综合护理干预对乳腺癌术后化疗患者焦虑抑郁情绪的影响

目的 探讨综合护理干预对乳腺癌术后化疗患者焦虑抑郁情绪的影响.方法 回顾性研究我科收治乳腺癌术后初次化疗患者80例,按时间顺序分为对照组和观察组,对照组采用常规护理干预,观察组在对照组的基础上采用包括心理指导、认知教育、放松训练、家庭支持在内的综合护理干预,对每位患者干预前后分别采用焦虑自评量表（SAS）、抑郁自评量表（SDS）和中文版SF-36生活质量量表评分并进行对比分析.结果 干预前两组患者SAS、SDS、SF-36评分比较差异均无统计学意义（P＞0.05）,具有可比性.干预后观察组SAS和SDS评分均低于对照组,观察组SF-36评分明显高于对照组,干预后两组患者SAS、SDS、SF-36评分比较差异均有统计学意义（P＜0.05）.结论 综合护理干预能够缓解乳腺癌术后化疗患者焦虑抑郁情绪,提高患者的生活质量,为临床护理工作提供一定参考.     

肺癌晚期患者临终关怀的护理伦理应用价值

【摘要】 目的 探讨肺癌晚期患者临终关怀的护理伦理应用价值。方法 选取2017年1月～2017年12月我院呼吸内科收治的68例肺癌癌症晚期患者为研究对象,随机分为对照组和研究组,每组各34例。其中,对照组采用常规晚期癌症的护理方法,研究组在常规护理的基础上对患者进行临终关怀,对两组患者护理前后的焦虑自评量（SAS）评分和抑郁自评量（SDS）评分进行记录比较,同时应用PSQI评分评估两组患者的睡眠质量并对患者及家属的护理满意度进行调查。结果 进行护理干预前两组患者的SAS评分以及SDS评分差异无统计学意义（P＞0.05）,护理干预后均得到一定的改善,研究组显著优于对照组（P＜0.05）;研究组的PSQI评分明显低于对照组,表明该组患者的睡眠质量明显优于对照组（P＜0.05）;研究组的患者及家属的满意度明显高于对照组,差异均有统计学意义（P＜0.05）。结论 对肺癌癌症晚期患者进行临终关怀护理能有效改善患者的SAS评分及SDS评分,并且能有效提升患者的睡眠质量及提高患者及其家属的护理满意度,可在临床推广应用。     

恶性肿瘤患者的心理护理干预效果分析

目的探讨恶性肿瘤患者的心理护理干预效果。方法将我院80例临床确诊的恶性肿瘤患者随机分为研究组与对照组,每组各40例。对照组患者给予常规护理,研究组患者在常规护理基础上给予心理护理干预,比较两组患者治疗前后焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分、汉密尔顿焦虑量表（HAMA）评分及汉密尔顿抑郁量表（HAMD）评分情况。结果研究组治疗后SAS评分及SDS评分均较治疗前及对照组显著降低,差异有统计学意义（P〈0.05）;HAMA评分及HAMD评分亦较治疗前及对照组显著降低,差异有统计学意义（P〈0.05）。对照组治疗后SAS评分、SDS评分、HAMA评分及HAMD评分与治疗前比较均无明显改善（P〉0.05）。结论实施合理的心理护理干预能够显著改善恶性肿瘤患者的焦虑、抑郁负性心理,为临床制订恶性肿瘤患者的护理方案提供参考。     

案例基础上超前护理对慢性乙型肝炎肝衰竭患者的影响

目的 探讨案例基础上超前护理对慢性乙型肝炎肝衰竭患者恢复的影响。方法 选取2019年2月至2021年5月浙江大学医学院附属第二医院临平院区收治的慢性乙型肝炎肝衰竭患者120例，根据随机数字表法将其分为对照组和试验组，每组各60例。对照组患者给予常规护理，试验组患者在对照组的基础上实施案例基础上超前护理，两组患者的护理周期均为患者入院至出院前，比较两组患者干预前后的焦虑自评量表（self rating anxiety scale，SAS）、抑郁自评量表（self rating depression scale，SDS）、健康调查量表36（36–item short form health survey，SF–36）评分及肝功能变化。结果 干预后，两组患者的SAS、SDS评分及血清谷丙转氨酶（alanine aminotransferase，ALT）、总胆红素（total bilirrbin，TBil）水平均显著低于干预前（P<0.05），SF–36各维度评分和白蛋白（albumin，Alb）均显著高于本组干预前（P<0.05）；试验组患者的SAS、SDS评分及血清ALT、TBil水平均显著低于对照组（P<0.05），SF–36各维度评分及Alb水平均显著高于对照组（P<0.05）。结论 采取案例基础上超前护理，可缓解慢性乙型肝炎肝衰竭患者的负性情绪，提高患者对疾病的认知，提高生活质量，从而改善患者的肝功能。     

聚焦解决模式在多囊卵巢综合征患者护理中的应用效果观察

目的 观察聚焦解决模式在多囊卵巢综合征（PCOS）患者护理中的应用效果。方法 将74例PCOS患者按照随机数字表法分为2组,每组37例,对照组患者入院后采用常规护理,观察组患者入院后采用聚焦解决模式护理进行干预。采用焦虑自评量表（SAS）及抑郁自评量表（SDS）评估2组患者护理前后心理情绪变化;采用匹茨堡睡眠质量指数量表（PSQI）评估2组患者护理前后睡眠质量;采用简明健康状况问卷（SF-36）评估2组患者护理干预前后生活质量。结果 观察组患者护理干预后SAS、SDS及PSQI评分均明显低于对照组（P<0.05）;观察组患者护理干预后SF-36评分均明显高于对照组（P<0.05）。结论 聚焦解决模式护理可明显改善PCOS患者心理情绪、睡眠质量及生活质量。     

延续精准护理结合心理干预在先兆流产患者中的应用

目的 研究延续精准护理结合心理干预对先兆流产患者心理情绪与保胎成功率的影响。方法 选取2020年1月至2022年6月浙江大学医学院附属第二医院临平院区收治的先兆流产患者共150例为研究对象,根据随机数字表法将其分为试验组与对照组,每组各75例。对照组患者实施常规护理干预方案3个月,试验组患者在常规干预基础上实施延续精准护理结合心理干预方案3个月。比较两组患者的焦虑自评量表（self-rating anxiety scale,SAS）、抑郁自评量表（self-rating depression scale,SDS）、匹兹堡睡眠质量指数（Pittsburgh sleep quality index,PSQI）、一般自我效能感量表（general self-efficacy scale,GSES）评分及保胎成功率、护理满意度。结果 干预后3个月,两组患者的SAS、SDS、PSQI评分均显著低于本组干预前,GSES评分、幸福感得分均显著高于本组干预前（P<0.05）,试验组患者的SAS、SDS、PSQI评分均显著低于对照组,GSES评分、幸福感得分、保胎成功率及护理满意度均显著高于对照组（P<0.05）。结论 延续精准护理结合心理干预可改善先兆流产患者的焦虑与抑郁症状,提高患者的睡眠质量、自我效能感、保胎成功率及护理满意度。     

个性化心理指导联合耳穴压豆对妇科腹腔镜手术患者术后恢复及心理状况的影响

目的 研究个性化心理指导联合耳穴压豆对妇科腹腔镜手术患者术后恢复及心理状况的影响。 方法 便利抽取安徽省亳州市人民医院妇一科2021年1月至2022年8月接诊的82例妇科腹腔镜手术住院患者进行研究。按数字奇偶法分为对照组与研究组各41例。对照组采用常规护理干预,研究组采用耳穴压豆联合个性化心理指导干预。两组在住院期间记录并比较肠鸣音恢复时间、肛门排气时间、住院时间、干预前后焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分、视觉模拟评分法（VAS）评分及并发症发生率。 结果 研究组术后肛门排气时间、肠鸣音恢复时间、住院时间均短于对照组,差异有统计学意义（P＜0.05）。干预后,两组SAS、SDS、VAS评分低于干预前,且研究组低于对照组,差异有统计学意义（P＜0.05）。研究组术后并发症总发生率低于对照组,差异有统计学意义（P＜0.05）。 结论 个性化心理指导联合耳穴压豆有助于妇科腹腔镜手术患者术后恢复,能有效地改善患者的心理状况,减轻疼痛,具有临床应用价值。     

优质护理干预对功能性便秘患者不良心理的影响分析

目的：分析优质护理干预对功能性便秘患者不良心理的影响。方法选择60例功能性便秘患者（FC）患者作为研究对象。将60例患者分为观察组和对照组,每组30例。对照组给予常规护理干预。观察组在常规护理干预基础上实施优质护理干预。干预4周后,比较2组患者干预前后焦虑自评量表（SAS）及抑郁自评量表（SDS）评分变化。结果干预前2组患者SAS评分及SDS评分差异无统计学意义。干预后,2组患者的SAS评分及SDS评分相比干预前均有所下降,但观察组患者下降幅度比对照组明显,2组患者SAS评分及SDS评分差异具有统计学意义（P＜0.05）。观察组患者干预前后SAS评分及SDS评分差异有统计学意义（P＜0.05）。结论优质护理能显著改善FC患者抑郁、焦虑等不良心理情绪,有助于FC治疗。     

围术期程序护理在老年骨质疏松性椎体压缩骨折患者微创手术治疗中的应用

目的探讨围术期程序护理干预对老年骨质疏松性椎体压缩骨折（OVCF）患者微创手术治疗中护理质量的影响。方法选择老年OVCF行经皮球囊扩张后凸成形术（PKP）患者62例,采用随机数字表法分为观察组及对照组各31例,观察组采用程序护理,对照组采用常规护理。观察两组患者焦虑自量表(SAS）评分、抑郁自评量表（SDS）评分变化,比较两组患者术后并发症发生情况及护理满意度。结果护理干预后两组患者SAS评分及SDS评分均明显低于干预前,且观察组SAS评分及SDS评分均明显低于对照组,差异均有统计学意义（均P＜0.05）。观察组患者术后并发症发生率为9.7%,明显低于对照组的22.6%,差异有统计学意义（P＜0.05）。观察组护理满意度为96.7%,明显优于对照组的83.9%,差异有统计学意义（P＜0.05）。结论对行PKP的老年OVCF患者,围术期进行程序护理,能明显缓解其紧张焦虑情绪、有效防止术后并发症的发生、提高患者满意度,值得临床推广。     

护理干预对甲状腺腺瘤切除术患者应激反应及术后疼痛的影响

目的：探讨护理干预对甲状腺腺瘤手术患者心理、生理应激反应及术后疼痛的影响。方法：选择符合标准的患者68例,随机分为研究组35例和对照组33例,两组均给予常规护理,研究组加用护理干预,比较抑郁自评量表（ SDS ）、焦虑自评量表（ SAS ）、收缩压（ SBP ）、舒张压（ DBP ）、心率（ HR）及视觉模拟评分（ VAS）变化情况。结果：入院时两组SAS评分、SDS评分及者SBP、DBP、HR相似,差异无统计学意义（ P＞0．05）;手术当天早晨两组SAS及SDS评分较入院时下降,差异有统计学意义（ P＜0．05）,但是研究组较对照组下降幅度更大（ P＜0．05）;手术中,研究组SBP、DBP及HR与入院时相似,差异无统计学意义（ P＞0．05）;对照组SBP、DBP 及HR较入院时升高,差异有统计学意义（ P＜0．05）。两组术后6h疼痛VAS评分相似,差异无统计学意义（ P＞0．05）;但术后12h、24h及48h研究组VAS评分低于对照组,差异有统计学意义（ P＜0．05）。结论：护理干预能有效减轻甲状腺腺瘤手术患者心理、生理应激反应,降低术后疼痛程度。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.