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《广州医药》编辑部
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 探讨早期康复护理干预对胸腰椎骨折内固定术后患者的临床护理效果。方法 2014年6月—2016年12月,将94例胸腰椎骨折内固定术后患者按数字随机法,分为实验组51例和对照组43例,分别实进行早期康复护理和常规性护理。比较两组患者胸腰背部功能状况、胸腰背部疼痛情况、术后抑郁水平,以及护理满意度等相关指标,以评价早期康复护理的效果。结果 94例患者均获得3个月随访。与对照组比较,实验组患者平均住院天数减少4.1 d,差异有统计学意义(P<0.05);平均住院费用也有所下降;实验组和对照组总并发症发生率分别为7.84%和20.9%,两组间比较差异有统计学意义;实验组的护理工作满意度高达90.20%,高于对照组的67.44%,差异具有统计学意义(P<0.05)。术后3个月随访时,Oswestry功能障碍评分实验组为(14.74±3.25),低于对照组的(20.04±5.32)(P<0.05); SDS评分实验组的为42.35±3.68,低于对照组的(47.28±3.49)(P<0.05);胸腰背痛VAS评分实验组的为(1.07±0.67),低于对照组的(2.62±1.86)(P<0.05)。结论 早期康复护理干预是促进胸腰椎骨折内固定术后患者快速康复的有效方法,提高患者对护理工作的满意度,值得推广应用。
Objective To evaluate and compare the outcomes of early rehabilitation nursing and routine nursing care for patients with thoracolumbar bursting fracture after internal fixation. Methods From June 2014 to December 2016, this study enrolled ninety-four subjects who were randomly divided into observe group with fifty-one cases and control group with forty-three cases according to the digital random method. Patients in the control group were treated with routine nursing care, and early rehabilitation nursing care were used in the observe group. The physical function of thoracolumbar spine, psychological condition, pain of thoracolumbar spine, nursing satisfaction and soon. were compared between the two groups. Results The average days of hospital stay in the observation group was 4.10 days, it was less than that of control group, and the difference was statistically significant(P<0.05). Average hospital costs were also declined. The total complication rate were 7.84% in observe group and 20.9% in control group, there was significant difference between the two groups (P<0.05). The nursing satisfaction was 90.20% in observe group, which was higher than 67.44% in that in control group (P<0.05). When follow-up three months after operation, the ODI score in experiment group was(14.74±3.25), which was lower than that (20.04±5.32)in control group (P<0.05). The SDS score in experiment group was (42.35±3.68), which was lower than that (47.28±3.49)in control group(P<0.05). And the VAS score in experiment group was (1.07±0.67), which was lower than that(2.62 ±1.86)in control group (P<0.05). Conclusion Early rehabilitation nursing care is effective to the rapid functional recovery for patients with thoracolumbar bursting fracture after internal fixation, and improves the nursing satisfaction.
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 探讨优质护理模式干预对凶险性前置胎盘患者胎盘恢复及胎儿的影响。方法 选取2015年3月—2017年6月我院妇产科收治的凶险性前置胎盘患者80例,随机分为对照组和观察组,各40例,分别实施常规护理及优质护理模式干预,对比分析两组患者护理干预效果。结果 观察组患者术后大出血及感染总并发症发生率低于对照组(P<0.05)。观察组患者产前、产后总出血量低于对照组,同时新生儿Apgar评分高于对照组,其差异比较均有统计学意义(P<0.01)。结论 在凶险性前置胎盘患者中实施优质护理模式干预对胎盘恢复效果更显著于常规护理,同时改善新生儿健康情况。
目的 探讨快速康复外科(enhanced recovery after surgery, ERAS)理念在膀胱癌根治加回肠膀胱术后护理的有效性和安全性。方法 分析我院2012年1月—2016年12月行膀胱癌根治加回肠膀胱术的患者共98例,其中ERAS组47例,传统组51例。比较两组术后伤口感染率、出血率、吻合口瘘率、肺部感染率及术后住院日等指标。结果 两组患者的伤口感染率、出血率、吻合口瘘率无差异,ERAS组的肺部感染率4.26%低于传统组21.57%,差异有统计学意义(P<0.05)。ERAS组的术后住院日短于对照组[(8.53±1.82)vs (13.21±2.16)],差异有统计学意义(P<0.05)。ERAS组的30天内再入院率6.38%低于传统组19.61%,差异有统计学意义(P<0.05)。两组的非计划再次手术率无统计学差异。结论 快速康复外科理念应用在膀胱癌根治加回肠膀胱术后护理是有效和安全的,ERAS能减少术后并发症及缩短术后住院日。
目的 观察和研究功能锻炼和心理护理对中风后肩手综合征老年患者功能康复的影响,以及对运动功能、日常生活活动能力的影响。方法 选取2015年6月—2017年2月收治的中风后肩手综合征老年患者60例为研究对象,随机法分为干预组与对照组,各30例。干预组在给予内科常规治疗及护理的同时,采用功能锻炼心理干预等方法进行处理;对照组仅进行内科的常规治疗及护理。运动功能则采用Fugl-Meyer评分法(FMA)进行评分,而日常生活活动能力采用改良Barthel指数(MBI)进行评分。并比较两组患者干预前后焦虑、抑郁水平。结果 干预组FMA评分以及MBI评分均高于对照组,差异有统计学意义(P<0.05)。干预后干预组患者焦虑、抑郁评分低于对照组,两组比较差异有统计学意义(P<0.01)。结论 采用功能锻炼和心理护理能提高中风后偏瘫患者的运动功能以及日常生活活动能力,缓解或消除患者焦虑抑郁等负性情绪,效果明显,值得推广应用。
Objective To observe and study of functional exercise and psychological nursing for stroke shoulder hand syndrome after the influence of the elderly patients with functional rehabilitation, and the influence on motor function and ability of daily life activities. Methods 60 cases of elderly patients with apoplexy after apoplexy were selected from June 2015 to February 2017. They randomly were divided into two groups: intervention group and control group, each with 30 cases. The intervention group was treated with functional exercise psychological intervention with giving routine treatment and nursing care as the same time. The control group only conducted routine treatment and nursing care. The exercise function was rated by the Fugl-Meyer scoring method (FMA), while the improved Barthel index (MBI) was used to score the daily activities. The anxiety and depression levels were compared between the two groups. Results The FMA score of the intervention group and MBI score were higher than that of the control group, and the difference was statistically significant(P<0.05). The anxiety and depression scores of the intervention group were lower than those in the control group, and the difference between the two groups was statistically significant(P<0.01). Conclusion The functional exercise and psychological care may improve movement function in patients with hemiplegia after stroke, and daily life activities ability, alleviate or eliminate negative emotions, including anxiety depression. It is worth promoting.
目的 探讨红外线照射联合中药穴位贴敷在骨外科术后护理工作中的应用。方法 选择2014年2月—2015年6月我院收治的120例骨外科手术治疗患者,随机分为对照组与观察组,每组各60例;两组患者均给予饮食、心理、排便训练等常规护理,观察组在常规护理基础上给予中药穴位贴敷联合红外线照射综合护理,比较两组患者术后自主排便功能恢复情况,采用汉密尔顿抑郁量表(HAMD)与汉密尔顿焦虑量表(HAMA)评估患者干预前后心理状态,于术后不同时间采用视觉模拟评分法(VAS)对患者的疼痛情况进行评定,记录患者住院时间及下肢深静脉血栓发生情况。结果 术后观察组自主排便恢复情况(88.3%)高于对照组(73.3%)(χ2=4.357,P<0.05),观察组自主排便恢复时间低于对照组(t=5.422,P<0.05);术后5、30 d两组患者HAMD和HAMA评分均性降低(P<0.05),观察组低于对照组(P<0.05);术后5、10、20 d观察组患者疼痛评分比对照组降低(P<0.05);观察组患者住院时间少于对照组(P<0.05),观察组下肢深静脉栓发生率1.7%低于对照组6.7%,但无统计学意义(P>0.05)。结论 红外线照射联合中药穴位贴敷可改善骨外科手术术后患者自主排便功能,降低患者心理压力,促进手术后恢复。
目的 探讨鼻—空肠营养管在小儿急性胰腺炎中的疗效观察及护理。方法 采用回顾性分析法,选取2013年2月—2015年5月期间我院收治的116例急性胰腺炎患儿的临床资料,按照营养支持方法的不同将患儿分为对照组和观察组,每组58例。对照组患儿肠功能恢复后给予经口进食,观察组给予鼻—空肠营养管进行营养支持;并给予患儿针对性的护理措施。比较分析两组患儿的治疗效果。结果 观察组患儿平均住院时间、平均花费、并发症发生率、手术率及死亡率等指标均低于对照组(P<0.05),差异有统计学意义。结论 鼻—空肠营养管应用于小儿急性胰腺炎具有较好的效果,降低患儿并发症发生率、手术发生率,缩短住院时间,减少住院消费,促进患儿康复。
Objective To observe the clinical efficiency of nasal jejunal nutrition in children with acute pancreatitis and explore the effective nursing. Methods The clinical characteristics of 116 children with acute pancreatitis from February 2013 to May 2015 in our medical center were retrospectively analyzed. Based on nutritional support, the patients were divided into two groups: the control group consisted of 58 patients receiving oral feeding after the recovery of bowel function, and the experiment group consisted of 58 patients with nasal jejunal nutrition. And all the patients were treated with special care on case-by-case. The efficiency was then compared between the two groups. Results Compared with the control group, the length of hospital stay, cost of care, the incidence of complications, the surgical proportion and the mortality were significantly decreased in the experiment group (P<0.05). Conclusion In the children with acute pancreatitis, application of nasal jejunal nutrition is more effective, leading to decrease incidences of complications and surgical proportion, shorten the length of hospital stay, reduce patients' cost, and finally help rehabilitation.
目的 探讨分析品管圈在提高腔镜肾癌术后护理流程管理中的应用,以提高肾癌术后患者的存活率也避免术后并发症出现。方法 对我院肾癌术后护理流程管理的现状进行分析,并将目前我院在肾癌术后护理流程管理当中出现的问题进行分析探讨和总结,并制定出详细的工作目标拟定可行的工作计划,并组织人员进行实施,并将实施之后的结果与预期的结果进行对比分析总结。结果 在实施了品管圈活动之后,我院对腔镜肾癌术后护理流程的管理得到了显著的提升,其中人员操作不规范的发生率由实施活动之前的13.2%(5/38)减低到了5.3%(2/38),同时患者发生术后并发症的例数也由之前的7例降低到了3例,结果对比较之前的差异有统计学意义。结论 使用品管圈活动不仅能够有效的提高对腔镜肾癌术后护理流程管理中的效力,而且还能够减少患者术后并发症的发生几率。
目的 探讨应用家庭访视护理与中医体质辨识相结合的方式提高居民健康管理能力,改善居民体质。方法 随机抽取广州市越秀区某社区的128例居民为研究对象,通过体检和中医体质辨识了解居民健康状况,责任护士开展家庭访视护理和具有中医特色的干预措施,通过干预前、后研究对象的中医体质量化计分、生存质量变化和健康知识共3个方面评价项目效果。结果 中医体质平和质得分显著升高,气虚质、痰湿质、湿热质、血瘀质、气郁质共5种偏颇体质的得分均降低(P<0.05),阳虚质、阴虚质、特禀质3种体质的得分差异无统计学差异(P>0.05)。简明健康状况调查问卷评分(MOS SF-36)在PCS领域和MCS领域的生命质量得分比干预前增高(P<0. 05)。健康教育知识在中医保健养生、慢性疾病防治、药物使用规范以及家庭护理知识评分有提高(P<0. 05)。结论 家庭访视护理结合中医体质调理措施可以拉近居民与医护人员距离,增强居民健康管理观念和能力,促进居民关注自身体质状况,达到“未病先防”的效果。