舒适护理在癌症化疗患者中的应用

目的 探讨舒适护理模式在癌症化疗患者中的应用效果.方法 将120例癌症化疗患者随机分为观察组(60例)和对照组(60例).观察组运用舒适护理模式加以干预,对照组采用常规护理方法.采用问卷调查两组患者对护理工作的满意度.结果 观察组对护理工作的满意度高于对照组(P＜0.01),化疗的不良反应发生率低于对照组(P＜0.05).结论 在癌症化疗患者中应用舒适护理可提高癌症患者的生活质量,同时患者对护理工作的满意度也显著提高.     

舒适护理对乳腺癌化疗患者生活质量的影响

目的 探讨舒适护理对乳腺癌化疗患者生活质量的影响.方法 采用方便抽样法选取乳腺癌改良根治术后住院化疗患者80例作为研究对象,将其随机分为干预组与对照组各40例.对照组采用常规护理,干预组在此基础上给予化疗全程的舒适护理.采用欧洲癌症研究和治疗组织癌症患者生活质量问卷调查表(QLQ-C30)、医院焦虑和抑郁量表(HADS)和自编护理工作满意度调查表定期对2组患者进行评定.结果 干预前2组患者的生活质量比较差异无统计学意义(P＞0.05),干预后差异有统计学意义(P＜0.05).干预组的抑郁和焦虑的发生率明显低于对照组(P＜0.05),对护理工作的满意度明显高于对照组(P＜0.05).结论 舒适护理能够提高护理服务质量,减少焦虑、抑郁状态的发生,提高乳腺癌化疗患者的生活质量.     

优质护理对子宫内膜息肉宫腔镜手术患者疾病认知及生活质量的影响分析

目的 分析优质护理对子宫内膜息肉宫腔镜手术患者的影响.方法 选取2020年9月至2022年9月期间于本院治疗的70例子宫内膜息肉患者作为研究对象.随机将患者分为对照组和观察组,每组各35例.对照组宫腔镜手术治疗中开展常规护理;观察组实施优质护理.分析对比两组的疾病认知水平、生活质量、预后情况以及护理满意度.结果 观察组的疾病认知率显著高于对照组(P＜0.05).干预后观察组的SF-36评分显著高于对照组(P＜0.05).观察组的住院时间显著短于对照组,并发症总发生率显著低于对照组(P＜0.05).观察组的护理满意度显著高于对照组(P＜0.05).结论 在子宫内膜息肉患者宫腔镜手术治疗中,优质护理的实施能提升患者的疾病认知水平和生活质量,改善患者预后,提高护理满意度.     

人性化护理对肺癌手术患者生活质量及护理满意度的影响

目的 探讨人性化护理对肺癌手术患者生活质量及护理满意度的影响.方法 选取肺癌手术患者40例,采用多中心、随机、双盲的方法分为观察组和对照组,每组20例.对照组患者采用常规护理,观察组患者常规护理的基础上采用人性化护理,观察两组患者术后并发症、死亡率、生活质量、护理质量满意度及住院时间.结果 观察组的护理满意度均显著高于对照组(P＜0.05),住院时间、并发症、死亡率显著少于对照组(P＜0.05);观察组各个生活质量评分均显著高于对照组(P＜0.05).结论 人性化护理真正的体现以人为本的护理理念,有利于满足肺癌患者的心理和生理需求,提高患者的生活质量,降低病死率.     

思维导图引导渐进性康复护理用于腰椎间盘突出症的效果观察

目的 研究分析腰椎间盘突出症患者护理过程中思维导图引导渐进性康复护理的应用效果.方法 选取2020年9月至2022年9月期间于本院就诊的80例腰椎间盘突出症患者作为研究对象.采用双盲对照原则,将患者随机分为对照组及观察组,每组各40例.对照组实施常规护理,观察组采用思维导图引导渐进性康复护理.分析对比两组的生活质量、腰背部功能以及护理满意度.结果 两组干预前生活质量QOLI评分无显著差异(P＞0.05).干预后,观察组QOLI评分显著高于对照组(P＜0.05).术后一天时,两组的Oswestry功能障碍指数评分无显著差异(P＞0.05).术后一个月时,观察组的各项Oswestry功能障碍指数评分均显著低于对照组(P＜0.05).观察组的护理满意度显著高于对照组(P＜0.05).结论 在腰椎间盘突出症患者护理中应用思维导图引导渐进性康复护理,能提升患者的生活质量,改善患者的腰背部功能,提高护理满意度.     

基于家庭的护理模式对首次化疗肺癌患者生活质量的影响

目的 观察基于以家庭的护理模式对首次化疗肺癌患者生活质量的影响.方法 选择我院首次化疗肺癌患者84例为观察对象,随机分为两组各42例.对照组采取常规护理,干预组在常规护理基础上实施基于家庭的护理模式.采用QLQ-C30量表评价干预前后两组的生活质量,采用自制满意度调查表评价护理满意度.结果 与干预前比较,干预后两组QLQ-C30评分均升高(P＜0.05).干预后,干预组QLQ-C30评分高于对照组(P＜0.05).与对照组比较,干预组护理满意度显著提高(P＜0.05).结论 基于家庭的护理模式可显著提高首次化疗肺癌患者的生活质量及护理满意度,大力提高及应用的价值较高.     

糖尿病肾病的血液透析临床护理效果分析

目的 本文探讨糖尿病肾病血液透析时应用临床护理的具体效果.方法 选取2020年12月至2021年10月本院收治的接受血液透析治疗的50例糖尿病肾病患者作为研究对象.通过随机数表法将患者分为对照组和观察组,每组各25例.对照组予以基础护理干预;观察组予以全面护理干预.分析对比两组的治疗依从性、负性情绪、生活质量、护理满意度以及并发症发生率.结果 观察组治疗依从性显著高于对照组(P＜0.05).护理前,两组负面心理评分无显著差异(P＞0.05);护理后,两组的负面情绪均有所改善,且观察组抑郁自评量表(SDS)与焦虑自评量表(SAS)评分均比对照组显著降低(P＜0.05).观察组的躯体功能、情感功能、社会功能、角色功能等各项生活质量评分均对照组显著提高(P＜0.05).观察组的护理满意度显著高于对照组(P＜0.05).结论 糖尿病肾病患者接受全面护理,能提高治疗依从性,改善负面情绪,提升生活质量,减少并发症,提高护理满意度.     

综合护理在小儿再生性障碍性贫血中的应用效果分析

目的 分析在小儿再生性障碍性贫血中应用综合护理的临床效果.方法 选取我院2021年3月至2021年8月实施治疗的再生性障碍性贫血患儿50例作为研究对象.按照随机盲选法将患儿分为对照组和观察组,每组各25例.对照组接受常规护理干预,观察组实施综合护理.分析对比两组的血常规指标、护理满意度、并发症发生情况以及生活质量.结果 护理干预前两组的白细胞、血红蛋白、血小板等血常规指标水平比较无显著差异(P＞0.05).护理干预后,两组的白细胞、血红蛋白、血小板等血常规指标水平均较干预前显著上升,且观察组各指标水平均显著高于对照组(P＜0.05).观察组的护理满意度显著高于对照组(P＜0.05).观察组的并发症发生率显著低于对照组(P＜0.05).观察组的环境、心理功能、社会功能、躯体功能等生活质量指标评分均显著高于对照组(P＜0.05).结论 将综合护理措施应用在再生性障碍性贫血患儿护理中,能改善血常规指标水平,减少并发症,提升生活质量和护理满意度.     

多方位护理管理在产科住院产妇护理质量及满意度的影响

目的 探讨多方位护理管理在产科住院产妇护理质量及满意度的影响.方法 将100例产妇分为观察组和对照组,对照组采用常规护理管理,观察组采用多方位护理管理,比较两组产妇的住院期间的护理质量及满意度.结果 观察组护理后的各项生活质量评分均显著高于对照组(P＜0.05).观察组的护理质量评分、健康知识知晓率、护理质量满意度显著高于对照组,并发症的发生率显著低于对照组(P＜0.05).结论 多方位护理管理有助于提高产科住院产妇的护理质量,为产妇提供更优质的服务.     

认知行为干预在急性创伤性肾出血介入治疗术患者中的应用及护理

目的 探讨认知行为干预在急性创伤性肾出血介入治疗术患者中的应用及护理方法.方法 将我院2009年12月～2010年8月收治的50例急性创伤性肾出血的患者分为观察组和对照组,均采用介入术治疗,对照组采用常规护理,观察组在对照组的基础上加强认知行为干预和排便护理,比较两组患者便秘、再出血的发生率、护理质量满意度及生活质量.结果 观察组在生理、心理、社会文化及环境方面的舒适度显著优于对照组(P＜0.05).观察组便秘、再出血的发生率显著低于对照组,护理质量的满意度显著高于对照组(P＜0.05).结论 加强对介入治疗急性创伤性肾出血患者的认知行为干预和排便护理,有利于降低再出血的发生率,提高患者的生活质量.     

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.