应用失效模式效应分析预防脑卒中住院病人跌倒

成立我院神经内科失效模式和效应分析(failure model and effective analysis,FMEA)小组,对2008年我科预防脑卒中病人跌倒采取的护理流程及措施进行失效模式分析,计算事先风险数,得分最高的5项高风险因子作为最需改善的失效模式。针对此制订改进措施,并于2009年1月开始实施,结果表明,得分最高的5项高风险因子的事先风险数都有不同程度的下降,科室的脑卒中住院病人跌倒发生率明显下降。     

急性液化石油气中毒大鼠脑内髓鞘的超微结构研究

目的研究急性液化石油气中毒大鼠脑内髓鞘的超微结构以及血清MBP的变化。方法采用大鼠液化石油气中毒模型,根据LPG浓度分组,在LPG中毒后24 h、48 h、72 h、7 d时间点处死大鼠,电镜观察大鼠脑内髓鞘结构,采取血清样本检测MBP数值。结果 LPG中毒大鼠脑组织内髓鞘损害明显,电镜可见髓鞘板层紊乱,髓鞘与轴索间隙增大,外形不规则,有空泡出现。50%LPG中毒组髓鞘损害较20%LPG中毒组明显,不同时间点比较,24 h时间点髓鞘损害最明显。LPG中毒大鼠血清MBP增高,50%LPG中毒组MBP值高于20%LPG中毒组,动态观察显示24 h时间点MBP值最高。结论液化石油气中毒可导致大鼠脑内髓鞘损害,同时伴有血清MBP的增高。     

护理干预对阿尔茨采默氏病患者的效果观察

目的 探讨护理干预对阿尔茨采默氏病患者的效果.方法 对32例阿尔茨采默氏病患者入院时进行护理评估,住院期间及出院后采取生活护理、日常生活能力训练和认知训练,6个月后评估护理干预效果.结果 32例阿尔茨采默氏病患者日常生活能力训练和认知功能干预后均显著提高,差异具有统计学意义(p<0.01).结论护理干预能显著改善阿尔茨采默氏病患者的生存质量.     

急性液化石油气中毒大鼠血清S100B和髓鞘碱性蛋白的检测及意义

目的 研究急性液化石油气(LPG)中毒大鼠血清S100B和髓鞘碱性蛋白(MBP)的变化.方法 健康雄性成年SD大鼠54只按随机数字表法分为正常对照组(n=6)、20%LPG中毒组(n=24)和50%LPG中毒组(n=24).后2组大鼠分别吸入20%、50%LPG,对照组吸入等体积的空气.在中毒1、2、3、7 d时每组取6只大鼠进行神经功能缺损评分(NSS),ELISA法检测血清样本S100B和MBP的含量.结果 与正常对照组比较,20%LPG组中毒1 d、50%LPG组中毒1 d和2 d时NSS评分均较高,差异有统计学意义(P＜0.05);在1 d和2 d时,20%LPG组和50%LPG组大鼠血清S100B、MBP均高于正常对照组,且50%LPG组高于20%LPG组,差异有统计学意义(P＜0.05);3 d时50%LPG组血清S100B、MBP高于正常对照组和20%LPG组,差异有统计学意义(P＜0.05);大鼠LPG中毒1 d时NSS评分、血清S100B、MBP浓度最高,与其它时间点比较差异均有统计学意义(P＜0.05),后随时间延长逐渐恢复.结论 LPG中毒大鼠血清S100B和MBP同时升高,提示胶质细胞参与LPG中毒对神经系统的损害.

Abstract：

Objective To observe the changes of serum S100B and MBP in rats with liquid petroleum gas poisoning. Methods Fifty-four healthy adult male SD rats were randomized into normal control group (n=6), 20% LPG poisoning group (n=24) and 50% LPG poisoning group (n=24). Rat models of liquid petroleum gas poisoning were established in the later 2 groups, and controls were given the same volume of air. The rats of each group(n=6) were scored with neurological severity scale (NSS) and the blood serum was collected on the 1st, 2nd, 3nd and 7th d of poisoning, respectively. The levels of S100B and MBP were detected by euzymelinked immunosorbent assay (ELISA).Results As compared with the scores of NSS in the normal control group, those on the 1st d of poisoning in the 20% LPG poisoning group and those on the 1st and 2nd d of poisoning in the 50% LPG poisoning group were significantly higher (P＜0.05). The levels of Sl00B and MBP in 20% and 50% LPG poisoning groups were higher than those in the control group on the 1st and 2nd d of poisoning (P＜0.05); the levels of S100B and MBP in 50% LPG poisoning group were higher than those in 20% LPG poisoning group on the 1st and 2nd d of poisoning (P＜0.05). The levels of S 100B and MBP in 50% LPG poisoning group were higher than those in 20% LPG poisoning group and normal control group on the 3rd of poisoning (P＜0.05). The NSS scores and the levels of S100B and MBP in rats with LPG poisoning enjoyed the highest scores or levels on the 1st d of poisoning and those decreased after that. Conclusion The levels of S100B and MBP of rats with LPG poisoning increase, indicating that gliocytes participate in the mechanism of nervous system injury in rats with liquid petroleum gas poisoning.     

实习护生语言表达能力及沟通技巧的培养

2003年1月~2005年12月,我院将培养护生语言表达能力及沟通技巧纳入教学内容,效果满意。现报告如下。1加强临床带教队伍建设加强临床带教队伍的管理是提高临床教学质量的重要途径[1]。挑选德才兼备的护师担任带教,定期举办带教老师培训班,每2个月召开1次护生评教会,建立激励机制     

APACHEⅡ评分在神经内科危重病人护理中的应用

[目的]探讨急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)在制定神经内科一级护理以上病人护理措施中的应用效果。[方法]对2005年1月—2005年12月在我院神经内科住院的一级护理以上197例病人应用APACHEⅡ评分,预测病人预后并根据评分结果进行护理人员配置和指导护理措施。[结果]197例一级护理以上病人APACHEⅡ评分范围5分~59分(22.02分±10.05分),其中176例生存病人评分为19.34分±7.15分;病人住院时间、医疗费用、住院期间并发症发生率均减少,病人对护理工作满意度均明显上升。[结论]APACHEⅡ评分系统应用于神经内科危重病人中,能在一定程度上评价重症病人疾病的严重程度和预测预后,并可更好地指导护理人力资源的合理配置,实施相应的护理措施,从而提高护理质量及病人对护理工作的满意度。     

多发性硬化患者的护理体会

目的:总结对多发性硬化(MS)患者的护理经验,提高对本病的整体护理水平,从而提高患者生存质量及延长生命。方法:对24例MS病例进行回顾性分析,归纳护理要点。结果:加强对MS患者的基础护理、心理护理、功能锻炼及饮食、出院指导等,患者的病情均有不同程度的稳定和好转。结论:有效的护理措施是提高MS患者治疗效果和减少复发的重要因素。