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目的 探讨学生实验室安全知识盲区,以提高高校实验室安全管理工作的成效。方法 考试人数192人,共计235次考试,根据考试系统的统计分析结果,观察各题目错误率和各选项构成比;结合统计描述和χ2检验,探讨影响学生实验室安全考试成绩的原因和所存在的知识盲区。结果 41%的考生身份为在读硕士研究生,59%的考生为在读本科生,男生占48%,女生占52%,且比较不同身份的性别构成比,差异无统计学意义;题目被归纳分为“行为规范”“应急自救技能”和“事故防范能力”三大部分,比较“行为规范”和“应急自救技能”类题目的错误率,差异存在统计学意义(χ2=7.570,P=0.006),“应急自救技能”类题目的错误率为3.14%,高于其余两类。结论 高校学生对应急自救技能类可能存在较多的知识盲区,应以之作为实验室安全管理工作关键控制点,加强应急自救技能培训可以极大地降低事故的严重程度。
Objective To enhance the efficiency of laboratory safety management in colleges,we analyzed the insufficiency of students in the knowledge about laboratory safety. Methods A total of 192 college students had attended the education tests of laboratory safety and totally 235 tests had been successfully recorded.According to the statistical analysis results,we observed the error ratio and the and the composition of the options for each question in the tests.With statistical description and Chi-square test,the impact of the test scores and the main insufficiency in the knowledge about laboratory safety were discussed. Results 41% of the students were pursuing master's degree,59% of them were pursuing bachelor's degree,48% are males and 52% are females,there was no significant difference in gender composition among different identities.All the questions had been categorized into three types,which were principle for conduct in laboratory,the skills of self rescue and the capability to prevent accidence.There was statistical significance between types of questions on principle for conduct in laboratory and the skills of self rescue(χ2=7.570,P=0.006),the error ratio of the question type of skills of self rescue was 3.14%,which was higher than the other types. Conclusions The insufficiency in the knowledge of skills of self rescue might probably be the critical control point in laboratory safety management,which should set as the key point of lab security,improve the self rescue skill of students may decrease thu severity accidence.
目的 基于计划行为理论探讨妊娠期糖尿病(GDM)孕妇自我管理行为意向,为促进其孕期良好的自我管理提供依据。方法 运用质性研究中的现象学研究方法,对12例GDM孕妇进行深度半结构式访谈,并用Colaizzi七步内容分析法对主题进行归纳。结果 根据计划行为理论对主题进行归纳,共提炼出3种类别:①行为态度:认知不足,积极态度,消极态度;②主观规范:家庭影响,医护压力,人际压力;③知觉行为控制:知识技能获取受限,客观条件束缚共8个主题。结论 GDM患者在自我管理过程中存在对疾病认知不足的问题GDM,自我管理行为受到家庭、医护人员、人际关系等外界压力对自我管理态度的影响,且存在知识技能欠缺,客观条件制约多方面阻碍。医护人员应加强对GDM孕妇的自我管理教育,适时提供支持,提高其自我管理效率。
Objective To explore the self-management behavior intention of pregnant women with gestational diabetes mellitus(GDM)based on the theory of planned behavior,and to provide a basis for promoting good self-management during pregnancy. Methods Using the phenomenological research method in qualitative research,12 pregnant women with GDM were interviewed in an in-depth semi-structured interview,and then the themes were summarized by Colaizzi's seven-step content analysis. Results According to the theory of planned behavior,the themes were summarized into three categories and eight themes including(1)Behavioral Attitudes:cognition deficiency,positive attitude,and negative attitude,(2)Subjective norms:family influence,medical pressure,interpersonal pressure,and(3)Perceptual behavior control:self-management knowledge acquisition limitations,self-management Objective conditions constraint. Conclusions Most of the respondents have insufficient awareness of self-management of gestational diabetes,different patients have different attitudes towards self-management,and self-management behavior is affected by external pressures such as family,medical staff,and interpersonal relationships,and there are many obstacles due to a lack of knowledge and skills,Objective conditions.Medical staff should strengthen the self-management education of pregnant women with gestational diabetes,provide timely support,and improve their self-management efficiency.
目的 探讨标准化沟通(SBAR)模式交接班联合护理质量指标管理在胆管结石患者中的应用效果及护理质量、不良事件及并发症影响。方法 选取天津市人民医院2021年1月—2022年12月收治的80例胆管结石患者,应用抽签法分为观察组与对照组,每组各40例。所有患者均采取手术治疗,其中对照组患者实施常规护理,观察组患者在对照组基础上增加SBAR沟通模式交接班联合护理质量指标管理。对比两组患者的护理质量、护理不良事件发生率、护理满意度及术后并发症发生率。结果 观察组基础护理、护理态度、护理责任心、风险识别能力、风险防范能力护理质量评分高于对照组(P<0.05);两组注射、口服给药差错、换药、抽血差错、病例书写错误以及执行医嘱不及时等护理不良事件发生率对比差异无统计学意义(P>0.05),观察组患者护理满意度高于对照组(P<0.05);观察组患者压疮、感染、静脉血栓等并发症发生率均低于对照组(P<0.05)。结论 SBAR沟通模式交接班联合护理质量指标管理针对胆管结石患者应用效果显著,可改善临床护理质量,同时患者护理满意度较高,进一步降低患者术后并发症发生率。
Objective To investigate the application effect of SBAR communication mode shift combined with the management of care quality indicators on patients with bile duct stones and their influence on postoperative complications. Methods Eighty patients with bile duct stones admitted to our hospital from January 2021 to December 2022 were selected,and divided into observation group and control group by drawing lots,40 cases each.All the patients were treated by surgery,and the control group patients received routine care,and the observation group patients added the SBAR communication mode.The quality of care,incidence of adverse events,satisfaction with care and incidence of postoperative complications of the two groups were compared. Results The quality of care values of basic care,nursing care,nursing responsibility,risk identification and risk prevention in the observation group were significantly higher than in the control group(P<0.05).There was no difference in the incidence of nursing side effects such as injection and oral administration errors,dressing changes,blood sampling errors,case clerk errors and delayed execution of medical orders between the two groups(P>0.05).Patient satisfaction in the observation group was significantly higher than that in the control group(P<0.05).The incidence of complications such as pressure ulcers,infections and venous thrombosis in the observation group was significantly lower than that in the control group(P<0.05). Conclusions SBAR communication mode and combined nursing quality index management for patients with bile duct stones,which can improve the quality of clinical nursing and patient nursing satisfaction,and further reduce the incidence of postoperative complications in patients.
目的 探讨终末期肾病患者血液透析中实施基于依从性曲线变化规律的阶段性护理的效果。方法 选择2022年1月—2023年10月濮阳市人民医院收治的接受血液透析治疗的86例终末期肾病患者,将其通过单双号抽签的方式分组,即对照组与观察组,各43例,前者实施常规护理,后者在此基础上实施基于依从性曲线变化规律的阶段性护理,对比两组患者护理前后心理状态评分情况、生活质量评分情况及治疗依从性。结果 两组患者护理前后正性负性情绪量表(PANAS评分有一定差距,其中负性情绪显著降低,正性情绪显著提升,而护理后观察组负性情绪评分为(11.67±2.55)分,低于对照组的(16.11±3.02)分,正性情绪为(25.07±5.28),高于对照组的(20.11±5.23)分(t=7.366、4.376,P<0.05);护理后观察组生活质量综合评定量表(GQOLI-74)躯体、心理、社会及物质生活等维度评分分别为(82.17±7.11)分、(82.02±7.45)分、(81.11±7.78)分及(81.11±7.42)分,高于对照组的(71.22±7.23)分、(72.12±7.56)分、(71.23±7.45)分及(70.23±7.33)分(t=7.081、6.116、6.015、6.840,P<0.05);观察组(95.35%)与对照组(76.74%)的治疗依从性比较,前者更高(χ2=6.198,P<0.05)。结论 基于依从性曲线变化规律的阶段性护理对于接受血液透析治疗的终末期肾病患者,不仅有助于调整其心理状态,还有助于提高其治疗依从性,使其生活质量也得以全面提高。
Objective To explore the effect of implementing phased nursing based on compliance curve changes in hemodialysis for end-stage renal disease patients. Methods The research deadline was from January,2022 to October,2023.The research object was 86 patients with end-stage renal disease who received hemodialysis treatment in Puyang People's Hospital,and they were divided into control group and observation group with 43 patients in each group by odd and even numbers.The former was given routine care,while the latter was given stage nursing based on the change of compliance curve.The psychological state score,quality of life score and treatment compliance of the two groups were compared before and after care. Results There was a certain difference in the Positive and Negative Affect Scale(PANAS)scores between the two groups before and after nursing,in which the negative emotion was significantly reduced and the positive emotion was significantly improved.After nursing,the negative emotion score of the observation group was(11.67±2.55),which was significantly lower than that of the control group(16.11±3.02),and the positive emotion score was(25.07±5.28),which was significantly higher than that of the control group(20.11±5.23)(t=7.366,4.376,P<0.05).After nursing,the scores of Generic Quality of Life Inventory-74(GQOLI-74)in the observation group were(82.17±7.11),(82.02±7.45),(81.11±7.78)and(81.11±7.42),which were significantly higher than those in the control group(71.22±7.23),(72.12±7.56),(71.23±7.45)and(70.23±7.33)(t=7.081,6.116,6.015,6.840,P<0.05).The treatment compliance of the observation group(95.35%)was higher than that of the control group(76.74%)(χ2=6.198,P<0.05). Conclusions Choosing stage nursing based on the variation pattern of compliance curve for end-stage renal disease patients undergoing hemodialysis not only helps to adjust their psychological state,but also improves their treatment compliance,leading to a comprehensive improvement in their quality of life.
目的 探讨对于重症肺部感染患者采用药物+纤维支气管镜肺泡灌洗吸痰术治疗的效果。方法 选取2021年9月—2023年5月在郑州市第一人民医院ICU中94例肺部感染患者,分为观察组、对照组,对照组进行常规治疗,观察组采用药物+纤维支气管镜肺泡灌洗吸痰术治疗,对比两组患者的疗效、症状的缓解时间、炎性因子、实验室相关指标以及不良反应。结果 治疗后,观察组患者的治疗有效率91.49%高于对照组76.60%(χ2=3.887,P<0.05),观察组患者的发热、肺部湿啰音、咳嗽以及咳痰等症状的缓解时间分别为(3.09±1.25)(4.17±2.24)(3.95±1.53)(4.05±1.77)d,均低于对照组(5.14±2.43)(7.03±3.23)(6.40±2.62)(6.32±1.81)d(t=5.143、4.988、5.536、6.147,P<0.05),观察组的 C 反应性蛋白(C-reactive protein,CRP)、白细胞介素-6(Interleukin-6,IL-6)以及Toll样受体4(Toll-like receptor 4,TLR-4)水平分别为(3.64±0.87)mg/L、(54.59±10.65)ng/mL、(7.94±1.57)%,均低于对照组(7.51±1.43)mg/L、(87.66±11.17)ng/mL、(12.11±2.48)%(t=15.850、14.690、9.740,P<0.05),观察组的气道压力、动脉血二氧化碳分压(partial pressure of carbon dioxide in artery,PaCO2)水平分别为(6.92±3.60)cmH2O、(43.19±6.29)mmHg,低于对照组(8.68±2.98)cmH2O、(55.43±5.95)mmHg,观察组动脉氧分压(Partial arterial oxygen pressure,PaO2)(86.06±5.31)mmHg、血氧饱和度(oxyhemoglobin saturation,SpO2)(98.03±6.63)%高于对照组(68.04±5.19)mmHg、(90.22±5.51)%要高(t=2.582、9.692、16.638、6.221,P<0.05),观察组中的不良反应发生率为2.13%与对照组10.64%比较差异无统计学意义(χ2=2.849,P>0.05)。结论 对处于ICU中的肺部感染患者治疗时,使用药物+纤维支气管镜肺泡灌洗吸痰术能够改善患者症状,降低炎性因子水平。
Objective To investigate the efficacy of medication combined with bronchoscopic alveolar lavage and sputum aspiration in ICU patients with severe pulmonary infection. Methods Ninety-four patients with pulmonary infection in the ICU of Zhengzhou First People's Hospital from September 2021 to May 2023 were selected and divided into observation group and control group.The control group received routine treatment,and the observation group was treated with medication and bronchoscopic alveolar lavage and sputum aspiration.The efficacy,duration of symptom remission,inflammatory factors,laboratory-related indicators and adverse reactions were compared between the two groups. Results After treatment,the effective rate of 91.49% in observation group was significantly higher than 76.60% in control group(χ2=3.887,P<0.05).The relief time of fever,pulmonary rale,cough and sputum in observation group was(3.09±1.25)d,(4.17±2.24)d,(3.95±1.53)d,and(4.05±1.77)d,respectively,which were significantly lower than the control group[(5.14±2.43)d,(7.03±3.23)d,(6.40±2.62)d and(6.32±1.81)d](t=5.143,4.988,5.536,6.147,P<0.05).The levels of CRP,IL-6 and TLR-4 in the observation group were(3.64±0.87)mg/L,(54.59±10.65)ng/mL and(7.94±1.57)%,respectively.They were significantly lower than(7.51±1.43)mg/L,(87.66±11.17)ng/mL and(12.11±2.48)% in the control group(t=15.850,14.690,9.740,P<0.05).The airway pressure and PaCO2 levels of the observation group were(6.92±3.60)cmH2O and(43.19±6.29)mmHg,respectively,which were significantly lower than those of the control group[(8.68±2.98)cmH2O and(55.43±5.95)mmHg].The levels of PaO2[(86.06±5.31)mmHg] and SpO2[(98.03±6.63)%] in the observation group were higher than those in the control group[(68.04±5.19)mmHg and(90.22±5.51)%],and there were statistically significant differences(t=2.582,9.692,16.638,6.221,P<0.05).The adverse reactions of 2.13% in the observation group were lower than 10.64% in the control group,and there was no statistically significant difference(χ2=2.849,P>0.05). Conclusions In ICU patients with severe lung infection,the treatment of drugs combined with alveolar lavage and fiberoptic bronchoscopic aspiration is better,and can significantly improve the symptoms and inflammatory factor levels of patients.
目的 探讨责任制助产护理模式配合体位管理对高龄产妇分娩方式及产程的影响。方法 选择2023年6月—12月医院接收的高龄产妇68例进行研究,按照护理方式分为两组各34例,对照组为常规助产护理,观察组为责任制助产护理模式配合体位管理,比较两组分娩方式、产程、疼痛程度及护理满意度。结果 观察组阴道分娩率为76.47%(26例),高于对照组52.94%(18例),剖宫产率为8.82%(3例),低于对照组29.41%(10例)(χ2分别为4.121、4.660,均P<0.05)。观察组第一产程(6.25±0.50)h、第二产程(0.79±0.21)h、总产程(7.15±0.63)h、宫口开大3 cm、10 cm时的疼痛程度(4.12±1.08)分、(6.29±1.25)分明显低于对照组(7.01±0.62)h、(0.96±0.30)h、(8.11±1.07)h、(7.84±1.45)分、(9.09±0.74)分(t分别为5.563、2.706、4.508、11.997、11.239,均P<0.05)。观察组的护理满意度为97.06%(33例),比对照组的76.47%(26例)高(χ2=4.610,P=0.031)。结论 高龄产妇展开责任制助产护理模式配合体位管理可促进自然分娩,并缩短产程,减轻产时疼痛程度,降低剖宫产率,提高护理满意度。
Objective To explore the effect of responsibility midwifery nursing model combined with position management on delivery mode and labor process of elderly parturient.Methods A total of 68 cases of elderly pregnant women admitted to the hospital from June to December 2023 were selected,and they were divided into two groups according to the nursing mode,34 cases in each group.The control group was given routine midwifery nursing,and the observation group was given responsible midwifery nursing mode combined with position management.The methods of delivery,labor process,pain degree and nursing satisfaction of the two groups were compared.Results The vaginal delivery rate was 76.47%(26 cases)in the observation group,which was higher than 52.94%(18 cases)in the control group,and the cesarean section rate was 8.82%(3 cases)in the observation group,which was lower than 29.41%(10 cases)in the control group(χ2=4.121 and 4.660,P=0.042 and 0.030).The pain degree of the first stage of labor(6.25±0.50)h,the second stage of labor(0.79±0.21)h,the total stage of labor(7.15±0.63)h,the pain degree of the cervical dilation 3 cm,10 cm in the observation group were significantly lower than those in the control group[(7.01±0.62)h,(4.12±1.08)points,(6.29±1.25)points vs (0.96±0.30)h,(8.11±1.07)h,(7.84±1.45)score,(9.09±0.74)score(t=5.563,2.706,4.508,11.997,11.239,P<0.05).The nursing satisfaction of the observation group was 97.06%(33 cases),which was higher than 76.47%(26 cases)of the control group(χ2=4.610,P=0.031).Conclusion sResponsibility midwifery nursing mode combined with position management can promote natural childbirth,shorten the labor process,reduce the pain during labor,reduce the rate of cesarean section,and improve nursing satisfaction in elderly women,which is worthy of promotion.
目的 探讨基于失效模式与效应分析法(FMEA)风险管理模式的在消化内镜诊疗护理中的应用价值。方法 选取2021年7月—2022年12月在河南省人民医院接受无痛消化内镜诊疗的368例患者为研究对象,根据入组时间顺序,2022年3月及其之前入组患者为对照组(n=171),实施常规护理管理;2022年3月之后入组的患者为观察组(n=197),在对照组基础上,增加基于FMEA的护理风险管理模式,对比两组患者的护理质量。结果 观察组各环节风险优先级(RPN)值较干预前明显好转,RPN总分由1 044分降至336分,观察组不良事件发生率低于对照组(17.3% vs 33.3%,P<0.05),观察组患者对医护人员满意度高于对照组(92.9% vs 85.4%,P<0.05),观察组患者所需的等待时间低于对照组[(35.68±7.29)min vs (44.27±8.65)分min,P<0.05]。结论 FMEA风险管理模式能有效提高无痛消化内镜诊疗中的护理质量。
Objective To explore the application analysis of failure mode and effect analysis(FMEA)risk management model in digestive endoscopy diagnosis treatment and nursing.Methods A total of 368 patients who underwent painless endoscopic diagnosis and treatment at Henan Provincial People’s Hospital from July 2021 to December 2022 were selected.According to the order of enrollment,patients enrolled in March 2022 and before were selected as the control group(n=171),and routine nursing management was implemented.The patients enrolled after March 2022 were in the observation group(n=197).In addition to the control group,a nursing risk management model based on FMEA was added to compare the nursing quality of the two groups of patients.Results The risk priority number(RPN)values of each link in the observation group showed a significant improvement compared to that before intervention.The total RPN score decreased from 1 044 points to 336 points,and the incidence of adverse events in the observation group was lower than that in the control group(17.3% vs 33.3%,P<0.05).The satisfaction of the observation group with medical staff was higher than that in the control group(92.9% vs 85.4%,P<0.05).The waiting time required by the observation group was lower than that in the control group[(35.68±7.29)min vs(44.27±8.65)min,P<0.05].Conclusion sThe FMEA risk management model can effectively improve the nursing quality in painless endoscopic diagnosis and treatment.
目的 了解行角膜胶原交联术患者围术期的体验感受,为角膜胶原交联术的顺利进行及术后康复提供参考依据。方法 采用目的抽样法,于2023年8月—2023年10月在中山大学中山眼科中心选取12例行角膜交联术的患者进行半结构式访谈,采取Colaizzi七步法进行整理分析资料。结果 通过分析得出患者在围手术期的5种感受:焦虑、疼痛、恐惧、紧张、盲目乐观。结论 分析角膜交联手术患者在围术期不同感受,做好围术期护理,希望有利于提高手术效果。
Objective To understand the perioperative experience of patients undergoing corneal collagen cross-linking surgery,and provide reference for the smooth progress of corneal collagen cross-linking surgery and postoperative rehabilitation.Methods Using purposive sampling method,12 patients who underwent corneal cross-linking surgery were selected from the Sun Yat-sen Ophthalmology Center of Sun Yat-sen University from August 2023 to October 2023 for semi-structured interviews.The data were analyzed using the Colaizzi seven step method.Results Through analysis,five feelings of patients during the perioperative period were identified:anxiety,pain,fear,tension and blind optimism.Conclusion sAnalyzing the different feelings of patients undergoing corneal cross-linking surgery during the perioperative period and providing good perioperative care can help achieve satisfactory results in the surgery.
目的 探究对神经根型颈椎病(CSR)患者开展悬吊运动疗法+推拿的临床价值。方法 选择2020年1月—2021年7月100例神经根型颈椎病患者,参考“数字双盲法”,分为对照组和观察组(均n=50);对照组患者为推拿治疗,观察组基于对照组基础+悬吊运动疗法;对比治疗结果。结果 观察组临床总有效率94.00%较对照组80.00%高(P<0.05)。2组治疗后VAS疼痛评分较治疗前均下降,且观察组较对照组更低(P<0.05)。治疗前120°/s的等速度运动状态下2组峰力距(PT)、平均功率(AP)、屈肌峰力距/伸肌峰力距(F/E)比较(P>0.05),经治疗后2组均显著改善,且观察组PT、AP、F/E指标较对照组均更优(P<0.05)。2组治疗后颈椎功能障碍指数(NDI)评分、颈椎病临床评价量表(CASCS)评分较同组治疗前均改善,且观察组较对照组NDI评分更低,CASCS评分更高。结论 针对CSR患者开展悬吊运动疗法+推拿治疗,有利于调节患者颈部肌群协调能力,减轻疼痛感,改善临床症状,促进颈椎功能恢复,实现理想的治疗效果。
Objective To explore the clinical value of sling exercise therapy (SET) and massage in patients with cervical spondylotic radiculopathy (CSR). Methods From January 2020 to July 2021, 100 patients with CSR were selected and divided into control group and observation group (both n=50). The patients in the control group were treated with massage, and the observation group was treated with massage+SET, the treatment results were compared. Results The total clinical effective rate of 94.00% in the observation group was significantly higher than 80.00% in the control group (P<0.05). The VAS pain scores of the two groups after treatment were lower than those before treatment, and the VAS pain score of the observation group was lower than that of the control group (P<0.05). The peak torque (PT), average power (AP) and flexor peak force distance/extensor peak force distance (F/E) of the two groups were significantly improved after treatment, and the PT, AP and F/E indexes of the observation group were better than those of the control group (P<0.05). After treatment, the neck disability index (NDI) score and clinical assessment scale of cervical spondylosis (CASCS) score of the two groups were significantly improved compared with those before treatment, and the NDI score of the observation group was lower and the CASCS score was higher in the observation group. Conclusions SET+massage therapy for patients with CSR is helpful to adjust the coordination ability of cervical muscle group, reduce pain, improve clinical symptoms, promote the recovery of cervical function and achieve ideal therapeutic effect.
目的 探讨不同年龄段皮罗序列征患儿血气分析的特点、手术后机械通气时间和住院时间。方法 收集新生儿及非新生儿III度皮罗序列征(PRS)患儿各30例,PRS患儿入院后通过桡动脉进行采集血标本进行血气分析,比较2组血标本的 pH 值、PCO2 、PO2 、HCO-3、BE、乳酸、AG、A-aDO2的特点、手术后机械通气时间及住院时间。结果 新生儿组PCO2、HCO-3、BE、乳酸及A-aDO2高于非新生儿组,非新生儿组PO2及AG高于新生儿组。2组pH值、PO2、AG均在正常范围,机械通气及住院时间与乳酸呈正相关,与年龄呈负相关。结论 不同的年龄阶段,PRS患儿的动脉血气分析的结果不同,高乳酸与低年龄PRS患儿手术后机械通气时间及住院时间长。
Objective To investigate the characteristics of arterial blood gas analysis, time of mechanical ventilation and hospital stay in different age patients with Pirre Robin sequence (PRS). Methods Sixty children with III-grade PRS were divided into two groups according to their age, as neonate group and non-neonate group. The blood samples were collected from radial artery after admission for blood gas analysis, the characteristics of pH value, partial pressure of carbon dioxide (PCO2), partial pressure of blood oxygen (PO2), bicarbonate ion (HCO-3), base excess (BE), lactic acid (Lac), anion gap (AG) , alveolar artery oxygen pressure difference (A-aDO2) , postoperative mechanical ventilation time and hospital stay were compared between the two groups. Results The levels of PCO2, HCO-3, BE, Lac and A-aDO2 in neonate group were higher than those in non-neonate group, and the levels of PO2 and AG in non-neonate group were higher than those in neonate group. The pH value, PO2 and AG of the two groups were in the normal range. Post-operative mechanical ventilation time and hospital stay were positively correlated with Lac and negatively correlated with age. Conclusions In different age groups, the results of arterial blood gas analysis in PRS children were different, and the time of mechanical ventilation and hospital stay were longer in higher Lac level and younger patients with PRS.