护理干预对造血干细胞移植患者自我管理能力的影响

目的探讨护理干预对造血干细胞移植患者自我管理能力的影响，旨在提高移植成功率，防止并发症发生。方法对34例病情相对稳定的造血干细胞移植患者进行以自我管理教育为导向的全程护理干预。结果护理干预后，患者治疗依从性明显改善，自我管理能力明显提高。结论护理干预能明显改善造血于细胞移植患者自我管理能力，提高其生活质量。     

自我管理教育对性病患者自我效能影响的研究

目的：探讨自我管理教育对性病患者自我效能影响效果.方法：对2013年3月至2013年8月期间收治、走访、问卷调查的1000例性病患者,均进行自我管理教育,对比分析干预前后患者的自我效能水平.结果：干预后患者的性病相关知识的认知水平、自我效能评分以及生活质量评分等,均显著高于干预前,对比差异具有统计学意义（均P ＜0.05）.结论：对性病患者进行自我管理教育,能够有效提高患者的护理满意度,强化性病相关知识的认知,并改善患者的自我效能水平,值得临床上进一步推广应用.     

知-信-行模式护理干预对艾滋病患者自我管理能力及用药依从性的影响

目的观察知-信-行模式护理干预对艾滋病患者自我管理能力及用药依从性的影响。方法选取2017年9月至2019年6月某医院收治的76例艾滋病患者,按随机数字表法分为两组,各38例。对照组给予常规护理,观察组采用知-信-行模式护理。对比两组自我管理能力及用药依从性。结果干预前两组自我管理能力对比,差异无统计学意义(P>0.05);干预6个月,观察组自我管理能力(193.03±10.21)分、用药依从性94.74%,均高于对照组的(187.52±11.78)分、76.32%,差异有统计学意义(P<0.05)。结论知-信-行模式护理能够提升艾滋病患者自我管理能力,改善用药依从性,值得推广应用。     

应用教学反馈对高血压患者进行健康教育的效果评价

高血压是心脏病、脑卒中最主要的危险因素[1],是危害居民健康最常见的慢性病[2].就疾病的相关知识和自我管理技能对患者及家属进行健康教育,是护理工作重要内容之一[3].临床上,笔者对40名高血压患者采用教学反馈[4]的方法进行健康教育,取得了很好的效果,现报道如下。     

妊娠期高血压疾病遗留高血压患者肾损伤及性生活质量的变化观察

目的:观察与分析妊娠期高血压疾病遗留高血压患者肾损伤及性生活质量的变化情况。方法:选取2014年10月至2016年6月期间本院收治的65例妊娠期高血压疾病遗留高血压患者为A组,同时期的65例妊娠期高血压无遗留高血压患者为B组,65例健康妊娠者为C组,然后统计及比较三组的肾功能指标、肾动脉血流参数及性生活质量评分,同时将A组中不同血压水平者的上述统计结果进行比较。结果:A组的肾功能指标、肾动脉血流参数及性生活质量评分均差于B组及C组,B组的统计结果则差于C组,且A组中不同血压水平者的统计结果也存在显著性差异,经spearman分析显示,上述方面与疾病均有密切的相关性,P均0.05。结论:妊娠期高血压疾病遗留高血压患者肾损伤及性生活质量处于较差的状态,且血压水平对上述方面状态的影响较大,因此应加强对上述方面的调节与改善。     

高血压性鼻出血的应急处置与护理体会

高血压合并鼻出血现已成为耳鼻喉科的急症之一。出血后，患者和家属易出现恐惧、焦虑情绪。护士在处置鼻出血患者时的沉着冷静、动作迅速、细心观察、准确判断病情、密切配合医生迅速止血是急救成功的关键。急救后给予针对性的护理是术后患者早日康复的前提。现对我院2004年1月～2007年12月3年中收治的高血压性鼻出血患者的应急处置与护理体会报告如下。     

蓝趾综合征1例

<正>1 病历摘要患者男,65岁。双足趾青紫4个月,加重伴疼痛2个月,于2014年1月17日来卫生部北京医院就诊。患者4个月前因鼻出血经右股动脉行介入栓塞治疗,1 d后双足趾出现青紫色斑片,无自觉症状,伴血肌酐进行性升高,未诊治。2个月前足趾斑片颜色加深,局部出现破溃结痂,伴双足疼痛,夜间及寒冷时明显,遇热稍缓解,行血管超声检查发现下肢动脉粥样硬化伴斑块形成,静脉无异常,予止痛及营养神经等治疗,疼痛未见缓解。既往史:冠心病3年。高血压15年。个人史:吸烟40余年,40支/d。余无特殊。家族史:家族中无遗传病史及类似疾病患者。     

女性压力性尿失禁患者自我管理的研究进展

压力性尿失禁是尿失禁最常见的类型,近年来其患病率逐年上升,越来越多的患者开始倾向于自我管理。本研究首先介绍了自我管理的释义,然后从女性压力性尿失禁患者的自我管理策略、影响因素、干预措施等方面综述女性压力性尿失禁患者自我管理的研究进展,并立足于国内外现状进行分析,以期为国内女性压力性尿失禁患者疾病的康复与管理提供参考和借鉴。     

自我管理效能干预在艾滋病抗病毒患者中的应用

目的探讨基于自我效能理论指导下的护理干预对艾滋病抗病毒治疗患者自我管理能力及生活质量的影响。方法选择2016年1月至2017年12月淮安市第四人民医院感染科诊治的96例艾滋病抗病毒治疗患者作为研究对象。采用实验对照研究方法,将其随机平均分为观察组和对照组,每组48例患者。观察组患者在常规护理干预的基础上联合基于自我效能理论指导下的护理干预,对照组患者给予常规护理干预,治疗后6个月,比较两组患者自我管理能力、抗病毒治疗依从性、生存质量等指标。结果观察组患者情绪管理、药物管理、症状管理、获取支持与帮助、疲惫症状管理等自我管理评分明显高于对照组患者(t=3.176,5.479,3.444,7.853,4.438,均P0.05);抗病毒治疗患者依从性(95.8%)明显高于对照组患者(81.2%)(χ~2=5.031,均P0.05);生理功能、社会功能、情感职能评分明显高于对照组患者(t=4.973,4.900,7.136,均P0.05)。结论基于自我效能理论指导下的护理干预有助于促进艾滋病抗病毒治疗患者自我管理能力的养成,提高抗病毒治疗依从性,改善患者生存质量。     

HIV/AIDS患者自我管理能力、家庭关怀度、生存质量现状及影响因素分析

目的 调查分析人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)患者自我管理能力、家庭功能、生存质量现状及影响因素。方法 于2021年7月至12月选取512例HIV/AIDS患者作为研究对象,采用HIV/AIDS患者自我管理量表、HIV感染者生存质量量表、家庭关怀度指数问卷对其进行调查分析。结果 HIV/AIDS患者自我管理得分为(113.95±19.85)分,家庭关怀度得分为(7.42±2.57)分,生存质量得分为(81.69±12.06)分;自我管理与家庭关怀度、生存质量呈正相关(r=0.237、0.591,P=0.000);影响因素分别为年龄、性别、职业、文化程度、经济水平及CD4⁺T淋巴细胞计数。结论 HIV/AIDS患者自我管理能力、家庭功能及生存质量较差,临床医务人员需聚焦影响因素,采取多学科干预策略促进积极自我管理,提升生存质量。     

替米沙坦对肾性高血压患者性功能影响的临床研究

目的:观察替米沙坦治疗肾性高血压患者对患者性功能的影响,为临床选择替米沙坦治疗肾性高血压患者提供参考。方法:选择2015年10月至2016年3月我院收治的120例初诊肾性高血压患者,根据就诊入组顺序将其编号,采用数字随机表法将其随机分为对照组和观察组,每组60例。两组患者均根据原发疾病对症治疗肾脏病变,并对患者进行血压控制饮食和运动的健康指导,对照组患者采用贝那普利控制血压,观察组采用替米沙坦控制血压,两组患者连续治疗6个月。比较两组患者治疗前后的尿微量白蛋白及肌酐变化,治疗前后性功能相关评分。男性采用勃起功能评分表(IIEF-5)和射精功能评分表(CIPE)评分判断性功能的影响,女性采用女性性功能指数评估量表(FSFI)评判患者性功能影响。结果:试验组与对照组治疗前尿微量白蛋白和肌酐水平比较差异无统计学意义(P0.05);治疗后,两组患者微量尿蛋白均较治疗前明显下降,肌酐较治疗前明显上升,但观察组患者尿微量白蛋白低于对照组。对照组患者治疗前后男性IIEF-5和CIPE评分较治疗前明显下降,治疗前后比较差异有统计学意义(P0.05),女性治疗前后FSFI评分变化无统计学差异;观察组患者治疗后男性IIEF-5和CIPE评分与治疗前比较略有升高,但差异无统计学意义(P0.05),女性治疗前后FSFI评分变化无统计学差异(P0.05)。结论:替米沙坦控制肾性高血压患者血压,不会对对患者的肾功能产生损害,同时也不降低患者的性功能,避免了大多数抗高血压药物存在的缺陷,对提升患者的生活质量具有较高的临床价值。     

Blood pressure as a parameter in dermatologic surgery

Elevated blood pressure is a major cause of perioperative bleeding and postoperative hematoma. Seventy-five patients scheduled for dermatologic surgical procedures were prospectively asked if they were aware of any personal history of hypertension. If patient response alone is relied on as a preoperative screen for hypertension, over half of the individuals affected with this disease will be missed. Epinephrine-containing local anesthetics were found not to increase blood pressure in doses commonly employed by dermatologists; in fact, they lowered blood pressure in hypertensive individuals.     

Rarity of hypertension in adult patients with atopic dermatitis

BACKGROUND: Patients with atopic dermatitis show a tendency for vasoconstriction of the small vessels in the skin. As peripheral vasoconstriction contributes to the cause of hypertension, it is natural to suppose that blood pressures might be on the high side in adult patients with atopic dermatitis. In the literature, however, there was little information on the subject. OBJECTIVES: To study the incidence of hypertension in adult patients with atopic dermatitis. PATIENTS/METHODS: Blood pressure was measured in 521 adult patients with active atopic dermatitis (235 males; 286 females) aged 30-59 years, and 87 adults with "healed" atopic dermatitis (26 males; 61 females) aged 34-52 years. The blood pressures were classified as definite hypertension, borderline hypertension or normal blood pressure. RESULTS: In those patients aged 30-39 years with active atopic dermatitis, the incidence of definite hypertension in the male patients and the female patients was 1.1% and 1.6%, respectively. The incidence remained almost at a plateau for the 30-39-year-old age group through to the 50-59-year-old age group, in both the male and female patients. There was no difference in the incidence of definite hypertension between patients with severe dermatitis and patients with mild dermatitis. Adult patients with "healed" atopic dermatitis also showed a low incidence of definite hypertension. CONCLUSIONS: These findings indicate that hypertension is rare in adult patients with atopic dermatitis. It is most probable that the rarity of hypertension is a primary feature of the disease.     

低密度脂蛋白对H型高血压患者卒中风险分层的评估作用

目的探讨低密度脂蛋白(LDL)在H型高血压患者卒中风险分层中的评估作用。方法选择铜川市人民医院2016—2019年确诊为H型高血压的患者116例,年龄50~85岁,进行一比一配对病例对照研究,获得环境暴露等资料,进行单因素和多因素Logistic回归分析,计算各因素的调整比值(OR)和95%可信区间(CI)。结果单因素分析发现H型高血压患者中,患糖尿病,高敏C反应蛋白、高尿酸血症、高纤维蛋白血症、肥胖,吸烟、酗酒,动脉炎、TIA、重度颈动脉狭窄、心律失常、应激、高LDL血症可增加脑卒中的危险。多因素分析发现高LDL血症、糖尿病、高敏C反应蛋白、重度颈动脉狭窄是H型高血压患者患脑卒中的主要危险因素,而口服马来酸依那普利叶酸片联合匹伐他汀钙片能降低脑卒中风险。H型高血压患者脑卒中危险分层与LDL呈正相关(P<0.05);血同型半胱氨酸(Hcy)与LDL水平呈正相关(P<0.05);不同危险水平的H型高血压患者的血清LDL水平相比较有显著差异,卒中和卒中各级危险组的LDL水平显著高于非H型高血压组(P<0.05);LDL水平分层比较,卒中组>高危组>中危组>低危组>对照组(P<0.05);非H型高血压患者的Hcy水平与LDL无明显相关性(P>0.05)。结论LDL水平可作为H型高血压患者卒中风险分层的评估依据;口服马来酸依那普利叶酸片联合匹伐他汀钙片可减少患脑卒中的风险。     

Lessons learned from patients with spinal cord injury in managing pressure ulcers: A qualitative study

ObjectivesTo explore how individuals with spinal cord injury self-manage the prevention and treatment of pressure ulcers and to provide insight into experiences with self-management support.DesignQualitative study using semi-structured interview and a deductive thematic analysis.SettingCommunity.ParticipantsTwelve of the 14 participating adults with a spinal cord injury had experience with pressure ulcers, and eight of these had a current pressure ulcer.ResultsRespondents suggested to tailor treatment of pressure ulcers to patients’ individual wishes and capabilities of patients. Patients and caregivers need to be aware of the importance of determining the cause of pressure ulcers to prevent deterioration. Patients often depend on informal caregivers for follow-up and prevention, and healthcare professionals in non-SCI specialties often lack the knowledge needed to manage pressure ulcers in this specific patient group. Tailored education and peer support are important for patients to set boundaries, be assertive, and cultivate a positive attitude when dealing with pressure ulcers. It is difficult to combine treatment of severe pressure ulcers and preventive measures with work roles. Managing the social impact of pressure ulcers requires more coordination with caregivers.ConclusionsTo support self-management of pressure ulcers in patients with a spinal cord injury, they must find out which preventive measures and treatments suit them best. Healthcare professionals play an important role in the self-management of pressure ulcers and can help patients deal with the emotional and social impact of pressure ulcers. To know patient's needs and tailor their education, healthcare professionals of non SCI organizations need to have knowledge of pressure ulcers management of this specific patient group.     

计划二胎妊娠妇女优生健康检查高风险人群筛查结果分析

目的:通过分析计划二胎妊娠妇女体格、内外科疾病(如甲状腺亢进、糖尿病、高血压等)筛查结果,为二胎备孕提供重要依据。方法:以本院2014年6月至2016年1月门诊咨询、孕前检查的5000名计划二胎妇女为研究对象,均接受体格(如身高、体重、病史、血常规)、甲状腺功能、血糖、血压等检查,统计甲状腺亢进、糖尿病及高血压发生率,并分析上述疾病与妇女年龄、体重、流产史、首胎不良妊娠结局等关系。结果:5000名妇女中BMI值25kg/m2以上者1050名(21.00%),甲状腺疾病家族史占10.00%,首胎妊娠期高血压、妊娠期糖尿病分别413名、750名,流产史18.68%,吸烟史12.16%。筛查出甲亢648名,占12.96%,糖尿病1006名,占20.12%,高血压783名,占15.66%。年龄≥30岁、BMI25kg/m2、多次流产史妇女甲亢、糖尿病、高血压发生比例显著高于对应因素(P0.05);甲状腺疾病家族史妇女检出甲亢100名,首胎妊娠期高血压、妊娠期糖尿病妇女分别检出糖尿病102名、187名,高血压89名、140名,吸烟妇女中检出高血压137名。结论:计划二胎妊娠妇女年龄以30岁及以上为主,甲亢、糖尿病、高血压筛查率较高,这与计划二胎妊娠妇女年龄(≥30岁)、多次流产史、肥胖等有关。     

A guide for education programs in atopic dermatitis

BACKGROUND: Education about therapy applies to many chronic diseases. The aim is to improve patient management through the development of certain skills by patients themselves. Atopic dermatitis is an area amenable to the development of therapeutic education. The purpose of this study was to define the skills required for management of atopic dermatitis suitable for therapeutic education and to bring together these skills in a handbook suitable for use. MATERIALS AND METHODS: Thirty caregivers were involved in the drafting of the handbook (dermatologists, a doctor specialising in therapeutic education, a psychologist and nurses), each of whom has experience of therapeutic education in atopic dermatitis. RESULTS: Four age groups were selected (under 5 years, 6 to 10 years, pre-teens/adults, parents of children aged under 5 years). For each age group, different levels of skill were identified for patients or parents of children and suitable learning methods were selected. Skills were classed according to 3 levels: (i) knowledge about the disease, treatments, triggering factors, (ii) knowledge about provision of care by patients or their parents, (iii) knowledge in terms of explaining the disease and treatment methods to family, and knowing who to contact and when. Finally, a 10-question evaluation guide was drawn up. DISCUSSION: In this paper we report the method of production and content of the handbook of skills for atopic dermatitis patients. The aim is not to impose all skills listed in this work on patients but rather to provide caregivers with a complete handbook covering therapeutic education. The book is intended for patients with moderate to severe forms of atopic dermatitis currently in therapeutic failure. It may be used by anyone treating such patients, whether doctors, nurses or psychologists, depending on the items chosen. It is intended for use as a support for the elaboration, diffusion and evaluation of a therapeutic education programme for atopic dermatitis.     

尿毒症血液透析患者并发脑出血28例单中心临床观察

目的探讨尿毒症合并脑出血患者的临床特征。方法收集2013年5月-2019年5月黄山市人民医院收治的终末期贤脏病合并脑出血患者28例(研究组)及同期收入院的未合并脑出血终末期肾脏病患者68例(对照组)的临床资料,包括年龄、性别、每周透析时长等,患者肾功能衰竭基础病因、死亡原因、合并症或并发症情况,如冠心病、糖尿病、高血压等,比较患者进入透析时的相关指标:血肌軒、每周透析时间、收缩压和舒张压、血小板计数等。结果研究组患者的收缩压、舒张压以及血肌酐(透析前)和对照组相比显著升高,每周透析时长和平均透析时长显著增多,差异有统计学意义(P<0.05)。两组高血压病史、糖尿病病史、年龄、性别的差异无统计学意义(P>0.05)。两组患者血小板计数的差异无统计学意义(P>0.05),研究组的活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)显著长于对照组,而血浆纤维蛋白原(FIB)水平显著低于对照组,差异均有统计学意义(P<0.05)。结论终末期肾脏病血液透析患者血肌醉水平以及收缩压和舒张压升高,每周透析时间增,凝血功能受损,血小板数目无异常。