结肠造口病人恢复期的护理目标

分析结肠造口病人恢复期的护理问题，找出相关因素，确定具体的护理目标，并针对性地提出７方面的护理对策：①造口护理教育；②减轻疼痛；③预防切口感染；④保护造口周围皮肤；⑤观察造口并发症；⑥恢复造口者自尊；⑦饮食指导。帮助患者提高术后的生存质量。     

Miles术结肠造口并发症的护理

回顾总结47例Miles术后结肠造口并发症病人的护理.结果发生并发症8例,发生率为17.02%,其中造口缺血坏死1例,肠造口皮肤粘膜分离2例,造口周围皮炎5例.经治疗及护理,无1例再次手术.提示结肠造口并发症的预防不仅有赖于手术者的手术处理,同时应加强手术后造口的护理管理;教会病人正确使用造口袋,减少造口并发症的发生.     

结肠造口并发症分析

目的探讨结肠造口方式与造口并发症之间的关系。方法回顾性总结385例行结肠造口患者的临床资料,分析造口类型、造口途径等因素对造口并发症的影响。结果 385例结肠造口中有158例(41.0%)出现226个造口并发症。襻式造口与端式造口相比,局部肠坏死率低,但早期皮肤刺激发生率高,后期肠脱垂和造口旁疝的发生率高。端式造口通过腹膜外隧道可有效减少并发症的发生率。结论结肠造口并发症有较高的发生率,与造口类型、造口途径有密切关系。     

结肠造口患者肠道准备方法

目的探讨结肠造口患者有效的肠道准备方法，提高工作效率。方法对40例结肠造口患者实施口服泻药的同时在造口袋内进行清洁灌肠。结果40例结肠造口患者均饮完复方聚乙二醇4000口服溶液用粉后无不良反应，灌肠过程中无1例患者出现腹痛、腹胀及肠穿孔，肠道清洁度达100％。结论口服泻药的同时在造口袋内进行清洁灌肠可减轻患者的痛苦，提高工作效率。     

Miles直肠癌根治术结肠造口的围术期护理

目的探讨Miles直肠癌根治术永久性结肠造口的围术期综合护理体会。方法对126例Miles直肠癌根治术永久性结肠造口患者实施心理、预防造口术并发症、健康教育等综合护理措施。结果本组126例直肠癌患者均顺利完成Miles手术,术后发生造口并发症11例(8.73%),经对症处理后均获痊愈。结论对Miles直肠癌根治术永久性结肠造口患者实围术期综合护理及做好健康教育等措施,可有效减少并发症发生率,提高生活质量。     

结肠造口护理的体会

结肠造口包括临时造口及永久性人工肛门两种，是某些病变救治的重要手段。LockartMummery早在1917年即提出造口的护理叫，然而由于临床上仅注意手术技术及术后并发症的防治，造口护理未受到重视。随着医学科学的不断发展，结、直肠     

特殊肠造口患者造口袋更换方法的改进

目的改进造口袋更换方法,以提高回肠造口、襻式造口和水肿造口三类特殊造口患者的维护效果。方法将行临时性或永久性肠造口术患者77例随机分为对照组39例和观察组38例。对照组采取常规方法更换造口袋,观察组采取改进方法更换造口袋,即调整涂抹防漏膏、套入造口袋和清洁皮肤的顺序。比较两组术后9 d内粪水性皮炎发生率、造口底盘渗漏率和造口袋更换用时。结果观察组术后9 d内粪水性皮炎发生率显著低于对照组,术后第3天和第6天造口底盘渗漏发生率显著低于对照组(均P0.05),但观察组术后第1天、第3天和第6天造口袋更换时间显著长于对照组(均P0.01)。结论采取改进的造口袋更换方法对特殊造口进行维护,有利于减少造口底盘渗漏,降低粪水性皮炎的发生。     

小儿结肠造口及其并发症

１８２例小儿结肠造口术后并发症７８例，新生儿期造口，结肠穿孔腹膜炎和造口闭合一期开放病例的并发症显著增高。１３３例造口闭合术后并发症３７例，强调造口原则和规范操作。     

以家庭为中心护理模式在造口患儿中的应用研究

目的探讨以家庭为中心护理模式在造口患儿护理中的应用效果。方法将67例肠造口患儿按时间段分为对照组(34例)和观察组(33例),对照组按照常规方法护理,观察组采取以家庭为中心护理模式,包括心理护理和人文关怀,鼓励照护者参与全程护理,多途径的健康教育,建立出院指导标准。比较两组患儿术后住院时间,造口周围皮肤情况,以及家庭造口护理能力。结果观察组术后住院时间显著短于对照组(P0.01),造口周围皮肤情况显著优于对照组(P0.01),家庭造口护理能力4个维度及总分显著高于对照组(P0.05,P0.01)。结论以家庭为中心护理模式可有效改善患儿造口周围皮肤问题,缩短患儿术后住院时间,提高家庭造口护理能力。     

预防性护理减少坠积性肺炎发生的临床观察

目的预防性护理对临床长期卧床患者坠积性肺炎发生率的效果。方法采用前瞻性研究方法,收集2016年5月到2016年11月的75例长期卧床(入院时间2个月)的住院患者,分为预防护理组(纳入病例38例)和常规护理组(纳入病例38例)。预防护理组采用交常规护理更积极的护理,主要包括增加依从性的专人护理监督、预防饮食呛咳和加强口腔护理。结果预防性护理组35例完成项目,常规护理组完成研究34例。预防性护理组5例(14.29%)、常规护理组有8例(23.53%)发现坠积性肺炎发生,两组比较,差异没有统计学意义(X~2=0.964,P=0.326);预防性护理组的依从性高于常规护理组(74.28%vs 50.00%,X~2=,P=0.037);预防性护理组的满意度明显优于常规护理组(91.43%vs 70.59%,X~2=4.899,P=0.027)。结论预防性护理提高护士的工作依从性,增加患者满意度;但是否减少长期卧床患者坠积性肺炎的发生尚需要更多病例观察。     

The comparison between experimental nursing and routine nursing interventions on the quality of life of stoma patients: A systematic review and meta-analysis

The advance in nursing care for stoma patients is a challenging issue, which will influence the life quality. The quality of life is a major issue in the recovery of stoma patients. The evidence of experimental nursing has not been explored enough. A systematic search and a meta-analysis were performed for the studies of experimental nursing interventions versus routine warming interventions on patients with a stoma. The comparisons between nursing interventions were performed to find which kind of intervention will be superior in improving life quality. After a restricted selection, 10 studies, 460 subjects with experimental nursing intervention, and 478 controls with the routine nursing intervention were enrolled in a variety of causes of the stoma. The focused outcome was the quality of life. The meta-analysis was performed by Review Manager 5.4. Among the stoma patients, the meta-analysis favours the experimental nursing intervention group with higher scores of life quality when compared to the routine nursing intervention group. The meta-analysis results were with positive mean differences, significant tests for overall effect, and significant heterogeneities in the random-effects model. The experimental nursing intervention showed higher positive effects on the quality of life when compared to routine nursing intervention for stoma patients. Experimental nursing intervention might be an option for stoma nursing practitioners to improve stoma care.     

优化急诊护理流程对急性心肌梗死患者抢救效果的影响

目的在急性心肌梗死患者的抢救过程中,优化抢救过程中的急诊护理流程,分析取得的抢救效果。方法从2011～2012年这两年间入院抢救的急性心肌梗死患者中各抽取100例患者。2011年的100例患者作为对照组,2012的100例患者作为观察组。我院在2012年优化了急诊的护理流程,所以对照组采用的是常规的急诊护理程序,而观察组则采用的是优化后的急诊护理流程。抢救结束后,比较两组患者的抢救效果。结果观察组的抢救时间,急诊球囊的扩张时间比对照组要短,观察组住院期间的急性心肌梗死的复发率要比对照组的低（P〈0.05）。两组的住院时间相当,差异无统计学意义（P〉0.05）。结论对于急诊护理流程进行优化后,提高了急性心肌梗死患者的抢救效果,抢救时间缩短,使抢救成功率大大增加,值得推广应用。     

ICU机械通气患者早期阶段性康复护理程序的实施

目的探讨ICU机械通气患者早期康复护理程序的建立及实施效果。方法将机械通气患者随机分成干预组(28例)与对照组(26例)。对照组患者给予呼吸机集束化护理干预,定时翻身、拍背、排痰等基础护理;干预组在此基础护理上经多学科协作评估,应用早期阶段性康复护理程序,比较两组干预效果。结果干预后干预组Barthel指数、握力显著优于对照组,机械通气时间、ICU住院时间显著短于对照组,一次脱机成功率显著高于对照组(P0.05,P0.01)。结论实施早期阶段性康复护理程序,能显著缩短ICU患者机械通气时间,提高一次性脱机成功率,帮助患者恢复肌力,促进康复。     

The use of an ileostomy connector to diminish the frequency of defecation prior to ileostomy closure in patients with a pelvic pouch

A new method for allowing stool passage into the pelvic pouch before ileostomy closure to verify the defecation state and diminish stool frequency is reported herein. This was accomplished by fitting an ileostomy connector connecting the proximal and distal openings of the diverting loop stoma. The ileostomy connector was initially in place for 6 h a day, the length of time being gradually increased until it was able to be left in for 24 h a day over a 3-month period. The calculated daily frequency of stools decreased from 24 to 6 or 7 times, and the mean daily frequency immediately after ileostomy closure was 6.5 times. Physiological study also showed an improvement, with squeeze pressure increasing from 35 cmH₂O to 116 cmH₂O and the maximum tolerated volume increasing from 35 ml before, to 90 ml 3 months following the use of an ileostomy connector. Thus, we conclude that an ileostomy connector may be useful to predict postoperative functional outcome and its complications, and to diminish the frequency of defecation before ileostomy closure in patients with a covering loop stoma.This study was submitted as a poster presentation at the meeting of the XIVth Biennial Congress of the University of Colon and Rectal Surgeons in Creta, Greece, October 25–29, 1992.     

导管护理标准化程序的建立及临床应用

目的提升导管护理质量,减少意外拔管,保证患者安全。方法导管小组在对全院各病区带有导管的患者进行横断面调研的基础上,制定29种导管的临床护理操作规范,并完善导管各种规章制度及交接流程、制定转运过程中导管的处理原则。结果导管标准化程序建立后,各种导管非计划拔管发生数由2012年的35例次降至2013年的16例次。2013年导管固定规范率、标识规范使用率,护理人员对意外拔管紧急处理掌握合格率,首次置管护理文件书写记录合格率,患者对导管自护知识知晓合格率显著高于2012年(P0.05,P0.01)。结论导管标准化程序的建立提高了临床护理人员导管护理规范性,提升护理人员护理各种导管的能力和业务水平,减少意外拔管的发生,保证了患者管道护理安全。     

点阵双极射频治疗面部痤疮瘢痕的疗效观察与护理

目的：评价点阵双极射频治疗面部痤疮瘢痕的疗效并探讨其护理。方法：点阵双极射频治疗仪（以色列Syneron公司）治疗43例面部痤疮患者,使用64tip治疗头,能量60～70mJ/pin,皮损处治疗2遍,4～6周一次,连续治疗3次,治疗前后使用ECCA权重评分评价痤疮严重程度,使用Wilcoxon秩和检验进行统计分析疗效差异。结果：入选的43例患者除一例疼痛明显放弃治疗,其余42例均完成3次治疗。治疗前后ECCA权重评分值分别为（85.60±42.74）和（47.50±24.35）,采用Wilcoxon秩和检验Z=4.21,P=0.000,差异有统计学意义。治疗前后照片比较疗效判断：痊愈1例,显效26例,有效12例,无效3例,总有效率92.9%。患者满意度评价：非常满意6例,满意22例,比较满意12例,不满意2例,总满意率95%。结论：点阵双极射频是治疗面部痤疮瘢痕有效的方法,具有恢复期短,患者痛苦小,副作用小,疗效显著等优点,及时有效的护理也是保证其疗效的关键。     

标准作业程序在手术室工人管理中的应用

目的探讨标准作业程序管理在手术室工人管理中的实施效果。方法对手术室工人采用标准作业程序管理方法,包括标准作业程序的制定、实施、培训与监管,比较实施前后工人工作质量考核结果、医护满意度评分及工作缺陷数。结果管理后,手术室工人工作质量考核分、医护满意度评分显著高于实施前(均P0.01),缺陷检出由126起降至38起。结论实施标准作业程序管理能提高手术室工人工作质量和效率,提升医护满意度。     

The comparison between experimental nursing and routine nursing interventions on the quality of life of stoma patients: A systematic review and meta‐analysis

The advance in nursing care for stoma patients is a challenging issue, which will influence the life quality. The quality of life is a major issue in the recovery of stoma patients. The evidence of experimental nursing has not been explored enough. A systematic search and a meta‐analysis were performed for the studies of experimental nursing interventions versus routine warming interventions on patients with a stoma. The comparisons between nursing interventions were performed to find which kind of intervention will be superior in improving life quality. After a restricted selection, 10 studies, 460 subjects with experimental nursing intervention, and 478 controls with the routine nursing intervention were enrolled in a variety of causes of the stoma. The focused outcome was the quality of life. The meta‐analysis was performed by Review Manager 5.4. Among the stoma patients, the meta‐analysis favours the experimental nursing intervention group with higher scores of life quality when compared to the routine nursing intervention group. The meta‐analysis results were with positive mean differences, significant tests for overall effect, and significant heterogeneities in the random‐effects model. The experimental nursing intervention showed higher positive effects on the quality of life when compared to routine nursing intervention for stoma patients. Experimental nursing intervention might be an option for stoma nursing practitioners to improve stoma care.