Preoperative psychological guidance on anesthesia

ncycgdxhl · Wysłany: Czw 0:05, 10 Mar 2011

Preoperative psychological guidance on anesthesia of restlessness and nausea and vomiting

, After the disease can leave behind thrombosis syndrome, affecting the quality of life of patients, resulting in patients with pulmonary embolism can be life-threatening, so early diagnosis and timely treatment on the prognosis is extremely important. Our hospital from July 1999 to May 2005 two-dimensional and color Doppler ultrasound in 36 cases of lower extremity venous thrombosis were examined, the final report is as follows. 1 Data and methods 1.1 General Information The group of 36 patients were diagnosed with color Doppler in patients with deep vein thrombosis, including 28 males and 8 females; aged 24-78 years,[link widoczny dla zalogowanych], mean 49 years old. One result of surgery or trauma caused by a variety of lumbar spine, pelvis or lower extremity fractures were 23 cases, 5 patients bedridden due to chronic diseases, 3 cases of postpartum pelvic tumor compression of iliac vein in 2 cases, 3 cases of other instruments and methods of application of 1.2 L0g] Q400CLPROSeries mode color Doppler ultrasonic diagnostic apparatus, the probe frequency of 7.5MHz and 3.5MHz. Check the patient according to the needs and circumstances, choose supine, lateral or prone position, the natural extension of bilateral lower extremities, so that the muscles in a relaxed state. Along the common iliac vein, external iliac vein, femoral vein, torso, and the anterior tibial vein,[link widoczny dla zalogowanych], the vein diameter longitudinal section lines and go cross-section of the probe. 3.5MHz probe with the iliac vessels, other vessels with a 7.5MHz probe, real-time observation of the vessel lumen, vessel diameter, vascular wall and membrane, blood vessel elasticity and blood vessels surrounding circumstances, record thrombus location, extent and change of color Doppler flow . During operation should be as far as possible the most sensitive color Doppler image shows,[link widoczny dla zalogowanych], the blood sampling frame deflection, making it the smallest angle with the vein. Check the popliteal vein, such as when to take the prone position, the dorsum of the foot and ankle pad in a softer material to avoid the high traction and popliteal vein shows Hyperextension unclear ¨ J. Should be fully exposed during the operation and check the site compared with the contralateral observation,[link widoczny dla zalogowanych], as appropriate, with the local probe pressure, valsalva test and distal limb compression test will help show diseases and diagnosis. 2 Results of 36 cases of deep vein thrombosis cases were obtained by color Doppler ultrasound diagnosis. The left lower extremity in 22 cases, 12 cases of right lower limb, both lower limbs in 2 cases. 29 cases of acute deep vein thrombosis, including 24 cases of complete embolization, ultrasound tests showed lesion cavity was enlarged, filled with homogeneous hypoechoic, vascular walls and thrombosis clear boundaries, no thickening, rounded cross section, rather than normal flat circle. Color Doppler showed no blood flow signal lesions; 5 patients with incomplete embolization, indicating lesion-like substance within the low echo of broadband, accounting for one half of the vessel lumen over time was observed with blood clots swinging distal , Color Doppler shows filling defect of local blood flow, blood thinner. Sub-acute and chronic deep vein thrombosis in 7 cases, the vessel wall and thrombosis ill-defined, localized or diffuse wall thickening, vessel diameter was normal, blood clots were higher echo. Thrombosis or blood clots in the middle of the edge of banded or spotted color blood flow, blood flow was significantly thinner, the thickness varies, in some cases after only to see the point of extrusion sheet distal limb blood flow, there are blue red, indicating the direction of blood flow in the thrombus change. Occlusion site was superficial venous collateral formation and a significant expansion, the main way to venous blood or unusual non-dependent way back. 3 discussed deep vein thrombosis because of the vessel wall chemical, mechanical, infectious causes such as inflammation and tissue thickening or hypercoagulability of the blood and the formation of venous flow stagnated. The incidence of fractures and significantly increased after surgery, trauma and surgery because of the hemodynamic changed. While the long post-traumatic limb fixed limit a patient's activities, so long in bed, lower extremity venous reflux stagnant, creating the conditions for the thrombosis. The left lower extremity deep venous thrombosis more common than the right side, because the left iliac vein by the abdominal aortic bifurcation and left iliac artery and the pressure caused by the inguinal ligament. Improve the patient's psychological threshold. At the same time we also taught the method in patients with extubation, can better meet the anesthesia recovery, significantly reduced the emergence of agitation, nausea and vomiting and other symptoms. Communicate with the anesthesiologist, the patient's anxiety and fear has been a large degree of ease,[link widoczny dla zalogowanych], this study showed that after treatment, preoperative psychological guidance, restlessness and nausea and vomiting was significantly reduced, and cardiovascular events significantly reduced the incidence of postoperative follow-up, patients expressed satisfaction with this method.