自制专用病号裤联合自制弹性加压盐袋在肝癌介入治疗术后的应用

【摘要】 目的 探讨在肝癌患者介入治疗术后使用自制专用病号裤联合自制弹性加压盐袋的应用效果。方法 选取符合标准的100例肝癌介入治疗患者,随机分为观察组（n =50）和对照组（n =50）,对照组用简易盐袋压迫穿刺点和穿一般病号裤,观察组用自制弹性加压盐袋压迫穿刺点和穿专用病号裤,比较两组患者的穿刺点出血并发症发生率、患者的舒适度、腰背部痛、满意度。采用SPSS18.0软件包进行数据处理。采用卡方检验评估穿刺部位出血并发症发生率,采用t检验评估患者舒适度、腰背部痛及满意度,以 P＜0.05为差异有统计学意义 。结果 观察组术后出血并发症（2例）明显低于对照组（8例）（P＜0.05）;观察组术后舒适（80.2±6.0）%明显高于对照组（71.8±5.8）%（P＜0.05）;观察组腰背痛（5.0±1.0）%明显低于对照组（5.4±1.1）%（P＜0.05）,观察组患者满意度高于对照组（P＜0.05）。结论 肝癌患者介入治疗术后联合使用上述两项自制护理用具,可以减低穿刺点出血并发症,提高患者的舒适度,缓解腰背部疼痛,改善患者的就医体验,提高患者对优质护理的满意度,在肝癌血管介入手术的临床护理和应用程序中值得推广。

     

对肝癌介入栓塞术后并发症循证护理的临床应用

【摘要】 目的 探讨肝动脉化疗栓塞（TACE）治疗原发性肝癌术后并发症的护理策略。方法 入选2010年2月—2013年2月进行肝动脉化疗栓塞（TACE）术的原发性肝癌患者98例,分为常规护理组49例和循证护理组49例,给予不同护理措施,观察两组患者并发症情况以及患者对护理服务的满意程度。结果 循证护理措施实施前,两组患者术后各并发症发生率差异均无统计学意义（P > 0.05）;实施后,循证护理组并发症发生率明显低于常规护理组（P ＜ 0.05）。循证护理组患者满意度明显高于常规护理组,差异具有统计学意义（P ＜ 0.05）。结论 循证护理理论应用于原发性肝癌患者介入栓塞术治疗,对并发症预防有积极意义,能够对护理工作进行积极指导,同时提高护理质量,提升护理人员个人素质。
     

循证护理应用于经皮冠状动脉支架植入患者围术期舒适度的效果评价

【摘要】 目的 探讨经皮穿刺冠状动脉造影及支架植入的患者围术期循证护理的效果。方法 136例患者随机分为干预组和对照组各68例,对照组采用传统护理措施,干预组采用循证护理干预,比较两组术后24、48、72 h舒适度,并发症和护理满意度。结果 术后24、48、72 h干预组舒适量表（GCQ）各维度评分及总分均显著高于对照组（均P ＜ 0.05）。干预组腰痛、尿潴留、低血压的发生率显著低于对照组（P ＜ 0.05）。干预组患者对护理的满意度显著高于对照组（P ＜ 0.05）。结论 循证护理有效提高对经皮冠状动脉介入患者围术期的护理技能和针对性,减少腰痛、尿潴留和低血压的发生,显著提高患者术后舒适度和护理满意度,值得推广。     

TACE术后加压制动裤在预防术后出血和压疮中的应用

【摘要】 目的 探讨TACE术后加压制动裤在预防术后出血和压疮中的作用。方法 选取2015年5月至2016年5月行肝癌经股动脉穿刺介入治疗的50例患者作为研究对象,将患者随机分为观察组和对照组,每组各25例。观察组采用TACE术后穿加压制动裤并按TACE术后护理常规执行,对照组按TACE术后护理常规并予沙袋压迫穿刺点6 h执行。观察两组患者穿刺点处局部淤血、血肿和假性动脉瘤指标的差异;观察两组患者的受压部位皮肤情况,有无皮肤潮湿感、灼热感、麻木感及发红情况。结果 观察组出血发生率为4%,明显低于对照组的出血发生率32%。两组患者均无压疮发生,但是皮肤潮湿及灼热感、麻木感、皮肤发红方面,观察组优于对照组（P＜0.05）。结论 TACE术后加压制动裤有预防术后出血、压疮发生的作用。该裤设计合理,结构简单,穿脱方便,提高了患者的舒适度及满意度,值得推广使用。
     

肝动脉化疗栓塞联合门静脉栓塞治疗中晚期肝癌的疗效评价

目的评价经导管肝动脉化疗栓塞术（TACE）联合门静脉化疗栓塞术（PVCE）治疗中晚期肝癌的疗效。方法中晚期肝癌患者４８例,随机分为治疗组２２例和对照组２６例,分别采用TACE联合PVCE和常规TACE方法治疗。结果术后复查CT和甲胎蛋白（AFP）,治疗组有效率较对照组高,两组差异有统计学意义（P＜０．０５）。治疗组术后非栓塞肝组织体积显著增大。结论TACE和PVCE联合治疗中晚期肝癌疗效优于单独TACE技术,且可有效增加手术切除率。     

中晚期原发性肝癌合并症的介入治疗研究

目的探讨中晚期原发性肝癌合并症的综合介入治疗方法。方法将经病理、影像学诊断及AFP值证实的原发性肝癌符合筛选条件的患者共６２例,按住院号数的单、双数随机分成两组:对照组（单纯TACE组）３２例,综合治疗组（TACE＋合并症处理组）３０例。综合治疗组行TACE术时对肝动静脉瘘、门静脉癌栓及下腔静脉病变等并发症给予综合处理。结果TACE组治疗３２例患者,１、２和３年生存率分别为６８％、５０％和１９％,中位生存期１．５年;综合治疗组３０例患者１、２和３年生存率分别为８７％、７５％和４８％,中位生存期２．０年。综合治疗组的生存率及生存期均显著高于对照组（P＜０．０５）。与对照组相比综合治疗组疗效与死亡风险率差异有统计学意义（P＜０．０５）。结论原发性肝癌合并症的控制可增加TACE的疗效,显著提高原发性肝癌患者生存率,延长生存期。     

综合干预对乙肝病毒相关性肝癌TACE患者药物依从性的效果研究

【摘要】 目的 探讨由护理人员主导的综合干预对乙肝病毒相关性肝癌TACE患者药物依从性的影响。方法 本研究采用随机抽样的方法纳入96例某三级甲等肿瘤医院介入科曾接受TACE治疗并服用核苷酸类似药物1个月的乙肝病毒相关性肝癌患者。患者在知情同意的前提下,接受由护理人员主导的、医师和护士共同实施的综合干预。结果 ①干预后的服药依从性得分平均值（93.67±6.046）高于干预前（82.04±10.024）（P＜0.05）,干预后服药依从性良好的患者的比率（97.8%）高于干预前（62.4%）（P＜0.05）;②干预后血清HBVDNA处于正常范围的患者比率（45.16%）高于干预前（15.05%）（P＜0.05）。结论 由护理人员主导的综合干预能有效改善乙肝病毒相关性肝癌TACE患者药物依从性,有利于控制血清HBVDNA水平。
     

快速康复理念在肝癌患者行肝动脉化疗栓塞中的应用

【摘要】 目的 探讨快速康复理念在肝癌患者行肝动脉化疗栓塞（TACE）中的应用效果。方法 入选行TACE的肝癌患者98例，以2014年7月至10月的50例患者为对照组，以2014年11月至2015年3月的48例患者作为观察组。对照组按常规方法进行护理，观察组根据快速康复理念，在围手术期采取有循证医学证据的一系列优化措施，比较两组患者TACE后住院时间，疼痛、发热、腹胀、便秘、恶心呕吐及穿刺点并发症等方面的差异。结果 两组患者术后住院时间、疼痛、腹胀、便秘、恶心呕吐比较，差异有统计学意义（P＜0.05），两组患者发热、穿刺点并发症发生率比较，差异无统计学意义（P＞0.05）。结论 快速康复理念应用于肝癌患者行TACE是安全可行的，可减少术后不良反应，促进康复。

     

穴位按摩联合音乐疗法对肝癌介入术后患者疼痛的影响

【摘要】 目的 探讨穴位按摩联合音乐疗法对肝癌介入术后患者疼痛程度的影响。方法 在常规护理的基础上,将150例首次行介入术治疗的原发性肝癌患者随机分为3组,穴位按摩组50例,音乐疗法组50例,联合组50例。采用数字疼痛评分（NRS）法、休斯顿疼痛情况调查表（HPOI）,评价3组患者术后疼痛程度及疼痛控制满意度。结果 穴位按摩组、音乐疗法组与联合组之间疼痛疗效存在组间差别（P＜0.05）,同一时间内,穴位按摩组和音乐疗法组患者疼痛评分明显高于联合组（P＜0.05）;穴位按摩组和音乐疗法组患者疼痛对身体或日常生活的影响高于联合组（P＜0.05）,患者疼痛控制方法满意度低于联合组（P＜0.05）。结论 穴位按摩联合音乐疗法能够有效降低肝癌介入术后患者疼痛程度,减轻患者痛苦,提高患者疼痛控制满意度。
     

肝动脉化疗栓塞联合微波消融与单独肝动脉化疗栓塞治疗大肝癌疗效meta分析

【摘要】 目的 对比肝动脉化疗栓塞（TACE）联合微波消融（MWA）与单独TACE治疗大肝癌的临床疗效。方法 计算机辅以人工检索国内外关于MWA+TACE与单独TACE治疗大肝癌效果对比的临床对照试验。纳入分析患者生存率和肿瘤反应及并发症。结果 符合条件的16篇文献1199例患者纳入分析。Meta 分析结果显示:TACE+MWA组1、2、3年生存率优于单独TACE组,差异均有统计学意义（P＜0.01）。TACE+MWA组CR和PR高于单独TACE组,差异均有显著统计学意义（P＜0.01）。TACE+MWA组SD和PD低于单独TACE组,差异均有统计学意义（P＜0.01）。结论 TACE + MWA 对于大肝癌的治疗要优于单独TACE治疗。
     

融媒体在下肢动脉硬化闭塞症介入治疗患者健康教育中的应用

【摘要】 目的 探讨融媒体在下肢动脉硬化闭塞症介入治疗患者健康教育中的应用效果。方法 选取符合条件的动脉硬化闭塞症患者96例,按随机数字表法分为观察组及对照组各48例,观察组采用融媒体结合口头教育从入院到出院后持续进行健康教育,对照组采用传统口头教育方法住院期间进行健康教育,比较两组患者自我管理能力、生理指标达标率（血压、血糖、血脂、踝肱指数ABI）、健康教育满意度。结果 观察组患者自我管理能力、生理指标达标率、健康教育满意度均优于对照组,差异具有统计学意义（P＜0.05）。结论 使用融媒体能够提高动脉硬化闭塞症介入治疗患者健康教育效果,有利于患者早日康复。

     

Energy education

An attempt to present briefly some important aspects of energy-education as an emerging discipline is made in this paper. Suggestions concerning the evolvement of an effective approach for energy-education at all levels have also been made.     

RE education and training

Widespread education in sustainable energy could hold the key to the accelerated implementation of renewables and the long-term future of the industry. Bruce Douglas, Public Relations Manager at LIOR International, Belgium explores a range of education and training resources for all levels.     

Reengineering education: a change is needed in U.S. engineering education

This article discusses the need to redesign engineering education in the US. The author emphasizes that the prime directive of engineering education must be subject integration. The solution is not merely teaching more math and science, or experimenting with the curricula to remove this suite of subjects and add that series of topics. It should be about teaching tomorrow's engineers how to make tough choices and tradeoffs that blend both the technical and nontechnical aspects of a problem into a choice that has real value to society.     

Effective education for energy efficiency

A lot of today's world vices can be eliminated if certain targeted modules and adapted curricula are introduced in the schooling system. One of these vices is energy squandering with all its negative consequences for the planet (e.g. depletion of finite energy sources and the subsequent climate change). This paper describes the results of an energy-thrift information and education project taking place in different levels of education in Crete—Greece, which records 321 students’ and their parents’ routine energy-related behavior and proves that this behavior changes to a more energy efficient one, after the dissemination of relevant information and the participation into the energy education projects. Namely, response percentages indicating the energy-efficient behavior increased after project participation while the ones indicating an energy-squandering behavior decreased. The Wilcoxon signed rank test was statistically significant in all energy behavior questions related to students and to most questions related to parents.     

A European photovoltaic education initiative

Twyford CE High School has an ongoing research project developing CdS-CdTe thin film solar cells. Using a wet dip process, cells of 10% efficiency (over 1 cm²) are fabricated, with 75% of the cells made reaching this efficiency. The school has used its contacts formed during this work with academic and commercial institutions in the Community to develop an international curriculum project, which is described here.This project has developed a teaching module suitable for 16–18 year olds studying Physics at advanced level in the area of Renewable Energy, principally photovoltaics. This has provided a curriculum focus for exchange visits between the participating schools in London and Frankfurt.     

Renewable energy education in Turkey

Utilization of renewable energy sources and the application of environmentally sound energy technologies are essential to sustainable development and will help to secure the quality of living and the well-being of the future generations. Turkey presently has considerable renewable energy sources. The most important renewable sources are hydropower, wind, solar, geothermal, and biomass. The use of renewable energy as a topic to study energy and its forms permits a novel way to motivate students, particularly those who energy topics taking conscience with the environment. This paper presents the analysis and classification of renewable energy sources and how to find out their origin and a way to motivate students in energy topics related to renewable sources and also, the development of didactic competencies in special blended learning arrangements for educationalists, trainers and lecturers in adult education in the field of renewable energies in Turkey.     

New directions in renewable energy education

The renewable energy industry is growing rapidly amidst rising concerns about oil depletion and climate change. Renewable energy is seen by many as part of the appropriate response to these concerns and some national Governments have put programs in place to support the wider use of sustainable energy systems. This has led to a rapid increase in demand for renewable energy specialists who are able to design, install and maintain such systems. Most engineers are not trained to use these renewable energy technologies and most are not aware of the principles of sustainability. There is therefore an urgent need to develop and implement new courses that prepare engineers, scientists and energy planners to work with renewables to produce sustainable energy generation systems.Renewable energy education is a relatively new field and previously it formed a minor part of traditional engineering courses. These days it has an identity of its own, with special techniques, standards and requirements which are not normally encountered in other disciplines. Attempts to add one or two units of study on renewables into traditional science and engineering degrees are unlikely to produce graduates with sufficient knowledge or understanding to use renewables effectively. Modern renewable energy education includes a study of the technology, resources, systems design, economics, industry structure and policies in an integrated package. This prepares the graduates to design sound systems from amongst the range of options available. There are more pitfalls in the use of renewables than there are in using the more mature conventional technologies and systems. Designers, installers and service personnel need to be particularly aware of the industry and the characteristics of the various firms and their technologies.Over the past decade several new approaches have emerged to renewable energy education that seek to address the needs of the 21st century for sustainable energy supply systems.This paper will describe the aims, philosophy, structure and outcomes of several of these initiatives. It includes courses in renewable energy science, renewable energy engineering, renewable energy policy and planning and renewable energy technician training. The paper will also describe some aspects of the training of researchers in cooperation with the renewable energy industry.     

Renewable energy education for sustainable development

Rising international concern about global warming and the rapid development of the renewable energy industry over recent years has led to a need for multidisciplinary programs in energy studies. We have developed a postgraduate program in energy studies which is based on the principles of ecologically sustainable development. This program combines work in energy technology with energy policy, energy economics and environmental and social issues. The program is offered on campus at Murdoch University and by external study, via the internet, throughout Australia and overseas. It has attracted considerable interest from students seeking to find new opportunities within the renewable energy industry. This paper outlines the philosophy of the energy studies program, its implementation and outcomes.