老年危重患者营养支持及护理

随着社会经济及医学水平的不断发展,人们的预期寿命不断提高,因此,老年患者明显增多,且有研究表明,老年危重患者营养不良的发生率高达40%～100%[1].危重患者机体大都处于应激状态下的高分解代谢水平,能量消耗多,尤其是蛋白质高分解代谢,使病人处于负氮平衡.因此,及时、合理、有效的营养支持及全方位人性化的护理治疗对提高老年危重患者具有重要意义.单纯肠内营养(EN)往往不能满足危重患者的高能量消耗,而单纯使用肠外营养(PN)的并发症多,易发生肠道粘膜萎缩,从而导致肠道细菌易位,最终可能导致胃肠功能障碍和衰竭.我们对80例老年危重患者采取PN+EN支持,并加强人性化护理,取得较好效果.现报道如下.     

对老年病患者实施人性化护理的几点体会

把人性化护理落实到老年性疾病患者的护理工作中是社会文明进步、医学模式转变、医疗服务更趋完善的一项护理实践,是护理工作落实一切为病人,为病人一切理念的重要组成部分。在对老年性疾病患者实施整体护理过程中,应强调人性化,给予全方位护理是护理学科发展的必然;为老年性疾     

人性化护理管理在肿瘤科病房的应用探讨

目的:探讨人性化护理在肿瘤科患者中的应用效果.方法:通过实施人性化护理措施,根据病人的心理需求改进相应的护理措施.结果:实施人性化护理可以有效地减轻病人的绝望恐惧心理、促进护患沟通、使病人能正确面对疾病,积极的配合治疗.结论:实现真正的人性化护理服务,在肿瘤科护理中的意义重大.     

经鼻气管插管伴褥疮患者护理体会(附1例病例)

目的:探讨经鼻气管插管危重病人患者伴褥疮的有效护理.方法:心理护理、饮食护理、生命体征的检测、人工气道的护理、预防感染和应用烧伤皮肤再生医疗技术治疗褥疮等多因素结合进行护理.结果:经过全方面的护理,能够帮助患者更好地恢复健康,预防并发症.结论:应注重对经鼻气管插管危重病人的全方面护理.     

213份危重病患者的护理记录单缺陷分析与对策

目的检查危重病人的护理记录单,了解和分析其缺陷原因,并针对缺陷问题提出防护对策,提高危重病人护理记录单书写质量。方法抽取2012年6月～2013年5月213份危重病患者的护理记录单,对照护理相关检查标准进行逐一审核,将其主要缺陷问题进行统计。结果与结论危重病人的护理记录单在书写规范和病情记录内涵方面还有待提高。     

浅谈气管插管术后的护理体会

气管插管术是危重病人的抢救和气管内麻醉过程中的必须操作技术。通过气管插管，达到保持呼吸道通畅，减少气道阻力和解剖死腔，便于清除气道分泌物或异物，增加有效气体交换量的目的，同时为危重病人抢救中气管内用药，应用呼吸机保证危重病人的生命安全提供必不可少的条件。因此气管插管技术的使用及护理十分重要，为总结经验，提高器官插管术后护理水平，我们对95例患者应用气管插管术的护理资料进行了分析，报告如下。     

谈麻醉苏醒期的人性化护理体会

对病人的周到、细致、更富有人情味的护理,是现代医学模式护理工作的人性化护理的体现,麻醉苏醒期的护理工作,应注意不同护理环节、不同年龄、不同民族及不同心理状态的病人,给予不同的人性化护理,体现出＂以病人为中心＂的护理理念及多元化的护理内涵。     

谈麻醉苏醒期的人性化护理体会

对病人的周到、细致、更富有人情味的护理,是现代医学模式护理工作的人性化护理的体现,麻醉苏醒期的护理工作,应注意不同护理环节、不同年龄、不同民族及不同心理状态的病人,给予不同的人性化护理,体现出＂以病人为中心＂的护理理念及多元化的护理内涵。     

人性化护理在风湿性关节炎患者临床护理中的应用研究

风湿性关节炎在临床属于中老年患者的多发病、常见病。临床表现为大关节及肌肉的游走性疼痛,严重者反复发作,可累及心脏。由于病症反复,治疗周期较长,明显影响患者的肢体活动,因此对患者的生活质量影响较大。人性化护理干预是临床以患者为核心的新型护理模式,其在优质护理服务的基础上,将患者作为健康服务中心。为临床护理事业的发展提供了新的方向。本研究分析了我院近年来对风湿性关节炎患者实行人性化护理干预的方法及效果,现报道如下。     

影响危重病人护理告知效果的因素及对策

目的 探索影响危重病人护理告知效果的因素.方法 通过对护理人员法律意识不强,对护理告知的主体及告知的对象不明确,病人的维权意识不断增强,护理人力资源不足等因素的分析,并针对这些因素提出了相应的对策.结果 减少了护患纠纷,提高了危重病人护理工作质量.结论 提高护理告知效果不仅可以加强护患沟通,减少护患纠纷,更重要的是可以提高危重病人护理工作质量,确保护理安全,保障病人的知情同意权.     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.