目的 观察头孢哌酮钠舒巴坦钠联合美罗培南治疗危重症伴多重耐药革兰阴性菌感染患者的有效性及安全性.方法 回顾性选取2019年1月—2021年3月福建医科大学附属漳州市医院收治的危重症伴多重耐药革兰阴性菌感染患者58例,根据治疗方法不同分为对照组和观察组,各29例.对照组采用头孢哌酮钠舒巴坦钠治疗,观察组在对照组基础上增加注射用美罗培南.2组均治疗1～2周.比较2组临床疗效、细菌清除率,治疗前及治疗72 h、1周、2周后血清肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、降钙素原(PTC)、超敏C反应蛋白(hs-CRP)水平及白细胞计数(WBC)、中性粒细胞百分数(N％),不良反应发生情况.结果 观察组治疗总有效率为93.10％,高于对照组的72.41％(χ2=4.350,P=0.037).治疗后观察组细菌清除率为93.10％,高于对照组的72.41％(χ2=4.350,P=0.037).治疗72 h、1周、2周后,2组血清TNF-α、IL-6、PTC、hs-CRP水平及WBC、N％低于治疗前,且观察组低于对照组(P<0.05).观察组不良反应总发生率为6.90％,低于对照组的27.89％(χ2=4.350,P=0.037).结论 头孢哌酮钠舒巴坦钠联合美罗培南治疗危重症伴多重耐药革兰阴性菌感染患者的临床疗效确切,能够更有效地清除病原菌,减轻炎性反应,且安全性较高.

综述慢性心力衰竭病人再入院的影响因素,并分析未来研究趋势.以便在此基础上构建风险模型,筛选高危病人,并为高危病人制订综合的疾病管理计划以及治疗和随访方案,从而降低慢性心力衰竭病人的再住院率.

卵巢癌是女性生殖系统恶性肿瘤之一,发病率呈逐年上升趋势,致病因素中遗传和环境因素逐渐受到重视。大多数外源性致癌物进入人体之后经过两个阶段代谢[1],（1）经Ⅰ相代谢酶启动致癌过程;其典型代表是CYP450家族中的CYP1A1基因,而该基因中的MSPI多态性成为了主要的研究对象。

目的 探讨宫颈高级别上皮内病变(HSIL)的三阶梯诊断模式、个体化治疗方法及其临床意义.方法回顾性分析2800例进行宫颈癌筛查的患者,对三阶梯检查方法及个体化治疗进行临床分析.结果2800例患者中,通过三阶梯检查的方法联合检查出并确诊HSIL47例,经过个体化治疗,28例保留子宫的患者中,有生育的5例,未发生宫颈机能不全,2680例TCT、HPV均阴性的患者中,无宫颈上皮内病变及宫颈癌发生.结论三阶梯联合检查包括TCT、HPV,阴道镜,宫颈活检,对于及早发现及诊断HSIL,预防宫颈癌发生,具有重要价值,HSIL的个体化治疗具有重要临床意义.

OBJECTIVE To explore the related factors for Salmonella typhi infection during the pregnancy and put forward corresponding nursing countermeasures so as to reduce the incidence of S .typhi infection during the preg-nancy .METHODS A total of 21 pregnant women complicated with S .typhi infection ,who were treated in the hos-pital from Jan 2010 to Sep 2013 ,were assigned as the group A ,22 female patients with S .typhi infection were set as the group B ,meanwhile ,30 pregnant women with normal pregnancy were assigned as the control group ;the related factors for the infection were analyzed ;the erythrocyte sedimentation rate ,blood routines ,liver function , and electrolytes indicators were respectively determined .RESULTS The constituent ratios of the participants who lived in rural area ,with poor nutrition status ,low immunity ,and complications were significantly higher in the group A and group B than in the control group(P<0 .05) .The incidence of reduction in the biochemical indicators such as the albumin ,prealbumin ,and total albumin was significantly higher in the group A than in the group B and the control group;the incidence of the elevated liver function indicators was significantly higher in the group A than in the group B and the control group ;the incidence of decrease in the white blood cell counts and eosinophils counts was higher in the group A than in the group B and the control group ;the incidence of decrease of electro-lytes or the increase of erythrocyte sedimentation rate was higher in the group A than in the group B and the con-trol group ,and there were significant between-group differences (P<0 .05) .All the pregnant in the group A re-lived from fever within 2-5 days ,with average time of fever (3 .4 ± 1 .6)days;the blood routines and electrolytes returned to normal within two weeks ;the liver function indicators recovered within 4 weeks .Totally 19 pregnant women delivered after full term of pregnancy ,2 pregnant women volunteered to terminate the pregnancy ,and there was no case of neonatal asphyxia or fetal abnormalities .CONCLUSION The pregnant women with poor nutri-tion status ,low immunity ,or poor health status tend to be infected with S .typhi ,with the symptoms more severe than those without pregnancy ;the pregnant women with S .typhi infection are usually complicated with liver func-tion damage .It is necessary to take targeted nursing measures so as to minimize the damage and ensure the safety of the mother and infant .

新型的医护关系的构建是现代医疗行业必须面对的迫切问题，医护关系是医疗人际关系的重要组成部分。在医疗事业快速发展的时代，要求医护人员要高的协调配合、高度理解和尊重。在整个医疗过程中，医护人员要做好各自的角色定位，遵守医院的医护规章制度，保证医护质量，减少医疗纠纷，共同建立一个良好的医疗环境。

目的：对人性化护理进行探讨。方法从人性化护理的内涵、必要性以及实现三个方面进行分析。结果人性化护理的开展是各级医院迫切解决的问题。结论人性化护理的实施，真正把“以人为本”的护理理念推向快速发展的轨道。

产后抑郁症是产妇产后的情绪障碍,严重可影响母婴的身心健康及家庭幸福。因此,我们应针对产妇的妊娠及分娩心理给予产妇最大的安慰及最优的护理,使产妇心理感受到来自家庭及社会的温暖,以健康的心态分娩及哺育婴儿。

目的:研究地塞米松预防肿瘤病人PICC置管后血栓的作用.方法:113例留置PICC的肿瘤病人分为2组,观察组采用常规护理的基础上,置管后使用地塞米松磷酸钠注射液5毫克连续3天静脉输入;对照组采用常规护理,未采用地塞米松.两组病人置管后均采用超声监测PICC血管,观察是否有血栓形成,比较血栓发生率的差异.结果:观察组的血栓发生率低于对照组(P＜0.05).结论:肿瘤病人置管后连续3天使用地塞米松可降低PICC置管后血栓的发生率.

OBJECTIVE To further understand the current status of nosocomial infection management and the existing problems in secondary grass-roots hospitals,and to propose improved measures by combining practice.METHODS By the means of supervision and check,the common problems checked out were analyzed to propose corresponding improved measures.RESULTS The nosocomial infection management should be supported by the hospital leadership,and the infection control personnel should give full play to this cause,strictly obey the laws,rules and principles,everyone involved to ensure the smooth operation of nosocomial infection management.CONCLUSION The professional infection control personnel should continuously study and summarize the knowledge about nosocomial infection to find the problems,take effective measures in time,ensure the medical safety and improve the quality of medical service.

目的:探讨护理干预对下肢静脉血栓形成的影响。方法:选取传统护理方法护理的1 046例患者作为对照组,系统护理干预措施护理的1 183例患者作为观察组,观察两组下肢静脉血栓的发生率及平均住院天数。结果:观察组患者的下肢静脉血栓发生率及平均住院天数明显低于对照组。结论:针对下肢静脉血栓高危因素制定的护理干预措施可以明显降低下肢静脉血栓的发生率并缩短住院天数。

目的:探讨PICC置管后期异位的原因及预防方法。方法:对165例患者PICC置管期间发生导管异位原因进行分析和预防。结果:165例PICC置管期间发生导管异位4例,发生率2.42%,其原因与胸腔压力升高、上腔静脉受压有关。结论:针对PICC导管异位的成因提出三级预防措施降低异位发生率,提高对导管异位的鉴别能力。

腹腔镜手术具有切口小、不开腹、术后疼痛轻、恢复快及住院时间短、腹部不留蚯蚓状瘢痕等优点,较易被医生和患者接受.为探讨妇科腹腔镜手术的护理方法,对在我院接受妇科腹腔镜手术治疗的100例患者的护理进行回顾总结,现报告如下.

静脉输液过程中会遇到茂菲式壶下输液管中进入大量气泡甚至空气柱,传统的排气法如振动管壁气泡向上排气法适合输液管中气泡量少,而排液排气法适用于气泡量大,但浪费药液,不适用于输液量小的药液.通过多年的临床观察和实践,作者总结出3种比较简单、更为有效、更为科学的排气法.现介绍如下.

孕卵在子宫体以外着床发育,称为异位妊娠,习惯称宫外孕.以输卵管妊娠为多见.宫外孕破裂是妇产科常见的急腹症之一,如果诊断及抢救不及时,常因失血过多导致失血性休克,严重者危及生命.我院从1999年12月到2003年12月共收治宫外孕患者123例,经急诊手术治疗者89例,其中重症者28例,现将重症者抢救及护理体会报告如下: