目的 观察八步流程结合四轨交叉质控用于颅脑损伤术后护理的应用效果.方法 采用回顾性研究方法,从2019年1月至12月入住北京天坛医院国际部神经外科的163例颅脑损伤术后患者中,经1:1倾向性匹配评分选取,获得2019年1月至6月给予术后常规护理的43例患者为对照组,2019年7月至12月在常规护理基础上给予八步流程联合四轨交叉质控护理干预的43例患者为观察组.记录患者术后意识恢复时间、拔管时间、康复锻炼开始时间及住院时间,比较两组并发症、护理不良事件发生率;术后随访3个月,采用脑损伤后生活质量(QOLIBRI)评定量表评价患者生活质量.结果 观察组术后意识恢复时间、拔管时间、康复锻炼开始时间及住院时间均短于对照组(P＜0.05,P＜0.01).与对照组比较,观察组术后并发症总发生率(9.30％vs 32.56％,P＜0.01)、护理不良事件总发生率(2.33％vs 20.93％,P＜0.01)显著降低.术后3个月,观察组QOLIBRI评分中日常生活和自主性、认知思考能力、人际关系、自我评价、情感、身体机能受限各维度评分均高于对照组(P＜0.01).结论 颅脑损伤术后采用八步流程结合四轨交叉质控护理模式,有利于缩短患者术后恢复时间、降低并发症发生率,对提高临床护理质量及患者生活质量有积极意义.

Objective To explore nursing methods of postoperative patients with brain stem tumor complicated with stress hyperglycemia. Methods The medical and nursing measures of 56 postoperative patients with brain stem tumor complicated with stress hyperglycemia were analyzed retrospectively. Results Among 56 cases, 48 cases were clinically cured, 6 cases was improved, 2 cases died of multiple organ failure. Conclusions It is especially important to intensify insulin therapy, necessary to closely observe the patients' consciousness, pupils and the change of vital signs. Meanwhile, strengthening nursing on common complications such as infection and gastrointestinal hemorrhage, and paying more attention to patients' dietary, mental state and rehabilitation are also important measures.

目的 探讨饮食提示卡在腩卒中后吞咽困难患者饮食管理中的应用效果.方法 将住院的100例脑卒中伴吞咽困难患者分为观察组52例和对照组48例,观察组应用饮食提示卡辅助进行饮食管理.结果 观察组患者对饮食护理知识的掌握情况及对饮食具体要求的依从行为均好于对照组.结论 饮食提示卡作为一种特殊的健康教育形式,值得应用于脑卒中后吞咽困难患者的饮食管理。

Objective To investigate the current situation and demands of specialized training among neurosurgery nurses in Beijing,and to provide evidence for the formulation and standardization of the training plan.Methods A self-designed questionnaire about status quo and demands of specialized training was used to investigate 178 neurosurgery nurses who came from 15 hospitals in Beijing.Results Strictly,65.73% of nurses received specialized training in recent 3 years;the training rate in nurses with different length of service showed significant difference(P0.01),while it in nurses with different title,education backgrounds and level of hospitals had no significant difference(P0.05 for all).The items of short-term training on special subjects was preferred by 43.82% nurses,and 34.27% of nurses chose visit to other hospitals;nurses' demand rates of 9 training items ranged from 92.13% to 100%.Conclusion The current situation of specialized training for neurosurgery in Beijing is not satisfactory.Measures should be taken according to nursing characteristics.