危重症专科护理小组的建立与实施

目的总结危重症专科护理小组的实施方法和成效。方法成立危重症专科护理小组,定期组织查房、会诊指导、制订工作指引,并对全院危重患者的护理质量进行质控。结果建立和实施危重症专科护理小组1年多以来,小组共负责全院危重症专科以及疑难病例护理会诊53例;全院危重症患者的护理质量达标率从93.28%上升到98.71%。结论危重症专科护理小组的建立和实施对解决危重症患者的护理难题,提高危重症患者的护理质量具有积极的意义。     

1例急性暴发型心肌炎致多脏器功能障碍综合征患儿的护理

目的通过暴发型心肌炎致多脏器功能障碍综合征（MODS）患儿抢救成功的实例,分析危重症专科护理小组在危重患者管理中的作用。方法启动危重症护理紧急程序,进行完整的护理评估,抽调经验丰富的专科护理人员,制定严格、有效的监测和护理,完备医疗器械。结果危重症护理管理有序,护理对策行之有效,患儿未发生护理并发症,救治成功,出院。结论危重症专科护理小组管理的及时运作可以确保护理质量和护理措施的效果,最终能为患者提供优质的护理服务。     

急诊科急性心肌梗死抢救护理流程模式的改进

Objective To increase the success rate of first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments.Methods A total of 50 patients with acute infarct of cardiac muscle were taken,for seeking for the most convenient,effective flow model for first-aid and nursing under current conditions,which has a smooth cooperation with doctors,and shortens the time of patients staying in hosptal.Results The 50 patients were primarily first-aided in emergency department,and shew a stable status of disease,and were sent to the complex ICU or the cardiacology department in the in-patient section with care.The success rate was 94%.Compared with 50 patients in the past,the success rate was increased by 10% (P＜0.05).The time for staying in hospital was reduced to 6 rain for a patient at a time in average,from the tradiational average time for a patient at a time of 15.5 rain.Conclusions This exploration in nursing model for first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments provides an improvement which can closely match with doctors,and increase the success rate of first aid.It clearly shortens the in-hospital time for patients.The model gives valuable time for the first-aid process which shows time is life,and increases the patients' satisfication degree.     

经静脉留置针采血标本影响检验值的研究

目的 探讨用BD静脉留置针采集血标本对检验值的影响.方法 选取30例患者采用BD静脉留置针在同部位、连续时间、抽取等量血标本,分别放入标为1,2,3号试管.1号为无封管保留液,2号为含肝素稀释液封管保留,3号为抽弃肝素稀释封管保留液;同时检验电解质,对3组结果进行比较.结果 含封管液与无封管液组比较,钾、二氧化碳结合力差异有统计学意义(P<0.01);抽弃封管液组与无封管液组比较,差异无统计学意义(P>0.05).结论 BD静脉留置针采含封管保留液的血标本,除钠、氯外,均有明显影响,其检验值相对降低;保留封管液1 min后,先抽弃含封管液的血1 ml,再取血标本,不影响检验值.     

深圳盐田区不同季节急诊患者病种分析及护理对策

目的了解深圳东部地区不同季节急诊患者常见病种结构及分布规律,预见性指导临床急救护理。方法对2005—2008年268006例急诊患者病例资料进行回顾性分析。结果急诊患者就诊数逐年增加;4个季度的就诊构成比分别为19．75％,25．50％,29．62％,25．13％;排在前5位是外伤、呼吸系统疾病、消化系统疾病、神经系统疾病、循环系统疾病,其中外伤居首,在2,3季度最多。结论本区域急诊病种有明显季节分布特点,急诊护理管理者根据不同季节疾病分布特点,可预见性的提前科学做好科室设备及场地建设,调配足够护理人力资源,实行弹性排班,确保上述病种高峰期来临时,急诊救护有条不紊,提高工作效率、抢救成功率和患者满意度。     

内镜下探条加球囊扩张联合质子泵抑制剂治疗十二指肠溃疡瘢痕狭窄的效果观察与护理

目的研究十二指肠溃疡瘢痕性狭窄病人治疗及护理方法。方法23例十二指肠溃疡瘢痕性狭窄病人在内镜引导下行特制沙氏探条及球囊扩张治疗。结果23例病人治疗后复查内镜均能顺利通过原狭窄部位到达十二指肠降部,随访6—24个月,症状缓解率为81．25％～95．65％,无严重并发症发生。结论内镜引导下特制是治疗十二指肠溃疡瘢痕狭窄的有效方法。而术前禁食、术中护士娴熟的配合及术后饮食控制、做好并发症护理是沙氏探条及气囊扩张治疗成功的重要措施,坚持服用质子泵抑制剂对于防止十二指肠溃疡瘢痕狭窄复发十分重要。     

急诊科急性心肌梗死抢救护理流程模式的改进

目的为了提高急诊科急性心肌梗死抢救护理成功率。方法对50例急性心肌梗死患者,采取在现有条件下,改进配合医生最便捷、有效抢救护理流程模式,缩短收住院时间。结果50例患者经急诊科初步急救,病情稳定护送综合ICU或心内科住院部,成功率94％,与改进前50例比较,成功率提高10％（P〈0．05）,收住院时间由传统平均每人次15．5min,下降到平均每人次6min（P〈0．01）。结论探索急诊科急性心肌梗死抢救护理流程模式,改进能有效配合医生提高抢救成功率;明显缩短收住院时间,为时间就是生命的抢救中争取了更宝贵的时间,提高满意度。     

急诊科急性心肌梗死抢救护理流程模式的改进

Objective To increase the success rate of first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments.Methods A total of 50 patients with acute infarct of cardiac muscle were taken,for seeking for the most convenient,effective flow model for first-aid and nursing under current conditions,which has a smooth cooperation with doctors,and shortens the time of patients staying in hosptal.Results The 50 patients were primarily first-aided in emergency department,and shew a stable status of disease,and were sent to the complex ICU or the cardiacology department in the in-patient section with care.The success rate was 94%.Compared with 50 patients in the past,the success rate was increased by 10% (P＜0.05).The time for staying in hospital was reduced to 6 rain for a patient at a time in average,from the tradiational average time for a patient at a time of 15.5 rain.Conclusions This exploration in nursing model for first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments provides an improvement which can closely match with doctors,and increase the success rate of first aid.It clearly shortens the in-hospital time for patients.The model gives valuable time for the first-aid process which shows time is life,and increases the patients' satisfication degree.     

穿刺模式对人工血管动静脉内瘘的影响

目的探讨穿刺模式对人工血管动静脉内瘘的影响。方法选取采用人工血管进行血液净化患者60例次,按人工血管内瘘穿刺模式随机分成对照组（28例）和观察组（32例）。对照组选择A穿刺模式：动一静脉点穿刺部位选择人工血管。观察组选择B穿刺模式：动脉点穿刺部位选择人工血管的静脉或动脉侧交替进行,静脉点穿刺部位选择自体血管。比较两种穿刺模式对人工血管动静脉内瘘通畅率及血管瘤发生率的影响。结果对照组平均透析次数、人工血管的平均穿刺次数分别为（208±56）和（416±112）均高于观察组的（482±60）和（482±60）;对照组血管瘤形成比率（25．00％）高于观察组的（15．63％）,差异均有显著性（P〈0．05）。结论选择B穿刺模式优于选择A穿刺模式,不但可以延长人工血管使用寿命,而且能降低血管瘤发生率。     

两种方法治疗新生血管性青光眼的临床对比研究

目的探讨玻璃体切割、视网膜光凝联合Ahmed青光眼阀植入与睫状体联合视网膜冷冻治疗新生血管性青光眼的疗效。方法选择我院2003年至2005年43例(43只眼)新生血管性青光眼患者。其中,25例给予玻璃体视网膜手术 眼底激光联合Ahmed青光眼阀植入(简称青光眼阀组);18例给予睫状体联合视网膜冷冻术(简称冷冻组)。术后记录视力、眼压、炎症反应、用药及并发症情况。结果两组患者术后18个月眼压>21 mmHg的患者分别为青光眼阀组28.0%、冷冻组27.8%,两组比较无显著差异。术后18个月两组视力变化比较青光眼阀组明显优于冷冻组(P<0.01)。术后1周和2个月冷冻组炎症反应明显重于青光眼阀组。术后虹膜新生血管均有不同程度回退,两组比较无显著差异。术后不同时间两组均出现不同的并发症。结论玻璃体切割、视网膜光凝联合青光眼阀植入与睫状体联合视网膜冷冻治疗新生血管性青光眼两种方法均疗效持久且安全,是治疗新生血管性青光眼的有效方法。其中青光眼阀组术后炎症反应较轻,视力恢复好,适合于术前视功能较好且经济条件好的患者;冷冻组术后炎症反应重,更适合于术前视功能差且经济困难的患者。