多磺酸粘多糖乳膏外用预防长春瑞滨所致静脉炎的临床观察

目的探讨多磺酸粘多糖乳膏外用预防长春瑞滨所致静脉炎的临床观察的效果。方法将我院肿瘤科使用长春瑞滨化疗的病人分为2组，每组50例，平均使用长春瑞滨4次。实验组实施护理干预，用多磺酸粘多糖乳膏外用预防静脉炎；对照组行常规治疗。对长春瑞滨化疗后出现的静脉炎进行对照观察与研究。结果实验组静脉炎发生率为0％，对照组静脉炎发生率为32％。经x^2检验，两组比较有统计学意义。     

地塞米松对长春瑞滨所致静脉炎的预防作用观察

长春瑞滨（商品名：盖诺，江苏XX药业生产）是长春碱半合成衍生物，为广谱抗肿瘤药物，是治疗非小细胞肺癌、乳腺癌等肿瘤最有效的药物之一，且神经毒性较低。而在血液科，它同样广泛应用于对淋巴瘤等疾病的治疗，并取得良好的疗效。但长春瑞滨用于周围静脉注射时常引起局部严重的静脉炎，据报道，外周静脉单纯输注长春瑞滨引起的静脉炎高达36．1％-89．5％，有的甚至导致局部皮肤出现水疱、溃疡、皮下组织坏死，严重者可导致肢体功能障碍。本科尝试使用多种方法预防长春瑞滨所致的静脉炎，其中使用地塞米松预防长春瑞滨所致的静脉炎，取得了良好的效果，现报道如下。     

电话回访在妇产科出院患者中应用的效果评价

目的 探讨电话回访在妇产科出院患者中应用的效果。方法对2316例妇产科出院患者在出院后1周和第3周末,采用电话回访方式,了解患者出院后恢复情况、遵医情况,并进行针对性健康指导。结果成功回访2166例,回访率93．52％;需再次来院治疗12例,占0．55％;患者满意度由电话回访前的85．97％上升至95．01％;患者出院后遵医率为96．02％。结论对出院患者进行电话回访,可提高患者的满意度及遵医率。     

地塞米松联合喜疗妥预防长春瑞滨致静脉炎的效果观察

[目的]观察地塞米松联合喜疗妥预防长春瑞滨所致静脉炎的临床疗效。[方法]采用含长春瑞滨化疗的非霍奇金淋巴瘤病人105例,随机分为对照组和实验组。对照组在静脉输注长春瑞滨前后不使用地塞米松和喜疗妥;实验组在长春瑞滨静脉输注时外涂喜疗妥,输注后注射地塞米松。观察两组静脉炎发生情况。[结果]两组静脉炎发生率比较差异有统计学意义（χ^2=44.35,P〈0.01）。[结论]应用地塞米松结合喜疗妥能有效预防长春瑞滨所致静脉炎。     

地塞米松联合喜疗妥预防长春瑞滨致静脉炎的效果观察

[目的]观察地塞米松联合喜疗妥预防长春瑞滨所致静脉炎的临床疗效。[方法]采用含长春瑞滨化疗的非霍奇金淋巴瘤病人105例,随机分为对照组和实验组。对照组在静脉输注长春瑞滨前后不使用地塞米松和喜疗妥;实验组在长春瑞滨静脉输注时外涂喜疗妥,输注后注射地塞米松。观察两组静脉炎发生情况。[结果]两组静脉炎发生率比较差异有统计学意义(χ2=44.35,P<0.01)。[结论]应用地塞米松结合喜疗妥能有效预防长春瑞滨所致静脉炎。     

预防长春瑞滨输注后静脉炎的临床研究

长春瑞滨以抗瘤谱宽，抗瘤活性强，在临床上被广泛应用。但长春瑞滨属强刺激化疗药，在很短时间内大量快速进入血管内。会刺激局部血管发生痉挛，致血管壁缺血、缺氧，血管内膜受累，静脉炎的发生率达57．6％，更有报道长春瑞滨致静脉炎的发生率可高达87．0％-93．3％。我科2004年1月-2006年6月对使用长春瑞滨化疗的50例患者给予喜疗妥涂搽、鲜芦荟外敷、50％樟脑乙醇湿敷加间断冰敷预防静脉炎。经临床应用效果较显著，现报道如下。     

应用浅静脉置管术预防长春瑞滨致静脉炎的疗效观察

目的 探讨应用浅静脉置管预防长春瑞滨引起静脉炎的临床效果.方法 将60例接受长春瑞滨化疗的肿瘤病人随机分为两组,30例患者采用常规静脉穿刺推注长春瑞滨治疗(对照组),30例患者采用浅静脉置管术接受长春瑞滨治疗(实验组).结果 实验组出现静脉炎5例,发生率为16.7%,对照组出现静脉炎24例,发生率为80.0%,两组相比P＜0.05,两组有明显差异.结论 应用浅静脉置管能预防长春瑞滨引起静脉炎的发生率.     

循证护理在减少长春瑞滨化疗不良反应中的作用

目的探索应用循证护理对降低长春瑞滨所致不良反应的效果。方法将160例应用长春瑞滨化疗的患者随机分为观察组和对照组。各80例，对照组采用常规护理措施，观察组在循证护理的基础上制定出系统的防治措施并实施。化疗后1周，比较2组患者的局部化疗不良反应发生率。结果化疗1周后观察纽的局部化疗不良反应发生率低于对照组（p〈0.01），差别有统计学意义。结论在长春瑞滨化疗中，应用循证的方法，针对长春瑞滨导致静脉炎的原理，全程进行综合护理干预，可有效降低长春瑞滨所致不良反应的发生，提高临床护理质量。     

二联疗法预防诺维本致迟发性静脉炎的临床观察

[目的]观察静脉输注地塞米松及湿敷75％乙醇预防诺维本（盖诺）所致迟发性静脉炎的疗效。[方法]将120例静脉输注盖诺的病人随机分为两组，观察组采用二联疗法，即静脉输注盖诺前后分别给予生理盐水100mL加地塞米松5mg静脉输注，穿刺成功后用75％乙醇外敷静脉穿刺点上方0．5cm处；对照组只给予生理盐水100mL加地塞米松5rng静脉输注，观察两组用药后迟发性静脉炎的发生率。[结果]观察组迟发性静脉炎发生率（10．0％）明显低于对照组（43．3％，P〈0．01）。[结论]二联疗法预防盖诺所致迟发性静脉炎效果优于单用地塞米松法.     

长春瑞滨联合放疗对老年晚期非小细胞肺癌患者生活质量的影响

目的：探讨单药长春瑞滨+放疗与长春瑞滨+顺铂对老年晚期非小细胞肺癌(nonsmall cell lung caIlcer，NSCLC)的疗效以及对患者生活质量的改善情况。方法：将55例患者随机分两组，长春瑞滨+顺铂组27例，长春瑞滨25mg／m^2+生理盐水100mL，第1，5天各1次，15～20min滴完；顺铂75mg／m^2，于第2，3，4天分3次静滴。长春瑞滨+放疗组28例，长春瑞滨25mg／m^2，第1，8，29，36天给药，第2天开始放疗．DT 55～65Gy。对治疗后的患者进行生活质量问卷随访调查并比较。结果：两组患者3，6个月的生活质量满意度比较，差异有显著性意义(X^2=3．019，X^2=8．256，P&;lt;0．01)。长春瑞滨+顺铂组近期有效率为44％(12／27)，长春瑞滨+放疗组为54％(15／28)，两组比较，差异有显著性意义(X^2=4．187，P&;lt;0．05)。两组中位生存期及1，2，3年生存期长春瑞滨+顺铂组为9．2个月，49％，20％，7％，长春瑞滨+放疗组为11．6个月，52％，22％，7％，两组比较，差异均无显著性意义(P&;gt;0．05)。结论：单药长春瑞滨+放疗对老年晚期NSCLC安全有效，具有良好耐受性，能够显著改善患者生活质量。     

The impact of follow-up telephone calls to patients after hospitalization

We studied whether pharmacists involved in discharge planning can improve patient satisfaction and outcomes by providing telephone follow-up after hospital discharge. We conducted a randomized trial at the General Medical Service of an academic teaching hospital. We enrolled General Medical Service patients who received pharmacy-facilitated discharge from the hospital to home. The intervention consisted of a follow-up phone call by a pharmacist 2 days after discharge. During the phone call, pharmacists asked patients about their medications, including whether they obtained and understood how to take them. Two weeks after discharge, we mailed all patients a questionnaire to assess satisfaction with hospitalization and reviewed hospital records. Of the 1,958 patients discharged from the General Medical Service from August 1, 1998 to March 31, 1999, 221 patients consented to participate. We randomized 110 to the intervention group (phone call) and 111 to the control group (no phone call). Patients returned 145 (66%) surveys. More patients in the phone call than the no phone call group were satisfied with discharge medication instructions (86% vs. 61%, P = 0.007). The phone call allowed pharmacists to identify and resolve medication-related problems for 15 patients (19%). Twelve patients (15%) contacted by telephone reported new medical problems requiring referral to their inpatient team. Fewer patients from the phone call group returned to the emergency department within 30 days (10% phone call vs. 24% no phone call, P = 0.005). A follow-up phone call by a pharmacist involved in the hospital care of patients was associated with increased patient satisfaction, resolution of medication-related problems, and fewer return visits to the emergency department.     

出院患者电话随访中出现的问题分析及对策

目的完善出院患者电话随访工作,更好地为出院患者服务。方法通过对840例普通外科出院患者电话随访资料进行分析、总结,发现主管医生在此项工作中参与率低,责任护士指导的健康教育内容欠规范,工作中求数量而忽略质量等问题,并提出相应对策。结果随访工作质量提高,出院患者院外满意率由94.8%上升至98.0%。结论出院患者电话随访工作的不断改进,能有效提高出院患者的生活质量,值得进一步深化、推广。     

电话回访对肝胆外科出院患者自我护理行为影响的研究

目的通过电话回访对肝胆外科出院患者进行健康教育,解决患者出院后存在的健康问题,以提高其自我护理能力,促进康复。方法建立患者健康档案,对出院后需要继续治疗或休息的患者进行电话回访式健康教育。于出院后1周开始对患者进行电话回访,持续一个月,根据患者的健康状况每周对患者进行1～2次健康教育,内容包括引流管护理、伤口护理、饮食休息指导等,对电话回访前和回访后患者的自我护理情况进行比较。结果经χ~2检验,回访前、后患者的自我护理能力的差异具有统计学意义(P<0.05)。结论电话回访式健康教育的开展体现了护理模式的转变,将医院健康教育工作延伸到出院患者的治疗康复过程中,能提高患者的自我护理能力,值得推广。     

Inability to Follow up ED Patients by Telephone: There Must Be 50 Ways to Leave Your Number

Objective: To determine the ability to complete follow-up home telephone calls to ED patients.
Methods: A retrospective review of the ability to reach 4, 741 patients called during a posttreatment patient satisfaction survey of visits to a suburban community hospital ED.
Results: Only 54. 9% of all patients called could be contacted after three or fewer phone calls. Of the 2, 139 (45. 1%) who could not be reached, there was no answer for 1, 260 (58. 9%), despite three telephone calls to a number currently in service. A significant minority (21. 1%) had given nonworking numbers. Another 12. 4% indicated that no one by the name of the patient lived at the number called, and 2. 9% of the respondents alleged that the patient was deceased.
Conclusions: Almost half of the patients who present to the ED and supply home telephone numbers give telephone numbers at which they cannot be reached in follow-up. Using telephone follow-up alone to reach patients seen in the ED may be an unreliable method of communication.     

电话随访对肾移植患者的影响

目的 探讨电话随访对肾移植患者的影响.方法选择2002年7月-2007年11月在我院行肾移植术后患者31例进行电话随访.随访时间:出院后1个月内每周1次,出院后1-3个月2周随访1次,3～12个月每月随访1次,1年后每3个月随访1次,随访内容相同,并于电话随访前及6个月后对患者进行自我管理能力和自我效能水平的测评及抑郁、焦虑情况等测评.结果 31例患者电话随访前自我管理总分(7.24±0.93),随访后评分(8.32±0.86);随访前自我效能评分(6.47±2.51),随访后评分(7.96±2.53),经t检验,差异具有统计学意义.31例患者电话随访前及随访6个月后SAS、SDS测评结果,随访前后SAS评分(50.32±9.16),(42.53±6.32),SDS评分(53.63±11.81),(42.78±8.25),经t检验,差异具有统计学意义.结论 电话随访能及时准确给院外患者以医学健康指导,能及时发现早期并发症,明显提高患者的自我管理能力和自我效能水平,减轻患者的抑郁、焦虑情绪.     

电话随访时间在急性脑血管病患者院外延伸护理中的影响

目的:探讨电话随访时间在急性脑血管病患者院外延伸护理中的影响。方法:将200例急性脑血管病出院患者分成两组,观察组100例在出院一周后的周一进行电话随访,对照组100例在出院四周后的周一进行电话随访。结果:观察组患者满意度、门诊就诊、来电咨询比例高于对照组,再次住院比例低于对照组(P<0.05)。结论:采用电话随访时间在急性脑血管病患者延伸护理可有效提高患者出院后的生活质量,降低再住院率,促进患者全面康复。     

2859例出院患者电话随访中反映的问题及分析

目的：通过电话随访了解2859例出院患者反映的住院期间问题并加以分析,以达到持续改进服务质量的目的。方法：于2011年9月至2012年2月,采用电话随访的方式对2859例出院患者进行调查,采用开放性的交流方法,了解患者住院期间在病房设施、医院管理、护理服务和医疗服务中发现的问题。结果：2859例出院患者共反映住院期间发现的问题494件,其中病房设施203件,医院管理112件,护理服务95件,医疗服务84件。结论：电话随访出院患者能客观了解其在住院期间发现的问题,医院应针对患者反映的问题制定相应的整改措施,营造良好的住院环境,不断改进护理服务质量,满足患者多方面的需求。     

Dispensing home nebulizers for acute wheezing from the hospital is cost-effective

The objective was to investigate the use characteristics of home nebulizers and to measure the benefit gained from dispensing home nebulizers (compared with their cost) to patients from the hospital. During the study period, August 28,1996 to May 17,1997, a sample of 232 of the 291 entries from a log of home nebulizers dispensed by the hospital respiratory care department were surveyed over the telephone. Of the 232 study subjects under the age of 21, a telephone interview of a guardian or supervising adult was completed in 106 subjects (46%) a mean of 43 weeks after the home nebulizer was prescribed (47% of the cohort received their home nebulizers from the inpatient service and another 47% were discharged with home nebulizers from the emergency department (ED)). An average of 3.6 estimated additional ED visits and 5.4 office/clinic visits for each patient were prevented by the home nebulizer. The benefit (savings from reduced ED and office visits alone) to cost ratio estimates range from $855:$90 to $1710:$90 or more. The overwhelming majority of the patients felt that the home nebulizer was a good idea, it was easy to use, they had no problems with the nebulizer and they received adequate training for home nebulizer use. Home nebulizers are a cost-effective means of providing home nebulized albuterol for selected outpatients. Hospital inpatient units and EDs which have the ability to dispense a home nebulizer, have an additional therapeutic option available for selected patients who may benefit from it. Medical insurance companies should fully support (ie, pay for) home nebulizers because it is cost effective. If there is any concern about the reliability of the patient to follow-up with their primary physician, the patient's primary physician should be contacted to discuss the feasibility of discharging the patient with a home nebulizer.     

出院精神病患者电话随访失败原因分析与对策

目的探讨出院精神病患者电话随访失败的原因,提出对策,提高电话随访成功率。方法对2009年1—6月出院后第1次电话随访失败的107例精神病患者资料进行回顾性分析。结果导致电话随访失败的原因是：随访电话号码错误、不真实51例,占47．7％;患者及家属不配合22例,占20．6％;随访时间选择不恰当16例,占14．9％;随访护士缺乏临床经验和沟通技巧18例,占16．8％。结论随访电话号码有误、患者及家属不配合、随访时间不当、随访护士缺乏技巧是导致对出院精神病患者电话随访失败的主要原因,认为应做好患者资料收集工作、加强宣教、选择恰当随访时间和提高护士素质,以提高电话随访成功率。