角膜移植术护理探讨

以１５例角膜移植术的护理实践，总结出该手术的护理常规，并对本组病例中发生的并发症的护理进行了讨论，强调护士密切观察病情，有效地处理并嫌下对手术成功的重要性。     

创伤骨科中责任制护理初探

本文复习了有关责任制护理的理论，从创伤骨科的角度，介绍了这一护理技术在创伤骨科中具体应用方法。通过对创伤骨科病人心理及临床特点的分析，提出了针对创伤病人的护理问题，订出护理计划，在阐述了责任制护理具体实施的优点时，对现存的问题也进行了分析，提出了改进措施。     

Glutamine and Other Amino Acid Losses During Continuous Venovenous Hemodiafiltration

Abstract: Serum amino grams and daily losses of glutamine (Gin) and other amino acids (AAs) into diafiltrate were measured during the first 5 days of continuous venovenous hemodiafiltration (CVVHDF) in 6 ICU patients with acute renal failure (ARF). Four patients had ARF as a part of multiple organ failure (MOF) of septic origin, and 2 patients had isolated ARF because of primary renal disease. During the study, all the patients received defined total parenteral nutrition (TPN). The mean daily AA losses into dialysate were relatively low (0.61 ± 0.1 g N ) and reached 4.5% of the daily AA substitution. Gln represented 32.7 ± 5.9% of the total AA losses (0.19 ± 0.04 g N ). Serum levels of Gin (p = 0.002) and of most other AAs were significantly lower in the patients than in the control subjects (AA analysis in 16 healthy volunteers). Phenylalanine (Phe) was the only AA that was increased significantly (p < 0.01) in the patients. The mean patient serum concentrations of Phe and tyrosine were significantly higher (p < 0.03) than the correspondent concentrations in dialysate, but the lysine concentration was higher in dialysate (p < 0.03). The serum and dialysate concentrations of other AAs did not differ. Gin in serum decreased significantly (p < 0.03) on the second day of CVVHDF but returned to the baseline levels subsequently. Serum concentrations of Phe increased on the second day of CVVHDF (p < 0.05). Serum concentrations of other AAs remained stable during the whole study. We conclude that Gin losses into dialysate during CVVHDF are relatively low, but CVVHDF itself may induce changes in Gin metabolism and distribution that are reflected by a decrease of serum Gin levels at the institution of this treatment. Therefore, the need for Gin supplementation in ICU patients is even greater in the first days of CVVHDF.     

护理人员的职业损伤因素及健康维护

作者指出临床一线的护理人员是发生职业损伤的高危群体。产生职业损伤的危险因素包括基础教育和继续教育缺乏职业损伤及其防范知识；影响护理人员身体健康的诸因素，如化疗专用的溶药设备、洁净操作台或相对密闭的溶药环境不健全；乙型肝炎等医院内易感性等疾病增加，被血液、体液等污染的医疗锐器刺伤是护理人员职业感染的主要途径；护理人员工作职业特点对健康不利的影响，护理人员心理压力大。为维护护理人员身心健康，应加入医院感染、职业损伤和健康维护的在校理论教育内容，加强护理人员职业安全教育，采取防范职业损伤的措施，如化疗药物中心配药、使用一次性手套等措施。     

神经外科导航辅助神经内镜透明隔囊肿造瘘手术前后护理

目的总结神经外科导航辅助硬质内镜进行透明隔囊肿造瘘术的围手术期护理特点,提高专科护理质量。方法回顾性分析1998年4月至2006年4月,在我科进行神经外科导航下,应用Storz硬质内镜进行透明隔囊壁造瘘术13例,针对透明隔囊肿的形成,症状体征的产生原理,手术方法,及其手术特点,给予有针对性的围手术期重点护理。结果13例手术病人取得满意疗效,术后未出现护理缺陷,无心理障碍发生,无切口感染,无护理并发症。结论神经外科导航下,应用内镜行透明隔囊肿造瘘术前术后护理,可以帮助病人树立战胜疾病信心,自如应对复杂手术程序,减少术后并发症的发生。     

胆道外引流感染的预防

目的 总结胆道外引流感染的预防，以利提高胆道外引流的护理质量。方法 通过经治的临床病例总结各胆道外引流的观察和处理要点。结果 通过向患者说明胆道外引流的重要性，帮助患者适应和解决各种生活问题，消除心理负担，观察引流伤口、胆汁引流情况，保持引流管的位置并保持通畅，使良性患者早日康复，晚期恶性肿瘤患者的生活质量得以提高。结论 胆道外引流是胆道良性或恶性疾病引发梗阻治疗的一个措施，有时是唯一的姑息性手段，做好引流术后的观察及护理，对改善患者的全身情况，恢复身体健康，提高生活质量非常重要。     

护理人员工作中被针刺伤调查及对策

目的：了解护理人员被针刺伤的情况，为采取职业防护措施提供科学依据。方法：采用问卷调查法调查护理人员被针头伤的有关情况。结果：不同职称护理人员被针刺伤的情况存在差异高度显著性，P＜0．01；不同科室护理人员被针刺伤的操作环节比较均存在差异高度显著性，P＜0．01，绝大多数护理人员对针刺伤后的处理不规范。结论：护理人员应主动增强职业防护意识，加强职业防护管理；改进废弃的一次性医疗用品管理方法和尽快采用防刺性护理用具。     

产后出血的预防和护理（附117例分析）

目的探讨产后出血的原因与护理、预防的方法，确保产妇安全。方法回顾性分析本组产妇分娩后大出血的病情观察、护理、治疗和预防的方法。结果经过精心护理和积极治疗，及时止血，解除了病人的紧张情绪，117例病人平均住院8d，均痊愈出院。结论加强对产妇，特别是产后出血病人的护理，对预防和及时控制出血，加快病人康复有重要意义。     

从中日沿海城市部分老年人生活满足感比较看老年社区护理的发展

目的 通过比较中日两围老年人生活满足感，探讨老年人社区护理的发展方向。方法 中国大连市选取60岁以上老年人，进行人户调查，日本滨松市选取俱乐部的65岁以上老年人，填写问卷。结果 除在与亲人、朋友交往及存钱以防万一等方面外，2国老年人在其他生活满足感方面比较，差异均有统计学意义，P〈0．05。结论 中日两国不同的经济基础导致了不同层次需求的差异。在中国发展老年人社区护理，一方面可以借鉴国外经验，从物质基础上改进和完善；另一方面，借助传统文化优势，从社会风气上进行促进。     

Analysis on Mental Features and Nursing Countermeasures for Malignant Ovarian Tumor Patients

Objective To inquire into the mental features of malignant ovarian tumor patients and advance the way to appease the mental state. Methods The mental health status of 168 malignant ovarian tumor patients was evaluated using Symptom Checklist 90 （SCL-90）, and compared with that of normal crowd and other gynecologic malignant tumor patients. Results The scores of suppression, anxiety, fear, somatization, constrain, hostility, interpersonal relationship of the ovary malignant tumor patients were higher than those of the normal model, and the scores of suppression, anxiety, interpersonal relationship higher than those of other gynecologic malignant tumor patients. Conclusions To strengthen the nursing teaching, understand the mental state on time, use moral support therapy, and help the patients to change their inadequate attitude and behavior, can strengthen the therapy confidence and promote the health rehabilitation.