颅内动脉瘤合并脑血管痉挛栓塞术后的观察与护理

目的:探讨颅内动脉瘤合并脑血管痉挛栓塞术后观察与护理的重要性。方法:本组36例颅内动脉合并脏血管痉挛患者入院72h内在全麻下行颅内动脉瘤栓塞术。术前、术中常规罂粟硷30mg/10ml持续静脉内泵入,术后持续泵入3d,给予尼莫通抗血管痉挛。术后第2天开始实施三高疗法,术后常规腰大池引流,放出血性脑脊液。结果:本组行颅内动脉瘤栓塞术后,32例恢复良好(可恢复工作,无明显神经系统功能障碍),2例持续昏迷自动出院;2例中度致残(轻度神经系统功能障碍,但生活能自理)。结论:利用护理手段干预4方面中的可控因素,如平均动脉压、颅内压、中心静脉压、血流速度(血液稀释度),使其控制在预设定目标范围内可保证脑的有效灌注压,预防CVS的发生。     

Care of the child in a body cast

Caring for a child in a body cast is a stressful situation for most families and many families state they do not receive adequate information on how to care for their child. This paper presents a comprehensive guide on caring for a child in a body cast. It examines the physical care issues, transportation and cast care. An instrument for assessing the family’s ability to cope with caring for a child in a body cast is described, and further resources for parents and nurses are presented.     

颈动脉支架植入术的术中护理干预

目的:探讨颈动脉支架植入术的术中护理干预的疗效及护理。方法:54例患者分为对照组和干预组。对照组(n=21),干预组(n=33),对照组给于常规护理,干预组在常规护理基础上给与认知、心理、行为干预。观察两组的疗效并进行比较。结果:干预组的静脉输液通畅,高压灌注线管理良好,恐惧,意识体征变化,尿潴留均较对照组有明显改善(P<0.01)。结论:在颈动脉支架植入术的术中实行护理干预有重要意义,值得推广应用。     

护理干预对蛛网膜下腔出血患者便秘的影响

目的探讨护理干预对蛛网膜下腔出血患者便秘的影响。方法采用随机分组，实验组采取护理干预措施，对照组采取神经内科护理常规。结果2组患者排便情况、便秘相关反应比较差异显著。结论护理干预减少蛛网膜下腔出血患者便秘的发生，提高抢救成功率。     

罗衣适应模式在护理外固定支架固定胫骨骨折患者中的应用

目的：减少患者对外固定支架治疗胫骨骨折的恐惧心理，提高患者的适应能力，促进骨折愈合，预防并发症。方法：运用美国护理专家罗依的适应模式，分析113例患者受到的主要刺激，根据护理目标，制订具体护理措施，帮助患者找出适应性问题，做出适应性反应。结果：113例患者全部适应外固定支架的治疗，完成了护理目标。护理效果良好，早期即能下床活动，骨折愈合快，出院随访，无因该治疗方法出现并发症。结论：罗依的适应模式使患者配合护理，能不断识别环境中的新刺激，调整适应方式，做出适应性反应，达到预期目标。     

168例甲状腺功能亢进症手术的围手术期护理

目的为了观察甲状腺功能亢进症（甲亢）手术的围手术期的护理与疗效。方法全部患者均采用深入细致的心理护理、术前准备和术前术后病情密切观察以及对术后并发症的防治等方法。结果全组手术治疗168例，治愈163例（97．0％），术后并发甲低3例（1．8％），2例（1．2％）死于术后呼吸道误吸窒息及急性左心衰。结论强高甲亢手术围手术期的护理是保证手术安全、减少病死率及术后并发症的重要环节。     

改良式牙科吸唾管在人工气道中的应用

目的探讨改良式牙科吸唾管在人工气道护理中的应用效果。方法将2007年6月~2009年1月入住ICU建立人工气道的118例患者分为两组,两组患者进行比较。结果两组患者肺部感染、口腔感染、颜面部皮肤破损发生率及护理工作量实验组少于对照组,差异显著有统计学意义(p<0.01)。结论应用改良式牙科吸唾管持续吸引人工气道患者口腔分泌物,可降低肺部感染、口腔感染、颜面部皮肤破损的发生率,增加患者舒适度,减少护理工作量。     

House officers in general medicine: their perception of educational value of rotation components

Summary: As curriculum planners in general medicine residency training programmes we were concerned about house officers' anecdotal reports that hospital work requirements often overshadow individual learning goals. After each of five rotations, we asked residents to identify the educational 'usefulness' of certain rotation components which can be included in three categories; team members, work-related activities and educational events. Of 165 surveys distributed, 127 (77%) were returned. Data were analysed by residency year and by all years combined. The mean overall perception of learning was 3.9 out of a possible 5 points suggesting that residents do find some learning value. Results suggest that different residency years vary as to the significance of specific educational components. The importance of faculty/resident relationships to residents' perceptions of learning value was highlighted in particular.     

Psychotropic drug intake in residents newly admitted to nursing homes

While several surveys have shown that psychotropic drugs are frequently used by nursing home residents, no studies have been performed to investigate whether the rates of drug use increase during the stay in nursing homes or whether residents have taken these drugs already before admission. Therefore, we investigated 262 residents admitted to rural and urban nursing homes in Austria for prevalence of psychotropic drug intake before admission, shortly after admission, and 6 months later. Two weeks after admission, 72.1% of the residents were being treated with psychotropics, while 6 months later 79.0% were receiving these drugs. The significantly higher rates of psychotropic drug use among the psychiatrically ill and in those suffering from sleeping problems suggest that these drugs were prescribed aptly, but residents without appropriate criteria for drug intake were often also treated with psychotropics. During 3 months before admission to nursing homes, 45.5% of the sample reported having taken psychotropics. In more than half of residents without drug intake before admission, psychotropic treatment was initiated within the first 2 weeks after admission, while during the first 6 months after admission the rate of drug use increased only slightly. This suggests that a large percentage of psychotropic intake is due to nursing home orders. Received: 20 January 1997/Final version: 21 May 1997