无痛人流不同麻醉的比较

为了更好地实行无痛人流,提高无痛人流的镇痛效果、降低麻醉风险及提高患者满意度,用比较治疗学的理念及方法对目前国内报道的一些主要无痛人流的麻醉方法进行比较和分析.结果发现镇静药丙泊酚与强效镇痛药复合应用于无痛人流安全有效.比较治疗学方法有助于无痛人流不同麻醉的临床抉择.     

无痛人流利弊谈

无痛人流术是对早孕妇女的一种人文关怀,它缓解了手术对身体和精神上的痛苦,但也引发了一些医疗、认识和社会问题.文中阐述了我国人流现状和无痛人流术的实施方法,分析了无痛人流的利与弊.指出应加强生殖健康教育和避孕知识宣传,规范医疗广告,让青年妇女正确认识无痛人流.     

无痛人流利弊谈

无痛人流术是对早孕妇女的一种人文关怀,它缓解了手术对身体和精神上的痛苦,但也引发了一些医疗、认识和社会问题。文中阐述了我国人流现状和无病人流术的实施方法,分析了无痛人流的利与弊。指出应加强生殖健康教育和避孕知识宣传,规范医疗广告,让青年妇女正确认识无痛人流。     

临床麻醉中常用中效肌肉松弛剂的比较

为了更准确在临床麻醉过程中使用中效肌肉松弛剂,用比较治疗学的理念及方法对目前国内报道的中效肌肉松弛剂阿曲库铵、顺式阿曲库铵、维库溴铵、罗库溴铵的应用方法进行比较和分析。结果发现：插管起效时间罗库溴铵最短,临床时效顺式阿曲库铵最长,阿曲库铵有组胺释放的作用,阿曲库铵和顺式阿曲库铵药物代谢主要是霍夫曼消除。比较治疗学方法有助于临床麻醉肌松剂的抉择。     

孕妇非产科手术麻醉的评估和思考

临床上约有1%~2%的孕妇在孕期接受非产科手术麻醉;因孕期生理改变和手术麻醉对孕妇、胎儿的影响,加之妊娠合并心脏病、糖尿病等特殊病例以及现代腔镜手术、无痛人流特殊技术等复杂因素,为确保孕妇与胎儿安全,术前充分的评估、恰当的麻醉方法、药物选择与术中调控是我们必须重视与思考的课题。     

孕妇非产科手术麻醉的评估和思考

临床上约有1%～2%的孕妇在孕期接受非产科手术麻醉;因孕期生理改变和手术麻醉对孕妇、胎儿的影响,加之妊娠合并心脏病、糖尿病等特殊病例以及现代腔镜手术、无痛人流特殊技术等复杂因素,为确保孕妇与胎儿安全,术前充分的评估、恰当的麻醉方法、药物选择与术中调控是我们必须重视与思考的课题.     

口腔治疗中心理干预配合无痛麻醉的体会

为了评价心理干预配合无痛麻醉技术的临床效果,寻求一种更有利于减轻患者恐惧心理的技术方法,将80例急性牙髓炎患者随机分为两组,实验组为心理干预配合无痛麻醉镇痛的患者,对照组为注射利多卡因局部麻醉镇痛的患者。观察两组在牙髓治疗中患者的恐惧程度与治疗效果。结果显示,心理干预配合无痛麻醉的实验组与注射利多卡因的对照组比较有显著差异（P〈0．05）．实验组患者的恐惧程度明显比对照组低。提示心理干预配合无痛麻醉可以明显减轻患者对治疗的恐惧感,值得在临床治疗中推广应用。     

“比较治疗学”与“循证医学”之比较

对比较治疗学与循证医学兴起的历史背景、基本内涵的差异以及在临床决策方法方面的关系进行了较为细致的比较。循证医学与比较治疗学分属于临床决策的两个不同的阶段,比较治疗学的内涵范围要大于循证医学,同时循证医学为比较治疗学提供主要的基础性决策依据,比较治疗学的决策方法是循证医学在临床决策方法上的新发展。两者对促进临床科学决策都具有重要意义。     

"比较治疗学"与"循证医学"之比较

对比较治疗学与循证医学兴起的历史背景、基本内涵的差异以及在临床决策方法方面的关系进行了较为细致的比较.循证医学与比较治疗学分属于临床决策的两个不同的阶段,比较治疗学的内涵范围要大于循证医学,同时循证医学为比较治疗学提供主要的基础性决策依据,比较治疗学的决策方法是循证医学在临床决策方法上的新发展.两者对促进临床科学决策都具有重要意义.     

“比较治疗学”的原理与方法浅析

重点论述比较治疗学的发展背景和历史、基本概念、治疗方法、以及比较治疗学的发展基础和其对临床医学所带来的影响等。比较治疗学的产生和发展对传统医学以及临床医生来说都是一个严峻的挑战,如果临床医生能熟练地掌握和综合地运用比较治疗学的决策方法去解决临床医学的问题,将会大大提高临床诊疗工作的科学性和合理性。     

人工流产手术室安全管理隐患剖析与思考

人工流产手术室（以下称人流室）的安全管理隐患直接导致人工流产术意外的发生,本文作者从多方面剖析了人流室安全管理隐患发生的原因,同时针对人流室的安全管理隐患如何有效防范提出了诸多解决措施,最后就目前人流室工作中存在的一些不足进行了必要的思考。     

合并精神疾病患者剖宫产术麻醉优化与医患安全保障

合并精神疾病患者接受剖宫产术时,由于此类患者的特殊性,患者以及其家属、医务人员心理表现都有别于普通情况。合理遵守此类患者的如下麻醉方案优化原则：麻醉操作可以实施原则、麻醉效能有效控制原则、避免诱发或加重精神疾病原则、患者无痛和新生儿安全原则、术后镇痛衔接原则、全程心理干预原则和替代麻醉预案制定原则,同时科学制定患者围术期如下管理规章制度：应急程序的及时启动、患者家属及监护人的沟通与知情同意、麻醉前后特定病房或医疗单位的建立和麻醉医疗期间医患合法权益的保障,只有这样医患双方安危和权益才能得到最佳保障。     

无痛胃镜麻醉的方法优化

探讨丙泊酚复合小剂量芬太尼进行无痛胃镜检查的麻醉效果及对呼吸循环的影响。选择胃镜检查患者80例,随机分为二组,每组40例。I组静注丙泊酚2mg/kg~2.5mg/kg;II组静脉先注入芬太尼1μg/kg,1分钟后静注丙泊酚1.5mg/kg~2mg/kg。两组均直至患者睫毛消失即可插入胃镜。观察检查中麻醉效果、苏醒时间、HR、SBP、DBP和脉搏血氧饱和度(SPO2)的变化。两组检查完成率均为100%。两组注药后HR稍有下降,但无明显差异(P0.05),SPO2较注药前明显下降(P0.05),但很快恢复到97%以上;I组SBP、DBP下降比II组显著(P0.05)。II组麻醉效果明显优于I组,两组苏醒时间相仿。丙泊酚用于门诊实施无痛胃镜安全可行,丙泊酚和芬太尼复合用药效果更佳,可减少丙泊酚用量。     

Cultivating a “Chairside Manner”: Dental Hypnosis,Patient Management Psychology,and the Origins of Behavioral Dentistry in America, 1890–1910

Discussions regarding the use of hypnotism in dentistry featured prominently in dental journals and society proceedings during the decades around the turn of the twentieth century. Many dentists used hypnotic suggestion either as the sole anesthetic for extractions or in conjunction with local and general anesthetics for excavation and cavity filling. With the heralding of humanitarian dentistry and improved local anesthesia around 1905, a number of dentists advocated using suggestion psychology to calm nervous patients and increase their comfort and satisfaction levels while undergoing dental procedures. The practice of hypnotic suggestion with local and general anesthesia in providing patients with increasingly painless procedures constituted the earliest variety of behavioral dentistry, a discipline not fully developed until the closing decades of the twentieth century. Hypnosis and suggestion became driving forces for psychological applications in the formative years of behavioral dentistry.     

中国古代堕胎考略

中国见于史书记载的堕胎行为从汉代就开始了,并且形成三种堕胎技术。唐宋以后,由于人口增长的压力,堕胎在一些地区出现了普遍化倾向,导致堕胎的公开化和职业化。但由于传统重生育、反堕胎观念的存在,堕胎技术一直受到歧视,得不到完善,人们为此付出了长期的血的代价。     

Severity and cost of unsafe abortion complications treated in Nigerian hospitals

CONTEXT: Each year, thousands of Nigerian women have unintended pregnancies that end in illegal abortion. Many such procedures occur under unsafe conditions, contributing to maternal morbidity and mortality. METHODS: In a 2002-2003 survey of women and their providers in 33 hospitals in eight states across Nigeria, 2,093 patients were identified as being treated for complications of abortion or miscarriage or seeking an abortion. Women's abortion experiences and the health consequences and associated costs were examined through bivariate analysis. Multivariate analysis was used to examine the characteristics of women by type of pregnancy loss and to compare characteristics among three groups of women who had induced abortions in differing circumstances. RESULTS: Among women admitted for abortion-related reasons, 36% had attempted to end the pregnancy before coming to the hospital (including 24% with and 12% without serious complications), 33% obtained an induced abortion at the facility (not withstanding the country's restrictive law) without having made a prior abortion attempt and 32% were treated for complications from a miscarriage. Of women with serious complications, 24% had sepsis, 21% pelvic infection and 11% instrumental injury; 22% required blood transfusion and 10% needed abdominal surgery. The women in this group were poorer and later in gestation than those who sought abortions directly from hospitals. They paid more for treatment (about 13,900 naira) than those who went directly to the hospital for an abortion (3,800 naira) or those treated for miscarriage (5,100 naira). CONCLUSIONS: Policy and program interventions are needed to improve access to contraceptive services and postabortion care in order to reduce abortion-related morbidity and mortality.     

芬太尼用于无痛胃镜检查优于等效剂量瑞芬太尼的临床研究

在无痛胃镜检查中观察并比较等效剂量瑞芬太尼和芬太尼血流动力学指标、氧饱和度的影响以及不良反应的发生率。择期无痛胃镜检查ASAⅠ级～Ⅱ级的患者90例,随机分为丙泊酚＋芬太尼组（PF组,n=40）和丙泊酚＋瑞芬太尼组（PR组,n=50）,记录患者睫毛反射消失时间、胃镜操作时间、苏醒时间以及用药前（T1）、睫毛反射消失时（T2）、胃镜过咽喉部时（T3）、胃镜退出时（T4）、苏醒时（T5）等时点血流动力学指标和氧饱和度。结果两组患者较术前都有明显的血压下降,PR组窦性心动过缓20例（40．8%）、PF组8例（20．0％）,PR组窦性心动过缓发生率明显增加（P〈0．05）。用于无痛胃镜检查麻醉时,瑞芬太尼不良反应较多,芬太尼相对更为安全。     

A Thematic Analysis of Men's Experience With a Partner's Elective Abortion

Research concerning men's experience with a partner's abortion is limited. To foster understanding of this topic, the authors used online surveys to gather data from men whose partners underwent induced abortion. A thematic analysis of men's comments about their experience revealed 3 salient themes: loss and grief, helplessness and/or victimization, and spiritual healing. Findings are discussed in terms of future research and counseling practices as they relate to pregnancy outcome decisions.