浅谈护患沟通

随着人类社会的进步和发展,国家法律法规的建立和健全,人们文化生活水平日益提高及健康观念的转变,现代医学模式已逐渐转变为生物-医学-心理的全新模式,整体化护理的推广要求以人为中心,而住院患者的自我保健意识也日益增强,病人的健康教育在护理工作中越来越重要,要求护士不但要掌握健康知识,     

谈五官科的感染控制与措施

目的 加强医院感染的管理,减少和降低五官科院内感染的发生.方法 根据五官科的易感因素,制定相对应的管理制度与防控措施.结果 严格执行消素隔离制度,规范医院内感染管理工作,是降低医院内感染的关键.结论 通过有效的措施和规范化管理,我科的院内感染发生率为0 %.     

健康教育路径表在脑血管病患者中的应用

健康教育是一种干预措施,对临床各种治疗和护理有增效作用,但神经内科患者多为“脑出血、脑梗死”,有的患者病情严重,特别是我们基层医院农村病人多,文化水平较低,健康教育质量难以保证。因此,我科在临床实践中,结合基层神经内科的特点,神经内科健康教育方法,在应用中不断改进措施,提高教育质量。     

自制冰袋及冰袋套在中枢性发热患者中的应用

发热是疾病中常见的临床症状之一,而中枢性发热在发热的各种病因中较为少见,中枢性发热为丘脑下部体温调节中枢受损伤导致机体散热、产热功能障碍引起的高热状态,解热药物不能控制。脑血管意外、脑外伤、脑手术、急性脑水肿、癫痫、中暑等患者,易出现中枢性发热症状,需要头部持续放置冰袋,才能有效降温,保持头部低温状态,有益于脑细胞。     

沈阳市大东区中学教室微小气候现状调查

学校是人群密集的场所,学生在教室内居留时间多于任何其他公共场所,多种呼吸道传播为主的传染病在学校内极易暴发[1].为了解沈阳市大东区部分初中教室微小气候的现状,以便于在学校卫生工作中进行监督和指导.我们于2007年11月对沈阳市大东区6所初中的微小气候状况进行了检测.     

间盘镜下髓核摘除术围术期护理

腰椎间盘突出症是因椎间盘变性、纤维环破裂、髓核突出刺激或压迫神经根、马尾神经而引起一系列临床症状的常见病、多发病[1]。既往以半椎板或全椎板切除为主,近年来大多以小切口"开窗"切除椎间盘。后路腰椎间盘镜(MED)下髓核摘除术是治疗腰椎椎间盘突出症的一种新方法,是将传统的开放式椎间盘摘除术与内窥镜术相结合的一种脊柱微创技术,具有切口小、组织剥离少、修复快、出血少、术后硬膜和神经根粘连轻、     

Results of the randomized international FAB/LMB96 trial for intermediate risk B-cell non-Hodgkin lymphoma in children and adolescents: it is possible to reduce treatment for the early responding patients

A previous study (LMB89) of the French Society of Pediatric Oncology for childhood mature B-cell lymphoma (B-NHL) demonstrated a 92% 3-year event-free survival (EFS) for intermediate-risk group B defined as "non-resected" stage II/I and CNS-negative advanced-stage IIV/IV (70% of cases). We performed the FAB/LMB96 trial to assess the possibility of reducing treatment in children/adolescents with intermediate-risk B-NHL without jeopardizing survival. "Early responding" patients (tumor response > 20% at day 7) were randomized in a factorial design between 4 arms, 2 receiving half-dose of cyclophosphamide in the second induction course with cyclophosphamide, Oncovin (vincristine), prednisone, Adriamycin (doxorubicin), methotrexate (COPADM) and 2 not receiving the maintenance course M1. A total of 657 patients were randomized (May 1996 to June 2001) and 637 were analyzed. The analysis showed no significant effect of any of the treatment reductions on EFS and survival. The 4-year EFS was 93.4% and 90.9% in the groups with full-dose and half-dose of cyclophosphamide (RR = 1.3, P = .40) and 91.9% and 92.5% in the groups with and without M1 (RR = 1.01, P = .98). There was no interaction between the 2 treatment reductions or between each treatment reduction and LDH level or histologic subtypes (Burkitt/Burkitt-like or large B-cell). Children/adolescents with intermediate-risk B-NHL who have an early response and achieve a complete remission after the first consolidation course can be cured with a 4-course treatment with a total dose of only 3.3 g/m2 cyclophosphamide and 120 mg/m2 doxorubicin.     

A comparison of hexaminolevulinate fluorescence cystoscopy and white light cystoscopy for the detection of carcinoma in situ in patients with bladder cancer: a phase III, multicenter study

PURPOSE: We compared hexaminolevulinate (Hexvix) fluorescence cystoscopy with white light cystoscopy for detecting carcinoma in situ. MATERIALS AND METHODS: In this multicenter study 298 patients with known or suspected bladder cancer underwent bladder instillation with 50 ml 8 mM hexaminolevulinate for 1 hour. Cystoscopy was then performed, first using standard white light and then hexaminolevulinate fluorescence cystoscopy. Lesions or suspicious areas identified under the 2 illumination conditions were mapped and biopsied for histological examination. In addition, 1 directed biopsy was obtained from an area appearing to be normal. RESULTS: Of 196 evaluable patients 29.6% (58 of 196) had carcinoma in situ, including 18 with carcinoma in situ alone, and 35 with carcinoma in situ and concomitant papillary disease, which was only detected on random biopsy in 5. Of the 18 patients with no concomitant papillary disease carcinoma in situ was detected only by hexaminolevulinate fluorescence in 4 and only by white light in 4. In the group with concomitant papillary disease carcinoma in situ was found only by hexaminolevulinate fluorescence in 5 patients and only by white light in 3. The proportion of patients in whom 1 or more carcinoma in situ lesions were found only by hexaminolevulinate cystoscopy was greater than the hypothesized 5% (p=0.0022). Overall more carcinoma in situ lesions were found by hexaminolevulinate than by white light cystoscopy in 22 of 58 patients (41.5%), while the converse occurred in 8 of 58 (15.1%). Biopsy results confirmed cystoscopy findings. Of a total of 113 carcinoma in situ lesions in 58 patients 104 (92%) were detected by hexaminolevulinate cystoscopy and 77 (68%) were detected by white light cystoscopy, while 5 were detected only on directed visually normal mucosal biopsy. Hexaminolevulinate instillation was well tolerated with no local or systemic side effects. CONCLUSIONS: In patients with bladder cancer hexaminolevulinate fluorescence cystoscopy with blue light can diagnose carcinoma in situ that may be missed with white light cystoscopy. Hexaminolevulinate fluorescence cystoscopy can be used in conjunction with white light cystoscopy to aid in the diagnosis of this form of bladder cancer.