目的 探讨微通道经皮肾镜取石术治疗上尿路结石合并肾积脓的临床疗效.方法 回顾性分析上尿路梗阻患者47例的临床资料,所有患者均行一期微通道经皮肾镜取石术,其中21例合并有肾积脓,26例未合并肾积脓,合并肾积脓患者术中采用稀释络合碘冲洗.比较两组患者术后情况发热情况、穿刺液培养结果、术后住院天数等.结果 所有患者均行一期手术,并顺利完成手术.冲洗前后,细菌培养阳性率比较差异有显著统计学意义(P＜0.01).术后两组平均发热天数和术后住院天数无显著差异(P＞0.05).结论 对于上尿路梗阻合并肾积脓患者,可采用一期mPCNL手术,术中采用络合碘溶液冲洗脓腔,能够达到较好的临床疗效.

OBJECTIVE To explore the etiology of pulmonary infections in the oral and maxillofacial surgery patients after tracheotomy and put forward intervention measures so as to provide basis for reasonable clinical use of antibiotics.METHODS The clinical data of 58patients with postoperative pulmonary infections who underwent the oral and maxillofacial tracheotomy in the hospital from Apr 2007to Mar 2013were retrospectively analyzed, then the sputum culture and the drug susceptibility testing were performed,and the drug-resistant strains were detected.RESULTS A total of 120strains of pathogens have been isolated from the submitted specimens from the 58cases of pulmonary infections,among which the gram-negative bacilli accounted for 71.7%,the gram-positive cocci 24.2%,the fungi 4.2%;the Pseudomonas aeruginosa,Acinetobacter baumannii,Staphylococcus aureus, Klebsiella pneumoniae,and Escherichia coli ranked the top five species of pathogens,accounting for 10.8%, 25.3%,20.0%,13.3%,and 12.5%,respectively.The drug resistance rates of the P.aeruginosa,A.baumannii,and K.pneumoniae to ampicillin were 100.0%,and the drug resistance rates to cefazolin and cefuroxime were more than 70.0%;the drug resistance rates of the S.aureus and S.epidermidis to penicillin,ampicillin,and piperacillin were more than 80.0%;the vancomycin-resistant strains have not been detected.CONCLUSION The gram-negative bacilli are dominant among the pathogens causing pulmonary infections in the patients undergoing the oral and maxillofacial tracheotomy and are highly drug-resistant;it is necessary to take comprehensive measures to strengthen the management of respiratory tract,reasonably use antibiotics according to the results of culture and drug susceptibility testing,and actively carry out clinical interventions so as to control the pulmonary infections.

OBJECTIVE To investigate the influence factors causing nosocomial infections to superficial bladder cancer patients after surgery so as to provide reference basis for taking specific intervening measures .METHODS The clinical data of 375 cases of superficial bladder cancer patients who were treated in the urology department from Jun 2011 to Jun 2013 were selected to analyze the influence factors causing nosocomial infections after super-ficial bladder cancer surgery and to establish specific intervening measures ;SPSS 18 .0 software was adopted for statistical analysis .RESULTS Totally 54 of the 375 superficial bladder cancer patients suffered from nosocomial in-fections after surgery ,with an infection rate of 14 .40% .Pathogens were detected from 50 of the 54 specimens submitted for test ,with a detection rate of 92 .59% .A total of 52 strains of pathogens were isolated ,with 38 strains of gram-negative bacteria ,accounting for 73 .08% ,11 strains of gram-positive bacteria accounting for 21 .15% ,and 3 strains of fungi accounting for 5 .77% ;the top 3 pathogens were Escherichia coli ,Mycetozoan , and Enterococcus f aecalis ,accounting for 30 .77% ,17 .31% and 11 .54% respectively ;diabetes (OR=3 .328 ,P<0 .01) and reception of catheterization for uroschesis (OR=7 .406 ,P<0 .01) were the risk factors causing nosoco-mial infections after superficial bladder cancer surgery .CONCLUSION The nosocomial infection rate is high after superficial bladder cancer surgery and the dominant pathogen is gram-negative bacteria ,which can be aroused by many factors ,so it is necessary to take corresponding intervening measures to reduce nosocomial infection rate .

目的 探讨膀胱癌患者面对压力时采用何种应对方式及其影响因素,为临床心理干预提供依据,提高患者的生活质量.方法 对100例膀胱癌患者进行问卷式调查法.问卷包括基本情况调查表和医学应对方式调查量表(MCMQ)两部分.基本情况调查表包括患者的性别、年龄、文化程度、医疗费用支付方式.MCMQ包含20个条目,分为面对、回避、屈服3种应对方式.结果 膀胱癌患者面对应对方式得分低于常模(P<0.01),回避、屈服应对方式得分均高于常模(P<0.05),差异均有统计学意义.膀胱癌患者采取的应对方式受性别、医疗费用支付方式的影响(P<0.05).结论了解膀胱癌患者的应对方式及其影响因素,护理人员应根据患者的特点,指导和帮助患者采取积极的应对方式,有效缓解各方面的压力,促进患者顺利康复,提高生活质量.

口腔颌面部肿瘤病人由于肿瘤位置偏后或需切除下颌骨或部分舌组织,口内创面较大,切口渗液、渗血较多,局部组织肿胀,病人吞咽困难,加上全身麻醉后口腔、呼吸道分泌物增多,唾液在口内滞留、黏稠,同时由于术后舌肌附着关系改变可能发生舌后坠,为避免病人术后发生呼吸道梗阻的危险,常有病人带气管插管返回病房,因此,做好气管插管的护理尤为重要.

[目的]探讨全程系统护理干预对前列腺癌撤除雄激素治疗后不良事件的影响。[方法]将80例接受去雄激素治疗的前列腺癌病人随机分为两组,全程护理组40例采用全程系统跟踪护理干预,常规护理组采用常规方法进行护理,比较两组不良事件的发生情况。[结果]两组不良事件发生情况比较差异有统计学意义（P＜0.05或P＜0.01）。[结论]全程系统护理干预可减少前列腺癌去雄激素治疗后的不良事件,提高前列腺癌病人生活质量。

<正>膀胱镜检查是膀胱疾病诊断过程中必不可少的一项检查,但是膀胱镜检查是一项侵入性操作,大多数患者对此项检查缺乏认知和了解,我们通过对膀胱镜检查患者进行积极有效的认知行为干预,提高了患者对膀胱镜检查的耐受性,报告如下。

<正>膀胱肿瘤是我国临床上最常见的肿瘤之一,是一种直接威胁患者生存的疾病,是泌尿生殖系统肿瘤中最常见的肿瘤。世界范围内膀胱癌发病率位居恶性肿瘤的第9位,在男性排名第

<正>循证护理是护理人员在计划其护理活动过程中,审慎的、准确的、明智的将科研结论与临床经验,患者的愿望结合获取证据,作为临床决策的依据过程[1]。高危前列腺增生症是指年龄大于70岁,合并心、肺、脑、高血压、肾功能不全或糖尿病等疾病的前列腺增生症患者[2]。随着我国人口老龄化的进程,人们对生活质量的重视及手术技术的进步,高危患者接受手术治疗不断增加,我科自2007年1月至2010年4月将循症护理应用于经尿道前列腺电切术的高危患者取得良好效果。报告如下。

目的:应用舒适护理措施,解除肾癌根治术患者术后不适,促进患者舒适.方法: 将80例患者根据住院日期分为对照组和观察组.对照组采用常规护理,观察组采用常规护理加舒适护理措施.结果:两组患者术后疼痛程度比较经检验差异有统计学意义(P<0.05),两组患者在舒适度和满意度的比较经检验均有显著性差异(P<0.01).结论: 舒适护理模式可以减轻肾癌根治术患者疼痛程度,增加舒适度和满意度,促进患者早日康复,促进护患关系和谐.

<正>膀胱肿瘤是全身比较常见的肿瘤之一,对浸润性和复发性膀胱癌患者,根治性膀胱全切手术,是最可能治愈的方法[1]。该手术涉及到消化和泌尿两个系统,手术时间长,出血多,花费

口腔颌面部是肿瘤的好发部位之一,手术目前仍是治疗口腔颌面部肿瘤主要和有效的方法。疾病给病人带来了痛苦,术后造成的面部瘢痕、塌陷、左右不对称等加重了病人的心理负担,本文调查病人焦虑的主要原因,帮助病人减轻负面心理。现介绍如下。1对象与方法1.1调查对象我科2008年1月—2010年3月收治口腔颌面部肿瘤术后病人192例,其中男106例,女86例;腮腺肿瘤46

<正>牙龈癌多为分化较高的鳞状细胞癌,生长较慢,以溃疡型为最多见。早期向牙槽突及颌骨浸润,使骨质破坏,引起牙松动和疼痛。男性多于女性。以外科手术治疗为主[1]。手术治

目的探讨循证护理对前列腺癌去雄激素治疗后不良事件的影响。方法将接受去雄激素治疗的前列腺癌患者80例随机分为循证组和常规组,每组40例。对2组不良事件的发生情况及治疗依从性进行比较。结果循证组不良事件发生率低于常规组,治疗依从性高于常规组,差异均有统计学意义(P<0.05)。结论运用循证护理可减轻前列腺癌去雄激素治疗后的不良事件,提高前列腺癌患者的生活质量。

<正>舌癌是最常见的口腔癌,男性多于女性,但近年来有女性增多及发病年龄更年轻化的趋势。多数为鳞癌[1]。舌癌多发生于舌前2/3的舌缘处,其次为舌尖、舌背及舌根等处。常为溃疡型或浸润型,恶性程度极高。生长快、浸润性较强,破坏性极大。同时发生早期淋巴结转移,且转移率较高[2]。目前对于舌癌多以早期手术切除治疗为主,术后由于舌体缺损导致病人语言障

<正>后腹腔镜下肾上腺肿瘤切除术具有创伤小、出血少、术后疼痛轻、恢复快、住院时间短等优点,已成为临床上治疗肾上腺疾病的金标准。但无论是诊断还是治疗目的都无法绝对避免并发症的发生。我科自2008年1月至2010年10月将循证护理应用于后腹腔镜下肾上腺肿瘤切除术并发症的预防与护理,取得良好的效果,介绍如下。

<正>本文对经我院口腔颌面外科诊断为肿瘤且术后造成面部外形及功能改变的患者192例进行回访,了解患者对面部外形及功能改善需求状况,并根据此调查结果制定了行之有效的护理对策,提高了患者的生活质量。

[目的]了解恶性肿瘤病人家属的情绪状况,探讨其心理疏导对策。[方法]采用问卷调查法,对225名住院恶性肿瘤病人家属进行情绪状况调查。[结果]本组29.33%病人家属对疾病有积极向上的情绪反应;39.1%病人家属存在怀疑、不平衡的情绪反应,有"恐癌"心理。经心理疏导干预后,90%的病人家属能主动支持病人积极配合治疗和护理,并以乐观的心态对待病人和生活。[结论]恶性肿瘤病人家属对恶性肿瘤存在不同的情绪反应,应有针对性地进行心理疏导干预,实现家庭支持系统的价值。

前列腺癌是老年男性较常见的恶性肿瘤,随着男性平均寿命的延长,前列腺癌发病率呈明显增加的趋势.前列腺癌撤除雄激素的结果使病人产生比一般中老年男子雄激素部分缺乏综合征更加强烈的雄激素缺乏症状,比较明显的有潮热、骨质疏松症、骨折、性功能障碍、贫血、体重和脂类成分的改变、抑郁等,使前列腺癌病人生存期间的生活质量降低.

Objective:To discuss the impact of comprehensive nursing intervention on social support for patients with prostate cancer.Methods: 50 patients with prostate cancer were randomly divided into experimental and control groups(25 cases for each group).The patients in the control group received routine nursing intervention and the patients in the experimental group were given comprehensive nursing intervention.The "social support rating scale" was used to assess and compare the status of social support between the two groups.Results: The scores of objective support,subjective support,utilization of support and the total scores of social support were higher in the experimental group than those in the control group(P<0.05,P<0.01).Conclusion: Comprehensive nursing intervention can improve the social support for patients with prostate cancer.