Objective:To analyze the clinical characteristics of hospitalized patients with distal deep venous thrombosis (DDVT).Methods:Medical records of patients without DDVT at admission and discharged from January 1,2021 to June 30,2021, were retrospectively reviewed. During the pre-hospitalization and hospitalization period the ultrasonography was performed for detection of DDVT. The venous thromboembolism (VTE) risk scores were evaluated with Caprini scale for surgical patients, and evaluated with Padua scalefor nonsurgical patients.Results:A total of 16 400 patients, 8 827 males and 7 573 females with a mean age of (63.8±14.2) years (14 to 101 years) were enrolled, among whom DDVT occurred in 1 193 patients (DDVT group), including 73 cases developed during pre-hospitalization; meanwhile 124 patients were diagnosed as deep vein thrombosis(DVT), and 15 083 patients without DVT served as non-DDVT group. The detection rate of DDVT in patients with medium/high VTE risk scorewas significantly higher than thatin low-risk patients [12.8% (982/7 644) vs. 2.4% (211/8 756), χ2=659.10, P<0.001]. The detection rate of DDVT for medium/high VTE risk score group was the highest in emergency intensive care unite and intensive care unite(ICU; 34.3%, 68/198), followed by that in departments of rehabilitation (25.7%, 45/175), neurology (19.9%,37/186), neurosurgery(19.4%,83/428), respiratory medicine(19.0%,56/295) and orthopedics (15.4%, 378/2 451).The detection rate of DDVT increased with age.The lowest detection rate was found in the age group 14 to 40 years, for low VTE risk score group it was 0.5%(4/770), for the medium/high VTE risk score group it was 3.0%(11/362, χ2=10.10, P<0.001).In patients over 75 years of age, the detection rate of DDVT was 5.2%(85/1 624) in low VTE risk score group, and 18.0%(389/2 158) in medium/high VTE risk score(χ2=138.82, P<0.001).The mean age of the DDVT group was older than that of non-DDVT group [(71.0±12.1) vs. (63.2±14.2) years, t=21.14, P<0.001]. The abnormality rate of D-dimer level in DDVT patients was significantly higher than that in non-DDVT patients [71.4%(813/1 138) vs. 25.4%(3 492/13 770), χ2=1 086.80, P<0.001]. The median length of hospital stay was significantly longer than that of the non-DDVT group [11.0 (8.0, 19.0) vs. 6.0 (4.0, 10.0)d, Z=-26.67, P<0.001].The risk factors for non-surgical DDVT patients were age, bed rest for ≥3 d, and acute infection; while the risk factors for surgical DDVT patients were age, fracture in hip, pelvis or lower limb, bedridden for ≥3 d and body mass index (BMI)>25 (kg/m 2). Conclusion:The detection rate of DDVT is higher in hospitalized patients, especially for those in ICU and rehabilitation department, and those over 75 years old with high VTE score. Advanced age, fracture or immobilization, and long-term bed rest are the main risk factors for DDVT.

Obj ective To observe the effect of continuous epidural labor analgesia combined with nursing supports on puerpera.Methods By convenience sampling,450 cases were selected and equally divided into A,B,C three groups. Group A received continuous epidural labor analgesia combined with nursing supports including verbal communication, emotional support,Lamaze breath,and posture intervention.Group B received only epidural labor analgesia and other routine nursing.Group C was not received epidural labor analgesia in second stage until end and other routine nursing supports.Time of second stage of labor,delivery outcome,and the visual analog scale (VAS )pain scores at 1 .0 cm (T1),3.0 cm (T2),10.0 cm cervical dilation(T3),delivery (T4)and perineal trauma repair (T5)were recorded.Results There was no statistical significance of VAS scores in T1,T2 and T3 among three groups (all P>0.05).The VAS score in T4 and T5 of group A and B were significantly lower than group C (P<0.05).The duration of second stage of labor in group A and C were significantly shorter than group B (all P<0.01).The nature birth rate in group A was higher than group B and group C (all P<0.01).The analgesic satisfaction rate in group A and B were significantly higher than group C (all P<0.05).Conclusions Continuous epidural labor analgesia combined with nursing supports can promote nature birth,which is safe for mother and child.

目的：探讨改良连续性助产服务模式对降低无医学指征孕妇要求剖宫产（CDMR）的影响。方法选择2013年6月至2014年6月分娩的产妇509例，以产妇自愿为原则将产妇随机分为观察组255例与对照组254例。观察组产妇自孕28周起在整个围生期接受改良连续性助产服务，对照组接受常规的产前检查和护理。比较两组孕妇孕晚期选择分娩方式意向、实际分娩方式以及CDMR率。结果观察组孕37周分娩意向选择自然分娩、剖宫产和意向不定的比例分别为93.73％、4.71％和1.56％；而对照组分别为68.11％、20.87％和11.02％，与对照组比较，观察组孕妇选择剖宫产意向的比例下降明显（P<0.01）。实际分娩结局产妇剖宫产率及CDMR率观察组为21.18％、1.57％，对照组为40.55％、9.84％，两组产妇剖宫产率及CDMR率比较差异有统计学意（P<0.01）。结论改良连续性助产服务模式能使产妇更易接受自然分娩，有效降低CDMR，值得临床推广。

OBJECTIVE To monitor and analyze the condition of multidrug-resistant bacteria infections,provide the corresponding nursing strategies in pediatrics.METHODS The monitoring was carried out for the hospitalized pediatric patients with multidrug-resistant bacteria infections from Jan 2011 to Dec 2011.RESULTS There were totally 208 cases with multidrug-resistant bacteria infections in the pediatrics department.There were 123(59.13%) strains of ESBLs-producing Escherichia coli,54(25.98%) strains of ESBLs-producing Klebsiella pneumoniae,30(14.42%) strains of methicillin-resistant Staphylococcus aureus,and 1(0.48%) strain of imipenem-resistant Pseudomonas putida.Moreover,there were 202(97.12%) cases with community-acquired infections and 6(2.28%) cases with hospital-acquired infections.CONCLUSION Intensifying the training and education of knowledge of the multidrug-resistant bacteria infections,implementing the strict disinfection isolation measures,strengthening hand hygiene management,stressing the standard prophylaxis,rationally using antimicrobial drugs and strengthening health propaganda and education are important measures for effectively controlling and reducing the occurrence of multi-drug resistant bacteria infections,preventing the transmission of multidrug-resistant bacteria in the hospital.

目的观察两种消毒方法对氧气湿化瓶的消毒效果。方法将470只氧气湿化瓶分为A组和B组各235只,两组氧气湿化瓶经相同前期处理后,A组用含有效氯浓度1 000mg/L施康液消毒,B组用酸性氧化电位水消毒,消毒后用纯水漂洗、烘干,对两组氧气湿化瓶采用棉拭子涂抹采样和细菌定量检测,比较消毒效果,并计算经济成本。结果两组消毒合格率均为100%,每只氧气湿化瓶消毒成本B组为0.10元、A组为0.21元。结论酸性氧化电位水消毒效果可靠,经济成本低,无刺激性,氧气湿化瓶宜用酸性氧化电位水消毒。

目的:探讨孕中期超声引导下经腹胎儿脐静脉穿刺术并发症的预防与护理。方法:分析261例孕妇在B超引导下行胎儿脐静脉穿刺术并发症的预防与护理措施。结果:穿刺成功率为96.9%;261例中发生胎儿心动过缓3例(1.2%),脐带渗血35例(13.4%),子宫不规则收缩10例(3.8%),无早产、流产、胎死宫内、宫内感染等并发症。结论:脐静脉穿刺术术中和术后严密观察胎心、宫缩、穿刺点渗血情况、孕妇生命体征的变化以及加强心理护理是预防并发症、保证手术成功的重要护理措施。

医务人员在医院工作中面临着严重职业暴露的危险,如接触各种病原体、传染病和进行侵入性操作时接触的血液、体液、器械刺伤等[1].为进一步促进医务人员职业防护健康,有效预防和减少职业暴露的发生,本院2006年7月,建立了医务人员职业暴露防护体系.现对建立防护体系前后6个月的职业暴露上报情况进行分析,报告如下.

目的探讨吸氧对腹式子宫切除患者术后恶心呕吐的影响.方法选择腰硬联合麻醉下行腹式子宫全切术后患者114例,随机分为实验组(58例)和对照组(56例),对照组予常规监护,实验组除常规监护外给予鼻导管吸氧8 h,观察两组术后24 h恶心、呕吐发生情况.结果实验组术后恶心呕吐的发生率明显低于对照组,两组间差异有显著性意义(P＜0.05).结论对腰硬联合麻醉下行腹式子宫切除术后患者常规给予鼻导管吸氧8 h,能明显减少术后恶心呕吐的发生率.

目的了解不孕症患者的健康需求.方法对515名不孕症患者的健康信息需求进行调查.结果 (1)不孕症患者对护士的要求以讲解疾病知识最多,占97%;(2)患者对疾病相关知识需求:不孕病因、检查目的、治疗方法疗效、用药作用及注意事项的需求均在79%以上;(3)患者对健康信息获得方法以医务人员讲解最多,占95%.结论患者渴望了解不孕症的各类知识,希望医务人员给予支持和帮助.护士应从心理护理、宣教疾病知识、为病人保守秘密等方面进行护理.