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《广州医药》编辑部
目的 探究综合性口腔护理干预方案在机械通气患儿中的应用效果。方法 将2023年5月—12月泉州市妇幼保健院重症监护科接收的66例机械通气患儿选为研究对象。以密封信封抽签法分为综合干预组(n=33)及常规干预组(n=33)。常规干预组实施常规口腔护理,综合干预组实施综合性口腔护理模式干预。对比两组患儿口腔情况、并发症、静态全唾液流率(UWS)及机械通气时间。结果 干预后综合干预组Beck总分为(6.33±1.05)分,低于常规干预组的(8.55±1.85)分(t=6.069,P<0.001)。综合干预组出现呼吸机相关肺炎(VAP)发生率较常规干预组更低(3.03% vs 18.18%)(χ2=3.995,P=0.046)。干预后综合干预组UWS为(0.37±0.09)mg/min,高于常规干预组的(0.29±0.09)mg/min(t=3.611,P=0.001)。结论 综合性口腔护理模式能较大程度改进机械通气患儿的口腔卫生问题,对菌斑、口腔异味及牙龈情况均有改善作用;也能减少并发症发生率,提升UWS,维持口腔卫生健康。
Objective To explore the effect of comprehensive oral nursing intervention in children with mechanical ventilation.Methods A total of 66 mechanically ventilated children admitted to the intensive care department of the hospital from May 2023 to December 2023 were selected as the study objects.They were divided into comprehensive intervention group(n=33)and routine intervention group(n=33)by sealed envelope lottery method.The routine intervention group implemented routine oral care,and the comprehensive intervention group implemented comprehensive oral care mode intervention.Oral conditions,complications,unstimulated whole saliva(UWS)and mechanical ventilation time were compared between the two groups.Results After the intervention,the total Beck score of the comprehensive intervention group was(6.33±1.05),which was lower than that of the conventional intervention group([8.55±1.85],t=6.069,P<0.001).The incidence of ventilator-associated pneumonia(VAP)in the comprehensive intervention group was lower than that in the conventional intervention group(3.03% vs 18.18%)(χ2=3.995,P=0.046).After the intervention,the UWS of the comprehensive intervention group was(0.37±0.09)mg/min,which was higher than that of the conventional intervention group([0.29±0.09] mg/min,t=3.611,P=0.001).Conclusions The comprehensive oral care mode can improve the oral health of children with mechanical ventilation to a great extent,and can improve the plaque,oral odor and gingiva condition.It can also reduce the incidence of complications,improve UWS,and maintain oral health.
目的 分析肺结核合并Ⅱ型呼吸衰竭患者经鼻高流量湿化氧疗期间应用多维度强化护理的效果。方法 纳入2022年12月—2025年1月在河北省胸科医院进行经鼻高流量湿化氧疗的肺结核合并Ⅱ型呼吸衰竭患者294例,随机分为强化护理组(147例,多维度强化护理)、对照组(147例,常规护理),测量比较两组患者在护理前后气道重塑指标、肺功能指标、血气分析指标,进行疗效评估。结果 护理后强化护理组气道壁面积、气道壁厚度低于对照组,气道腔面积高于对照组(P<0.05);护理后强化护理组第1秒用力呼气容积、用力肺活量高于对照组(P<0.05);护理后强化护理组动脉血氧分压高于对照组,动脉血二氧化碳分压低于对照组(P<0.05);强化护理组总有效率高于对照组(P<0.05)。结论 肺结核合并Ⅱ型呼吸衰竭患者经鼻高流量湿化氧疗期间接受多维度强化护理可改善其气道重塑及肺功能,有利于血气分析指标恢复,应用效果显著。
Objective To analyze the efficacy of multidimensional enhanced nursing during nasal high-flow humidified oxygen therapy in patients with pulmonary tuberculosis and type Ⅱ respiratory failure.Methods A total of 294 patients with pulmonary tuberculosis and type Ⅱ respiratory failure who received nasal high-flow humidified oxygen therapy at Hebei Chest Hospital between December 2022 and January 2025 were enrolled and randomly divided into an enhanced nursing group(147 patients,receiving multidimensional enhanced nursing)and a control group(147 patients,receiving conventional nursing).Airway remodeling,pulmonary function,and blood gas analysis were measured and compared between the two groups before and after nursing,and the efficacy was evaluated.Results After nursing,the enhanced nursing group had lower airway wall area and airway wall thickness,and higher airway lumen area than the control group(P<0.05).The forced expiratory volume in 1 second and forced vital capacity in the enhanced nursing group were higher than those in the control group(P<0.05).The blood oxygen partial pressure(PaO2)in the enhanced nursing group was higher than that in the control group,and the carbon dioxide partial pressure(PaCO2)was lower than that in the control group(P<0.05).The total effective rate in the enhanced nursing group was higher than that in the control group(P<0.05).Conclusions Multidimensional enhanced nursing during nasal high-flow humidified oxygen therapy can improve airway remodeling and lung function in patients with pulmonary tuberculosis and type Ⅱ respiratory failure,and is beneficial for the recovery of blood gas analysis indicators.The application effect is significant.
目的 探讨预后营养指数(PNI)对脓毒症合并心力衰竭患者发生谵妄的预测价值,并评估其在指导护理风险分层中的作用。方法 采用回顾性队列研究,纳入2022年2月—2024年9月广东省第二中医院收治的162例脓毒症合并心力衰竭患者。通过ROC曲线确定PNI预测谵妄的最佳截断值,并以此将患者分为高低PNI组。比较两组基线特征,采用Kaplan-Meier曲线分析谵妄累积发生率和28天院内死亡率,通过Cox比例风险模型评估PNI与谵妄及预后的独立关联,并利用ROC曲线评价其预测性能。最后利用亚组分析技术进一步评估PNI预测价值的普适性。结果 低PNI(≤35.72)是谵妄发生的独立危险因素。竞争风险模型显示,低PNI组10 d谵妄累积发生率达37.8%,高于高PNI组的10.0%。多因素分析表明,PNI每降低一个单位,谵妄风险增加约17.2%。限制性立方样条分析提示PNI与谵妄风险呈线性负相关。ROC曲线分析显示PNI预测谵妄的AUC为0.721,其预测效能优于白蛋白和SOFA评分。亚组分析进一步证实PNI的保护效应在不同临床特征患者中具有一致性。结论 PNI是脓毒症合并心力衰竭患者谵妄风险的独立预测指标,其预测效能优于传统单一指标。基于PNI的风险分层有助于早期识别谵妄高危患者,为实现精准护理干预提供重要依据。
Objective To explore the predictive value of the prognostic nutritional index(PNI)for delirium in patients with sepsis complicated by heart failure,and to evaluate its role in guiding nursing risk stratification.Methods A retrospective cohort study was conducted,including 162 patients with sepsis and heart failure admitted to Guangdong Provincial Second Hospital of Traditional Chinese Medicine between February 2022 and September 2024.The optimal PNI cut-off value for predicting delirium was determined using ROC curve analysis,and patients were divided into high and low PNI groups accordingly.Baseline characteristics of the two groups were compared.Kaplan-Meier curves were used to analyze the cumulative incidence of delirium and 28-day in-hospital mortality.Cox proportional hazards models were employed to assess the independent association between PNI and delirium as well as prognosis,and ROC curves were used to evaluate its predictive performance.Subgroup analysis was further utilized to assess the generalizability of PNI’s predictive value.Results A low PNI(≤35.72)is an independent risk factor for delirium.The competing risk model showed that the cumulative incidence of delirium in the low PNI group was 37.8% at 10 days,significantly higher than the 10.0% in the high PNI group.Multivariate analysis indicated that for each unit decrease in PNI,the risk of delirium increased by 17.2% approximately.Restricted cubic spline analysis suggested a linear negative correlation between PNI and delirium risk.ROC curve analysis demonstrated that the AUC of PNI for predicting delirium was 0.721,with its predictive performance surpassing that of albumin and SOFA score.Subgroup analysis further confirmed that the protective effect of PNI was consistent across patients with different clinical characteristics.Conclusions PNI is an independent predictor of delirium risk in patients with sepsis and heart failure,with superior predictive performance compared to traditional single indicators.Risk stratification based on PNI aids in the early identification of patients at high risk for delirium,providing an important basis for precise nursing interventions.
目的 调查国内养老机构痴呆照护服务现状,为今后国内进一步推进养老机构痴呆照护服务的发展提供可借鉴的依据。方法 2024年1月1日至3月31日以全国养老机构为研究对象, 采取两阶段分层抽样, 随机抽取国内15个省、自治区、直辖市的养老机构, 采用网络问卷调查方法对抽取的养老机构管理人员进行问卷调查。结果 共回收线上调查问卷443份, 经过去重和排除无效问卷, 最终得到的有效问卷为412份, 有效率为93%。调查发现有313家(76%)机构有收住痴呆患者, 养老床位规模为100~299张的养老机构占比最高。小规模的养老机构中,民办民营机构收住痴呆患者的比例高于公建公营机构。有181家机构设置了痴呆照护专区。床位数在300张以上的养老机构中设立痴呆照护专区的比例高于中、小规模的养老机构。结论 本调查较客观地呈现了我国养老机构痴呆照护服务开展的现状, 大规模的养老机构提供痴呆照护服务的能力更高, 设置痴呆照护专区的机构更能满足痴呆患者多层次、多样化的照护需求。目前国内仍存在专业化的痴呆照护服务供给不足、照护人员短缺等现象, 急需国家加强顶层设计, 促进行业健康发展。
Objective To explore the current situation of cognitive care services in nursing homes in China, and provide reference for further promoting the development of cognitive care services in nursing homes in China.Methods From January 1 to March 31, 2024, a two-stage stratified sampling was carried out to randomly select pension institutions in 15 provinces, autonomous regions and municipalities directly under the central government across the country, and a questionnaire survey was conducted on the nursing homes.Results A total of 443 online questionnaires were recovered in this survey, and 412 valid questionnaires were obtained after eliminating duplicated and invalid questionnaires, with an effective rate of 93%.In this survey, 76% of the institutions admitted the elderly with dementia, and the nursing homes with 100-299 beds accounted for the highest proportion.Among the small-scale nursing homes, the proportion of the elderly with dementia in private institutions is significantly greater than that in public institutions.There were 181 nursing homes with special cognitive care areas.The proportion of cognitive care area in nursing homes with more than 300 beds was significantly greater than that in medium and small scale nursing homes.Conclusions This survey Objectively presents the current situation of the development of cognitive care services in nursing homes in our country.Large-scale nursing homes have a higher capacity to provide cognitive care services.Nursing homes that set up special areas for cognitive care can better meet the multi-level and diversified care needs of the elderly with dementia.At present, there are still insufficient supply of professional cognitive care services and shortage of nursing personnel in China.It is urgent for the country to strengthen top-level design and promote the healthy development of the industry.
目的 系统评价护士的护理伦理敏感性现状及影响因素,为针对性干预提供参考。方法 检索国内外相关数据库,检索时限为2024年7月护士的护理伦理敏感性现状及影响因素的相关文献。由两名分析人员独立筛选文献、提取资料、质量评价后采用Stata 15.0和RevMan 5.3软件进行meta分析。结果 纳入16篇文献,包括4 961例研究对象。Meta分析结果显示,护士的护理伦理敏感性处于中等偏高水平,总分为[OR=67.29,95%CI(53.24,81.34)]分。年龄[OR=2.78,95%CI(1.45,5.33),P=0.002]、工作年限[OR=3.55,95%CI(1.35,9.33),P=0.001]、伦理知识教育[OR=14.60,95%CI(4.24,50.32),P<0.001]、共情能力[OR=1.35,95%CI(1.01,1.80),P<0.001]、工作场所氛围[OR=1.85,95%CI(0.42,4.51),P<0.001]、工作嵌入量[OR=3.60,95%CI(0.40,32.84),P=0.001]是护士护理伦理敏感性的主要影响因素。结论 当前证据表明,护士的护理伦理敏感性处于中等偏高水平,影响因素较多,管理者需结合人群特征实施干预,以提高护士护理伦理敏感性水平。
Objective To systematically evaluate the current status of nurses’ ethical sensitivity in nursing and influencing factors that influence it,in order to inform targeted interventions.Methods Domestic and international databases were searched to collect literature related to the current status of nurses’ ethical sensitivity in nursing and the factors influencing it from the year of construction to July 2024.Meta-analysis was performed by two analysts independently screening the literature,extracting information,and quality evaluation using Stata 15.0 and RevMan 5.3 software.Results Sixteen papers including 4 961 study subjects were included.Meta-analysis results showed that nurses had moderately high level of ethical sensitivity in nursing with a total score of 67.29(95%CI[53.24,81.34]).Age(OR=2.78,95%CI[1.45,5.33],P=0.002),years of experience(OR=3.55,95%CI[1.35,9.33],P=0.001),education on ethical knowledge(OR=14.60,95%CI[4.24,50.32],P<0.001),and empathic ability(OR=1.35,95%CI[1.01,1.80],P<0.001),workplace atmosphere(OR=1.85,95%CI[0.42,4.51],P<0.001),and the amount of job embeddedness(OR=3.60,95%CI[0.40,32.84],P=0.001) were the main influences on nurses’ ethical sensitivity in nursing.Conclusions The previous evidence suggests that nurses have moderately high levels of nursing ethical sensitivity,with a high number of influencing factors,and managers need to give interventions that incorporate the characteristics of the population in order to increase the level of nursing ethical sensitivity among nurses.
目的 探讨基于思维导图的绿色通道急救干预对急性心肌梗死患者介入治疗的效果。方法 对天津市人民医院2022年1月—2024年12月收治的80例AMI患者进行研究,依照收治时间进行分组,将2022年1月—2023年6月采取常规急救流程干预的40例患者分为常规组,将2023年7月—2024年12月的采取基于思维导图的绿色通道急救干预的40例患者分为思维导图组。比较两组患者急救效率、急救前后生命体征(心率、舒张压、收缩压)、心肌损伤指标[磷酸肌酸激酶(CK-MB)及肌钙蛋白Ⅰ(cTnI)],最后比较两组患者干预满意度。结果 对比急救效率发现,思维导图组的预检时间、会诊时间、导管室激活时间、急诊送至PCI手术时间均短于常规组(P<0.05);对比急救前后生命体征发现,与急救前对比,急救后两组的心率、舒张压、收缩压均降低(P<0.05),急救前后两组心率、舒张压、收缩压比较差异无统计学意义(P>0.05);对比急救前后心肌损伤指标发现,急救前两组CK-MB、cTnI比较差异无统计学意义(P>0.05),急救后,思维导图组CK-MB、cTnI低于常规组与急救前(P<0.05);对比干预满意度发现,思维导图组干预满意度为100.00%,高于常规组的85.00%(P<0.05)。结论 基于思维导图的绿色通道急救干预可提升AMI患者的急救效率,稳定患者生命体征,减轻心肌损伤的同时,提升患者干预满意度。
Objective To explore the effect of green channel emergency nursing based on mind mapping on percutaneous coronary intervention(PCI) of patients with acute myocardial infarction(AMI).Methods A study was conducted on 80 AMI patients admitted to Tianjin People’s Hospital from January 2022 to December 2024.The patients were divided into two groups based on their admission time.The 40 patients who received routine emergency nursing interventions from January 2021 to June 2023 were assigned to the conventional group,while the 40 patients who received green channel emergency nursing based on mind mapping from July 2023 to November 2024 were assigned to the mind mapping group.The emergency treatment efficacy,vital signs(heart rate,diastolic blood pressure,systolic bloodpressure),myocardial injury indicators(phosphocreatine kinase[CK-MB],and troponin I[cTn1])between two groups of patients before and after emergency treatment were compared.Results The pre-examination time,consultation time,catheterization room activation time and emergency room to PCI operation time of mind mapping group were all shorter than those of conventional group(P<0.05).Compared with the vital signs before and after emergency treatment,we found that the heart rate,diastolic pressure and systolic blood pressure of the two groups decreased after emergency treatment(P<0.05),and there was no significant difference between the heart rate,diastolic pressure and systolic blood pressure of the two groups before and after emergency treatment(P>0.05).Comparing the myocardial injury indicators before and after emergency treatment,there was no significant difference in CK-MB and cTn1 between the two groups before emergency treatment(P>0.05).After emergency treatment,CK-MB and cTn1 in the mind map group were lower than those in the conventional group and before emergency treatment(P<0.05).Comparing the intervention satisfaction,it was found that the mind mapping group of 100.00% was higher than the conventional group of 85.00%(P<0.05).Conclusions Green channel emergency nursing based on mind mapping can improve the efficiency of emergency treatment for AMI patients,stabilize their vital signs,reduce myocardial injury,improve patient intervention satisfaction.
目的 探讨优化护理路径在急性缺血性脑卒中介入手术中的应用及效果。方法 采用随机对照研究,纳入2024年1月—2025年1月收治的112例急性缺血性脑卒中取栓患者,观察组(56例)实施优化介入护理路径,对照组(56例)采用常规护理。结果 观察组患者的满意度评分、医护满意度评分均优于对照组(P<0.05);观察组的术前等待时间、患者自进入介入室至股动脉穿刺时间、手术时间、住院费用、并发症发生率、差错事故发生率也优于对照组(P<0.05)。结论 通过标准化术前准备、术中多学科协作及术后康复衔接,优化护理路径可显著提升急性缺血性脑卒中治疗时效性(缩短急性脑卒中患者从进入医院到开始静脉溶栓给药的时间至黄金时间窗内),改善患者神经功能预后。
Objective To explore the application and efficacy of an optimized nursing pathway in endovascular therapy for acute ischemic stroke(AIS).Methods A randomized controlled trial was conducted,enrolling 112 AIS patients undergoing mechanical thrombectomy from January 2024 to January 2025.Patients were randomly assigned to either the observation group(n=56),which received the optimized interventional nursing pathway,or the control group(n=56),which received routine nursing care.Results Patient satisfaction score,medical staff satisfaction score,and postoperative favorable recovery rate in observation group were better than those of control group(P<0.05).Additionally,the observation group showed significant improvements in preoperative waiting time,time from entering the operation room to femoral artery puncture,surgical duration,hospitalization costs,complication incidence rate,and medical error incidence rate(P<0.05).Conclusions By standardizing preoperative preparations,implementing intraoperative multidisciplinary collaboration,and enhancing postoperative rehabilitation coordination,the optimized nursing pathway significantly improved the timeliness of thrombectomy treatment(shortening door-to-needle time to reach the golden time window)and enhanced neurological functional prognosis in AIS patients,demonstrating substantial clinical applicability.
目的 探讨基于区域专科联盟模式,在联盟医院内建立淋巴水肿专科干预小组的有效策略及其对患者干预效果的影响。方法 对区域医联体内7家联盟医院(包括德阳市人民医院、广汉市人民医院、罗江区人民医院、广汉妇幼保健院、德阳肿瘤医院、中江妇幼保健院、什邡市妇幼保健院)20名医护人员进行淋巴水肿知识及干预技能培训,建立区域性淋巴水肿专科干预小组,制定小组工作职责、实施专科质量控制。选取2024年5—8月淋巴水肿专科干预小组干预模式开展期间作为观察组, 选取2024年1—4月淋巴水肿专科干预小组干预模式开展前作为对照组。对比两组医护人员淋巴水肿相关知识掌握合格率、住院患者淋巴水肿风险筛查率、淋巴水肿高风险患者措施落实率、出院随访患者上肢功能评定评分及患者就医满意度。结果 干预后,护理人员淋巴水肿知识各维度得分[基础知识(17.36±2.54)、诊断与评估(25.66±4.34)、治疗与管理(25.08±4.73)、预防与康复(15.36±2.53)、总分(85.36±8.52)]均高于干预前[基础知识(11.35±2.29)、诊断与评估(17.87±3.18)、治疗与管理(18.28±3.85)、预防与康复(10.39±2.24)、总分(55.35±7.56)](t=7.859, P<0.001; t=6.475, P<0.001; t=4.986, P<0.001; t=6.578, P<0.001; t=11.782, P<0.001); 观察组住院患者淋巴水肿风险筛查率高于对照组(80.72% vs 61.24%), 对比差异有统计学意义(χ2=31.454, P<0.001); 观察组患者出院时及出院后1月上肢功能评定(DASH)量表评分[(23.36±8.63)(20.16±7.34)分]低于对照组[(25.32±9.16)(22.25±7.67)分], 对比差异有统计学意义(t=2.884, P=0.004; t=3.646, P=0.001); 观察组患者出院时患者就医满意度评分(83.36±8.63)高于对照组(71.37±10.33), 对比差异有统计学意义(t=16.460, P<0.001)。结论 基于区域专科联盟体的联盟医院淋巴水肿专科干预小组能够有效地实现三级医院优质干预资源下沉, 在联盟内可实现淋巴水肿防治同质化、专科人才培训基地建设,整体提升区域内淋巴水肿防控效果,提高患者就医满意度。
Objective To explore effective strategies for establishing a lymphoedema specialty nursing team within alliance hospitals based on a regional specialty alliance and assess its impact on patient care outcomes.Methods A regional lymphedema specialty nursing team was established by training 20 healthcare professionals from 7 hospitals(Deyang City People’s Hospital,Guanghan People’s Hospital, Luojiang People’s Hospital, Guanghan Maternal and Child Health Hospital, Deyang Tumor Hospital, Zhongjiang Maternal and Child Health Hospital, and Shifang Maternal and Child Health Hospital)in a regional medical consortium, focusing on lymphedema knowledge and intervention skills.The team’s responsibilities and nursing quality control protocols were standardized.The observation group included data from May to August in 2024(post-intervention period), while the control group comprised data from January to April in 2024(pre-intervention period).Comparisons were made between the two groups regarding healthcare professionals’qualification rate in lymphedema knowledge,inpatients’ lymphedema risk screening rate, implementation rate of preventive measures for high-risk patients, upper extremity function assessment scores(using the Disabilities of the Arm,Shoulder and Hand [DASH] scale)at discharge and 1-month post-discharge, and patient satisfaction.Results After the intervention, healthcare professionals’ lymphedema knowledge scores significantly improved across all domains:basic knowledge(17.36±2.54 vs 11.35±2.29), diagnosis/assessment(25.66±4.34 vs 17.87±3.18), treatment/management(25.08±4.73 vs 18.28±3.85),prevention/rehabilitation(15.36±2.53 vs 10.39±2.24),and total score(85.36±8.52 vs 55.35±7.56)(t=7.859, P<0.001; t=6.475, P<0.001; t=4.986, P<0.001; t=6.578, P<0.001; t=11.782, P<0.001).The observation group demonstrated a higher lymphedema risk screening rate(80.72% vs 61.24%,χ2=31.454,P<0.001).DASH scores in the observation group were significantly lower than the control group at discharge(23.36±8.63 vs 25.32±9.16)and 1-month post-discharge(20.16±7.34 vs 22.25±7.67)(t=2.884, P=0.004; t=3.646, P=0.001).Patient satisfaction scores at discharge were higher in the observation group(83.36±8.63 vs 71.37±10.33, t=16.460, P<0.001).Conclusions The lymphoedema specialty nursing team in alliance hospitals based on a regional specialty alliance effectively facilitates the high-quality nursing resources homogenization in primary hospitals.Within the alliance, it achieves homogenization of lymphoedema prevention and treatment, establishes a training base for specialty talents, and overall enhances lymphoedema prevention and control within the region, thereby improving patient satisfaction with healthcare.
目的 分析“侧俯卧位”MRI引导腰脊神经后根神经节脉冲射频治疗腰椎间盘突出症的手术体位护理效果。方法 对2018年9月—2020年12月在广州市荔湾中心医院住院接受经MRI引导腰脊神经后根神经节脉冲射频的腰椎间盘突出症患者62例随机分为两组:侧俯卧位组和俯卧位组,每组各31例。侧俯卧位组采用患侧抬高约30 °的侧俯卧位手术,俯卧位组采用标准俯卧位手术。记录两组手术时间、手术并发症、手术体位相关并发症及术者对术野显露的满意度评价。结果 所有患者均顺利完成手术,未见出血、感染、下肢麻痹加重神经损伤、脏器损伤等手术并发症,无患者发生眼压增高、臂丛损伤、压疮等体位相关并发症。侧俯卧位组手术时间(60.65±12.45)min,俯卧位组手术时间(70.58±10.25) min,组间比较差异有统计学意义(t=3.429,P=0.001)。术者对侧俯卧位组和俯卧位组术野侧显露总满意度分别为93.55%和77.42%,组间比较差异有统计学意义(χ2=4.292,P=0.038)。结论 侧俯卧位MRI引导腰脊神经后根神经节脉冲射频治疗腰椎间盘突出症安全、有效,做好手术体位护理可有效防止并发症。
Objective To analyze the effect of surgical position nursing for radiofrequency ablation in posterior root ganglion in lumbar spinal nerve guided by MRI in lateral prone position.Methods Sixty-two patients with lumbar disc herniation hospitalized in Liwan Central Hospital of Guangzhou from September 2018 to December 2020 were randomly divided into two groups(the lateral prone position group and the prone position group,31 patients in each group).The lateral prone position group used the lateral prone position with about 30 degrees elevation of the affected side,and the prone position group used the standard prone position for operation.Operating time,surgical complications,surgical position related complications,and operator satisfaction evaluation of surgical field exposure were recorded in both groups.Results All patients completed the operation successfully.No surgical complications such as bleeding,infection,lower limb paralysis,aggravated nerve injury or organ injury were found in the two groups.No surgical position related complications such as intraocular pressure raising,brachial plexus injury or pressure ulcers in both the groups either.The operation time was(60.65±12.45)min in the lateral prone position group and(70.58±10.25)min in the standard prone position group,respectively,and the difference was statistically significant(t=3.429,P=0.001).The surgeon’s satisfaction evaluation of the surgical field exposure was much higher in the lateral prone position group(93.55%)compared with the standard prone position group(77.42%),and the difference was statistically significant(χ2=4.29,P=0.038).Conclusions Radiofrequency ablation in posterior root ganglion of lumbar spinal nerve guided by MRI in lateral prone position is safe and effective.Good surgical position nursing can effectively prevent complications.
目的 探讨基于健康意识理论(HEC)的健康管理联合早期活动护理干预应用于急性胰腺炎(AP)患者的效果。方法 将南阳市第一人民医院2020年1月—2023年1月期间收治的80例AP患者作为研究对象,按照随机数字表法分为对照组(n=40)和观察组(n=40)。两组患者均按照AP护理常规进行护理,对照组予早期活动护理干预,观察组予早期活动护理和基于HEC的健康管理,观察两组健康行为能力、健康促进行为和并发症发生情况。结果 干预后,两组患者健康行为能力自评量表得分均高于干预前,且观察组得分高于对照组(P<0.05);两组患者健康促进生活方式量表Ⅱ得分均高于干预前,且观察组得分高于对照组(P<0.05);观察组并发症发生率(5.00%)低于对照组(20.00%)。结论 基于HEC的健康管理联合早期活动护理可以有效改善AP患者的健康行为能力、健康促进行为减少并发症的发生。
Objective To explore the effect of health management combined with early activity nursing intervention based on health as expanding consciousness(HEC)on patients with acute pancreatitis(AP).Methods Eighty patients with AP admitted to the First People’s Hospital of Nanyang City from January 2020 to January 2023 were selected as the study subjects.They were randomly divided into a control group(n=40)and an observation group(n=40)using a random number table method.Both groups of patients received routine AP nursing care.The control group received early activity nursing intervention,while the observation group received early activity nursing and HEC based health management.The health behavior ability,health promotion behavior,and incidence of complications were observed in both groups.Results After the intervention,both groups of patients had higher scores on the Self Rating Health Behavioral Ability Scale than before the intervention,and the observation group had higher scores than the control group(P<0.05).The scores of the Health Promotion Lifestyle Scale II for both groups of patients were higher than before intervention,and the scores of the observation group were higher than those of the control group(P<0.05).The incidence of complications in the observation group(5.00%)was lower than that in the control group(20.00%).Conclusions Health management based on HEC combined with early activity nursing can effectively improve the health behavior ability of AP patients,promote health behavior,and reduce the occurrence of complications.