两种卧位吸氧改善COPD急性发作期患者氧合的效果探讨

目的为延长置管时间,减少患者反复穿刺的痛苦和不必要的费用,寻找一种对糖尿病患者静脉留置导管最有效的肝素封管液浓度.方法对120例静脉留置针输液的糖尿病患者按输液时间的先后分为A、B组各60例(A组4例,B组1例中途退出试验).A组在第1次留置针时用1.50%肝素液封管;B组用2.50%肝素液封管;两组第2次留置针时封管肝素液对换.结果 2.50%肝素液封管堵塞率明显低于1.25%液(P＜0.05),患者在整个输液过程中均无封管不良反应、静脉炎及出血等发生.结论 2.50%肝素液是糖尿病患者静脉留置导管最为有效的封管浓度.     

护士对常规检验项目认知情况调查分析

目的了解护士对常规检验项目及相关知识的掌握情况.方法采用自拟问卷,对538名护士进行检验报告知识掌握情况的调查.结果护士对检验项目认知的总正确率仅为27.5%.不同护龄、职称、学历护士回答正确率均处于低水平.结论护士应充分认识检验报告对护理工作的重要意义,应加强相关知识的学习,以提高护理质量.     

成人外周静脉留置针使用情况调查

目的了解成人外周静脉留置针使用现状,为规范使用留置针提供参考。方法采用多阶段抽样,对湖南省14个地州市14所医院1 594例成人患者进行留置针使用情况调查,包括留置针类型、输液接头类型、穿刺部位、冲封管情况、置管侧肢体情况及结局。结果 90.96%的患者使用密闭式留置针,47.99%的患者使用肝素帽接头,45.92%穿刺部位为手背,冲封管液主要为生理盐水(80.93%),脉冲式冲封管占86.20%,输液结束后冲封管占94.98%,置管侧上肢下垂超过1h占40.84%,并发症或不良事件主要为堵管(19.39%)、外渗/渗出(12.67%)、静脉炎(7.28%)。结论临床护士使用留置针的安全防范意识有所提高,但穿刺部位选择、冲封管手法和时机及对患者的健康教育有待加强,以减少并发症的发生。     

不同浓度肝素液封管对糖尿病患者留置针堵管的影响

目的为延长置管时间,减少患者反复穿刺的痛苦和不必要的费用,寻找一种对糖尿病患者静脉留置导管最有 效的肝素封管液浓度。方法对120例静脉留置针输液的糖尿病患者按输液时间的先后分为A、B组各60例(A组 4例,B组1例中途退出试验)。A组在第1次留置针时用1.50%肝素液封管;B组用2.50%肝素液封管;两组第2 次留置针时封管肝素液对换。结果2.50%肝素液封管堵塞率明显低于1.25%液(P<0.05),患者在整个输液过程 中均无封管不良反应、静脉炎及出血等发生。结论2.50%肝素液是糖尿病患者静脉留置导管最为有效的封管浓 度。     

胺碘酮致静脉炎防治的循证护理

目的探讨预防胺碘酮致静脉炎循证护理效果。方法运用循证护理方法得出证据形成建议,制定静脉应用胺碘酮操作规范。收集循证护理前后胺碘酮致静脉炎发生率,并调查患者对静脉应用胺碘酮用药知识的知晓率、考核护士对静脉应用胺碘酮护理规范的掌握情况。结果循证护理实施后胺碘酮致静脉炎发生率显著降低、患者相关知识知晓率显著提高,护士考核分显著高于培训前(均P0.01)。结论采用循证护理实践规范静脉应用胺碘酮可降低患者静脉炎的发生,减轻患者痛苦,提升护理质量。     

《静脉治疗护理技术操作规范》践行的质量促进

目的确保临床护士按照《静脉治疗护理技术操作规范》的要求执行静脉输液治疗,保证静脉治疗护理的安全。方法根据国家卫生与计划生育委员会发布的《静脉治疗护理技术操作规范》(2014),制定"静脉治疗护理操作质量评价标准",每个月对临床静脉输液治疗进行质量督导,分别于实施前与实施后对住院输液患者各抽取1d进行静脉输液情况调查,比较两个时间段输液患者钢针使用情况、静脉输液工具选择正确性、血管通路固定正确率、患者健康教育知识掌握率。结果实施后钢针使用率从21.78%下降至14.20%,钢针、留置针选择正确率分别由59.79%、83.26%上升至78.72%、95.69%,留置针、PICC、CVC固定正确率分别由58.14%、69.09%、60.26%上升至79.11%、85.15%、75.95%,患者静脉治疗健康教育知识掌握率上升;实施前后比较,差异有统计学意义(P0.05,P0.01)。结论通过有效的静脉治疗护理技术操作质量控制,有效降低钢针使用率,提高血管通路管理质量。     

医院高年资护士从事社区护理意向调查

目的 了解湖北省部分综合性医院高年资护士从事社区护理意向、影响因素及需培训内容.方法 采用自制的高年资护士从事社区护理愿意调查问卷对270名在职高年资护士进行问卷调查.结果 66.7%高年资护士愿意从事社区护理,88.1%认为从事社区护理能发挥才能;影响因素主要是待遇低(占39.3%)、欠缺社区护理知识(占35.6%)...     

结核病专科医院临床护士营养知识态度现状调查分析

目的了解结核病专科医院护士的营养知识和态度的现状,分析其相关性,为针对性地进行营养知识培训提供依据。方法采用方便抽样的方法,对某三甲结核病专科医院的256名临床护士的营养知识和态度进行调查。结果护士营养知识正确率53.74%,得分(16.12±4.56)分,其中良好、一般、差者分别占1.2%、41.0%、57.8%;不同年龄、工作年限、学历、职务、编制、工作状况护士的营养知识掌握情况比较,差异有统计学意义(P0.05,P0.01);态度得分为(94.56±10.53)分,持正性、中性、负性态度者分别占64.5%、33.6%、1.9%,不同职称护士的营养态度得分差异有统计学意义(P0.01);营养知识与态度呈正相关(P0.01)。结论护理管理者应加强对护士营养知识的培训,端正其对营养的态度,从而提高营养护理质量。     

社区护士对老年居民跌倒预防认知的调查

目的了解社区护士对老年人跌倒预防的认知情况,为制定社区老年人跌倒预防工作方案提供参考。方法采用自行设计的问卷,对宁波市20所社区卫生服务中心的220名护士进行老年人跌倒预防认知情况调查。结果 93.64%社区护士愿意参加老年人跌倒预防知识技能培训,84.54%愿意参与社区老年人跌倒预防管理。社区护士对老年人跌倒预防认知总分(75.54±12.27)分,其中跌倒知识(54.07±10.24)分,知识条目均分为3.40~3.77分,处于中等水平;跌倒态度(21.47±3.60)分,各条目均分为4.20~4.40分,态度总体良好。有无接受过跌倒预防相关知识培训,既往有无对老年人进行跌倒风险评估、有无对老年人进行跌倒预防教育的社区护士在跌倒预防知识得分及总体得分方面存在差异(均P0.01)。结论社区护士对老年人跌倒预防态度较好,但需采取多种形式对社区护士进行跌倒预防相关知识培训,使社区护士更好地掌握老年居民跌倒预防知识和技能。建议开展和推进社区老年人跌倒预防工作。     

护士对常规检验项目认知情况调查分析

目的了解护士对常规检验项目及相关知识的掌握情况。方法采用自拟问卷,对538名护士进行检验报告知识掌握情况的调查。结果护士对检验项目认知的总正确率仅为27．5％。不同护龄、职称、学历护士回答正确率均处于低水平。结论护士应充分认识检验报告对护理工作的重要意义，应加强相关知识的学习,以提高护理质量。     

牙体牙弓颌骨阻力中心及其临床意义

牙体、牙弓及颌骨的阻力中心在正畸矫治力系统中具有重要的意义,也是正畸学领域争论较多的一个问题。Dermaut等研究表明,当力作用于物体阻力中心时,物体将发生平动,否则将发生平动和转动的复合运动。目前,国内外多数学者认为牙体、牙弓及颌骨存在阻力中心,但其位置存在争议。本文就牙体、牙弓及颌骨的阻力中心及其临床意义作一综述。     

Hazards and complications of endoscopic transurethral ureterolithotripsy and lithoextraction and means of prevention

Complications related to ureterolithotomy and ultrasonic ureterolithotripsy performed under the control of visual endoscope were analyzed in 86 ureterolithiasis patients, methods of their prevention discussed. All the aforementioned complications were distributed into three groups: inapplicability of surgery due to anatomic and functional defects of lower and upper urinary tracts, intraoperative, and postoperative complications. The commonest ones were ureteral abruption and perforation, acute pyelonephritis, temporary vesicoureteral reflux. Their control measures were considered as relative methods of treatment: immediate surgical intervention in case of ureteral abruption, renal catheterization in patients with insignificant ureteral perforation or acute pyelonephritis. Adequate ureteroscopy, careful consideration of pro- and contraindications, catheterization of renal pelvis and urinary bladder performed within 2-3 days after the surgery and adequate antibacterial therapy are the most decisive steps in the control of aforementioned complications.     

Histochemical and contractile properties of striated muscles of urethra and levator ani of dogs and sheep

AIMS: To understand their possible importance in long- and short-term control of continence, some properties of the striated muscles of the urethra and pelvic floor (levator ani) of dogs and sheep were investigated, especially fiber types and contractile characteristics. MATERIALS AND METHODS: Striated muscles of urethra and levator ani of 29 male and 6 female dogs and 11 male and 6 female sheep were removed and cut into strips. Some strips were frozen and stained for ATPase at pH 9.4 and 4.3 for fiber typing; others were set up in an organ bath to study contractile responses to nerve stimulation. RESULTS: All muscles contained both type I (slow) and type II fibers, ranging from 97% type II in female greyhound urethra to 60% in female sheep levator ani. For each muscle, there were fewer type II muscles in sheep than in dog. The diameters of the urethral fibers were about 60% of the levator ani in dogs and 34% in sheep. Contraction of the urethral muscle was faster than for levator ani and declined to about 80% of the peak, 500 msec after the beginning of stimulation at 20 Hz. The levator ani contraction rose to a steady level as long as stimulation continued. CONCLUSIONS: Both the levator ani and urethral striated muscles contain slow and fast fiber types. The levator ani muscles are capable of sustained contraction with rapid onset which will produce long-term closure of the urethra. The circular urethral muscle contraction was faster but less well maintained.     

Characterisation and differentiation of chondroblastomas and chondromyxoidfibromas - presence and expression of collagen types I and II

AIM: Chondroblastomas and chondromyxoidfiibromas are rare benign skeletal neoplasms with reported overlapping histology. Aim of this study was to analyse the biochemical composition of the matrix of these tumour entities in order to further characterise the cellular phenotypes of these neoplasms using typical cell biological marker genes. METHODS: The matrix compositions of chondroblastomas and chondromyxoidfibromas were analyzed by HE-histology, histochemistry, and immunolocalization techniques. Cellular gene expression patterns were detected by mRNA in situ hybridization. RESULTS: Chondroblastomas are rich in collagen type I and show foci of an osteoid-like matrix, whereas collagen type II as a typical marker of chondrocytic differentiation was not detected in any of the specimens. Chondromyxoidfiibromas had foci of chondroid appearance with chondroblastic cellular differentiation characterised by collagen type II expression. CONCLUSION: These results characterise chondroblastomas and chondromyxoidfiibromas as skeletal neoplasms that have a different biology and which can be distinguished by matrix protein expression products: collagen type II, the typical marker of chondroblast differentiation, could only be detected in chondromyxoidfibromas, but not in chondroblastomas. Thus, both neoplasms are clearly different on the cell biological level.