目的 研究鼻内镜下三线减张矫正术治疗鼻中隔偏曲的疗效及安全性。方法 纳入2010年9月—2015年9月我院120例鼻中隔偏曲患者作为研究对象,采用随机数表法分为两组,各60例。观察组行鼻内镜下三线减张鼻中隔偏曲矫正术,对照组行鼻内镜下传统鼻中隔黏膜下切除术。比较两种手术方法对患者鼻塞、头痛、鼻出血等临床症状的改善情况,随访记录两组术后疼痛、鼻阻力及并发症发生情况,评价疗效和安全性。结果 观察组术后鼻塞、头痛及鼻出血症状评分分别为(1.05±0.16)分、(1.3±0.14)分及(1.63±0.14)分,均显著低于对照组和术前水平(P＜0.05)。观察组术后1周、2周及4周各时间点VAS评分和鼻阻力值均显著低于对照组(P＜0.05)。观察组术后鼻中隔血肿和黏膜撕裂发生率均为1.67%,无鼻中隔穿孔和外形改变病例,发生率显著低于对照组,差异有统计学意义(P＜0.05)。结论 鼻内镜下三线减张矫正术能显著改善鼻中隔偏曲患者鼻塞、头痛及鼻出血症状,促进鼻腔通气功能恢复,有效降低术后并发症发生率,安全性高。

目的 探讨追踪护理模式对中青年保留神经宫颈癌根治术后膀胱功能恢复的影响效果。方法 按住院先后顺序将82例患者分为对照组40例、实验组42例,对照组给予常规护理,实验组实施追踪护理模式,3个月后对两组患者的尿失禁、尿潴留发生率,膀胱功能恢复情况及尿失禁严重程度进行测评。结果 实验组尿失禁、尿潴留的发生率分别为2%、4% ,膀胱功能Ⅰ级、Ⅱ级达100%,68%患者无尿失禁,与对照组比较差异均有统计学意义(P>0.05)。结论 对中青年保留神经宫颈癌根治术实施追踪护理模式,可提高患者膀胱功能锻炼的有效性,促进膀胱功能的早日恢复,改善其生活质量。

Objective To explore the effect of follow-up nursing on the recovery of bladder function in young and middle-aged patients with cervical cancer after radical operation. Methods 82 patients were divided into control group (n = 40) and experimental group (n=42). The control group was given routine nursing care, experimental group to implement the follow-up nursing model. After 3 months, the incidence of urinary incontinence and urinary retention were observed in the two groups, including bladder function recovery and severity of urinary incontinence. Results The incidence of urinary incontinence and urinary retention in the experimental group were 2% and 4%, respectively. Bladder function level I and II reached 100%. There was no urinary incontinence in 68% patients. Compared with the control group, the difference was statistically significant (P>0.05). Conclusion It may improve the effectiveness of bladder function training, promote the early recovery of bladder function and improve the quality of life of young and middle-aged patients with cervical cancer.

目的 观察尝试采用激素替代疗法(hormonereplace menttherapy,HRT)治疗更年期疾病的干眼症的临床疗效。方法 将80例(160眼)干眼症患者随机分成2组,治疗组40例(80眼)在滴人工泪液的基础上采用激素替代疗法(HRT)口服治疗。对照组40例(80眼)单纯采用人工泪液滴眼液滴双眼。两组同时给予综合护理。3个月后观察疗效。结果 治疗组总有效率82.5%,对照组总有效率60%,两组总有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。结论 在人工泪液滴眼液滴双眼的基础上尝试采用激素替代疗法(HRT)治疗更年期疾病的干眼症患者,效果优于单纯应用人工泪液点眼。

Objective To investigate the role of hormone replace menttherapy (HRT) in treating xerophthalmia among patients with climacteric disease. Methods Eighty xerophthalmia patients (160 eyes) were randomly divided into two groups. Forty patients in the treatment group (80 eyes) were treated using combined HRT and artificial drops. Forty patients in the control group (80 eyes) were treated using artificial drops alone. All patients were provided comprehensive nursing. The evaluation of clinical effects was performed after 3 months of treatment. Results The total effective rate of both groups was 82.5% in the treatment group and 60% in the control group, respectively (P<0.05). Conclusion Combined HRT and artificial drops is more effective in treating climacteric disease-related xerophthalmia than using artificial drops only.

目的 探讨康复护理路径早期功能训练对桡骨远端骨折LCP(锁定加压接骨板locking compression plate, LCP)内固定术后患者腕关节功能康复的影响。方法 对2014年5月—2016年6月住院80例桡骨远端骨折LCP 内固定术后患者分为对照组和观察组,每组各40例,对照组按桡骨远端LCP内固定术后护理措施进行护理,观察组患者在此护理基础上,制定术后功能康复护理路径,按功能康复护理路径对术后患者实施早期功能康复训练,随访评价两组患者患肢的组织肿胀、疼痛、骨折复位和腕关节功能康复效果。结果 疼痛评分:对照组在术后第3天~14天疼痛评分均高于观察组(P＜0.005);肿胀程度评分:对照组在术后第3天~7天肿胀程度评分均高于观察组,消肿速度比观察组慢(P＜0.001);腕关节的屈伸活动范围、握力和捏力比较观察组优于对照组(P＜0.001);腕关节复位优良率观察组95%高于对照组87.5%(P＜0.001)。结论 应用康复护理路径对桡骨远端骨折的LCP内固定术后患者进行早期腕关节功能康复训练,能减轻患者疼痛和局部软组织肿胀,减少并发症,提高术后患者康复质量。

Objective To investigate the early functional training of rehabilitation nursing path to the effects of distal radius fracture LCP (locking compression plate LCP) in patients after internal fixation of wrist joint function rehabilitation. Methods From May 2014 to June 2016, 80 patients with distal radius fractures were divided into control group and observation group(n=LCP), each with 40 cases. The control group was treated with nursing care of patients with distal radius LCP internal fixation. On the basis of nursing, the patients in the observation group were given rehabilitation nursing pathway, and the patients were followed up according to the rehabilitation path including evaluation of two groups of patients with fracture limb swelling, pain, fracture reduction and wrist joint function rehabilitation. Results Pain score: in the third days to fourteenth days pain score of the control group was higher than the observation group (P<0.005); Swelling degree score: swelling scores of the control group for the third days to seventh days after were higher than those in the observation group, the swelling reduced slowly (P<0.001); The wrist flexion range, grip and pinch strength compared to the observation group was better than the control group (P<0.001); The good rate of wrist joint reduction in the observation group (95%) was higher than that in the control group[(87.5%) (P<0.001)]. Conclusion The application of rehabilitation nursing path for patients with distal radius fracture after LCP internal fixation for early rehabilitation of wrist function may reduce the pain and local soft tissue swelling, reduce complications and improve the quality of postoperative rehabilitation.

目的 探讨个体化健康管理对超高龄结直肠癌患者希望水平的影响效果。方法 对66例超高龄结直肠癌患者实施个体化健康管理,3个月后对患者进行希望水平、肛门括约肌功能、生活质量的测评。结果 3个月后患者排便功能恢复良好的达90.91%,与出院前比较差异有统计学意义(P＜0.01);3个月后患者HHI各维度和SF-36各维度的得分明显提高,与干预前比较差异均有统计学意义(P＜0.01)。结论 对超高龄结直肠癌患者实施个体化健康管理,可提高其生存希望水平,改善生活质量。

Objective To explore the effect of individualized health management on the hope level of patients with advanced colorectal cancer. Methods Using individualized health management for 66 elderly patients with colorectal cancer for 3 months, the level of hope, anal sphincter function and quality of life were evaluated. Results After 3 months, the defecation function of the patients recovered well to reach 90.91%, and the difference was statistically significant (P<0.01); After 3 months, the scores of each dimension of Herth Hope Index (HHI) and SF-36 were significantly improved, and the difference was statistically significant (P<0.01). Conclusion The implementation of individualized health management for the elderly patients with colorectal cancer may improve the survival level and improve the quality of life.

目的 探讨阳性强化法对社区门诊静脉输液患儿穿刺疼痛及依从性的影响。方法 选取社区门诊2014年4月—2016年4月收治的100例行静脉输液治疗的患儿作为研究对象,采取随机数字表法将其分成两组,每组50例。观察组患儿给予阳性强化法干预,对照组给予常规护理干预,对比两组患儿穿刺疼痛相关指标、穿刺效果、患儿静脉输液依从性及患儿家长的满意度。结果 观察组患儿疼痛面容持续时间明显短于对照组,穿刺后心率明显慢于对照组,啼哭时间>30s的患儿占比明显低于对照组(P<0.01)。观察组一次穿刺成功率、穿刺耗时>5min占比分别为94.00%、24.00%,对照组分别为74.00%、62.00%,观察组一次穿刺成功率明显高于对照组,穿刺耗时>5min占比明显低于对照组(P<0.01)。观察组患儿静脉输液依从率为90.00%,与对照组的66.00%对比有明显上升(P<0.01)。观察组患儿家长满意度为96.00%,与对照组的80.00%对比有明显上升(P<0.05)。结论 对社区门诊静脉输液患儿实施阳性强化法干预可有效减轻穿刺疼痛,提高患儿的输液依从性,患儿家长满意度高。

Objective To explore positive reinforcement on pain and compliance of puncture to children in community outpatients with intravenous infusion. Methods Select 100 cases of children who receive intravenous infusion in community outpatients from April 2014 to April 2016 as research objectives and divide them into two groups randomly with each group of 50 cases. Provide positive reinforcement to observation group while provide routine nursing to control group. Compare two groups' puncture pain relevant indicator, puncture effect, children's intravenous infusion compliance and parents' satisfaction. Results Children in observation had less duration of pain face expression, lower heart rate after puncture and less children crying >30s than those in control group (P<0.01). Observation group's first puncture success rate, puncture time duration >5mins rate were 94.00% and 24.00% respectively while control group's data were 74.00% and 62.00%. Observation group's first success rate was significant higher than that of control group. Observation group's puncture time duration >5mins rate was significant lower than that of control group (P<0.01). Children's intravenous infusion compliance rate in observation group was 90.00% which was significant higher than control group's 66.00% (P<0.01). Parents satisfaction rate in observation groups was 96.00% which was significant higher than control group's 80.00% (P<0.05). Conclusion Implementing positive reinforcement on children in community outpatient may help to relieve puncture pain, improve children's compliance to intravenous infusion and increase parents' satisfaction.

目的 探讨小骨窗显微手术不同手术时机对高血压脑出血患者疗效及神经功能的影响。方法 选取我院2014年5月—2016年5月收治的80例高血压脑出血患者作为研究对象,脑出血量约30～40 mL,根据出血到手术时间不同分为两组,每组40例。从出血到手术时间<6 h者为超早期作为观察组,出血到手术时间处于6~24 h间者为早期作为对照组,比较两组患者治疗后1个月GOS(格拉斯哥预后)优良率,治疗后3周、6周的斯堪的纳维亚(SSS)评分,治疗后3个月、6个月的生存质量评分及治疗后的生存情况、再出血情况。结果 观察组治疗后1个月GOS优良率为77.50%,相对于对照组明显上升(P<0.05);观察组治疗后3周、6周的SSS评分较对照组明显降低(P<0.01);观察组治疗后3个月、6个月的生存质量评分较对照组明显升高(P<0.01);两组治疗后的生存率差异有统计学意义(P<0.05),再出血率差异无统计学意义(P>0.05)。结论 对高血压脑出血患者在超早期行小骨窗显微手术可提高疗效,明显改善患者神经功能,提高生活质量及生存率,值得临床推广。

Objective To investigate the curative effects of microsurgical treatment with small bone flap craniotomy in patients with hypertensive cerebral hemorrhage and on their nerve function in different timing of surgery. Methods To select 80 cases of hypertensive cerebral hemorrhage in our hospital from May 2014 to May 2016 as the research object. The amount of cerebral hemorrhage of the patients was about 30-40 mL. According to the different time of bleeding, they were divided into two groups, 40 cases in each group. The super early period that the time from bleeding to operation was less than 6 h was regarded as the observation group, and the early period that the time from bleeding to operation is during 6~24 h was regarded as the control group. To compare the GOS (Glasgow outcome) excellent rate of patients in two groups in 1 month after treatment, the Scandinavia (SSS) score in 3 weeks and 6 weeks after treatment, and the quality of life score and survival and re-bleeding condition after treatment in 3 months and 6 months. Results Compared with the control group, the GOS excellent rate in the observation group in 1 month after treatment was 77.50% which increased significantly (P<0.05); the SSS score in the observation group in 3 weeks and 6 weeks after treatment was significantly lower than that in the control group (P<0.01); The quality of life score in the observation group in 3 months and 6 months after treatment was significantly higher than that in the control group (P<0.01); There was statistically significant difference in survival rate between the two groups after treatment (P<0.05), and the re-bleeding rate showed no significant difference (P>0.05). Conclusion The curative effects of microsurgical treatment with small bone flap craniotomy on patients with hypertensive cerebral hemorrhage is significant, which can improve the patients' neurological function, the life quality and survival rate, thus it is worthy of clinical promotion.

目的 探讨加味六君子汤联合经口营养补充对COPD稳定期伴营养不良患者营养状况和肺功能的影响。方法 收集呼吸内科COPD稳定期并伴营养不良的患者40例,分为试验组和对照组各20例。试验组在对照组基础上再给予加味六君子汤和经口营养补充,观察治疗前、治疗后3月的营养相关指标和肺功能指标,然后进行统计分析。结果 ①治疗后3月,试验组的体质量、白蛋白、前白蛋白和肺功能指标较治疗前均明显改善(P<0.05)。②与对照组比较,试验组的白蛋白、前白蛋白、血红蛋白均明显升高(P<0.05),肺功能亦有显著改善(P<0.05)。③上臂肌围(MAMC)、三头肌皮褶厚度(TSF)在治疗后的组内及组间比较差异均无统计学意义(P>0.05)。结论 加味六君子汤联合经口营养补充有助于COPD稳定期伴营养不良患者体质量增加、蛋白升高,营养状况好转,从而增加呼吸肌储备,改善患者肺功能。

Objective To observe the influence of modified-liujunzi-decoction combined with Oral nutritional supplements(ONS) on the nutrition status and lung function in patients with chronic obstructive pulmonary disease(COPD). Methods 40 patients of COPD stable phase with malnutrition were divided into two groups and each group with 20 cases. On the basis of the control group, the experimental group was given again modified-liujunzi-decoction and ONS. All cases were tested before and 3 months after treatment, for detecting the nutrition related index and lung function index; T-test was used for data statistical analysis. Results ①3 months after treatment, the body weight, serum albumin, prealbumin and lung function index of the experimental group were significantly improved compared with those before treatment (P<0.05). ②Compared with the control group, the serum albumin, prealbumin and hemoglobin were significantly increased in the experimental group (P<0.05), and lung function was also significantly improved (P<0.05). ③After treatment, the mid-arm muscle circumference (MAMC), triceps skinfold thickness (TSF) comparison of intra group and intra group differences were not statistically significant(P>0.05). Conclusion Modified-liujunzi -decoction combined with oral nutritional supplements help to increase body weight, protein, and improve nutritional status in patients of COPD stable phase with malnutrition, thereby increasing their respiratory muscle reserve and improving lung function.

目的 探讨配偶参与式护理对腹腔镜保留盆腔自主神经子宫切除术年轻患者功能恢复的影响效果。方法 按时间先后将96例患者分为实验组50例和对照组46例,对照组按常规护理,实验组采用先培训配偶,然后让配偶与护士共同对患者实施整体护理,6个月后测试患者膀胱和性功能恢复情况。结果 实验组术后7天膀胱功能恢复41例,尿管留置时间为(10.8±2.1),术后6个月FSFI评分为(29.11±3.65),均优于对照组,两组比较差异均有统计学意义(P＜0.05)。结论 配偶参与式护理可使腹腔镜保留盆腔自主神经子宫切除术年轻患者得到更多专业的照顾,利于术后膀胱功能和性功能的恢复。

Objective To evaluate the influence of spouse participatory nursing on functional recovery of young patients who experienced laparoscopic nerve-sparing radical hysterectomy. Methods 96 patients were divided into the experiment group (50 patients) and the control group (46 patients) according to the timeline. The control group accepted normal nursing while the experiment group accepted the method that the spouse was provided with training first and then nurses provided overall nursing to the patient along with the spouse. Six months later, patients' recovery of bladder and sexual function were assessed. Results In the experimental group, 41 patients' bladder function recovered in seven days after the surgery, and the catheter retention time was(10.8±2.1); the FSFI score was (29.11±3.65)in six months after the surgery, and the score was better than that in the control group. The differences between both groups had statistical significance (P<0.05). Conclusion Spouse participatory nursing can provide more professional care to young patients who experienced laparoscopic nerve-sparing radical hysterectomy, therefore help to recover bladder and sexual function.

目的 探讨快速康复外科理念对降低子宫全切术后患者下肢深静脉血栓形成的应用效果。方法 采用方便抽样的方法,将185例子宫全切术后患者分为观察组(95例)和对照组(90例)。观察组实施快速康复外科护理路径,对照组实施常规护理路径。结果 两组患者术后的下肢深静脉血栓发生率、D-二聚体水平、日常生活活动能力评分的比较差异均有统计学意义(P<0.05);观察组下肢深静脉血栓形成的发生率和D-二聚体水平低于对照组(P<0. 01),观察组日常生活活动能力评分低于对照组(P<0.05)。结论 快速康复外科理念应用于子宫全切术后患者,可降低患者下肢深静脉血栓的发生率,提高患者自理能力,使患者尽快恢复健康水平。

Objective To explore the effect of fast-track surgery on the treatment of lower extremity deep venous thrombosis in patients after total hysterectomy. Methods A total of 185 patients with hysterectomy were divided into observation group(n=95) and control group (n=90) randomly. The observation group implemented a rapid rehabilitation surgical care path, and the control group implemented routine nursing path. Results There were significant differences in the incidence of deep venous thrombosis, D-dimer level and daily living activity score between the two groups (P<0.05). The incidence of deep venous thrombosis and the level of D-dimer in the lower extremity of the observation group were significantly lower than those in the control group (P<0.01). The score of the daily living activity was lower in the observation group than that of control group (P<0.05). Conclusion Fast-track surgery for patients after total hysterectomy could reduce the incidence of postoperative deep venous thrombosis and improve the self-care abilities of patients, so that patients may return to health as soon as possible.