以家庭为中心的赋权模式在PICC化疗患者中的应用

目的探究以家庭为中心的赋权模式对PICC化疗患者家庭照顾者照顾能力和照顾准备度的影响。方法将122例行PICC置管化疗的恶性肿瘤患者及其家庭照顾者随机分为对照组与赋权组各61例。对照组给予肿瘤科常规护理,赋权组实施以家庭为中心的赋权模式护理。结果干预后赋权组患者家庭照顾者照顾能力及照顾者准备度显著优于对照组(均P<0.01)。结论以家庭为中心的赋权模式可提高家庭照顾者的照顾能力和照顾准备度。     

急性ST段抬高型心肌梗死患者急诊PCI术后Ⅰ期心脏康复护理研究

目的 探讨Ⅰ期心脏康复七步训练法用于急性ST段抬高型心肌梗死急诊PCI术后患者的效果.方法 将100例急性ST段抬高型心肌梗死直接PCI术后患者随机分为观察组52例和对照组48例,对照组给予急性心肌梗死PCI术后常规护理,观察组在对照组的基础上实施Ⅰ期心脏康复七步法护理.结果 两组住院期间心律失常发生率比较,差异无统计学意义(均P＞0.05),观察组CCU监护时间、住院时间显著短于对照组,PCI术后首次排便时间显著早于对照组(均P＜0.01).结论 对急性ST段抬高型心肌梗死直接PCI术后患者实施个体化的Ⅰ期心脏康复护理有利于缩短CCU监护时间及住院时间,预防便秘发生,促进患者安全.     

家庭赋权干预对永久性肠造口患者照顾者的影响

目的 探讨家庭赋权干预应用于永久性肠造口患者主要照顾者的效果。 方法 选择永久性肠造口患者及主要照顾者97对作为研究对象,按照患者住院时间分为对照组48对和观察组49对。对照组患者给予常规护理,观察组在对照组基础上实施家庭赋权干预方案。比较两组照顾者干预前后照顾准备程度、照顾负担及心理一致感评分。 结果 干预后,观察组照顾者照顾准备度评分及心理一致感评分显著高于对照组,照顾负担评分显著低于对照组（均P＜0.05）。 结论 家庭赋权干预有利于提高永久性肠造口患者主要照顾者的准备度及心理一致感,对缓解照顾者照顾负担具有积极意义。     

对早产儿父母实施家庭赋权方案的效果研究

目的 探讨家庭赋权方案对早产儿住院期间父母疾病不确定感、出院照顾准备度及出院后1个月应时能力的影响.方法 将2019年6～12月收治的45例早产儿的父母纳入对照组,将2020年1～7月收治的45例早产儿的父母纳入观察组.对照组采用常规护理,观察组在常规护理基础上增加家庭赋权方案进行干预,比较两组早产儿父母疾病不确定感、照顾准备度、出院后1个月应对能力的差异.结果 出院当天观察组父母疾病不确定感评分显著低于对照组,照顾准备度评分显著高于对照组,早产儿出院1个月父母应对能力评分显著高于对照组(P＜0.05,P＜0.01).结论 家庭赋权方案能减轻早产儿父母疾病不确定感,提高家庭照顾准备度及出院后应对能力.     

家庭尊严干预对乳腺癌患者照顾者的影响

目的 探讨家庭尊严干预对乳腺癌患者照顾者照顾感受、创伤后成长及照顾能力的影响.方法 将220名乳腺癌患者照顾者随机分为观察组和对照组各110人.对照组给予常规干预,观察组在此基础上实施家庭尊严干预.两组出院时及出院后3个月分别采用照顾者负担量表、创伤后成长评定量表及中文版照顾者能力量表进行调查.结果 观察组照顾负担显著低于对照组,创伤后成长及照顾能力评分显著高于对照组(均P＜0.01).结论 家庭尊严干预能有效降低乳腺癌患者照顾者的照顾负担,提升其创伤后成长水平及照顾能力.     

急性ST段抬高型心肌梗死患者急诊PCI术后I期心脏康复护理研究

目的探讨I期心脏康复七步训练法用于急性ST段抬高型心肌梗死急诊PCI术后患者的效果。方法将100例急性ST段抬高型心肌梗死直接PCI术后患者随机分为观察组52例和对照组48例,对照组给予急性心肌梗死PCI术后常规护理,观察组在对照组的基础上实施I期心脏康复七步法护理。结果两组住院期间心律失常发生率比较,差异无统计学意义(均P0.05),观察组CCU监护时间、住院时间显著短于对照组,PCI术后首次排便时间显著早于对照组(均P0.01)。结论对急性ST段抬高型心肌梗死直接PCI术后患者实施个体化的I期心脏康复护理有利于缩短CCU监护时间及住院时间,预防便秘发生,促进患者安全。     

照顾者同步随访对老年髋部骨折患者术后康复的影响

[目的]探讨照顾者同步随访干预对老年髋部骨折患者术后康复的影响。[方法] 2019年2～12月入住骨科一病区的42例患者及主要照顾者为干预组,同期入住骨科二病区的40例患者及主要照顾者为对照组,干预组在常规出院指导基础上,对患者及主要照顾者进行为期3个月的同步随访干预,对照组仅接受常规出院指导。[结果]术后3个月内,干预组并发症发生率为7.14%;对照组为27.50%;两组间比较差异有统计学意义(P0.05)。干预3个月后干预组SF-36评分显著优于对照组(P0.05)。干预3个月后干预组主要照顾者自我效能评分显著高于对照组(P0.05);而干预组主要照顾者SAS评分显著低于对照组(P0.05)。[结论]基于医院随访平台对患者及主要照顾者实施同步随访干预,能够增加主要照顾者的自我效能感、缓解焦虑情绪,有效降低患者术后并发症发生率,改善生活质量。     

以家庭功能为导向的首发脑卒中患者照顾者支持干预方案实施

目的 评价以家庭功能为导向的首发脑卒中患者照顾者支持干预方案的实施效果。 方法 便利抽取103名首发脑卒中患者照顾者,按时间段分为对照组51名和干预组52名。对照组实施常规护理;干预组在此基础上实施以家庭功能为导向的照顾者支持干预方案,共3个月。比较两组照顾者做好家庭护理的准备、综合照顾能力及家庭功能得分。 结果 干预组出院时照顾者做好家庭护理的准备得分显著高于对照组（P＜0.05）;两组综合照顾能力总分及各维度得分、家庭功能得分比较,组间效应、时间效应和交互效应差异有统计学意义（均P＜0.05）。 结论 以家庭功能为导向的照顾者支持干预方案的实施可提高首发脑卒中照顾者家庭护理准备、综合照顾能力及改善患者家庭功能水平,可帮助患者更好地从医院过渡到家庭。     

积极自我表露干预对中青年脑卒中患者照顾者获益感的影响

目的 探讨积极自我表露干预对中青年脑卒中患者照顾者获益感、照顾负担及生活质量的影响。方法 将78名中青年脑卒中患者的照顾者按照病区分为对照组和干预组各39名。对照组接受常规护理，干预组在对照组的基础上实施为期4周、共8次的积极自我表露干预。比较两组干预前，干预后即刻，干预后1个月、3个月的获益感、照顾负担、生活质量情况。结果 干预组、对照组各有36名照顾者完成研究。干预后即刻及干预后1个月，干预组照顾者获益感评分显著高于对照组（均P＜0.05）；干预后即刻及1个月、3个月干预组照顾负担评分显著低于对照组，生活质量评分显著高于对照组（均P＜0.05）。结论 积极自我表露干预可有效地提高中青年脑卒中患者照顾者获益感，减轻照顾负担，提高生活质量。     

经皮冠状动脉介入术后患者早期康复运动程序的应用

目的探讨急性心肌梗死患者经皮冠状动脉介入（PCI）治疗术后应用早期康复运动程序的护理效果。方法将86例急性心肌梗死患者随机分为观察组（44例）和对照组（42例）,观察组PCI术后按照康复运动程序进行康复运动、生活护理、健康教育,术侧肢体制动5h后给予被动翻身,24h后开始康复运动。对照组按照护理常规实施护理计划,PCI术后绝对卧床24h,1周后下床活动。结果两组术后腰背痛、焦虑、便秘发生率及住院时间比较,差异有统计学意义（均P〈0．01）。两组术后并发症发生率比较,差异无统计学意义（均P〉0．05）。结论早期康复程序的实施可以减轻患者术后腰背疼痛不适症状及减少便秘,并对调节患者情绪有积极的作用。     

Importance of echocardiography in prognosis of surgical outcomes in cholecystitis in elderly patients

The authors propose to use more often echocardiography (EchoCG) in examination of elderly (over 60 years) of age patients with cholecystitis that permits to increase surgical activity to 92.4%. Left ventricular ejection fraction is the most informative. When this fraction is lower than 45% surgery must be recommended on vital indications only. EchoCG was used in 155 patients with cholecystitis, 131 of them were operated. 2 (1.52%) patients died due to acute cardio-vascular insufficiency and pulmonary artery thromboembolism.     

杭州健康女性定量骨超声测定原发性骨质疏松

目的 评价杭州健康女性骨超声速度(SOS)值随增龄减少和骨质疏松患病率，建立杭州地区女性骨超声速度值参考数据库。方法 定量超声法测定1208例杭州地区健康女性桡骨远端(RAD)，第3指骨近节(PLX)，第V跖骨(MTR)和胫骨中段(TIB)的超声速度值。结果 RAD、PLX、MTR和TIBSOS峰值(Peak of SOS)均出现在40-45岁，TJB的SOS峰值出现在35—40岁，此后随年龄增长而下降。绝经后妇女在绝经后早期和晚期各有1个SOS快速减少期，前见于桡骨近端，平均年减少率为2．4％，后见于胫骨中段，平均年减少率为1．8％。各部位骨SOS累积减少率随年龄增长而增加，到85岁4部位累积减少为13％-18％。60岁以后骨质疏松性症(OP)检出率为45％-70％，OP检出率以桡骨远端最高，60-70岁平均为67％，第3指骨近端次之约50％，胫骨中段最低为36％；75岁以后分别为70％，65％和45％。结论 全身各部位骨超声速度值到达峰值的年龄不同，峰值也各有差异。绝经后妇女骨超声速度值随年龄增加减少较快，应予激素和补钙治疗，桡骨远端为本地区SOS检测和OP检出的敏感部位。     

中脑导水管周围灰质小胶质细胞活化在大鼠神经病理性痛中的作用

目的 评价中脑导水管周围灰质小胶质细胞活化在大鼠神经病理性痛中的作用.方法 雄性SD大鼠176只,体重200 ～ 250 g,9周龄,采用随机数字法,将其分为4组:假手术组(S组,n=40)、神经病理性痛组(NP组,n=40)、生理盐水组(NS组,n=48)和米诺环素组(M组,n=48).NP组、NS组和M组采用慢性坐骨神经缩窄性损伤法制备大鼠神经病理性痛模型;S组仅暴露坐骨神经,而不结扎.术后第7天时,NS组和M组分别于中脑导水管周围灰质的腹外侧区注射生理盐水或米诺环素0.5μl.取8只大鼠,分别于术前1 d(T0)、术后第3天(T1)、第7天给药前30 min(T2)、第7天给药后30 min(T3)、第14天(T4)和第21天(T5)时测定机械痛阈.于T1-5时各处死8只大鼠,取脑组织,行小胶质细胞计数.结果 与S组比较,NP组、NS组和M组T1-5时机械痛阈降低,小胶质细胞计数升高(P＜0.05);NP组和NS组各时点机械痛阈和小胶质细胞计数差异无统计学意义(P＞0.05);与NP组和NS组比较,M组T3时机械痛阈升高,小胶质细胞计数降低(P＜0.05).结论 中脑导水管周围灰质小胶质细胞的活化参与了大鼠神经病理性痛中的形成与维持.     

沈阳男性髋部骨折多于女性原因探讨

为找出沈阳地区髋部骨折发生男性多于女性的原因，探索该病在不发达国家或地区的流行特点，我们再次通过查阅病例记录，对沈阳市１９９４年５０岁以上人口的部分髋部骨折病发生的原因进行了较详细的调查分析。共调查分析２６６髋部骨折病例，其中男１６３例，女１０３例。损伤原因记为单纯摔倒（滑倒或绊倒）、骑自行车摔倒、自行车撞倒、机动车事故和高位跌下（滚楼梯或从较高位置掉下）。结果表明：男女在髋部骨折伤因构成上有差别（Ｐ＝０．００４）。女性髋部骨折的大多数（７０％）是由单纯摔倒引起，而在男性则不足一半（４９％），即男性髋部骨折的一半以上不是由于单纯摔倒而是由各种意外事故造成的（Ｐ＝０．０００８）。在各种意外事故中，男性骑自行车摔倒引起骨折的频率（２８％）明显高于女性（１０％）。除了骑自行车摔倒外，男性由自行车撞倒和高位跌下引起骨折的频率稍高于女性，但无太大差别。机动车事故造成骨折的频率男女基本一致。此结果在一定的程度上说明，１９９４年沈阳５０岁以上的男性髋部骨折发病率高是由于男性发生的各种意外事故多，尤其是骑自行车引起的事故造成的。     

脊髓胶质细胞在大鼠炎性痛形成中的作用

目的 评价脊髓胶质细胞在大鼠炎性痛形成中的作用.方法 清洁Ⅱ级成年雄性SD大鼠,体重180～220 g,取蛛网膜下腔置管成功的大鼠65只,随机分为5组(n=13),生理盐水组(NS组):右后肢踝关节外侧皮下注射NS 50μl;炎性痛组(IP组):采用右后肢踝关节外侧皮下注射完全弗氏佐剂50μl的方法制备炎性痛模型;氟代柠檬酸组(FC组):经蛛网膜下腔导管注射FC 1 nmol/10 μl,15 min后右后肢踝关节外侧皮下注射NS 50 μl;NS+IP组:经蛛网膜下腔导管注射NS 10 μl,15 min后制备炎性痛模型;FC+IP组:经蛛网膜下腔导管注射FC 1 nmol/10 μ,15 min后制备炎性痛模型.于模型制备前2 d(T_0)、皮下注射药物前(T_1)和注射药物后2、4、6、8、10、12、24、26 h(T_(2～9))时测定机械缩足阈值(MWT)和热缩足潜伏期(TWL).皮下注射药物后8 h时采用免疫组化法测定脊髓背角星形胶质细胞标记物(GFAP)和小胶质细胞标记物(OX-42)的表达水平.结果 与NS组比较,IP组和NS+IP组T_(3～9)时MWT和TWL降低,FC+IP组T_(3～9)时MWT降低,T_(8,9)时TWL降低,IP组、NS+EP组和FC+EP组脊髓GFAP和OX-42的表达水平均上调(P<0.05);与IP组比较,FC组T_(3～9)时MWT和TWL升高,FC+IP组T_(3～7)时MWT和TWL升高,2组脊髓GFAP和OX-42的表达水平均下调(P<0.05或0.01).结论 脊髓胶质细胞的活化参与了大鼠炎性痛的形成.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.