Objective:To retrieve, evaluate and summarize the evidence of prevention of venous thromboembolism in gynecological cancer patients during perioperative period, so as to provide scientific basis for clinical practice.Methods:We systematically searched the Chinese and English databases, the guide website, and the professional association website for evidence on the prevention of venous thromboembolism in gynecological cancer patients during perioperative period, including the guideline, evidence summary, recommended practice, systematic review, and expert consensus. The retrieval time limit was from the establishment of the database to February 19, 2022. Two evidence-based trained researchers selected corresponding evaluation tools according to different types of articles to evaluate the quality of the articles, including the extraction, translation and integration of recommendations.Results:A total of 18 articles were included, including 9 guidelines, 1 evidence summary, 2 recommended practices, 5 systematic reviews, and 1 expert consensus. Finally, 20 pieces of evidence were formed from 6 aspects: risk factors, admission assessment, deep venous thrombosis screening, prevention of venous thromboembolism, duration and health education.Conclusions:This study summarizes the best evidence for prevention of venous thromboembolism in gynecological cancer patients during perioperative period, in order to reduce the incidence of venous thromboembolism in patients through early prevention, screening and identification, and provide evidence-based basis for clinical nurses.

近年来随着临床对PICC的使用量增加，随之会出现一些PICC保护的问题，比如会出现贴膜卷边；输液接头使用胶带固定于手臂或贴膜上，会出现压迫症状；穿刺点渗血，增加感染的风险等情况，不仅增加患者经济负担和痛苦，还增加了护理工作量。目前临床使用的网状弹力绷带虽有保护固定作用，但是随着时间的延长，弹性变差，不能起到保护作用。为克服现有技术不足，笔者设计了一种可视PICC保护套，现介绍如下。

本文总结了1例因穿刺部位选择不当导致桡神经损伤的护理经验,包括药物治疗、物理治疗、心理干预以及预防措施等.

本文主要总结了1例宫颈炎症性肌纤维母细胞肿瘤(IMT)患者的围手术期护理经验,包括术前的入院介绍、护理评估、疾病讲解以及术前准备,术后的体位摆放、饮食指导、管道管理、疼痛干预、并发症防治等.

目的 探讨缓解化疗脱发对妇科肿瘤患者治疗期间焦虑情绪的影响.方法 选取本院妇科2017年1月—2018年7月术后辅助化疗行TP(紫杉醇+顺铂)方案的60例恶性肿瘤患者为研究对象.按照随机数字表法将患者分为干预组和对照组,每组各30例.对照组进行常规治疗和护理,干预组在常规治疗及护理的同时,化疗期间佩戴冰帽,同时加强护士与患者的互动.化疗4个周期后,采用焦虑自评量表(SAS)评估两组患者的焦虑程度,比较两组患者的脱发程度.结果 护理后,干预组患者的脱发程度、焦虑程度明显轻于对照组,差异有统计学意义(P<0.05).结论 治疗期间佩戴冰帽能缓解患者脱发,维持患者外观形象,加强护士与患者的互动,能够有效改善妇科肿瘤患者的焦虑情绪.

妇科恶性肿瘤术后淋巴囊肿是常见的手术并发症,不仅影响患者的生活质量,如果出现感染甚至会危及患者生命.大黄、芒硝外敷,穿刺置管引流及硬化治疗是目前常用的治疗方法.选择适当的手术路径、术中开放后腹膜、放置经腹引流管、适当使用止血材料及能量器械、尽量避免不必要的腹腔化疗、围术期尽量纠正低蛋白可降低术后淋巴囊肿的发病率.

目的 探讨新型腹带在妇科腹盆腔术后患者中的应用效果.方法 将腹盆腔术后需要应用腹带的200例患者按时间先后分成2组,2014年1-12月的100例患者设为对照组,2015年1-12月的100例患者为试验组,对照组采用国内现有腹带,试验组采用新型腹带(此腹带已获得专利).观察并比较2组伤口暴露次数、腹带上窜现象发生率、引流管打折受压次数和医护人员满意度.结果 对照组在伤口暴露次数、腹带上窜现象发生率、引流管打折受压次数发生率分别为16%(16/100)、42%(42/100)、8%(8/100),试验组均为1%(1/100),差异有统计学意义(χ2=5.70~49.80,均P<0.05).试验组医护人员满意度为98%(98/100),高于对照组的86%(86/100),差异有统计学意义(χ2=9.783,P<0.05).结论 本款实用新型腹带经临床应用效果满意,可减少伤口暴露次数;防止患者在使用腹带过程中腹带上窜现象发生;能够妥善固定尿管及引流管;可有效提高护理服务的连续性,减轻了护理工作量;提高医、护、患的满意度.建议在临床推广使用.

目的 探讨妇科手术后监测血钾的倾向性及低钾血症的影响因素.方法 回顾性分析2012年1月至12月在北京大学第一医院妇科行择期手术的325例住院患者术后低钾血症的临床资料.比较术后监测血钾组与未监测血钾组及低钾血症组与血钾正常组恶性肿瘤、清洁洗肠、开腹手术、是否48 h后进普通饮食(普食)等临床特点.结果 术后监测血钾组与未监测血钾组恶性肿瘤、清洁洗肠、开腹手术、48 h后进普食与术后监测血钾相关(r分别为41.262、30.656、28.564、25.270,p均=0.000);多因素分析显示,手术方式、肠道准备类型是妇科手术后是否监测血钾的独立影响因素(OR=2.608,95％CI:1.405 ～ 4.839;OR=2.620,95％CI:1.535 ～4.471).术后低钾血症组与血钾正常组术后48 h内进普食者与术后低钾血症相关(r=5.525,p=0.030).结论 对恶性肿瘤、清洁洗肠、开腹手术、术后48 h后开始进普食患者,术后应加强监测患者术后血钾情况,对低钾血症者提早采取补钾措施,以保证患者安全.

<正>我院积极响应2010年卫生部提出的"优质护理服务示范工程",特别是妇产科荣幸地成为全院优质护理服务试点病房。在开展优质护理服务期间,科主任和科护士长认真贯彻落实,充分调动大家情绪,让全体护士牢记"以患者为中

Objective To explore an effective method to prevent the postoperative shoulder pain after gynecologic laparoscopy. [Methods] Ninety-eight patients who underwent laparoscopic surgery in No.1 Gynecologic Ward of Peking University First Hospital from Jun.2004 to Aug.2004 were randomly divided into two groups with 49 cases each. The treatment group received intraperitoneal instillation of 2000 ml fluid, which was drained before suturing of the incision, at the conclusion of operative laparoscopy to assist the evacuation of residual intra-abdominal gas. The control group received traditional method to evacuation of residual intra-abdominal gas. The postoperative shoulder pain was evaluated by visual analog scores (VAS) 6 hours, 1 to 4 days after laparoscopy. [Results] The frequency of shoulder pain was significantly lower in the treatment group (36.7 %)compared with the control group (55.1, P 0.05). Among patients with shoulder pain, the ratio of double-side shoulder pain was also significantly lower in the treatment group (38.9%) compared with the control group(92.6%, P 0.001). The shoulder pain occurred commonly during the first 3 days in both groups. The pain persisted for an average of (1.8±1.3) days in the treatment group and (2.4±1.3) days in the control (P =0.056). The mean VAS score was (2.9±1.4) in the treatment group and (3.3±1.6) in the control (P 0.05). The mean days of hospitalization and recovery to work were similar between the 2 groups. There were no major postoperative complications in either group. The patient satisfaction rates were also similar in the two groups. [Conclusions] Postoperative shoulder pain frequently occurs following laparoscopic surgery. Intraperitoneal fluid instillation at the conclusion of operative laparoscopy to assist the evacuation of residual intra-abdominal gas decreases the the frequency of postoperative shoulder pain.