目的:探讨采用LISA技术干预早产儿呼吸窘迫综合征(RDS)的临床效果.方法:选取2016年5月至2019年9月期间张家港市中医医院收治的32例患RDS的早产儿为研究对象.根据给药方法的不同将其均分为试验组和对照组.采用LISA技术对试验组16例患儿进行干预,采用传统的气管插管-气道开放式注药法对对照组16例患儿进行干预.治疗结束后,对比两组患儿的胸部X线影像表现、血气分析指标、肺表面活性物质(PS)反流的发生情况、血氧饱和度(SpO2)下降及心率下降的发生情况.结果:经治疗,两组患儿中胸部X线检查结果分级为Ⅰ级、Ⅱ级、Ⅲ级患儿的占比相比,P>0.05.治疗后24 h,两组患儿的动脉血氧分压(PaO2)及动脉血二氧化碳分压(PaCO2)相比,P>0.05.在接受治疗的过程中,与对照组患儿相比,试验组患儿中发生PS反流患儿的占比、发生SpO2下降及心率下降患儿的占比均较低,P<0.05.结论:用LISA技术对患RDS的早产儿进行干预后,其肺部体征得到显著改善,其血气分析指标及生命体征稳定,其PS反流的发生率较低.

Objective:To explore the application effect of training methods based on cross-theoretical model in improving the master of knowledge, compliance and implementation rate of nursing students to standard prevention.Methods:A total of 92 nursing trainees participating clinical practice in Zhangjiagang Traditional Chinese Medicine Hospital and Zhangjiagang First People's Hospital in 2017 were selected as the control group, and 112 trainees were selected as the experimental group; the control group adopted conventional standard prevention training method; the training procedure of the experimental group were divided into five stages according to the behavior of trainees, and training was carried out corresponding to different stages and behavioral transformation processes. Standard prevention knowledge, compliance belief scale score, behavior change stage distribution and standard prevention implementation rate between these two groups were compared.Results:The standard prevention theory and skill assessment scores were 84.41±4.64 and 67.01±4.53 in the experimental group and the control group after intervention, respectively. The difference was statistically significant ( t value was 26.934, P<0.01). Nurse standard prevention compliance belief scale scores were 156.21±6.96 and 119.73±5.77 in the experimental group and the control group after intervention, respectively. The difference was statistically significant ( t value was 40.156, P<0.01). The distribution of behavioral changes was statistically significant ( Z value was 8.173, P<0.01). The standard prevention implementation rate of hand washing and hand disinfection, protective equipment uses, sharp and medical waste disposal, item and environmental treatment after intervention was 78.78%(438/556), 76.69%(385/502), 91.47%(193/211), 88.27%(173/196) in the experimental group, and 62.72%(254/405),62.26%(231/371), 76.22%(141/185), 69.23%(117/169) in the control group, the differences were statistically significant( x 2 values were 17.367-29.987, all P<0.01). Conclusions:The training strategy based on cross-theoretical model can improve the attention of nursing trainees to standard prevention work, change adherence beliefs, working attitudes and behaviors, and thus improve the implementation rate of standard prevention behaviors.

Objective To explore the role of quality control circle activity in regulating the use of insulin pen in with non-specialist diabetes mellitus. Methods Quality control circle group was set up.The theme of to improve the standard rate of using insulin pen in non specialist diabetes patients was carried out.Through the investigation of the current situation, the causes of nonstandard use of insulin pen were analyzed, and the effect was evaluated after 4 months. Results After quality control circle activity, the patients' standard using insulin pen rate was increased from 24.62% to 75.00%, and the difference was statistically significant(P<0.01). The knowledge of insulin injection of non-specialist nurses was significantly higher than that before activity, and the difference was statistically significant(P<0.01). The activity target achievement rate was 109.26%, and the progress rate was 66.83%.The comprehensive quality score of circle members was better than that before the activity. Conclusions Quality control circle activities can effectively regulate the use of insulin pen in non specialist diabetics, and improve the comprehensive quality of nursing staffs. Key words: Quality control circles; Non specialist diabetes patients; Using insulin pen; Standard rate

Objective:To discuss the application effect of insulin injection maps in patients using insulin pen for the first time.Methods: Selected 100 diabetics patients using insulin pen for the first time in endocrinology department from July 2015 to December 2016,and they were equally divided into test group and control group,where patients in the test group were guided in the use of insulin pen with insulin injection maps,and patients in the control group were guided in the use of insulin pen with the routine method,and patients in the two groups were compared in mastering of insulin injection knowledge,insulin injection operation normalization rate 1d before discharge and 3 months after discharge and satisfaction to health education.Results: The insulin knowledge mastering,injection operation normalization rate 1d before discharge and 3 months after discharge of patients in the test group were higher than those of patients in the control group(P<0.05),and the satisfaction to the nurses' health education of patients in the test group was higher than that of patients in the control group(P<0.05).Conclusion: The insulin injection maps was popular and easy to understand,patients using insulin pen for the first time could well master the insulin related knowledge and master the injection skills rapidly in a more regulated manner,so as to improve the patients' satisfaction.

目的 探讨能提高系统性硬化症患者一次性静脉穿刺成功率,减轻穿刺时疼痛的静脉穿刺方法.方法 选择2011年1月～2012年11月张家港市中医医院系统性硬化症9例患者为研究对象,以静脉输液治疗日期为单数者为对照组,日期为双数者为观察组.对照组采用传统的静脉穿刺法,观察组采用改良式静脉穿刺法.比较两组静脉穿刺的一次性成功率及穿刺时患者的疼痛程度.结果 观察组一次性静脉穿刺成功率(87.1％)明显高于对照组(73.3％),差异有统计学意义(P＜ 0.05);观察组和对照组中度以上疼痛分别为9例和24例,观察组总体疼痛感低于对照组(P＜0.05).结论 改良式静脉穿刺法能提高系统性硬化症患者静脉穿刺成功率,减轻患者穿刺时的疼痛感.

总结了31例糖尿病酮症酸中毒患者的用药安全策略，主要包括对糖尿病酮症酸中毒患者补液、使用胰岛素、补钾、补碱、使用抗生素5个方面进行规范及护理，确保用药安全。认为对糖尿病酮症酸中毒患者注重用药护理，保证用药安全，可以更有效地挽救患者的生命，为患者的治疗和急救提供有力的保证，减少不良反应的发生，取得了良好的效果。

<正>雷诺现象(RP)是指因受寒冷或紧张的刺激后,肢端细动脉痉挛,使手指(足趾)皮肤突然出现苍白,相继出现皮肤变紫、变红,伴局部发冷、感觉异常和疼痛等短暂的临床表现[1],多发生于上肢,两侧对称,也可累及下肢,或同时波及

目的探讨小儿静脉注射地塞米松的安全速度,以减少恶心呕吐的发生。方法将148名患儿随机分成三组,第一组48例,地塞米松以原液静脉注射,速度为每毫克10s;第二组50例,将地塞米松稀释后以每毫克20s的速度静脉注射;第三组50例,将地塞米松稀释后以每毫克30秒的速度静脉注射,将三组患儿10min内恶心呕吐发生率进行比较。结果第一组患儿发生恶心或呕吐11例,第二组患儿发生恶心或呕吐4例,第三组无患儿发生恶心或呕吐。结论地塞米松静脉注射过快易导致恶心或呕吐,稀释后以每毫克30秒左右的速度缓慢注射将更安全。

<正>干燥综和征(SS)是一种主要累及全身外分泌腺的慢性自身免疫性疾病,以唾液腺和泪腺的症状为主,呼吸系统、消化系统、皮肤、阴道等外分泌腺亦有相应表现,还可出现腺体外的病变[1]。它是仅次于类风湿关节炎第2位的常见自身免疫病症[2],表现为干燥性角膜结膜炎和口腔干燥症[3]。继发

<正>糖尿病是由遗传和环境因素相互作用而引起的一组以慢性高血糖为共同特征的代谢异常综合征[1]。糖尿病肾病是糖尿病患者常见的慢性血管合并症,其肾脏损害的主要病理改变是特异的结节型肾小球硬化,临床上除原有的糖尿病表现外还有蛋白尿、水肿和高血压,血尿素氮、肌酐增高,最终发生肾功能衰竭,是目前糖尿患者死亡的主要原因。血清钾浓度超过5.5 mmol/L临床即诊断为高钾血症[2],大于7.0

目的:探讨重度精神类药物中毒患者行血液灌流的相应护理。方法:采用血液灌流对26例重度精神类药物中毒患者进行治疗及护理。结果:26例患者全部治愈,抢救成功率为100%。结论:血液灌流是治疗重度精神类药物中毒的有效方法,周密细致的病情观察和护理可提高抢救成功率。

目的:探讨急症重症患者三种静脉输液及静脉采血的方法,找出一种最佳的工作方法。方法:将300例急诊患者随机分为传统组、对照组和实验组,各100例。传统组采用一侧肢体留置静脉针进行静脉输液,另一侧肢体用一次性注射器进行采血;对照组在静脉留置针末端接一次性头皮针再接一次性注射器进行采血,采血后利用该留置针进行静脉输液;实验组在静脉留置针末端接一次性采血针再接真空采血器进行采血,采血后利用该留置针进行静脉输液。比较三种方法护士平均操作时间和患者溶血发生率的情况。结果:三种方法在护士操作时间及患者标本溶血发生率方面比较,实验组均明显低于传统组和对照组(P<0.01)。结论:留置针末端接一次性采血针再接真空采血器进行静脉输液联合静脉采血既节约时间又降低标本溶血发生率,在急诊抢救中取得了良好的临床效果。