糖尿病肾病的血液透析临床护理效果分析

目的 本文探讨糖尿病肾病血液透析时应用临床护理的具体效果.方法 选取2020年12月至2021年10月本院收治的接受血液透析治疗的50例糖尿病肾病患者作为研究对象.通过随机数表法将患者分为对照组和观察组,每组各25例.对照组予以基础护理干预;观察组予以全面护理干预.分析对比两组的治疗依从性、负性情绪、生活质量、护理满意度以及并发症发生率.结果 观察组治疗依从性显著高于对照组(P＜0.05).护理前,两组负面心理评分无显著差异(P＞0.05);护理后,两组的负面情绪均有所改善,且观察组抑郁自评量表(SDS)与焦虑自评量表(SAS)评分均比对照组显著降低(P＜0.05).观察组的躯体功能、情感功能、社会功能、角色功能等各项生活质量评分均对照组显著提高(P＜0.05).观察组的护理满意度显著高于对照组(P＜0.05).结论 糖尿病肾病患者接受全面护理,能提高治疗依从性,改善负面情绪,提升生活质量,减少并发症,提高护理满意度.     

针对性护理对重症消化性溃疡患者负性情绪及生活质量的影响

目的探讨实施针对性护理在重症消化性溃疡患者负性情绪和生活质量中的作用效果观察。方法选取2016年1月—2019年1月就诊于本院的80例重症消化性溃疡患者为研究对象,采用数字随机表法将其随机分为对照组和观察组,每组40例,对照组实施常规护理干预,观察组实施针对性护理,比较两组的症状缓解时间、住院时间、睡眠质量评分、舒适度评分、负性情绪评分、生活质量评分和护理满意度情况。结果护理后,观察组的腹痛缓解时间、腹泻缓解时间、住院时间明显短于对照组(P0.05);护理后,两组患者睡眠质量评分均较护理前降低(P0.05),但观察组明显低于对照组(P0.05);两组舒适度评分均较护理前增高(P0.05),但观察组明显高于对照组(P0.05)。在负性情绪方面,护理后,两组的焦虑及抑郁评分均较护理前降低(P0.05),而观察组均明显低于对照组(P0.05);两组各方面生活质量评分均较护理前显著提高(P0.05),而观察组各项评分均明显高于对照组(P0.05);观察组的总满意率高于对照组(P0.05)。结论对重症消化性溃疡患者实施针对性护理,可有效促进其症状缓解,改善其睡眠质量、舒适度和心理状态,有利于提高其生活质量水平,使其对护理服务更加满意。     

人性化护理对肺癌手术患者生活质量及护理满意度的影响

目的 探讨人性化护理对肺癌手术患者生活质量及护理满意度的影响.方法 选取肺癌手术患者40例,采用多中心、随机、双盲的方法分为观察组和对照组,每组20例.对照组患者采用常规护理,观察组患者常规护理的基础上采用人性化护理,观察两组患者术后并发症、死亡率、生活质量、护理质量满意度及住院时间.结果 观察组的护理满意度均显著高于对照组(P＜0.05),住院时间、并发症、死亡率显著少于对照组(P＜0.05);观察组各个生活质量评分均显著高于对照组(P＜0.05).结论 人性化护理真正的体现以人为本的护理理念,有利于满足肺癌患者的心理和生理需求,提高患者的生活质量,降低病死率.     

围术期优质护理对老年性白内障患者的效果

目的 研究老年性白内障患者实施围术期优质护理的效果.方法 我院2021年5月至2022年5月期间收治的190例老年性白内障手术患者,以随机数表法分为对照组与观察组两组,每组95例.对照组实施常规围术期护理,观察组实施围术期优质护理.比较两组的焦虑抑郁评分,并发症发生率,住院时间及护理满意度.结果 观察组焦虑抑郁评分和术后并发症明显低于对照组(P＜0.05).观察组的平均住院时间明显短于对照组(P＜0.05).观察组护理满意度评分明显高于对照组(P＜0.05).结论 老年性白内障患者实施围术期应用优质护理,能够减少并发症,改善负性情绪,提高护理满意度.     

心理护理对食管癌手术病人负面情绪的影响分析

目的 探讨对食管癌患者采取心理护理干预后的影响.方法 选择2020年6月至2022年7月期间我院接诊的食管癌手术患者60例作为观察对象.经随机抽签法将患者分为对照组和观察组,每组各30例.对照组采取常规护理干预,观察组采取心理护理干预.分析对比两组的负面情绪、护理满意度、并发症以及生活质量.结果 护理前,两组SAS及SDS评分均无显著差异(P＞0.05).护理后,观察组的SAS及SDS分值均比对照组显著降低(P＜0.05).观察组并发症发生率比对照组显著降低(P＜0.05).观察组的护理满意度比对照组显著提高(P＜0.05).结论 对食管癌手术患者采取心理护理,能改善患者的负面情绪,降低并发症发生率,提高生活质量以及护理满意度.     

优质护理在老年股骨颈骨折患者中的应用效果观察

目的:探讨优质护理在老年股骨颈骨折患者中的应用效果。方法:将110例老年股骨颈骨折患者随机分为观察组和对照组各55例,对照组实施常规护理,观察组在此基础上实施优质护理干预,比较两组患者负面情绪改善情况及患者满意度。结果:两组干预后焦虑自评量表(SAS)、睡眠状况自评量表(SRSS)、抑郁自评量表(SDS)评分明显低于干预前,且观察组干预后SAS、SRSS、SDS评分明显低于对照组干预后(P0.05);观察组患者对护理的满意度显著高于对照组(P0.05);观察组干预后总体健康、生理功能、社会功能、情感职能、精神健康评分明显高于对照组干预后(P0.05);观察组住院时间、住院费用及医患纠纷发生率低于对照组(P0.05)。结论:优质护理能显著缓解老年股骨颈骨折患者紧张、焦虑、压抑等负面情绪,提高患者生活质量和满意度,值得临床推广。     

全面性护理干预对老年进展期胃癌化疗患者负面情绪状态、生存质量及满意度的影响

目的探讨全面性护理干预对老年进展期胃癌化疗患者负面情绪状态、生存质量及满意度的影响。方法选取2015年1月至2017年6月该院收治的老年进展期胃癌化疗患者88例为研究对象,按照随机数字表法分为对照组(44例)和观察组(44例)。对照组给予常规护理,观察组给予全面性护理,比较两组患者的负面情绪状态、生存质量、不良反应及满意度的差异。结果经护理干预后,观察组焦虑、抑郁负面情绪评分及不良反应发生率均明显低于对照组(P0.05);观察组生存质量及满意度明显高于对照组(P0.05)。结论全面性护理干预可显著改善老年进展期胃癌化疗患者负面情绪状态、生存质量及满意度,临床效果显著,可广泛应用于临床。     

肺癌患者应用护理干预对疼痛状况及生活质量改善的研究

目的探讨护理干预对肺癌患者疼痛状况以及生活质量改善的作用。方法选取本院收治的90例肺癌患者,按照随机数表法分为观察组和对照组,对照组患者给予常规护理,观察组给予心理护理,观察比较2组患者护理后,疼痛状况的改变以及生活质量改善情况。同时,比较护理后患者疾病的认知程度、负面情绪的消除、不良生活习惯的改善以及用药依从性提高情况、以及满意度和临床疗效。结果护理后,观察组患者的心理功能、躯体功能、社会功能以及物质生活评分明显高于对照组(P0.05);观察组对疾病的认知程度、负面情绪的消除、不良生活习惯的改善以及用药的依从性明显高于对照组(P0.05);观察组临床疗效、满意度明显高于对照组(P0.05);观察组疼痛评分、呼吸困难评分明显低于、优于对照组(P0.05)。结论心理护理干预可以有效减轻患者负面情绪,减轻疼痛感受,提高患者生活质量评分。     

护理干预对高血压脑出血患者疗效及满意度的影响

目的探讨护理干预对高血压脑出血患者临床疗效及满意度的影响。方法将本院120例高血压脑出血患者,随机分为对照组(常规护理)和观察组(护理干预),各60例,比较2组干预前后SAS和SDS评分,生活质量评分(Barthel)、生活活动能力评分(FIM)以及患者对护理服务满意度。结果与对照组相比,观察组SAS和SDS评分均明显降低(P0.05);与对照组相比,观察组Barthel评分、FIM评分均显著增高(P0.05);与对照组相比,观察组患者对护理服务满意度明显提升(P0.05)。结论护理干预能够明显改善高血压脑出血患者的负面情绪,提高生活质量及日常生活能力,提升患者对护理服务的满意度。     

观察临床护理路径预防血液净化深静脉导管感染的效果

目的探析临床护理路径预防血液净化深静脉导管感染的效果。方法选取2016年6月～2017年12月在我院接受血液净化治疗的82例患者为研究对象,随机将其分为两组,每组41例。给予对照组常规护理,观察组患者实施临床护理路径,对两组患者的深静脉导管感染发生率、负面情绪改善情况、护理满意度以及生活质量等进行比较。结果观察组深静脉导管感染发生率为7.32%,对照组感染发生率为29.27%,两组对比差异有统计学意义(P0.05);经护理后,观察组患者焦虑情绪、抑郁情绪明显缓解,各项评分均明显优于对照组(P0.05);观察组患者的护理满意度为95.12%,对照组满意度为63.41%,两组对比差异有统计学意义(P0.05);经护理3个月后,观察组患者各项生活质量评分均明显高于对照组,差异均有统计学意义(P0.05)。结论对血液净化患者实施临床护理路径干预,一方面可以降低深静脉导管感染发生率,减少患者的生理痛苦;另一方面,可以缓解患者的负面情绪,提高满意度,改善生活质量,减轻患者的心理压力,值得进一步推广应用。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.