住院患者请假的原因分析及护理对策

目的 了解住院患者请假的原因,针对性的提出护理对策,加强对住院患者管理.方法 对住院请假患者分析请假原因,并提出护理对策.结果 住院患者请假原因有工作需要、家庭因素、医院环境因素等.护理措施包括加强入院健康教育、加强护患沟通、营造良好的病房气氛等.结论 通过对住院患者请假原因分析,采取有效护理措施,保障患者安全.     

乳腺癌根治术12例围术期护理

目的:探讨行乳腺癌根治术患者围术期的护理方法. 方法:对12例行乳腺癌根治术的患者在围术期加强心理护理,积极治疗合并症,加强病情观察,做好引流及饮食护理,做好功能锻炼及出院指导. 结果:患者预后良好,无严重并发症发生. 结论:对乳腺癌患者加强围术期护理,可改善患者术后的生活质量.     

预防消化道手术患者切口感染的护理干预研究进展

综述了预防消化道手术患者切口感染的护理干预研究进展,主要包括更新洗手方法、患者皮肤准备、加强手术间无菌环境和病室的管理、加强患者围手术期管理、加强术中管理、合理使用抗菌药物.认为加强护理干预措施,可预防消化道手术患者切口的感染.     

无名氏患者在急诊科的护理管理

总结了本科对382例无名氏患者的护理管理,包括做好患者交接,为无名氏患者开通绿色通道,加强病历管理等.382例无名氏患者中有22例抢救无效死亡,其余均得到了妥善安置.认为加强急诊科无名氏患者的护理管理是社会的需要,需进一步完善.     

颈段食管癌手术围手术期护理

目的 探讨颈段食管癌患者的围手术期护理.方法 术前对患者进行全面身心评估,解除思想顾虑完善各项术前检查,术后重点加强生命体征的观察,加强各种管和颈、腹部切口的观察及护理,注意营养支持,确保呼吸道通畅.结果 15例患者术后恢复良好,无明显护理并发症.结论 加强颈段食管癌患者的围手术期护理,能使患者减少并发症的发生,顺利完成手术治疗,早日康复.     

基础胰岛素治疗的2型糖尿病患者进行餐后行走与增加餐前胰岛素治疗的对比研究

目的 评估餐后行走与餐前加强胰岛素注射对基础胰岛素治疗的2型糖尿病的影响.方法 对接受基础胰岛素治疗的2型糖尿病患者进行了餐后行走或餐前加强胰岛素注射的随机对照研究.在餐后行走组中,患者每天晚饭后行走15～20 min,持续10周.在餐前加强胰岛素组中,早餐或主餐前使用短效胰岛素进行加强注射.结果 32名患者完成了本次...     

支气管哮喘患者的健康教育

目的 探讨对支气管哮喘患者实施健康教育的效果.方法 选择2009年3月至2010年8月于我院呼吸内科住院治疗的支气管哮喘患者66例,并对其加强健康教育,观察健康教育的效果.结果 加强健康教育后,66例支气管哮喘患者均获得了满意的效果.结论 对支气管哮喘患者加强健康教育,可以增加患者对疾病的了解和自我保健意识,有利于其康复.     

心血管重症病房压疮的预防及护理体会

目的:总结心血管重症病房患者压疮的预防措施及护理体会.方法:2009年1月至2010年12月期间,在我科心血管重症病房救治超过3天以上的1685例患者,加强压疮管理制度、加强患者的皮肤清洁及保护,配合完善的生活护理,加强营养等支持治疗,以预防患者压疮的发生.结果:出现新发压疮13例.经处理后所有Ⅰ期压疮、Ⅱ期压疮及Ⅲ期压疮均治愈.结论:严格执行压疮管理制度相关规定.加强患者的皮肤护理,避免局部受压,是预防心血管重症病房患者发生压疮的关键.     

2例皮肌炎合并乳腺癌护理体会

总结2例皮肌炎合并乳腺癌患者的护理体会.重点是密切观察病情,加强患者皮肤护理和观察,同时加强乳腺癌术后患肢功能锻炼.经过积极的治疗和护理,2例患者好转出院.     

癌症患者家属对化疗安全需求的调查分析

目的调查癌症患者家属对化疗安全需求,并探讨加强对癌症患者家属对化疗安全的健康指导,有效发挥患者家属的社会支持作用.方法对80名癌症患者家属进行问卷调查.结果不同化疗周期患者家属对化疗安全需求有差异.结论癌症患者家属迫切需要医护人员的指导.应加强预防化疗药物毒副反应的指导,健康指导要建立全程教育模式,个体化.     

B-lines quantify the lung water content: a lung ultrasound versus lung gravimetry study in acute lung injury

B-lines (also termed ultrasound lung comets) obtained with lung ultrasound detect experimental acute lung injury (ALI) very early and before hemogasanalytic changes, with a simple, noninvasive, nonionizing and real-time method. Our aim was to estimate the correlation between B-lines number and the wet/dry ratio of the lung tissue, measured by gravimetry, in an experimental model of ALI. Seventeen Na-pentobarbital anesthetized, cannulated (central vein and carotid artery) minipigs were studied: five sham-operated animals served as controls and, in 12 animals, ALI was induced by injection of oleic acid (0.1 mL/kg) via the central venous catheter. B-lines were measured by echographic scanner in four predetermined chest scanning sites in each animal. At the end of each experiment, both lungs were dissected, weighed and dried to determine wet/dry weight ratio by gravimetry. After the injection of oleic acid, B-lines number increased over time. A significant correlation was found between the wet/dry ratio and B-lines number (r = 0.91, p < 0.001). These data suggest that in an experimental pig model of ALI/ARDS, B-lines assessed by lung ultrasound provide a simple, semiquantitative, noninvasive index of lung water accumulation, strongly correlated to invasive gravimetric assessment.     

Endogenous lung stem cells for lung regeneration

Introduction: Lifelong maintenance of a healthy lung requires resident stem cells to proliferate according to tissue requirements. Once thought to be a quiescent tissue, evolving views of the complex differentiation landscape of lung stem and progenitor cells have broad implications for our understanding of how the lung is maintained, as well as the development of new therapies for promoting endogenous regeneration in lung disease.

Areas covered: This review collates a large body of research relating to the hierarchical organization of epithelial stem cells in the adult lung and their role in tissue homeostasis and regeneration after injury. To identify relevant studies, PubMed was queried using one or a combination of the terms ‘lung’, ‘airway’, ‘alveoli’, ‘stem cells’, ‘progenitor’, ‘repair’ and ‘regeneration’.

Expert opinion: This review discusses how new technologies and injury models have challenged the demarcations between stem and progenitor cell populations.     

单肺通气中肺保护策略研究进展

目的 通过对单肺通气中肺保护策略研究进展的分析,为临床工作提供理论指导,减少单肺通气术中低氧血症和术后肺部并发症的发生.方法 应用计算机在Pubmed上检索2007年1月～ 2012年5月有关单肺通气的文章,检索词为:one lung ventilation,hypoxemia,lungprotection,限定文章语言种类为English.对资料进行初审,并查找全文.纳入标准:①有关单肺通气的实验及临床研究;②有关肺保护的试验研究.排除标准:①综述文献;②重复研究.共收集到200多篇有关单肺通气方面的文献,纳入14篇.结果 纳入的14篇文章中有关单肺通气术中管理方面的文献12篇,有关单肺通气时低氧血症方面的文献2篇.通过对入选文献进行分析、整理,将单肺通气术中管理从通气模式选择、潮气量与呼吸频率的设置、PEEP及CPAP的运用、吸入氧浓度及液体管理等5方面进行分析,归纳总结出目前在单肺通气时的肺保护策略和麻醉管理进展.结论 随着对单肺通气中肺保护的深入研究,单肺通气的麻醉管理将更加有效、合理.     

终末期肺病肺移植术后并发症的影像学表现

目的探讨肺移植术后并发症的影像学改变。方法6例患者进行了同种异体肺移植术,其中4例终末期慢性阻塞性肺疾病患者和1例为中毒性细支气管炎患者接受单肺移植,另1例为外周型肺腺鳞癌并双肺转移接受双肺移植。用胸片及CT观察术后并发症的影像学变化。结果6例肺移植手术全部成功,6例中围手术期3例死亡,3例已存活16~36个月。术后2例发生急性排斥反应,5例出现再移植肺水肿,3例并发肺部感染,2例出现气胸,2例术后1~2个月出现吻合口狭窄。结论及时的胸片和CT检查对肺移植术后并发症的防治有非常重要的指导价值。     

Massive brain injury enhances lung damage in an isolated lung model of ventilator-induced lung injury

OBJECTIVE: To assess the influence of massive brain injury on pulmonary susceptibility to injury attending subsequent mechanical or ischemia/reperfusion stress. DESIGN: Prospective experimental study. SETTING: Animal research laboratory. SUBJECTS: Twenty-four anesthetized New Zealand White rabbits randomized to control (n = 12) or induced brain injury (n = 12) group. INTERVENTIONS: After randomization, brain injury was induced by inflation of an intracranial balloon-tipped catheter, and animals were ventilated with a tidal volume of 10 mL/kg and zero end-expiratory pressure for 120 mins. Following heart-lung block extraction, isolated and perfused lungs were subjected to injurious ventilation with peak airway pressure 30 cm H2O and positive end-expiratory pressure 5 cm H2O for 30 mins. MEASUREMENTS AND MAIN RESULTS: No difference was observed between groups in gas exchange, lung mechanics, or hemodynamics during the 2-hr in vivo period following induction of brain injury. However, after 30 mins of ex vivo injurious mechanical ventilation, lungs from the brain injury group showed greater change in ultrafiltration coefficient, weight gain, and alveolar hemorrhage (all p < .05). CONCLUSIONS: Massive brain injury might increase lung vulnerability to subsequent injurious mechanical or ischemia-reperfusion insults, thereby increasing the risk of clinical posttransplant graft failure.