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1.
骨科健康教育临床路径内容的研究   总被引:12,自引:2,他引:10  
目的 提高骨科健康教育的有效性,使骨科患者早日康复。方法 通过成立骨科健康教育临床路径小组,采取书写、修改、临床应用、再修改、定稿的方式完成了共性与专病健康教育临床路径表及落实检查登记单。结果 经临床试用,每种疾病的路径表针对性强,既有文字又有图片,有利于患者的学习,也对护士的工作起指导作用,一方面提高教育的知晓率,另一方面提高护士的工作效率。结论 研制科学、统一的骨科健康教育临床路径内容,能够为护士提供一条有效的教育途径,为骨科患者提供更优质的服务。  相似文献
2.
健康教育路径对预防骨科卧床病人便秘的临床研究   总被引:2,自引:1,他引:1  
目的:探讨健康教育路径对防治骨科长期卧床病人便秘的临床效果,从而找出防治便秘的最佳健康教育模式。方法:将380例骨科长期卧床病人随机分为实验组和对照组,两组分别采用健康教育路径和传统的方法进行健康教育。结果:入院后1周实验组骨科卧床病人便秘发生率明显低于对照组,两者间有极显著性差异(P<0.01);入院后3周对两组便秘者排便效果进行对比分析,实验组的总有效率明显高于对照组,两者间有极显著性差异(P<0.01)。结论:应用健康教育路径对骨科长期卧床病人进行健康教育,可以显著降低便秘的发生率,为一种科学合理、切实可行的健康教育模式。  相似文献
3.
加温输血对全身麻醉骨科手术患者术中中心体温的影响   总被引:1,自引:0,他引:1  
目的探讨加温输血对全身麻醉骨科手术患者术中中心体温的影响。方法 将60例行全身麻醉手术且需术中输血的骨科患者按随机数字法分为干预组和对照组,两组各30人。干预组患者输血前采用便携式输液加温器将库存血加温直至37℃;对照组患者输血前将库存血放置在常温下15-20 min。采用肛温探头检测患者麻醉前和麻醉后30、60、90、120 min的肛温,并观测患者麻醉清醒后到离开苏醒室这段时间内的寒颤发生情况。结果干预组有2名患者、对照组有1名患者由于麻醉方式改变而退出研究。随着手术时间的推移,两组患者的肛温均呈下降趋势,差异有统计学意义(P〈0.05);干预组患者的肛温下降的程度较小,与对照组比较差异有统计学意义(P〈0.05)。干预组和对照组患者寒颤发生率分别为32.14%和86.21%,差异有统计学意义(χ^2=17.809,P〈0.05)。结论加温输血可以有效避免体温的大幅度下降,可降低全身麻醉骨科手术患者寒颤的发生率,能提高患者的舒适度。  相似文献
4.
术后认知功能障碍(post—operative cognitive dysfunction,POCD)是指术后患者出现定向、思维、记忆、注意力、自知力等认知能力的改变,严重者可出现精神错乱、人格改变、焦虑、躁狂、谵妄等明显的精神症状。随着社会人口的老龄化,我院行骨科手术的老年患者不断增加,术后出现认知功能障碍的患者也越来越多。  相似文献
5.
A sterilisable radiation probe of small dimensions was designed to locate the lesions at orthopaedic surgical sites according to the procedure of intraoperative bone scintigraphy. The probe has a collimated opening 2 mm in diameter. It is connected to a portable radioactivity counter which converts the disintegration rates detected at surgical sites into an acoustic signal that increases steeply with increasing disintegration rate. The acoustic signal enables the surgeons and isotope specialists to readily monitor radioactivity in the region of interest without attention being distracted from the surgical site. Dimethylaminodiphosphonate (designated SF44) was the osteotropic radiopharmaceutical chosen for carrying out intraoperative bone scintigraphy, since the available data show that this chemical increases the pathological: normal bone uptake ratio of the lesion by 25% compared to the usual diphosphonates. Forty-seven orthopaedic interventions were carried out according to the intraoperative bone scintigraphy procedure. They showed that this procedure facilitated the rapid location of the lesion, the objective termination of the operation, less frequently the reduction in dimension of the excised areas, and rarely the simplification of the surgical technique. Practice of intraoperative bone scintigraphy requires proper training and caution.  相似文献
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7.
SUMMARY. The use of autologous blood in support of orthopaedic surgery has been assessed for 296 patients; 150 underwent hip arthroplasty, 69 underwent knee arthroplasty, 37 underwent spinal procedures and 40 underwent miscellaneous operations. Overall, 87% of patients received no allogeneic blood and 23% of the autologous blood collected was not used. For hip and knee arthroplasty, there appears to be an increased willingness to transfuse patients when autologous blood is available, and a decreased proportion of patients receiving more than 3 units for hip arthroplasty and 2 units for knee surgery, when compared with an audit of blood use
when almost all blood used was allogeneic. Wastage of autologous blood in support of spinal surgery was 66%, prompting a review of ordering practices. Assessment of avoidance of allogeneic transfusion by the standard schedule of 3 units for hip arthroplasty and 2 units for knee arthroplasty appears justified by the calculation that collection of an additional unit in each case would avoid allogeneic transfusion in 11 (5%) more patients with the unnecessary collection of 208 units.  相似文献
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9.
Wound blood for postoperative autologous transfusion is drained through an area of damaged tissue, the surgical wound, and contains inflammatory mediators. The inflammatory cytokines interleukin-1-beta (IL-1beta), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor-alpha (TNF-alpha) and their modulators interleukin-1-receptor antagonist (IL-1Ra), interleukin 6 soluble receptor (IL-6sR), soluble tumour necrosis factor receptor 1 (sTNF-R1) and interleukin 10 (IL-10), together with white cell count (WCC) and white cell differential count were measured in arterial and mixed venous blood before, during and after infusion of postoperatively drained untreated blood in nine patients operated for thoracic scoliosis. We found a transient increase in IL-6, an increase in TNF-RI, an increase in IL-8 with granulocytosis and a decrease in IL-10 in the systemic circulation. The increase in IL-6 was higher in mixed venous than in arterial blood.  相似文献
10.
The aim of this double blind, placebo-controlled trial was to determine the analgesic efficacy of high-dose dipyrone (metamizol) infusion for perioperative pain treatment. Local ethics committee approval and written informed consent was obtained for 160 patients undergoing orthopaedic or trauma surgery. Dipyrone 5 g was given intravenously within 1 hour, starting 30 minutes before the end of surgery. Quality of analgesia was improved with a significant reduction in the visual analogue scores (VAS) (p<0.006) and the doses of opioids (piritramid 0.1mg kg−1 i.m.) required (p<0.0001), with no additional side effects. High-dose dipyrone combined with opioids proved effective in the treatment of perioperative pain treatment when compared with opioids only. Acute Pain 1999; 2 (4): 167–171.  相似文献
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