Objective:To investigate the clinical characteristics and bacterial distribution of bloodstream infection in the pediatric patients of our hospital,providing references for the clinical study.Method:Totally of 2531 cases of pediatric admitted to our hospital from January 2013 to December 2014 were selected and retrospective analyzed,in which 58 cases were bloodstream infected and the incidence rate,infection site,pathogen distribution and antimicrobial susceptibility results were analysed.Result:The most of infected pediatric patients were acute lymphoblastic leukemia(ALL) children,which were accounted for 77.59%,the top 5 sites of primary infection were pulmonary,upper respiratory,oral mucosa,intestinal and perianal infection,and the proportion of these infection were 18.97%,13.79%,12.07%,10.34% and 6.90% respectively.Gram positive bacteria was accounted for 53.45%(31 strains),in which Staphylococcus epidermidis was the main pathogenic bacteria(18.97%),followed by Staphylococcus haemolyticus(10.34%);Gram negative bacteria was accounted for 43.10%(25 strains),in which Klebsiella pneumoniae accounted for 13.79%(8 strains),Escherichia coli accounted for 12.07%(7 strains).The absolute value of the peripheral blood in most children patient were <1.0×109/L,52 cases(89.66%) of which were <0.5×109/L.Gram positive bacteria were sensitive to Vancomycin,while partly susceptible to Ampicillin and Penicillin G;Gram negative bacteria were susceptible to Imipenem,while highly resistant to Ampicillin and the third generation Cephalosporins;Escherichia coli was resistant to Penicillin-G,and the drug of first choice was Imipenem.49 children with bloodstream infection were cured,the cure rate was 84.48%.Conclusion:The pathogenic bacteria of nosocomial bloodstream infection in children are conditional pathogenic bacteria in most,and Gram positive bacteria gradually become the main strains of nosocomial infection,the intervention strategy and antibiotic application should be formulated to prevent and control the hospital-acquired bloodstream infection in pediatric patients.

Objective:To know about the sleep quality of cancer patients undergoing chemotherapy and its related influencing factors,so as to provide a scientific evidences for improving their sleep quality.Methods:Cancer patients undergoing chemotherapy were inquired with questionnaires by using Pittsburgh Sleep Quality Index(PSQI)and self-made affecting sleep factors questionnaire.Results:The total PSQI score of cancer patients undergoing chemotherapy was 8.17±3.45,55 cases of patients with PSQI score>7 accounted for 51.40%.The scores of subjective sleep quality,time of falling asleep,sleep efficiency,sleep disturbances,hypnotic drug usage and total PSQI score were higher than that of national norm score in normal adults,there were statistically significant differences(P<0.05).The age,worry and fear on disease,chemotherapy side effects,ambient noise and economic burden of chemotherapy patients were related to their sleep quality.Conclusion:The sleep quality of cancer patients undergoing chemotherapy was poorer than that of normal people.The influencing factors of the sleep quality are many,and that should be pay sufficient attention to.A number of measures should pertinently be adopted to improve the sleep quality of cancer patients undergoing chemotherapy.

Objective To study the relationship between the methylation of RASSF1A promoter and the TNM stage of non-small cell lung cancer(NSCLC).Methods The literature on the methylation of RASSF1A promoter in the tissue of NSCLC were collected and the recepted and rejected criteria were established strictly.These articles were evaluated by Review Manager 5.0 and the combined OR between methylation of RASSF1A and TNM stages was got.Results A total of 5 articles were accepted,the different analysis betweenⅠstage andⅡ-Ⅳstages of NSCLC showed that the combined OR was 1.24(0.90-1.72),and Z=1.30,P=0.47 when CI was 95%.It indicated that the methvlation of RASSF1A promoter occured in different stage and the rate of methylation had not significance difference between early and mid-late NSCLC tissues(P>0.05).Conclusions The methylation of RASSF1A promoter was a molecular event during the development of NSCLC and there was not distinct correlation between methylation of RASSF1A promoter and the TNM stages of NSCLC and the methylation can be a candidature of early molecular diagnosis of NSCLC.

目的 探讨CHOP方案治疗非霍奇金淋巴瘤(NHL)患者的护理.方法 自2006年3月至2009年12月共护理NHL病人36例,均采用CHOP方案化疗,主要观察药物副作用及化疗不良反应的预防与治疗.结果 5例死亡,3例因经济困难放弃治疗,余患者处于完全或部分缓解期.结论 严密全面的护理可提高治疗效果,促进患者康复,减少并发症的发生,提高生存质量。

目的:探讨甲状腺切除术后并发症的预防和护理。方法:回顾性分析700例甲状腺切除术后患者的临床资料,探讨术后并发症的发生原因和预防及护理措施。结果:700例病人全部康复出院,疗效满意。结论:针对甲状腺术后并发症的原因,早期预防及采取相应的护理对策是病人康复的保障。

目的:探讨双水平气道正压通气(BIPAP)呼吸机治疗慢性阻塞性肺疾病(COPD)早期呼吸衰竭患者的疗效及护理。方法:在常规治疗的基础上采用BIPAP呼吸机治疗COPD早期呼吸衰竭患者60例,观察患者治疗前后动脉血气分析的变化。结果:COPD早期呼吸衰竭患者经BIPAP治疗后PaO2、pH值升高,PaCO2降低,临床症状缓解。结论:双水平气道正压通气治疗COPD早期呼吸衰竭患者取得满意的临床疗效,正确的护理有助于提高治疗效果。

目的:探讨在三维标测系统CARTO指导下射频消融治疗室性早搏(室早)的护理方法。方法:观察26例行射频消融治疗室早患者的配合及护理。术中做好各项准备工作、打印室早参考图、加强心理护理及病情观察、及时追加肝素等。结果:本组成功治疗26例,术中无并发症发生。结论:CARTO指导下行室早射频消融是一种安全、高效的方法,减少放射线透视量,术中配合恰当、护理精细、及时,是取得手术成功的重要保障。

目的:探讨腔镜甲状腺部份切除术的临床效果及护理。方法:回顾性分析我科行腔镜下甲状腺手术30例的护理方法。结果:病人均痊愈出院。结论:腔镜甲状腺手术达到了传统开放甲状腺手术的临床效果,而且腔镜手术具有切口隐蔽、美容效果好的特点,正确到位的护理,是该手术得以顺利开展的必要支持和重要保证。

目的:探讨在职夜大护士压力源及压力程度,同时探讨其应对措施,帮助医院管理层和护士正确认识并设法减轻学习及工作压力,正确处理好学习、工作与家庭关系,从而提高护理质量及维护护士的身心健康。方法:采用问卷调查法,对在职夜大护士压力进行调查分析。结果在职夜大护士处于中、重度压力水平状态,而暂时未接受再教育的护士处于轻、中度压力状态,两者相比较,在职夜大护士压力要明显大于暂时未接受再教育的。排序前5位的压力源为:超负荷的工作状态、学习压力、对护理高水准要求、更新专业知识的需求、护患冲突。结论:从护理教育部门、医院管理层、护士自身3方面共同努力,减轻护士工作压力。

Objective:To explore the clinical nursing experiences of percutaneous endoscopic gastrostomy(PEG).Methods:To retrospectively analyze the clinical data of 36 patients with PEG.Results:All patients got successful PEG operation.After PEG,all the patients got enteral nutrition and had better nutritional state.3 patients had local infection of incisional wound and the infection was cured after carefully change dressings.1 patient had a fracture of the PEG tube, and the treatment was continued after we transferred the PEG tube.After 6 months to 24 months follow-up,all the patients were in good states without any complications such as blockage,aspiration or peritonitis.Conclusion:PEG is a simple, little wound and little complication operation.It is a safe and effective way for enteral nutrition.The sufficient preparation and mental nursing before the operation, the complete nursing after the operation are the key to the successful operation.

Objective:To discuss the clinical application measurement of high-frequent snare electric excision via bronchoscopy for benign tumors and its nursing care.Methods:In 17 cases with bronchus tumors diagnosed by bronchoscopy pathology,efficacy and nursing were observed after the treatment of high-frequent snare electric excision via bronchoscopy.Results:In 17 cases with benign tumors, the symptoms were relieved after treatment for 1～4 times.Neoplasm in bronchoscopy completely dropped.After 0.5～2 years follow-up no recurrence happened.Conclusion:The therapy of high-frequent snare electric excision is effective.The adequate pre-operative preparation and skilled cooperation with careful postoperative care are the keys to improve the treatment success rate and to reduce complications.

目的:探讨康惠尔透明贴在深静脉置管口护理中的应用.方法:将110例深静脉置管的病人随机分成两组,实验组采用康惠尔透明贴保护深静脉置管口,并进行连续观察,对照组采用常规护理方法(采用3M灭菌透明膜保护),两组进行比较.结果:采用康惠尔透明贴病人的皮肤水泡、发红、红肿、置管口皮肤増生、深静脉导管相关发病率等明显低于采用常规护理方法的病人.结论:康惠尔透明贴在深静脉置管口护理中的作用明显优于3M透明膜,且经济实惠,可减少更换敷料次数,从而减轻护理工作量.

目的:探讨腔隙性脑梗死急性期的治疗和护理。方法:对我院腔隙性脑梗死急性期患者48例给予卧床休息、控制血压、脱水、利尿、抗凝等对症治疗,加强心理护理、生活护理、病情监测及预防并发症等。结果:患者均痊愈出院。结论:及时的治疗与全面的护理大大提高了治疗效果,降低并发症及后遗症的发生。

目的:探讨急性胰腺炎的护理方法。方法:护理急性胰腺炎病人30例,其中2例因胆管梗阻需手术治疗,余28例均采用非手术治疗,给予禁食、胃肠减压、静脉营养、抑制胃酸分泌、生长抑素使用、抗感染等对症治疗;护理上给予心理护理、病情监测、生活护理等。结果:病人均痊愈出院,并缩短了平均住院日。结论:正确到位的护理对急性胰腺炎的治疗有很大的帮助。

目的分析慢性阻塞性肺病伴呼吸衰竭患者行机械通气治疗产生呼吸机依赖的原因,以及相应的护理对策。方法对中山大学附属第二医院呼吸内科6年来行机械通气治疗的患者34例进行回顾分析。结果在34例患者中,其中16例产生了呼吸机依赖。病人的心理因素、呼吸肌功能不全、营养不良、感染、撤机时机选择不当是产生呼吸机依赖的主要原因。结论做好心理护理,改善营养状态,加强呼吸肌训练,预防控制感染,做好撤机前及撤机过程护理,把握适宜撤机时间,是防治呼吸机依赖的关键。

良好的服务态度及行为是实施整体护理、提高护理质量、为病人提供最佳服务的关键.然而在实施整体护理的过程中,许多时候过多重视护理程序形式和技术的完美,却很少关注护士在完成这些工作时,是以怎样的态度去对待病人,病人的实际感受等.因此如何改善护士的服务态度,使整体护理的实施落到实处,提高医院的社会效益和经济效益,是当前每一位护理管理者值得深思的问题.