对影响手术室护理质量满意度因素的讨论

目的 调查手术患者对于手术室护理质量的满意度以及分析相应的影响因素.方法 在我院2011年5~8月份进行手术治疗的患者中随机选择305例患者,对其进行手术室护理质量满意度调查并将相应的影响因素进行分析总结.结果 手术患者对于手术室护理质量满意289例,满意度为94.8%.影响手术室护理质量满意度的主要因素有:患者的疼痛情况、对手术的记忆及惧怕、麻醉过程以及患者的教育水平职业状况等(P<0.05).结论 保证手术室护理质量是一切条件的前提,临床护理工作中,护理人员应因患者情况,为其提供生理、心理等方面的服务并完善影响满意度的因素,提高患者对手术室护理质量的满意度.     

手术患者对手术室护理满意度调查研究

目的 了解手术患者对手术室护理满意状况并对影响患者对手术室护理满意度评价的相关因素进行分析,为提高手术室护理质量提供参考依据.方法 以我院2011年1月-2012年1月收治的1124例行外科手术治疗的患者为研究对象,采用发放调查问卷的方式对患者展开调查.结果 1124例手术患者中有1027例患者对手术室护理比较满意,满意率达91.4%;患者的受教育程度、对手术和麻醉的心理反应以及疼痛反应是影响患者对手术室护理质量满意度评价的主要因素（P 〈0.05）;术前未提供系统的健康教育和未给予患者足够的人文关怀是手术患者对手术室护理不满意的主要原因.结论 临床护理人员应结合患者的个体情况加强对患者的健康教育和心理支持,改善患者对手术室护理满意度评价的影响因素,进而进一步提高手术室护理质量.     

患者对手术室护理质量满意度的影响因素与建议

目的:针对患者对手术室护理质量满意度的影响因素与建议进行探讨方法我院于2016年调查了手术室患者的对手术室护理质量的满意度,将这360位调查患者作为研究对象,这次调查研究采用两种调查问卷,分别是手术室护理质量满意度调查表和一般情况调查表,对患者的人口统计学资料和护理质量的满意度进行调查,最主要的是调查手术室患者的对手术室护理质量的满意度,并对影响因素进行了分析.结果:对患者进行手术室护理质量满意度调查,采用linkert5级评分法,反馈会来的调查问卷信息显示这360位患者对手术室护理质量满意度评分的平均分为(4.45±0.45)分,其中患者对于护士性格及特征的评分最高,而评分最低的是手术室的环境.调查的单因素分析结果显示,手术室护理质量满意度会受到患者的年龄以及患者的学历和患者的从业状况、手术恐惧程度、术后并发症以及疼痛程度的影响,是因变量.结论:手术患者比较满意手术室护理的质量,调查手术室患者的对手术室护理质量的满意度,并对影响因素进行了分析,开展这项调查不但能够提高手术室护理的满意度,同时也能为其提供理论依据.     

患者对手术室护理质量满意度及其影响因素分析

目的：统计患者对手术室护理质量满意度并分析其影响因素。方法：将我院2009年7～10月手术治疗的296例患者作为研究对象，调查其对手术室护理质量的满意度，对影响患者对手术室护理质量满意度的因素进行分析。结果：296例患者中，满意268例，满意率为90．5％。患者手术前对手术的惧怕及离开手术室时的疼痛是影响患者对手术室护理质量的满意度的主要因素。结论：临床护理工作中应加强心理护理，改善患者对手术室护理质量满意度的影响因素，以提高患者对手术室护理质量的满意度。     

手术患者对手术室护理质量满意度及影响因素研究

目的:研究手术患者对手术室护理质量的满意度并进一步分析影响因素。方法:将我院2014年10月至2014年12月的296例手术患者作为此次研究的对象,调查患者对手术护理的满意度,并进一步的分析影响患者对手术护理质量满意度的因素。结果:共有268例患者对手术护理感到满意,满意度达到90.5%。另外患者对手术的恐惧以及疼痛是导致患者满意度降低的主要因素。     

患者对手术室护理质量满意度的影响因素分析

探讨患者对手术室护理质量满意度的影响因素。方法：为2012年8月至2013年8月我院收治的892例患者进行问卷调查,在每例患者出院前向其发放医院自制的调查问卷,问卷调查的内容包括患者的性别、年龄、学历状况、婚姻状况、入室时对手术感到恐惧、离室时发生疼痛的情况及对手术室环境、护理工作、护士性格及特征、护理环节及流程、手术操作前的准备和解释工作的满意度等。结果与结论：本研究的结果显示,本组患者对手术护理服务的评价整体较高,其对手术室护理服务满意度的平均分为4.36±0.16。本组患者的学历、入室时对手术治疗产生的恐惧感及离室时发生的疼痛是影响其对手术室护理质量满意度的主要因素。本组患者的性别、年龄、婚姻状况不是影响其对手术室护理质量满意度的主要因素。护理人员在为患者进行手术室护理时应将精湛的专业技术与人文关怀结合起来,切实地提高患者对手术室护理服务的满意度。     

患者期望值与手术室整体护理干预的相关性

目的:探讨实施手术室整体护理干预与患者对护理质量期望值的相关性。方法:对1 192例患者在治疗期间均予手术室整体护理干预,并选择自制一般资料调查表以及手术室整体护理干预期望值评价量表进行问卷调查。结果:患者对护理干预质量期望值得分为(4.48±0.71)分。手术患者不同年龄、学历、从业状况以及离开手术室对疼痛程度等记忆,对护理期望值评分差异均有统计学意义(P<0.05~P<0.01)。结论:实施手术室整体护理干预,患者期望值评价较好。能够影响患者期望值的因素较多,因此手术室的护理人员需参照患者个体情况,尽量提供疼痛、手术及麻醉等相关知识,使患者掌握信息并得到心理支持,从而满足个体化需求,提高手术室的护理质量。     

急诊气管插管全麻手术的护理配合

目的:探讨急诊气管插管全麻下手术护理与麻醉配合,提高手术室护理质量,为急诊患者的治疗赢得宝贵时间.方法:通过对245例急诊全麻手术患者进行回顾,分析手术室护士对全身麻醉患者行气管插管前、中及拔管时的护理配合.结果:手术室护士与麻醉医师做好完善地配合,有效避免了麻醉与手术并发症的发生,无1例患者出现用药及护理方面的差错.结论:手术室护士对麻醉医师工作的护理配合是影响急诊手术麻醉质量的重要因素,充分的术前准备是麻醉、手术安全顺利进行的保障.     

口腔颌面外科全麻手术患者在麻醉复苏期的护理干预效果分析

目的 探讨针对性护理在口腔颌面外科全麻手术患者麻醉复苏期的干预效果。方法 在2020年4月—10月于厦门医学院附属口腔医院进行口腔颌面外科全麻手术治疗患者中随机抽出82例,分为观察组、对照组。对照组予以常规护理,观察组予以针对性护理。比较2组患者临床护理效果。结果观察组不良反应发生率较对照组低（7.32%<34.16%）;观察组苏醒时间、留室时间均短于对照组;观察组护理满意度、主观舒适度均高于对照组,上述各项差异均明显（P<0.05）。结论针对口腔颌面外科全麻手术患者麻醉复苏期阶段,予以针对性护理措施进行干预,能有效加快患者苏醒,减少其留室时间,有利于降低不良反应发生率,提高患者机体舒适度,满意度较高,效果显著。值得推广。     

手术室实施无缝隙护理办法对护理质量的影响评价

目的:评价分析在手术室实施无缝隙护理对临床护理质量的影响作用。方法:将本院普外科2013年12月-2014年12月收治的210例患者纳入研究,按随机数字表法,将全部患者均分为研究组和对照组,每组105例。对照组给予常规的手术室护理,研究组则采用手术室全程无缝隙护理办法,比较两组患者心理舒适度、心率、血压、皮质醇、术后疼痛等护理指标的变化及护理满意度等情况。结果:研究组麻醉前的SAS评分、SDS评分、心率、血压、皮质醇指标均比对照组低;研究组术后疼痛评分显著更低于对照组;另外,研究组医生、患者对护理满意度评分高于对照组,无缝隙护理模式获得的认同程度更高,比较差异均有统计学意义(P<0.05)。结论:对外科手术患者实施手术室全程无缝隙护理,对改善其术前负性情绪、手术应激反应等有积极影响,且能减轻术后疼痛程度,提高护理的满意率。     

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.