7例肝细胞体内移植患者临床护理需求的探讨

目的观察肝细胞体内移植术的有效性与安全性,探讨相应的护理需求。方法从自愿捐献者的肝脏内分离纯化肝细胞,制成悬液,经股动脉插管行脾动脉灌注移植,观察治疗后肝衰竭患者的肝功能恢复率、恢复时间、治疗不良反应及患者心态变化,针对不良反应及患者心理给予完善护理,建立肝细胞体内移植术护理规范。结果7例肝衰竭患者治疗后,4例临床治愈,有效率为57.1%,胆红素、凝血酶原活动度改善50%以上的发生时间约在术后4周。术后患者不同程度出现恶心、呕吐(57.1%),少量腹水(57.1%),肝性脑病(42.9%),发热(42.9%),穿刺点皮下血肿(28.6%),肺部真菌感染(14.3%)。术后71.4%的患者有焦虑情绪。经过相应的临床及心理护理,症状均有不同程度的改善。结论肝细胞体内移植可延长终末期肝病患者生存期,但病情明显改善所需时间约4周,防治肝性脑病、预防穿刺点皮下血肿及运用心理护理消除患者焦虑情绪是重要的护理需求。     

33例婴幼儿复发性喉乳头状瘤的观察与护理

目的探讨婴幼儿复发性喉乳头状瘤的观察与护理。方法对33例婴幼儿复发性喉乳头状瘤患儿密切观察病情,以赢取抢救机会;进行有效的术前术后护理,包括完善术前准备和进行术前护理评估及术后并发症的预防、气管切开术后呼吸道管理等。结果33例中31例均好转出院,2例病情变化抢救无效死亡。结论婴幼儿复发性喉乳头状瘤患儿的术前、术后观察与护理对及时发现患儿病情变化,进行有效的抢救措施至关重要。     

Professional Education in Co-occurring Disorders: Some Considerations towards Practice Development

The aims of this paper are to provide a brief overview of the types of education and training as well as a framework for co-occurring disorders courses at foundation and advanced levels. Mental health nurses encounter substance abuse problems as part of their workload and should be prepared adequately to work with individuals with the co-existence of mental health and substance abuse. However, co-occurring disorders are not often picked up by substance abuse or mental health services, indicating a need for improvement in ongoing professional development. The targeted audience for education and training in core competencies should be staff working in community mental health teams, inpatient services, assertive outreach teams, early intervention teams, crisis resolution teams, primary care, mental health services for older people, independent mental health projects, accommodation services, day care services, statutory drug and alcohol services, independent drug and alcohol service providers, and those working in hostel accommodations, housing, prison health care probation, and others in the criminal justice system. The theoretical and skills-based training will need to adopt a two-tiered approach as individuals working within mental health services will by definition need a higher emphasis on training around substance misuse and vice versa for individuals working in substance misuse services. One of the agenda items for interagency training is to challenge negative attitudes and prejudices around both mental health problems and substance misuse.     

单侧唇裂功能性修复320例护理体会

目的:探讨单侧唇裂功能性修复的护理特点和方法。方法:对我院320例行单侧唇裂功能性修复患儿的护理行回顾性分析和总结。结果:患儿及家属能积极配合,患儿术后恢复良好,家属满意。结论:在常规护理的基础上,患儿特别是家属对疾病和手术方案的认识将对手术和护理效果产生重要影响。     

The workload of trainees in general practice

During their first training period in general practice the authors felt that they did not encounter the balanced workload which is the foundation for learning to be a GP. Previous studies confirmed the existence of differences in overall and specific workload between trainees and trainers. From their own experience and from the relevant literature they addressed several factors which might affect the workload of trainees. A study was undertaken to determine differences in workload between trainees and trainers, and to investigate whether certain characteristics of practice and of trainees affect the workload of trainees. Details of surgery consultations with 34 trainee-trainer partnerships were recorded in the north of the Netherlands over 2 weeks. Questionnaires were filled in by trainers, trainees and practice assistants from these 34 general practices. The total number of contacts recorded was 10,103. It was found that trainees see fewer elderly and female patients, less chronic and oncological conditions, but more minor illnesses. They see only 30% of patients with problem behaviour. Factors that influence the trainees' workload, as compared to their trainers' are: list size; selection in the allocation of patients; trainee's experience prior to starting the training stage, and the trainee's sex. Except for problem behaviour, trainees generally see a cross-section of their trainer's practice population. Selection would provide a more balanced workload for trainees.     

更新护理观念 促进护理学科发展

随着新的医学模式的确立，护理学科的核心思想已从以疾病为中心的功能护理逐步发展为以病人为中心的整体护理阶段。其内涵：把病与病人，反生物学的病人与社会和心理学的人，把病人与其所处的环境，把病人从入院－出院－康复都作为一个整体，目前，我国护理工作主体仍处于以疾病为中心的护理思考指导下的功能制护理，局限了护理学科的发展，近年来，我国护理界引进了整体护理，并将其思想应用于临床护理工作中，进行了多方位探讨，旨     

吉林省38所医院护理工作抽查情况分析

吉林省第一周期的医院评审工作基本结束,为了巩固成果,防止滑坡,吉林省医院评审委员会多次组织专家对38所二三级甲乙等医院护理工作进行现场抽查。对吉林省护理工作的概况及抽查中发现的共性问题进行了分析。同时建议:加强护理人员的职业道德教育;解决护理人员编制不足问题;提高护理人员技术劳务价值;运用激励手段提高护理工作质量。     

脑出血患者的康复护理

通过长期对脑出血患者的康复护理研究,总结出对脑出血患者的发病初期护理、各种并发症护理、心理护理及其营养护理等有效的护理方法,从而消除或减轻患者的功能残损,提高患者的生活质量。     

人本原理在医院管理中的应用价值

目的:研究人本原理在护理管理中的应用。方法:把人本原理的管理原则、动力原则、行为原则、能级原则应用于护士长的管理中,尊重、关心、帮助和激励护士,人人参与管理。选择2005年上半年住院病人180例作为改革组,应用人本原理管理。2004年下半年住院病人150例作为传统组,用传统方法管理。结果:通过人本原理管理原则的应用,提高了护理质量,各项指标应用后高于应用前(P<0.05或P<0.01),无投诉、无差错事故发生,病人满意度一直在95%以上,护士参与管理意识增强,团队精神加强,护士按期晋升。护士对病人实行人性化服务,为医院赢得了相应的社会效益和经济效益。结论:人本原理应用于护理管理行之有效,值得推广。     

甲基强的松龙冲击疗法治疗重型脱髓鞘脑病患者的护理

采用大剂量甲基强的松龙治疗脱髓鞘脑病患者１５例。在治疗过程中，积极预防应激性溃疡，加强呼吸道及人工冬眠护理。经５次治疗，１４例症状明显改善。