简介:摘要目的探讨80 kV管电压联合个体化对比剂低剂量注射方案行颈动脉CT血管成像的可行性。方法前瞻性纳入需要行颈部CT血管成像(CTA)检查的136名患者,采用完全随机区段法分成A、B、C、D 4组,A组为100 kV 15 s团注常规组,53例;其他3组为80 kV 10 s团注对照组,根据≤50 kg、50~70 kg、70~90 kg体重分为B、C、D组,分别给予20、25和30 ml对比剂,B组20例,C组38例,D组25例。比较4组的有效剂量(E)、图像质量主观评价和客观指标。结果B、C、D 3组的E分别为(1.85±0.91)、(1.89±1.08)和(2.14±1.27)mSv,显著低于A组的(5.66±0.56)mSv,差异有统计意义(F=169.34, P<0.05),B、C、D组间两两比较差异无统计学意义(P>0.05)。4组图像的主观评价和诊断效果差异无统计学意义(P>0.05)。A组的颈总动脉CT值、信噪比(SNR)、对比噪声比(CNR)明显低于其他3组,差异均有统计意义(F=14.90、12.94、14.43,P<0.05),但所有颈动脉靶血管内CT值均在250 HU以上,均符合临床诊断要求。结论80 kV管电压10 s团注方案,可有效降低颈部CTA检查的辐射剂量和对比剂用量,而并不影响诊断效果。因此,该扫描方案可行且具有很大的临床应用价值。
简介:摘要:本文对门诊手术室的麻醉复苏室设立和护理相关内容进行了研究,阐述了我院门诊复苏室规模和现状,介绍麻醉复苏室功能和使用价值。研究过程中,重点分析了护理工作程序,总结相关护理体会,为进一步完善医院麻醉手术服务提供理论指导。相关研究也为临床护理工作水平提升贡献了价值,为我院整体形象提升作出有益贡献。
简介:AbstractBackground:Models to predict mortality in trauma play an important role in outcome prediction and severity adjustment, which informs trauma quality assessment and research. Hospitals in China typically use the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) to describe injury. However, there is no suitable prediction model for China. This study attempts to develop a new mortality prediction model based on the ICD-10-CM lexicon and a Chinese database.Methods:This retrospective study extracted the data of all trauma patients admitted to the Beijing Red Cross Emergency Center, from January 2012 to July 2018 (n = 40,205). We used relevant predictive variables to establish a prediction model following logistic regression analysis. The performance of the model was assessed based on discrimination and calibration. The bootstrapping method was used for internal validation and adjustment of model performance.Results:Sex, age, new region-severity codes, comorbidities, traumatic shock, and coma were finally included in the new model as key predictors of mortality. Among them, coma and traumatic shock had the highest scores in the model. The discrimination and calibration of this model were significant, and the internal validation performance was good. The values of the area under the curve and Brier score for the new model were 0.9640 and 0.0177, respectively; after adjustment of the bootstrapping method, they were 0.9630 and 0.0178, respectively.Conclusions:The new model (China Mortality Prediction Model in Trauma based on the ICD-10-CM lexicon) showed great discrimination and calibration, and performed well in internal validation; it should be further verified externally.
简介:【摘要】目的:讨论手术室急诊患者护理中实施循证手术室护理的临床效果。方法:选取我院2019年11月-2020年11月期间我院手术室急诊患者120例作为研究对象,将患者采用数字随机分组法分为实验组组和观察组,实验组(n=60),观察组(n=60)。实验组患者给予手术室常规护理,观察组患者给予手术室循证护理,研究其临床意义。结果:数据表明,观察组患者术后不良反应有2例,发生率为3.33%,实验组患者不良反应有9例,发生率为15.00%,观察组较优。差异有统计学意义(P<0.05)。结论:手术室急诊患者护理中实施循证手术室护理具有较好的临床意义,可以有效降低患者术后不良反应的发生,值得借鉴。