目的 了解临床护理人员对循证护理的认知情况,分析存在的问题,为临床循证护理相关培训提供参考.方法 选择 2022 年 6-8月本院的 217 名临床护士作为调查对象.对 217 名临床护士进行问卷调查,问卷包括一般资料调查表,循证实践知识、态度、行为问卷和循证护理能力评定量表.通过临床护士循证护理能力得分,分析循证护理能力与循证实践知识态度行为现况,对循证护理能力与循证实践知识态度行为的相关性分析.用多重线性回归分析临床护士循证护理能力得分的影响因素.结果 217名临床护士循证实践知识态度行为问卷总分为(104.27±27.95)分,循证护理能力总分为(49.00±28.95)分;循证实践知识态度行为总分及其三个维度与临床护士循证护理能力得分均呈正相关(P<0.05);多重线性回归分析显示,英语水平、循证护理教育培训经历及循证实践的知识技能、态度及实践行为总分是临床护士循证护理能力的影响因素(P<0.05).结论 当前临床护士的循证护理认知及实践能力,亟待提高.建议护理管理者,加大对临床护士循证护理能力的培养,明确护士不同角色的具体职能,发挥各自的优势,强化培训循证护理最实用、最核心内容,逐步提高临床护士循证护理能力.

急性心肌梗死(AMI)起病急,而实施直接经皮冠状动脉介入术(PCI)可降低患者死亡率及预后风险.随着医疗水平的进步,直接PCI治疗AMI成功率升高,但仍有部分患者术后无复流,可进一步加重患者预后风险,有一定院内致死率.PCI后无复流的发生与血管内皮功能、心肌微循环障碍等机制有关,但其确切机制尚未明确.未来应对AMI患者直接PCI后无复流的发生机制进行深入探讨,进一步制订预防及诊治措施,以提高AMI患者直接PCI治疗的成功率,降低患者预后风险.

目的 研究对心血管疾病患者实施人性化护理干预的临床效果.方法 选取2016年1月～2018年2月我院接收的心血管疾病患者56例展开研究,按护理措施差异分为2组,对照组常规护理,观察组实施人性化护理干预,对比分析患者护理满意度、护理前后睡眠质量和日常生活能力改善情况以及生活质量改善情况.结果 对照组护理满意度71.4％,观察组为92.8％.观察组PSQI(6.33±1.22)分,ADL(79.33±3.22)分,观察组睡眠质量评分较对照组低,日常生活能力评分高.观察组患者生活质量各项评分高于对照组,上述指标对比,差异有统计学意义(P<0.05).结论 对心血管疾病患者实施人性化护理干预效果显著,临床应用价值较高,值得推广.

目的 探讨早泄合并包皮过长行商环微创术的围术期护理方法.方法 回顾分析我院2014年1月—2018年1月收治的早泄合并包皮过长116例患者行商环微创术治疗的临床护理情况,从围术期心理护理、术中术后疼痛护理、术后商环及并发症护理、伤口护理、专项健康宣教等方面进行分析.结果 平均手术时间(21.6±1.68)min,平均出血量(4.81±0.77)mL,术后24 h患者疼痛评分(VAS)为(3.26±0.05)分,平均性交时间(7.89±0.78)min,3个月后性生活满意度93.1％(108/116),外观满意度为94.8％(110/116).主要并发症的发生率为:系带切口裂开2.58％(3/116)、系带区感染1.72％(2/116)、系带中重度水肿4.31％(5/116)、出现龟头麻木感6.03％(7/116).结论 商环微创术治疗早泄合并包皮过长具备简单易行,短时微创,并发症发生率低,患者易于接受、术后易护理且外观恢复满意等优点,做好术前术后的护理工作对患者快速康复起到了不可忽视的重要作用.

目的 探讨影响心电监护报警阈值设置正确执行率的相关因素及质量改进效果.方法 选取我院心内科护理人员34人,通过心电监护知识问卷调查和现场设置报警考核分析,根据结果分析护士对报警阈值设置的执行情况,实施心电监护专科护理管理干预以达到质量改进效果.结果 护理人员干预前后心电监护相关知识掌握自评得分及心电监护报警阈值设置正确执行率对比有明显差异,干预后护士自评得分正确执行率明显高于干预前;干预后的三级质控资料中患者安全及护理质量评分明显高于干预前;差异均有统计学意义(P<0.05).结论 心电监护专科护理管理干预,能明显提高护理人员心电监护相关知识的掌握自评得分及设置报警阈值正确执行率,确保患者安全与护理质量.

目的 探讨GRACE评分对非ST段抬高型急性冠脉综合征(NSTE—ACS)患者危险分层管理的指导作用.方法 选取我院心内科2013年1月—2016年8月收治的NSTE—ACS患者60例作为研究对象.根据随机分配原则,选取其中单日入院30例作为对照组,给予常规护理;选取双日入院30例作为实验组,实施GRACE评分指导下的危险分层管理,出院后随访1年.对比两组患者出院时和随访1年GRACE评分及健康状况评价结果.结果 两组患者入院时GRACE评分危险分层及健康状况问卷得分对比,差异无统计学意义(P>0.05);出院时,两组GRACE评分危险分层及健康状况问卷得分比较,差异具有统计学意义(P<0.05);随访1年,两组GRACE评分危险分层比较,差异具有统计学意义(P<0.05);两组患者健康状况问卷得分相比,差异具有统计学意义(P<0.001).结论 GRACE评分对NSTE—ACS患者预后有较高的预测准确度,能促进患者危险分层管理和针对性干预,降低心血管不良事件,提高患者生活质量.

目的 探讨5步式叙事护理干预对老年PCI术后患者服药依从性及生活质量的影响.方法 选取我院心内科2013年1月-2015年12月收治的30例行冠状动脉介入(PCI)术后的老年冠心病患者作为对照组,2016年1月-2017年1月收治的30例同病种和年龄段的PCI术后患者作为观察组.对照组术后给予常规护理和出院后社区延伸护理.观察组在对照组基础上应用5步式叙事护理干预方法.对比两组患者出院后半年内服药依从性和生活质量调查结果.结果 两组患者出院时服药依从性和生活质量差异无统计学意义(P＞0.05);出院第1个月和第6个月时观察组服药依从性和生活质量平均得分均优于对照组,差异有统计学意义(P＜0.05).结论 老年冠心病PCI术后患者接受5步式叙事护理干预,能改善患者对术后服药的自我管理水平,提高患者生活质量.

目的:探讨品管圈(QCC)活动在降低心血管住院患者便秘发生率的临床践行效果.方法:开展以“降低心血管住院患者便秘发生率”为主题的品管圈活动,根据品管圈活动步骤对心血管病住院患者便秘的发生进行主题选定、拟定活动计划、现状把握、目标设定、解析、对策拟定、对策实施与检讨、效果确认、标准化、检讨与改进.结果:开展品管圈活动后,心血管病住院患者便秘的发生率由改善前的50.0％降至17.1％,进步率为65.5％,目标达标率为118.3％,圈员的解决问题能力、责任感、团队精神、沟通能力、积极性、自信心、创新能力、QCC手法8项能力均分由活动前的4.0～6.9分提高至7.1～9.3分.结论:品管圈活动能有效降低心血管住院患者便秘发生率,提高心内科护理质量,避免心脏恶性事件发生,保障医疗安全.

目的 探讨专科监测指标法对降低皮下注射低分子肝素血肿发生率的临床应用效果.方法 选取我院东院区心内科收治的冠心病患者200例,根据自愿原则,选取其中自愿接受常规注射法的100例患者作为对照组,另外自愿接受监测下标准注射法的100例患者作为观察组,观察组通过使用病区专科监测指标来规范护理人员按照评判标准进行低分子肝素皮下注射.对比两组患者皮下注射低分子肝素血肿发生率及护理服务满意度.结果 观察组患者皮下注射低分子肝素血肿发生率明显低于对照组;观察组护理服务满意度显著高于对照组;差异有统计学意义(P<0.05).实施监测一年前后同组护士规范注射标准执行率比较结果有明显差异,实施后各项得分显著高于实施前,差异有统计学意义(P<0.05).结论 专科监测指标法能严格规范护士皮下注射低分子肝素操作方法,杜绝注射部位血肿的发生,提高患者护理服务满意度.

目的 探讨与分析叙事护理对老年冠心病便秘合并焦虑患者的影响.方法 选择2016年5月~2017年4月我院收治的80例老年冠心病患者为研究对象,采用信封法将其随机分为对照组和干预组,各40例.对照组予以常规护理,干预组予以叙事护理,比较两组护理后的心理及便秘变化情况.结果 护理后,两组SAS评分较护理前均降低,差异有统计学意义(P<0.05),其中干预组护理后SAS评分明显低于对照组,差异有统计学意义(P<0.05);护理后,两组每周大便次数、大便性状均明显改善,差异有统计学意义(P<0.05),其中干预组护理后每周大便次数、大便性状改善情况明显优于对照组,差异有统计学意义(P<0.05).结论 叙事护理能改善老年冠心病患者焦虑心理状态,缓解便秘情况,利于患者预后.

Human urinary bladder cancer (UBC) is the one of the most common malignancies worldwide and occurs at a higher frequency in male individuals. ATP-binding cassette, subfamily C, member 3 (ABCC3), a member of the ABC transporter family, is highly expressed in tumor cells, where it actively effluxes a broad spectrum of metabolites. However, the expression and role of ABCC3 in human UBC remains unclear. Our study aimed to identify the expression status of ABCC3 in UBC cases and investigate the biological effects on UBC in cells. We found that both mRNA and protein levels of ABCC3 were significantly higher in UBC tissues than normal tissues. Immunochemistry evaluation of ABCC3 expression in 122 UBC clinical specimens showed that high expression of ABCC3 had a positive correlation with UBC tumor size, advanced tumor node metastasis stage, and malignant histology. Moreover, high ABCC3 expression was linked to poor overall survival in UBC. ABCC3 effects on cell proliferation and drug resistance were measured by colony formation and methylthiazolyldiphenyl-tetrazolium bromide (MTT) assays. ABCC3-knockdown cells showed a significant decrease in cell growth and drug resistance. RNA interference of ABCC3 also caused downregulation of lactate dehydrogenase A (LDHA), which positively correlated with ABCC3 expression in UBC specimens. In addition, cancer cell glycolytic ability was decreased upon ABCC3 knockdown. The activity of LDHA was also abrogated in ABCC3-deficient UBC cells, and the blockade of LDHA increased UBC cells sensitivity to Cis-diamine dichloroplatinum (CDDP). In summary, our study suggests ABCC3 is an important oncoprotein involved in glycolysis and drug resistance. These data also indicates that ABCC3 could be a potential prognostic marker and promising therapeutic target in UBC.

Objective To investigate the efficacy and safety of Shang Ring microsurgery in the treatment of prosper -mia patients with redundant prepuce .Methods A total of 73 prospermia patients with redundant prepuce were included into the current study .Their data about surgical duration , complication , satisfaction of the appearance , quality of sexual life, and erectile dysfunction were retrospectively analyzed .Results All patients underwent Shang Ring microsurgery successfully.The average bleeding volume was (5.0 ±1.0) ml.The average surgical duration was (21 ±4) min.The VAS pain score was (3.15 ±0.90) min 24 h after surgery.The average duration of sexual life was (7.0 ±1.5) min. The satisfaction of the appearance was 90.9%, while the quality of sexual life was 93.6%.The main complications in-cluded wound dehiscence (2.7%), infection (4.1%), moderate and severe edema (5.4%), and glans numbness were (6.8%).No erectile dysfunction and other serious complications were reported .Conclusion Shang Ring microsurgery is safe and effective to treat prospermia patients with redundant prepuce , with advantages such as a short operation time , less bleeding , little trauma, fewer complications , higher satisfaction and acceptance , and good cosmetic effects .

Objective To investigate the efficacy and safety of Shang ring combined with penile dorsal nerve neurotomy for prospermia with redundant prepuce. Methods From January 2014 to October 2015, 110 patients diagnosed as prospermia combined with redundant prepuce were collected and were randomly divided into two groups. Patients in experimental group received the treatment of the Shang ring combined with penile dorsal nerve neurotomy (n=55). Patients in control group received the conventional circumcision and penile dorsal nerve neurotomy (n=55). The operation time, blood loss, pain score, the duration of sexual time, postoperative complications, satisfaction with the penile appearance, postoperative sexual satisfaction and glans numbness were compared between the two groups. Results The operation time, blood loss, the pain scores, the duration of sexual time, postoperative sexual satisfaction and&nbsp;satisfaction with the penile appearance in the experimental group were (22.3±1.67)min, (4.93±0.76)ml, (3.28±0.04)scores, (7.99±0.79)min, 92.8% (51/55) and 91.8% (49/55), respectively. The five parameters in the control group were (56.4±2.89)min, (15.1±2.11)ml, (5.37±0.58)scores, (5.89±0.65)min, 63.7% (35/55) and 76.3% (39/55). There were significant differences between them (t=75.59, P=0.000; t=33.56, P=0.000;t=26.74, P=0.000; t=15.09, P=0.000; χ2=7.698, P=0.010; χ2=5.682, P=0.030). The rates of important complications including wound dehiscence, infection, moderate, severe edema and glans numbness in the experimental group were 1.80% (1/55), 1.80% (1/55), 3.60% (2/55) and 7.20% (4/55), respectively. The four parameters in the control group were 9.09% (5/55), 10.9% (6/55), 16.3% (9/55) and 7.20% (4/55), respectively. There were no significant differences between the two groups (P>0.05). Conclusion The Shang ring combined with penile dorsal nerve neurotomy for patients of prospermia with redundant prepuce has the advantages of shorter operation time, little trauma, fewer complications and higher satisfaction and acceptance of the patients, which is an effective and safe surgical approach.

目的 探讨个案护理考评法在护士临床护理能力培养中的应用效果.方法 以在内科临床工作3～10年的49名护士为考评对象,组建护士长考评团队,调研护士护理能力现状,制定考评方法,采取情景模拟答辩、床边考核等方法实施现场考评,结束后采用自制满意度调查表对各专科同一工作场所的医生和护士(共68人)进行调查.结果 培养责任护士护理能力方面,满意率达95.59％,培养护士长管理能力方面,满意率达91.18％.结论 基于个案护理的考评方法,可以激发护士的学习热情和兴趣,提高年轻护士的临床护理综合能力,培养护士长以问题为本的管理理念,提高护士长现场管理水平,在一定程度上促进了优质护理的发展.

目的:探讨糖尿病足的护理方法,为临床护理提供经验。方法:对63例糖尿病足患者进行有效的护理干预与健康教育。结果:经过治疗和精心的护理,63例糖尿病足患者中无1例患者致残及被迫截肢,保证了患者的生活质量。结论:在临床治疗中全面的评估、严密的观察和系统有效的护理干预是提高糖尿病足治愈率、降低截肢率的有效措施。

目的:探讨老年人无痛型心肌梗死的护理对策,以提高诊断救治的成功率。方法:对106例老年人无痛型心肌梗死患者进行护理总结。结果:本组病例均得到有效及时的救治,避免了意外的发生。结论:对老年人症状可疑及应用硝酸甘油等血管扩张药物不能缓解时,应警惕心肌梗死的发生。

急性心肌梗死(AMI)是冠状动脉急性闭塞引起局部心肌发生缺血性坏死.目前,在发达国家急性心肌梗死已成为首要死亡原因,而在我国虽然发病率、病死率低于发达国家,但随着我国经济的发展、生活水平的提高、饮食结构的改变,急性心肌梗死的发病率、病死率也已明显增加.