目的 探究产科创伤事件对医护人员职业倦怠的影响,从而为专项干预提供依据.方法 2017年至2019年期间我院内各科室不同岗位的医务人员作为调查对象,观察其经历的产科创伤事件,对是否出现职业倦怠的医护人员在不同社会学资料及产科创伤事件发生的情况进行分析.结果 本次调查研究374例医护人员中,经历创伤事件的医护人员为277名,占74.1％.职业倦怠与非职业倦怠医护人群在性别差异无统计学意义(P>0.05),在年龄、工作年限、婚姻状况、教育程度、专业类型及月收入等指标对比差异有统计学意义(P<0.05).职业倦怠多因素分析结果显示未婚(OR=0.136,95％CI=0.022,0.848)、已婚(OR=0.159,95％CI=0.027,0.942)、大专学历(OR=1.243,95％CI=1.018,2.918)、月收入低于1万(OR=54.268,95％CI=4.491,655.805)、月收入1～3万(OR=29.575,95％CI=2.454,356.387)、护士专业(OR=2.391,95％CI=1.245,4.595)、未定级护士(OR=9.949,95％CI=2.872,34.469)、初级职称(OR=6.197,95％CI=2.065,18.489)、未创伤(OR=0.512,95％CI=0.345,0.711)是产科医护人员出现职业倦怠的重要因素.其中未婚、已婚、未经历创伤事件是职业倦怠的保护性因素,大专学历、月收入3万以下、护士专业、职称仅为护士是高危因素.结论 院内产科医护人员职业倦怠发生率较高,应当引起医院及卫生部门重视.尤其是未经历创伤事件的医护人员是职业倦怠的保护性因素,而经历创伤事件的医护人员则是重要的高危因素,此外,还有婚姻状态、收入、学历、职称、护士职业等因素同样影响产科医护人员职业倦怠的发生情况.医院应根据研究结果,针对产科内创伤事件,做好针对性心理疏导,合理安排工作制度,以有效降低产科医护人员的职业倦怠感.

目的 探究腰椎间盘突出患者联合应用常规护理与心理干预在摘除术后取得的临床成效.方法 选取我院2015年6月~2016年6月入院的腰椎间盘突出症患者300例,随机分为观察组和对照组各150人.对照组护理方法为常规护理,观察组为常规护理与心理干预联合应用.针对治疗效果、焦虑和抑郁情绪改善情况,对两组进行分析.结果 观察组治疗总有效率(95%)比对照组(75%)高(P<0.05);观察组干预后焦虑和抑郁评分明显优于对照组(P<0.05).结论 腰椎间盘突出患者联合应用常规护理与心理干预在摘除术后取得的临床成效显著,在改善患者焦虑和抑郁情绪的同时,使治疗效果显著增高.

目的:探究综合性围手术期护理对于促进脊髓型颈椎病患者的效果.方法:收治脊髓型颈椎病患者100例,随机分两组.试验组采取综合性的围手术期护理措施,对照组给予常规的基础护理和健康教育.评价两组患者的自我康复训练知信行行为和生活质量得分.结果:试验组患者的自我康复训练知信行行为和生活质量评分明显高于对照组,差异具有统计学意义(P<0.05).结论:综合性的围手术期护理能够显著提高脊髓型颈椎病患者的自我康复训练知识,促进其自我训练行为的养成,提高其生活质量,促进患者的康复.

目的：探讨肝脓肿手术最好的护理措施。方法对78例肝脓肿手术患者实施临床护理，总结护理经验。结果肝脓肿手术患者临床护理包括：术前：心理护理，饮食护理，肠道准备，生命体征监，疼痛护理，高热护理等。术后密切观察生命体征变化，保持呼吸道通畅，做好引流管、皮肤护理，观察有无出血、胆瘘、等并发症的发生。结论术前后护理措施有效落实，能预防并发症发生，促进肝脓肿病人尽早康复。

Objective:To explore the application of case - based teaching method to the on - the - job training of the nurses of the de-partment of gynecology and obstetrics in order to improve the effect of training. Methods:70 nurses of the department of gynecology and ob-stetrics were randomly divided into the control group(n = 34)and the experimental group(n = 36). The nurses in both groups received one - year training,the lecture - based training was conducted in the control group and the case - based teaching method was adopted in the experimental group. The mastery of the relevant theoretical knowledge of the nurses and the evaluation on the different teaching methods was assessed after the training. Results:After the training,the results of theory test of the nurses was significantly better in the experimental group than the control group(P < 0. 05);the evaluation on the teaching method was significantly better in the experimental group than that in the control group(P < 0. 05). Conclusion:The case - based teaching method is beneficial to the improvement of the effect of the train-ing.

目的：探讨护理风险管理教育在肝胆外科护生带教中的应用效果。方法选择2012年7月～2013年5月在肝胆外科的实习护生60名，依据完全随机对照原则分为观察组与对照组（每组30名），对观察组实施护理风险管理教育及肝胆外科常规带教，对照组实施肝胆外科常规带教。实习结束后，采用问卷调查法，调查2组护生对风险管理的认知情况及患者满意度，并对2组护生发生风险事件的例数进行统计。结果观察组护生对护理风险的认知情况明显好于对照组，而风险事件发生率明显低于对照组，观察组的患者满意度明显高于对照组，差异有统计学意义（P＜0．05）。结论在本科实习护生的临床带教中实施风险管理能有效提高学生对风险的认识水平，降低护生的风险事件发生率，提高患者满意度。在临床带教中应加强对肝胆外科本科护生的护理风险管理。

目的探讨原发性肝癌射频治疗的最好的护理措施。方法对94例原发性肝癌患者射频治疗实施临床护理，总结护理经验。结果发性肝癌患者射频治疗临床护理包括：穿刺前心理护理，饮食护理，作息指导，训练呼气后屏气的动作等。穿刺后密切观察生命体征变化，低流量吸氧，6h内绝对卧床休息，局部疼痛护理，肝功能、尿液观察等。结论术前后护理措施有效落实，能促进原发性肝癌射频治疗后的病人能尽早康复。

Objective To find the application effect of risk management in nursing management in delivery room.Methods 1200 hospitalized parturients in 2011 were selected as the observation group,and 1186 parturients in 2008 were set as the control group.The observation group received risk management and nursing measures,while the control group was given traditional nursing.Nursing defects rates,the rate of post-partum haemorrhage,the incidence of neonatal asphyxia,dystocia rate,nursing disputes and patient satisfaction degree were compared between two groups.Results Neonatal label defects rates,the rate of post-partum haemorrhage,the incidence of neonatal asphyxia,dystocia rate and nursing disputes in the observation group were much lower than that in the control group.The patient satisfaction degree was significandy increased in the observation group.Conclusions Summarizing the risk factors,performing risk management in delivery room can greatly increase the delivery and nursing quality and patient satisfaction degree.

目的:探讨脊柱侧凸术后的最好的护理措施.方法:对26例脊柱侧凸术后患者实施临床护理,总结护理经验.结果:脊柱侧凸术后患者临床护理包括:术前心理护理,术前呼吸功能训练及体位训练.术后密切观察生命体征变化,预防并发症的发生,术后的功能锻炼等.结论:术前后护理措施有效落实,能促进脊柱侧凸术后患者尽早康复.

目的：探讨原发性肝癌的最好的护理措施。方法：对110例原发性肝癌患者实施临床护理，总结护理经验。结果：发性肝癌患者临床护理包括：术前心理护理，饮食护理，注意凝血机制障碍表现。术后密切观察生命体征变化，观察有无腹腔内感染、胆瘘，有无肝性脑病、胸腔积液等并发症的发生，术后心理护理，饮食指导等。结论：术前后护理措施有效落实，能促进原发性肝癌病人尽早康复。

Objective To explore the influence of blood-activating and stasis-removing herbal medicine on therapeutic effect of laparoscopic operation for endometriosis.Methods Eighty-nine endometriosis patients confirmed by laparoscopic operation were randomly divided into control group(N=42) and combination group(N=47,treated with traditional Chinese medicine combined with western medicine).Therapeutic effect was evaluated after treatment,and the recurrence of postoperative dysmenorrhea,abdominal pain and pelvic mass was observed in the two groups.Results Six months after operation,the recurrence rate of postoperative dysmenorrhea,abdominal pain and pelvic mass was lower in the combination group than that in the control group,the difference being significant(P0.05).The therapeutic effect in the combination group was superior to that in the control group,the difference being significant(P0.05).Conclusion Blood-activating and stasis-removing herbal medicine has synergistic effect on laparoscopic operation for endometriosis,with lower recurrence rate.

目的:探讨石膏固定术患者最佳的护理措施,方法:对56例石膏固定术后患者的护理过程进行总结分析,找出有效的护理措施.结果:石膏固定术患者的护理措施包括:术前要做好充分有效的护理评估,皮肤的清洁及护理,病人的心理护理,术后保持正确体位,严密观察病情变化,加强基础护理,指导患者做好功能锻炼.结论:石膏固定术患者术前得到及时充分的护理评估,有效预防病情恶化及"5P"征情况发生,术后密切观察病情变化,可有效预防并发症的发生.

目的:骨科住院老年患者的心理状况及心理要求.方法:对80例住院老年患者进行心理调查.结果:老年住院患者心理状况包括有:抑郁和焦虑、疑惑心理、抗拒心理、依赖心理、孤独自卑与自弃心理.结论:针对老年住院病人的不同心理状况实施不同的护理对策,使老年住院患者保持良好的心理状态,有利于患者疾病的恢复,提高临床治疗的效果.

Objective To study the influence of different operative methods on postoperative upper limb function in patients with early stage breast cancer. Methods From January 2006 to December 2008,125 cases with early satge breast cancer receiving sentinel lymph node biopsy(SLNB) replacing axillary lymph node dissection (ALND) were servered as study group;45 cases receiving ALND and postoperative pathological lymph node negative were served as control group at the same time. The postoperative upper limb complications were compared between two groups. Results In SLNB group,the incidence of numbness,swelling,pain,impaired sense and stiffness was 22.5% (18/80),5.0% (4/80),33.8% (27/80),15.0% (12/80),3.8% (3/80) respectively,less than those in ALND group 78.8% (26/33),39.4% (13/33),54.5% (18/33),57.6% (19/33),18.2% (6/33) (P ＜0.05 or P＜0.01). The incidence of myodynamic attenuation in the SLNB group was 8.7% (7/80),significantly lower than that in ALND group42.4% (14/33) (P＜0.01). In SLNB group,the average arm circumference difference was (0.12 ±0.67) cm,statistically lower than that in ALND group (0.86 ± 1.13) cm(P ＜0.01).Conclusions With the progress in surgical treatment of breast cancer,breast-conserving surgery and SLNB have been applied widely,so the impact of surgery on upper limb function gradually has bean reduced. At the same time,to develop different upper limb exercise program according to different operations can improve upper limb function and quality of life.

目的:探讨产科弥漫性血管内凝血(DIC)的诱因及抢救与护理效果。方法:回顾性分析产科DIC患者44例临床资料。结果:在44例DIC中,4例孕产妇出现>3个器官衰竭后均死亡,其余全部治愈出院,治愈率90.9%。结论:产科急性DIC发病急骤,母婴病死率较高,故要重视主要病因的预防,及时去除病因,合理治疗和精心护理,从而降低病死率的发生。

目的 探讨斜坡体位穿刺法应用于恶性肿瘤患者术后PICC置管的影响.方法 采取方便抽样原则,将70例病人分为两组,每组35例;对照组采用传统的平卧位,实验组指导患者活动需置管的上肢及采用斜坡体位.观察两组穿刺置管首次管尖直接到达上腔静脉的成功率.结果 斜坡体位置管方法成功率显著高于传统置管方法,成功率97.14%(P＜0.05).结论 斜坡体位置管能减少PICC置管过程管尖异位,置管后并发症降低,操作简单,患者容易接受.

[目的]探讨子宫收缩乏力产妇的产程观察和护理措施,促进产妇自然分娩,减少并发症的发生。[方法]回顾分析我科89例在产程中子宫收缩乏力产妇的临床资料,并加以分析总结。[结果]给予产妇全面的心理、生理护理,严密观察,适时加强宫缩,经阴道自然分娩81例,阴道助产分娩6例,中转剖宫产2例,新生儿无窒息发生,2例产妇发生产后出血,及时发现和处理,未发生危险。[结论]精心护理、严密观察、适当加强宫缩是子宫收缩乏力产妇产程护理的重点,同时可提高自然分娩率,减少并发症的发生。

将135例高危妊娠患者随机分为循证护理组65例和对照组70例,循证护理组实施循证护理,对照组采用传统护理模式。比较两种护理模式的疗效及患者满意度。结果循证护理组的特质性焦虑(T-AI)分值、状态性焦虑(S-AI)分值和爱丁堡产后抑郁(EPDS)分值均小于对照组(P<0.05);偱证护理组患者总满意率为89.23%,对照组为72.86%,两组比较差异均有统计学意义(P<0.05)。表明循证护理可有效提高患者的心理应激能力,促进患者早日康复,值得在临床实践中推广应用。

Objective To investigate employment stress and coping styles of nursing interns in order to provide a basis for clinical teaching.Methods Totally 34 nursing interns were investigated by using Nurses' Employment Stress Questionnaire and Nurses Coping Style Questionnaire.Results The employment stress of nursing interns included profession factor,personal factor,social environment factor,and college and family factor,among which the social environment factor was the highest.The students used different coping styles to solve different problems,but most of them faced the problems positively.Conclusion The teachers should know employment stress and coping styles of nursing students,provide psychological support for the students,and help the students face employment problems.

Objective To understand the factors for employment pressure source in apprentice male nurse students. Methods By self-designed questionnaires, a survey on employment pressure source was conducted in 67 apprentice male nurse students. Results The employment pressure was highest in school factor, followed by social environment factor, family factor, professional factor, individual factor.Educational background besides the social environment factor had a difference in the pressure source, other various factors do not have a difference. The parent occupation doesn't have the difference with the health enterprise correlation in the pressure source factor besides school factor. All had a difference in other four factor. The number of sibling and the family factor had a difference in the pressure source, other factors do not have the difference. Conclusions The employment pressure in male nurse students is associated with social environment factor, family factor, professional factor, and individual factor. Teachers should understand the factors for employment pressure and help their student to relieve pressure and to understand employment direction.