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| 1 | 优化无创机械通气:哪个科室应护理这些患者?一项队列研究显示文摘背景:无创通气(NIV)已经不局限于在重症监护室(ICUs)使用,在急诊科(EDs)和普通病房,NIV也逐渐成为常规手段。目的:分析不同临床科室中,护理和NIV结局的关系。方法:根据患者特点、所提供的护理和所使用的医疗程序、评估治疗的成功和失败、接口不耐受以及并发症。并发症分析包括支气管吸引术、气胸、皮肤损伤、气道分泌物过多、眼刺激、意识水平恶化、胃扩张和面罩周围过量的空气消耗。结果:387例患者中,194例(50.1%)来自ICU,121例(31.3%)来自ED,38例(9.8%)来自术后病房,34例(8.8%)来自普通病房。校正APACHE评分和NIV适应证后,进行回归分析。结果显示,与社区医院ICU比较,在一所每年NIV病例数低于50例的大学医院的ICU,NIV失败的风险升高3.3倍[95%CI(1.2~9.2)];在ICUs和普通病房,12%的患者由于接口不耐受而中止使用NIV;急慢性肺病(ACLD)患者的NIV失败风险更低[OR 0.2,95%CI(0.06~0.69)];缺乏湿化与治疗失败没有相关性[OR 0.2,95%CI(0.1~0.4)];气道分泌物过多的相关因素是肺炎[OR 2.5,95%CI(1.1~5.9)]和早期中止和(或)拔管[OR 3.3,95%CI(1.2~8.9)];接口不耐受的相关因素是使用传统ICU呼吸机[OR 4.4,95%CI(2.1~9.2)]和过度空气消耗造成的鼻部皮肤损伤[OR 2.4,95%CI(1.1~5.3)],尤其是口鼻面罩的使用[OR 3.5,95%CI(1.1~11.3)]。结论:普通病房收治的急性呼吸衰竭的肺炎患者,其接口不耐受和NIV失败的风险增加。在任何给予NIV治疗的科室,旋转型面罩均能促进NIV的成功。 | Marta Raurell-Torredà E.Argilaga-Molero M.Colomer-Plana A.Ródenas-Fransico M.T.Ruiz-Garcia J.Uya Muntana | 2017 | 中国护理管理2017，17，8： | 3 |
| 2 | Characteristics and origins of coal cleat: A review显示文摘 | S.E Laubach R.A Marrett J.E Olson A.R Scott | 1998 | International Journal of Coal Geology1998，，1： | 3 |
| 3 | Safety assessment methodology for a German high-level waste repository in clay formations显示文摘In the ANSICHT project that was jointly carried out by DBE TECHNOLOGY Gmb H,BGR,and GRS g Gmb H,two generic geological site models were used to develop a first draft of a methodology to demonstrate the safety of a high-level waste(HLW) repository in argillaceous formations in Germany,taking into account the regulatory requirements.The main results of the project are characterised by the developed repository concepts adapted to the geological conditions.The specific quantifications of the integrity criteria and their exemplary application with calculational proofs were used to demonstrate the integrity of the host rocks.The development of site-specific FEP(features,events,and processes) cataloges provided a complete system description for evaluation of the repository evolution.The developed work flow of the demonstration concept illustrated the complete sequence of the safety proof in a transparent way.It shows that various steps have to be performed,possibly iteratively,to provide a successful safety proof.The results form a useful tool in the pending search for a HLW repository site,especially when providing a basis for comparing safety analyses of different sites in Germany. | M.Jobmann A.Bebiolka V.Burlaka P.Herold S.Jahn A.Lommerzheim J.MaBmann A.Meleshyn S.Mrugalla K.Reinhold A.Rübel L.Stark G.Ziefle | 2017 | Journal of Rock Mechanics and Geotechnical Engineering2017，9，5： | 2 |
| 4 | Physical status of the E2 human papilloma virus 16 viral gene in cervical preneoplastic and neoplastic lesions显示文摘 | S.A Tonon M.A Picconi P.D Bos J.B Zinovich J Galuppo L.V Alonio A.R Teyssie | 2001 | Journal of Clinical Virology2001，，2： | 2 |
| 5 | 埋藏式钢管外压分析显示文摘埋藏式钢管外压分析F.M斯沃依斯基A.R弗列依谢斯特1前言最初,世界各国的钢衬设计实践都是采用一种基于如下假定的分析方法:外压作用使钢衬形成几个鼓包,这些鼓包关于管轴对称分布。随后,由阿姆斯图兹发展的一种更符合实际和更可靠的方法已被许多国家采用,它假... | F.M 斯沃依斯基 A.R 弗列依谢斯特 陈观福 | 1998 | 水电站设计1998，14，2： | 2 |
| 6 | A Model of Fishing Vessel Accident Probability显示文摘 | Jin D Powell H.L.K Thunberg E Solow A.R Talley W.K | | 0，，04： | 1 |
| 7 | Carrier-mediated auxin transport显示文摘 | Rubery P.H Sheldrake A.R | | 0，，02： | 1 |
| 8 | Molecular epidemiology of foot-and-mouth disease virus显示文摘 | N.J Knowles A.R Samuel | 2002 | Virus Research2002，，1： | 1 |
| 9 | The R6 procedure: recent developments and comparison with alternative approaches显示文摘 | P.J Budden J.K Sharples A.R Dowling | 2001 | International Journal of Pressure Vessels and Piping2001，，14： | 1 |
| 10 | The effect of affregating accounting reports on the quality of the lending decision:an empirical investigation显示文摘 | Abdel-Khalik A.R | | 0，，11： | 1 |
| 11 | A K-sample significance test for independent alpha coefficients显示文摘 | Hakstian A.R Whalen T.E | | 0，，2： | 1 |
| 12 | Transparent thin film transistors based on indium oxide semiconductor显示文摘 | Lavareda G de Carvalho.C.N Fortunato E Ramos A.R Alves E Conde O and Amaral A | | 0，，23： | 1 |
| 13 | Fine diameter ceramic fibres显示文摘 | A.R Bunsell M.-H Berger | 2000 | Journal of the European Ceramic Society2000，，13： | 1 |
| 14 | Relative performance of mutual information estimation methods for quantifying the dependence among short and noisy data显示文摘 | Khan S Bandyopadhyay S Ganguly A.R Saigal S Erickson D.J Protopopescu V Ostrouchov G | | 0，，02： | 1 |
| 15 | 查看详情显示文摘 | Muci A.R Buchwald S.L | | 0，，： | 1 |
| 16 | Lateral prefrontal cortex and self-control in intertemporal choice显示文摘 | Finger B Knoch D Johnson E.J Krosch A.R Lisanby S.H Fehr E & Weber E.U | | 0，，： | 1 |
| 17 | Personnel in cadaveric organ transplant‐related hospital units faced with living liver donation: an attitudinal study in a Spanish hospital with a cadaveric and living liver transplant programme显示文摘 | A.Ríos P.Ramírez M. M.Rodríguez L.Martínez M. J.Montoya D.Lucas P.Parrilla | 2007 | Liver International2007，，5： | 1 |
| 18 | Analytic versus holistic scoring of science performance tasks显示文摘 | Klein S.P Stecher B.M Shavelson R.J McCaffrey D. Ormseth T. Bell R.M. Comfort K.& Othman A.R | | 0，，02： | 1 |
| 19 | 查看详情显示文摘 | Katritzsky A.R Weiss D.E | | 0，，02： | 1 |
| 20 | Simulation of dynamic compaction of loose granular soils显示文摘 | J.L Pan A.R Selby | 2002 | Advances in Engineering Software2002，，7： | 1 |
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