目的:了解行全飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)患者围手术期的体验感受.方法:采用定性调查的方法,选取广东省某医院的15名行SMILE的患者,进行半结构式访谈,将患者围手术期体验归纳为顾虑、紧张、疼痛、担心、放松5个主题概念,用现象学分析法整理、分析资料.结果:把5种体验汇总制成韦恩图,通过韦恩图提炼发现有1人有围手术期5种感受,3位有紧张、疼痛、担心、放松4种心理感受,2位只有紧张的感受,而无其余感受.结论:行SMILE患者的围手术期具有多种体验感受,分析不同感受状态和因素,为眼科医护人员对于寻求SMILE手术的患者做好围手术期的服务提供依据.

目的 了解我国珠海市横琴新区高血压前期流行现状及影响因素.方法 采用横断面调查的方法,抽取2020年5月～9月在珠海市人民医院横琴医院参加年度健康体检的共670名横琴新区各企事业单位在职员工进行血压测量及体检信息登记.结果 本次共调查670名员工,高血压前期组有194人(占29.00％),其中男性患病率为37.40％,而女性的患病率为18.30％;单因素分析显示不同血压亚组职工在年龄、性别、婚姻、BMI、血糖、肝肾功能及血红蛋白测量比较,差异有统计学意义(P<0.05),有序Logistic回归分析显示,年龄(OR=1.309,P<0.000)、超重/肥胖(OR=1.586,P<0.000)、肌酐(OR=0.971,P<0.001)、尿酸(OR=1.003,P<0.008)、ALT(OR=1.010,P<0.012)、血红蛋白(OR=1.020,P<0.010)是高血压前期的独立危险因素(P<0.05).结论 该地区职业人群高血压前期患病率较高,可能预测未来的心血管病事件及肾脏疾病的重要危险因素,应该加强对该群体的早期干预,以预防更严峻的心血管及肾脏等靶器官的损害.

Objective:To research the influence muscle relaxation therapy has to patients after retinal detachment surgery. Methods:Selected 60 patients who took retinal detachment surgery from May 2013 to October 2014 and divided them into control group and observation group randomly,the control group a-dopted normal care,and used the care positions of prostration,head drop and so on alternatively;the observation group took muscle relaxation therapy based on the control group′s nursing measures,and did questionnaire and intraocular pressure(IOP)testing toward patients′ anxiety when one week,one month and three months before and after training. Results:Patients′ anxiety score and IOP comparison had no statistic difference when one week before and after training(P ﹤ 0. 05),both showed obvious anxiety and IOP above normal value;when after one and three months,anxiety score and IOP both declined,but the control group declined slowly while the observation group declined obviously,and the comparison of the two groups both had statistic difference(P ﹤0. 05). Conclusion:Match muscle relaxation therapy with position care can improve the patient′s comfort and emotion after retinal detachment surgery,re-duce patientˊs anxiety and IOP,and has positive effect toward patientˊs postoperative rehabilitation.

目的：探讨依据ISO15189质量体系培训护士血标本采集的效果。方法成立血标本培训与质量控制小组，依据I S O15189质量体系标准制定培训方案进行培训，自制问卷调查分析培训前后护士血标本采集相关知识的认知程度，比较培训前后血标本的不合格率。结果培训后护士血标本采集相关知识认知程度明显提高（P<0.05）；血标本不合格率在培训后较之前下降（P<0.05）。结论通过实施依据I S O15189质量体系的培训，能够有效提高护士的血标本采集相关知识，规范护士血标本采集行为，提高血标本检验前质量，降低血标本不合格率。

目的：了解护士长对血液标本采集相关知识的掌握情况,为血液标本采集流程的培训和管理提供依据。方法于2014年8—10月采用自行设计的调查表对珠海市人民医院38名护士长进行血液标本采集相关知识调查,了解其对血液标本采集知识的患者准备、标本采集、标本存储3个维度知识掌握情况。结果护士长对血液标本采集知识的患者准备、标本采集、标本存储3个维度回答正确率分别为63.16%,60.20%,71.05%。不同职称、担任护士长不同年限、不同学历的护士长对血液标本采集知识认知差异有统计学意义(F/ t 值分别为27.010,14.405,-1.941；P <0.05)。结论护士长对血液标本采集相关知识的认知方面存在一定缺陷,需加强培训与管理,提高送检血液标本的质量。

目的 了解护士血液标本采集认知状况.方法 采用自行设计的调查问卷对400名护士血液标本采集认知状况进行调查.结果 除血液标本处理和血液标本采集量外,护士血液标本采集认知正确率为75.75％以下.不同年龄、职称和学历及科室护士血液标本采集认知情况比较,差异均有统计学意义(P＜0.05).结论 护士血液标本采集知识较缺乏.进行血液标本采集技术和相关知识培训,建立和健全检验质量管理的标准与质量要求,可确保检验前标本的采集质量.

Objective To explore the effect of scenario simulation training to nurses in improving the rescue ability at com-munity site.Methods A total of 60 nurses were enrolled and randomly divided into intervention group and control group.The control group only received routine training, and the intervention group received scenario simulation mode training .Results The score of disaster rescue ability of the intervention group was significantly higher than the control group (p<0.05).There was no significant difference in the level of education (p>0.05).Significant differences were evident in different sections, professional titles and work-ing years (p<0.05).Conclusion Scenario simulation model training can improve the ability of disaster rescue as an ideal and intu-itive method.

Objective To observe the influence of point massage and auricular point sticking on postoperative pain relief of patients with sinusitis. Methods Totally 240 patients with endoscopic sinus operation were randomly divided into ice compress group (ICG), point massage group (PMG) and point massage and auricular point sticking group (PMAPSG), with 80 cases in each group. Intervention intervals were 1 hour, 4, 24, 48 hours after operation and at bedtime of the surgery day and pain score was measured at the same time. Inter-group and intra-group pain scores were compared before and after the intervention. Results The pain was relieved obviously in PMG and PMAPSG 1 hour and 4 hours after operation (P<0.05). After intervention, patients in PMAPSG felt less pain than those in other two groups 1 hour and 4 hours after operation. At bedtime of surgery day, 24 and 48 hours after operation, patients in PMAPSG felt less pain than those in ICG (P<0.05). Conclusion Point massage and auricular point sticking can effectively lessen pain for postoperative patients with sinusitis, which is worth to be promoted.

目的探讨耳鼻咽喉科护理技术操作中存在的潜在风险,并提出防范措施。方法选取在耳鼻咽喉科诊治的患者56例,随机分为实验组和对照组,每组28例。对照组实施常规的护理措施,实验组患者在常规护理的基础上分析护理技术操作中存在的潜在风险,加强防范措施。观察两组患者护理差错的发生率及患者的满意度。结果实验组患者与对照组患者相比,护理差错发生率明显降低,患者的满意度也有所提高。结论有针对性的采取防范干预,能够提高耳鼻咽喉科的护理质量,提高患者满意度,防范护患纠纷。

目的:探讨耳鼻咽喉科门诊医院感染的预防及护理管理的效果。方法:分析耳鼻咽喉科门诊医院感染因素,从管理制度入手,以门诊环境管理及各项检查的感染管理为外部因素重点,以医务人员手卫生、医务人员的自我防护意识为内部因素重点,从多方面进行耳鼻咽喉科门诊医院感染的预防及护理管理。结果:干预后手卫生依从性、医院感染知识知晓率以及标准预防执行情况均优于干预前,差异均具有统计学意义(P<0.05)。干预后在消毒灭菌、无菌物品保管、患者隔离防护、废弃物处理等方面结果均优于干预前,差异均具有统计学意义(P<0.05)。结论:全方位的医院感染预防及管理策略能够有效改善医院感染预防及管理实施前后监测结果,提高消毒隔离管理质量。

目的:探讨等离子低温消融术治疗重型鼾症的围术期护理方法。方法:对60例重型鼾症患者行等离子低温消融术,并给予精心围术期护理,观察手术疗效及睡眠质量改善情况。结果:本组患者均手术顺利,效果满意,治愈42例、有效18例,术后恢复快。术后48 h与术前比较,最长呼吸暂停时间、呼吸紊乱指数和最低血氧饱和度差异均有统计学意义(P<0.05)。结论:低温等离子消融术治疗重型鼾症患者在减少创伤、减轻疼痛等方面具有优势。术前做好心理护理,术中密切配合和术后保持呼吸道通畅,做好出血、疼痛、饮食、切口护理及出院指导,防止并发症是手术成功的重要保证。

目的 结合临床实践经验,探讨非侵袭性真菌性鼻窦炎患者行鼻内镜手术治疗的围手术期护理方法.方法 选取2008年6月至2010年6月,我院收治的非侵袭性真菌性鼻窦炎行鼻内镜手术治疗的患者87例为研究对象,采用总结回顾分析法,将研究对象的病历资料、临床治疗资料等搜集整理,并与经治医生、管床护士共同分析.结果 患者均接受0°镜和70°镜行功能性鼻内镜手术,术后病理均证实为真菌感染.在良好的护理配合下,所有患者顺利完成手术,术后有5例患者并发眶周血肿,2例患者出现视觉障碍,经处理后恢复正常.随访1～2年,4例患者复发,其余恢复良好,无脑脊液鼻漏及其他并发症.结论 良好的护理措施有助于患者的早日康复,对于非侵袭性真菌性鼻窦炎行鼻内镜手术治疗的患者应从术前、术后以及出院前三方面做好护理工作,使患者更好的康复.

Objective To investigate the repairing effect on nasal cartilage defect with associated graft of perichondrium and allogenic demineralized bone matrix (DBM). Methods Eighteen New Zealand rabbits were randomly divided into 3 groups (in each group,n=6). Nasal alar cartilage and perichondrium were ablated in each rabbit. Autogenic auricular perichondrium wrapped by allogenic DBM was grafted into the defect in group A,autogenic auricular cartilage in group B and autogenic auricular perichondrium in group C. At the 10th week after repair,the effect was evaluated by gross inspection,histopathology,immunohistochemical detection of Soluble protein-100 (S100) and transforming growth factor-β1 (TGF-β1) antibodies of the cartilage from the defect. Results The cartilage cell and matrix from group A and B were similar to those of the normal cartilage with no obvious differences between group A and group B. Being compared with the cartilage cells from group A and group B,the cell number,cytoplasm,and positive S100 and TGF-β1 cells were significantly reduced in group C (P 0.01). Conclusion The repairing effect on nasal cartilage defect with associated graft of perichondrium and allogenic DBM is coincide with autogenic cartilage and surpass the autogenic perichondrium.

Objective:To summarize the cooperative nursing experience of vacuum trephine applied in penetrating keratoplasty.Methods:Good preoperative preparations and clinical cooperation and observation under strict nursing rules for 21 cases who received penetrating keratoplasty with vacuum trephine.Results:The surgeries progressed well without any accidents and achieved satisfactory results.Conclusion:Nurses should be skilled of the cooperative techniques.Good preoperative preparations and close clinical cooperation guarantee a successful surgery.

目的:探讨护理干预对鼻内镜手术患者并发症的影响。方法:选择284例行鼻内镜手术治疗的患者,并随机分为干预组和对照组各142例,对照组给予常规护理,干预组在常规护理的基础理上术前、术后进行护理干预。观察两组患者并发症的发生情况。结果:对照组患者并发症发生率为16.90%,干预组患者并发症发生率为3.52%,两组比较差异具有显著性(P<0.01)。结论:对鼻内镜患者实施综合护理干预可有效减少并发症的发生率,提高患者生活质量。

Objective To investigate the clinic results on fresh amniotic membrane transplantation (AMT) for treating the children's severe ocular burns at the early stage. Method Fresh AMT was performed on the children's severe ocular burns (15 cases, 24 eyes), and the amniotic membrane and the children's visions before and after surgery were observed. Result The acute rejection reaction and infections didn't happen on the amniotic membrane, and the children's visions were gradually improved after the fresh AMT. Conclusion Fresh AMT can be effectively used to reconstruct the ocular surface of the children's severe ocular burns, reduce the inflammatory response and decrease the severe complications after ocular burns.

目的 寻求改善糖尿病性白内障患者的焦虑、抑郁状态、维护其心理健康、减少术后并发症的护理方法.方法 将96例患者随机分干预组和对照组各48例,干预组实施个性化干预,注重心理护理;对照组进行一般的护理干预,对比两种护理方法在糖尿病性白内障患者术后的影响.结果 两组患者出院时焦虑、抑郁评分、术后角膜水肿、伤口感染率、患者满意度比较.差异有统计学意义(P<0.05).结论 有效的护理干预能减轻糖尿病性白内障病患术后并发症和不良心理反应,提高自我管理水平.

气管切开术是紧急建立人工气道,保证呼吸道通畅的手段之一,手术并发症的观察及护理一直护理人员探究的课题。本文对109例接受气管切开术的患者所发生的并发症进行分析,并得出一些护理经验。

目的:探讨喉癌喉切除术后患者生活质量的主要影响因素及护理对策。方法:根据罗健、孙燕制定的癌症患者生活质量调查表并加以修改,制定调查问卷,对65例来院复诊的喉癌术后患者进行问卷调查。采用logis-tic回归分析法进行影响喉癌术后患者生活质量的多因素分析。结果:65例患者生活质量平均得分为27.35分,生活质量好者39例(60%),生活质量差者26例(40%);患者自身对疾病认识(β=2.102)、对治疗的态度(β=2.003)及婚姻家庭配合(β=1.883)为影响患者术后生存质量的主要因素。结论:喉癌喉切除术后患者生活质量受多种因素的影响,心理因素与生活质量有着密切的关系,提供患者精神心理支持、各方面给予护理干预是提高其生活质量的有效措施。

患者,男,34岁,因双眼高度近视来我院行准分子激光原位角膜磨镶术(LASIK).术前检查:右眼-6.50DS/-2.00DC×1800-1.0,左眼-7.50DS/-2.00DC×180°-1.0.散瞳三面镜检查:双眼底视网膜高度近视表现,周边视网膜未见变性区及裂孔.