护理工作影响健康教育深入开展的两大因素

健康教育是一门研究传播保健知识和技术影响个体和群体行为,消除危险因素,预防疾病,促进健康的科学,它有利于病人,医院及护理专业建设和学科发展,作为整体护理中开展得最为成功环节之一     

肠折叠术在肠闭锁手术中的应用

Objective To evaluate the efficacy of bowel plication as a part the surgical treatment of intestinal atresia (IA) in childrea Methods Between April 2005 and April 2009,68 neonates with IA underwent surgical treatment in this center. According to the surgical procedures the patients underwent, the 68 neonates were divided into bowel plication group and control group. The 38 children underwent bowel plication after atretic segments resection and primary anastomosis. The 30 children of the control group underwent tapering enteroplasty after atretic segments resection. Data including operation procedures,ages,birth weight,concomitant diseases,age at surgery, length of hospital stay, length of total parenteral nutrition (TPN),postoperative intestinal function recovery (the time of the first oral feeding and the oral feeding volume reached 40 ml/kg/3h),growth and development,complications and reoperations were retrospectively analyzed. Results No differences of ages, birth weight, age at operation, and concomitant diseases were found between the two groups. The time of operation and hospital stay of the bowel plication group were significantly shorter than those of the control group [(1.21±0.24)h,(12.2±2.5)d vs. (1. 77 ± 0. 31)h, (17. 3 ± 3. 2)d,P＜0. 010]. The time of the first oral feeding, the time when oral feeding volume reached 40 ml/kg/3h,and TPN length of the bowel plication group were also shorter than those of control group [(8 ± 2. 3)d, (13. 1 ± 1. 9)d, (8. 3 ± 1.8)d vs (12. 9 ±1. 7)d,(18. 7 ± 1. l)d,(13. 6 ± 2. 5)d,P＜0. 05]. In the bowel plication group, 1 (2. 6%) underwent reoperation for adhesive intestinal obstruction half a year after the initial surgery. However,in the control group,6 (20%) included 3 underwent reoperation for intestinal obstruction,2 for anastomotic leakage and 1 for adhesive intestinal obstruction. The patients were followed up for an average period of 2. 7 years (6 months-5 years). All infants thrived. Conclusions The additional bowel plication after atretic segment resection and primary anastomosis improves the clinical outcomes for children with intestinal atresia.     

乳腺癌患者的术后护理体会

乳腺癌是女性常见的恶性肿瘤,当前的主要治疗手段是手术治疗及术后放、化疗。手术切除乳腺给广大女性患者的身体和心理上带来了极大的创伤;长期的化疗后反应也使患者的生活质量下降,乳腺癌患者术后不同阶段的护理及健康教育指导在患者整体治疗过程中起到重要作用。     

肿瘤坏死因子α对新生大鼠心肌成纤维细胞增殖的影响及其机制

目的: 探讨肿瘤坏死因子α（TNF-α）刺激对新生大鼠心肌成纤维细胞（CFs）增殖的影响及其机制。方法: 采用消化法培养新生SD大鼠的CFs。实验分为4组,即5、10和20 μg/L TNF-α处理组及空白对照组。将CFs培养36 h后,用四氮唑蓝(MTT)比色法测定细胞的增殖;分别用半定量RT-PCR和Western blot技术检测在5 μg/L和10 μg/L TNF-α刺激下细胞周期蛋白D1（CyclinD1 mRNA及其蛋白）表达的变化。结果: 随着TNF-α浓度的增高,MTT比色法检测的A490值呈明显递增趋势,其中5、10及 20 μg/L组的A490值,分别为0.417±0.011、0.622±0.015和0.602±0.013,与对照组（0.235±0.013）相比,有显著差异（P<0.05）。RT-PCR和免疫印迹检测表明,以5 μg/L和10 μg/L TNF-α刺激36 h后,CyclinD1 mRNA(0.706±0.113,1.698±0.135)和其蛋白(1.270±0.168,2.749±0.170)的水平均明显高于对照组CyclinD1mRNA(0.192±0.039)和蛋白（0.658±0.101）的表达水平（均P<0.01）。结论: TNF-α可通过上调CyclinD1的表达促进心肌成纤维细胞增殖,这可能为应用TNF-α信号通路抑制剂进行抗心肌纤维化治疗提供实验依据。     

盾叶冠心宁片治疗高脂血症的临床试验研究

目的 观察盾叶冠心宁片治疗高脂血症(气滞血瘀证)的临床疗效和不良反应.方法 采用3∶1随机、双盲、阳性对照(对照药选用脂必妥片)的设计方法 ,共观察符合标准的高脂血症患者240例,其中试验组180例,对照组60例.试验组予盾叶冠心宁片,2片/次,3次/日,温开水送服.对照组早晚予脂必妥片,2片/次,中午安慰剂片,2片/次.温开水送服.两组治疗8周.结果 盾叶冠心宁片降血脂的总有效率为75.28%,临床控制率为23.60%,显效率为31.46%,有效率为20.22%;对照药脂必妥片的总有效率为83.34%,临床控制率为31.67%,显效率为31.67%,有效率为20.00%,两组比较无统计学意义(P＞0.05).两组血脂分型疗效比较均无统计学意义.盾叶冠心宁片中医证候总有效率为83.15%,对照药脂必妥片的总有效率为90.00%(P＞0.05).临床研究过程中未发现该药有明显的不良反应.结论 盾叶冠心宁片治疗高脂血症(气滞血瘀证)安全有效,与临床降血脂常用药物脂必妥片具有相似的临床疗效.     

老年心功能不全预见性护理体会

<正>在护理工作中,我们高度重视BNP检测值,并根据BNP检测结果按心功能分级进行预见性护理,收到较好效果,现作如下报道。1资料与方法1.1一般资料2005年2月至2008年10月入院的42例老年心功能不全患者,其中男34例,女8例,年龄68～100岁,平均年龄81岁,冠状动脉粥样硬化性心脏病31例,心房颤动3例,高血压5例,慢性支气管炎2例,风湿     

胃癌术后预后因素的Cox比例风险回归

目的探讨影响胃癌术后预后的相关因素。方法回顾性分析随访资料完整的315例胃癌术后病例,以死亡为结果量,以性别、年龄等13个因素为解释变量,采用Cox比例风险回归筛选影响预后的相关因素。结果胃癌术后5年累计生存率为45.70%,单因素Cox比例风险分析显示：年龄、肿瘤最大径、肿瘤组织学分型、肿瘤分化程度、UICC-TNM分期、淋巴结转移站数、肿瘤远处转移、浸润深度、联合脏器切除、血管癌栓形成与患者5年生存相关。多因素Cox比例风险分析保留在方程中的协变量是：肿瘤组织类型、肿瘤分化程度（RR=0.588）、UICC-TNM分期（RR=1.423）、淋巴结转移站数（RR=1.536）、肿瘤远处转移（RR=4.544）、联合脏器切除（RR=3.147）。结论肿瘤组织类型、肿瘤分化程度、UICC-TNM分期、淋巴结转移站数、肿瘤远处转移、联合脏器切除是影响胃癌术后生存的强相关因素。