人性化护理干预应用于疝气术后患者护理的价值分析

目的探讨疝气手术患者术后护理中采取人性化护理干预的临床价值。方法抽取我院2017年1月至2018年1月收治的疝气手术患者60例作为研究对象,入组对象有完整的临床资料,签署知情同意书愿意配合本研究,按照1:1比例随机分为2组,每组各30例。对照组患者接受常规护理模式进行干预处理,而观察组则在术后加用人性化护理干预处理。记录两组患者并发症发生率、住院时间及术后疼痛评分,调查患者对护理满意率,实施统计学处理。结果观察组患者并发症发生率稍低于对照组(P0.05);观察组患者住院时间显著短于对照组(P0.05);观察组患者术后疼痛评分显著低于对照组(P0.05);观察组患者对护理满意率显著高于对照组(P0.05)。结论疝气手术患者术后护理中采取人性化护理干预处理,不仅可以减少并发症发生,缩短住院时间,而且可以缓解术后疼痛,提高护理满意率,值得借鉴。     

个体化心理干预对胃癌术后疲劳综合征的影响

目的观察个体化心理干预对胃癌患者术后疲劳综合征的影响。方法将100例胃癌患者随机分为对照组和干预组,每组50例。对照组接受常规护理,干预组在其基础上予以个体化心理干预,比较两组疲劳评分、术后康复指标以及并发症发生率。结果干预组术后第5d疲劳评分及术后主动下床、胃肠减压时间、肛门排气时间等指标均显著优于对照组(P0.05);干预组的并发症发生率显著低于对照组,差异有统计学意义(P0.05)。结论个体化心理干预有助于改善胃癌手术患者术后疲劳状态,促进其早日康复。     

围手术期护理干预在阑尾炎手术护理中的价值

目的探讨围手术期护理干预在阑尾炎手术护理中的临床价值。方法选取2017年2月～2018年6月期间我院收治的48例阑尾炎手术患者,随机分为观察组和对照组,各24例,其中观察组患者围手术期间实施综合性护理干预,对照组患者围手术期实施常规护理干预,对比两组患者的护理效果(患者术后疼痛评分情况、术后并发症及住院时间)及患者护理满意度。结果观察组患者术后疼痛评分要低于对照组,住院时间短于对照组,两组数据对比观察组情况明显优于对照组,差异有统计学意义(P0.05);观察组的护理总满意度(95.83%)明显高于对照组(75.00%),组间对比差异有统计学意义(P0.05);两组患者术后并发症发生率分别为4.17%、12.50%,观察组并发症发生率低于对照组,差异有统计学意义(P0.05)。结论阑尾炎患者围手术期间实施综合性护理干预效果良好,能降低患者术后疼痛度和并发症发生率,减少其住院时间,且患者满意度高,值得在临床上大力推广。     

对围手术期的疝气患者进行舒适护理的效果观察

目的探讨对围手术期的疝气患者进行综合护理干预的临床效果。方法选取我院2015年1月至2016年2月收治的68例疝气患者的临床资料进行回顾性分析。随机分为对照组和观察组,每组各34例。为对照组患儿进行常规护理,为观察组患儿进行综合护理干预。比较两组患者住院时间、并发症及护理满意度。结果观察组患儿的下床时间及住院时间明显少于对照组患儿,观察组患儿并发症的发生率明显低于对照组患儿,差异有统计学意义(P0.05)。观察组患儿家属对护理的满意度明显高于对照组患儿家属,差异有统计学意义(P0.05)。结论综合护理干预的护理效果好,对疝气术后患者能显著缩短患者住院治疗时间,降低术后并发症发生比例、减轻术后疼痛程度、缩短术后肛门排气时间,提高患者术后满意度,适宜基础临床广泛应用开展。     

优质护理措施对急性阑尾炎患者的临床效果

目的探讨优质护理措施对急性阑尾炎患者的临床效果。方法选取2015年2月至2019年2月在平舆县中医院接受腹腔镜手术治疗的122例急性阑尾炎患者,按照护理方法分为两组,各61例。对照组接受常规基础护理,观察组在常规护理基础上接受优质护理。对比两组患者首次排气时间、术后卧床时间及住院时间,记录两组术后胃肠道反应、腹部囊肿等并发症的发生情况,采用GCQ量表对比两组住院期间的舒适度。结果观察组首次排气时间、术后卧床时间及住院时间均短于对照组,术后并发症发生率低于对照组,舒适度评分高于对照组(均P<0.05)。结论给予接受腹腔镜手术治疗的急性阑尾炎患者优质护理,可缩短康复时间,降低术后并发症发生率,提高舒适度。     

全程精细化综合护理在化脓性阑尾炎围手术期的应用效果

目的观察全程精细化综合护理在化脓性阑尾炎围手术期的应用效果。方法选取2017年2月至2018年11月在民权县人民医院接受化脓性阑尾炎手术治疗的92例患者,采用随机数表法分为对照组和观察组,每组46例。对照组接受常规护理,观察组接受全程精细化综合护理。比较两组患者干预后疼痛程度、胃肠道功能恢复情况、心理状况、护理满意度及术后并发症发生情况。结果观察组患者护理后VAS评分低于对照组,首次下床活动时间、首次排气时间、首次排便时间、住院时间均短于对照组,干预后SAS、SDS评分低于对照组,护理总满意度高于对照组,术后并发症发生率低于对照组,差异有统计学意义(均P<0.05)。结论在化脓性阑尾炎围手术期实施全程精细化综合护理,可有效缓解患者术后疼痛,加快术后康复,减少术后并发症的发生,减轻负面情绪,提高护理满意度。     

心理护理干预在腹腔镜全胃切除术中的应用效果观察

目的观察心理护理干预在腹腔镜全胃切除术中的应用效果。方法选择2015年6月~2016年12月期间于我院行腹腔镜全胃切除术患者60例,年龄38~72岁,随机分成干预组和对照组,比较两组患者干预前后的SAS、SDS评分,以及护理满意度、并发症情况。结果干预前两组患者的SAS评分、SDS评分之间的差异不显著(P0.05)。干预后两组患者的SAS评分、SDS评分明显降低,分别与干预前比较差异具有显著性(P0.05),且干预组患者干预后的SAS评分、SDS评分显著低于对照组(P0.05),两组患者术前、术后第1天、术后第3天的VAS评分分别显著低于对照组(P0.05)。干预组患者的护理满意度显著高于对照组(P0.05),干预组患者术后并发症发生率显著低于对照组(P0.05)。结论心理护理干预可以提高腹腔镜全胃切除术的手术效果,减轻患者的焦虑、抑郁等负性心理,缓解患者的术后疼痛,降低术后并发症的发生率,有利于促进疾病及早康复。     

个性化护理干预在乳腺癌患者围手术期中的应用效果评价

目的 探讨乳腺癌患者围手术期有效的个体化护理干预措施对提高乳腺癌患者的生存质量影响.方法 选择我院2010年12月至2013年4月乳腺癌患者60例.随机分为观察组与对照组各30例,观察组与对照组均行手术治疗,对照组采取常规护理措施实行围术期护理,观察组在对照组护理基础上采用护理干预措施进行护理,比较两组术后并发症发生率和住院时间.结果 观察组术后并发症发生率、住院时间、VAS评分明显低于对照组,QOL评分明显高于对照组,差异有统计学意义（P＜0.05）.结论 有效可行的个性化围手术期护理干预可以减少术后并发症,提高患者的生活质量.     

颈椎骨折伴脊髓损伤的术后护理探讨

目的探讨颈椎骨折伴脊髓损伤的术后护理方法及效果。方法选取我院收治的颈椎骨折伴脊髓损伤行手术治疗患者74例依据随机平均原则划分为对照组与观察组各37例。对照组术后实施常规护理,观察组术后采取细节护理。对两组患者护理干预后并发症情况、颈椎JOA评分、住院时间等情况进行记录与分析。结果观察组护理并发症发生率显著低于对照组,P0.05;观察组JOA评分显著高于对照组,P0.05;观察组住院时间显著短于对照组,P0.05。结论在颈椎骨折伴脊髓损伤患者术后采取细节护理干预,能有效降低并发症的发生率,缩短患者住院时间,提升临床护理质量,值得推广。     

综合护理模式在疝气手术患儿中的临床效果观察

目的探讨并分析疝气手术患儿中综合护理干预的临床效果。方法选取我院2014年3月至2015年3月所收治的疝气手术患儿90例,将其随机分为对照组和观察组,对照组实施常规护理,观察组实施综合护理。分析并比较两组患者术后疼痛的情况以及并发症的发生率。结果在疝气手术患儿的护理观察中,通过对患者的术后疼痛情况以及并发症发生率等比较,发现观察组的各方面情况均优于对照组,其并发症发生率0%也明显低于对照组6.67%,P0.05。两组不同患者的比较是具有统计学意义的。结论在疝气手术患儿的护理观察中,综合护理对患者的健康更有利,能够促进患者更好的康复,综合护理干预值得在临床中推广。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.