膀胱功能锻炼对宫颈癌根治术患者术后膀胱功能的影响

目的 探究膀胱功能锻炼对宫颈癌根治术(Radical hysterectomy, RH)患者术后膀胱功能恢复的作用。方法 按照护理方式不同,选择60例进行膀胱功能锻炼的RH患者作为对照组,60例常规护理的RH患者作为观察组,比较手术15d后RH患者膀胱功能恢复情况。结果 观察组患者尿潴留发生率、再置尿管发生率及膀胱刺激症状明显低于对照组(P<0.05);观察组患者尿液残余量及尿管留置时间显著低于对照组(P<0.05);观察组患者泌尿感染发生率明显低于对照组,但其差异不具有统计学意义(P>0.05)。结论 常规护理结合膀胱功能锻炼可以有效降低RH患者手术后并发症产生,抑制尿潴留及再置尿管现象发生与发展,加快患者手术后膀胱功能的恢复。     

膀胱充盈时拔除留置导尿管降低继发尿潴留发生

妇科手术患者术中都要留置尿管，术后拔除尿管后有继发尿潴留的可能，尤其是留置尿管时间长的患者，继发尿潴留的可能性更大。自2004年4月～2006年4月，我科对术后留置导尿患者采纳了选择膀胱充盈时拔除尿管的方法，有效地降低了继发性尿潴留的发生。     

可摘局部义齿修复后电话随访对复诊率的影响

目的：探讨电话随访对可摘局部义齿患者复诊率及满意度的影响。方法选取可摘局部义齿修复患者100例,随机分为观察组和对照组,每组50例。两组修复后均进行常规健康宣教,观察组加施电话随访,3个月后复诊并统计复诊率,采用VAS量表由患者对义齿满意度进行评价,评价方面主要包括佩戴后的义齿满意度、舒适度、美观性、咀嚼能力、发音情况及护理服务满意度。结果观察组复诊率24.0%,显著低于对照组50.0%（P<0.05）;观察组患者佩戴义齿的满意度、舒适度及对护理工作的满意度显著高于对照组（P<0.05）,而在美观性、咀嚼能力及发音情况等项目的对比中,观察组患者情况得到一定改善,但结果无统计学差异。结论电话随访能够降低可摘局部义齿患者复诊率,提高患者满意度。     

手术患者不同时机导尿对苏醒期躁动和适应性比较

目的比较全麻手术患者不同时机导尿后全麻苏醒期躁动和术后1天尿管耐受性。方法将180例全麻手术患者随机分为三组,I组为术晨在病房导尿;II组为手术前1日,由巡回护士访视患者,进行心理护理后,麻醉前在手术室导尿;III组为全身麻醉平稳后由巡回护士导尿。对患者就不同时机进行导尿所引起的不舒适感、麻醉苏醒时的躁动情况及术后1日对尿管适应性进行比较。结果III组患者麻醉苏醒期躁动率明显高于I、II组,有统计学意义（P〈0.05）。术后1日患者尿管适应度,II组术后留置尿管的适应度较好,III组患者较差。结论麻醉前对患者进行心理护理后导尿可提高手术患者对留置尿管的适应度,大大降低麻醉苏醒时的躁动率。     

快速康复外科综合护理方案在乳腺癌手术患者护理中的应用

目的 研究快速康复外科(enhanced recovery after surgery, ERAS)综合护理方案在乳腺癌手术患者护理中的应用。方法 选择2019年1月-2021年1月期间收入102例乳腺癌手术患者进行研究,按随机法分为两组均51例,对照组采取常规护理措施,研究组实施快速康复外科综合护理,观察两组术后恢复相关情况、生活活动能力、并发症情况、生活质量情况、护理质量以及满意度调查。结果 两组患者在接受康复前生活活动能力、生活质量评分无差异(P>0.05);康复后生活活动能力明显好转,术后饮水时间、术后进食时间、下床活动时间、拔除尿管时间、住院时间相比对照组更短,出血并发症发生率5.88%,明显低于对照组23.53%,生活质量评分高于对照组,各项满意度更高,组间存在明显差异(P<0.05)。结论 快速康复外科综合护理方案在乳腺癌择期手术患者中具有重要意义,能够改善术后相关情况,提升患者生活质量,降低并发症发生率,患者生活质量及护理质量明显提升,护理满意度较高。     

延续性护理模式在经皮肝穿刺胆道引流患者的应用

目的 探讨延续性护理服务在恶性梗阻性黄疸行经皮肝穿刺胆道引流(PTCD)治疗患者中的临床应用效果.方法 120例恶性梗阻性黄疸行PTCD治疗患者入组,60例为对照组给予常规出院指导和健康宣教,观察组60例除常规出院宣教外,责任护士对患者予延续性护理即出院后继续予以跟踪服务,指导其伤口的观察与换药、引流液的量色质观察、PTCD管护理知识和并发症的处理、饮食和休息等,并建立延续性护理档案.结果 两组患者随访3个月,观察组患者PTCD带管相关知识知晓率明显高于对照组;患者伤口感染率、PTCD管脱出、堵塞、管道相关再次住院率显著低于对照组(P＜0.05).结论 延续性护理能明显提高患者PTCD带管相关知识知晓率,降低胆道感染、PTCD管堵塞或脱出、伤口感染、管道相关人院率,提高生活质量.     

中长期静脉通路互联网平台的构建与应用

【摘要】 目的 了解超声引导下中长期静脉通路带管患者居家自我管理的现状,开发互联网平台,解决中长期静脉通路带管患者在静脉治疗间歇期对导管的自我管理、相关问题辨识及处理、远程问诊、维护提醒等问题。方法 收集2018年9月至2019年4月首次进行超声引导下中长期静脉通路穿刺的患者,对照组、观察组各40例。对照组按中长期静脉通路护理常规进行宣教、门诊维护及咨询。观察组按中长期静脉通路护理常规外,同时使用互联网平台,以协助患者对中长期静脉通路的自护管理。 结果 两组患者带管期间的依从性、带管期间获得信息资源的满意度,观察组均优于对照组,差异具有统计学意义（P＜0.05）,观察组并发症发生率低于对照组（P＜0.05）。 结论 中长期静脉通路互联网平台可以有效地帮助带管患者进行居家自我管理,降低静脉导管相关并发症的发生,提高患者导管自我管理能力、导管维护依从性及获得信息资源满意度。     

减少留置导尿污染新法巧接尿管与尿袋

留置导尿是外科常用的护理操作,是某些手术的术前准备以及观察记录尿液,促使昏迷、尿潴留、尿失禁等患者膀胱功能恢复的重要手段。常规操作是:在严格执行无菌操作下,铺完洞巾,弯盘置于会阴处,插入尿管成功后先引尿液于弯盘内,夹紧尿管,再倒掉弯盘内尿液,固定尿管,最后连接尿管末     

PBL结合微视频健康教育方案在PTCD带管患者中的应用

【摘要】 目的 探讨基于问题学习（problem- based learning，PBL）结合微视频健康教育方案在经皮肝穿刺胆道引流（PTCD）带管患者中的应用价值。方法 采用前瞻性对照研究，将南通市第一人民医院介入科2018年3月至12月收治的45例恶性梗阻性黄疸行PTCD治疗留置管道的患者作为研究对象，以2017年1月至10月收治的45例恶性梗阻性黄疸PTCD治疗留置管道的患者作为对照组。对照组采用常规的健康教育、出院指导、出院后电话随访；研究组采用PBL结合微视频的教育方案，出院后，在电话回访的基础上配合使用移动终端信息交流工具。分别于入组时、出院后3个月门诊复诊时对两组患者进行问卷调查，评估患者PTCD管相关知识知晓率、患者生活质量状况及患者居家护理管道并发症（管道脱落、堵塞、伤口周围皮肤损伤、胆道感染）的发生率。结果 研究组患者PTCD管道护理知晓率、引流液量色观察知晓率、并发症识别知晓率分别为97.8%、100%、93.3%，明显高于对照组，差异具有统计学意义（P＜0.05）；研究组患者居家护理管道并发症发生率（其中管道堵塞4.4%、管道脱落或移位2.2%、胆道感染4.4%、伤口周围皮肤损伤4.4%）明显低于对照组，差异有统计学意义（P＜0.05）；研究组患者躯体功能、角色功能、情绪功能、认知功能、社会功能评分依次为（75.19±6.35）、（74.22±5.14）、（73.83±4.25）、（74.36±6.22）、（72.05±5.17）高于对照组，差异具有统计学意义（P＜0.05）。 结论 PBL结合微视频的健康教育方案明显提高患者PTCD相关知识的知晓率，有效降低PTCD带管患者出院后居家管道并发症的发生率，保障患者安全，并提高患者的生活质量。     

专病护士在介入专科护理门诊建设中的作用

【摘要】 目的 探讨胆道介入专病护士在介入专科护理门诊建设中的作用。方法 培养胆道介入专病护士,开设全国首家介入专科护理门诊,由护士长和胆道介入专病护士坐诊。2017年2月至2018年1月接诊94例胆道介入术后出院患者为观察组,患者经介入专科护理门诊定期经皮经肝胆道引流（PTBD）伤口换药（含蝶形固定装置）、管道维护和健康教育。2016年2月至2017年1月介入专科护理门诊开诊前的94例为对照组,对两组患者对护理工作的满意度、患者伤口及PTBD管护理知识、PTBD管伤口和管道管理合格率进行比较。结果 观察组患者伤口及PTBD管护理知识、患者对护理工作的满意度均明显优于对照组,差异具有统计学意义（P＜0.05）;观察组患者带管期间的并发症和非计划性急诊入院明显减少,差异具有统计学意义（P＜0.05）。结论 培养胆道介入专病护士,开设介入专科护理门诊,定期给PTBD出院患者伤口换药、管道维护和健康教育,能显著提高患者伤口及PTBD管护理知识、患者对护理工作的满意度,降低患者带管期间的并发症和非计划性急诊入院,保障了患者的安全,促进了医护和谐团队的建立,提高了护士专业能力和职业价值感。 【关键词】 专病护士; 胆道介入; 介入专科护理门诊; 作用     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.