[目的]探讨运用五星教学模式对透析病人陪护者进行高钾血症防治知识的培训效果。[方法]应用五星教学模式,以聚焦问题为宗旨,通过激活旧知、论证新知、应用新知和融会贯通4个环节对102例维持性血液透析病人的陪护者进行高钾血症防治知识的培训,观察培训前后病人陪护者对高钾血症相关知识的知晓情况以及培训后1个月、2个月、3个月病人食物钾摄入量、透析前血钾水平及高血钾症发生率。[结果]培训3个月后,病人对高钾血症相关知识知晓率提高;饮食钾摄入量由（61.38±9.16）mmol/d下降至（44.68±7.28）mmol/d,透析前血钾由（6.21±0.28）mmol/L下降至（5.32±0.37）mmol/L,高钾血症发生率由32%下降至14%。[结论]运用五星教学模式对陪护者进行高钾血症防治知识的培训,可以有效降低维持性血液透析病人的血钾水平,减少高钾血症的发生。

Objective To investigate the effect of empowerment education on self-management in patients with diabetes mellitus. Methods A total of 128 patients with diabetes mellitus who met the criteria of WHO in 1999 were selected and divided into the control group(62 cases)and the observation group(66 cases). The control group accepted the traditional nursing methods, and the observation group accepted the empowerment education model. FBG, PBG, HbA1c and Diabetes Management Self-efficacy Scale (C-DMSES) were compared between two groups of patients after 3 months and 6 months. Results After the intervention with the empowerment education model, the patient′s FBG, PBG, HBA1c of the control group were (7.69±4.21) mmol/L, (11.78±3.21) mmol/L, (7.95±1.46)%three months after discharge, and (7.21 ± 3.19) mmol/L, (10.48 ± 4.65) mmol/L, (9.15 ± 2.36)% six months after discharge; while in the observation group, FBG, PBG, HBA1c were (6.23 ± 3.59) mmol/L,(9.32 ± 4.06) mmol/L, (6.69 ± 1.10)%three months after discharge, and (6.15 ± 1.89) mmol/L,(7.33 ± 2.10) mmol/L,(6.02 ± 2.17)%. The differences between two groups were significant (t=2.012-5.196, P<0.05). C-DMSES scores of the control group were 103.48 ± 18.41, 134.38 ± 13.01 on admission and six months after discharge, while in the observation they were 102.83 ± 10.91,157.64 ± 19.56. The differences between two groups were significant (t=3.151, P<0.05). Conclusions Empowerment education model can improve the ability of self-management of diabetes patients, improve self-efficacy to improve their own ability to control blood glucose.

调节情绪 早春乍暖还寒,外出活动较少,容易出现情绪波动.而情绪变化又与糖尿病有着密切而微妙的内在联系,由于情绪激动引起交感神经兴奋,可促进肝脏中的糖原释放进入血液而使血糖水平升高,导致病情加重或降低治疗效果.因此,糖尿病患者应学会控制情绪,避免负面情绪影响,保持情绪稳定.

总结1例Nelson综合征伴垂体卒中患者的护理.此例患者有多种疾病的并发症,护理中全面正确地评估患者,制定有针对性的护理措施:术前以观察患者的生命体征为重点,制定预防高颅压、空腹低血糖及餐后高血糖等个性化护理措施,使患者顺利达到手术标准,顺利转往神经外科进行垂体切除术.

目的探讨用培高利特替代溴隐停治疗对溴隐停耐药的垂体泌乳素瘤患者.方法对32例服大剂量溴隐停无明显疗效的患者改用培高利特治疗,观察治疗前后患者血泌乳素水平、月经、生殖情况.结果改用培高利特治疗后29例患者(90.6%)血泌乳素降至正常,恢复正常月经, 其中26例患者性腺激素也恢复正常,已婚妇女中24例(82.8%)妊娠,3例(9.4%)血泌乳素水平下降不满意,临床症状无改善.结论对溴隐停不敏感又不愿接受手术治疗的泌乳素瘤患者可试用培高利特治疗.