目的 比较耳温枪、非接触式红外测温仪所测温度与水银体温计所测口温之间的差异与一致性,寻找可替代水银体温计的测温方法.方法 便利选取 2021 年 3-5月骨科住院患者 720例.采用自身同期对照设计,用耳温枪测量鼓膜温度,非接触式红外温度仪测量前额、耳后和内关温度,同时以水银体温计测量口腔温度作为标准参照,使用配对 t检验和 Bland-Altman分析方法比较这 4 种测温方式所测温度与口温之间的差异和一致性.结果 4 种测温方式中,仅耳后温与口温差异有统计学意义(P＜0.001);鼓膜温与口温 95％一致性界限范围最窄,为(-0.605,0.601),95％一致性界限外数据点占比 3.06％,均优于其他测温方式所测温度.结论 耳温枪所测鼓膜温与水银体温计所测口温的一致性相对较好,在水银体温计停产后,可以优先选择耳温枪替代水银体温计测量患者体温.
Objective To explore the feasibility, practicability and accuracy of other body parts as alternative parts for blood glucose monitoring. Methods With self-control method, 100 volunteers were enrolled in a tertiary grade-A hospital in Shenyang from December 2021 to June 2022. Random blood glucose values were obtained by puncture（interval ＜5 min） in different parts（including earlobe, fingertip, maisar, minnoir, arm and toe）, and venous biochemical blood glucose was collected. The sampling, accuracy and pain scores of the six sites were compared. Results The difference in puncture sampling at six sites was statistically significant（P ＜0.05）. Blood glucose value of other 5 sites was highly correlated and consistent with that of the fingertip, showing statistical significance（P＜0.05）. There was no significant difference in blood glucose and venous biochemical blood glucose in earlobe, fingertip,arm and toe（P＞0.05）. NRS pain score of the 6 sites was statistically significant（P＜0.05）. Conclusion The blood glucose value of the earlobe shows high accuracy and consistency, and the puncture is convenient and with less pain, so it may be the best alternative site for blood glucose monitoring.
Objective To summarize and analyze the current status of reports regarding nursing operation key points in moxibustion for the treatment of rheumatoid arthritis, and to provide reference for the standardization of moxibustion nursing operation and the formulation of relevant guidelines. Methods We searched literature pertaining to moxibustion intervention in the treatment of rheumatoid arthritis from CNKI, Wanfang Data, VIP, SinoMed, PubMed, Embase and Cochrane Library databases from the inception to September 26, 2022. We extracted, summarized and analyzed the included literature based on the 12 key points of moxibustion nursing operation determined by our research team in the early stage. Results A total of 262 pieces of Chinese literature and 5pieces of English literature were included. No literature fully reported the 12 key points of nursing operation in moxibustion for rheumatoid arthritis. In one Chinese article, none of the 12 key points of nursing operation were reported; 26 articles reported two or more moxibustion methods. In English literature, 5 key points of nursing operation were reported clearly while 3 of them were not reported. Conclusion Current research pays little attention to the time-response relationship in moxibustion nursing operation. In the selection of moxibustion site and the direction, inadequate attention to the relationship between meridians and diseases is found.There is no report regarding the evaluation from the patients’ perspective before, during and after the procedure. Reports vary considerably pertaining to the key points of many kinds of moxibustion or different key points of the same moxibustion.
目的 检索国内外癌性伤口渗液管理的相关证据,并对最佳证据进行汇总,为制定科学的高渗出癌性伤口渗液管理方案提供参考.方法 遵循循证"6S"模型,自上而下检索国内外相关临床决策、指南、证据总结、系统评价、专家共识,检索时限为 2000 年至 2023 年 2 月.由 2 名经过系统的循证培训的研究人员独立进行文献检索和筛选、质量评价和证据提取.结果 共纳入 14 篇文献,临床决策 1 篇,指南 4 篇,证据总结 4篇,系统评价 2篇,专家共识 3篇.汇总出包括管理目标、伤口评估、伤口清洗、伤口清创、敷料使用、渗液收集、周围皮肤保护、营养支持、多学科合作 9 个方面的 28条证据.结论 本研究从管理目标、伤口评估、伤口清洗、伤口清创、敷料使用、渗液收集、周围皮肤保护、营养支持、多学科合作这 9个方面总结的高渗出癌性伤口渗液管理的最佳证据,具有一定的科学性和实用性,可为相关临床实践提供循证依据.
目的 综述重症监护后综合征患者(post-intensive care syndrome,PICS)的干预管理策略,为形成统一、规范、安全的管理方案和促进临床深入实践提供借鉴.方法 结合国内外文献,对PICS的管理进行探讨,分析并总结其概述、疾病负担、干预实施者和干预对象、干预时间及场所、干预内容、干预效果评价等.结果 ICU阶段的干预主要是预防性干预.干预时机、场所、效果评价指标等没有统一的标准.ICU后干预报道较少,ICU内的干预效果未能高质量的延续至病房及家庭/社区.结论 重症监护后综合征患者的管理普遍存在重ICU内、轻ICU后,重院内、轻院外及重预防、轻康复等问题.未来的工作应侧重于研究现有干预措施对患者预后的影响,探索具有潜在益处的新干预措施,并确定最有效的ICU后护理模式,以患者和家属为中心,建立起一个从ICU到社区或基层医疗的连续护理体系,实现筛查、治疗、康复闭环管理路径,将精准干预与全程照护相结合,针对性、阶段性实施干预管理,逐渐形成重症监护后综合征患者全过程、全周期健康管理模式.
