目的 探究并分析北京市某3家三级甲等医院骨科护理人员科研能力现状与影响因素.方法 选取2017年6月至2019年6月北京市某3家三级甲等医院工作的骨科护理人员(包括规培及进修人员)752例,收集护理人员一般资料(包括用工性质、年龄、工龄、学历、阅读期刊、撰写论文、参加科研培训、参加科研活动情况等),并调查护理人员科研相关活动(撰写论文、发表论文、申报课题、参加科研培训、参加学术会议、参加科研活动)、科研能力评分.对护理人员科研能力的影响因素做单因素及多因素Logistic回归分析.结果 相关科研活动中,参加学术会议及撰写论文的护理人员分别为94.81％及17.55％,而发表论文及参加科研培训等人员显著占比较少,仅为13.56％及12.37％,申报课题及参加科研究活动的护理人员比例分别为3.46％及4.92％.本地区骨科护理人员科研能力总体处于中等水平,其中问题发现、文献检索、论文写作能力处于中级水平,而科研实践、资料处理、科研设计能力处于低级水平.不同学历、阅读期刊情况、撰写论文情况、参加科研培训频率、参加科研活动频率护理人员科研能力比较差异有统计学意义(P<0.05);学历、阅读期刊情况、撰写论文情况、参加科研培训频率、参加科研活动频率与骨科护理人员科研能力有相关性(P<0.05).结论 提高骨科护理人员学历,鼓励阅读期刊及撰写论文情况,定期举办科研培训班及科研活动能有效改善骨科护理人员科研能力,值得临床关注.

目的:了解学龄前儿童家长对口腔保健的认知、态度及行为,可以进一步分析学龄前儿童口腔健康现状并有效控制和预防学龄前儿童的口腔疾病.方法:采取便利抽样法,选取北京市通州区某幼儿园106名儿童家长,以调查问卷进行资料收集.结果:学龄前儿童家长在口腔保健知识方面了解不足:了解巴氏刷牙法刷牙的家长有8.5％;认为孩子刷牙时间应为3～5分钟的家长有28.3％;认为儿童在需要时应用牙线的家长有27.4％.在态度行为方面家长的正面引导较少:从孩子长第一颗牙开始刷牙的有31.1％;会定期带孩子去医院检查牙齿的家长有19.8％;做过涂氟防龋治疗的儿童有36.8％;做过窝沟封闭的儿童有24.5％;学龄前儿童患龋率68.9％.结论:学龄前儿童家长对儿童口腔保健知识了解有限,与家长学历有一定关系.学龄前儿童口腔日常保健行为不足,与家长对孩子的关注程度和家长对口腔卫生的重视程度有密切关系.

目的:探讨在老年患者心电监护拔牙术前开展静脉留置针穿刺安全性.方法:选择2017年1月至2019年2月在我科接受心电监护拔牙治疗的老年患者222例.按是否给予心电监护拔牙术前静脉留置针穿刺将研究对象分为实验组和对照组,比较两组患者在术中、术后血压及心率及变化情况.结果:在两组各阶段差值变化方面,与对照组相比,实验组在拔牙手术中与穿刺前的舒张压差值、拔牙手术后与拔牙手术中的收缩压和舒张压差值方面,差异无统计学意义(P>0.05).结论:在规范操作的前提下,口腔科护理人员与患者进行良好沟通后,在拔牙前开展静脉留置针穿刺,对于保障医疗护理质量安全、赢得突发状况抢救时间具有积极意义.

目的 观察通腑法对胸腰椎压缩性骨折患者围手术期并发症和切口愈合的影响.方法 选取2012-06-2014-12手术治疗的腰椎压缩性骨折患者52例,均有便秘、腰背疼痛以及腹胀症状.将52例患者随机分为治疗组和对照组各26例,对照组采用非甾体类抗炎药止痛,按摩腹部以及饮食规范化等常规方法;治疗组在此基础上根据通腑法自拟加味桃仁承气汤治疗.结果①服药6 d后,两组便秘症状均有改善,治疗组总有效率为92.3％,显著高于对照组的57.7％,且治疗组恢复排便时间显著短于对照组(P<0.05).②腹胀:治疗组优良率为76.9％,显著高于对照组的30.7％,组间差异有统计学意义(P<0.05).③切口愈合:治疗组切口有92.8％的甲级愈合率,7.2％的乙级愈合率,与对照组的95.6％、4.8％相比,差异无统计学意义(P>0.05).结论 采用通腑法自拟加味桃仁口服治疗,可显著改善胸腰椎压缩性骨折患者围手术期便秘和腹胀症状,对切口愈合无不良影响.

目的 探讨影响急性牙髓炎患者牙科恐惧症的影响因素及防护措施.方法 选取2018年2月至2019年2月我院收治的98例急性牙髓炎患者为研究对象,其中15例出现不良心理的患者作为发生组,83例未出现不良心理的患者作为未发生组,比较两组性别、年龄、文化程度、居民来源、直接牙科经历、间接牙科经历、疼痛耐受度,心理紧张度和最恐惧治疗环节,确定影响急性牙髓炎患者的心理特征的单因素.采用lo-gistic回归分析确定影响急性牙髓炎患者牙科恐惧症的因素.结果 间接牙科经历、疼痛的耐受度及最恐惧治疗环节是影响急性牙髓炎患者牙科恐惧症的影响因素(P<0.05).多因素logistic回归分析显示,痛苦的间接牙科经历和疼痛耐受度差以及时拔牙的恐惧是急性牙髓炎患者牙科恐惧症的影响因素(P<0.05).结论 痛苦的间接牙科经历、疼痛的耐受度差及最恐惧的治疗环节是拔牙为影响急性牙髓炎患者牙科恐惧症的独立危险因素,护理人员应强化相应的护理措施,减少其不良心理,促进预后康复.

目的:探究并分析整体护理干预对复发性口腔溃疡临床疗效的影响.方法:选取2016年10月～2017年6月我科收治的复发性口腔溃疡患者74例,将其作为临床研究对象.随机分为实验组和对照组各37例.实验组采取整体护理干预结合口腔护理的方式;对照组单纯采用口腔护理.观察两组患者的疗效.结果:实验组和对照组的治疗总有效率分别为94.59％和72.97％,两组间比较差异具有统计学意义(P<0.05);实验组的并发症发生率明显低于对照组,P<0.05,具有统计学意义.结论:整体护理干预结合口腔护理对复发性口腔溃疡的疗效优于单纯口腔护理,值得在临床推广和应用.

Objective To analyze the effect of dental anxiety on tooth extractionin patients with cardiovascular disease,provide guidance for clinical work. Methods A total of 157 cases were selected from patients with cardiovascular disease who underwent tooth extraction by electrocardiograph monitoring in stomatology department. The Modified Dental Anxiety Scale (MDAS) and Wong-Baker Facial Scale was used to assess preoperative anxiety, pain degree of operation. The heart rate and blood pressure were recorded by biological measurements, and the length of operation was recorded.Whether or not could hemostasis after the operation.According to the MDAS scoring standard, patients who scored more than or equal to 13 points were classified as anxiety. Results The age of the patient was (74.73±8.98) years,the anxiety score was (9.95±3.35) points, there was a negative correlation between age of patients and anxiety score (r=-0.383, P<0.05). There was a positive correlation between anxiety score and the degree of pain in the patient, the length of the operation (r=0.340-0.445, P<0.05). Forty-nine cases of anxiety patients and 108 cases of non anxiety patients. The diastolic blood pressure after anesthesia for 5 minutes was (80.24± 8.10) mmHg(1 mmHg=0.133 kPa) in the patients with dental anxiety, the diastolic blood pressure afteranesthesia for 5 minutes was (77.04 ± 9.15) mmHg in the patients without dental anxiety,there were statistic differences in diastolic blood pressure after anesthesia for 5 minutes between the patients of two groups (t=2.11, P<0.05). The effective hemostasis rate of the patients with dental anxiety was 77.551％(38/49) and the patients without dental anxiety was 92.592％(100/108), there were statistical differences in hemostatic effect after the operation between the two groups of patients (χ2=7.169, P<0.05).Conclusions Medical staff can assess dental anxiety condition in patients with cardiovascular diseases who underwent tooth extraction and analysis its effecton surgery, implement targeted and personalized health education, eliminate the negative emotions of patients, reduce the incidence of anxiety, thereby reduce the adverse effects of anxiety on surgery, and guarantee safety during operation.

Objective To calculate effective dose based on the dose-area Product (DAP) measured in dental cone beam computed tomograhic (CBCT) scanning and using a conversion coefficient.Methods The method of the DAP was used to calculate the effective dose from KODAK 9500 dental CBCT scanner with fields of view (FOV) of 16 cm×15 cm and 12 cmu×8 cm.The DAP-values (mGy · cm2) were measured using a transmission ionization chamber connected to an electrometer (Doseguard 100,RTI Electronics AB,Sweden) and the chamber was placed directly on the exit of the X-ray tube.All measurements were repeated three times and averaged on each FOV data.The conversion coefficient of 0.080 μSv/mGy · cm2 was used to estimate the effective dose on the basis of DAP values,which was quoted from a literature.Results DAP values were found between the two FAOs to vary from 512 to 1 083 mGy · cm2,and the effective doses calculated with 0.080 μSv/mGy · cm2were 41 to 87 μSv.The effective doses given in this paper was lower than those reported in other literatures.Conclusions DAP measurement was found to be well defined and easy-to-use method of determining effective dose for some CBCT Units.However,determination of specific conversion coefficient in the CBCT must be further developed.

目的 分析四手操作配合心理护理对行根管治疗术患者术中疼痛及恐惧的影响.方法 选取2015年3月—2016年5月在该院需要进行根管治疗术患者82例,按抽签顺序分为两组,各41例.对照组实施四手操作等常规护理措施,不进行心理护理,研究组在对照组基础上采用心理护理,比较两组患者治疗前后视觉模拟评分法(VAS)评分、知识掌握度及护理满意度.结果 干预前,观察组VAS评分(7.34±1.23)分与对照组(7.46±1.14)分比较,差异无统计学意义(P>0.05);干预后两组患者VAS评分较干预前明显降低,差异有统计学意义(P<0.05);干预后,研究组VAS评分为(1.82±0.86)分,较对照组的(2.63±0.77)分明显降低,差异有统计学意义(P<0.05).观察组护理满意度(92.68%)明显高于对照组(63.41%),差异有统计学意义(P<0.05);观察组知识掌握度(97.56%)较对照组(73.17%)明显提高,差异有统计学意义(P<0.05).结论 对进行根管治疗术患者实施四手操作配合心理护理,可有效降低患者疼痛程度,改善或消除术中恐惧感.

目的:观察缠绕式牙线和带棒牙线作为辅助清洁方法对慢性牙周炎基础治疗后维护期患者的口腔卫生维护情况的观察.方法:将就诊牙周专业且依从性好的90例牙周炎患者,年龄45～55岁之间,男女不限,入选病人全身健康,无系统性疾病,牙列无缺失,随机分为三组:对照组30例,只刷牙不用牙线组;刷牙后使用缠绕式牙线组(组一)30例;刷牙后使用带棒式牙线组(组二)30例.然后分别用2％碱性品红5ml含漱1分钟后用清水漱口,然后检查着色的邻面菌斑面积,识别缠绕式牙线或带棒牙线的使用清洁度对牙周炎的辅助意义.结果:刷牙和使用两种形式的牙线相比较具有明显差异,有统计学意义;缠绕式牙线和带棒式牙线都能有效清除邻面菌斑,两者相比较无明显差异,无统计学意义.结论:两种牙线均有助于邻面菌斑清洁,有助于牙周炎的辅助治疗.

目的：在口腔特需门诊开展六手操作护理后，使患者感受到更加人性化的服务，使整个诊疗工作更具有连续性和完整性，充分做好消毒隔离工作有效预防医源性感染的发生。方法在常规四手操作的基础上再增设一名巡台护士，诊疗前负责接诊完善辅助检查，诊疗中负责处理外围辅助工作，诊疗后协助收费及费用告知、护理指导、电子病历及整理资料等工作[1]。结果在口腔特需门诊开展六手操作护理后，临床满意度调查显示医生对实行六手操作护理的满意度为91%，患者为97%，椅旁护士为100%。结论特需门诊实行六手操作比传统四手操作为患者提供更加优质和人性化的护理服务，提高患者对医务工作的满意度，使医生的诊疗工作更加快捷高效，有效预防医源性感染的发生。

Objective: To discuss the essential aspects of per operation period nursing intervention in tooth extraction under electrocardiogram monitoring for the elderly patients, so as to improve the success rate of surgery. Methods:According to the physiology and psychology characteristics of the elderly patients, psychological intervention and correct cooperation were provided by nurse along with the electrocardiogram monitoring during the whole process. Results:Seven hundred and nineteen cases of elderly patients went through a smooth operation of tooth extraction under electrocardiogram monitoring. Conclusion: It is highly important that we combine professional medical team with tacit cooperation, appropriate psychological intervention as well as good management system to succeed in tooth extraction under electrocardiogram monitoring.

In clinic of stomotology, the operation is performed in the patient?s mouth; therefore nosocomial infection is very easily to occur. In order to decrease the nosocomial infection, expounded in this article the main measures and relative factors for self-protect of the medical staffs major in stomatology in the period of infection disease epidemic and non-infection disease epidemic.

随着医学科技的发展,口腔临床科室已普遍使用高速牙钻.然而口腔科器械消毒问题日益突出.在口腔科器械中尤以口腔钻针的价格最昂贵又不耐腐蚀,而且直接进入口腔,接触口腔粘膜、牙体硬组织,所以,对它的消毒就有更高的要求.现在临床上钻针消毒大多采用浸泡方法,虽然能达到消毒目的,可由于牙钻的特殊构造,对那些钻针纹道内存在的微少蛋白固状物靠浸泡法无法彻底消除,仍存在感染的隐患.我们经多年临床试验及借签外国经验,总结出一套在临床较为适用的牙钻综合消毒方法,现介绍如下.

对3所小学7～8岁儿童766颗六龄齿作窝沟封闭术(实验组)与659颗未做窝沟封闭术的六龄齿(对照组),分别在3、6个月进行观察比较,结果实验组无人患龋,而对照组分别患龋100颗,141颗,经统计学处理,均P＜0.01,两组有非常显著性差异,实验组效果明显优于对照组,提示行窝沟封闭术有预防龋齿的效果.