临床药师干预对骨科Ⅰ类切口手术患者围术期预防用抗菌药物的合理性影响

目的:分析临床药师干预对骨科Ⅰ类切口手术患者围术期预防用抗菌药物的合理性影响.方法:选取医院2019年1月-12月收治的骨科Ⅰ类切口手术患者82例病历资料,按手术时间先后分为干预前组和干预组,每组41例;统计与分析其患者抗菌药物使用率,以及抗菌药物不同使用品种、给药时机和用药疗程的占比及其用药的合理性及不合理用药的原因与措施.结果:干预前组28例患者围术期预防用抗菌药物使用率为68.29％;干预组25例患者围术期预防用抗菌药物用药率为60.97％;干预组患者抗菌药物不合理使用率明显低于干预前组(4.00％ vs 14.29％,P＜0.05),给药时机不合理率也明显低于干预前组(8.00％ vs 17.86％,P＜ 0.05),用药疗程不合理率也明显低于干预前组(4.00％ vs 10.71％,P＜0.05).结论:医院骨科Ⅰ类切口患者围术期预防用抗菌药物的不合理情况在临床药师的干预下得到显著改善,预防感染用抗菌药物的品种、疗程、给药时机等均明显趋于合理,药学干预提高了临床用药的合理性.     

前列腺素I2-内皮祖细胞保护氧化应激受损心肌细胞凋亡： 心肌电生理验证

BACKGROUND:Prostacyclin (PGI2) and its analogs have been reported to prevent pressure overload-induced cardiac hypertrophy, and to reduce cardiac ischemia/reperfusion injury. However, clinical application of PGI2 is challenging due to its short half-life (< 2 minutes). Thus, we have generated PGI2 expressing rat endothelial progenitor cell strains (PGI2-EPCs) that constitutively secrete prostacyclin. OBJECTIVE:To investigate the protective effect of PGI2-EPCs against oxidative stress-induced cardiomyocyte injury. METHODS:Cultured H9c2 cells in vitro were assigned into four groups: H9c2 cells treated by H2O2 for 4 hours. H9c2 cells were pretreated by conditioned medium (collected form EPCs and PGI2-EPCs or collected form EPCs and PGI2-EPCs mixed with native EPCs) before the addition of H2O2. PBS instead of conditioned mediums served as negative control. The paracrine effect of PGI2-EPCs on in vitro angiogenesis of native EPCs was evaluated. MTT and Hoechst 33342 assays were used to examine the protective effect of conditioned medium on H2O2-induced rat embryonic cardiomyocyte apoptosis and cell viability. Finally, the effect of conditioned medium on the electric activities of adult cardiomyocytes was measured by whole-cell patch clamp techniques. RESULTS AND CONCLUSION:When native EPCs mixed with conditioned medium of PGI2-EPCs, the total length of tubes was significantly longer compared with those mixed with CM of EPC. Rat embryonic cardiomyocytes pretreated with conditioned medium of PGI2-EPCs significantly reduced H2O2-induced apoptosis and preserved cell viability compared with pretreatment with EPC-conditioned medium and without pretreatment (P < 0.01). Pretreatment of rat adult cardiomyocytes with conditioned medium of PGI2-EPCs abolished H2O2-induced early after depolarization and shortened H2O2-induced action potential duration prolongation (P < 0.01) towards baseline. Our findings indicate that PGI2-EPCs protect against oxidative stress-induced cardiomyocyte injury through paracrine action. This Study provides the groundwork for an innovative cell therapy approach to treat ischemic heart disease. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

垂体腺瘤护理中使用临床路径的临床研究

目的：探讨实施临床路径应用于垂体腺瘤手术患者临床效果的评价.方法：将92例垂体腺瘤手术患者随机分为临床路径（CP）组和非CP组各46例,CP组采用临床路径护理,非CP组采用传统护理方法,分别观察两组患者的治疗、护理效果.结果：两组在住院时间、健康知识评分、满意度、不良反应和并发症比较均有显著性差异（P〈0.05）.结论：临床路径是一种明确工作方向的表格,应用于垂体腺瘤手术患者,优化了病人的住院流程,规范了诊疗护理的操作程序,实现了医疗护理活动的程序化和标准化.在路径表上明确了各专业组成员的工作,避免了过去由于护理人员工作繁忙造成护理的遗漏或疏忽现象,同时也避免了由于个人水平、能力不同而造成的护理缺陷.培养了护士的主动性与自觉性,进一步提高了护理工作的质量.缩短了护士的书写时间,增加了护士与病人的接触机会.临床路径的运用,提高了健康教育效果及服务满意度,并提高了患者对疾病的认知度,树立患者战胜疾病的信心,充分调动了患者的主观能动性.从而明显减少垂体腺瘤手术的不良和并发症,可以明显缩短平均住院时间.     

颅后窝畸胎瘤的围手术期护理

报告了手术治疗颅后窝畸胎瘤的围手术期护理.术前做好心理护理;术后严密观察意识状态与神经系统体征、腰大池引流袋的护理,做好并发症的观察和护理,认真做好出院指导.     

个体化营养支持联合协同护理在老年食管癌患者围术期中的应用效果

食管癌是肿瘤科常见疾病,该病发病率高,且多发于中老年人群[1]。目前,临床针对食管癌主要采用手术治疗,但手术本身的创伤性以及术后应激反应均可影响治疗效果,甚至导致手术治疗失败;此外,部分患者手术治疗后还存在机体营养状态失衡,进而影响患者后续恢复速度,增加疾病风险,因此针对食管癌手术患者围术期制定合理的干预措施尤为重要[2]。本研究拟探讨个体化营养支持联合协同护理在老年食管癌围术期中的应用效果,报道如下。