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1.
目的 降低神经外科术中获得性压力性损伤发生率。 方法 将2019年10~12月的1 378例神经外科择期手术患者作为对照组,采取常规护理措施预防术中获得性压力性损伤。将2020年10~12月的1 551例患者作为观察组,成立护理专案小组,开展多学科协作,实施护理专案改善。 结果 观察组术中获得性压力性损伤发生率为0.90%,对照组为2.18%,两组比较,差异有统计学意义(P<0.05);两组术中获得性压力性损伤治愈率比较,差异无统计学意义(P>0.05)。观察组预防术中获得性压力性损伤关键监测指标落实率较好,除术后规范交接班落实875例(61.40%)外,其他指标均>88.00%。 结论 多学科协作护理专案能够有效降低术中获得性压力性损伤发生率,提高术中获得性压力性损伤预防和管理质量。  相似文献   
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目的了解神经外科住院患者及护士对护士人文关怀的感知与评价差异,为更好地实施人文关怀护理服务提供参考。方法选取86例神经外科住院患者及92名神经外科护士作为研究对象,分别使用关怀行为量表进行问卷调查。结果患者与护士对护士人文关怀的总体评分分别为4.77±0.84、4.86±0.60,无统计学差异(P>0.05),双方均在“尊重患者”及“联系患者”2个维度评分较低。在“支持和保证”维度,患者对护士人文关怀的感知水平显著低于护士自评结果(P<0.01)。结论护患双方均对护士关怀行为的评价较好且双方在对护士关怀行为的整体认知上存在较高的一致度,但护士对患者心理层面的关怀相对不足,患者对护士在“支持和保证”相关关怀行为方面具有较高的期待。护士需要进一步改进与提升人文关怀质量。  相似文献   
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Background

RIPPLY2-associated spondylocostal dysostosis is a rare disorder that leads to segmentation defects of the vertebrae. These vertebral defects can result in severe instability of the cervical spine, leading to cardiac arrest after only minor whiplash injury.

Case Report

We present the case of a healthy 7-year-old child who experienced an out-of-hospital cardiac arrest. He was reported to have profound respiratory distress and collapsed after going down a slide, without trauma. He was resuscitated in the field, and presented to the emergency department, where return of spontaneous circulation was achieved. Imaging of his cervical spine revealed multiple abnormalities. It was determined that a whiplash injury led to hypoxia and bradycardia due to the anatomic abnormalities of his cervical spine, resulting in cardiovascular collapse. He recovered fully and was later diagnosed with SCDO6, an autosomal recessive inherited disorder caused by a mutation in the RIPPLY2 gene.

Why Should an Emergency Physician Be Aware of This?

Unfamiliarity of providers with this mechanism of cardiac arrest, and the rarity of the syndrome itself, make early recognition very difficult. Late diagnosis and lack of preventative measures, including immediate cervical spine stabilization, can lead to catastrophic outcomes. In patients with cardiac arrest of unclear etiology, early consideration of cervical spine immobilization and evaluation can be lifesaving.  相似文献   
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吴光英  陈劼  马丽丽  任平 《上海护理》2020,20(12):23-27
探索和规范儿童早期预警评分在神经外科患儿的应用,持续提高临床护士的评估准确率。方法:2018年2月至12月,以PDCA循环模式为路径,对某三甲医院儿童神经外科的23名护士应用PEWS评估的情况进行现状分析,找出评估不准确的主要障碍因素并落实相对应的改进措施,进行质量改进,对比分析实施前后神经外科护士应用PEWS评估准确率的差异,并持续改进。结果:改进后神经外科护士应用 PEWS的准确率得到显著提高,由改善前的89.1%逐渐上升至99.5%(P<0.05)。结论:应用PDCA循环可促进神经外科护士对PEWS的评估准确率提高,从而保障一线护士早期发现患儿病情变化和筛查出潜在危重病人,提高了患儿安全。  相似文献   
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Magnetic resonance imaging (MRI) is a widely available imaging modality providing high-resolution images of soft tissues. The magnetic fields generated by these scanners create an array of safety challenges which require specialist equipment and trained staff to safely operate within this environment.Guidance exists for the anaesthetist working in the MR suite, though for many individuals it remains a less familiar environment and remote site for practising safe anaesthesia.We outline the specific concerns with commonly encountered implanted devices and some of the practicalities related to caring for patients with these devices in the MRI suite.Within neuroanaesthesia, advances in procedural techniques and technology in MRI lead to an increased number of patients requiring scanning for diagnosis and treatment progress.This includes patients on the critical care unit and intraoperatively in the interventional MRI suites.  相似文献   
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颅颈畸形手术涉及复杂的解剖变异,手术风险高,操作难度大,传统的教学方式受制于抽象的讲解,学习者很难对颅颈畸形解剖,手术方案及过程有直观的认识。本研究将CTA三维重建导航和术中外视镜操作技术引入颅颈畸形手术教学实践中,术前通过CTA三维重建在导航仪软件上了解颅颈畸形变异情况,规划手术方案。术中采用外视镜操作,所有学生戴上3D眼镜观看手术。将无法直观显示的、抽象的解剖结构以三维立体图像对学生进行展示。使传统被动抽象的教学方式变成直观形象生动的学习方式。增强了神经外科临床专业研究生对颅颈畸形手术解剖认识,提高了手术操作的积极性,缩短了培养时间。  相似文献   
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As in many Western countries, deep brain stimulation (DBS) is already being used daily in Japan to clinically treat neurological diseases such as Parkinson’s disease, essential tremor, and dystonia. Additionally, in both Europe and the United States, numerous case reports as well as multicenter randomized controlled trials have examined its use for treatment-refractory mental illnesses such as obsessive compulsive disorder (OCD) and major depressive disorder. Based on a number of the reports, the European Union (EU) and the USA Food and Drug Administration (FDA) granted limited approval of DBS for treatment-resistant OCD in 2009. Furthermore, a systematic review and meta-analysis in 2015 showed that DBS therapy for patients with treatment-resistant OCD had efficacy and was safe. Unlike the EU and the USA, DBS is not used to treat OCD or other psychiatric disorders in Japan, even though people with treatment-resistant OCD and their physicians and families urgently need additional treatments. This situation results from the “Resolution of total denial for psychosurgery,” which the Japanese Society of Psychiatry and Neurology adopted in 1975. We believe that the appropriateness of using DBS for treating psychiatric disorders including OCD should be considered after thorough discussion and consideration based on accurate and objective understanding. Currently, the field of psychiatry in Japan seems to lack scientific consideration as well as scientific understanding in this area. Under these circumstances, we hope that this review article will help psychiatrists and other relevant parties in Japan to gain an accurate and scientific understanding of DBS.  相似文献   
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