人性化护理干预在阴道炎治疗中的效果观察及分析

目的观察对阴道炎患者实施人性化护理干预的护理效果。方法选取2017年1月-2017年4月本院收治的阴道炎患者160例作为研究对象,将其随机分成观察组及对照组,各80例。对照组患者实施常规护理干预,观察组患者实施常规护理联合人性化护理干预,观察两组患者的护理满意度,患者健康行为接受情况以及治疗效果。结果观察组的护理满意度为95.00%、健康行为好为77.50%、总有效率为96.25%,对照组分别为86.25%、43.75%、81.25%,观察组患者阴道炎治疗效果显著好于对照组,差异有统计学意义(P0.05)。结论对阴道炎患者实施人性化护理干预,可以提升患者的护理满意度与健康行为接受率,降低阴道炎的复发率,护理效果显著,值得临床推广。     

胃癌术后早期急性胆囊炎的观察与护理

总结4例胃癌术后早期急性胆囊炎患者的观察与护理。密切观察胃癌术后患者发热、腹胀、腹痛情况,动态观察实验室检查及辅助检查,做好高热护理、腹痛护理、经皮经肝胆囊穿刺引流术后护理和口腔护理,做好患者的心理护理。4例患者经治疗和护理后均痊愈出院。     

PDCA循环模式护理管理改善高龄结直肠癌患者及家属情绪的效果观察

目的观察PDCA循环模式护理管理对高龄结直肠癌患者及家属情绪的改善效果。方法选取80例高龄结直肠癌患者随机分为对照组和观察组,对照组患者接受常规护理措施,观察组患者则接受PDCA循环模式管理下的护理措施,观察2组患者护理前后焦虑、抑郁情况以及患者与家属的护理满意度、护理后患者的生活质量。结果护理后,观察组患者SAS评分和SDS评分均低于对照组,差异有统计学意义(P0.05);观察组患者及家属的护理满意度为97.5%,显著高于对照组的82.5%,差异有统计学意义(P0.05);护理后,观察组患者生活质量各项评分均高于对照组,差异有统计学意义(P0.05)。结论 PDCA循环模式护理管理能明显改善高龄结直肠癌患者及家属情绪。     

临床护理路径对脑梗死急性期患者的效果评价

目的:探讨临床护理路径在脑梗死急性期患者护理中的应用效果。方法:本次临床以68例脑梗死患者为观察对象,利用随机分组法将其分为对照组和观察组,对照组患者接受常规临床护理,观察组患者接受临床护理路径护理,共观察3个月,对比2组患者临床护理效果。结果:观察组患者接受护理路径后,健康知识掌握、生活自理能力、护理满意度等各项临床指标均显著优于对照组患者,2组患者临床护理效果对比统计学差异显著(P<0.05)。结论:临床护理路径应用于脑梗死急性患者实施可以有助于患者的康复,改善预后,提高患者护理满意度,且临床护理效果显著优于常规的临床护理,因而临床应用价值较高。     

急性脑梗死溶栓治疗中综合护理干预的效果分析

目的分析综合护理干预措施在急性脑梗死溶栓治疗中的干预效果,完善急性脑梗死护理措施。方法将300例接受溶栓治疗的急性脑梗死患者作为观察对象,根据护理方法的不同,分为观察组和对照组各150例。对照组患者给予溶栓治疗的同时采用常规护理,观察组在对照组的基础上联合心理护理、健康教育、康复护理、出院指导等综合护理干预措施,比较2组患者护理干预后的临床疗效、血清IL-6水平、日常生活能力以及护理满意度。结果观察组患者治疗有效患者数多于对照组,治疗有效率高于对照组,差异有统计学意义(P0.05);观察组患者护理干预后血清IL-6水平显著低于对照组;患者日常生活能力评分的结果显示,观察组患者日常生活能力评分高于对照组;观察组患者满意度高于对照组,2组比较差异有统计学意义(P0.05)。结论综合护理干预能够提高患者治疗效果、促进患者日常生活能力和对护理满意度的提高、降低血清IL-6的水平,值得借鉴。     

颅脑外伤患者躁动的观察及护理

总结颅脑外伤患者躁动的观察及护理。认为重点是对颅脑外伤躁动患者做好安全护理,重视病情观察及用药反应的观察,加强舒适护理、心理护理,向患者及家属提供医疗性、信息性、情感性支持,使患者早日康复。     

手术室整体护理对硬膜外麻醉患者护理质量及满意度的影响

目的：探讨硬膜外麻醉患者的手术室护理过程中应用整体护理后的护理质量以及患者满意度，给临床护理提供理论依据。方法选取在我院诊治需进行硬膜外联合麻醉手术的572例患者，随机分为对照组和观察组，每组286例。对照组采用常规护理，观察组采用整体护理，分析比较两组患者经不同手术室护理后的护理质量和患者满意度。结果经护理后，患者的SDS评分均比护理前低，但观察组患者的降低幅度明显大于对照组，护理后观察组的SDS评分显著低于对照组；护理前两组SAS评分相差不大，经护理后，观察组患者SAS评分的降低幅度明显大于对照组，护理后观察组的SAS评分显著低于对照组；观察组穿刺成功率为96.15％，对照组穿刺成功率为80.77％，观察组穿刺成功率显著高于对照组；观察组患者配合的比例高于对照组；观察组患者的满意度高于对照组。结论对腰硬麻醉患者的手术室护理过程中应用整体护理，能明显提高穿刺成功率、患者治疗依从性和患者的护理满意度，值得在临床护理中推广使用。     

细节护理在手术室护理工作中的临床分析

目的对手术时护理工作中使用细节护理的临床效果进行观察分析。方法将我院2011-12—2013-12的240例手术患者作为研究对象随机分为观察组与参考组,各为120例,给予两组患者优质护理干预,观察组患者在护理工作中同时采用细节护理干预,比较两组患者护理前后焦虑、抑郁情绪的变化及患者对护理满意度的评分。结果护理后观察组患者抑郁、焦虑评分明显低于参考组(P0.05);观察组患者对护理工作满意评分明显优于参考组,差异有统计学意义(P0.05)。结论在手术室护理中采用细节护理有助于提高护理质量,缓解患者不良情绪,改善护患关系。     

细节护理在手术室优质护理服务中的应用效果分析

目的探讨细节护理在手术室优质护理服务中的应用效果。方法选择3650例手术患者为研究对象,根据手术时间分为观察组和对照组,对照组给予手术室常规护理,观察组在对照组的基础上给予细节护理,比较2组患者手术配合度及舒适度、护理质量、患者满意度、术后并发症。结果观察组患者舒适率、配合率显著高于对照组,观察组基础护理、规范使用抗生素、候台时护理和手术室护理质量评分均显著高于对照组,观察组沟通评分、正性心理疏导、护理服务态度、护理操作准确及时等均显著高于对照组,观察组并发症发生率显著低于对照组,差异均有统计学意义(P0.01)。结论细节护理有助于增强患者舒适度与配合度,并能提高护理质量,降低手术并发症发生率。     

探讨 ICU气管切开患者肺部感染的护理干预措施及效果

目的：探讨ICU气管切开患者肺部感染的护理干预措施及临床效果。方法本研究选取在本院ICU行气管切开治疗的患者100例,在所有患者或家属知情且同意的情况下,将患者进行随机分组,分为观察组和对照组两组,每组各50例患者。对照组患者在气管切开治疗过程中给予常规的临床护理,主要包括严密观察、严格执行无菌操作、并发症护理等。观察组患者在治疗组患者的临床护理基础上再给予心理护理、环境护理、气管切开护理、气道湿化护理、吸痰护理、口腔护理、鼻饲护理等护理干预。结果观察组患者的临床护理总有效率为96．0％,显著高于对照组患者的84．0％,组间比较差异具有统计学意义（ P＜0．05）。观察组患者的焦虑、抑郁不良情绪评分显著低于对照组患者,组间比较差异具有统计学意义（ P＜0．05）。观察组患者局部感染、皮下气肿、脱管、导管阻塞、出血等并发症的发生率为4．0％显著低于对照组患者的26．0％,组间比较差异具有统计学意义（ P＜0．05）。观察组患者临床护理满意度为95．8％显著高于对照组患者的80．9％,组间比较差异具有统计学意义（ P＜0．05）。结论对于ICU气管切开肺部感染患者,实施心理护理、环境护理、气管切口护理、气道湿化护理、吸痰护理、口腔护理、鼻饲护理等护理干预,能够显著的降低患者的死亡率、改善患者的不良心理情绪、降低患者的并发症发生率,促进患者取得良好预后,提高患者的临床护理满意度。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.