Objective:To explore the effect of combined nursing intervention on the prevention of deep vein thrombosis (DVT) after orthopedics surgery and provide guidance for the orthopedics department to reduce the incidence of thrombosis.Methods:A total of 166 patients undergoing major orthopaedic surgery in the Department of Orthopaedics, the Second Affiliated Hospital of Inner Mongolia Medical University from May 2016 to February 2018 were randomly divided into the experimental group and the control group. The patients in the control group underwent general perioperative nursing. The experimental group developed a targeted DVT preventive nursing process according to the thinking and methods of "composite nursing intervention". The main blood indexes (plasma D-dimer, platelet) of the two groups were observed. Changes, DVT incidence, and patient satisfaction.Results:Compared with control group, experimental group a lower incidence of postoperative DVT (χ2=26.231, P<0.05), the patient's nursing satisfaction rate higher (χ2=11.093, P<0.05). Meanwhile, the d-dimer level of the experimental group was lower than that of the control group 24 hours after surgery, and the platelet count was higher than that of the control group (t=2.061, t=11.582, P<0.05).Conclusions:The composite nursing intervention is used in the perioperative clinical practice of orthopedics, which can effectively reduce the incidence of thrombosis without increasing the risk of bleeding. It has important clinical significance for the reasonable prevention and control of deep venous thrombosis DVT after orthopedic surgery.

[目的]探讨临床护理路径在短节段椎间融合术后病人护理中的应用效果。[方法]将80例短节段椎间融合术病人随机分为观察组和对照组，对照组给予传统护理，观察组按临床护理路径实施护理，在出院时对两组护理满意度进行比较，并分别在术前、出院时及出院3月后对两组病人进行 ODI评分。[结果]观察组满意度为97.50%，高于对照组的82.50%(P<0.05)；出院时及出院3个月后观察组病人 ODI评分均低于对照组(P<0.05)。[结论]在短节段椎间融合术后病人护理中实施临床护理路径，在促进病人恢复及提高护理满意度方面有明显效果。

总结了应用振动排痰仪协助胸椎骨折合并创伤性湿肺患者排痰的护理方法,主要包括使用排痰仪前的评估和使用排痰仪的时间、体位、方法、注意事项及使用后的护理. 认为应用振动排痰仪为胸椎骨折合并创伤性湿肺患者进行呼吸道护理,可以有效协助患者排痰,防止肺部并发症的发生,加速患者康复.

军队医院文职护士是医疗救护的一支重要力量。本文分析了当前军队文职护士战救能力素质存在的主要问题与不足，提出通过在教育中“强基”、在养成中“补钙”，在训练中“摔打”、在任务中“磨砺”，同时完善必要的制度机制，扎实提高军队文职护士战场救护能力素质。

我院是一所军队三级甲等医院，床位开展规模1500张，常因患者住院治疗需求加床，搬床需要投入护士大量精力，实际工作中，由于涉及的人员、内容较多，经常会忽视床头卡、腕带、护理文书等处信息的更改，存在患者床号信息与实际不符的问题，个别科室还引发了护理差错。为确保护理工作安全有序，控制安全隐患，护理部于2013年6月设计了搬床患者医嘱执行与信息更改核查表并应用于临床，取得较好效果。现将方法报道如下。

通过加强管理、开展多形式感控知识培训、严格督导和检查考评,提升保洁员的素质和认知水平,规范职业行为,改善医院环境卫生质量,对有效预防医院感染、确保医疗安全发挥作用.

新加坡护理事业发展很快，通过借鉴西方发达国家的护理模式与理念，并结合本国实际情况不断完善，形成了自身独特的护理管理模式［1-2］。笔者一行于2013年6月在新加坡中央医院进修学习，亲身参与了医院的护理实践，了解了新加坡医院护理架构，深入学习了新加坡先进管理理念、医护团队建设与沟通等具体内容。通过本次学习，笔者认识到新加坡在护理领导角色认知、护理管理体系及护理管理中的人性化等方面都有其独到之处，现就新加坡护理基本情况，以及医院的护理管理体系与护理管理理念、护理人员管理机制、护理人性化管理等方面介绍如下。

目的：探讨护理干预对金融系统录用体验者血压稳定的效果。方法选择血压≥140/90mmHg的体检者161人，随机分为对照组81人和实验组80人。对照组在相对安静的房间闭目休息30min；实验组采用综合护理方法干预。两组30min后再测血压，并比较两组血压的变化。结果实验组经过护理干预后复测收缩压下降值为13．24±6．289mm-Hg，对照组复测收缩压下降值为7．21±3．499mmHg，两组比较有显著性差异（P＜0．05）。结论护理干预能有效缓解体检者紧张情绪，起到稳定体检者血压的作用，客观准确测量血压。

Objective:To evaluate the effect of clinical nursing pathway(CNP)for the operation patients of lumbar intervertebral disc protrusion(LIDP).Methods:Retrospective analysis was carried out in 60 patients of LIDP,who were divided into the control group(30 cases)and the experimental group(30 cases).The control group received routine nursing model,while the experimental group was given managed with clinical pathway. Comparison the 2 groups of average hospital stay,cost of hospitalization and the incidence of postoperative complications.Results:The average length of hospital stay of the experimental group was(7.9±2.1)days,which was shorter than that of the control group,(14.3±3.4)days.The average hospitalization cost of the experimental group was(3251.3±845.9)yuan,while the control group was(4935.5±983.2)yuan.The postoperative complications of the experimental group was 6.7%,which was lower than that of the control group,26.7%. Conclusions:The establishment of CNP for the operation patients of LIDP can shorten the length of hospital stay,reducing hospitalization costs and the incidence of postoperative complications.

目的对胸椎管狭窄症的患者进行系统的围手术期护理,最大限度的促进患者的功能恢复。方法根据患者病情制定有针对性的整体护理计划,做好心理护理、基础护理和健康指导。结果所有12例患者均在良好心态下接受手术,并在术后积极配合治疗及护理,无并发症发生,术后恢复良好。结论对胸椎管狭窄症患者进行系统的围手术期护理可以有效的改善患者心态,预防并发症,促进功能恢复。

目的:探讨拔除术后病人留置尿管的最佳流程。方法:198例留置导尿患者随机分为观察组和对照组各99例。观察组病人,在给病人拔除尿管前,先与病人沟通,使病人有拔尿管的心理准备,然后用含有硫酸庆大霉素注射液的溶液250ml进行膀胱冲洗,冲洗液在膀胱内滞留10 min。将装有50～55℃温开水的便盆放入病人臀下,浸有40～45℃温开水的小毛巾置于病人会阴部,抽出导尿管气囊中的全部液体,拔出尿管。对照组采取在膀胱空虚时,抽出气囊中全部液体,拔出尿管。比较两组病人在拔出尿管后的尿道疼痛情况和自行排尿情况。结果:应用护理流程拔出尿管的观察组病人,留置尿管拔出后,自行排尿人数明显多于对照组,病人尿频、尿痛症状明显少于对照组。结论:应用膀胱冲洗加基础护理流程拔出尿管,能提高骨科术后病人的自行排尿成功率。

对48例肺癌患者,术前给予针对性心理护理,做好肺部护理,术后密切观察生命体征,加强胸腔引流管及呼吸道护理,对并发症早期发现并采取相应护理措施。结果本组术后肺部感染3例,肺不张5例,呼吸衰竭2例,心律失常5例,支气管胸膜瘘1例。死亡1例,其余47例均治愈出院。认为精心的围术期护理是手术成功及患者康复的重要保障。

目的:对青少年脊柱结核患者进行有针对性的特色护理,促进术后恢复。方法:充分了解青少年胸椎结核的特点,针对每个病人的不同情况实施术前术后整体护理,评估患者的恢复情况。结果:本组病人术前准备充分,手术顺利,术后无并发症发生,恢复良好。结论:针对青少年胸椎结核患者的特点给予特色护理,可以为手术成功奠定基础,有效的促进患者的术后恢复。

This thesis aims to build a nursing work system and mission of modern field warfare under the condition of modern high technology.The characteristics of the nursing work of field warfare under integrated combined operation of modern high technology are analyzed through consultation,investigation and analysis,including outburst of wars,a surge in the wounded the complexity of serians injury,seriousness of wound and the burden of nursing work,which demands high nursing skills as well as sound working skills of nurses.The increasing cases of psychological problems of war injury protrude the curing for this wound.Therefore,it is very urgent to establish an integrated organization commanding system of nursing to meet the needs of the information based warfare,which requires the transform of the information based nursing organization combined with automated and intelligent nursing methods and equipments.The major task of nursing work for modern field warfare is to organize and manage nursing during the war,aid and treat the wounded,classify and evacuate the wounded,provide psychological caring to the wounded and manage the materials and the information during the warfare.It analyzes the contents and the goal of all kinds of nursing tasks under the condition of high technology war respectively so as to ensure the nursing work performed smoothly.

目的:总结前后路同期手术治疗脊柱侧弯的护理。方法:对采用前后路同期手术治疗的6例脊柱侧弯患者在治疗中实施相应护理。结果:6例脊柱侧弯患者采用前后路同期手术治疗,通过精心护理均未发生任何并发症。结论:对采用前后路同期手术治疗脊柱侧弯的患者,术前应加强心理护理,完善术前准备,训练呼吸功能及卧床大小便。术后严密监测生命体征,保持呼吸道通畅,预防肺部感染,观察脊髓神经功能变化,预防迟发性神经损伤,做好引流管及翻身的护理,重视健康宣教及出院指导,是手术成功的重要组成部分。

Objective To study the application of Karnofsky Performance Scale(KPS)in nursing of tumor patients receiving radiotherapy,so as to provide evidence for setting up nursing grade. Methods Totally 408 tumor patients were divided into the observation group(n=211)and the control group(n=197).The health state of patients in observation group was assessed by the KPS questionnaire and the nursing class was given;patients in the control group were nursed con- ventionally.The hospital stay,the incidence of complications,patients'satisfaction rate and the cost-effectiveness were analyzed in the two groups.Results The average hospital stay and the in- cidence of complications in the observation group were significantly lower than those in the control group;and result of the cost-effectiveness showed that the cost was lower in the observational group.Conclusion Application of KPS can upgrade the nursing quality in nursing patients under- going radiotherapy.

目的:探讨上颈椎不稳定病人的术前术后的治疗及护理方法。方法:术前做好心理护理,消除患者的心理恐惧,稳定患者的情绪,练习床上大小便,练习气管食管的推移,严格的术前准备,以提高手术安全性。术后严密监测生命体征,观察引流物的量、颜色和性质,保证引流有效安全,做好卧位护理和并发症观察,指导功能锻炼是护理的关键。结果:本组均无护理并发症,安全渡过手术期。结论:加强上颈椎不稳定患者的术前术后护理,对于减少并发症,安全渡过手术期至关重要。

随着结核病在近年来发病率的提高,脊柱结核的病人也越来越多.我科在2000年10月～2006年12月期间共收治脊柱结核患者26例.均采取一期病灶清除、减压、椎体间自体骨植骨、前路ALPS钢板内固定术治疗.经过术前详细的检查,认真的术前准备,细致的心理护理,以及术后对不同阶段的护理及出院指导,26例患者均在术后14～17d痊愈出院,均无手术并发症.现报道如下.