmHg, with statistical significance between the two. CONCLUSION Approximately 21. 05% of patients can not tolerate carotid artery balloon occlusion test, theory for carotid artery reconstruction operation. After blocking the stump pressure is less than 40. 44 mmHg, the theory for reconstruction of the internal carotid artery operation. Blocking instant artery stump pressure dropped more than 55. 46%, in theory the need for internal carotid artery reconstruction.
Balloon Occlusion ; Blood Pressure ; Carotid Artery, Internal ; surgery ; Feasibility Studies ; Humans ; Ligation ; Preoperative Care ; Risk Assessment ; Vascular Surgical Procedures

Objective To observe and analyze the application of Pareto law and PDCA principle in ICU nursing teaching. Methods Totally 133 nursing interns in ICU from October 2015 to October 2016 were chosen as the control group adopting the routine nursing teaching method; 137 nursing interns from November 2016 to November 2017 were selected as the experimental group for whom Pareto law and PDCA principle were applied in ICU nursing teaching. The post-teaching theory, skill test scores, quality of nursing documents and satisfaction with teaching were compared between the two groups. Results As for the doctor's order list, body temperature list, nursing record sheet, repairable rate of nursing document defect, the test group accounted for 0.73％ (1/137), 0, 0.73％ (1/137) and 1.46％ (2/137) respectively, while those of the control group were respectively, 5.26％ (7/133), 4.51％ (6/13), 8.27％ (11/13), and 18.05％(24/133). The difference between the two groups was statistically significant (χ2=4.8235-39.3526, P<0.05 or <0.01)). In the experimental group, the scores of theoretical knowledge, professional operation, patient management and work attitude were as follows:(93.5±1.4), (94.9±1.1), (89.2±3.3) and (91.5±2.6);those of the control group were respectively (93.5 ± 1.4), (94.9 ± 1.1), (89.2 ± 3.3) and (91.5 ± 2.6). The difference was statistically significant (t=21.3228-26.9353, P<0.01). The satisfaction rate of the test group was 100.00％ (137/137), and that of the control group was 69.17％ (92/133). The difference was statistically significant (χ2=41.3671, P<0.01). Conclusion In ICU nursing teaching, the application of Pareto law and PDCA principle can effectively improve the test scores of theory and skill operation after nursing teaching, enhance the quality of nursing documents, improve the interest of nursing interns in learning, and raise the teaching satisfaction rate. Thus, the effect is ideal.