雾化吸入减轻放射性食管炎患者疼痛的护理方法探讨

目的 探讨雾化吸入减轻放射性食管炎疼痛的护理方法.方法 将研究对象100例随机分为实验组和对照组各50例.实验组给予生理盐水20 ml+庆大霉素8万U+地塞米松5 mg雾化吸入和护理干预;对照组进行放射治疗后常规护理.比较2组放射性食管炎发生率.结果 对照组患者的放射性食管炎发生率为60%,明显高于实验组的10%.结论 早期雾化吸入的护理干预对于预防和缓解放射性食管炎疼痛效果显著,且操作简便,患者依从性较好.     

放射性食管炎的针对性护理干预

目的:对食管癌放疗患者进行针对性护理干预,评价其临床效果.方法:将2010年10月～2011年9月在肿瘤科住院行放射治疗的食管癌患者158例随机分为干预组79例和对照组79例,对照组按放疗常规护理,干预组按放疗常规护理的同时,给予心理护理、饮食护理、蜂蜜酸奶饮等措施,观察比较两组患者放射性食管炎的发生情况.结果:干预组放射性食管炎的发生率为54.43％(43/79),对照组放射性食管炎的发生率为86.08％ (68/79),两组比较有统计学意义(P＜0.05).结论:针对性护理干预可明显降低放射性食管炎的发生率及严重程度,减轻患者的痛苦,提高其生活质量,保证放疗的顺利完成.     

肺癌放疗致放射性食管炎的预防性护理干预

[目的]探讨预防性护理干预对肺癌放疗致放射性食管炎的防治效果.[方法]将我院收治的100例肺癌放疗病人分为实验组和对照组,每组40例,对照组采用常规护理措施,实验组采用预防性护理干预措施,比较两组病人放射性食管炎的发生率和严重程度.[结果]对照组和实验组放射性食管炎的发生率分别为26%和8%,差异具有统计学意义.与对照组相比较,实验组放射性食管炎的严重程度显著减轻.[结论] 对肺癌放疗病人进行有效的预防性护理干预有助于降低放射性食管炎的发生率.     

食管炎合剂与康复新联用防治放射性食管炎的护理

目的 观察自制食管炎合剂联用康复新对放射性食管炎的预防和治疗作用.方法 设立观察组和对照组观察食管癌放疗患者放射性食管炎的发生率及严重程度.结果 采用食管炎合剂与康复新口服辅以综合护理措施进行干预可有效降低放射性食管炎的发生率并减轻症状(P＜0.01).结论 放射治疗的中后期采用自制食管炎合剂联用康复新防治放射性食管炎疗效确定、用药方便、价格低廉,值得推广.     

护理干预对食管癌患者放疗并发放射性食管炎的影响

目的:探讨护理干预对食管癌放疗后并发放射性食管炎的影响.方法:将120例食管癌首次根治性放疗患者随机分为干预组和对照组各60例,对照组给予常规护理,干预组给予全面护理干预,观察、比较两组患者在放射剂量为20 Gy、40 Gy、70 Gy时放射性食管炎的发生情况及两组完成治疗情况.结果:干预组在放射剂量达20 Gy时发生3～4级放射性食管炎者少于对照组,但两组比较差异无统计学意义(P＞0.05);放射剂量达40 Gy和70 Gy时,干预组3～4级放射性食管炎的发生率均低于对照组(P＜0.01),且以0～2级放射性食管炎为主.干预组60例均按时完成放疗;对照组13例延迟了放疗进程,2例中途放弃治疗.结论:护理干预可以减少放射性食管炎发生率、降低其损伤程度,帮助患者按时完成全程治疗,改善患者生活质量.     

食管炎合剂与康复新联用防治放射性食管炎的护理

目的观察自制食管炎合剂联用康复新对放射性食管炎的预防和治疗作用。方法设立观察组和对照组观察食管癌放疗患者放射性食管炎的发生率及严重程度。结果采用食管炎合剂与康复新口服辅以综合护理措施进行干预可有效降低放射性食管炎的发生率并减轻症状(P<0.01)。结论放射治疗的中后期采用自制食管炎合剂联用康复新防治放射性食管炎疗效确定、用药方便、价格低廉,值得推广。     

护理干预对食管癌患者急性放疗反应的影响

目的:探讨护理干预对食管癌放疗患者发生急性放疗反应的影响.方法:将食管癌行首次根治性放疗患者80例随机分成观察组和对照组各40例,对照组接受常规护理,观察组由护理干预小组在放疗开始后3个月内通过护理评估、健康教育、随访等进行护理干预,比较两组患者治疗依从性及放射性食管炎、放射性肺炎的发生率.结果:观察组放射性食管炎的发生率低于对照组(P＜0.05),放射性肺炎发生率比较无统计学意义(P＞0.05);治疗依从性高于对照组(P＜0.05).结论:对食管癌放疗患者给予护理干预可增加患者治疗的依从性,减少急性放疗性食管炎的发生率,提高患者放疗的安全性.     

预见性护理对非小细胞肺癌放化疗不良反应的影响

选取2013年10月~2014年10月我院就诊并进行放化疗治疗的56例Ⅲ期非小细胞肺癌患者.随机分为对照组和观察组各28例。对照组接受常规护理干预,观察组接受预见性护理干预,比较两组在预防及缓解放化疗治疗过程中出现放射性肺炎、风蛇行食管炎、骨髓抑制等不良反应的临床效果。结果观察组白细胞下降、血小板下降发生率均较对照组低,差异有统计学意义(P0.05);观察组恶心呕吐发生率低于对照组,差异有统计学意义(P0.05);观察组急性放射性食管炎发生率(7.14%)较对照组(21.43%)低,观察组肺炎发生率(3.57%)较对照组(17.86%)低,差异有统计学意义(P0.05)。在Ⅲ期非小细胞肺癌放化疗期间开展预见性护理干预可有效减少不良反应发生,值得临床推荐。     

典型问题模块化护理模式在食管癌放疗并发放射性食管炎病人中的应用

[目的]分析典型问题模块化护理模式在食管癌放疗并发放射性食管炎病人中的应用效果。[方法]医院2016年4月起开始采用典型问题模块化护理模式对食管癌放疗并发放射性食管炎病人实施专项护理,将实施前(2016年1月—2016年3月)收治的42例食管癌放疗并发放射性食管炎病人设为对照组(给予常规护理),将实施后(2016年4月—2016年6月)收治的42例同类病人设为观察组,比较两组病人各相关观察指标的差异性。[结果]观察组干预后严重放射性食管炎发生率和因放射性食管炎中断治疗率均显著低于对照组(P0.05),病人满意度评分明显高于对照组(P0.05),实施后护士满意度评分明显高于实施前(P0.05)。[结论]将典型问题模块化护理模式应用于食管癌放疗并发放射性食管炎病人的护理实践中,可显著降低该类病人的放射性食管炎严重程度和中断治疗的可能性,提高护士及病人满意度。     

预防放射性口腔黏膜反应方法的探讨

目的 探讨预防头颈部肿瘤患者放疗所致口腔黏膜反应的有效方法.方法 将92例头颈部肿瘤放疗患者随机分为A组31例,B组31例,C组30例.A组每次放疗前、后1 h给鱼腥草注射液20 ml+丹参注射液加20ml+蒸馏水30 ml雾化吸入,20 min/次,至放疗结束.B组给予康复新注射液2 ml+维生素B12注射液0.5 mg+生理盐水50 ml雾化吸入,方法同A组.C组采用中草药养阴清肺汤方剂水煎取汁500 ml,分别在放疗前、后1 h各服一半,至放疗结束.比较3组口腔黏膜反应的发生情况.结果 A组患者Ⅱ级、Ⅲ级口腔黏膜反应发生率及严重程度均明显低于B、C组.结论 鱼腥草、丹参注射液合剂雾化吸人预防放射性口腔黏膜反应的临床效果显著.     

Improvement of thigh muscles by neuromuscular electrical stimulation in patients with refractory heart failure: a single-blind, randomized, controlled trial

OBJECTIVE: To determine the impact of an 8-wk neuromuscular stimulation program of thigh muscles on strength and cross-sectional area in patients with refractory heart failure listed for transplantation. DESIGN: Forty-two patients with a stable disease course were assigned randomly to a stimulation group (SG) or a control group (CG). The stimulation protocol consisted of biphasic symmetric impulses with a frequency of 50 Hz and an on/off regime of 2/6 sec. RESULTS: Primary outcome measures were isometric and isokinetic thigh muscle strength and muscle cross-sectional area. Our results showed an increase of muscle strength by mean 22.7 for knee extensor and by 35.4 for knee flexor muscles. The CG remained unchanged or decreased by -8.4 in extensor strength. Cross-sectional area increased in the SG by 15.5 and in the CG by 1.7. CONCLUSIONS: Activities of daily living as well as quality of life increased in the SG but not in the CG. Subscales of the SF-36 increased significantly in the SG, especially concerning physical functioning by +7.5 (1.3-30.0), emotional role by +33.3 (0-66.6), and social functioning by +18.8 (0-46.9), all P < 0.05. Neither a change nor a decrease was observed in the CG. Neuromuscular electrical stimulation of thigh muscles in patients with refractory heart failure is effective in increasing muscle strength and bulk and positively affects the perception of quality of life and activities of daily living.     

^131I内照射治疗隔离期患者的人文关怀

目的应用人文关怀,使131I内照射治疗隔离期患者能积极主动地配合治疗,以促进行早日康复。方法选择分化型甲状腺癌术后行131I治疗的患者84例,随机分为2组,即实验组42例,对照组42例,对照组按常规治疗护理,实验组在常规护理的基础上,应用人文关怀理论,加强护理软硬环境的构建与实施,即营造人文环境,构建人文氛围。比较2组患者实施护理后焦虑缓解情况、隔离中的依从性和对医护质量满意度的情况。结果经统计学分析比较,实验组患者焦虑的控制程度、隔离中的依从性和患者的满意度均优于对照组(P<0.01,P<0.05)。结论坚持以人为本,以患者为服务中心的理念,对131I内照射治疗隔离中的患者,做到以情感人,以理服人,处处体现人文关怀,使患者获得最大满意度,提高了护理质量和管理水平,取得了良好的社会效益和经济效益。     

Neurodynamic responses in children with migraine or cervicogenic headache versus a control group. A comparative study

Headache in children with unknown aetiology is an increasing phenomenon in industrial countries, especially during growth spurts. During this growth phase, the Long Sitting Slump (LSS) can be a useful tool for measurement of neurodynamics and management. This study investigated the difference in cervical flexion and sensory responses (intensity and location) during the LSS tests in children (n=123) aged 6-12 years, between a migraine (primary headache group=PG), cervicogenic headache (secondary headache group=SG) and control group (CG). The results indicated that the intensities of the sensory response rate were highest in the PG and SG when compared to CG. The responses in the legs were predominantly found in the PG (81.9%) and responses in the spine in the SG (80%). The sacrum position varied significantly between both headache groups (PG and SG) and the CG (p<0.0001), but there was no significant difference between the CG and the PG (p>0.05). No significant difference in the neck flexion range was measured in LSS, nor in standardized knee flexion between the PG and CG (p>0.05). The cervical flexion ranges differed significantly (p<0.0001) between the SG on the one hand and the PG and CG on the other. The biggest difference in neck flexion during knee extension was between the SG and CG.     

不同强度运动对大鼠自由基代谢影响的研究

目的：研究不同强度运动对大鼠血清、骨骼肌、心肌、肝脏中自由基代谢的变化。方法：18只雄性Wistar大鼠随机分为安静对照组（CG）、适度运动组（MG）和运动性低血色素组（SG）,每组6只。5周递增负荷跑台运动后测定血清、腓肠肌、心肌、肝脏丙二醛（MDA）、总抗氧化能力（T-AOC）。结果：经5周递增负荷跑台运动后,MG组T-AOC活性在血清、腓肠肌、肝脏中显著高于CG组（P<0.01）;SG大鼠各组织中MDA含量明显高于CG和MG（P<0.01）,T-AOC活性（除心肌外）明显低于MG（P<0.01）。结论：①适度运动可提高大鼠各组织总抗氧化能力,增强机体清除自由基的能力。②长时间大强度递增负荷跑台运动导致的总抗氧化能力下降,脂质过氧化反应增强是引起运动性低血色素的重要原因之一。     

临床护理路径在食管癌放射治疗中的应用

目的:探讨临床护理路径在食管癌放射治疗中的应用效果。方法:选取2010年1月～2011年12月在我院进行放射治疗的食管癌患者113例。随机分为临床护理路径组和对照组。观察并比较两组护理效果和放射治疗毒副作用。结果:临床护理路径组患者的相关知识掌握率、治疗依从性和情绪稳定性均高于对照组,两组间的差异均具有统计学意义(P<0.05)。临床护理路径组发生放射性食管炎4例,放射性皮炎5例,对照组出现放射性食管炎7例,放射性皮炎9例。临床护理路径组患者对仪容仪表、护理服务和护理质量的满意度均高于对照组(P<0.05)。结论:在食管癌放射治疗中实施临床护理路径措施,能够有效提高患者对相关知识的知晓率,降低毒副作用的发生率,提高患者满意度。     

Perioperative goal-directed hemodynamic therapy based on radial arterial pulse pressure variation and continuous cardiac index trending reduces postoperative complications after major abdominal surgery: a multi-center,prospective, randomized study

Introduction

Several single-center studies and meta-analyses have shown that perioperative goal-directed therapy may significantly improve outcomes in general surgical patients. We hypothesized that using a treatment algorithm based on pulse pressure variation, cardiac index trending by radial artery pulse contour analysis, and mean arterial pressure in a study group (SG), would result in reduced complications, reduced length of hospital stay and quicker return of bowel movement postoperatively in abdominal surgical patients, when compared to a control group (CG).

Methods

160 patients undergoing elective major abdominal surgery were randomized to the SG (79 patients) or to the CG (81 patients). In the SG hemodynamic therapy was guided by pulse pressure variation, cardiac index trending and mean arterial pressure. In the CG hemodynamic therapy was performed at the discretion of the treating anesthesiologist. Outcome data were recorded up to 28 days postoperatively.

Results

The total number of complications was significantly lower in the SG (72 vs. 52 complications, p = 0.038). In particular, infection complications were significantly reduced (SG: 13 vs. CG: 26 complications, p = 0.023). There were no significant differences between the two groups for return of bowel movement (SG: 3 vs. CG: 2 days postoperatively, p = 0.316), duration of post anesthesia care unit stay (SG: 180 vs. CG: 180 minutes, p = 0.516) or length of hospital stay (SG: 11 vs. CG: 10 days, p = 0.929).

Conclusions

This multi-center study demonstrates that hemodynamic goal-directed therapy using pulse pressure variation, cardiac index trending and mean arterial pressure as the key parameters leads to a decrease in postoperative complications in patients undergoing major abdominal surgery.

Trial registration

ClinicalTrial.gov, {"type":"clinical-trial","attrs":{"text":"NCT01401283","term_id":"NCT01401283"}}NCT01401283.     

Is pain relief equally efficacious and free of side effects with repeated doses of oral sucrose in preterm neonates?

The aim of the present study was to examine the efficacy and potential side effects of repeated doses of oral sucrose for pain relief during procedures in NICU. Thirty-three preterm neonates were randomly allocated in blind fashion into two groups, the sucrose group (SG=17) and the control group (CG=16). The responses of neonates to pain and distress were assessed during blood collection on four consecutive assessment (ass.) days. For the first assessment, the neonates did not receive any solution before the blood collection procedure. During the next three days, the SG received oral sucrose (25%; 0.5 ml/kg) and the CG received sterile water, 2 min before each minor acute painful procedure. The neonates were evaluated during blood collection each morning. The assessment was divided into five phases: Baseline (BL), Antisepsis (A), Puncture (P), Dressing (D), and Recovery (R). The neonates' facial activity (NFCS), behavioral state, and heart rate were evaluated. The data analysis used cut-off scores for painful and distressful responses. No side effects of using sucrose were detected. There were significantly fewer SG neonates with facial actions signaling pain than CG neonates in P (ass.2) and in A (ass.3). We found significantly fewer SG neonates in the awake state than CG neonates in P (ass.2 and ass.4). There were significantly fewer SG neonates crying during A (ass.2), P (ass.2 and ass.4), and D (ass.3). There was no statistical difference between-groups for physiological response. The efficacy of sucrose was maintained for pain relief in preterm neonates with no side effects.     

早期护理干预对假性球麻痹患者吞咽功能恢复的影响

摘要：目的 探讨假性球麻痹所致吞咽障碍的护理方法和治疗时机。 方法 将61例病患随机分为两组,治疗时间为1个月,对照组30例采用传统的常规护理方法进行治疗及鼻饲营养和饮食指导。治疗组31例在前者的基础上采用早期系统化康复护理,包括基础训练、吞咽功能的训练等。 结果 治疗组的吞咽功能有明显的改善,吸入性肺炎的发生率也有所降低,与对照组有着有显著性差异（P<0.05）。 结论 早期、系统化进行护理干预能够有效的改善假性球麻痹患者吞咽功能,减少呛咳和吸入性肺炎的发生率,提高患者生活质量。     

早期吞咽功能训练在预防脑卒中相关性肺炎中的作用

目的 探讨早期吞咽功能训练在预防脑卒中相关性肺炎(SAP)中的作用.方法 78例脑卒中伴吞咽功能障碍患者分为训练组(n=39)和对照组(n=39).两组均采取常规护理,训练组早期增加吞咽功能训练.结果 训练组仅有10例发生SAP(25.6%),低于对照组发生率(46.2%)(x2=3.57,P<0.05).结论 早期进行吞咽功能训练是预防脑卒中相关性肺炎的重要护理措施.