目的 分析综合护理干预对急性心肌梗死(AMI)患者下肢深静脉血栓形成(DVT)的影响.方法 收集2017年12月～2018年12月入住我院的92例AMI患者,分为对照组与观察组各46例,对照组与观察组分别实施常规护理干预措施和综合护理干预措施,分析两种不同的护理方案对患者下肢DVT的影响.结果 观察组与对照组下肢DVT发生率分别为4.35％、17.39％(P<0.05).在护理质量评分方面,观察组入院评估、血栓知识宣教、血管专项护理、防护技能指导的评分均显著高于对照组.护理后观察组患者的aPTT、PT、TT上调及Fbg水平下调均明显优于对照组患者;观察组患者护理满意达到了97.83％,高于对照组的78.26％(P<0.05).结论 综合护理干预的实施可减少AMI患者下肢DVT的发生,改善患者凝血功能,提高护理质量值.

Objective To explore the values of SMART nursing principles in preventing the occurrence of delayed hematoma after coronary angiography in elderly patients.Methods From August 2013 to January 2017,120 patients with acute coronary syndrome in our hospital were selected as the research objects.All the patients were divided into observation group(60 cases) and control group(60 cases),accordeding to the random lottery envelopes randomly.All the patients were treated by transradial approach coronary intervention.The control group was given the perioperative routine care.The observation group was given the SMART nursing principles intervention based on the control group.The nursing of two groups was observed for 1 month.Results The incidence of Delayed Limb hematoma in the observation group and the control group were 1.7％ and 13.3％,respectively.The observation group was significantly lower than that of the control group (P＜0.05).The observation group after the nursing of prescribed medication,self monitoring,motion management and diet management score were 12.35 ± 2.09,21.84 ± 2.83,11.52 ± 1.98 and 15.43 ± 2.37,while the control group scores were 9.74±1.79,17.49±2.21,8.24±1.74 and 13.21±2.14 (P＜0.05).The satisfaction degree of the observation group and the control group was 100％ and 88.3 ％,respectively.The satisfaction of the observation group was significantly higher than that of the control group (P＜0.05).The pain scores in the observation group and control group after nursing were 2.12±0.38 point and 2.72±0.45 point,which were significantly lower than those before treatment (P＜0.05),The pain scores of observation group were significantly lower than that of the control group (P＜0.05).Conclusion The SMART nursing principles can prevent the occurrence of delayed postoperative limb hematoma after transradial coronary angiography in elderly patients,improve self-care ability,relieve pain and improve nurse patient relationship.

Objective To establish cardiac catheterization room nursing quality sensitive indicator system based on the structure-process-outcome theory, so as to guide clinical nursing and evaluate cardiac catheterization room nursing quality. Methods Based on structure-process-outcome theory,the sensitive indicator system were established by literature review,expert group discussion, Delphi method .Results The returning rates of questionnaires in the first and second round expert consultation were100.00% and 96.77%, respectively. The authority coefficient of the experts was 0.88, and the coordination coefficient of experts′ opinion was 0.293. The program included 3 first indexes, 17 second index, and 55 items. Conclusion The result of the study is scientifically reliable and credible, which can provide evaluation for the clinical nursing operation.

Objective To discuss the application effects of interactive mode of health education in patients with coronary heart disease. Methods From January 2013 to June 2013, 90 patients with coronary heart disease in our hospital were selected as control group, and from January 2014 to June 2014, 90 patients with coronary heart disease in our hospital were selected as observation group. The patients of control group were given health education, while the patients of observation group was given interactive mode of health education. We compared the difference of treatment compliance after general self management efficiency education between these two groups. Results After education self management effectiveness was obviously higher in the observation group than that of the control group (t =11. 236, P <0. 01). Since the implementation of interactive mode health education nursing intervention, the scores of medicine compliance, reasonable rest, fellow-up on time, reasonable diet, giving up smoking and drinking, reasonable exercise, preventing infection and total scores [(2. 83 ± 0. 42), (2. 95 ± 0. 54), (2. 82 ± 0. 41), (2. 77 ± 0. 44), (1. 97 ± 0. 43), (2. 89 ± 0. 64), (2. 89 ± 0. 37), (18. 76 ± 1. 68)] were significantly higher than that control group (t=5. 224, 6. 035, 5. 942, 4. 993, 4. 798, 5. 648, 6. 498,5. 858;P<0. 01). Conclusions Interactive mode of health education based on routine health education can improve motivation, self management ability, and treatment compliance in patients with coronary heart disease health education.

Objective The objective of this study was to examine the effects of social support and stressful life events on health-related quality of life ( HRQoL) in female patients with acute coronary syndrome (ACS).Methods The subjects were 260 ACS (including acute myocardial infarction and unstable angina) female patients in Cardiovascular Department in a level three class A hospital from January 2014 to July 2015. Study group included acute myocardial infarction patients and unstable angina patients. The general condition questionnaire, the 36-item short form medical outcome questionnaire ( SF-36) , social readjustment rating scale and multidimensional scale of perceived social support were used as measurement tools. Multivariate linear regression analyses were performed to assess the relationship between domain of HRQoL and general condition, stressful life events and perceived social support. Results In female patients with ACS, both physical and psychological domains of the HRQoL were associated only with social characteristics, especially with perceived social support.Conclusions Perceived social support and stressful life events have independent significant effects on the HRQoL in female patients with ACS. When planning cardiac rehabilitation programs, special attention should be paid to patients who experience high levels of stress and have low social support.

目的 探讨老年慢性心力衰竭患者的自我感受负担状况,并分析其影响因素.方法 运用横断面调查法,对242例老年慢性心力衰竭患者采用一般资料调查问卷、自我感受负担量表进行问卷调查.结果 慢性心力衰竭患者的自我感受负担得分均值为(33.26±8.78)分,总体处于中度水平;单因素、多因素回归分析显示心功能分级、医疗费用支付方式、年龄、病程、合并症种类5个因素为老年慢性心力衰竭患者的自我感受负担的主要影响因素(P＜0.05,P＜0.01).结论 自我感受负担在老年慢性心力衰竭患者中普遍存在,且受多种因素影响,医护人员应开展有针对性的干预措施.

Objective To evaluate the effect of nursing intervention on the quality of life of patients with heart failure based on the transtheoretical model ( TTM).Methods Totals of 100 heart failure patients were divided into the control group and the intervention group , 50 cases each .The control group was treated with conventional health education .The intervention group was treated with the nursing intervention based on TTM . We evaluated the quality of life in the time of before intervention , 1 month and 3 months after the intervention , respectively , by the Minnesota living with heart failure questionnaire ( MLHFQ) , and compared the differences . Results 1 month and 3 months after discharge , 2 cases were died and 5 cases were lost during the follow-up in the intervention group , and 43 cases finished the investigation .3 cases were died and 7 cases were lost during the follow-up in the control group , and 40 cases finished the investigation .Before the intervention , 1 month and 3 months after the intervention, the total score of MLHFQ were (40.14 ±17.59), (59.98 ±17.44), (52.28 ±16.46) in the intervention group, and (38.45 ±16.00), (45.25 ±14.80), (41.30 ±14.40) in the control group .Before the intervention , there was no statistically difference between the two groups ( P>0.05).After the intervention for 1month and 3 months, the differences were significant ( t =3.29, 3.22, respectively;P<0.05).Conclusions Comparing with the conventional healthy education , the method based on TTM is one of the most effective ways , which can improve the quality of life of patients with heart failure . Thus, it is worthy of getting widely promoted in hospital .

>经皮冠状动脉支架介入手术(简称经皮冠脉介入术,PCI)已成为治疗冠心病的主要手段,如何预防、减少术后并发症的发生,成为保证手术质量和手术成功的关键环节,也是医护关注的重点。我科2006年2-9月收治3例经皮冠脉介入术后皮下注射低分子肝素抗凝药物数日后出现腹壁淤青、大血肿患者,经精心护理后取得了满意的效果,现报道如下。

扩张型心肌病所致心力衰竭是心肌细胞舒缩功能减弱,心肌细胞失去增值能力或增值能力极低[1].增加具有舒缩功能的心肌细胞数目是改善心功能的关键.干细胞是具有自我更新、多分化潜能的早期未分化细胞[2].骨髓干细胞(MSCs)移植可分化成心肌细胞,增加有功能的细胞,新生的血管内皮细胞形成的侧支循环改善了供血及心脏局部和整体收缩功能[3].我科于2004年8月开展MSCs移植术治疗心力衰竭病人12例,均采用导管介入移植手术,在病人同意下行自体MSCs冠状动脉内注射,MSCs移植与经皮冠状动脉成形术一并进行,现将其护理总结报道如下.

护理服务成本是医院成本核算不可缺少的一部分,临床护理服务在疾病诊治与康复中占很大的比重,而护理服务成本却普遍降低,护士的劳动价值没有受到足够的重视.

心肌病是一种以心肌功能障碍为主要表现的心肌疾病,因其妊娠可加大循环血容量,临床上不建议妊娠.妊娠到32周循环血容量可增加原血容量的30%～45%[1],极大地加重了心脏负荷,极易造成心衰,造成胎儿宫内供血供氧不足,引起孕妇及胎儿两方面的危险.我科收治了1名35岁心肌病患者妊娠32周合并心衰,经医护人员精心治疗、护理,在产科行剖宫术,顺产双胎女婴.现将护理体会介绍如下.

患者,女,24岁.3天前因劳累后出现乏力,逐渐加重,尿呈茶色,既往于2年前诊断"溶血性贫血",2003年1月8日入院.