混合痔术后大出血三腔二囊管压迫止血的护理

目的:探讨治疗混合痔术后大出血的有效方法。材料与方法:对38例混合痔PPH术后大出血患者分别采用三腔二囊管及肛管压迫法止血,并加强观察与护理,结果:三腔二囊管组止血时间、疼痛缓解时间少于肛管组,三腔二囊管组的满意度高于肛管组。结论:三腔二囊管压迫法用于混合痔PPH术后大出血效果较佳     

冷水囊压迫食管胃底静脉曲张破裂大出血23例

食管胃底静脉曲张破裂大出血是肝硬化最主要的死因之一 ,由于食管和胃内大量出血时 ,视野模糊 ,无法行内镜介入治疗。三腔二囊管用于紧急时暂时性止血 ,效果显著[1] ,但传统的三腔二囊管二囊内注入空气只起到压迫作用 ,没有使局部血管收缩的作用。 2 0 0 0年 6月～ 2 0 0 2年 12月 ,我院向三腔二囊管二囊内注入冷盐水能起到压迫和使局部血管收缩的双重作用 ,作为其他介入治疗的术前应用 ,止血快 ,有效率高 ,取得了满意的效果 ,现报告如下。1　资料与方法1.1　一般资料。 2 0 0 0年 6月～ 2 0 0 2年 12月 ,食管胃底静脉曲张破裂大出血需紧急…     

应用三腔二囊管的改良方法

三腔二囊管压迫止血是治疗食管胃底曲张静脉破裂出血的有效方法之一 ,但是由于此方法会造成众多不良反应 ,已有诸多报道[1] 。为了减少不良反应 ,增加患者的耐受性及止血效果 ,现将其改良方法加以总结如下。1　置入方法的改良罗伟香等[2 ] 运用导丝交换法置管 ,与传统置管法比较 ,成功率有明显的提高。具体方法为 :常规检查胃管和三腔二囊管 ,剪去胃管前端盲端及有侧孔部分 ,插入 5 0～ 6 0cm至胃内 ,将不锈钢导丝涂上石蜡油 ,从胃管内插入至胃内 ,助手固定导丝 ,操作者慢慢退出胃管 ,将三腔二囊管外抹石蜡油 ,腔内注射石蜡油 5～ 10ml润滑…     

胃液实验室检查辅助判断三腔二囊管压迫止血效果的研究和观察

目的探讨胃液实验室检查辅助判断食管胃底静脉曲张破裂出血时使用三腔二囊管牵引压迫止血的效果。方法50例食管胃底静脉曲张破裂出血患者，经三腔二囊管压迫止血，定时定量使用生理盐水反复冲洗胃管，抽出胃液，采用万华公司大便潜血胶体金检测试纸测定胃液潜血滴度，来辅助判断食管胃底静脉曲张破裂出血是否达到止血间期，并以胃镜对照判断符合率。结果50例食管胃底静脉曲张破裂出血患者，经三腔二囊管压迫止血，胃液潜血滴度测定结果在1：1024以下可判断达到止血间期，经胃镜检查对照符合率为90％，平均压迫时间较传统方法减少了14．1h。结论胃液潜血滴度测定辅助判断三腔二囊管压迫止血效果优于传统方法，该方法可随机检查，操作简便、费用低、效果确切，减轻了患者留置三腔二囊管的身心痛苦，降低了并发症的发生率，同时促进了护理观察质量，减少了护理并发症，提高了护理水平及能力。     

两种不同牵引方法对三腔二囊管压迫止血的效果观察

目的探讨两种不同牵引方法对三腔二囊管压迫止血术的效果观察。方法选择2013年2月~2014年1月本科住院行三腔二囊管压迫止血的31例患者设为实验组,选择2012年1~12月在本科住院行三腔二囊管压迫止血的32例患者设为对照组,实验组采用改良方法进行牵引,对照组采用传统方法进行牵引,对两组患者置管24 h内的压迫止血有效率及置管期间发生鼻黏膜损伤情况进行对比。结果两组患者置管24 h内止血有效率比较,差异无统计学意义(P0.05),两组置管期间鼻黏膜损伤情况比较,差异具有统计学意义(P0.05),实验组鼻黏膜损伤轻于对照组。结论改良的三腔二囊管牵引压迫止血术与传统方法达到同等有效的止血效果,且降低患者鼻黏膜损伤,减轻患者痛苦,适于临床应用。     

三腔二囊管置入术的护理研究进展

食管胃底静脉曲张破裂出血是肝硬化门脉高压严重的并发症之一[1],其死亡率高达35%~50%[2]。三腔二囊管压迫止血一直是治疗食管静脉曲张破裂出血的首选方法[3],常用于紧急时暂时性止血,并作为其他介人治疗的术前应用,其止血率可达到95%[4]。传统的插管方法,由于三腔二囊管管身软,操作时间长、对患者刺激性强,常因其不配合、无法下咽等导致插管失败或加重出血。近年来,为提高三腔二囊管置管成功率,提高治疗效果,护理研究者进行了大量的研究。现将置管目的、配合体位、置管方法、固定方法及护理要点综述如下。1置管的目的置入三腔二囊管的目的,主要是用于门静脉高压引起的食道胃底静脉曲张破裂出血的紧急止血。肝硬化失代偿并食管胃底静脉曲张破裂大出血时,常因起病急、出血量大,危及患者生命。而内科应用药物治疗往往难以止血,三腔二囊管压迫技术仍然是目前治疗食管胃底静脉破裂出血的一种有效方法。2配合体位2.1平卧位传统的置管体位为平卧位,头偏向一侧,操作者立于患者右侧插管。2.2左侧卧位患者取左侧卧位,头稍向前屈,操作者立于患者左侧插管。其优点是:任国珍[5]报道,患者喉头的位置向左前移位,左侧的会厌壁呈水平位,掩盖左侧梨状窝,右侧会厌...     

应用面罩固定三腔二囊管的临床观察与护理

目的探讨面罩法固定三腔二囊管在食管胃底静脉曲张破裂出血中的止血效果。方法用面罩固定三腔二囊管作牵引压迫止血,与传统悬吊法固定三腔二囊管作牵引压迫止血相对照。结果面罩法与传统悬吊法,在止血效果、并发症发生情况方面有显著差异。结论面罩法固定三腔二囊管具有止血效果好、取材方便、简便易行的优点,能减少并发症,减轻心理压力,提高患者舒适度,值得临床推广应用。     

三腔单囊管在门静脉高压上消化道大出血病人中的应用

[目的]观察三腔单囊管在门静脉高压致上消化道大出血病人中的应用效果.[方法]将38例采用三腔单囊管止血的病人设为实验组,将38例采用三腔二囊管止血的病人设为对照组,比较两组止血效果、肺部感染、痛苦程度、拔管后早期再出血的发生情况.[结果]两组止血效果相近,实验组肺部感染、痛苦程度、拔管后早期再出血发生率明显低于对照组,差异有统计学意义(P＜0.05或P＜0.01).[结论]三腔单囊管应用于肝硬化门静脉高压致上消化道大出血病人,能有效压迫止血,降低肺部感染、拔管后早期再出血的发生率,病人痛苦减轻.     

单胃囊三腔管压迫止血的方法和护理

我们对肝硬化胃底或食道静脉曲张破裂上消化道出血病人,由双囊三腔管压迫止血改用单胃囊压迫止血32例,其中食道静脉曲张破裂出血24例,胃底静脉曲张破裂出血6例,食道和胃底静脉曲张破裂出血2例,均收到了止血的效果。压迫止血成功与否,与护理工作关系很大。现将其方法和护理介绍如下。一、改进的目的 1.单胃囊三腔管压迫止血能减轻插、拔管和食道囊压迫时对病人的痛苦。 2.操作简便,插管容易成功,压迫止血迅速。 3.拔管方便,病人容易耐     

三腔二囊管改良牵引法的临床应用

食管、胃底静脉曲张破裂大出血是肝硬化门脉高压的严重并发症之一,其来势凶猛,危及病人的生命,而及时采用三腔二囊管进行食管、胃底气囊填塞术是一项及时有效的抢救措施。为探讨三腔二囊管改良牵引法止血效果,并发症的发生及病人的痛苦程度。对食管、胃底静脉曲张破裂大出血病人采用三腔二囊管常规法与改良法的对照比较。现将结果报告如下。1　资料与方法1.1　资料　我院1992年7月—2 0 0 3年10月使用三腔二囊管压迫止血病人5 6例,男5 2例,女4例;年龄3 5岁～70岁,平均年龄5 2岁;出血量在10 0 0ml～2 0 0 0ml。其中采用常规法2 2例,改良法3 4…     

多媒体在护理教学中应用的调查及对策

[目的]通过对护理教学中多媒体教学效果的调查及研讨,探讨如何在护理教学中更加合理地应用多媒体,促进教学质量的提高。[方法]选择护理专业有代表性的6门课程,一方面对在校护理系学生开展了问卷调查,另一方面在护理学院内部组织了多媒体授课效果研讨。[结果]问卷调查与专家研讨结果一致,即理论性强的课程不适合用多媒体教学。[结论]应根据教学内容选择合理教学手段,同时应从课件质量、加强评价及反馈体系方面提高多媒体授课水平。     

Enhancing nursing students' skills in vital signs assessment by using multimedia computer-assisted learning with integrated content of anatomy and physiology

Due to constraints of increasing number of nursing students and a disproportionate shortfall of faculty members in nursing schools, it was necessary to supplement traditional lecture or lecture-demonstration with on-line multimedia materials and/or multimedia compact discs for enhancing learning. The authors have developed a computer-assisted learning (CAL) multimedia on vital signs with animation and audio features for teaching in the classroom based on the 5Es inquiry cycle. When the CAL was tried on second-year undergraduates in two comparable schools, all groups of students gained significantly higher performance skills regardless of whether the groups were subjected to CAL/lecture or CAL/lecture/demonstration. However, they did not gain in factual knowledge.     

护生对不同层级带教老师教学效果的评价

目的探讨护生对不同层级带教老师的带教效果评价。方法选择2009年1月～2011年6月在本科室实习的380名护生为调查对象,了解护生对不同层级带教老师从思想品德、责任心、理论水平、操作技能等方面评价。结果主管护师及以上层级带教老师在观察病情及解决问题能力,护理文书书写,思想品德、责任心,教学计划安排及方法,对学生的人文关怀方面较突出;护师层级带教老师在理论知识、操作技能水平,教学计划安排及方法,思想品德、责任心方面较突出;护士层级带教老师在多媒体课件制作,授课能力方面较突出。结论根据不同层级带教老师的特点合理安排带教工作,能提高教学效果,从而提高护生临床实习效果。     

Effects of guided design and lecture teaching strategies on knowledge recall and on problem-solving performance of student nurses

The purpose of this study was to compare the effect of guided design and lecture teaching strategies on the clinical problem-solving performance of first quarter student nurses. The guided design treatment (written simulations and small group interaction) was selected especially with a view of developing new approaches to teaching nursing diagnosis. A total of 50 students, enrolled in Fundamentals of Nursing, were randomly assigned to two treatment groups: guided design and lecture. Each group received 10 hours of instruction. Treatment groups remained intact for 6 weeks of clinical practice following instruction. Recall knowledge of the nursing process was measured by an objective examination, and performance in problem solving was measured through the use of a care plan evaluation tool. Data were analyzed using analysis of variance and t-tests. Students taught by guided design scored significantly higher than those taught by lecture in preparing a patient care plan for an actual patient and for a simulated patient. Knowledge of the nursing process as tested by an objective examination was not significantly different for the two treatment groups.     

Effects of Guided Design and Lecture Teaching Strategies on Knowledge Recall and on Problem-Solving Performance of Student Nurses

The purpose of this study was to compare the effect of guided design and lecture teaching strategies on the clinical problem-solving performance of first quarter student nurses. The guided design treatment (written simulations and small group interaction) was selected especially with a view of developing new approaches to teaching nursing diagnosis. A total of 50 students, enrolled in Fundamentals of Nursing, were randomly assigned to two treatment groups: guided design and lecture. Each group received 10 hours of instruction. Treatment groups remained intact for 6 weeks of clinical practice following instruction. Recall knowledge of the nursing process was measured by an objective examination, and performance in problem solving was measured through the use of a care plan evaluation tool. Data were analyzed using analysis of variance and t-tests. Students taught by guided design scored significantly higher than those taught by lecture in preparing a patient care plan for an actual patient and for a simulated patient. Knowledge of the nursing process as tested by an objective examination was not significantly different for the two treatment groups.     

The effect of teaching method on objective test scores: problem-based learning versus lecture

This study investigated the effect of teaching method on objective test scores of students in a school of nursing. The hypothesis stated there was a difference between objective test scores of students who were taught content on diabetes using problem-based learning (PBL) and students taught the same content using the traditional lecture method. Junior nursing students enrolled in the Adult Health I nursing course in the fall of 2001 were taught the diabetes content using lecture as the teaching method, while students enrolled in the same course in the spring of 2002 were taught the same content using PBL. A pretest and posttest were administered to both groups of students. Both the pretest and posttest scores of the two groups were compared using an independent t test, and no statistically significant difference was found in the scores of the two groups. The results of this study support the null hypothesis: that there is no difference in objective test scores based on teaching method (lecture versus PBL).     

《心肺复苏术》多媒体课件的应用效果评估

目的探索护理教学中,应用多媒体技术改革传统的授课方法,提高教学质量。方法通过查随机数字表,将2002级护理本科班的学生随机分为两组。实验组采用讲授、示教加多媒体课件的方法授课;对照组采用传统的讲授、示教法。课后对两组学生进行理论及实践考核,对实验组的学生发放调查问卷,以了解其对使用课件教学的效果评价。结果实验组理论及操作成绩均高于对照组,P<0.05;90.6%的学生希望能使用课件学习,81.3%的学生认为使用课件能激发学习兴趣。结论多媒体课件教学在传授知识和技能方面比传统教学效果好,是一种可行的教学方法,但是多媒体课件教学不能取代教师的主导作用。     

多媒体网络课件在超声医学教学中的探讨

本文在分析传统超声医学教学现有模式及存在问题的基础上,探讨了利用网络课件进行超声医学教学的新方法,构建了基于网络的临床教学新模式:阐述了普及超声医学网络课件教学的必要性,介绍了课件的主要特征、组成及制作方法等内容;并指出该模式的应用可有效增强学生自主学习兴趣,对提高超声医学临床教学水平具有较大作用。     

人文关怀在实习护生岗前培训中的应用研究

[目的]将人文关怀融入临床实习护生的岗前培训中,以帮助护生顺利度过从学校到临床的关键时期。[方法]从2004年开始通过对实习护生岗前培训内容及授课形式的改进,加强人性化教学理念,选择2001年—2003年153名护生作为对照组,2004年—2007年187名护生作为实验组,均为大专及以上学历。[结果]护生对带教老师授课满意度及护生岗前培训考核成绩实施人文关怀前后比较差异有统计学意义(P均<0.05)。[结论]将人文关怀融入护生的岗前培训中,不仅加强了师生之间的沟通,能帮助护生尽快熟悉医院和科室的要求,同时也提高了岗前培训授课质量。