3+1整体康复护理模式对老年痴呆患者认知功能的影响

目的 探讨3+1整体康复护理模式对老年血管性痴呆患者疗效及认知功能的影响.方法 选择2008年1月至2010年12月广州某老人院收治的老年痴呆患者240例,随机分为对照组和观察组,对照组采用常规药物治疗及护理,观察组使用常规药物治疗及3+1整体康复护理.2组患者治疗前后进行MMSE、ADL、MS评分.结果 观察组治疗后的MMSE、MS和ADL评分明显好于对照组.结论 3+1整体康复护理能够有效提高痴呆患者治疗效果,改善患者的认知功能,对提高患者的生活质量具有十分重要意义.

Abstract：

Objective To study the effect of 3+1 rehabilitation nursing mode on treatment effect and cognitive function of dementia patients. Methods Two hundreds and forty cases of dementia patients were randomly divided into the observation group and the control group with 120 cases in each group. The observation group were treated with routing therapy and 3+1 nursing mode and the control group with routine therapy and nursing. Mini-mental state examination(MMSE), and main symptoms (MS) scales,activity of daily living (ADL) scale were used for assessment of symptoms and signs before and after nursing. Results Changes of scores for MMSE, MS and ADL before and after rehabilitation nursing had statistical differences in the two groups. Conclusions The 3+1 nursing mode can improve the effect on cognitive function of dementia patients.     

Nested case-control study of multiple serological indexes and Brighton pediatric early warming score in predicting death of children with sepsis

BACKGROUND Currently, it is difficult to predict the complications of children at the early stage of sepsis. Brighton pediatric early warning score(PEWS) is a disease risk assessment system that is simple and easy to operate, which has good sensitivity and specificity in disease recognition among children. Because detection indicators vary widely in children, a single indicator is difficult to assess the posttreatment status of children with sepsis.AIM To investigate the relationship between serological markers, Brighton PEWS, and death in children with sepsis after treatment.METHODS A total of 205 children diagnosed with sepsis at our hospital were enrolled. The baseline data, serum scores, and PEWS scores were recorded. In the nested casecontrol study, children who died during the study period were included in an observation group. According to the matching principle, the children who were not dead in the same cohort were included in a control group. The influencing factors of death in children with sepsis after treatment and the value of each evaluation index in predicting the prognosis of children were analyzed.RESULTS A total of 96 children were enrolled in the study, including 48 each in the observation group and the control group. Multivariate logistic regression analysis indicated that antibacterial treatments within 1 h(P = 0.017), shock(P = 0.044),multiple organ dysfunction syndrome(MODS)(P = 0.027), serum procalcitonin(PCT)(P = 0.047), serum albumin(ALB)(P = 0.024), and PEWS(P = 0.012) were independent risk factors for the death of children with sepsis. The area under the curve of the combination of ALB, PCT, and PEWS to predict the death in children with sepsis was the highest(0.908).CONCLUSION Antibacterial treatments within 1 h, shock, MODS, PCT, ALB, and PEWS are independent risk factors for the death of children with sepsis. The predictive accuracy of the combination of PCT, ALB, and PEWS for the prognosis of children with sepsis is the best.     

极低出生体重儿持续气道正压通气联合药物雾化的效果研究

目的 探讨极低出生体重儿呼吸暂停持续气道正压通气联合药物雾化的效果.方法 将56例同期入院的极低出生体重儿伴发呼吸暂停随机分为两组,观察组28例,施行持续气道正压通气时及2 h后,给予药物雾化;对照组28例,按常规持续气道正压通气.结果 观察组鼻咽部干燥症状、管道堵塞发生数、痰液黏稠度显著低于对照组(P值均<0.01),观察组持续气道正压通气时间与对照组相比明显缩短,呼吸暂停发生数、并发症发生率观察组少于对照组(P值均<0.01).结论 极低出生体重儿持续气道正压通气联合药物雾化,有效减少呼吸暂停的发生次数,减低并发症发生率,提高存活质量.

Abstract：

Objective To investigate the effect of continuous positive airway pressure combined with atomizing inhalation on very low birth weight infants who were apnea.Methods A total of 56 infant patients with apnea were involved in this study and divided into two groups.Observation group consist of 28 cases and were treated with continuous positive airway pressure and atomizing inhalation 2 hours later;Control group consist of 28 cases and were treated with continuous positive airway pressure.Results The symptoms of nasopharyngeal dry, the number of pipe blocking and the sputum viscosity was significantly in observation group lower than that in control group (P all<0.01), the time of observation group's continuous positive airway pressure ventilation was significantly shorter than that of control group;Observation group had lower incidence of apnea and complications than control group. (P all<0.01).Conclusions The method of continuous positive airway pressure combined with atomizing inhalation may effectively reduce incidence of apnea and complications and improve the life quality.     

护理干预对宫颈癌患者放疗后并发症的影响

Objective To investigate the nursing intervention on the complication after radiotherapy of cervical cancer patients.Methods A total of 130 cervical cancer patients undergoing radiotherapy were randomly divided into two groups:control group was given conventional methods only treatment and care,while the observation group was given additional routine treatment and care according to the situation in which two radiation therapy in patients with stages of psychological nursing,health education,guidance,individualized care and symptomatic treatment intervention,and then the number of cases of complications for the patients as well as the degree of satisfaction were compared.Results After the first phase of the second phase,the incidence of complications was significantiy lower in observation group than that of the control group,the degree of satisfaction was significantly higher (P＜0.05) .Conclusions The implementation of nursing intervention for cervical cancer patients undergoing radiotherapy can be effective in reducing the incidence of complications and improve patients' satisfaction.     

健康教育对乙肝患者抑郁心理及治疗依从性的影响

目的 探讨健康教育对慢性乙型肝炎患者心理状态及治疗依从性的影响.方法 将148例慢性乙型肝炎患者随机分为观察组和对照组各74例.对照组采用常规护理,观察组在此基础上实施健康教育.采用SDS比较2组患者抑郁发生情况,自行设计调查问卷比较患者的治疗依从性.结果 1年后,观察组抑郁发生率及SDS得分显著低于对照组;观察组治疗依从性显著高于对照 组.结论 健康教育可降低慢性乙肝患者抑郁发生率,改善其心理状态,提高治疗依从性,从而提高乙肝患者的生活质量.

Abstract：

Objective To study the impact of health education on the depression state and compliance of patients with chronic hepatitis B. Methods 148 patients were randomly divided into the observation group and the control group with 74 patients in each group. Conventional nursing care was taken in the control group and the health education was applied based on conventional nursing care in the observation group. The SDS was used to compare the occurrence of depression of the patients and the self-designed questionnaire was used to compare treatment compliance. Results After 1 year, the incidence of depression and SDS score were significantly lower in the observation group. The treatment compliance of the observation group was significantly higher than the control group. Conclusions The health education canreduce depression state, improve mental state, the treatment compliance and quality of life of patients with chronic hepatitis B.     

人性化管理在妇产科手术室护理管理中的应用观察研究

Objective To discuss the value of humanized management application in obstetrics and gynecology operating room nursing management. Methods 200 cases of patients admitted to the department of obstetrics and Gynecology of our hospital in the operating room as the research objective, divided into observation group, reference group by parity method, humanized management application in the observation group, routine operating room nursing management application in the reference group, compare the nursing data of the two groups. Results The rate of nurse-patient dispute in the operation room of the observation group was lower than that of the reference group, and the total incidence of complications was also lower than that of the reference group, which was significant (P＜0.05). Compared with the reference group, all nursing quality scores in the observation group were significantly higher (P＜0.05). The total nursing satisfaction in the observation group was significantly higher than that in the reference group (P＜0.05). Conclusion The application of humanized management in obstetrics and gynecology operating room nursing management, help to improve patient nursing satisfaction, and reduce the incidence of complications, reduce the incidence of nurse-patient disputes, improve the quality of nursing, improve the quality of life of patients, has clinical application value.     

护理干预对脑梗死患者疗效及便秘症状的影响

目的 观察护理干预对脑梗死患者疗效及便秘症状的影响.方法 2009年10月至2010年10月,将我院98例脑梗死患者随机分为对照组和观察组各49例,对照组采用常规护理方法,观察组采用护理干预,比较观察2组的疗效和便秘症状变化.结果 2组治疗后ADL疗效评分明显升高,与治疗前比较差异显著.并且,观察组治疗后ADL疗效评分明显高于同期对照组.观察组排便困难、粪便性状、下坠感、排便频度和腹胀评分明显低于对照组.结论 对脑梗死患者实施护理干预,可明显改善患者的日常生活活动能力,提高临床疗效,改善便秘症状,值得临床参考应用.

Abstract：

Objective To observe the effect of nursing intervention on treatment effect and constipation symptoms of patients with brain infarction. Methods From October 2009 to October 2010, 98 cases patients with brain infarction were randomly classified into the control group and the observation group with 49 cases in each group. The control group was treated with normal nursing and the observation group received nursing intervention. The effect and the changes of constipation symptoms between the two groups were compared. Results Compared with pre-nursing, the scores of ADL in two groups were significantly improved after nursing. Moreover, the scores of ADL in the observation group were significantly higher than those in the control group. The scores of difficult defecation, characteristics of feces, feeling of bearing down was lower than those of the control group. Conclusions Nursing intervention for patients with brain infarction can improve the clinical effect and constipation symptoms, which can be applied in clinic.     

换瓣术后急性肾功能衰竭患者无抗凝剂行连续性静脉-静脉血液滤过治疗的护理

目的 探讨换瓣术后急性肾功能衰竭患者无抗凝剂行连续性静脉-静脉血液滤过 (CVVH)治疗的护理.方法 对28例心脏直视换瓣术后并发急性肾功能衰竭(ARF)的患者实施无抗凝剂CVVH治疗138例次,治疗过程中密切观察滤器和管道的血凝情况、采用定时冲洗管路等护理措施.结果 本组治疗138例次,滤器寿命3.5～24 h,多数为10～13 h,连续治疗者每天更换1～2套滤器及管路;1例在连续4次治疗中机械反复出现低压动脉报警,造成滤及管路在3.5～7 h凝血而更换滤器及管路,2例病人出现皮下出血点,1例病人出现血便.结论 对换瓣术后ARF的患者进行CVVH无抗凝剂治疗,结合相应护理措施,能使治疗能顺利完成,减小患者出血并发症.

Abstract：

Objective To study the observation and nursing with continuous veno- venous hemofiltration (CVVH) without anticoagulation therapy in acute renal failure after valve surgery.Methods During the treatment with 138 times of non-anticoagulant CVVH in open heart valve replacement surgery with concurrent acute renal failure (ARF) in 28 cases, the condition variation, filters and piping clotting conditions were closely observed, and regular flushing piping and other nursing measures were taken.Results In the treatment of 138 times, filter life was 3.5 ～ 24 h, 10 ～ 13 h in the majority; continuous treatment replaced 1 to 2 sets of filters and pipes one day; one case of 4 times treatment in a row occurred recurrent mechanical alarm of hypotension, causing coagulation in filters and pipes in 3.5 ～ 7 h and replacement of filters and pipes; 2 patients occurred subcutaneous bleeding, and 1 patient had bloody stools.Conclusions In the patients with ARF after valve surgery, CVVH without anticoagulation therapy, combined with the appropriate care measures, can make the successful completion of treatment and reduce bleeding complications in patients.     

以家庭为中心的健康教育在肿瘤患者放射治疗中的应用

目的 探讨健康教育在肿瘤患者放射治疗中的实施及效果.方法 选择接受放射治疗的肿瘤患者160例,随机分为观察组(80例)和对照组(80例).观察组遵循以家庭为中心的健康教育模式;对照组按常规方法进行健康教育.结果 观察组患者健康知识技能的掌握情况、放射反应程度、患者家属满意度明显优于对照组(P<0.05);观察组患者治疗过程中出现中、重度放疗反应的人数、医院感染的发生率及放疗的天数明显少于对照组(P<0.05).结论 实施以家庭为中心的健康教育路径能够提高健康教育的效果、减轻放疗反应、提高满意度和患者的生活质量.

Abstract：

Objective To explorer the effect of health education on tumor patients during radiotherapy .Methods A total of160 tumor patients who accepted radiotherapy were randomly divided into observation group (80 cases) and control group (80 cases). The patients in observation group were treated with family-centered health education and routine health education was performed in control group.Results The awareness of health knowledge and skills, the extent of radiation reaction and the satisfaction degree of patients' family member in observation group were better than in control group (P<0.05); and the patients' number of middle and serious radiation reaction, the incidence rate of hospital infection and days of taking radiotherapy in observation group were less than in control group (P<0.05).Conclusions To practice family-centered health education could raise the effect, relieve the radiation reaction, elevate satisfaction degree and life quality of patients.     

护理干预对艾滋病患者亲属照顾者不良心理行为表现的影响

Objective To investigate mining intervention's influence on relative caregivers of AIDS patients with adverse psychological reactions and behavior. Methods Sixty five cases with advene psychological reactions and behavior of the relative caregivers of AIDS patients in hospital were selected and randomly divided into control group 30 cases and observation group 35 cases. Relative caregivers of patients in control group were given routine nursing care, while nursing interventions were added in observation group, the two groups of caregivera' adverse psychological reactions and behavior were observed. Results The patients relative caregiven in observation group with advene psychological reactions and behavior were significantly reduced compared with the control group. The difference was statistically significant (P＜0.01) . Conclusions Nursing intervention can reduce advene psychological reactions and behavior of relative caregivers of AIDS patients, and play a active role to them.     

持续高流量血液滤过对重症急性胰腺炎猪炎症反应的影响

目的探讨高流量持续血液滤过对重症急性胰腺炎(SAP)时炎症反应的影响。方法采用胰管内高压力注射牛磺胆酸钠和胰蛋白酶的方法诱导猪SAP模型。将SAP模型动物随机分为3组,每组8只:对照组只行常规支持治疗;低流量持续性静静脉血液滤过(CVVH)组除常规支持治疗外,模型诱导成功后立即行低流量(20 m l.kg-1.h-1)CVVH;高流量CVVH组模型诱导成功后立即行高流量(100 m l.k-g 1.-h 1)CVVH以及常规支持治疗。于SAP诱导前和诱导成功后6、12、24和36 h间断测定血浆肿瘤坏死因子α(TNFα)、白细胞介素6(IL 6)和IL 10含量,于SAP诱导后6、12和24 h测定外周血中单核细胞核转录因子κB(NFκB)活性。结果对照组平均生存时间为41 h,低流量CVVH组平均生存时间为50 h,高流量CVVH组平均生存时间为65 h。早期行CVVH治疗动物生存时间均显著高于对照组(P<0.05和P<0.01),高流量CVVH组的生存时间明显高于低流量CVVH组(P<0.05)。CVVH治疗后TNFα、IL 6和IL 10均较对照组显著降低,高流量CVVH组的TNFα、IL 6和IL 10含量均显著低于低流量CVVH组。两个CVVH组动物的外周血单核细胞NFκB活性在6、12和24 h均显著低于对照组,高流量CVVH组更低。结论早期CVVH能改善SAP猪过度的炎症反应,明显延长生存时间,改善预后,而且高流量CVVH的效果明显优于低流量CVVH。     

连续性血液滤过对重症急性胰腺炎诱发组织器官损害的保护作用

目的　探讨连续性静静脉血液滤过 (CVVH)对重症急性胰腺炎 (SAP)诱发组织器官损害的保护作用。方法　 37例 SAP患者随机分为 CVVH治疗组 (2 2例 )和对照组 (15例 )。对照组采用常规综合治疗方法 ,CVVH治疗组在常规综合治疗的同时进行 CVVH治疗。两组均同时监测血内毒素、肿瘤坏死因子 α(TNFα)、白介素 1β(IL 1β)、C 反应蛋白 (CRP)及淀粉酶 (AMS)、脂肪酶 (L ip)水平 ,并进行血、尿液和滤出液的常规检查 ,同时观察肺、肝、肾、心和脑等脏器功能。结果　 CVVH治疗组对脏器组织的保护作用优于对照组 ,可改善体内炎症状态 ,病死率 (18.2 % )较对照组 (33.3% )低 (P <0 .0 5 ) ,平均住院时间为 (18.3±5 .7) d,亦短于对照组 (2 7.5± 8.6 ) d。结论　 CVVH对 SAP诱发的组织器官的损害具有保护作用。     

持续静脉-静脉血液滤过治疗重症急性胰腺炎的护理

目的总结24例重症急性胰腺炎(SAP)患者行持续静脉-静脉血液滤过(CVVH)的护理体会。方法对24例SAP患者在行CVVH过程中的心理变化、生命体征、血滤机参数及治疗并发症进行观察及护理。结果在治疗过程中监测血液生化指标和尿量,均能平稳清除多余水分和毒素,维持水、电解质和酸碱平衡,为SAP的救治提供了有效的支持。结论CVVH治疗SAP的重点是做好患者的心理护理,严密观察生命体征,注意监测血滤机参数,加强管路护理,预防CVVH的并发症等。     

连续性和反复间断血液滤过治疗重症急性胰腺炎的临床价值

目的：研究早期连续性静脉-静脉血液滤过和反复间断静脉一静脉血滤治疗重症急性胰腺炎的临床价值。方法：45例SAP患者随机分为CVVH组（25例）和RIVVH组（20例）。比较2组患者的生命体征、生化指标、治疗前后的APACHEⅡ评分、死亡率、好转率。结果：CVVH组中3例死于MODS,死亡率为12%,RIVVH组死亡3例（15%）,其差异有统计学意义（P〈0.05）;CVVH组好转率为80%（20/25）,与RIVVH组的80%（16/20）一致。在治疗的早期阶段,对于改善生命体征,降低APACHEⅡ评分CVVH效果更显注,但随着治疗时间的延长,这种差异逐渐变小,在后期两组间不再存在疗效差异,最终疗效上没有明显的差异,而RIVVH组,在治疗费用和人员成本上具有优势。结论：早期RIVVH治疗SAP可以作为SAP重要的辅助治疗措施。     

脉冲式高容量血液滤过治疗重症急性胰腺炎的疗效分析

目的 对脉冲式高容量血液滤过(PHVHF)与连续性血液滤过(CVVH)治疗重症急性胰腺炎(SAP)的疗效进行比较分析.方法 2005年1月至2009年12月收住苏州大学附属第四医院的38例SAP患者常规治疗的同时,72 h内随机(随机数字法)接受PHVHF或CVVH治疗,分别为18例及20例,血滤72 h后观察两组治疗前后临床症状,急性生理学及慢性健康状况评价Ⅱ(APACHEⅡ)评分,生化指标的改变及死亡率.ELISA法检测治疗前后血浆TNF-α,IL-6,IL-10水平.观察休克患者多巴胺的使用量.计量资料使用均数±标准差((-x)±s),采用t检验分析相关指标,P＜0.05有统计学意义.结果 治疗后两组症状明显改善,APACHEⅡ评分、血清淀粉酶、肌酐、白细胞均有下降(P＜0.05),低氧血症、酸中毒纠正,在心率、呼吸、APACHE Ⅱ评分方面差异具有统计学意义(P＜0.05).两组患者治疗后TNF-α,IL-6,IL-10均有显著性下降(P＜0.05),PHVHF组优于CVVH组(P＜0.01).两组休克患者多巴胺使用量均明显下降(P＜0.01),PHVH组下降更明显(P＜0.05).PHVHF组死亡率为11.1%,CVVH组为25%.结论 PHVHF治疗SAP效果显著,明显优于CVVH组,它能有效降低炎症因子水平,维持血流动力学,降低死亡率,故可以作为SAP的重要辅助治疗.     

益生菌联合早期肠内营养在重症急性胰腺炎中的应用

目的探讨益生菌联合早期肠内营养在重症急性胰腺炎(SAP)患者中的应用效果。方法选取我院2017年1月至2019年1月76例SAP患者为研究对象,按照随机对照的原则均等分为对照组和观察组,对照组给予肠外营养,观察组在对照组基础上实施益生菌联合早期肠内营养方法,比较两组治疗前后营养状况、肠黏膜屏障功能和临床效果。结果治疗后2周,观察组血清中血清白蛋白(ALB)、转铁蛋白(TRF)、血淀粉酶(AMY)以及前白蛋白(PA)指标显著优于对照组,差异有统计学意义(P<0.05);观察组血清中DAO,TNF-α,D-乳酸指标明显优于对照组(P<0.05);观察组禁食天数、感染消退时间、手术率均明显低于对照组(P<0.05)。结论益生菌联合早期肠内营养在SAP患者中应用,不仅有效改善营养状况,提高肠黏膜屏障免疫功能,而且降低了并发症产生率。     

脉冲式高容量血液滤过与连续性血液滤过治疗重症急性胰腺炎的疗效比较

目的:比较脉冲式高容量血液滤过(PHVHF)与连续性血液滤过(CVVH)治疗重症急性胰腺炎(SAP)的疗效。方法:38例SAP患者随机接受PHVHF或CVVH治疗,分别为18例及20例,血滤72h后观察两组治疗前后临床症状,急性生理学及慢性健康状况评价Ⅱ(APACHEⅡ)评分,生化指标的改变及病死率。结果:治疗后两组症状明显改善,APACHEⅡ评分、血清淀粉酶、肝功能、血肌酐、白细胞和CRP均有下降(P<0.05)。低氧血症,酸中毒纠正,PHVHF组优于CVVH组,在心率、呼吸、肝功能、APACHEⅡ评分方面差异显著(P<0.05)。PHVHF组病死率为11.1%,CVVH组为25%。结论:PHVHF治疗SAP效果显著,明显优于CVVH组,可以作为SAP的重要辅助治疗。     

持续静脉-静脉血液滤过联合血液灌流在重症脓毒血症患者治疗中对炎性因子及器官功能的影响

目的：研究持续静脉-静脉血液滤过（CVVH）联合血液灌流治疗对炎性因子及器官功能的影响。方法将重症脓毒血症患者81例随机分为观察组41例和对照组40例,对照组给予常规治疗方法及CVVH治疗,观察组在对照组治疗基础上给予血液灌流治疗。观察两组患者治疗前后生命体征、炎症因子水平、脏器功能及急性生理学与慢性健康状况（APACHEⅡ）评分和全身性感染相关性器官功能衰竭（SOFA）评分的变化。结果两组治疗后呼吸、心率均低于治疗前,平均动脉压高于治疗前,差异均有统计学意义（t分别=7.99、11.81、9.43;4.77、4.04、5.33;P均＜0.05）,且观察组治疗后优于对照组治疗后,差异均有统计学意义（t分别=15.99、15.81、4.43,P均＜0.05）。两组治疗后肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、IL-10、丙氨酸氨基转移酶（ALT）、血肌酐（SCR）水平,以及APACHEⅡ评分、SOFA评分均低于治疗前,差异均有统计学意义（t分别=6.79、13.84、12.41、12.29、14.48、21.41、13.33;7.67、7.04、10.39、7.03、7.77、12.39、12.21,P均＜0.05）;且观察组治疗后低于对照组治疗后,差异均有统计学意义（t分别=30.89、25.11、14.93、26.11、20.89、13.66、14.93,P均＜0.05）。结论 CVVH联合血液灌流可有效清除重症脓毒血症患者血液中多种炎性介质,有助于脏器功能的保护。     

连续性静静脉血液滤过治疗重症急性胰腺炎的监护

目的探讨连续性静静脉血液滤过(CVVH)治疗重症急性胰腺炎的护理方法及生命体征监护的意义。方法对14例重症急性胰腺炎患者CVVH治疗前后体温、呼吸、心率、平均动脉压、中心静脉压(CVP)、指末氧饱和度(SpO2)的变化及影响CVVH正常运转的因素进行观察。结果CVVH治疗后,重症急性胰腺炎患者体温、呼吸、心率、平均动脉压、CVP均下降,SpO2上升,血流动力学稳定。结论重症急性胰腺炎患者采用CVVH治疗后,临床症状得到有效的缓解;治疗中应严密监护患者的生命体征,对指导CVVH参数设定起着关键作用。     

脉搏轮廓连续心排量监测指导下的液体复苏联合肠内营养在重症急性胰腺炎中的应用研究

目的 探讨脉搏轮廓连续心排量监测(PiCCO)指导下的液体复苏联合肠内营养治疗重症急性胰腺炎(SAP)的临床价值.方法 选择2015年6月至2019年6月SAP患者120例,按照是否进行肠内营养分为观察组和对照组各60例.对照组进行PiCCO指导下的液体复苏,观察组在此基础上联用肠内营养,检测干预前后评估营养状况和炎症...