肠造口患儿实施家庭参与护理模式的实践

通过制定肠造口患儿的家庭照顾目标、工作流程与护理方案,对52例肠造口患儿实施家庭参与护理模式,指导家庭成员参与到医疗护理全过程。52例患儿再入院时各项化验及检查指标正常,符合行造口闭合术标准。52例患儿家庭照护期间,无1例出现因造口并发症返院治疗情况。实施家庭参与护理模式,提升了肠造口患儿家庭的照顾能力和造口患儿的生活质量,提升了护理人员的专业能力和价值感,得到造口患儿家庭的普遍认可。     

消化道穿孔临床特点与诊断分析

目的 分析消化道穿孔的临床特点,提高诊断率.方法 回顾分析128例术后确诊为消化道穿孔患者的资料,总结其症状、体征特点及腹部X线、CT、超声等影像学特点,评价各项指标的临床诊断意义.结果 128例患者表现弥漫性腹膜刺激征者92例(71.9%),老年人较中青年缺乏典型体征[老年组:板状腹20.9%(9/43),全腹反跳痛32.6%(14/43),局部反跳痛37.2%(16/43),无反跳痛9.3%(4/43);中青年组:板状腹36.6%(30/82),全腹反跳痛51.2%(42/82),局部反跳痛11.0%(9/82),无反跳痛1.2%(1/82);P<0.01].78.7%(96/122)的患者在腹部X线片中发现膈下游离气体,低于CT检查的83.3%(15/18),差异有统计学意义(P<0.05).对X线或CT未检出的患者,诊断性腹腔穿刺的阳性结果为84.6%(11/13).结论 消化道穿孔的临床表现多不典型,超声引导下诊断性腹腔穿刺可明显提高诊断率.

Abstract：

Objective To analyze the clinical features of atypical digestive tract perforation, and to increase diagnostic ratio. Methods Retrospectively analyze 128 patients diagnosed as digestive tract after operation, summarize the symptoms, signs and the appearance of X-ray, CT and ultrasound. Then evaluate clinical diagnostic value of those items. Results In 128 cases, 92 cases (71.9% ) had diffuse peritoneal irritation sign, and the older man easily without typical symptoms and signs (P <0.01). 78.7% (96 cases in 122) finding free air sub-diaphragm in X-ray, lower than that in CT( P < 0.05 ) , which was 83. 33% (15 cases in 18 ). For those failed in diagnosis by X-ray and CT, the positive ratio of diagnostic abdominal paracentesis was 84. 6% (11 cases in 13). Conclusions There was always no special clinical characteristic in digestive tract. And diagnostic abdominal paracentesis under ultrasound would increase the diagnosis significantly.     

妇科经阴道手术患者围手术期心理变化研究

目的降低患者围手术期不良心理反应,为制定有针对性的围手术期健康教育内容和方法提供理论依据。方法选择因妇科良性疾病行经阴道手术患者400例,给予妇科常规临床护理,在围手术期,即患者入院时、术前、术后1d和术后7d分别评价其心理状态。结果患者入院时、术前、术后1d和术后7d心理状态评分分别为(8.80±0.70)分、(8.86±2.01)分、(6.65±0.50)分、(6.55±1.20)分。术后1d和术后7d患者的心理状态评分低于入院时和手术前,差异有统计学意义(P<0.01);入院与术前、术后1d与术后7d患者的心理状态评分差异无统计学意义(P>0.05)。结论妇科经阴道手术患者术后心理状态较手术前改善,护士可根据患者围手术期的心理变化特点有针对性地给予护理干预。