{"nowTime30":1711716731548,"lyBarModerator":null,"metaSearch":{"description":"大学生小闫在宿舍里拖完地洗拖把时,因旋转拖把上端的塑料手柄断裂,使里面的钢管裸露,小闫在给拖把快速旋转脱水时,右手手掌被裸露的钢管割伤,里面的肌腱和血管全部被割断。被送进医院后,医生在显微镜下用了两个小时,才将断开的肌腱和血管重新缝在一起。\n\n\n\n\n\n\n关于此事,且看网友如何评论:\n程宇默默:我是做","keywords":"家有这种扫帚拖把的当心 多人受伤 附划伤怎么处理恢复的快_洞医","title":"家有这种扫帚拖把的当心 多人受伤 附划伤怎么处理恢复的快_洞医","channels":null},"identificate":{"id":"0300b4bddfaf11e6a61c00163e04584d","isDel":0,"createAt":1484985344390,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","realName":"赵玉","certifiedStatus":2,"phone":"111111111111","email":"2276635444@qq.com","hospitalId":"31c19c1b453011e69d4700163e005165","departmentId":"2000","illName":"","illId":"793a72a2bb5f11e6a61c00163e04584d","cardType":1,"cardImg":"http://01luntan.com/ly_img/1484985951761.jpg","idCardImg":"","identityType":2,"stop":0,"departmentName":"儿科","hospitalName":null},"canEdit":null,"adList":[],"lyBar":{"id":"1690","isDel":0,"createAt":1483439340281,"createBy":"system","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"userId":null,"name":"北京协和医院神经外科","type":101,"twoCode":"http://zhao01.com/zly_img/zly_wx.jpg","image":null,"provinceId":"110000","cityId":"110101","illId":null,"hospitalId":"15009","keyWord":null,"totleTopic":0,"barDesc":null,"discussBarType":null,"metaSearch":"{\"description\":\"洞医为您提供:北京协和医院神经外科专家、北京协和神经外科专家、北京协和神经外科电话、病友的治疗经验等相关信息,让您在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"北京协和医院神经外科专家_北京协和神经外科专家_北京协和神经外科电话_洞医\",\"title\":\"北京协和医院神经外科专家_北京协和神经外科专家_北京协和神经外科电话_洞医\"}","adInfo":null},"isLikeThisTopic":null,"lastTopics":[{"id":"3342","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"颅底骨折并发尿崩症及其护理","content":"
一、原因分析
尿崩症的发生是由于下丘脑的视上核、室旁核、灰白结节、神经纤维束通路和脑垂体的损害,影响抗利尿激素 \n(adh)的分泌、释放和贮存减少,导致adh缺乏或肾小管对 \nadh失去反应,从而出现每天排出大量稀释性尿液。头部外伤后尿崩症系下丘脑或垂体柄损伤所致,垂体柄在颅底相对固定,颅底骨折由于外伤当时的旋转和剪力机制引起下丘脑或垂体柄的损伤而发生尿崩症。
二、 护理
1 病情观察
生命体征、神志、瞳孔的观察: 30 \nmin/次,准确记录,颅脑外伤患者首先应该着眼于颅内病情尤其是颅内压的变化的观察,如有血压、心率的变化,同时应及时准确计算出入量是否平衡。如有尿量突然增多并且排除利尿等因素的影响,应注意补充液体,纠正低血容量和电解质的紊乱,使生命体征恢复正常;尿量、烦渴的观察:对于清醒患者有烦渴症状要引起足够的重视,监测尿量和尿比重,有尿崩症表现应该及时处理。昏迷患者注意记录每小时尿量,观察尿的颜色, \n发现尿液增多,颜色逐渐变淡提示多尿或尿崩症的出现,每小时尿量>200 m,l比重<1. \n006,应该及时处理,我们的经验是,清醒患者嘱其多饮水;昏迷患者从胃管内补充所失去的体液,或者从静脉补充,但应注意防止补液过多造成脑水肿或心脏负担过重;水电解质平衡的监测:遵医嘱及时准确的监测血中k+、na+、cl-、ca2+、血糖、尿比重及血浆渗透压, \n4 h/次~ 6 \nh/次。观察患者有无面色的改变、全身乏力、肢体抽搐及意识淡漠等变化。通过血生化的监测了解机体水电解质平衡状态,合理的补充,保持机体内环境的平衡。清醒患者可以口服的尽量口服补充,有胃管的尽量从胃管鼻饲,急性失液经静脉补充。
2 药物治疗的监测
危重患者在尿崩症初期均采用垂体后叶素4 u~8 u皮下注射, 6 h/次~8 h/次,尿量控制后改为弥凝片口服,根据病情调整用药剂量。患者均在10 \nd左右尿量得到很好的控制,改为口服弥凝片。在用药的过程中要注意药物反应,出现过敏现象的及时停药,还应该注意尿量的变化,少尿时及时的调整用药剂量或停药。
3 加强基础护理,预防并发症
呼吸道管理:颅脑损伤患者宜尽早做气管切开,并且使用带气囊的气管导管,以防止口腔的分泌物和痰误吸入气管造成窒息,呼吸道管理不好容易造成脑缺氧加重病情,同时也增加了肺部感染的机会。在临床护理过程中,应及时的清理呼吸道的分泌物,颅底骨折的血液,呕吐物等,注意翻身、叩背以防止痰液堵塞气管支气管造成窒息或感染;口腔、皮肤护理:尿崩症的患者往往口腔黏膜、舌头及皮肤干燥,弹性差,注意口腔护理,同时保持皮肤润滑, \n适当使用护肤品,勤换衣裤,保持床单清洁、平整;饮食护理: \n危重患者应从鼻饲中补充水分及必要的营养,避免高蛋白,鼻饲不足的要经静脉补充,便秘者酌情运用导泻药。
2015年六月第一次发作,没有意识到是这个病,未就医。2016年四月第二次发作,去甘肃中西医结合医院确疹为癫痫开始每天吃一片德巴金,每三十几天发作一次,都是大发作。八月四号去唐都作全面检查,八月八号开始加量,控制的挺好,就是身上痒,有皮疹。
德巴金加量后效果理想,就是出现皮疹,望指导!
脑疝大家应该都不熟悉,我也是最近听同事说起才知道原来还有这样的一种疾病,但是不要小看这种疾病,脑疝是一种很严重的脑部疾病,出于好奇心我特意收集了一些关于脑疝的主要症状的一些文章,丰富下自己的知识面,下面我给大家分享下脑疝有什么症状。
\n一小脑幕切迹
\n1.颅内压增高的症状:表现为剧烈头痛及频繁呕吐其程度较在脑疝前更形加剧并有烦躁不安
\n2.意识改变:表现为嗜睡浅昏迷以至昏迷对外界的刺激反应迟钝或消失
\n3.瞳孔改变:两侧瞳孔不等大初起时病侧瞳孔略缩小光反应稍迟钝以后病侧瞳孔逐渐散大略不规则直接及间接光反应消失但对侧瞳孔仍可正常这是由于患侧动眼神经受到压迫牵拉之故此外患侧还可有险下垂眼球外斜等如脑疝继续发展则可出现双侧瞳孔散大光反应消失这是脑干内动眼神经核受压致功能失常所弓[起
\n4.运动障碍:大多发生于瞳孔散大侧的对侧表现为肢体的自主活动减少或消失脑疝的继续发展使症状波及双侧引起四肢肌力减退或间歇性地出现头颈后仰四肢挺直躯背过伸呈角弓反张状称为去大脑强直是脑干严重受损的特征性表现
\n5.生命体征的紊乱:表现为血压脉搏呼吸体温的改变严重时血压忽高忽低呼吸忽快忽慢有时面色潮红大汗淋漓有时转为苍白汗闭体温可高达41℃以上也可低至35℃以下而不升最后呼吸停止终于血压下降心脏停搏而死亡
\n二枕骨大孔疝:病人常只有剧烈头痛反复呕吐生命体征紊乱和颈项强直疼痛意识改变出现较晚没有瞳孔的改变而呼吸骤停发生较早
\n三大脑镰下疝:引起病侧大脑半球内侧面受压部的脑组织软化坏死出现对侧下肢轻瘫排尿障碍等症状
\n大家看完以后相信已经对脑疝这种疾病的主要症状了解一些,这种疾病还是比较厉害的,建议大家发现以后一定要去正规的医院就诊。
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引起脑疝的原因是什么
\n颅内任何体积较大的占位病变引起颅腔内压力分布不均时都可引起脑疝。病变在幕上者引起小脑幕切迹疝,病变在幕下者引起枕骨大孔疝。引起脑疝的常见病变有:
\n1.损伤引起的各种颅内血肿,如急性硬脑膜外血肿、硬脑膜下血肿、脑内血肿等;
\n2.各种颅内肿瘤特别是位于一侧大脑半球的肿瘤和颅后窝肿瘤;
\n3.颅内脓肿;
\n4.颅内寄生虫病及其他各种慢性肉芽肿。在上述病变的基础上如再附加一些人为的因素,例如作腰椎穿刺释放过多的脑脊液,使颅腔与椎管之间、幕上分腔与幕下分腔之间的压力差增大,可促使脑疝的形成。这种由于医源性因素造成的脑疝,临床医师应予避免。
\n\n
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大学生小闫在宿舍里拖完地洗拖把时,因旋转拖把上端的塑料手柄断裂,使里面的钢管裸露,小闫在给拖把快速旋转脱水时,右手手掌被裸露的钢管割伤,里面的肌腱和血管全部被割断。被送进医院后,医生在显微镜下用了两个小时,才将断开的肌腱和血管重新缝在一起。
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关于此事,且看网友如何评论:
\n程宇默默:我是做这个产品的,我知道、越厚不现实,主要还是拖把公司没有设计好,头上塑料扣用打孔卡死就不会出现这个情况,主要是拖把公司嫌费神费力吧
\n耐力不存在gyy:我老公前几年帮我拖地的时候也是把套脱落,往回拉拖把的时候一下杵到膝盖上了,血哗哗的流,骨膜都被磕掉一块,缝了好几针,现在阴天的时候膝盖就算疼,我的腿也被划破过,现在还有疤,这真的挺坑人的,还是要合理设计一下,避免更多人受伤。
\n鹊鸦:这个应该属出厂质量把关 总不能什么都便宜没好货 用个家用工具都提心吊胆
\n墨沫的摩尔之恋:我同事之前扫地的时候也被划过~流了好多血呢~
\n\n
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身体被划破的家庭应急处理方法。
\n1、如伤口不大不深,出血不多,伤口干净,可用酒精消毒伤口周围,不要将消毒液弄进伤口内,待干后用消毒纱布覆盖包扎,或用创可贴粘贴。
\n2、如果伤口切缘整齐并且干净,长度在2厘米之内,深度不超过1厘米,或虽不干净,但经过消毒处理后,在受伤后8小时内,可用创可贴或止血消炎贴粘合,使伤口合拢,促使其愈合。
\n3、如无创可贴,也可用胶布覆盖伤口。但伤口切忌直接接触胶布。可在伤口上涂以消炎药等敷料,或衬以小块消毒纱布。
\n4、为了防止感染,可以服些消炎药,如麦迪霉素每次0.2g,每日4次;或复方新诺明2片,每日2次。
\n5、若伤口较深,接触泥土或脏物,还须速去医院注射破伤风抗毒素。
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