腹腔镜胆囊切除术患者临床护理路径的研究

目的 观察临床护理路径在腹腔镜胆囊切除术患者中的应用效果.方法 选择2009年5月至2010年6月连续收治的腹腔镜胆囊切除术患者236例,根据患者入院时间按随机数字表分为常规护理组(对照组)和临床护理路径组(CNP组)各118例,分别接受常规护理和依据临床护理路径的护理.记录、分析和比较2组患者健康知识掌握情况、护理满意度、手术时间、麻醉时间、住院时间和住院费用等的差异.结果 CNP组患者的健康知识掌握情况和护理满意度好于对照组;与对照组比较,CNP组麻醉时间、手术时间、住院时间和住院费用明显减少.结论 在腹腔镜胆囊切除术中实施临床护理路径可提高患者的健康知识水平和护理满意度,减少手术时间和住院时间,减轻医疗负担,效果良好.

Abstract：

Objective To study the effect of clinical nursing pathway(CNP) in patients undergoing laparoscopic cholecystectomy( LC ). Methods Two hundred and thirty six LC patients were enrolled from May 2009 to June 2010, and randomly divided into the traditional nursing group (the control group) and the clinical nursing pathway group (the CNP group) with 118 cases in each group.The health knowledge score, nursing service satisfaction, operation time, anesthesia time, hospital stay time and hospitalization cost were recorded and analyzed between the two groups. Results The scores of health knowledge and nursing service satisfaction in the CNP group were higher than the control group; compared with the control group, the CNP group had less operation time, anesthesia time, hospital stay time and hospitalization cost. Conclusions Clinical nursing pathway may improve health knowledge and nursing service satisfaction, decrease the operation time and hospital stay time, reduce the medical burden, has a better effect in the patients undergoing laparoscopic cholecystectomy.     

罗伊适应模式在低位直肠癌患者焦虑中的应用研究

目的 探讨罗伊适应模式在低位直肠癌患者焦虑中的临床应用研究.方法 将60例低位直肠癌患者随机分为实验组30例和对照组30例.对照组按直肠癌术后护理常规进行护理,实验组除接受直肠癌常规护理外,按照罗伊适应模式的护理理念方法进行护理干预,采用90项症状自评量表(Symptom Checklist 90,SCL-90)及焦虑自评量表(SAS)用以测定患者的心理状况;应用本院质量检查的满意度调查量表对患者及家属进行评定.结果 实验组焦虑症状明显低于对照组,实验组满意度及住院天数明显优于对照组,两组比较差异有显著性(P＜0.05).结论 严格按罗伊适应模式实施整体护理能减轻低位直肠癌患者焦虑和压抑,提高病人术后自理能力,降低术后并发症的发生率,缩短了住院天数,从而减少病人的住院费用,提高了患者的满意度及生活质量.

Abstract：

Objective To study the application of Roy adaptation model in low rectal cancer patients who were in anxiety. Methods There were 60 rectal cancer patients, who were randomly divided half-and-half into experimental group and control group. The patients in control group were cared according to routine postoperative nursing of cancer, The patients in experimental group were received routine nursing of cancer, and were nursing intervention accordance with Roy adaptation model. The symptom checklist 90 ( SCL -90) and selfrating anxiety scale (SAS) were used to the determine patients'psychological status, and assess the patients and their families according to our hospital quality inspection application of satisfaction survey questionnaire. Results Anxiety symptoms in experimental group were significantly lower than those of the control group, the degree of satisfaction of experimental group was better than that of control group, and inpatient day of experimental group was significantly shorter than that of control group (P ＜ 0. 05 ) . Conclusions Application of Roy adaptation model in holistic nursing can reduce anxiety and depression in colorectal cancer patients , and improve postoperative self - care ability, reduce the incidence of postoperative complications, shorten hospital stay, reduce hospitalization expenses, make better satisfaction and quality of life of patients.     

快速恢复外科理念在多发性肋骨骨折内固定手术中的应用研究

Objective To evaluate the application of fast track surgery (FTS) in the rib internal fixation of multiple rib fractures. Methods Forty-eight chest trauma with multiple rib fractures patients from March 2008 to March 2010 were divided into FTS group and traditional care group randomly. Meanwhile two groups accepted FTS and conventional management of perioperative period respectively. The degree and duration of the chest pain, early exercise tolerance, intravenous infusion time, the length of postoperative hospital stay,chest scar and postoperative complications were observed and compared between the two groups. Results The duration of chest pain was significantly shorter in FTS group than in the traditional care group([ 112. 46 ±23. 24 ] mins vs [ 180. 23 ± 51.56 ] mins, t = 4. 23 ,P ＜ 0. 05); the early exercise tolerance was longer([ 68. 35 ±9. 30 ] mins vs [ 33.48± 5. 18 ] mins,t = 2. 87, P ＜ 0. 05) ;the intravenous infusion time was shorter ([ 10. 83 ±1.87 ] d vs [ 13. 30 ± 2. 12 ] d, t = 2. 38, P ＜ 0. 05); the length of postoperative hospital stay was shorter([ 12. 35 ± 2.03 ] d vs [ 16. 48 ± 3. 18 ] d, t = 3.04, P ＜ 0. 05); the less postoperative complications(8.3% vs 37. 5 %, x2 = 5. 005,P ＜ 0. 05); chest pain was relieved([ 3.43 ± 0. 45 ] cm vs. [ 6. 62 ± 0. 62 ] cm, P ＜ 0. 05);the scar healed well. All patients were successfully discharged. Conclusion The perioperative idea of fast track surgery was feasible and effective in the chest trauma with multiple rib fractures patients. FTS can improve the patients long term living quality.     

循证护理干预对肾病综合征患儿疗效及生活质量的影响

目的 探讨循证护理干预对肾病综合征(NS)患儿疗效及生活质量的影响.方法 将98例NS患儿随机分成对照组48例和干预组50例,对照组入院后采取常规护理,干预组患者在常规护理基础上予循证护理干预.比较2组患儿平均住院时间、疗效及生活质量.结果 干预组患儿的平均住院时间较对照组明显缩短,干预组治疗效果明显优于对照组.干预组患儿生活质量较对照组明显改善.结论 循证护理干预能明显提高肾病综合征患儿的治疗效果,进一步提高生活质量.

Abstract：

Objective To investigate the influence of evidence-based nursing intervention on treatment effect and quality of life in nephrotic syndrome children. Methods 98 cases were randomly divided into the intervention group and the control group. The control group received routine nursing and the intervention group additionally received evidence-based nursing intervention. We compared the average hospital stay, treatment effect and quality of life in two groups. Results The average hospital stay in the intervention group was shorter than that of the control group. The treatment effect in the intervention group was ameliorated than that of the control group. The quality of life in the intervention group was ameliorated than that of the control group. Conclusions Evidence-based nursing intervention could obviously improve the treatment effect and quality of life in children with nephrotic syndrome.     

中医辨证施护在老年性肺炎患者中的应用研究

Objective To explore the effect of Chinese medical dialectic nursing on age-related pneumonia patients. Methods Tatally 128 age-related pneumonia patients were selected randomly, and they were divided into control and intervention groiips stochastical ly, each with 64 cases. The control group was given the routine nursing, while the intervention group was given the extra Chinese medical dialectic nursing. Results Significant functional recovery efficiency of 87. 5% was seen in the intervention group, and 75% in the control group (P＜0.05) . Conclusions Chinese medical dialectic nursing can improve the functional recovery in patients with age-related pneumonia.     

中医辨证施护在老年性肺炎患者中的应用研究

Objective To explore the effect of Chinese medical dialectic nursing on age-related pneumonia patients. Methods Tatally 128 age-related pneumonia patients were selected randomly, and they were divided into control and intervention groiips stochastical ly, each with 64 cases. The control group was given the routine nursing, while the intervention group was given the extra Chinese medical dialectic nursing. Results Significant functional recovery efficiency of 87. 5% was seen in the intervention group, and 75% in the control group (P＜0.05) . Conclusions Chinese medical dialectic nursing can improve the functional recovery in patients with age-related pneumonia.     

肠内营养治疗食管癌和贲门癌术后功能性胃排空障碍

目的 探讨肠内营养在功能性胃排空障碍治疗中的作用.方法 15例食管癌、贲门癌手术后功能性胃排空障碍患者,10例应用肠内营养,5例应用肠外营养,比较2组术后住院时间、胃肠减压 量、胃排空障碍恢复时间,评估肠内营养的疗效.结果 肠外营养组住院时间为(20.3±6.6)d,肠内营养组为(14.4±4.6)d;胃排空障碍恢复时间分别为(19±9)、(12±4)d.结论 肠内营养能促进胃肠道功能恢复,是治疗食管癌、贲门癌手术后功能性胃排空障碍的有效手段.

Abstract：

Objective To explore the role of enteral nutrition in the treatment of functional delayed gastric emptying. Methods Among 15 patients with functional delayed gastric emptying after resection of esophageal or gastric cardiac carcinoma, 10 patients were treated with enteral nutrition( EN group),5 patients were treated with parenteral nutrition (PN group). Postoperative hospital stay, gastrointestinal decompression amount, recovering time of postoperative gastric emptying were observed to assess the efficacy of enteral nutrition. Results The average postoperative hospital stay was ( 14. 4 ± 4. 6) days in the EN group, whereas (20. 3 ±6. 6) days in the PN group. The average recovering time of postoperative gastric emptying was (19 ±9)days in the PN group and( 12 ± 4)days in the EN group. Conclusion The method of EN can enhance gastric emptying and is effective for functional delayed gastric emptying after resection of esophageal or gastric cardiac carcinoma     

护理干预对老年复治肺结核病人预后的影响

Objectiye To enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis by nursing intervention. Methods One hundred and six relapse agedness patients with pulmonary tuberculosis were divided into experimental (n=54) and control groups (n=52). The experimental group was given the whole course nursing intervention and the control group was given universality guidance when they left hospital. The therapy compliance, sputum negative conversion rate and absorbability instance of focus were investigated among the patients of the two groups. Results The therapy compliance,sputum negative conversion rate and absorbabilty instance of focus in the trial group were significant higher than those in the control group (P＜0.05). Conclusions The whole course nursing intervention can enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis.     

护理干预对老年复治肺结核病人预后的影响

Objectiye To enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis by nursing intervention. Methods One hundred and six relapse agedness patients with pulmonary tuberculosis were divided into experimental (n=54) and control groups (n=52). The experimental group was given the whole course nursing intervention and the control group was given universality guidance when they left hospital. The therapy compliance, sputum negative conversion rate and absorbability instance of focus were investigated among the patients of the two groups. Results The therapy compliance,sputum negative conversion rate and absorbabilty instance of focus in the trial group were significant higher than those in the control group (P＜0.05). Conclusions The whole course nursing intervention can enhance the therapy compliance and the cure rate of the relapse agedness patients with pulmonary tuberculosis.     

临床路径在食管癌围手术期护理中的应用效果分析

目的 探讨临床路径(clinical pathway,CP)在食管癌患者围手术期护理中的应用效果.方法 将100例食管癌患者随机分为对照组和观察组各50例,对照组使用传统的护理模式,观察组实施CP进行护理,比较两组患者的术后禁食天数、住院时间、平均住院费用、疾病的知识测试成绩(分)及患者对护理质量满意度(例).结果 观察组患者的术后禁食日、平均住院天数、平均住院费用以及疾病知识的掌握情况明显优于对照组,观察组患者护理质量满意度显著高于对照组.结论 临床路径增强了医护人员之间的信息交流和传递,减少了中间环节,降低了医疗成本,节约了医疗资源,提高了医疗护理质量和工作效率,是一种为食管癌患者提供高品质、高效率、低成本的医疗护理服务模式,值得在临床上推广应用.

Abstract：

Objective To investigate the application efect of the clinical pathway (CP) in the perioperative care of oesophagus cancer patients. Methods A total of100 oesophagus cancer patients were divided into observation group (n=50) and control group (n=50) randomly. The patients in observation group received the CP nursing and those in control group received routine nursing. Postoperative fasting days, average hospitalization days, average hospitalization expense, the test of related disease knowledge and patient satisfaction were compared between two groups. Results The observation group was significantly better than control group in all aspects. Conclusions The CP mode strengthens the communication among the health care workers, reduces the middle tache, lowers the medical costs, saves the medical resource, improves the medical care quantity and working effect , it's a medical care srvice mode which can provide higher quality, higher efficiency and lower costs for oesophagus cancer patients, and it is worth popularizing in clinical practice.     

快速康复外科理念在微创内固定治疗胸腰椎爆裂骨折患者围术期护理中的应用

目的探讨快速康复外科理念在微创内固定治疗胸腰椎爆裂骨折患者围术期护理中的应用效果。方法 2014年9月至2015年9月,便利抽样法选择在丽水市中心医院脊柱外科实施微创内固定治疗胸腰椎爆裂骨折患者90例为研究对象,按随机数字表法将其分为观察组与对照组,每组45例。对照组患者围术期采用传统常规护理方式,观察组患者围术期采用快速康复外科(fast-track surgery,FTS)护理方案。比较两组患者的术后并发症发生率、疼痛评分、住院时间和住院费用情况。结果观察组患者术后并发症发生率为6.5%(3/45)低于对照组24.4%(11/45),差异有统计学意义(χ~2=12.61,P0.05);术后24h、术后3d、出院时疼痛评分分别为(3.36±0.87)、(2.64±0.61)、(1.75±0.65)分均低于对照组的(4.26±1.12)、(3.48±0.84)、(2.35±0.53)分,差异均有统计学意义(均P0.05)。观察组患者术后住院时间为(7.07±1.70)d,较对照组的(10.04±2.51)d缩短;而观察组患者住院总费用为(29 794.05±882.44)元,较对照组的(33 929.92±1431.30)元降低,差异均有统计学意义(均P0.05)。结论在胸腰椎爆裂性骨折患者围术期护理中应用FTS,可以有效减轻患者术后疼痛,加速患者术后康复,并且可减少并发症的发生,是脊柱外科新型护理模式的方向。     

加速康复外科在腹腔镜下子宫肌瘤切除术护理中的应用

目的探讨加速康复外科理念在腹腔镜下子宫肌瘤切除围手术期护理安全性和有效性。方法将行腹腔镜下子宫肌瘤切除患者116例随机分为实验组和对照组,每组各58例。实验组患者将加速康复外科这一理念实施护理,对照组采用传统护理方法。比较两组患者术后恶心和呕吐的发生率,术后肛门排气时间,住院时间以及治疗费用等。结果实验组患者术后恶心、呕吐的发生率低于对照组,术后肛门排气时间早于对照组,住院时间短于对照组,治疗费用少于对照组,两组比较,均P〈0.05,差异具有统计学意义。结论将加速康复外科理念用于腹腔镜下子宫肌瘤切除术围手术期护理,有利于减少患者并发症,缩短住院时间,降低住院费用。     

快速康复外科在下肢静脉曲张围术期护理中的应用

[目的]探讨快速康复外科(FTS)在下肢静脉曲张围术期护理中的应用效果。[方法]血管外科收治的80例下肢静脉曲张手术病人,根据护理方法不同分为观察组40例(56条患肢)和对照组40例(52条患肢),对照组进行常规围术期护理,观察组在此基础上进行快速康复外科护理,比较两组病人术后康复情况间的差异。[结果]护理干预后,观察组病人术后下床活动时间、进食时间、术后静脉输液时间和住院时间均较对照组短(P0.05)。[结论]快速康复外科护理措施可减少病人住院时间和住院费用,提高病人术后康复效果。     

快速康复外科在急诊上消化道穿孔修补术中的应用

目的:探讨在急诊上消化道穿孔修补术中应用快速康复外科(FTS)的安全性、可行性及有效性.方法:回顾性分析2008年1月至2011年5月间广州军区广州总医院普外科收治的62例行上消化道穿孔修补术患者的临床资料,其中32例为FTS组,30例为传统组,两组行非随机对照研究.比较两组术后首次排气、排便时间、住院时间、住院费用和C-反应蛋白(CRP)、白细胞介素-6(IL-6)、皮质醇等应激反应指标及术后并发症.结果:FTS组同传统组相比,术后首次排气时间(2.5 d vs 4.7 d)、排便时间(3.2 d vs 5.1 d)提前,住院时间(4.5 d vs 7.8 d)缩短,住院费用降低(6.5千元vs 9.3千元),差异均具有显著性(P ＜ 0.05);FTS组术后第1、3天 CRP、IL-6、皮质醇等应激反应指标均明显低于传统组(P ＜ 0.05).FTS组肺部并发症(1/32,3.1%)显著低于传统组(5/30,16.7%,P ＜ 0.01),其余单个并发症及总体并发症FTS组略低于传统组,但差异无统计学意义(P ＞ 0.05).结论:FTS应用于急诊上消化道穿孔修补术安全有效,可促进术后胃肠功能恢复,缩短住院时间,降低住院费用,并不增加术后并发症.     

快速康复外科护理在腹腔镜胆总管切开取石一期缝合术中的应用效果分析

目的 探讨快速康复外科(FTS)护理理念在腹腔镜胆总管切开取石一期缝合术(LBEPS)中的应用效果.方法 将150例择期行LBEPS患者根据住院号随机分为2组,每组各75例.2组患者均接受同一组手术医师行腹腔镜胆总管切开取石一期缝合术,观察组围手术期采用FTS护理,对照组采用常规护理.对2组临床指标(住院总时间、住院总费用、术后腹腔引流管留置时间、导尿管留置率)及术后第7天实验室指标(总蛋白、血液白蛋白、总胆红素、丙氨酸转氨酶)进行比较.结果 与对照组相比,观察组在住院总费用、住院总时间、术后腹腔引流管留置时间和导尿管留置率均低于对照组,差异有统计学意义(P<0.05);观察组的血液白蛋白、总蛋白指标均显著高于对照组,而总胆红素、丙氨酸转氨酶水平显著低于对照组(P<0.05).结论 快速康复外科理念在LBEPS患者中的应用具有良好的安全性和有效性,可缩短术后腹腔引流管留置时间,降低导管留置率,缩短住院天数,减少住院总费用;可提高患者术后免疫及肝功能,使患者康复加速,减少患者的痛苦.     

快速康复外科在急腹症手术中的应用

目的探讨快速康复外科（FTS）在急腹症手术中的应用效果。方法采用随机数字表法将商丘市第一人民医院2004年3月至2007年7月收治的160例接受手术的急腹症患者分为两组,每组各80例,分别采用FI＇S新理念治疗（FTS组）及传统方法治疗（对照组）。比较两组患者术后首次排气、排便时间,恶心,呕吐发生率、并发症发生率及住院费用。结果与对照组比较,FTS组患者的术后住院时间明显缩短[（7．4±0．5）d比（10．3±0．7）d],治疗费用明显减少[（4235±231）元比（5731±211）元],术后首次排气时间[（1．3±0．4）d比（2．6±0．3）d]、排便时间[（2．1±0．3）d比（3．3±0．5）d]均明显提前,并发症发生率降低;两组患者手术时间[（0．8±0．2）h比（0．9±0．1）h]比较,差异无统计学意义（P〉0．05）。结论在急腹症外科治疗中应用FTS可有效促进术后患者胃肠道功能的恢复,减少并发症的发生率,缩短住院时间,节省住院费用,提高患者对护理的满意度。     

快速康复在老年结直肠癌根治术患者护理中的应用研究

目的探讨快速康复应用于老年结直肠癌根治术的方法及效果。方法试验组31例患者实施快速康复治疗并进行相应的护理,对照组31例按照常规治疗并实施相应护理。比较两组患者首次排气时间、首次经口进食时间、首次离床时间、术后住院时间及术后并发症发生情况。结果试验组首次排气时间、首次经口进食时间、首次离床时间及术后住院时间均短于对照组(P<0.01),试验组术后尿路感染、肠粘连发生率少于对照组(P<0.05)。结论将快速康复应用在老年结直肠癌根治术中,能促进患者恢复,但是对护理提出了更高的要求。     

冠状动脉旁路移植患者围术期分级心理护理的实施与效果

目的 探讨适用于冠状动脉旁路移植择期手术患者的心理护理对策.方法 将2012年1月至2013年2月88例冠状动脉旁路移植术患者随机分为干预组和对照组各44例,对照组给予冠状动脉旁路移植术围术期常规护理,干预组按照术前后SCL-90症状自评量表评分及匹兹堡睡眠质量指数（Pittsburgh sleep quality index,PSQI）进行分级心理护理,比较两组患者手术前后心理、睡眠、疼痛等主观指标及住院天数、护理工作满意度.结果 干预组术后除SCL-90总均分外,PSQI及疼痛评分低于对照组,食欲得分高于对照组,总住院天数、ICU住院天数及术后住院天数少于对照组,护理工作满意度评分高于对照组,差异均有统计学意义（P＜0.05或P＜0.01）.结论 针对不同心理特点的冠状动脉旁路移植围术期患者实施分级心理护理,有助于促进患者康复、提高患者的满意度,并在一定程度上缩短了患者的住院时间,减少了医疗费用,体现了较好的经济效益及社会效益.     

快速康复护理在单孔腹腔镜胆囊切除术患者中的应用

目的:探讨快速康复护理在单孔腹腔镜胆囊切除术患者中的应用方法及效果.方法:将100例单孔腹腔镜胆囊切除术患者随机分为观察组与对照组各50例,观察组给予快速康复护理,对照组给予常规护理,比较两组患者术后肠道通气、住院时间、住院费用、满意度及术后不良反应等有效指标.结果:观察组与对照组比较,术后肠道通气时间、住院天数缩短,住院费用、术后不良反应减少,满意度提高,两组比较差异均有统计学意义(P<0.05).结论:快速康复护理可加快单孔腹腔镜胆囊切除术患者术后肠道功能恢复,缩短住院时间,降低住院费用及减少术后不良反应,提高满意度,值得临床推广应用.     

快速康复理念在腹腔镜脾切除术围术期护理中的应用

目的：探讨快速康复理念（FTS）在腹腔镜脾切除术（LS）病人围术期的应用效果。方法：将40例LS病人随机分为FTS组和对照组各20例。对照组给予常规围术期护理,FTS组应用FTS进行围术期护理。结果：FTS组病人术后肠鸣音恢复时间、首次排气排便时间、住院费用、住院时间、并发症发生率均低于对照组（P〈0.05）,FTS组病人满意度高于对照组（P〈0.05）。结论：FTS在LS病人围术期的应用,有效促进病人术后康复,缩短了住院时间,降低了住院费用。