目的 研究护理干预对慢性阻塞性肺疾病患者抑郁焦虑情绪的效果。方法 选取2015年2月—2017年3月我院收治的慢性阻塞性肺疾病患者84例为观察对象。2015年2月—2016年2月入院患者42例为对照组,遵医嘱给予治疗,同时均予以常规慢性阻塞性肺疾病知识宣教。2016年3月—2017年3月入院患者42例为观察组在对照组基础上予以优质护理干预。分别比较干预前后两组患者抑郁、焦虑及干预前后肺功能变化、患者满意度、生活质量。结果 干预后观察组抑郁自评量表(SDS)、焦虑自评量表(SAS)评分分别为(20.05±5.24)分、(21.57±6.03)分,均低于对照组(28.57±5.29)分、(31.72±6.14)分,差异有统计学意义(P＜0.05)。干预后观察组FEV1水平(2.00±0.33)L,高于对照组的(1.68±0.25)L、观察组FEV1/FVC水平分别为(69.50±7.95)%,高于对照组的(65.18±8.43)%,差异有统计学意义(P＜0.05)。观察组患者满意度为95.24%(40/42),高于对照组的73.81%(31/42),差异有统计学意义(P＜0.05)。观察组患者各项SF-36评分均高于对照组,均P＜0.05差异有统计学意义。结论 优质护理干预可缓解患者负性情绪,改善肺功能,提高满意度及生活质量。

Objective To study effects of nursing intervention in paitents with chronic obstructive pulmonary disease. Methods 84 patients with chronic obstructive pulmonary disease admitted to our hospital from February 2015 to March 2017 were selected as the observation objects. From February 2015 to February 2016, 42 patients admitted to the control group were treated with conventional therapy. From March 2016 to March 2017, 42 patients admitted to the hospital as the observation group were given quality nursing intervention on the basis of the control group. The depression, anxiety, lung function changes, patient satisfaction and quality of life before and after intervention were compared between the two groups before and after intervention. Results After the intervention, the SDS and SAS scores of the observation group were (20.05±5.24), (21.57±6.03), which were lowered than that of the control group (28.57±5.29), (31.72±6.14), the difference was statistical significance (P<0.05). After intervention, the level of FEV1 in the observation group (2+0.33) L was higher than that in the control group (1.68+0.25) L, and the FEV1/FVC level in the observation group was (69.50+7.95)%, which was higher than that in the control group (65.18+8.43)%,the difference was statistical significance (P<0.05). Satisfaction of patients in the observation group was 95.24% (40/42), higher than the control group 73.81% (31/42),the difference was statistical significance (P<0.05). The SF-36 scores of the observation group were higher than those of the control group, P<0.05, the difference was statistical significance. Conclusion High quality nursing intervention may effectively alleviate depression, anxiety and other negative emotions, improve lung function, satisfaction and quality of life.

目的 对比分析甲氨蝶呤(methorexate,MTX)联合超声监视下清宫与甲氨蝶呤、子宫动脉栓塞术(uterine artery embolization,UAE)联合清宫治疗停经7周内Ⅱ-Ⅲ型剖宫产瘢痕妊娠(ceasarean scarpregnancy,CSP)的效果。方法 回顾性分析我院自2016年1月—2017年12月收治的停经7周内Ⅱ-Ⅲ型CSP患者的临床资料,按随机、平衡、对照原则分别筛选69例MTX+清宫治疗患者作为A组,68例MTX+UAE+清宫治疗患者作为B组,对比两组治疗成功率、一般治疗情况及术后并发症发生率,并统计两组月经周期恢复时间、血β-hCG恢复至正常时间、疤痕妊娠病灶消失时间。结果 两组术后恢复良好,术中、术后均未发生不可控制宫腔出血现象,胎囊组织均全部清出,A组术中出血量、子宫切除发生率、发热、术后盆腹腔疼痛及肝功能损伤发生率均低于B组,术后第1天血β-hCG下降超过50%及治疗成功率、住院时间均高于B组,且该组月经周期恢复时间、血β-hCG恢复至正常时间、疤痕妊娠病灶消失时间亦较B组短(P﹤0.05)。结论 于停经7周内Ⅱ-Ⅲ型CSP患者而言,行MTX+清宫治疗或可在不增加出血风险基础上避免UAE相关并发症及副反应。

Objective To comparatively analyze the effects of methotrexate (MTX) combined with uterine curettage under ultrasonic monitoring and MTX, uterine artery embolization (UAE) combined with uterine curettage in the treatment of cesarean scar pregnancy (CSP) within 7 weeks of menopause. Methods The clinical data of patients with type Ⅱ-Ⅲ CSP within 7 weeks of menopause who were admitted to the hospital from January 2016 to December 2017 were analyzed retrospectively. Another 69 cases treated with MTX combined with uterine curettage were selected as group A and 68 cases treated with MTX+UAE+uterine curettage were selected as group B. The success rate of treatment, general situation of treatment and the incidence of adverse reactions were compared between the two groups. The time of menstrual recovery, the recovery time of blood β-hCG and the disappearance time of scar pregnancy lesions were statistically analyzed. Results The two groups recovered well after operation, and there was no uncontrollable uterine bleeding. All fetal sac tissues were cleared. The intraoperative blood loss, hysterectomy rate, incidence rates of fever, postoperative abdominopelvic pain and liver function injury in group A were less/lower than those in group B, The rate of blood β-hCG decreasing more than 50% on the 1st day after operation, the success rate of treatment and hospitalization time of groups A were higher/longer than those of group B, while the time of menstrual recovery, recovery time of blood β-hCG and the disappearance time of scar pregnancy lesions was shorter than that of group B(P<0.05). Conclusion MTX combined with uterine curettage may avoid complications and side effects of UAE in patients with type Ⅱ-Ⅲ CSP within 7 weeks of menopause, without increasing the risk of bleeding.

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 探究以临床护理路径为主的健康教育在二胎异位妊娠患者中的应用效果。方法 选取2016年1月—2017年6月收治的80例二胎异位妊娠患者,随机分为实验组40例和对照组40例,实验组:实施以临床护理路径为主的健康教育,对照组以常规指导,比较两组临床效果。结果 实验组患者在健康教育知晓率、护理满意率方面与对照组比较,有差异(P<0.05);实验组在住院时间、住院费用及并发症发生率方面与对照组比较(P<0.05),观察组焦虑评分与抑郁评分均低于对照组(P<0.05)。结论 二胎异位妊娠患者运用临床护理路径进行健康教育,可有效提高患者对于异位妊娠疾病的了解程度,提高治疗护理依从性,促进患者早日康复出院,提高护理满意度,值得推广普及。

Objective To study the effect of applying clinical nursing pathway on health education of second womb ectopic pregnancy and explore more effective health education modes. Methods 80 patients with second-trimester ectopic pregnancy were randomly divided into experimental group (40 cases) and control group (40 cases). The experimental group was given health education through clinical nursing pathway. The control group was given routine guidance. We compared the effects of health education in two groups. Results 40 patients in the experimental group were compared with the 40 patients in the control group in terms of awareness rate of health education and satisfaction rate of care, P<0.05; the experimental group was compared with the control group in terms of length of stay, hospitalization costs, and complication rate, P<0.05 The anxiety scores and depression scores in the observation group were lower than those in the control group, P<0.05. There was a statistical difference between the two groups. Conclusions Applying clinical nursing pathway on health education of second womb ectopic pregnancy patients may effectively improve patients' understanding of ectopic pregnancy diseases, improve compliance of nursing care, facilitate patients to be discharged and improve satisfaction of nursing satisfaction, clinical care services in the popularization.

目的 分析超声检查前准备质量评价对超声检查效果的影响。方法 对进行泌尿科B超检查150例患者按数字表法随机分为对照组和实验组各75例,两组患者发放超声检查须知,按检查准备要求按预约时间前来完成超声检查;实验组在检查前对患者准备效果进行评价,及时落实检查须知事项。结果 检查前准备知识知晓、检查前准备质量、按时检查率对照组低于实验组(P＜0.05);检查前准备依从性、服务满意度对照组低于实验组(P＜0.05)。结论 开展检查前准备质量评价能促进患者落实超声检查前准备,提高准备依从性和准备知识知晓率,缩短检查等候时间,提高检查前准备质量和患者服务满意度。

Objective To analyze the influence of pre-preparation quality evaluation on the effect of ultrasound examination. Methods According to the digital table method, 150 patients were randomly divided into the control group and the experimental group, 75 cases in the control group and the experimental group each. The two groups were taken the ultrasound examination, and the ultrasound examination was completed according to the preparation requirements. The patients in the experimental group were evaluated before the examination, and the inspection notes were timely implemented. Results Knowledge of pre preparation, preparation quality before examination, and rate of check on time were lower in the control group than that in the experimental group(P<0.05). The control group was lower than the experimental group(P<0.05). Conclusion The preparation quality evaluation before examination may promote the patient's preparation before the ultrasonic examination, improve the preparation compliance and knowledge awareness, shorten the waiting time, and improve the quality of preparation and the satisfaction of patient service.

目的 探讨孕妇学校改革创新后,孕妇对孕妇学校授课的效果和满意度及影响因素分析。方法 2016年8月—2017年6月,通过师资授课比赛、课后孕妇满意度、对相关知识知晓率排名相结合方式竞争产生孕妇学校授课师资队伍,随机选取部分听课孕妇作为调查对象。结果 授课后,孕妇对相关知识的知晓得分提高约20分(P＜0.05),孕妇对核心知识点知晓率提高明显(P＜0.05),孕妇对课程讲授效果各方面满意度均在94%以上。对课程不满意的维度主要有授课PPT制作、教学计划、授课形式等,不满意比例分别为19.1%、18.0%和16.3%。对课程不满意组孕妇较满意组孕妇年龄偏大(P＜0.05),其余孕妇基本特征差异无统计学意义。结论 孕妇学校师资改革成效明显,行之有效,值得推广。

Objective To explore the effect of pregnant women's school after reform and innovation. Methods FromAugust 2016 to June 2017, teachers of pregnant women's school were produced by teaching competition and pregnant women's satisfaction and degree of knowledge. Survey objects were randomly selected. Results After teaching, knowledge degree of pregnant women improved about 20 points (P<0.05). The awareness rate of pregnant women on core knowledge points increased (P<0.05). Satisfaction degree of pregnant women on the course was over 94%. The main dimensions of dissatisfaction with the course included PPT production, teaching plan and teaching form. The proportions of dissatisfaction were 19.1%, 18.0% and 16.3% respectively. Unsatisfied women ages were older than satisfied women (P<0.05). Conclusion Reform and innovation is effective, and it is worth promoting.

目的 探究纽扣钢板内固定方法治疗新鲜Rockwood Ⅲ型以上肩锁关节脱位的效果。方法 选取2013年1月—2017年12月在我院诊断并治疗的肩锁关节脱位(Rockwood Ⅲ型以上)60例,随机分为观察组(30例)与对照组(30例),观察组采用纽扣钢板内固定方法,对照组采用锁骨钩钢板方法。对比两组治疗前后肩功能指标(Constant-Murley)、手术的治疗疗效指标(Karlsson)的优良率,以及手术时间和术中出血量。结果 治疗前两组的Constant-Murley评分无差异(P＞0.05),治疗后两组评分均提高(P＜0.05),其中观察组高于对照组(P＜0.05);观察组的Karlsson评分优良率、术中出血量均优于对照组(P＜0.05),观察组的手术时间高于对照组(P＜0.05)。结论 纽扣钢板内固定能够有效恢复患者正常肩部功能,具有良好的治疗效果,同时对患者造成的创伤较小。

Objective To observe the effect of button plates in treatment of Rockwood Ⅲ and greater acromioclavicular dislocation. Methods From January 2013 to December 2017, 60 Rockwood Ⅲ and greater acromioclavicular dislocation patients in our hospital were randomly divided into observe group(30 cases)and control group (30 cases), the observe group received button plates treatment, the control group received clavicula hook plate treatment. The shoulder function(Constant-Murley)of two groups before and after treatment were compared, and the effect of operation(the good rate of Karlsson), surgical time and intraoperative bleeding of two groups were also compared. Results There were no difference in shoulder function between two groups before treatment(P＞0.05). The indices were increased after treatment(P<0.05), and the indices in the observe group were higher than that of control group(P＜0.05), The good rate of Karlsson index, intraoperative bleeding of observe group were better than that of control group(P＜0.05).The surgical time of observe group were better than that of control group(P＜0.05). Conclusion Button plate's internal fixation nay better improve the shoulder function; it has better therapeutic effect, and smaller trauma to patient.

目的 探讨科学的出院后营养管理对肠道术后新生儿体格追赶的效果,分析影响体格追赶的相关因素。方法 通过营养门诊对出院术后婴儿及社区婴儿进行个体化营养喂养指导和营养咨询,比较两组每月体质量、身长及头围,并随访至生后9月龄。两组生后半年生长趋势行重复测量检验。结果 第1月龄时,手术组患儿体质量、身长、头围均落后于对照组婴儿(P<0.001, P=0.004, P=0.008),第2月龄时,手术组患儿体质量、头围仍落后于对照组(P=0.003,P=0.031),第4月龄时,手术组体质量低于对照组(P=0.012),第5～9月龄,两组体格指标均无明显差异。生后半年内两组的生长趋势差异无统计学意义。前半年身长的增长与出生身长、父母文化以及父亲的不良习惯存在负相关关系,头围的增长与住院天数呈明显负相关关系、与出生以及首诊时的体格状况呈正相关关系。结论 合理喂养对新生儿肠道术后体格追赶有利,帮助其接近正常生长曲线。再次手术可能是导致体质量增长下降的主要因素,但未明显影响身长、头围的正常增长。出生时和就诊时的体格状况、父母教育程度和不良习惯以及住院天数均是影响体格追赶的相关因素。

Objective To investigate the effect of scientific nutrition management after discharge on neonatal physical catch-up after intestinal operation, and to analyze the related factors affecting physical catch-up. Methods Individualized nutritional feeding instruction and nutrition consultation were performed on infants and community infants after discharge from hospital through nutrition clinic. The monthly body weight, body length and head circumference were compared between the two groups, and followed up to 9 months old. The growth trend of the two groups in half a year after birth was tested by repeated measurement. Results At the first month of age, the body weight, body length and head circumference of the patients in the operation group were lower than those in the control group (P<0.001, P=0.004, P=0.008). At the second month, the body weight and head circumference of the operation group were still behind those of the control group (P=0.003, P=0.031), and at the fourth month of age, the weight and head circumference of the patients in the operation group were still lower than those in the control group. The body weight of the operation group was lower than that of the control group (P=0.012), and there was no diffence in the physical indexes between the two groups at the age of 5~9 months. There was no statistical significance in growth trend between the two groups within half a year after birth. The growth of body length in the first half of the year had a negative correlation with the length of birth, parents' culture and father's bad habits. The growth of head circumference had a negative correlation with the length of stay in hospital, and had a positive correlation with the physical condition at birth and at first visit. Conclusion Reasonable feeding is beneficial to the physical catch-up of the newborn after intestinal operation and helps them approach the normal growth curve. Reoperation may be the main cause of weight loss, but it does not affect the normal growth of body length and head circumference. The physical condition at birth and medical visit, parents' education level, bad habit and hospitalization days were all related factors of physical catch-up.

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 探究我院静脉用药调配中心（PIVAS）对不合理医嘱的干预效果。方法 选取我院未实施不合理医嘱干预期间（2016年1月—2016年5月）的237 385条医嘱,以及实施不合理医嘱干预期间（2017年1月—2017年6月）的238 643条医嘱进行统计分析,观察比较干预前后不合理医嘱发生情况（给药途径不合理、溶媒选择不合理、频次不合理、浓度不合理、配伍不合理、其他等）,以及比较不合理医嘱干预方法等相关知识考核成绩。结果 不合理医嘱发生情况,主要包括溶媒选择不合理、频次不合理、浓度不合理、配伍不合理、其他;干预后,不合理医嘱总处方数及溶媒选择不合理、频次不合理、浓度不合理、配伍不合理、其他等单独处方数均明显少于干预前,（P<0.05）。干预后,医务人员接受静脉用药医嘱相关知识培训后的考核成绩（93.33±6.39）分明显高于未干预的考核成绩（75.03±7.86）分,（P<0.05）。结论 PIVAS对不合理医嘱的干预效果显著,可使不合理医嘱发生情况明显减少,促使静脉用药具有安全性与科学性的特点。