Ventricular tachycardia in patients with T peak an

xp574088 · Wysłany: Pon 12:04, 28 Mar 2011

Ventricular tachycardia in patients with T peak and T peak period between the end of the end of the test interval dispersion

26 cases, good in 4 cases; 44 cases of chronic osteomyelitis, excellent 3O cases, good 1O, and poor in 4 cases. Conclusion: The infusion of high concentrations of antibiotic treatment of acute and chronic osteomyelitis can be shortened course of treatment, the treatment of acute and chronic osteomyelitis in an effective way. [Key words osteomyelitis; antibiotics; high concentration; efficacy of purulent osteomyelitis is a bone infection, is a common orthopedic and easy to recurrent, prolonged unhealed by acute and chronic disease can be divided into two categories. Currently use more antibiotics marrow infusion catheter. Continuous perfusion with lesions of the method ¨】 to high concentrations of antibiotic infusion on acute and chronic osteomyelitis treatment, are reported as follows: 1 Data and methods 1.1 Clinical data: The group of 74 patients, 36 males and females 38 cases. Aged 6 to 62 years, average 22.4 years old. 3O cases of acute osteomyelitis (40.5%), chronic osteomyelitis in 44 cases (59.5%). 1.2 surgical procedures: incision in favor of debridement, soft tissue conditions were better, the site is conducive to wound closure. Sinus should be removed completely, if not removed thoroughly scraping. In the debridement of chronic osteomyelitis, the first window in the bone cortex, medullary cavity was opened butterfly, remove the sequestrum, thoroughly scrape the infection of the granulation, hardening hardening of the bone should be cut to occur until the fresh bleeding surface; acute cortical bone osteomyelitis is also used to open the window wide open medullary cavity (osteomyelitis narrow slower), marrow cavity must be thoroughly scraped clean. Perfusion tube and suction tube placed before the window in the talus on the 1 ~ 1.5cm at the bottom of the drilled hole, the top hole for the infusion, the bottom for attracting holes to children as a perfusion catheter tubes, catheters for attracting adult tube. Set the length of the bone window were catheter length prevail, two inserted in the opposite direction and parallel. The cross-shaped insert part of the side holes were cut 4 to 6, two were from the incision near the end of the catheter, distal 2 ~ 4cm, leads by a healthy skin puncture and fixed with a fine thread, two can not be twisted into the road on the way angle. Suture the wound must be thoroughly and properly before the bleeding, sutured, pressure bandage, as appropriate, with a plaster or brace fixation. Acute and chronic osteomyelitis are healthy periosteal stripping should be minimized to avoid affecting bone blood supply and the spread of infection. Canal must be repeatedly washed with saline, suction and debris net clot organization. To prevent blood clot caused by luminal obstruction in the tube side of the back wash to attract suture the wound. 1.3 Postoperative management 1.3.1 Local Treatment: The patient infusion line back to the ward immediately rinse, and use suction devices or electric aspirator suction. 24h after infusion volume should be larger, and the time to perfusion fluid such as water overflow of people like 1 ~ 2min. Interval of 15 ~ 30min suction tube suction, 15 ~ 30s / times. This is to prevent clot formation, to ensure pipeline flow, surgical success. Perfusion volume and time: after 24h1O00ml / times, once every 4h; the first 2 days and 3 days 50Oral / times, each 6h1 times; after 500ml / times, each 8 ~ 12h1, lasting 7 ~ lOd. Conventional choice saline perfusion fluid. Routine use of antibiotics gentamicin, clindamycin hydrochloride, lincomycin. Dosage: gentamicin 240 000 u, clindamycin hydrochloride 0.9g, lincomycin 24g. Antibiotic perfusion: 50ml each fluid left around, it will be above three kinds of antibiotics based on susceptibility to join Choose one case, immediately caught infusion tube, with a negative net absorption within the medullary cavity and tissue perfusion fluid, immediately caught in suction tube, and then perfusion tube open, the liquid droplets containing high concentrations of antibiotics in human marrow, and keep until the next perfusion. 1.3.2 the systemic administration: the choice of systemic antibiotics in principle, by use of blood culture and sensitivity results. 1.3.3 extubation: When the patients body temperature is normal, clear and transparent to attract fluid, no local wound redness, swelling, heat and other signs of inflammation before extubation. 1-2d extubation stop infusion before washing, but still time suction to suck the residual net marrow and tissue fluid. 1.3.4 perfusion tube blockage and treatment: infusion tube blockage often due to slow drip rate after 24h, 24 ~ 48h after clot blockage occurs, after 3 ~ 5d desquamation of necrotic tissue and bone block. Excessive negative pressure suction of soft tissue may be in possession of, the negative pressure is too small blood clot, necrosis of objects,[link widoczny dla zalogowanych], debris will plug the lumen, can be used as a retrograde saline flushing or perfusion pressure, suction tube for a short exchange with each other. 2 drops each time the results of this paper, normal saline and antibiotics were prepared for the full amount of the low concentration of perfusate, perfusion treatment outcome is: clear and transparent fluid infusion, the average time to ask for the 7.8d, body temperature returned to normal for the 9.7d, 13d extubation time . Perfusion with high concentrations of antibiotic treatment to retain the results: clear and transparent fluid infusion, the average time to ask for the 4.3d, body temperature returned to normal for the 37d, extubation time of 9d.