目的 探讨扩张型心肌病采用诺欣妥治疗的效果及对其心功能的影响。方法 本文将2020年2月—2020年10月收治的扩张型心肌病患者50例作为研究对象,对所有患者按照随机方式进行分组,对照组25例患者以常规抗心衰治疗与依那普利治疗,观察组25例患者在常规抗心衰治疗的基础上给予诺欣妥治疗,统计分析用药后有效率、治疗前后心功能指标、6 min步行距离及炎症因子水平。结果 两组之间炎症因子水平相比,观察组较对照组低;6 min步行距离、用药后有效率相比,观察组较对照组高;心功能指标相比,观察组SV、LVEF较对照组高,LVESD、LVEDD较对照组低,P＜0.05。结论 采用诺欣妥治疗扩张型心肌病效果显著,总有效率较好,可有效改善患者心功能指标,增加6 min步行距离,减轻炎症因子水平,改善患者预后。

目的 观察综合健康教育在门诊长期肌注黄体酮患者的应用效果。方法 选取2018年10月—2019年6月在本院门诊中心注射室进行黄体酮注射的先兆流产患者319例,按患者来门诊的注射顺序,采用随机分组方法,单数位为对照组,双数位为干预组。干预组在肌注黄体酮时实行综合健康教育,而对照组则进行基本指导。注射1个月后观察效果。结果 干预组发生硬结例数77例(48.4%),对照组147例(91.9%);而疼痛程度方面干预组为(1.34±2.125)分,而对照组则为(4.51±2.400)分;干预组的满意度平均分为(9.60±0.975)分,而对照组为(6.65±1.603)分,差异均有统计学意义(P<0.01)。结论 对门诊长期肌注黄体酮患者实行综合健康教育有助于减轻患者疼痛、降低硬结发生率,促进药物疗效,提高患者满意度。

Objective To observe the effect of comprehensive health education on outpatients with long-term intramuscular injection of progesterone. Methods 319 patients were enrolled from October 2018 to June 2019, and were divided into the observation group and control group according to the sequence of patients coming to the outpatient clinic. Comprehensive health education was applied in the intervention group, and general basic education was applied in the control group. Results There were 77 cases (48.4%) of callosity in the intervention group, 147 cases (91.9%) in the control group. In pain degree scores of (1.34±2.125) were in the intervention group, (4.51±2.400) in the control group. In degree of satisfaction, (9.60±0.975) were in the intervention group, and (6.65±1.603) in the control group, with statistically significant difference (P<0.01). Conclusion Comprehensive health education may alleviate pain and callosity in patients with long-term intramuscular injection of progesterone.

目的 观察腹腔镜下胆总管切开取石术中胆管一期缝合治疗胆总管结石的临床效果。方法 研究对象选取我院2016年3月—2017年3月术前诊断为胆总管结石且符合纳入标准的患者92例,采用随机法,将其分为一期缝合术组和T管引流术组各46例,两组患者均行腹腔镜下胆总管切开取石术,一期缝合术组行术中胆管一期缝合,T管引流术组行术中胆管T管引流。比较两组手术相关指标,住院时间,住院费用,术后并发症的发生率。结果 一期缝合术组在减少手术出血量、促进切口恢复、预防切口感染的发生率上优于T管引流术组（P < 0.05）;在住院时间、住院费用以及术后并发症的发生率上低于T管引流术组（P < 0.05）。结论 本次研究结果表明腹腔镜下胆总管切开取石术中胆管一期缝合的临床效果优于T管引流,可有效减少手术并发症,缩短病人的住院时间,是治疗胆总管结石理想的选择。

Objective To observe the clinical effect of primary suture in the treatment of common bile duct stones under laparoscopic common bile duct incision. Methods The subjects were enrolled in our hospital from March 2017 to March 2018. 92 patients with choledocholithiasis and met the inclusion criteria, were randomly divided into one-stage suture group and T-tube drainage group. Surgery-related indicators,length of hospital stay,hospitalization costs,and incidence of postoperative complications were compared. Results In the first-stage suture group,the incidence of surgical bleeding reduction,postoperative incision recovery,and prevention of wound infection were better than those in the T-tube drainage group （P < 0.05）. The incidence of hospitalization,hospitalization,and postoperative complications were lower in the first-stage suture group than in the T-tube drainage group（P < 0.05）. Conclusion The clinical effect of one-stage suture in laparoscopic common bile duct incision and stone removal is better than T-tube drainage,which may effectively reduce surgical complications and shorten the hospitalization time of patients. It is an ideal choice for the treatment of common bile duct stones.

目的 探讨健康教育路径联合集束化护理模式在预防脑卒中患者便秘的效果观察。方法 随机选择神经外科收治的脑卒中患者120例,分为实验组与对照组,各60例,其中对照组给予常规护理,而实验组在常规护理基础上应用健康教育路径联合集束化护理模式。比较两组患者便秘发生率、便秘措施落实率、患者满意度、及患者入院前后的健康教育知识知晓率的比较。结果 实验组便秘发生率明显低于对照组,便秘护理评估率,护理措施落实率,病人满意度明显高于观察组,患者入院后的健康教育知识知晓率明显升高(P<0.05),具有统计学意义。结论 健康教育路径联合集束化护理模式能有效的降低脑卒中患者便秘发生率,提高预防便秘发生护理措施落实率,提高患者满意度,提高患者舒适度。

目的 探讨蛛网膜下腔注射布比卡因与舒芬太尼预防剖宫产术中寒战效果的影响。方法 选取我院拟行剖宫产手术的产妇158例随机分为对照组(n=79)和观察组(n=79),两组均行蛛网膜下腔注射麻醉下的剖宫产术,对照组给予麻药为质量浓度为5 g/L的布比卡因,观察组为质量浓度为5 g/L的布比卡因+小剂量舒芬太尼,观察两组术中预防寒战效果。结果 观察组寒战发生率(16.64%)低于对照组(39.25%)(P<0.05);MAP、HR组内各时间点间有差异(P<0.05),组间同时间点比较无差异(P>0.05);观察组牵拉痛程度轻于对照组(P>0.05);两组新生儿1min Apgar评分和5min Apgar评分无差异(P>0.05);观察组产妇不良反应发生率为6.33%,与对照组的12.66%比较,无差异(P>0.05)。结论 剖宫产术进行蛛网膜下腔注射布比卡因和舒芬太尼,对预防产妇术中寒战的效果的具有积极影响。

目的 观察饮食干预管理和健康教育对糖尿病酮症酸中毒(DKA)患者的干预效果。方法 90例DKA患者根据数字表法随机分为2组,对照组(n=45)予以常规治疗及护理措施,观察组(n=45)在对照组治疗及护理基础上予以饮食干预管理和健康教育,比较两组患者干预后血糖控制时间、酸中毒纠正时间和住院治疗时间;采用相关效果量表调查两组患者干预前后相关知识知晓程度及健康饮食依从度;通过生活质量评分表和问卷表比较两组患者两组生活质量和护理满意度。结果 观察组干预后血糖控制时间、酸中毒纠正时间均早于对照组(P<0.05),而住院治疗时间少于对照组(P<0.05);两组干预前相关知识知晓程度比较无差异(P>0.05),观察组干预后相关知识知晓程度及健康饮食依从度均优于对照组(P<0.05);观察组干预后生活质量及护理满意度均优于对照组(P<0.05)。结论 饮食干预管理和健康教育可明显改善DKA患者症状及生活质量,提高相关知识知晓程度及健康饮食依从度。

目的 急性Stanford A型主动脉夹层(AAAD)患者往往需急诊手术,以挽救其生命。手术通常存在高风险。术后常见并发症包括:神经系统、呼吸系统、胃肠道、肝、肾脏等多器官系统的功能障碍,以及全身感染,其使得术后过程更加复杂。 因此, 围术期护理极为重要。方法 2016年2月—2018年2月, 共完成了24 例 AAAD患者的手术。术前所有病人收治科室ICU。手术方式为Bentall+Sun'氏术。 围术期,对患者随机分组进行密切观察和护理。A组:常规组(routine nursing):对患者给予常规护理;B组:整体组(integrated nursing):除了常规的基本护理外,加强了围术期镇静、镇痛和术后并发症的专业化的整合护理。结果 两组共24例成功完成了手术。两组术前资料比较,无显著差异。整体护理组ICU停留时间和住院时间短于常规组(P<0.05);护理满意度、生活质量比较,整体组患者优于常规组(P<0.05)。结论 护士提供的围术期专业化技术的整体护理,可改善患者围术期的治疗效果,促进康复。

目的 探究全程介入护理对慢性阻塞性肺疾病（COPD）和哮喘患者管理的治疗效果。方法 选取我院2016年4月—2018年4月收治的200例COPD患者组和100例哮喘患者作为研究对象。采用单双号数字分组法,将COPD患者和哮喘患者各随机分为两组,即A组和B组,COPD患者A组和B组各100例,哮喘患者A组和B组各50例。A组采用药物治疗配合全程介入护理,B组采用药物治疗配合住院期间常规护理,比较两组治疗前后的肺功能指标、六分钟步行试验和ACT测试。结果 治疗前,COPD患者和哮喘患者中,A组和B组的FEV1、FVC、FEV1%等肺功能指标和六分钟步行试验、ACT测试差异,无统计学意义（P>0.05）;治疗后,COPD患者和哮喘患者中,A组和B组的FEV1、FVC、FEV1%等肺功能指标和六分钟步行试验、ACT测试差异有统计学意义（P<0.05）。结论 全程介入护理应用在COPD和哮喘患者的管理中,效果显著,值得推广。

目的 对江门市新会区会城街道的严重精神障碍患者监护人进行守护APP干预并评价干预效果影响。方法 以会城街道辖区内登记在国家精神障碍信息系统1 488在册精神障碍患者作为研究对象,随机抽取分为安装守护APP组1 084例和无安装守护APP组404例。安装组通过监护人使用守护APP实现责任医生对患者进行动态监护和实时监护,提供免费咨询、心理干预、服药指导及随访管理服务;无安装组采用常规随访康复管理措施干预。干预满一年后对比分析两组患者康复措施落实情况、服药依从性（治疗率）、病情及社交改善情况、复发住院率、肇事肇祸率及家属疾病知识知晓情况等指标。结果 安装守护App组患者服药依从性（治疗率）及康复措施落实率高于无安装组,家属对精神疾病知识知晓良好率较高;干预后安装组患者的SCL-90评分及心理社交功能评估表评分改善情况优于无安装组,复发住院率和肇事肇祸率明显较低,以上差异均有统计学意义。结论 守护APP平台帮助医生与监护人把严重精神障碍患者的监护工作真正落到实处,康复效果优于传统的康复方法,值得进一步推广应用。

Objective Guardianship APP intervention was conducted for the guardians of severe mental disorders in Huicheng,Xinhui district,Jiangmen city and the effect of intervention was evaluated. Methods 1 488 psychiatric patients in the unit area were taken as the research objects,which were randomly divided into the guardian APP installation group of 1084 cases and the non - installation group of 404 cases. The installation group uses guardian APP to realize the dynamic guardianship and real-time monitoring of the patients,and we provided free charge consultation,psychological intervention,medication guide,case tracking and follow-up management services. The non installation group adopted the routine rehabilitation management measures after discharge. After a year the implementation of rehabilitation measures,compliance,condition and social improvement,relapse rate of hospitalization,accident rate and knowledge of family disease between the two groups of patients were compared and analyzed. Results The compliance and rehabilitation measures of the patients in the App group were higher than those in the non installation group. The rate of knowledge about mental illness was higher in family members,and the improvement of SCL-90 score and psychosocial function assessment score after intervention was better than that of non installation group. The rate of relapse hospitalization and cause trouble were lower. The differences above were statistically significant. Conclusion The guardian APP platform helps doctors and guardians to make the monitoring work of patients with severe mental disorder really practical,and the rehabilitation effect is better than the traditional rehabilitation method,which is worthy of further promotion and application.

目的 对比双腔耐高压PICC和股静脉置管在IV级心力衰竭患者中的应用效果。方法 选取我院 2016年1月—12月收治的端坐位IV级心力衰竭患者61例,按照便利抽样的方法将其随机分成研究组31例和对照组30例。研究组患者行耐高压PICC置管,对照组患者行双腔中心股静脉置管,观察2组患者的一次性置管成功率、导管头端位置、并发症发生率、留置导管天数和患者满意度等相关临床指标。结果 研究组患者的一次插管成功率为 93.55%(29例),高于对照组的83.33%(25例)(P<0.05);研究组患者的并发症发生率低于对照组(P<0.05)。结论 对IV级心力衰竭患者在端坐位下予以耐高压PICC 插管进行治疗,能提高一次置管成功率,降低并发症发生率,提高患者满意度,可作为患者抢救时的首选静脉通道。

Objective To compare the effect of dual chamber high pressure PICC (peripherally inserted central catheter) and femoral vein CVC(central venous catheter)catheterization in patients with IV class heart failure. Methods From January to December 2016, 61 patients with congestive heart failure in the sitting position were selected from our hospital. According to the convenient sampling method, they were randomly divided into the study group (31 cases) and the control group(n=30). The study group were treated with high pressure PICC tube, the control group underwent femoral vein catheterization. Two groups of patients with the success rate of catheterization, catheter tip location, complications, indwelling catheter days and related clinical indicators of patient satisfaction were observed. Results The successful rate of intubation in the study group was 93.55% (29 cases), higher than that of the control group (25 cases)(P<0.05), and the incidence of complications in the study group was lower than that of the control group(P<0.05)(83.33%). Conclusion Treatment for patients with heart failure IV be in sitting position under high pressure PICC intubation, may improve the success rate of catheterization, reduce the incidence of complications, improve patient satisfaction, and be the first choice when the rescue of patients with venous channel.