呼吸训练联合音乐疗法对门诊患者肝脏MRI增强扫描效果的影响

目的探讨呼吸训练联合音乐疗法对患者肝脏MRI增强扫描的效果和负性情绪的影响。方法选取2017年3—10月在北京大学肿瘤医院行肝脏MRI增强扫描检查的门诊患者100例为研究对象。按检查单双号分为观察组(n=50)、对照组(n=50)。对照组患者在检查前、检查时给予常规的呼吸指导及护理措施,观察组患者在对照组基础上,在检查前增加呼吸训练指导、检查时给予音乐疗法。对比两组患者检查时间、心率波动、负性情绪、图像质量及检查配合度的情况。结果两组患者检查前准备时间无统计学差异(P0.05),观察组检查时间少于对照组(P0.05),观察组心率波动频次少于对照组(P0.05);检查前两组患者焦虑自评量表、抑郁自评量表评分无统计学差异(P0.05),检查结束后观察组焦虑、抑郁评分均低于对照组(P0.05);观察组肝脏MRI增强扫描图像质量、患者检查配合度高于对照组(P0.05)。结论呼吸训练联合音乐疗法能有效提高肝脏MRI增强扫描的检查效率,改善患者的负性情绪及检查配合度,提高肝脏核磁共振成像质量。     

背景音乐在纤维支气管检查术中的应用

目的通过在纤维支气管检查(bronchofiberscopy BFS)术中应用背景音乐,有效地稳定患者术中的心率、血压,使检查顺利地完成,提高患者的满意度。方法选择BFS术患者100例,随机分音乐组和对照组。音乐组术中给予常规护理,同时播放背景音乐,对照组仅给予常规护理,无背景音乐。比较两组患者检查术前、术中的心率、血压、血氧饱和度波动情况,术后进行满意度调查。结果音乐组患者在检查过程中情绪、心率、血压波动明显低于对照组(P<0.01),患者满意度明显高于对照组(P<0.01),血氧饱和度变化无差异(P>0.05)。结论在BFS术中应用背景音乐可有效减轻患者术中心率及血压波动,提高满意度。     

家属陪同模拟场景呼吸训练对冠状动脉CT血管造影检查的影响

目的 探讨在家属陪同下进行模拟场景呼吸训练对冠状动脉CT血管造影(CCTA)检查时患者呼吸配合及图像质量的影响,旨在提高患者检查配合度、检查效率及图像质量。方法 选取2021年7月至2022年6月收治于西安大兴医院心脏内科拟行CCTA检查的患者作为研究对象。将其随机分为3组,每组各90例。A组：检查前1 d至医院准备室,在家属全程陪同下于模拟场景中进行呼吸训练;B组：检查当天在无家属陪同的情况下,于模拟场景中进行呼吸训练;C组：检查当天接受常规呼吸训练。比较3组患者呼吸训练前及正式检查前焦虑自评量表(SAS)得分情况,以及正式检查时的呼吸配合达标率、心率稳定度和冠状动脉图像质量。结果 A组及B组患者CCTA检查呼吸配合达标率均为100%,C组为91.11%,3组比较差异有统计学意义(χ²=8.326,P=0.004)。正式检查前,A组患者SAS评分低于B组与C组(P<0.05);且A组患者检查过程中心率波动最小[(1.81±6.99)次/min],冠状动脉图像质量优良率最高(97.78%);均优于B、C组(P<0.05)。结论 检查前1 d在家属陪同下...     

聚焦解决模式对乳腺癌MRI检查患者负性情绪及应激反应的影响

目的探讨聚焦解决模式干预对乳腺癌核磁共振检查患者负性情绪及应激反应的影响。方法根据随机数字表将124例行乳腺癌核磁共振检查患者分为观察组及对照组各62例,对照组实施常规心理护理及健康宣教,观察组在对照组基础上应用聚焦解决模式干预,比较两组检查依从性、患者满意率、负性情绪及应激反应情况。结果观察组检查依从性及满意度显著高于对照组(P0.05),观察组患者检查后收缩压、舒张压、心率水平低于对照组(P0.05),观察组患者检查后汉密尔顿焦虑量表、汉密尔顿抑郁量表评分低于对照组(P0.05)。结论聚焦解决模式干预能有效改善乳腺癌核磁共振检查患者负性情绪及应激反应。     

音乐放松训练对心血管患者负性情绪的影响

目的:探讨音乐放松训练对心血管患者负性情绪的影响。方法:将100例心血管患者随机分为音乐组和对照组各50例。音乐组给予播放轻音乐进行放松训练,对照组予以常规护理,观察并记录两组患者的心率、血压、负性情绪变化,同时进行焦虑评分。结果:音乐组患者入院后血压、心率、HAMA得分与对照组比较差异有统计学意义(P<0.05)。结论:对心血管患者实行音乐疗法可改善患者的负性情绪,有利于身心健康和疾病康复,同时缩短住院时间。     

背景音乐在普通肠镜检查中的应用

目的 探讨背景音乐在普通肠镜检查中的应用效果.方法 将2006年9～11月来该中心进行普通肠镜检查并且符合研究条件的患者132例随机分成音乐组62例和对照组70例,音乐组患者给予全程播放背景音乐;对照组患者按常规程序进行.监测两组患者在候诊时、检查前、检查后10 min的心率、血压变化情况和检查时的疼痛指数、焦虑指数、检查时间和配合程度.并进行统计学分析.结果 两组患者在检查前血压波动、检查后心率和血压平稳的差异均有显著性(P<0.05),两组患者在检查前心率波动、焦虑指数,检查时的疼痛指数、操作时间、配合程度,检查后焦虑指数与检查结果的差异均无显著性.结论 背景音乐的播放能平稳普通肠镜检查患者的心率和血压,而对缓解焦虑和疼痛作用不显著,应用价值无显著性.     

呼吸训练在肝脏核磁共振成像增强扫描患者护理中的应用

目的探讨呼吸训练在肝脏核磁共振成像(magnetic resonance imaging,MRI)增强扫描患者护理中的应用效果。方法按检查先后将2010年1月至2011年12月在第二军医大学东方肝胆外科医院拟行肝脏MRI增强扫描的206例患者分为对照组(100例)和观察组(106例),对照组行普通常规护理,观察组在对照组的基础上予以呼吸训练及心理疏导。结果 206例患者均顺利完成检查,观察组患者MRI增强扫描的图像质量及合格率均优于对照组(均P0.01)。结论在肝脏MRI增强扫描过程中,对患者进行有效的呼吸训练及心理疏导,能够缓解患者的紧张情绪,提高检查图像的质量。     

呼吸训练联合ABC情绪护理对行肝脏磁共振动态增强扫描患者的影响

目的:探讨呼吸训练联合ABC情绪护理对行肝脏磁共振动态增强扫描患者的影响。方法:选取2017年6月1日~2018年12月31日行肝脏磁共振动态增强扫描的患者204例,按照随机数字表法分为观察组和对照组各102例,对照组实施常规护理,观察组采用呼吸训练联合ABC情绪护理;比较两组检查完成所需时间、一次性检查成功率、伪影发生率、不良反应及护理前后焦虑程度[采用焦虑自评量表(SAS)]。结果:观察组检查完成所需时间短于对照组(P<0.05),一次性检查成功率高于对照组(P<0.05),伪影发生率、检查期间不良反应发生率均低于对照组(P<0.05);护理后,观察组SAS评分低于对照组(P<0.01)。结论:呼吸训练联合ABC情绪护理应用于行肝脏磁共振动态增强扫描患者中,有利于稳定其不良情绪,减少应激反应,缩短检查时间,提高图像质量。     

护理干预在256层螺旋CT冠状动脉成像中的应用

目的:探讨护理干预在256层螺旋CT冠状动脉成像中的应用效果。方法:将行256层螺旋CT冠状动脉成像检查的482例患者随机分为干预组和对照组各241例,对照组进行心率及心律控制的常规护理,干预组在此基础上进行心理支持、心率及心律控制、呼吸训练等护理干预,比较两组患者检查时心率和呼吸的配合情况。结果:干预组患者检查时的心率和呼吸配合均优于对照组(P<0.05,P<0.01)。结论:对行256层螺旋CT检查的患者进行细致科学的护理干预,可消除患者的恐惧心理,保证患者呼吸配合及心率稳定,提高检查成功率。     

静默法放松训练应用于白内障手术患者对负性情绪、术中配合度及生理应激反应的影响

目的探究静默法放松训练应用于白内障手术患者对负性情绪、术中配合度及生理应激反应的影响。方法选取本院2017年8月-2017年10月收治的行常规护理的白内障手术患者30例作为对照组,另选取本院2017年11月-2018年1月收治的行静默法放松训练的白内障手术患者30例作为观察组。对比两组术中配合度及护理前后负性情绪、生理应激反应变化。结果观察组术中配合度优于对照组,差异有统计学意义(P0.05);观察组护理1周后SAS、SDS评分均低于对照组,差异有统计学意义(P0.05);观察组护理1周后收缩压、舒张压、心率均低于对照组,差异有统计学意义(P0.05)。结论静默法放松训练应用于白内障手术患者可有效提高术中配合度,缓解负性情绪,减轻生理应激反应,值得临床推广。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

骨脂肪瘤及血管脂肪瘤的CT及MRI表现:9例报告并文献复习

目的探讨骨脂肪瘤及血管脂肪瘤的CT及MRI表现。方法收集手术病理证实的9例骨脂肪瘤及血管脂肪瘤的临床及影像学资料,9例术前8例接受CT扫描,3例接受MRI检查。结果9例中骨脂肪瘤6例,骨血管脂肪瘤3例。6例骨脂肪瘤发生于骨内4例,骨旁2例。骨内脂肪瘤跟骨1例,距骨1例,眶骨1例,肱骨1例。骨旁脂肪瘤颅骨1例,股骨1例。骨血管脂肪瘤发生于肋骨1例,颅骨1例,椎骨1例。骨内脂肪瘤CT显示病变骨质呈轻度膨胀性改变,边缘见轻度硬化环,病灶内见脂肪密度及条弧形、结节状钙化,MRI显示病灶T1WI呈高信号,PDWI及T2WI抑脂序列呈低信号。骨旁脂肪瘤CT呈不均匀高密度团块,MRI显示病灶T1WI呈高信号,T1WI及T2WI抑脂序列呈低信号。3例骨血管脂肪瘤CT显示病变骨质呈显著膨胀性改变,骨破坏边缘及内部见多发骨嵴及粗大骨小梁,高密度骨针呈放射状、簇状或不规则排列。结论骨内脂肪瘤及血管脂肪瘤CT及MRI表现均以脂肪成分为主要特征,骨旁脂肪瘤CT以骨化性团块为特征,骨血管脂肪瘤骨质膨胀性改变较骨内脂肪瘤显著,病灶边缘及中心以多发骨嵴及粗大骨小梁为特征。