Objective To explore the application value of multi-slice spiral CT angiography in the diagnosis of pulmonary se-questration. Methods We collected 9 cases of pulmonary sequestration confirmed by surgery and pathology and retrospectively analyzed. All were examined by 64 slice spiral GE scanner,CT. First CT plain scan,and then double phase enhanced scan,the image will be transferred to the workstation,MPR,MIP,SSD and VR reconstruction. Results 9 cases of pulmonary sequestra-tion were located in the posterior basal segment of lower lobe,Of which 7 cases were located in the left lower lung,2 cases were located in the right lower lung. Abnormal blood supply artery in 8 cases was from thoracic aorta,1 case was from celiac trunk. CT scan was mainly manifested as pulmonary cyst,nodule or mass. Enhancement of blood vessel shadow in the lesion area was en-hanced,and a strip or nodular enhancement can also be seen. CT angiography showed that the lesion was supplied by the abnor-mal body artery. MPR and MIP can be used to show the overall shape of the feeding artery and the lesion of the lung parenchyma. SSD and VR can show the origin and stroke of the feeding artery and the venous drainage. Conclusion Enhanced multislice spi-ral CT and 3D reconstruction can clearly display the pulmonary lesions and abnormal blood supply and drainage vessels,which is the diagnosis of pulmonary sequestration the best noninvasive inspection method.

目的:探讨预防性护理干预措施对腰椎间盘突出症病人胶原酶溶解术后下肢深静脉血栓形成(deep venous thrombosis, DVT) 的影响.方法:将120例腰椎间盘突出症胶原酶溶解术后病人随机分成两组,每组60例,A组为对照组(一般护理组),于胶原酶溶解术后给予常规护理;B组为观察组(预防性护理干预组),于胶原酶溶解术后给予常规护理加预防性护理干预措施.比较A、B两组病人DVT发生率和血浆D-二聚体水平.结果:B组病人DVT发生率和D-二聚体水平均低于A组,且二者具有统计学差异(P < 0.05).结论:预防性护理干预措施有助于减少腰椎间盘突出症病人胶原酶溶解术后DVT的发生.

Objective To observe the effects of linear polarized near infrared light irradiation (Superlizer, SL) in the treatment of patients with pressure ulcer of stage Ⅱ, and explore the proper treatment parameters.Methods Fifty patients with pressure ulcer of stage Ⅱ according to National Pressure Ulcer Advisory Panel (NPUAP) were randomly divided into 70％ power group and 100％ power group, 25 cases in each group.The cure rate, effective rate and average wound healing time were observed in the two groups.Results The effective rate and cure rate were 78.4％ (29/37 wound numbers) and 51.4％ (19/37 wound numbers) respectively in 70％ power group, which were obviously lower than 92.5％ (37/40 wound numbers) and 65.0％ (26/40 wound numbers) in 100％ power group.The average healing time (17.5±2.2) d in 70％ power group was significantly longer than that of 100％ power group (14.9±2.3) d.Conclusion The effects of linear polarized near infrared light irradiation with B probe 100％ power are better than 70％ power in the treatment of pressure ulcer of stageⅡ, and its average healing time is shorter.

目的 探讨电话随访对癌痛患者鞘内吗啡输注系统治疗的影响.方法 将31例接受鞘内吗啡输注系统治疗的癌痛患者按出院的先后顺序分为试验组(15例)和对照组(16例).两组在住院期间均给予常规护理,出院时均给予常规出院指导.在此基础上,出院后,试验组给予电话随访.比较两组疼痛评分、按时更换蝶形针的比例、按时更换药囊的比例、按时复诊率、脱管率、药物不良反应的发生率.结果 试验组按时更换蝶形针、按时更换药囊、按时复诊所占比例与对照组比较,差异均有统计学意义(P<0.05).试验组疼痛评分、脱管率、药物不良反应发生率均明显低于对照组,差异均有统计学意义(P<0.05).结论 对接受鞘内吗啡输注系统治疗的癌痛患者给予电话随访,可降低患者的脱管率及药物不良反应发生率,减轻患者疼痛,提高了患者的遵医行为、依从性和生命质量.

目的 分析个体化护理干预对使用阿片类镇痛药物的癌痛患者的干预效果.方法 选取92例癌痛患者,均服用阿片类镇痛药物,根据护理方法的不同将其分为研究组(n=46)和对照组(n=46),对照组予常规护理方法,研究组采用个体化护理干预措施.观察2组患者的疼痛缓解效果及对阿片类镇痛药物不良反应的改善情况.结果 研究组疼痛缓解总有效率为89.1%,高于对照组71.7%(P<0.05),不良反应的发生率均亦低于对照组(P<0.05).结论 个体化护理干预方案使服用阿片类镇痛药物的癌痛患者的镇痛效果更佳,不良反应发生率更低.

Objective:To investigate the effects of self-management education on the quality of life in patients with implanted programmable continuous intrathecal morphine infusion pump to relieve advanced cancer pain.Methods:A total of 60 patients with terminal cancer pain were implanted a programmable device for continuous morphine infusion and were randomized into control and test group (30 cases for each group). Patients in control group received usual nursing care, while patients in test group received usual nursing care plus self-management training simultaneously. The questionaire of disease knowledge, self-management ability score table, together with the evaluation forms of life quality were selected to judge the status when patients were discharged from hospital, as well as at 1 and 3 months post-discharge.Results: Compared to control group, there were significant improvements in test group in disease knowledge, self-management ability and quality of life (P< 0.05).Conclusion:For patients with implanted programmable continuous intrathecal pump against advanced cancer pain, self-management education could contribute to set up a healthy hospital discharge self-management pattern to enhance the ability of self-management and improve the quality of life.

目的 探讨延续护理服务对PICC置管患者的护理效果.方法 将在本院行PICC置管患者2013年299例为对照组,2014年313例为干预组.对照组接受常规护理,干预组实施延续护理服务,比较2组患者出院后PICC导管自我护理能力、导管按时维护率、留置时间及并发症发生率.结果 干预组在自我护理能力、导管按时维护率、PICC留置时间均显著提高,并发症发生率显著下降,比较差异有统计学意义(P＜0.05).结论 对PICC置管患者开展延续性护理服务,能够对PICC置管患者进行有效管理,提高PICC专科护理水平,保证患者PICC置管的安全性.

通过阅读相关护理文献，结合临床护理实践，对PICC临床应用，PICC导管的禁忌症，穿刺置管方法，导管置管并发症及异常情况的预防及护理进行综述，以便更好地指导临床护理工作。

目的分析神经内科护理中的所存在的一些安全隐患,并且采取相应的措施防范给予防范。方法就神经内科护理中所出现的一些安全隐患,制定有针对性的防范措施,提升对于患者的护理质量。结果患者住院期间的安全得到了有效的加强。结论科学严谨的护理措施是预防神经内科护理中安全隐患的重要手段。

The essay introduces a kind of intelligent bedsore observation turning over bed which precisely carries on the measurement of the pressure of patient's bearing spot,draws up the pressure time safety zone curve automatically with its embedded data base,and makes the related data submit to computer for appraisal and judgment.If the result surpasses the pressure time safety zone,it automatically changes the patient's bearing spot pressure to control and prevent the re-occurrence of the bedsore.

护士肩负着救死扶伤的光荣使命。护士素质不仅与医疗护理质量有密切的关系,而且是护理学科发展的决定性要素。随着人们健康观念的改变,人们的健康需求逐渐涉及不同的层面,对护理的要求也日益强烈,标准日益提高。当前如何对护士进行素质教育,培养宽基础、高素质、强适应的护理人才,以适应21世纪的护理工作,是护理教育亟待解决的问题。

自控镇痛(patient controtled analgesia,PCA)即病人感觉疼痛时按压启动键,通过微处理器控制的微量镇痛泵,向体内注入设定剂量的镇痛药物以消除疼痛.我科自2003年开始对骨科手术病人分别采用了静脉PCA(PCIA)和硬膜外PCA(PCEA)的方法进行术后连续镇痛.现将两种镇痛的效果及术后护理分析如下:

腰椎间盘突出症胶原酶溶解术(简称溶盘术)是将胶原酶注入病变的椎间盘,有效地溶解髓核和纤维环中的胶原蛋白,降低间盘内压力并溶解突出物,解除神经根压迫,缓解临床症状,达到治疗目的的一种有效方法[1,2].该方法疗效肯定,应用越来越广泛[3,4].因术后需卧床3～7 d,易产生尿潴留,其副作用增加了病人的痛苦,最后需导尿,增加了病人的费用和护士的工作量.为探讨溶盘术后病人解决尿潴留的有效方法,我们对180例溶盘术后病人行大量饮水法促进排尿,效果满意,现报告如下.

目的探讨儿童腺样体肥大与儿童阻塞性睡眠呼吸暂停综合征(OSAS)的关系及手术治疗效果.方法对42例OSAS伴有腺样体肥大16例伴有扁桃体肥大患儿采用全麻下腺样体摘除和或扁桃体摘除术,术后随访3～6个月,并对其临床资料进行分析.结果42例全部治愈,40例打鼾消失,2例打鼾明显减轻,23例伴憋气者21例消失,2例明显缓解,36例张口呼吸者减轻32例,缓解4例,6月复诊未有复发.结论腺样体和/或扁桃体肥大是儿童OSAS的主要病因,手术摘除腺样体和/或扁桃体是治疗儿童OSAS的非常有效的方法