护士评判性思维能力的调查及其相关因素分析

Objective To investigate and analyze the nurses' critical thinking abilities and its related factors, and provide basic data for developing nurses' critical thinking. Methods 210 nurses accepted CTDICV and EPQ questionnaire investigation in a top hospital in Nantong. Results The total score of nurses' critical thinking was (276.41 ± 26. 107); Single factor analysis results revealed that the critical thinking scores of nurses were significant in different education background(266.5 ± 22.200,277.03 ± 25. 750,292.92 ± 24.841;F = 19. 168, P ＜ 0. 01 ), professional title, length of nursing working and different departments; The length of nursing service and the E scores were positively correlated with the scores of critical thinking; The P, N scores ( r =0. 292,0. 221 ,P ＜0. 01 ) were negatively correlated with the score of critical thinking( r = -. 0142, -0. 196,P ＜0. 05 or P ＜0. 01 ); Multivariate analysis showed that nurses' critical thinking abilities were correlated with the nurse education background, length of service, different departments and the E scores ( P ＜ 0. 01 or P ＜0. 05 ). Conclusions Nursing managers should pay attention on improvement nurses' critical thinking abilities.Nurses critical thinking abilities may be developed by individualized training according to their specific circumstances.     

经蝶垂体瘤手术患者临床护理路径的制定与应用

目的 制定适合经蝶垂体瘤手术患者的临床护理路径表,并观察其应用效果.方法 回顾71例行经蝶垂体瘤手术患者的护理资料,设计出标准化的临床护理路径表.将新收治的60例经蝶垂体瘤手术患者随机分为CNP组和对照组各30例,分别接受CNP护理和常规护理,比较2组的住院时间、住院费用、满意度及健康知识掌握率.结果 经蝶垂体瘤手术临床护理路径表的实施,缩短了平均住院日,降低了医疗费用,提高了服务质量和患者满意度,同时减少了记录时间,规范了医疗护理行为.结论 经蝶垂体瘤手术临床护理路径表对规范医疗护理服务具有重要作用,是一种科学的工作模式.     

恶臭在糖尿病足神经性溃疡中的作用研究

目的比较恶臭性糖尿病足神经性溃疡与无恶臭性糖尿病足神经性溃疡在临床表现、治疗及预后方面有无不同。方法收集2009年3月至2010年5月,在我院足科病房住院治疗的所有糖尿病足神经性溃疡61例患者资料,根据糖尿病足神经性溃疡有无恶臭分为恶臭组29例和非恶臭组32例。患者入院后当天收集患者基本资料,检查患者足溃疡感染情况,记录实验室数据、两组患者的治疗和预后情况。比较两组患者临床表现、实验室数据、治疗方式和预后的差异。结果恶臭组白细胞计数（WBC）13.64×109/L vs 9.15×109/L（P〈0.01）、超敏C反应蛋白（hsCRP）（12.9±1.4）mg/L vs（11.9±1.1）mg/L（P〈0.01）、血小板计数（PLT）346.62×109/L vs 286.97×109/L（P〈0.01）明显高于非恶臭组;恶臭组和非恶臭组比较,更易发生重度感染（P〈0.01）、骨髓炎（P〈0.05）和坏疽（P〈0.01）。最终恶臭组截肢风险明显高于非恶臭组（P〈0.01）。结论恶臭组较非恶臭组更易导致坏死性深部软组织感染和坏疽,更易导致骨髓炎,而且白细胞、血小板、C反应蛋白升高,这些都使恶臭组截肢风险明显高于非恶臭组。因此糖尿病足神经性溃疡出现恶臭是一个危险信号,预示着很高的截肢风险。     

小儿烧伤110例临床护理

通过对110例烧伤患儿严密观察病情变化,保持呼吸道通畅,做好创面护理,加强消毒隔离措施,加强心理护理和康复功能锻炼.结果本组患儿除1例发生严重的脓毒血症死亡外,其余病例全部治愈,无严重肢体功能障碍发生.认为周密细致的护理措施,可促进烧伤患者康复,降低致残率.     

全瓷冠修复患者的护理体会

随着人们对牙科修复体美观要求的提高,目前全瓷冠在临床上得到了越来越广泛的应用。全瓷冠修复体不仅克服了金属烤瓷修复体不透光、金属腐蚀、颈缘美学效果差等缺点,而且具有良好的光传播和光反射特性,能够再现天然牙的半透明度和色泽。但由于全瓷冠修复体制作工艺精密,对临床操作流     

经口喂养困难患儿口腔按摩和非营养性吸吮护理

NICU患儿病情危重,所需的营养通常都由鼻饲喂养供给,但鼻饲喂养时间过长不仅费用昂贵且存在着胆汁淤积、感染、栓塞等并发症。尽早开始胃肠道喂养可提高新生儿胃肠激素的水平,促进胃肠功能及代谢成熟,并且可以促进日后的体格发育,故NICU患儿病情度过急性期后,应尽早开始训练患儿逐步从鼻饲喂养向经口喂养过度,使患儿的营养最终可以实现经口喂养。     

运动疗法对终末期糖尿病肾病患者营养状况的影响研究

目的探讨运动疗法对终末期糖尿病肾病（ESDN）患者营养状况的影响。方法选取维持性血液透析的ESDN患者45例,采取自身前后对照研究方法,在常规护理的基础上进行16周的有氧运动干预。观察比较运动疗法干预前后患者人体学指标[BMI、肱三头肌皮褶厚度（TFS）、上臂围（MAC）]、反映营养状况的生化指标[血清白蛋白（Alb）、Hb、转铁蛋白（TRF）]、与营养相关的指标[空腹血糖（FBS）、空腹胰岛素（FINS）、尿素氮（BUN）、C反应蛋白（CRP）、胰岛素抵抗指数（Homa-IR）、尿素清除指数(Kt/V）]变化。结果运动疗法干预后患者BMI、TFS、MAC、Alb、Hb、TRF、Kt/V均高于干预前（均P＜0.05）,FBS、FINS、BUN、CRP、Homa-IR均低于干预前（均P＜0.05）。结论运动疗法可有效地提高ESDN患者血液透析的充分性,控制微炎症状态,降低胰岛素抵抗,从而改善营养状况。     

Forty Cases of Gastrointestinal Neurosis Treated by Acupunture

Objective: To compare the therapeutic effect of acupuncture for gastrointestinal neurosis with that of oral remedy. Methods: Eighty cases were randomly divided into the following 2 groups. In the treatment group, acupuncture was given for one month at the main points of Zhongwan (CV 12), Zusanli (ST 36), Taichong (LR 3) and Shenmen (HT 7), with the auxiliary points selected according to TCM differentiation. In the control group, Domperidone was orally administered for one month. Results: The total effective rate was 92.5% in the treatment group and 75.0% in the control group, with a significant difference between the 2 groups (χ2=4.423, P<0.05). Acupuncture was superior to the oral remedy in therapeutic effects. Conclusions: Acupuncture may show better results for gastrointestinal neurosis and with less toxic side effects.