Objective:To understand the current situation of nurses' willingness to engage in telecare in county-level hospitals in Henan Province and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 1 300 clinical nurses from 6 Class Ⅱ Grade A county-level hospitals in Zhengzhou, Hebi, Zhoukou and other cities in Henan Province were selected as the research objects from August 2022 to January 2023. General Data Questionnaire and Clinical Nurses' Willingness to Engage in Telecare Questionnaire were used to investigate the research objects. Non-parametric test and multiple linear regression were used to analyze the influencing factors of clinical nurses' willingness to engage in telecare.Results:A total of 1 300 questionnaires were sent out in this study, and 1 183 were effectively collected, with an effective recovery rate of 91.00% (1 183/1 300). The total score of Clinical Nurses' Willingness to Engage in Telecare Questionnaire of 1 183 nurses in county-level hospitals was [105.00 (98.00, 112.00) ] points, and all items were scored [3.50 (3.27, 3.73) ]. Multiple linear regression analysis showed that professional title, post, whether they knew about telecare, and the number of times of receiving training on nursing information each year were the influencing factors of nurses' willingness to engage in telecare in county-level hospitals ( P<0.05) . Conclusions:In Henan Province, 1 183 nurses in county-level hospitals have a high willingness to engage in telecare. Relevant departments should further strengthen the publicity of relevant contents of telecare, carry out practical operation training related to nursing information, improve the nursing information ability of nurses in county-level hospitals and strengthen the awareness of health management services, so as to promote the successful implementation of telecare services in rural areas.

Objective:To explore the application effect of scenario simulation exercise in standardized training of newly recruited nurses.Methods:Using the convenient sampling method, the newly recruited nurses in Henan Provincial People's Hospital from 2019 to 2020 were selected as the research objects. A total of 50 newly recruited nurses in 2019 were set as the control group, while 50 newly recruited nurses in 2020 were set as the observation group. The newly recruited nurses in the control group adopted traditional training methods, while the observation group added scenario simulation exercise teaching on the basis of the control group. The theoretical assessment and practical operation scores and Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) scores of the two groups were compared, and the training satisfaction was evaluated.Results:The theoretical assessment and practical operation scores, all dimensions scores of CTDI-CV and total satisfaction of training of the newly recruited nurses in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:In the standardized training of newly recruited nurses, the use of scenario simulation exercise can improve the theoretical and practical mastery of new nurses, promote the improvement of critical thinking ability of nurses and improve training satisfaction.

目的 探讨加速康复外科(ERAS)在腹腔镜结直肠癌切除术患者中的应用效果,并分析其对患者术后胃肠功能、炎症状态的影响.方法 以随机数字表法将2019年3月至2020年12月在河南省人民医院治疗的210例结直肠癌患者分为对照组和观察组,各105例.两组患者均接受腹腔镜结直肠癌根治术,对照组患者围手术期接受常规护理,观察组患者围手术期接受ERAS护理干预.采用疼痛数字评分法(NRS)评估患者疼痛程度,采用匹兹堡睡眠质量指数(PSQI)评估患者睡眠质量,比较两组患者术后胃肠功能恢复情况、手术前后血清炎症因子水平,记录术后近期并发症情况.结果 观察组患者术后肛门首次排气、排便时间,肠鸣音恢复时间均短于对照组(P<0.05).与术前比较,术后3 d两组患者血清肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平均升高,但观察组低于对照组(P<0.05).与术前比较,术后24 h两组患者NRS评分及术后10 d两组PSQI评分均降低,且观察组低于对照组(P<0.05).术后住院期间观察组总并发症发生率低于对照组(P<0.05).结论 ERAS可缓解腹腔镜结直肠癌切除术患者术后机体炎症反应状态,缓解术后疼痛程度,促进术后胃肠功能的恢复,还有助于改善患者睡眠质量,并发症少.

目的:分析胃癌患者自我效能感、心理弹性与术后康复的相关性.方法:选取某院162例胃癌患者(观察组),均行胃癌根治术,并取同期100例体检健康者为对照组,以一般自我效能量表(GSES)评估其自我效能感,以心理弹性量表(CD—RISC)评估其心理弹性,并采用世界卫生组织生存质量量表(WHOQOL—BREF)调查术后康复情况,分析GSES评分、CD—RISC评分与QLQ—C30评分相关性.结果:观察组GSES评分与CD—RISC中坚韧性评分、力量性评分以及乐观性评分(t = 17.905,15.907,12.788,13.138;P＜0.001)均显著低于对照组;观察组术后WHOQOL—BREF中生理评分、心理评分、环境评分及社会关系评分(t = 12.282,12.081,3.198,5.182;P＜0.01)明显低于对照组;相关性分析显示,GSES评分、CD—RISC评分中坚韧性评分、乐观性评分、力量性评分均与WHOQOL—BREF 中生理评分(r = 0.723,0.671,0.691,0.704;P＜0.001)、心理评分(r = 0.713,0.729,0.692,0.633;P＜0.001)、环境评分(r = 0.469,0.531,0.555,0.533;P＜0.001)、社会关系评分(r = 0.527,0.541,0.499,0.538;P＜0.001)呈正相关.结论:胃癌患者自我效能与心理弹性较低,且术后生存质量较差,二者与其术后生存质量均.具有显著相关性,临床可通过这两方面的干预改善患者术后康复情况.

目的:观察护士规范化培训在预防造口并发症中的应用效果.方法:采用自身前后对照实验设计,对普外科的23名护士进行规范化培训,比较培训前(2016-05 ～2017-04)和培训后(2017-05 ～2018-04)护士造口专业知识的掌握情况.另选取2016-05～2017-04普外科收治的36例造口患者作为对照组,2017-05 ～2018 ～04收治的45例则作为观察组,对比两组并发症发生率.结果:护士培训后造口专业知识得分明显高于培训前(P＜0.05);观察组造口并发症发生率明显低于对照组(P＜0.05).结论:规范化培训能有效促进护士对造口知识的掌握,从而预防造口并发症的发生.

目的:观察自拟中药痤疮合剂联合火针疗法治疗痰热瘀结型痤疮的临床疗效.方法:选取2017年5月～2018年8月我院收治的痰热瘀结型痤疮患者84例为研究对象, 按照随机数字表法将其分为观察组与对照组, 每组42例.对照组予外抹异维A酸红霉素配合口服螺内酯、米诺环素治疗, 观察组采用中药痤疮合剂联合火针疗法治疗, 两组均连续治疗4周.比较两组临床治疗效果、不良反应发生率以及复发率.结果:观察组治疗总有效率明显高于对照组 (χ2=6.57, P=0.01);观察组不良反应发生率、复发率均明显低于对照组, P<0.05.结论:自拟中药痤疮合剂联合火针疗法治疗痰热瘀结型痤疮疗效显著, 能够降低复发率且安全有效, 值得临床推广.

目的 探讨个体化护理在肠瘘患者护理中的应用效果.方法 选取2016年8月至2018年2月收治的92例肠瘘患者作为研究对象,按就诊顺序进行分组,单号的46例为观察组,双号的46例为对照组.对照组接受常规护理,观察组在常规护理方式的基础上接受个体化护理.记录患者排气时间、进食时间、瘘口愈合时间、住院时间,采用自制护理满意度问卷评价护理质量.结果 观察组排气时间、进食时间、瘘口愈合时间及住院时间均短于对照组,差异有统计学意义(均P<0.05).对照组护理满意度为84.78％(39/46),观察组护理满意度为97.83％(45/46),观察组护理满意度高于对照组,差异有统计学意义(P<0.05).结论 个体化护理能有效缩短肠瘘患者的康复时间,提高护理质量.

目的:观察芍药甘草汤联合阶梯针刺法治疗带状疱疹后遗神经痛的临床效果.方法:56例随机分为两组各28例,对照组给予西药常规治疗,观察组用芍药甘草汤联合阶梯针刺法治疗,比较两组治疗后PRI、VAS、PPI评分情况.结果:两组治疗后PRI、VAS、PPI评分观察组均低于对照组(P＜0.05).结论:芍药甘草汤联合阶梯针刺法治疗带状疱疹后遗神经痛临床效果明显,可有效改善疼痛程度,减少痛苦.

目的 探讨结直肠癌患者及照顾者进行造口护理预警教育的方法 及效果.方法 将98例肠造口患者随机分为干预组和对照组各49例.对照组给予常规造口健康教育,干预组在此基础上对患者及照顾者实施预警教育.比较干预后3个月两组造口护理依从性,患者焦虑水平及造口并发症发生率.结果 干预后3个月后,干预组患者及照顾者造口依从性得分显著高于对照组(均P＜0.05);患者焦虑得分显著低于对照组,造口并发症(粪水性皮炎、造口黏膜出血及造口周围皮肤湿疹)发生率显著低于对照组(P＜0.05,P＜0.01).结论 预警教育可有效提高肠造口患者及照顾者造口护理依从性,降低患者焦虑水平及造口并发症发生率,提高患者的生活质量.

目的:探讨对行胃癌根治术治疗的胃癌患者进行综合护理的效果.方法:选取河南省人民医院2014年1月之2015年1月期间收治的320例胃癌患者作为研究对象.随机将这些患者分为观察组和对照组.观察组中有151例患者,对照组中有179例患者.为对照组患者进行常规护理,为观察组患者进行综合护理.然后比较两组患者护理不良事件的发生情况及对护理服务的满意度.结果:经过护理后,观察组中发生护理不良事件的人次明显少于对照组中发生护理不良事件的人次.观察组患者对护理服务的满意度评分明显高于对照组患者,差异显著,具有统计学意义(P<0.05).结论:对行胃癌根治术治疗的胃癌患者进行综合护理的效果显著,值得在临床上推广应用.

肠造口是指因治疗需要,把一段肠管拉出腹腔,并将开口缝合于腹壁切口上以排泄粪便的方法[1].肠造口无控便能力,随时从造口排出粪便及分泌物,需使用造口袋收集,造口袋不渗漏的情况下每5～7 d更换1次[1].频繁的肠造口排泄物渗漏极易导致粪水性皮炎[2].有效的收集造口排泄物是提高造口患者残障接受度水平的重要保证,可帮助患者获得更好的生活质量[3].本研究回顾性分析了2008年1月至2013年1月在我院病房和造口门诊护理的肠造口排泄物收集困难而渗漏的患者68例,通过原因分析和优化处理对策,使肠造口排泄物得到了有效的收集,造口袋的佩带时间达到了5～7 d,现报道如下。

目的探讨复方乳酸左氧氟沙星阴道栓和来立信注射液(乳酸左氧氟沙星注射液)对阴道炎的治疗效果和经济效果。方法阴道炎患者162例,随机分为Ⅰ组和Ⅱ组,Ⅰ组给予复方乳酸左氧氟沙星阴道栓,Ⅱ组给予来立信注射液,运用药物经济学中的成本-效果分析方法进行比较。结果Ⅰ组治愈率97.6%,有效率100%,Ⅱ组治愈率95.0%有效率100%,两组无显著差异(χ2=0.6923,P>0.05),但治疗成本上却有很大差异。结论药物经济学在优化治疗方案、帮助临床用药、减轻病人经济负担等方面都具有重要意义。