综合性护理干预对鼻内镜术后患者舒适度的影响

目的观察综合性护理干预对鼻内镜术后患者舒适度的影响效果,并进行影响因素分析。方法选取本院收治的76例鼻内镜手术患者,以数字表法随机分为两组,各38例。对照组予以常规护理,实验组予以综合性护理,比较两组患者术后1d视觉疼痛模拟(Visual Analogue Scale,VAS)评分、术后3d舒适度评分,并对舒适度进行影响因素分析。结果实验组术后1d疼痛VAS评分程度明显轻于对照组(P0.05);实验组术后3d舒适度评分显著高于对照组(P0.05);不同年龄、文化程度患者舒适度评分比较有统计学差异(P0.05);多因素分析显示,年龄≤30岁、文化程度大学及以上为鼻内镜术后患者舒适度的独立危险因素(P0.05)。结论年龄越小、文化程度越高的患者,鼻内镜术后舒适度越低,临床可通过综合性护理予以针对性干预,促进其舒适度提升。     

舒适护理在蛛网膜下腔出血患者中的应用效果

目的探讨舒适护理在蛛网膜下腔出血患者中的运用效果。方法将2013年9月~2015年10月本院收治的90例蛛网膜下腔出血患者按随机数字表法随机分为观察组和对照组,各45例。对照组采用常规护理,观察组采用舒适护理。比较2组患者护理后的舒适度评分、抑郁程度评分、焦虑程度评分和护理满意率。结果观察组焦虑评分和抑郁评分分别为(40.01±5.29)分、(42.58±6.67)分,显著低于对照组(P0.05);观察组舒适度评分和护理满意率分别为(8.43±0.27)分、95.56%,显著高于对照组(P0.05),比较差异均有统计学意义。结论对蛛网膜下腔出血的患者予以舒适护理,可以显著改善患者舒适度,减少焦虑、抑郁等负性情绪,提升患者对护理的满意度,是一种较好的护理干预方法,在临床中具有较高的运用价值。     

模块式护理干预对鼻内镜术后病人疼痛和焦虑的影响

[目的]探讨模块式护理干预对行鼻内镜手术病人术后疼痛和焦虑的影响。[方法]将80例行鼻内镜手术的病人按照抛硬币的方法随机分为两组各40例。对照组病人住院期间给予耳鼻喉科常规护理,观察组在对照组的基础上给予模块式护理干预,采用视觉模拟量表(VAS)和汉密尔顿焦虑量表对两组病人的疼痛和焦虑情况进行测评。[结果]术后第3天,观察组病人的疼痛评分(2.67分±1.52分)、焦虑评分(6.94分±1.65分)均低于对照组病人(5.48分±2.75分,10.07分±2.03分),两组比较差异有统计学意义(P0.05)。[结论]模块式护理干预能在一定程度上减轻鼻内镜手术病人术后的疼痛、焦虑程度,有利于疾病的治疗和康复。     

围手术期舒适护理对乳腺癌患者负面心理及疼痛的影响

目的探究围手术期舒适护理对乳腺癌患者负面心理及疼痛的改善效果。方法选取2016年1月1日~2017年5月1日期间本院收治的60例乳腺癌患者,按照随机的原则分为2组,每组各有30例,观察组和对照组分别采用围手术期的舒适护理和常规护理。比较2组患者的总并发症发生率,焦虑评分、抑郁评分,以及术后12h,72h的疼痛评分。结果观察组患者的总并发症发生率(1.67%)、焦虑评分(15.32±2.17)分、抑郁评分(12.36±2.47)分、术后12h疼痛评分(3.02±0.12)分、术后24h疼痛评分(2.45±0.38)分、术后72h疼痛评分(1.20±0.01)分均优于对照组(P0.05)。结论围手术期的舒适护理在乳腺癌患者中效果显著,方可改善患者负面情绪,减轻患者疼痛感。     

不同护理模式在无痛消化内镜检查术中的应用效果比较

目的 比较2种不同护理模式在无痛消化内镜检查术中应用的临床效果.方法 将400例行清醒镇静型无痛消化内镜检查的患者随机分为实验组与对照组各200例,对照组采用无痛消化内镜检查常规护理模式,实验组在此基础上采用舒适护理模式,对2组患者的护理效果进行对比观察.结果 实施不同护理模式后,实验组患者焦虑值评分结果为(403±45)分,对照组患者焦虑值评分结果为(454±5.8)分,实验组与对照组相比较差异明显.2组患者自觉疼痛程度相比较差异明显.实验组与对照组检查中收缩压、舒张压和心率比较差异均明显.检查后,2组收缩压比1交差异明显.结论 舒适护理模式能减轻无痛消化内镜检查患者的焦虑等不良情绪,降低患者疼痛不适,避免并发症,对无痛消化内镜诊断、治疗的顺利开展具有重要意义.     

模块式护理干预对鼻内镜术后病人疼痛和焦虑的影响

[目的]探讨模块式护理干预对行鼻内镜手术病人术后疼痛和焦虑的影响。[方法]将80例行鼻内镜手术的病人按照抛硬币的方法随机分为两组各40例。对照组病人住院期间给予耳鼻喉科常规护理,观察组在对照组的基础上给予模块式护理干预,采用视觉模拟量表(VAS)和汉密尔顿焦虑量表对两组病人的疼痛和焦虑情况进行测评。[结果]术后第3天,观察组病人的疼痛评分(2.67分±1.52分)、焦虑评分(6.94分±1.65分)均低于对照组病人(5.48分±2.75分,10.07分±2.03分),两组比较差异有统计学意义(P<0.05)。[结论]模块式护理干预能在一定程度上减轻鼻内镜手术病人术后的疼痛、焦虑程度,有利于疾病的治疗和康复。     

舒适护理用于提高化疗患者治疗依从性及生存质量的效果观察

目的探讨舒适护理对提高化疗患者治疗依从性及生存质量的效果。方法选取2016年1月~2017年2月在本院治疗的90例化疗患者作为研究对象,采用随机信封法将研究对象分为两组,每组各45例。对照组采用常规护理,舒适组采用舒适护理。比较两组化疗患者的护理满意度、化疗依从性评分、环境舒适度评分、生理舒适度评分;干预前后患者生存质量评分、焦虑情绪评分、穿刺疼痛评分。结果舒适组化疗患者护理满意度高于对照组(P0.05);舒适组患者化疗依从性评分、环境舒适度评分、生理舒适度评分优于对照组(P0.05);干预前两组患者生存质量评分、焦虑情绪评分、穿刺疼痛评分比较,差异无统计学意义(P0.05);干预后舒适组患者生存质量评分、焦虑情绪评分、穿刺疼痛评分优于对照组(P0.05)。结论舒适护理可减轻化疗患者焦虑情绪,提高环境舒适度和生理舒适度,减轻疼痛感,提高化疗治疗依从性,改善患者生存质量,提高其对护理的满意度,值得临床推广。     

综合护理干预在鼻内镜手术治疗慢性鼻窦炎中的应用

目的:探讨综合护理干预在鼻内镜手术治疗慢性鼻窦炎中的应用效果。方法:将100例慢性鼻窦炎行鼻内镜手术治疗患者随机分为观察组和对照组各50例,对照组采用常规护理,观察组采用综合护理措施。比较两组患者护理效果。结果:护理后两组焦虑评分均显著低于护理前(P0.05),观察组护理后焦虑评分明显低于对照组护理后(P0.05)。观察组并发症、住院时间显著少于对照组,护理满意度明显高于对照组(P0.05)。结论:综合护理干预使护理更加系统、全面,能减少鼻内镜手术患者术后焦虑,降低并发症发生率。     

舒适护理干预在老年胆道手术患者中的效果分析

目的：探讨舒适护理预防老年胆道手术患者并发症、提升舒适体验的运用价值。方法以我院2014年2月~2015年10月收治的老年胆道手术患者共106例为对象,按照患者意愿分为观察组和对照组各53例。对照组采用常规护理,观察组采用舒适护理。比较两组围术期并发症发生率和住院时间,并在患者出院时采用舒适护理问卷从生理舒适、心理舒适和总体舒适对舒适度进行评价。结果观察组并发症总发生率为3.77%(2/53),显著低于对照组15.09%(8/53)的发生率(x2=3.975,P<0.05)。观察组住院时间为(10.4±3.3)d,显著短于对照组( t=4.715, P<0.05)。观察组心理舒适、生理舒适和总体舒适评分分别为(4.12±0.53)分、(4.07±0.46)分、(3.90±0.62)分,显著高于对照组(t=4.032、3.923、3.945,P<0.05)。结论对老年胆道手术患者予以舒适护理干预,能够降低术后并发症发生率,改善患者舒适度,缩短住院时间,值得临床推广运用。     

鼻内镜手术治疗慢性鼻窦炎30例围术期舒适护理

目的:探讨鼻内镜手术治疗慢性鼻窦炎患者的围术期舒适护理方法。方法:将60例经鼻内镜手术治疗的慢性鼻窦炎患者随机分为对照组和观察组各30例,对照组采用常规护理措施,观察组在常规护理基础上实施围术期舒适护理,比较两组围术期舒适度。结果:观察组在生理、心理、社会环境、文化方面的舒适度评分均显著高于对照组(P<0.05)。观察组术后疼痛程度明显轻于对照组,护理满意度显著高于对照组,差异均有统计学意义(P<0.05)。结论:舒适护理有利于提高鼻窦炎围术期患者的舒适度,减轻疼痛,促进患者的康复。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.     

自动化酸碱平衡图在急诊社区获得性肺炎诊治中的应用

目的 探讨自动化酸碱平衡图在急诊科社区获得性肺炎(CAP)患者诊断中的价值.方法 根据病史、肺功能测定结果、慢性阻塞性肺疾病(COPD)诊断标准,将111例CAP患者分为单纯CAP组(56例)和COPD合并CAP组[即慢性阻塞性肺疾病急性加重(AECOPD)组,55例].询问患者病史后即刻抽取动脉血测血气并进行自动化酸碱平衡图分析.结果 血气分析结果显示,AECOPD组动脉血二氧化碳分压(PaCO2,kPa)、HCO3- (mmol/L)、剩余碱(BE,mmol/L)均显著高于CAP组(PaCO2:7.714±2.414比5.896±1.308,HCO3-:30.767±7.185比25.014±3.043,BE:4.345±5.371比-0.354±3.180,均P＜0.01).自动化酸碱平衡图分析结果显示,AECOPD组患者酸碱平衡紊乱高达89.1％,CAP组为66.1％.将AECOPD组和CAP组患者中正常(10.9％、33.9％)、急性呼吸性酸中毒(急性呼酸,12.7％、14.3％)、慢性呼吸性酸中毒(慢性呼酸,49.1％、10.7％)、呼吸性碱中毒(呼碱,7.3％、14.3％)、代谢性酸中毒(代酸,12.7％、17.9％)、代谢性碱中毒(代碱,12.7％、8.9％)综合进行x2分析,差异有统计学意义(x2=24.421,P=0.001),而将正常、急性呼酸、呼碱、代酸及代碱进行x2分析,差异无统计学意义(x2=5.280,P=0.260),提示AECOPD患者慢性呼酸的发生率较单纯CAP患者显著增加.结论 自动化酸碱平衡图能帮助急诊科医师快速识别CAP患者是否存在多重酸碱平衡紊乱,并可快速识别急、慢性呼吸系统疾病.