孝感市社区居民脑卒中防治知信行现况调查分析

目的了解孝感市社区居民脑卒中防治知信行现状及相关影响因素,明确需要干预人群特点及干预重点,为开展社区脑卒中健康教育与健康促进干预提供依据。方法采取整群随机抽样方法,对孝感市6个乡镇社区居民1 420人进行脑卒中防治知信行现状调查。结果社区居民脑卒中防治相关知识总均分为28.43±6.79,总知晓率为39.47%,得分率由高到低依次为基础知识(42.26%)、诱发因素(39.36%)、危险因素识别(37.08%)、发病后急救处置知识(25.50%);脑卒中防治信念总均分为39.49±6.34,总得分率为62.68%,其中得分较低的为对脑卒中发病相关危险因素预防重要性的认识;防治行为总均分为37.46±6.47,总得分率为48.03%,其中相关疾病预防监测与治疗行为得分率不足50%。社区居民脑卒中防治知识、态度、行为互为影响(均P0.01)。结论社区居民脑卒中防治知识普遍缺乏,防治态度总体趋向积极,防治健康行为依从性较低。应针对居民知信行特点加大社区脑卒中健康教育和健康促进工作力度。     

5S管理改善山区居民卫生条件与健康知识知晓率的作用

目的分析5S管理改善贫困山区居民居住卫生条件及提高居民健康知识知晓率的效果。方法对贫困山区161户居民实施6个月的5S管理,包括整理、整顿、清扫、清洁、素养,比较5S管理前后居民居住的卫生条件及健康知识知晓情况。结果管理后,居民居住卫生条件显著优于管理前,居民健康知识知晓率显著高于实施前(均P0.01)。结论 5S管理有利于改善贫困山区居民居住卫生条件,提高居民健康知识知晓率。     

Impact of ‘soul mate service' on health-related knowledge and satisfaction in patients with coronary heart disease

目的 探讨知心护理服务干预对冠心病患者健康知识及满意度的影响.方法 将170例冠心病患者接收治病区分为对照组和干预组各85例.对照组利用健康教育宣传手册按照健康教育护理临床路径表对患者进行健康教育;干预组在此基础上,注重护士礼仪及专业知识培训,实施知心护理服务:包括设立知心小教员,利用知心小语吧及金色阳光俱乐部开展健康教育.分别于入院时、出院时、出院后3个月调查患者健康知识知晓情况,出院时调查患者满意率.结果 出院时及出院后3个月干预组患者冠心病健康教育知识知晓率显著高于对照组,干预组患者满意率显著高于对照组(P＜0.05,P＜0.01).结论 知心护理服务干预能提高患者冠心病相关知识的知晓率,同时可有效提高患者对护理工作的满意度.     

社区居民心肺复苏知识调查及其对策

采用自制问卷调查表对200名社区居民进行心肺复苏知识掌握情况调查,为进行健康教育提供参考。结果社区居民心肺复苏知识知晓率低,被调查者所在学校和社区未开展心肺复苏急救知识教育。提示社区居民缺乏心肺复苏知识,应对全民进行多层次、多样性的心肺复苏等急救知识的普及教育,以提高抢救成功率。     

网络互动式一级预防教育用于社区脑卒中高危人群效果观察

目的探讨网络互动式一级预防教育在社区脑卒中高危人群的实施效果。方法选取脑卒中高危患者110例随机分为对照组和观察组各55例。对照组进行常规健康教育,观察组在此基础上实施网络互动式一级预防健康教育6个月。结果干预后观察组健康知识知晓程度及遵医行为显著高于对照组(均P0.01)。结论网络互动式一级预防教育有助于患者积极参与,增加对脑卒中相关知识的了解,能有效提高脑卒中高危人群的遵医行为。     

社区公众心肺复苏急救知识的现状调查与培训

目的 了解社区公众对心肺复苏急救知识掌握的现状,寻求有效提高公众急救意识、应急能力的方法.方法 采用自制问卷对1 003名社区公众进行心肺复苏(CPR)急救知识现场调查,并由5名护理人员对该人群分批进行CPR急救知识培训,比较培训前后公众对CPR急救知识的知晓率.结果 培训后社区公众对CPR急救知识的知晓率显著高于培训前(均P<0.01).结论 社区公众CPR急救知识水平亟待提高.以社区为单位开展群众性CPR急救知识普及,可显著提高其CPR知识和技能,有利于社区公众应对突发公共卫生事件.     

医护人员共同参与临床健康教育的效果评价

目的 探讨医护共同参与健康教育的效果,为临床采取有效的健康教育提供依据.方法 将322例患者随机分为观察组(162例)和对照组(160例).观察组采用医护共同参与健康教育的模式对患者实施健康教育,对照组由管床护士负责实施健康教育.在患者出院前分别对两组患者健康知识的知晓程度进行评价,并对医护工作的满意度进行调查.结果 观察组患者健康知识掌握程度及对医护工作的满意度显著高于对照组(均P＜0.01).结论 医护人员共同参与健康教育,能有效提高患者学习健康知识的积极性,提高健康教育效果和患者对医护人员的满意度.     

合作学习模式培训对社区护士健康教育效果的影响

目的探讨合作学习模式培训对社区护士健康教育效果的影响。方法对39名社区护士采取以问题为基础、以学员为主体、以教师为引导的小组合作学习式模式培训96个学时,受训社区护士利用所学知识和方法对社区居民进行健康教育干预。比较培训前后社区护士对居民的健康教育效果。结果培训后社区居民常用健康评价指标、健康知识与健康行为评分较培训前显著提高,对社区健康教育护理服务的满意率显著提高(P0.05,P0.01)。结论合作学习模式为社区护士创设了主动参与的学习环境和教学情景,有利于社区护士健康教育能力的提高。     

四川省部分农村地区60～75岁老年女性生殖健康知识现状调查

目的了解四川农村老年女性生殖健康知识现状及其影响因素。方法用分层整群抽样方法抽取四川部分农村地区60~75岁老年女性,以8种常见的女性生殖系统良性疾病(宫颈炎、老年性阴道炎、盆腔炎、子宫脱垂、霉菌性阴道炎、生殖系统结核、老年性尿失禁、滴虫性阴道炎)和7种恶性疾病(乳腺癌、宫颈癌、子宫内膜癌、阴道癌、卵巢癌、外阴癌、输卵管癌)知晓者为衡量其对生殖健康相关知识知晓水平的指标,通过自制调查表进行流行病学调查。在描述性分析的基础上,采用多因素Logistic回归对数据进行分析,分析采用SPSS 13.0软件完成。结果受调查者1 010人,回收有效问卷988份,应答率97.8%。对于所调查的任一良性、恶性疾病均不知晓的调查对象分别为44.5%和39.9%。经多因素校正后,年龄、文化程度、职业是调查对象对相关疾病知晓的影响因素;本人可支配收入、婚姻状况分别是调查对象良、恶性疾病知晓的影响因素(P均0.05)。结论四川农村老年女性生殖健康知识缺乏,应加强相关宣教,提高该人群生殖健康认知,实现生殖健康老龄化。     

知心护理服务对冠心病患者健康知识及满意度的影响

目的探讨知心护理服务干预对冠心病患者健康知识及满意度的影响。方法将170例冠心病患者按收治病区分为对照组和干预组各85例。对照组利用健康教育宣传手册按照健康教育护理临床路径表对患者进行健康教育;干预组在此基础上,注重护士礼仪及专业知识培训,实施知心护理服务:包括设立知心小教员,利用知心小语吧及金色阳光俱乐部开展健康教育。分别于入院时、出院时、出院后3个月调查患者健康知识知晓情况,出院时调查患者满意率。结果出院时及出院后3个月干预组患者冠心病健康教育知识知晓率显著高于对照组,干预组患者满意率显著高于对照组(P<0.05,P<0.01)。结论知心护理服务干预能提高患者冠心病相关知识的知晓率,同时可有效提高患者对护理工作的满意度。     

Stroke Mimics and Chameleons from the Radiological Viewpoint of Glioma Diagnosis

Gliomas are sometimes difficult to differentiate from strokes and are often misdiagnosed on magnetic resonance imaging (MRI); thus, the terms “stroke mimics” and “stroke chameleons” have been introduced. In this study, we analyzed stroke mimics and stroke chameleons in glioma and discussed the diagnostic perplexity. We retrospectively reviewed cases that were removed from lesions that were considered to be brain tumors. This study enrolled 214 patients who underwent tumor resection for suspected glioma. Clinical characteristics and radiological findings of the patients were compared between the masquerade findings group, which was further divided into two groups: the stroke chameleons and stroke mimics according to their final diagnosis, and the intelligible findings group. Stroke chameleons and stroke mimics were significantly higher in age and smaller in lesion size than the intelligible findings group. In the multivariate analysis, the predictive factor of the masquerade finding group was higher age and smaller size. Stroke mimics group has a tendency to be higher rate of hyperintensity lesion on diffusion-weighted imaging (DWI) compared with stroke chameleons group. The average period from initial diagnosis to pathological diagnosis was 13.50 days in the stroke chameleons and 61.50 days in the stroke mimics, which proved significantly different. Proper diagnosis of glioma and stroke affects a patient’s prognosis, and should be diagnosed as soon as possible. However, stroke mimics and stroke chameleons caused by glioma can occur. Thus, the diagnosis of a stroke should take into consideration the possibility of a glioma in real clinical situations.     

每博量变异度指导围术期液体治疗的研究进展

每博量变异度（SVV）是液体管理的动态参数．基于全身麻醉机械通气的病人心和肺交互作用．并优于传统的静态指数（如CVP．PCWP等）。在机械通气下．SVV是计算一个呼暇循环的最大的每搏量（SVmax）与展小的每搏量（SVmin）之差值与每搏量平均值（SVmean）的比值．可预测心脏对容量负荷的反应以及与Frank-Starling曲线的关系。SVV近年来已作为指导围术期液体管理的重要方法应用在临床实践。SVV在预测补液反应中有较高的敏感性和特异性．但是仍有一些因素限制了其在临床实践的日常工作中的应用。     

他汀类药物预防治疗脑卒中的临床价值

他汀类药物在预防治疗脑卒中所展现出的良好疗效和潜力已得到了临床的普遍认可,本文结合他汀类药物在预防治疗脑卒中的临床应用研究现状,对其预防治疗脑卒中的作用机制、安全用药、应用前景等方面进行综述。     

Photothermal properties of shape memory polymer micro-actuators for treating stroke

BACKGROUND AND OBJECTIVES: In this paper the photothermal engineering issues of novel shape memory polymer (SMP) microactuators for treating stroke are presented. The engineering issues for using lasers to heat and subsequently actuate these SMP devices are presented in order to provide design criteria and guidelines for intravascular, laser activated SMP devices. MATERIALS AND METHODS: A total of three devices will be presented: two interventional ischemic stroke devices (coil and umbrella) and one device for releasing embolic coils (microgripper). The optical properties of SMP, methods for coupling laser light into SMP, heating distributions in the SMP devices, and the impact of operating the thermally activated material in a blood vessel are presented. RESULTS: Actuating the devices requires device temperatures in the range of 65-85 degrees C. Attaining these temperatures under flow conditions requires critical engineering of the SMP optical properties, optical coupling into the SMP, and device geometries. CONCLUSION: Laser-activated SMP devices are a unique combination of laser-tissue and biomaterial technologies. Successful deployment of the microactuator requires well-engineered coupling of the light from the diffusing fiber through the blood into the SMP.     

Heat stroke—an uncommon presentation

A case of heat stroke is reported in which there was a delayed diagnosis and a fatal outcome. Recent literature is reviewed.     

Successful intra-arterial thrombolytic therapy for a right middle cerebral artery stroke in a 2-year-old supported by a ventricular assist device

Embolic stroke is a common complication in patients on ventricular assist devices in both adults and children. The reported incidence of strokes in children supported by VAD's varies from 7 to 38%. The rapid increase in recent years in the availability of both adult and pediatric VADs will likely add to the overall prevalence of strokes in patients being bridged to heart transplant. Strokes in this population can be lethal as they frequently necessitate withdrawal of the extracorporeal device support and withdrawal from the organ transplant waiting list. We present a case of a fully anti-coagulated 29-month-old supported on a Berlin EXCOR LVAD (Berlin, Germany) with embolic stroke which was treated successfully with direct thrombolysis with recombinant tissue plasminogen activator. This is the first report which uses intra-arterial thrombolytics while on a ventricular assist device in a pediatric patient.