改良连续静-静脉血液滤过中局部枸橼酸抗凝的应用

目的探讨家庭式温馨护理环境对精神分裂症患者的影响。方法将80例住院精神分裂症患者随机分为观察组（n=39）和对照组（n=41）。两组患者均给予抗精神病药物治疗，对照组住普通病室，予精神分裂症常规护理；观察组住家庭式温馨单间病房，并实施家庭式温馨护理，内容包括人员培训、营造温馨环境、家属教育干预、实行开放式护理管理等。采用NOSIE、BPRS、SDS、SAS和自制住院患者满意度及家属健康教育知识掌握程度调查问卷进行评价。结果观察组住院1个月时BPRS、SDS、NOSIE、SAS评分与对照组比较，差异有显著性意义（P〈0．05，P〈0．01）；两组满意度、家属健康教育知识掌握程度比较，差异有显著性意义（均P〈0．01）；观察组平均住院时间显著短于对照组（P〈0．01）。结论家庭式温馨护理环境可减轻患者的焦虑、抑郁情绪，提高患者对治疗的依从性，减轻精神症状；可提高患者对医院工作的满意度和家属对疾病相关知识的了解程度；缩短平均住院时间,提高经济效益和社会效益。

Effects of Nursing Care to Schizophrenia Patients by Offering Homey Environment

Objective To evaluate the safety and clinical value of regional citrate anticoagulation (RCA) to continuous venovenous hemofiltration (CVVH) for patients with a high risk of bleeding.Methods Sixty-eight sessions continuous venovenous hemofiltration of the 19 patients with a high risk of bleeding were randomly divided into two groups: In the experiment group, 34 sessions were treated in regional citrate anticoagulation, while 34 sessions in control group using traditional rinse normal saline without heparinization. The efficiency of extracorporeal coagulation, treatment time, ultrafiltration value, serum creatinine and urea concentration in the two groups were compared.Results There was significant difference in the efficiency of extracorporeal coagulation, treatment time, ultrafiltration value, serum creatinine and urea concentration between experiment group and control group (P<0.05,P<0.01). In the experiment group, the serum ionized calcium concentration remained in normal range,the citrate level was in safe range,hypernatremia and metabolic alkalosis did not occur.Conclusion RCA is a safe and effective method for patients with a high risk of bleeding.