重型颅脑损伤患者急救护理体会

目的:探讨重型颅脑损伤适宜的手术室急救护理方式。方法:选取重型颅脑损伤患者100例随机分为观察组和对照组各50例。对照组实施常规手术室护理,观察组在此基础上加强护理,观察两组护理效果。结果:观察组患者总有效率为88%,明显优于对照组的64%,差异具有统计学意义(P<0.05)。结论:加强手术急救护理能够缩短重型颅脑损伤患者急救时间,降低死亡率。     

急诊护理路径在重症颅脑损伤患者急救中的应用效果观察

目的:对急诊护理路径的实施方法进行探讨,了解其与常规护理在抢救重症颅脑损伤中的临床效果。方法:按照随机数字表法将42例患者分为两组,观察组按急诊护理路径进行护理,对照组给予常规护理。分析和比较两组入院前以及救治后APACHEⅡ评分结果、住院时间、救治所耗费的时间、患者住院死亡例数、抢救中死亡例数、抢救所花费的治疗费用。结果:经及时抢救和护理处理后,两组患者救治后APACHEⅡ评分均明显下降(P<0.05),且观察组救治后分数明显低于对照组(P<0.05)。观察组各项情况均优于对照组,且所花费抢救费用更低(P<0.05)。结论:在对重症颅脑损伤患者进行抢救时,缩短时间是关键。急诊护理路径通过争取抢救的每一分每一秒,使患者能够在最佳时间获得最好的救治,故取得了非常好的救治效果。     

SOFA评分对颅脑损伤患者病情及预后的评价

目的探讨序贯器官衰竭估计（SOFA）评分系统对颅脑损伤患者病情及预后的评价。方法对105例符合条件的急性颅脑损伤患者进行回顾性分析,按临床结局分为死亡组（n=41）和存活组（n=64）,记录入院后每天的相关资料,进行SOFA评分,并对入院即刻（SOFA1）和入院72h（SOFA2）SOFA评分进行分析。结果死亡组和存活组SOFA1、SOFA2及△SOFA（SOFA1与SOFA2之差）,差异有统计学意义（均P〈0.01）。SOFA2评分越高,病死率越高。结论 SOFA评分结果与颅脑损伤患者的预后有关。动态应用SOFA评分,同时辅以其他指标,可以为颅脑损伤患者的病情及预后评估提供有价值的参考。     

重症颅脑损伤患者急救治疗中临床护理路径的建立与效果

目的:探讨重症颅脑损伤患者急救治疗中临床护理路径的建立方法与效果。方法:选取2016年12月-2018年12月本院急诊收治的102例重症颅脑损伤患者,随机分为对照组和观察组,各51例。对照组按颅脑重症损伤进行常规急救及护理,观察组在对照组基础上实施临床护理路径,对比两组救治结果、并发症情况、救治效率及病情危重程度改善情况。结果:观察组并发症发生率显著低于对照组(P<0.05)。观察组分诊评估时间、建立静脉通道及气管插管时间、急救总时间、住院时间均显著短于对照组(P<0.05)。急救后,观察组APACHEⅡ评分显著低于对照组(P<0.05)。结论:临床护理路径可有效提升重症颅脑损伤患者急救护理质量、急救效果与效率,有利于患者预后改善。     

快捷临床护理路径在重型颅脑损伤患者急救中的应用研究

目的:分析快捷临床护理路径在重型颅脑损伤患者急救中的应用效果。方法:收集本院2009年11月-2014年10月诊治的96例重型颅脑损伤患者作为研究对象,依据患者的护理方式将其分为快捷临床护理路径组与常规护理管理组,每组各48例患者。常规护理管理组患者在急救过程中按照常规护理管理模式进行护理,快捷临床护理路径组患者则在急救过程中应用快捷临床护理路径模式,观察患者的抢救时间、住院总费用、住院时间、GOS评分、二次损伤情况、肺部感染情况以及患者满意度情况。结果:快捷临床护理路径组患者的抢救时间和住院时间明显短于常规护理管理组,住院总费用明显低于常规护理管理组,GOS评分明显高于常规护理管理组,两组比较差异均有统计学意义(P<0.05)。二次损伤情况明显轻于常规护理管理组,快捷临床护理路径组中有2例患者发生肺部感染,肺部感染率为4.17%,常规护理管理组中有13例患者发生肺部感染,肺部感染率为27.08%,快捷临床护理路径组肺部感染率明显低于常规护理管理组,且快捷临床护理路径组患者满意度明显高于常规护理管理组,两组比较差异均有统计学意义(P<0.05)。结论:快捷临床护理路径在重型颅脑损伤患者急救中有良好的应用效果。     

急救支招：交通事故中颅脑的损伤

在交通事故中，因受撞击而导致驾驶员和乘员颅脑损伤的，多为常见。有些司机安全意识较强，但对交通事故的自救、他救、急救知识了解不多，一旦发生事故特别是颅脑损伤一筹莫展，延误了抢救的最佳时机，乃至痛失性命。     

急诊护理流程对急性心脏外伤患者救治效果的影响研究

目的:探讨急诊护理流程对急性心脏外伤患者救治效果的影响。方法:选取2013年1月-2015年12月本院心外科收治的心脏创伤手术患者共56例作为观察组,选取2011年1月-2012年12月收治的心脏创伤手术患者共57例作为对照组,对照组患者采取传统常规护理,观察组患者采用急诊护理流程,比较两组患者抢救成功率、并发症发生率(包括心律失常、心力衰竭、消化道出血、肺出血等)、住院期间死亡率(排除院前急救死亡者)、住院时间及患者满意率。结果:观察组患者的抢救成功率为98.21%,高于对照组的82.46%;观察组患者的并发症发生率为12.50%,低于对照组的43.86%;观察组患者住院期间死亡率为1.79%,明显低于对照组的17.54%;观察组患者的住院时间为(15.34±4.33)d,明显短于对照组的(20.53±5.04)d;观察组患者的满意率为90.91%,明显高于对照组70.21%。两组上述指标比较差异均有统计学意义(P<0.05)。结论:急诊护理流程能够使护理人员对心脏创伤患者进行针对性的护理干预,提高患者救治效果,降低并发症,临床效果满意。     

急诊老年重型颅脑损伤死亡的影响因素分析

目的探讨影响急诊老年重型颅脑损伤的因素。方法回顾性分析我院自2010年1月~2014年12月急诊收治的重型颅脑损伤的老年患者313例,其中因重型颅脑损伤死亡127例,采用单因素及多因素分析方法分析其其临床资料。结果单因素结果分析显示,年龄、血红蛋白(Hb)、体温(<36℃或>38.5℃)、ISS评分、GCS评分、损伤后时间、胸腹部联合损伤、休克为影响老年重型颅脑损伤死亡的因素(P均<0.05)。根据单因素分析结果,将P<0.05指标纳入多元logistic回归分析,结果显示Hb、ISS评分、GCS评分、损伤后时间、胸腹部联合损伤为老年重型颅脑损伤死亡的独立影响因素(P<0.05)。结论 Hb低、ISS及GCS评分低、损伤后时间较长、胸腹部联合损伤是老年重型颅脑损伤患者死亡的独立影响因素。     

早期护理干预对40例颅脑损伤患者预后的影响

目的:探讨早期护理干预对重型颅脑损伤患者预后的影响。方法:选取80例重型颅脑损伤患者,随机分为干预组和对照组,每组各40例,分别给予不同护理干预,比较患者住院期间并发症发生情况、预后情况。结果:干预组并发症发生率明显低于对照组(P<0.05);干预组术后预后结果显著优于对照组(P<0.05)。结论:给予重型颅脑损伤患者早期护理干预有助于减少患者并发症,缩短患者住院时间,有效改善预后。     

加强陪护人员管理对重型颅脑损伤患者下呼吸道感染的影响分析

目的:探讨加强陪护人员管理对改善重型颅脑损伤患者发生呼吸道感染的影响,为临床护理工作提供参考。方法:选取2012年收治的30例重型颅脑损伤患者为对照组,给予常规护理措施;选取2013年收治的30例重型颅脑损伤患者为观察组,在常规护理基础上,加强陪护人员对预防医院感染知识培训及考核,并在病房增添手卫生设备,指导陪护人员手卫生,通过加强对陪护人员的管理,观察两组患者发生下呼吸道感染的情况。结果:对照组有11例发生下呼吸道感染,发生率为36.7%,观察组有3例发生下呼吸道感染,发生率为10.0%,两组比较差异有统计学意义(P<0.05)。结论:加强陪护人员管理,让陪护人员参与医院感染控制,是降低重型颅脑损伤患者下呼吸道感染的有效措施之一。     

Thermal pyrolysis characteristics of polymer flocculated waste activated sludge

Polyelectrolyte conditioning is a common practice in wastewater management. This paper experimentally elucidated the thermal pyrolysis characteristics of waste activated sludge at a temperature range of 300-900 K (27-627 degrees C) using thermogravimetric analysis (TGA) in inert atmosphere, with especial attention on the effect of polyelectrolyte flocculation (using cationic polyacrylamide). On the pyrolysis rate vs temperature plot two maxima were noted. At the heating rate of 8 degrees C/min, polyelectrolyte does not influence the pyrolysis process. As higher heating rates (14 and 20 degrees C/min), on the other hand, flocculation to charge neutralization point would enhance the rate of thermal pyrolysis. A simple two parallel-reaction kinetic model is applied to interpret the experimental data. Possible roles of flocculant on sludge pyrolysis are discussed on the basis of change in sludge structures and the hindrance of surface reactions of sludge particles.     

关于小城镇污水处理厂污泥处理处置的探讨

针对我国小城镇污水处理厂污泥的特点,阐述了几种适于小城镇污泥处置的方法的优缺点,建议根据当地的资金和技术水平,因地制宜的选择污水处理厂污泥处理处置的方法。     

Effect of sludge retention time on inclined plate function,treatment performance and sludge characteristics of inclined plate membrane bioreactors treating municipal wastewater

Two identical bench scale inclined plate membrane bioreactors (ip‐MBRs) were operated for the treatment of real municipal wastewater for 1 year. Sludge retention time (SRT) was varied over the course of operation to investigate the effects on inclined plate function, treatment performance and sludge characteristic. Removal rates of chemical oxygen demand and ammonia over 90% and of total nitrogen (TN) more than 70% were achieved when ip‐MBRs were operated under SRTs between infinite and 40 days while short SRT (20 days) negatively affected TN removal. When the sludge concentration in anoxic tank exceeded 15 g/L, the failure of the inclined plate function was observed, resulting in no difference in sludge concentrations between aerobic and anoxic tanks. To avoid severe effects on inclined plate function and treatment performance, an SRT range of 40–80 days was recommended for ip‐MBRs. Moreover, sludge floc size under prolonged SRT became smaller than that under short SRT due to increased attrition among the sludge floc particles caused by strong aeration needed for keeping a sufficient dissolved oxygen level.     

污泥陶粒坯料热动力学特性

采用TG-DSC联合热分析方法开展污泥陶粒坯料的热反应特性研究,深入了解反应机理。根据试验所得TG曲线,分析其失重率,结合相应的温度段,判断陶粒在加热过程中发生的反应。采用多重扫描速率的不定温法,进行多条TG曲线的动力学分析,求取陶粒坯料的活化能,对三个扫描速率的热分解曲线进行多元非线性拟合,推断出最概然反应机理函数。分析结果表明:试样总的热失重率随升温速率的增加而单调增加;陶粒烧制过程升温速率不宜过快;预热温度为320~350℃;陶粒的烧成过程主要有四个阶段;陶粒坯料的热分解反应最概然机理是三步反应(t;i;i);超轻陶粒的烧结温度控制在1 150~1 200℃之间,高强陶粒的烧结温度控制在1 150℃左右。     

Anaerobic treatment kinetics of palm oil sludge

Treatment of palm oil sludge using the completely-mixed, suspended growth, continuous anaerobic fermentation system was studied in a laboratory scale. Biokinetic coefficients for system with and without solids recycle were evaluated. The treatment systems were effective in the removal of BOD, COD, and volatile suspended solids. The gas production rate averaged around 0.91 g⁻¹ BOD utilized with an energy yield of 20,000 J g⁻¹ BOD utilized for units with _c greater than 25 days. The _c^m, minimum solids retention time, was calculated to be more than 10 days. Measured _c^m was, however, lower than 7 days.     

沥青在贫氧气氛下的热解动力学实验研究

隧道内沥青热解燃烧通常在贫氧环境下进行。为研究沥青在真实火灾情况下,环境氧体积分数对其热解过程和动力学的影响,利用热重分析仪,对10#铺地基质沥青,在氧体积分数分别为0、7%、15%和21%的氧氮混合气氛下进行热解实验,研究沥青的热解过程,并进行动力学分析。结果表明：沥青在氧体积分数为0(纯N2)的气氛下热解过程只有一个主失重阶段,最终剩余量高;在有氧气氛下热解过程均呈现出3 个失重阶段,最终剩余量低于10%;随着氧体积分数的增加,沥青的起始分解温度升高、热解速度增加、高温段失重加剧,低温段活化能小幅降低,反应过程均属于扩散模型;高温段活化能在氧体积分数为21%时最高,反应模型由贫氧时的扩散模型转变为三级简单模型。     

Inhibition kinetics of salt-affected wetland for municipal wastewater treatment

A mathematical model was developed in order to describe the system behavior and performance of a constructed wetland (CW) treatment under salt-affected conditions. The rate of biodegradation of organic wastes was modeled using the first-order kinetics while the effect of salt concentrations was accounted by growth inhibition. Experimental data were used to determine model constants of the mathematical model. The experimental units were planted with cattail (Typha angustifolia) and fed with spiked municipal wastewater. The hydraulic retention time varied from 12 to 120 h and wastewater conductivity was in the range of 4-32 mS/cm. At specified conditions the model was found to well describe the trend of the experimental data in terms of BOD removal with the Pearson correlation of 0.872. The model also permits construction of a nomograph which can be used to aid the design and prediction of CW treatment under salt-affected conditions.     

Microwave-induced pyrolysis of sewage sludge

This paper describes a new method for pyrolyzing sewage sludge using a microwave furnace. It was found that if just the raw wet sludge is treated in the microwave, only drying of the sample takes place. However, if the sludge is mixed with a small amount of a suitable microwave absorber (such as the char produced in the pyrolysis itself) temperatures of up to 900 degrees C can be achieved, so that pyrolysis takes place rather than drying. Microwave treatments were also compared with those carried out in a conventional electric furnace, as well as the characteristics of their respective carbonaceous solid residues.     

Effects and modelling of ultrasonic waste‐activated sludge disintegration

Sonication is a well‐known sludge pretreatment technique with the advantages of simple operation and high efficiency. However, it is an energy‐intensive process. Hence, it is very important to predetermine its sludge disintegration efficiency at varying pretreatment conditions in order to minimize the ultrasonic energy consumption. In this study, it was found that the ultrasonic sludge disintegration occurred in two stages: rapid and subsequent slow disintegration stages. For this reason, it was aimed to develop a simple and accurate mathematical model to describe the two‐stage sludge disintegration as a function of pretreatment conditions. Sludge concentration and ultrasonic density along with sonication period were involved in this model as independent variables. It was determined that the mathematical model can predict accurately the degree of sludge disintegration. Thus, the proposed model was seen to be very useful for evaluating the disintegration efficiency and/or for process design using the operating parameters under different conditions.     

提高污泥浓度对市政污水处理的影响研究

综合分析了MLVSS的变化与MLSS之间的关系,以及COD,SS,氨氮的去除与MLSS的关系,并以某县城的污水处理厂为例,探讨了污泥浓度的变化情况,同时对浓度提高的污泥进行试验,结果表明:当MLSS不超过6 000 mg/L时,坚持正常的排泥较为合适。