目的 评价肺部三维立体虚拟解剖模型在重症医学部护士肺部超声培训中的应用效果.方法 便利选取河南省某三级甲等医院重症医学部120名护士作为研究对象,采用随机数字表法分为试验组(n=60)和对照组(n=60).试验组在对照组基础上,采用肺部三维立体虚拟解剖模型进行培训.通过3D医学影像可视化分析研究平台将肺部病变患者的CT数据转化为立体、虚拟的肺部解剖模型.培训导师佩戴增强现实眼镜将虚拟解剖模型与建模患者完全重合,按照改良床旁肺部超声评估方案,通过超声探头获取各筛查点的超声图像.护士通过显示屏观看在导师操作过程中的超声图像和相应虚拟解剖模型.比较两组理论考试成绩、操作技能成绩、操作耗时及对培训的满意度.结果 试验组理论成绩及其中的肺部超声征象识别成绩、操作技能成绩及其中的扫描出"蝙蝠征"成绩、对培训的满意度评分均高于对照组(P<0.05);试验组操作耗时少于对照组(P<0.05).结论 在培训中应用肺部三维立体虚拟解剖模型有助于护士对肺部超声图像和操作要求的理解,且护士的满意度较高.

目的 分析进展期结直肠腺瘤平均风险人群结直肠腺瘤的临床特点及相关危险因素,为其临床预防及治疗提供参考.方法 回顾性分析2019年9月至2022年5月就诊于郑州大学第一附属医院并行结直肠镜检查的736例结直肠腺瘤患者的临床资料,根据肠镜检查结果将患者分为进展期结直肠腺瘤组、非进展期结直肠腺瘤组,对2组患者临床资料进行比较,并对平均风险人群中发生进展期结直肠腺瘤的相关危险因素进行单因素及多因素Logistic回归分析.结果 进展期结直肠腺瘤检出率为18.3％(135/736),对患者临床资料分析发现患者年龄、是否患有2型糖尿病、是否患有高脂血症、腺瘤位置、腺瘤大体形态是进展期结直肠腺瘤发生的相关因素(x2=21.449,P＜0.001;x2=6.180,P=0.013;x2=7.927,P=0.004;x2=24.332,P＜0.001;x2=37.972,P＜0.001),多因素Logistic回归分析结果显示年龄、患有2型糖尿病(OR=1.816,95％CI:1.113～4.068,P=0.003)、是否患有高脂血症(OR=1.658,95％CI:0.782～2.237,P=0.016)、腺瘤分布位置(OR=2.779,95％CI:1.135～2.032,P=0.001)是患者发生进展期结直肠腺瘤的独立危险因素.结论 进展期结直肠腺瘤是直肠癌的主要癌前病变,临床上早期发现进发生进展期结直肠腺瘤的危险因素、及时进行结直肠内镜检查及治疗,制订针对性的随访计划可有.效降低进展期结直肠腺瘤发生率.

Objective:To compare the clinical efficacy of endoscopic resection and laparoscopic surgery in the treatment of gastric gastrointestinal stromal tumor (GIST) with a maximum diameter of 2 to 5 cm, and to analyze the influence of factors such as tumor surface, growth pattern and lesion origin on the choice of resection method, so as to provide a safer and more effective treatment for patients with gastric GIST.Methods:From January 2012 to November 2019, at the First Affiliated Hospital of Zhengzhou University, the clinical data of 301 patients with gastric GIST who underwent endoscopic resection (137 cases in the endoscopic resection group) or laparoscopic surgery (164 cases in the laparoscopic surgery group) were retrospectively analyzed, including age, gender, whether there was depression on the tumor surface (the local subsidence depth of the mucosa on the tumor surface was >5 mm), whether the tumor surface was irregular (non-hemispherical or non-elliptical tumor surface), whether there was combined ulcer, location, shape, origin of the lesion, growth pattern (intralumina growth or combined intraluminal and extraluminal growth), risk classification (very low risk, low risk, medium risk, high risk), whether the tumor was en bloc resection, operation time, whether bleeding or not, fasting time, indwelling time of gastric tube, time of hospitalization, time of postoperative hospital stay, postoperative complications and follow-up. Independent sample t test, chi-square test or Fisher′s exact test and Wilcoxon rank sum test were used for statistical analysis. Results:Among the 137 patients with gastric GIST in the endoscopic resection group, 85 cases (62.0%) underwent endoscopic submucosal dissection, 9 cases (6.6%) underwent endoscopic submucosal excavation, 42 cases (30.7%) underwent endoscopic full-thickness resection, and 1 case (0.7%) underwent submucosal tunnel endoscopic resection. There were no significant differences in gender, age, lesion location, tumor size, and risk classification between the endoscopic resection group and the laparoscopic surgery group (all P>0.05). The tumor surface was depressed, with ulcer or irregular in 1, 49, 26, and 2 cases of patients with gastric GIST of very low risk, low risk, medium risk and high risk, respectively. There was statistically significant difference in the proportion of depression, irregularity and ulcer on the tumor surface at different risk levels ( Z=-2.55, P=0.011). The complete tumor resection rate of the endoscopic resection group was lower than that of the laparoscopic surgery group (86.1%, 118/137 vs. 100.0%, 164/164), and the difference was statistically significant ( χ2=24.28, P<0.001). However the operation time, fasting time, the indwelling time of gastric tube, time of hospitalization, and the time of postoperative hospital stay of the endoscopic resection group were shorter than those of the laparoscopic surgery group, and the total hospitalization cost was lower than that of the laparoscopic surgery group (90.0 min (62.5 min, 150.0 min) vs. 119.5 min, (80.0 min, 154.2 min); 3 d (3 d, 4 d) vs. 5 d (4 d, 7 d); 3 d (2 d, 4 d) vs. 4 d (2 d, 6 d); 11 d (10 d, 14 d) vs. 16 d (12 d, 20 d); 7 d (6 d, 9 d) vs. 9 d (7 d, 11 d); (38 211.6±10 221.0) yuan vs. (59 926.1±17 786.1) yuan), and the differences were statistically significant ( Z=-2.46, -7.12, -4.44, -6.89 and -5.92, t=-13.24; all P<0.05). The incidence of postoperative abdominal pain and other severe postoperative complications (including shock, respiratory failure, pulmonary embolism, gastroparesis, etc.) of the endoscopic resection group were all lower than those of the laparoscopic surgery group (16.8%, 23/137 vs. 27.4%, 45/164; 0.7%, 1/137 vs. 4.9%, 8/164), and the differences were statistically significant ( χ2=4.84, Fisher′s exact test, P=0.028 and 0.043). There were no significant differences in the incidence of intraoperative bleeding, postoperative bleeding, fever and perforation between the two groups (all P>0.05). The incidence of operation-related complications of lesions with intraluminal growth and originating from muscularis propria in the endoscopic resection group were lower than those of the laparoscopic surgery group (19.5%, 25/128 vs. 32.6%, 45/138; 12.6%, 12/95 vs. 31.4%, 37/118), and the differences were statistically significant ( χ2=5.86 and 10.42, P=0.016 and 0.001). There was no significant difference in the postoperative tumor recurrent rate between the endoscopic resection group and the laparoscopic surgery group (0, 0/137 vs. 2.4%, 4/164; Fisher’s exact test, P=0.129). Conclusions:Endoscopic treatment is safe and effective for gastric GIST with a maximum diameter of 2 to 5 cm, which is superior to laparoscopic surgery. However, laparoscopic surgery is recommended for tumor with depressed, ulcerative, or irregular surface and combined intraluminal and extraluminal growth.

Data of 55 cases of gastric neuroendocrine neoplasms (G-NENS) with diameter ≤12 mm in the First Affiliated Hospital of Zhengzhou University from August 2014 to August 2019 were retrospectively analyzed. According to the methods of endoscopic resection, the patients were divided into two groups: the endoscopic mucosal resection with a cap (EMR-C) group (35 cases) and the endoscopic submucosal dissection (ESD) group (20 cases). The results showed that the success rates of operation, the whole resection rates and the complete resection rates were all 100.0% in the two groups. Compared with the ESD group, the EMR-C group had a shorter median operation time (12.00 min VS 28.35 min, P<0.001), less mean hospitalization costs (21 165.19 yuan VS 28 400.35 yuan, P=0.004), and a similar overall incidence of complications [2.86% (1/35) VS 0, P=1.000]. By March 2020, the recurrence rate of EMR-C group and ESD group were 28.6% (10/35) and 15.0% (3/20), respectively, without significant difference ( P=0.418). It is suggested that for G-NENS with diameter ≤12 mm, without muscular invasion, lymph node metastasis or distant metastasis, EMR-C and ESD are both safe and effective, but EMR-C has more advantages in terms of operation time and hospitalization costs.

目的:探讨手术室护理中应用循证护理和整体护理的效果及对舒适、疼痛程度的影响。方法:将郑州大学第一附属医院2018年1～12月收治的在手术室手术患者216例按照随机数字法分为对照组和研究组，各108例。对照组予以常规手术护理，研究组予以循证护理和整体护理。比较两组患者的护理质量，术前、术中、术后的舒张压、收缩压、心率变化情况及护理24 h及48 h时的舒适、疼痛情况。结果:研究组护理质量各维度评分均显著高于对照组，差异有统计学意义(均 P<0.05)。两组患者术前、术后血压及心率比较差异均无统计学意义(均 P>0.05)。术中研究组血压及心率均低于对照组；研究组护理24 h及48 h时舒适评分高于对照组，疼痛评分低于对照组，差异均有统计学意义(均 P<0.05)。 结论:循证护理和整体护理在手术室护理中应用可显著降低患者术中生理应激，缓解患者术后疼痛，提高其舒适度，护理质量较高。

目的 探讨"影子"体验活动在骨科护理实习生临床教学中的应用效果.方法 选取2020年8月—12月在某三级甲等医院实习的102名护理实习生作为研究对象,按照随机数字表法将其分为对照组和试验组.对照组给予常规临床护理教学干预,试验组给予"影子"体验活动,包括培训、示范和感知,跟随、体验和换位,分享、反思和内化,每周进行考核和反馈.教学后比较两组的临床综合素质、理论考核与实践操作成绩.结果 试验组迷你临床演练评估量表得分为(7.68±0.84)分,对照组为(7.04±1.28)分,两组差异有统计学意义(t=2.995,P=0.004).试验组出科理论考核成绩与实践操作成绩分均高于对照组,差异有统计学意义(P<0.05).结论 将"影子"体验活动用于骨科护理实习生临床教学,可进一步提升护理实习生的临床综合素质、理论及实践操作水平.

总结44例采用超声与腔内心电图进行PICC尖端定位的危重症患儿的护理经验.护理要点包括:置管前分段测量并记录导管内置长度;及时获取腔内心电图,观察P波变化;当导管置入长度接近预测长度时,立即采用超声心脏探头于患儿剑突下获取四腔心切面,根据推注生理盐水产生的不同超声征象间接引导导管尖端位于最佳位置.置管后首次胸部X线摄影显示导管尖端在位40例,导管尖端过深4例.

Objective:To explore the effect of situational behavior record reflection training on the listening ability of newly recruited clinical nurses.Methods:From March to September 2020, cluster sampling was used to select 116 newly recruited clinical nurses from the First Affiliated Hospital of Zhengzhou University as the research object. According to the entry order, nurses were divided into the observation group ( n=58) and the control group ( n=58). The nurses in the control group were trained in accordance with our hospital's regular standardized training system, while the observation group used situational behavior record reflection training method. Before the intervention and 6 months after the intervention, the Hodgetts Listening Performance Scale and the Patient Satisfaction with Nursing Care Questionnaire were used to compare the listening ability and patient satisfaction of the two groups of newly recruited clinical nurses. A total of 116 questionnaires were distributed and 113 valid questionnaires were returned with the valid response rate of 97.41%. Results:Before the intervention, there was no statistically significant differences in the scores of the Hodgetts Listening Performance Scale and the Patient Satisfaction with Nursing Care Questionnaire between the two groups of nurses ( P>0.05). After the intervention, the scores of the Hodgetts Listening Performance Scale and the Patient Satisfaction with Nursing Care Questionnaire of the two groups of nurses were higher than those before the intervention, and those of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:Situational behavior record reflection training can improve the listening ability and patient satisfaction of newly recruited clinical nurses, which is conducive to alleviating the nurse-patient relationship and improving the quality of nursing care.

目的 探讨脑心健康管理师专职岗位设置在卒中患者全程管理中的作用.方法 选取2019-06—12在郑州大学第一附属医院神经内科住院的56例患者为对照组,2020-06—12在神经内科住院的56例患者为干预组.对照组采用常规护理措施进行健康教育及出院后随访,干预组由专职脑心健康管理师进行个体化、全流程的院内健康管理及院外随访,比较2组卒中患者服药依从性、血液生化指标的变化.结果 脑心健康管理师专职岗位设置实施后,干预组出院6个月后服药依从性显著高于对照组(7.89±0.32 vs 6.62±1.28,P<0.001);干预组门诊随访≥3次患者占74.08％,显著高于对照组的44.23％(P<0.001);干预组血压(133.24±12.67/77.82±7.02)、血糖(5.20±0.82)、三酰甘油(1.41±0.31)、总胆固醇水平(4.30±0.85)均显著低于对照组(144.36±12.46/84.37±9.37、5.37±1.42、1.68±0.83、4.78±0.76,P<0.05).结论 脑心健康管理师专职岗位设置在医院卒中中心建设方面发挥重要作用,但亟需规范的培养、认证和考核.

Objective:To explore the effect of acknowledge, introduction, duration, explain and thank (AIDET) communication model on the awareness rate of health knowledge, self-perceived burden and quality of life of stroke patients in return visits.Methods:Using the convenient sampling method, a total of 300 stroke patients who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2019 were selected as the research objects. According to the odd and even order of admission, they were divided into the observation group and the control group, with 150 cases in each group. The control group was given regular communication mode intervention, while the observation group was given AIDET communication model intervention. Hamilton Anxiety Scale (HAMA) , Hamilton Depression Scale (HAMD) , awareness rate of health knowledge, Self-Perceived Burden Scale (SPBS) score, the MOS Item Short From Health Survey (SF-36) score and nursing satisfaction were compared between two groups.Results:After intervention, HAMA and HAMD scores in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . After the intervention, the awareness rate of health knowledge in the observation group was 96.67% (145/150) , which was higher than 83.33% (125/150) in the control group, and the difference was statistically significant ( P<0.05) . After the intervention, the total score of SPBS of the observation group was lower than that of the control group, and the difference was statistically significant ( P<0.05) . There was no statistically significant difference in the economic burden between the two groups ( P>0.05) . After the intervention, the SF-36 score in all dimensions and nursing satisfaction of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:AIDET communication mode can reduce the negative emotion and self-feeling burden of stroke patients in return visits and improve their awareness rate of health knowledge and nursing satisfaction.

目的:探讨胃肠道恶性肿瘤病人术后胃管拔除的合理指证.方法:回顾性分析2017年9月—2018年10月行胃肠道手术的329例病人的临床资料,根据不同胃管拔除时机分为4组,A组(n=86)常规拔除,B组(n=79)、C组(n=83)和D组(n=81)分别于胃液残余量50 mL、100 mL和200 mL时拔除胃管.比较4组病人首次排气和排便时间、住院时间、二次置入胃管情况及并发症发生率.结果:4组病人术后首次排气时间、排便时间比较差异无统计学意义(P>0.05);4组病人术后并发症(肺部感染、切口感染、吻合口瘘)发生率比较差异无统计学意义(P>0.05);C组和D组病人二次置管率均低于A组,差异有统计学意义(P<0.05).结论:以当日胃液引流液≤100 mL作为胃肠道恶性肿瘤病人术后胃管拔除指证,能够在避免病人术后腹胀发生及再次留置胃管的前提下尽可能缩短术后留置胃管时间.

目的:探讨内镜经黏膜下隧道肿瘤切除术(STER)和胸腔镜下切除术在直径2.0～5.0 cm食管固有肌层肿瘤治疗中的临床价值.方法:对2016年6月至2020年6月在郑州大学第一附属医院行STER(n=57,STER组)或胸腔镜下切除(n=40,胸腔镜组)的97例食管固有肌层肿瘤病例资料进行回顾性研究,对比分析两组手术成功切除率和肿瘤完全切除率、手术时间、并发症、术后住院时间以及复发情况.结果:两种术式肿瘤成功切除率均为100％.对于直径2.0～3.5 cm瘤体,两组完全切除率相近[82.9％(34/41)vs 86.4％(19/22),P>0.999],但STER组平均手术时间、术后住院时间短于胸腔镜组[(55.37±15.91)min vs(90.64±28.21)min,6.0(5.0,7.0)d vs 7.0(5.8,10.0)d,P均<0.05].对于直径>3.5～5.0 cm瘤体,胸腔镜组完全切除率高于STER组[83.3％(15/18)vs 43.8％(7/16),P=0.030];胸腔镜组术后发热发生率高于STER组[61.1％(11/18)vs 18.8％(3/16),P=0.017].不论肿瘤大小,STER组住院费用、术后胸痛和胸腔积液发生率均低于胸腔镜组.随访1～36个月,两组均无肿瘤残留及复发.结论:对于直径2.0～3.5 cm肿瘤,STER更加安全和高效;对于直径>3.5～5.0 cm肿瘤,胸腔镜手术在完全切除方面优势突出.

Objective:To compare the clinical efficacy of anti-reflux mucosectomy (ARMS) and endoscopic cardial constriction ligation (ECCL) on treatment of gastroesophageal reflux disease.Methods:A retrospective study was conducted on the data of 48 consecutive patients with gastroesophageal reflux disease, who underwent ARMS or ECCL at the First Affiliated Hospital of Zhengzhou University from December 2015 to August 2018. Twenty cases were in the ARMS group and 28 cases in the ECCL group. The short-term and long-term efficacies were compared between the two groups.Results:The success rate of operation was 100.0% in the both groups. The operation time of the ECCL group was significantly shorter than that of the ARMS group (8.43±1.59 min VS 34.05±12.35 min, t=-9.227, P<0.001). After 2 months follow-up, the symptom improvement rate of the ECCL group and the ARMS group was 89.3% (25/28) and 60.0% (12/20), respectively ( χ2=4.128, P=0.042). The GERD Q score of the ECCL group was significantly lower than that of the ARMS group (6.24 ±1.22 VS 7.35±1.79, t=-2.400, P=0.023). One year after operation, there were no significant differences in the symptom improvement rate, GERD Q score, DeMeester score and the time percentage of pH<4 between the two groups ( P>0.05). Conclusion:The long-term clinical effect of ARMS and ECCL is similar, but the short-term clinical effect of ECCL is superior to ARMS.

目的 探讨怀旧干预对老年糖尿病合并抑郁患者的临床疗效.方法 选择2017年4月～2020年4月我院收治的128例老年糖尿病合并抑郁患者作为研究对象,按随机数字表法均分为对照组和研究组,每组各64例.两组患者均给予降糖与抗抑郁治疗.对照组患者给予常规护理,研究组患者给予怀旧干预.观察比较两组患者干预前后的汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数(PSQI)、健康调查简表(SF-36)评分及临床疗效.结果 干预后,研究组患者的HAMA、HAMD评分和PSQI评分明显高于对照组(P＜0.05),SF-36评分明显高于对照组(P＜0.05).研究组患者的总有效率(93.75％)明显高于对照组的总有效率(81.25％)(P＜0.05).结论 怀旧干预可明显降低老年糖尿病合并抑郁患者的焦虑、抑郁情绪,改善其睡眠及生活质量,疗效显著,值得临床推广应用.

目的:探讨采用不同经口内镜下肌切开术(peroral endoscopic myotomy，POEM)术式治疗贲门失弛缓症的优劣。方法:回顾性分析2015年1月至2018年9月于郑州大学第一附属医院消化内科行POEM治疗并定期随访的223例贲门失弛缓症患者的病例资料，其中采用传统POEM治疗100例，Liu-POEM治疗60例，简化POEM治疗60例，O-POEM治疗3例，对比这4种术式的手术前后症状评分(Eckardt评分)、手术时间、并发症及复发情况。结果:这4种POEM手术成功率均为100%，且术后1个月、6个月、12个月时Eckardt评分均≤3分，均较术前显著降低，差异有统计学意义( P<0.05)。传统POEM、Liu-POEM和简化POEM组间比较差异无统计学意义( P>0.05)。与传统POEM相比，Liu-POEM和简化POEM手术时间和皮下气肿的发生率显著降低，差异有统计学意义( P<0.05)。O-POEM手术时间最短，无皮下气肿。所有患者术后无复发。 结论:这4种POEM治疗贲门失弛缓症均具有较好疗效，Liu-POEM和简化POEM相比传统POEM具有操作较简单、手术时间较短、并发症发生率较低的优点。对于既往有外科手术史、反复球囊扩张、POEM术后复发等黏膜下粘连而无法建立黏膜下隧道的患者，可考虑O-POEM作为补救治疗。

Objective:To explore and analyze the application effects of multi-site Mini-clinical Evaluation Exercise (Mini-CEX) method in teaching of orthopedic nursing interns.Methods:From September 2019 to December 2019, a total of 97 nursing students who took an internship in 4 Orthopedic Wards of the First Affiliated Hospital of Zhengzhou University were selected as research objects. Among them, 45 nursing students who took an internship in the First Ward and the Second Ward of Orthopedics were set as the control group and other 52 nursing students who took an internship in the Third Ward and the Sixth Ward of Orthopedics were set as the observation group. The control group was given routine nursing instruction, while the observation group was given multi-site Mini-CEX method on the basis of the control group. Scores of all dimensions of Mini-CEX and scores of departmental rotation examination after the completion of teaching and the scores of teaching efficacy of teachers before and after the implementation of multi-site Mini-CEX method were compared between the two groups.Results:Scores of all dimensions and the total score of Mini-CEX of nursing interns in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of theoretical assessment and practical operation of departmental rotation examination of nursing students in the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . After the implementation of multi-site Mini-CEX teaching program, the general teacher efficacy, personal teaching efficacy and total scores of nursing teachers were higher than those before the implementation, and the differences were statistically significant ( P<0.05) . Conclusions:Application of multi-site Mini-CEX method in surgical nursing practice teaching can improve clinical skills, comprehensive ability and learning interest of nursing students, and also help to improve the teaching efficacy of teachers, which is worthy of promotion and application.

目的 探讨复方聚乙二醇电解质散联合清胰汤用于肠镜检查前肠道准备的效果及耐受性.方法 将109例欲行结肠镜检查的住院患者按随机数字法分为联合组(55例)和单药组(54例),联合组服用复方聚乙二醇电解质散(2 L液体)联合清胰汤,单药组服用复方聚乙二醇电解质散(4 L液体),比较两组的清肠效果及不良反应发生状况.结果 两组患者肠道准备效果、肠道准备时间及排便次数比较差异无统计学意义(P>0.05),联合组恶心、呕吐、腹胀、腹痛发生率显著低于单药组(P<0.05或0.01).结论 复方聚乙二醇电解质散联合清胰汤用于肠道准备清肠效果显著,患者耐受性好.

目的 调查肿瘤科护士对经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)血栓防治知识的掌握情况,分析其影响因素,以期为肿瘤科护士的PICC培训提供参考.方法 于2018年2月-10月应用PICC相关血栓防治知识掌握状况问卷调查河南省7所三级甲等综合医院和3所三级甲等肿瘤专科医院的肿瘤科护士.结果 肿瘤科护士对PICC血栓防治知识掌握程度均分为(57.45±17.00)分;参与护理教学和参加过相关培训是影响护士对PICC血栓防治知识掌握程度的主要因素,可解释知识掌握情况29.4％的变异度.结论 肿瘤科护士对PICC血栓防治知识的掌握处于中等水平,有待进一步提高.鼓励护士参与临床教学,以及加强PICC专业培训是提升肿瘤科护士对PICC血栓防治知识掌握的重要因素.

目的:探讨目标管理在心胸外科患者术中压力性损伤预防中的应用.方法:采用方便抽样法选取心胸外科收治的140例患者,将2016年6月～2017年6月70例患者作为对照组,采用预防压力性损伤常规护理措施;将2017年7月～2018年6月70例患者作为观察组,应用目标管理法预防压力性损伤.比较两组患者护理效果.结果:观察组患者压力性损伤发生率、压力性损伤高危患者发生率低于对照组(P<0.05),且观察组压力性损伤分期主要为Ⅰ～Ⅱ期,对照组主要为Ⅲ～Ⅳ期;观察组Braden压力性损伤评分高于对照组(P<0.05),而压力性损伤预警反应时间短于对照组(P<0.05),观察组患者治疗满意度评分高于对照组(P<0.05).结论:目标管理能有效预防心胸外科患者压力性损伤发生风险,降低患者压力性损伤发生率,确保患者安全,提高患者治疗满意度.