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Association between insomnia and hypertension: a meta-analysis

ObjectiveTo systematically review the association between insomnia and the risk of hypertension. MethodsThe EMbase, PubMed, The Cochrane Library, VIP, WanFang Data and CNKI databases were electronically searched to collect cohort studies on the association between insomnia and hypertension from inception to October 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 13.0 software. ResultsA total of 20 cohort studies involving 607 409 participants were included. The results of meta-analysis showed that insomnia increased the risk of hypertension (RR=1.24, 95%CI 1.15 to 1.34, P<0.000 1). Subgroup analysis showed that insomnia increased the risk of hypertension in North American, European and Oceanian population, but not in Asian population. The difficulty falling asleep, difficulty maintaining sleep and early awakening all increased the risk of hypertension. ConclusionCurrent evidence suggests that insomnia increases the risk of hypertension.

神经外科麻醉苏醒室的呼吸道管理和护理体会

目的探讨神经外科麻醉苏醒室（N-PACU）麻醉苏醒期呼吸道管理及呼吸系统并发症的护理。 方法对2012年1月－2013年5月行颅脑神经外科手术的2 231例患者带气管导管术毕返回N-PACU进行观察记录，对麻醉苏醒期间出现的各种呼吸系统并发症及护理方法进行分析。 结果在麻醉苏醒期出现了124例低氧血症，发生率约为5%，所有患者经积极处理后均安全返回病房，无患者死亡。 结论N-PACU医护人员的谨慎观察和及时处理是保障患者安全渡过麻醉苏醒期的重要保障。

无痛纤维支气管镜检查围手术期护理

目的　总结无痛纤维支气管镜检查围手术期护理要点。 方法　对2011年11月－2012年5月行无痛纤维支气管镜检查的335例患者的围手术期护理方法进行回顾分析。 结果　335例患者均顺利完成检查，仅1例出现低氧血症但无麻醉意外发生，患者平均检查时间为（12.9 ± 2.27）min。 结论　采取积极有效的围手术期护理措施，能有效降低无痛纤维支气管镜检查患者围手术期相关并发症的发生率。

无痛胃肠镜检查患者麻醉苏醒期并发症及护理

【摘要】 目的 探讨无痛胃肠镜检查麻醉苏醒期常见并发症及其护理。 方法 对2003年7月-2009年3月行无痛胃肠镜检查术患者在麻醉苏醒期出现的各种并发症状况及护理方法进行分析总结。 结果 呼吸道不通畅导致的低氧血症是行无痛胃肠镜检查术患者在麻醉苏醒期间最常见的并发症，有756例，其次为因呼吸道分泌物致呛咳（421例）、恶心呕吐（131例）、低血糖（45例）等。经过积极处理后，无一例患者死亡。 结论 低氧血症是行无痛胃肠镜检查术患者在麻醉苏醒期间最常见的并发症，其次为因呼吸道分泌物致呛咳、恶心呕吐、低血糖等。加强麻醉苏醒期的护理可以预防和减少麻醉相关并发症的发生。

小儿七氟烷麻醉后苏醒期躁动的管理及护理要点

七氟烷作为一种无刺激味、气道刺激性小，尤其是诱导迅速、苏醒快、呼吸抑制弱的吸入麻醉药，目前已成为各类小儿外科手术全身麻醉诱导和维持的主要药物。但七氟烷全身麻醉苏醒期躁动的发生率显著高于静脉麻醉药。七氟醚麻醉后的苏醒期，即使无疼痛等其他刺激，部分患者也会出现躁动、兴奋。七氟醚麻醉后苏醒期躁动的发生率为 10%～67%，以学龄前儿童发生率最高。为防治这种现象，临床使用咪达唑仑、丙泊酚等药物，不仅可能出现呼吸抑制、缺氧等不良事件，同时会明显延长患儿在麻醉苏醒室（postanesthesia care unit，PACU）内的停留时间，增加医疗成本，对手术效果、PACU 医护人员配备、家长的满意度甚至患儿自身安全等都带来了严重的影响，所以七氟烷麻醉后苏醒期躁动是小儿麻醉医生及 PACU 医护人员最为关注的临床事件之一。为了提高小儿麻醉质量，该文系统回顾了小儿七氟烷全身麻醉苏醒期躁动的评估、病因、管理护理以及合理干预措施。

无痛胃镜下行食管静脉曲张套扎术后患者麻醉苏醒期的护理

【摘要】　目的　总结对无痛胃镜下行食管静脉曲张套扎术患者麻醉苏醒期的护理要点。　方法　2009年3月－2009年10月，对83例食管静脉曲张患者在无痛胃镜下行曲张静脉套扎术，术后麻醉苏醒期采取密切观察、积极预防、及时处置等有效护理措施，防止并发症发生。　结果　麻醉苏醒期，有7例患者出现低氧血症，1例出现反流但无误吸。　结论　积极有效的护理措施，能有效降低无痛胃镜下食管静脉曲张套扎术患者麻醉苏醒期相关并发症的发生率。

ICU医护人员对床旁X线摄片的防护对策

目的　探讨ICU医护人员对床旁X线摄片的防护方法与措施。 方法　通过采取时间防护、屏蔽防护、距离防护、提高医护人员防护认知等方法，加强对床旁X线摄片的辐射进行防护。 结果　医护人员对床旁X线摄片防护措施满意度较高；年度体检中未出现与X射线不良反应有关的表现，白细胞均在正常范围。 结论　在合理、科学、正确的应用辐射技术的同时，应使之达到辐射防护的最优化，最大限度的预防和缩小电离辐射对人类的危害。

下丘脑反应的紧急处理及护理一例

高危药品静脉输注外渗三例

Research status of peripherally inserted central catheter: a bibliometric analysis based on Foreign Medical Retrieval System

ObjectiveTo explore the trend and hotspots of research in the field of peripherally inserted central catheter (PICC), so as to provide a reference for clinical nursing and nursing research in the field of vascular access in China.MethodsAll PICC-related articles from 1806 to November 22nd, 2018 were searched in the Foreign Medical Retrieval System. The publication amount, year of publication, language, country, journals and impact factor, high-yield authors and high-frequent medical subject headings (MeSH) of the PICC-related articles were analyzed by using frequency, cumulative frequency, and constituent ratio.ResultsA total of 1 550 articles were included. They were published in 586 journals, of which 393 were included in Science Citation Index. English was the dominant publication language, and the top high-yield country was the United States. The top 16 high-yield authors published 199 articles, the top 3 of whom all had published co-operative papers, ranging from 1 article to 19 articles. The top 3 high-frequent MeSHs were “Catheters, Indwelling” “Catheterization, Central Venous” “Central Venous Catheter”.ConclusionsPICC has become a hotspot in clinical research, and the publication amount of relative literature has increased rapidly since 2000. Chinese scholars should improve their English and carry out multi-center cooperative research to improve the quality of PICC-related literature.