目的 探讨循证护理对烟雾病患者联合血管重建术(颞浅动脉—大脑中动脉搭桥+颞肌贴敷术)后并发症及生活质量的影响.方法 将2019年5月至2020年12月收治河南省人民医院神经外科因烟雾病接受联合血管重建术的106例患者根据护理方式分为观察组和对照组,观察组53例,对照组53例.对照组行常规护理,观察组在对照组的基础上实施循证护理.观察两组患者护理后并发症发生情况;并比较两组患者护理前后简明健康量表(SF-36)、日常生活能力评分(ADL).结果 对比两组并发症发生率,观察组低于对照组(P<0.05);对比两组护理前SF-36、ADL评分差异无统计学意义(P>0.05),护理后两组SF-36、ADL评分高于护理前,且观察组高于对照组(P<0.05).结论 循证护理能够减少烟雾病联合血管重建术患者术后并发症的发生,并有利于提高患者术后生活质量和生活能力.

目的:调查农村居民对脑卒中警示症状的认知情况及急救意识,为脑卒中的预防控制提供参考依据.方法:采用便利抽样法对新蔡县508名农村居民进行一对一问卷调查.结果:农村居民缺乏锻炼、高血压、高血脂、脑卒中家族史、吸烟、糖尿病和饮酒等危险因素暴露率分别为65.2％、53.3％、46.3％、36.4％、23.4％、19.7％、17.1％;其中,仅有31.0％的高血压病人,25.5％的高血脂病人,25.0％的糖尿病病人规律服药.65.94％的农村居民不知道脑卒中的预警症状;如果突发脑卒中,44.1％的农村居民选择求救儿女,40.9％的农村居民选择求救于村医,15.0％的农村居民选择不做任何处理.结论:农村居民脑卒中危险因素暴露率较高,危险因素的管理情况较差,对脑卒中警示症状认知水平不高,应尽早对农村居民进行脑卒中筛查并加强健康教育.

Objective: To explore the feasibility and safety of modified lower limb immobilized time after transfemoral cerebral angiography. Methods: A total of 100 cases of cerebrovascular angiography with modified lower limb immobilized time in the cerebrovascular disease fifth ward of Henan People's Hospital from March 1, 2019 to May 20, 2019 were prospectively collected. The modified lower limb immobilized time was defined as removing the bandage after 4 hours of lower limb immobilized, and getting out of bed to ambulate after 2 hours exercise of the punctured side lower limb on the bed. The primary safety observation indicators included subcutaneous hematoma, pseudoaneurysm, and arteriovenous fistula after lower limb excercise. Secondary safety indicators included puncture point oozing and deep venous thrombosis of the punctured lower limb. Results: All patients had no delayed subcutaneous hematoma, pseudoaneurysm and arteriovenous fistula. There were three other adverse events. One patient had subcutaneous congestion on the puncture side when the elastic bandage automatically released for 2 hours in bed, but the skin was soft and not indurated. The reason for subcutaneous blood stasis may be the spread of subcutaneous hematomas during puncture. The hematoma did not increase after the pressure bandage continued for 2 hours when patients were getting out of bed, and no pseudoaneurysm occurred within 24 hours. One patient developed a small amount of oozing, but no hematoma at the puncture site when the bandage removed after 4 hours of bed rest. No oozing and hematoma formation when patients continued to give another pressure 4 hours. One patient had a small subcutaneous hematoma after the conventional ultrasound, but no visible hematoma was visible to the naked eye. No deep vein thrombosis was found in all patients by ultrasound within 24 hours. Conclusions: It is safe and feasible to ambulate after immobilized the lower limbs for 4 hours and get out of bed for 6 hours after transfemoral cerebral angiography, but it still needs to be confirmed by large number of controlled studies. Key words: Cerebral angiography; Femoral artery puncture; Lower limb immobilized time

目的：了解脑卒中介入治疗患者住院不同阶段健康教育的需求内容及方式，提高健康教育的效率和质量。方法采用自行设计的调查表对100例脑卒中介入治疗的住院患者进行调查。结果患者入院时的主要需求是了解病情及相关检查；住院期间的主要需求是知道介入治疗方法及护理，并发症的预防；出院阶段的主要需求为用药安全及康复指导。结论脑卒中介入治疗患者住院不同阶段的健康教育需求存在多样性，对患者进行针对性教育，可提高患者的掌握度和满意度，提高护理工作效率和卫生资源的利用率。

目的：了解介入脑血管科护士在情感模拟体验过程中人文关怀能力的改变。方法分角色体验脑血管介入治疗患者及其家属在围术期24 h的感受，以质性研究中的现象学方法为指导，采用一对一深度访谈法收集资料，按Giorgi的分析程序进行资料分析。结果护士参与情感模拟体验之后，对情感模拟体验认同度得到了提高，人文关怀品质得到了提升，护理工作者之间的友谊得到了加强。结论情感模拟体验提升护士的人文关怀品质。

Objective To discuss the clinical application of medical coordination and hierarchical responsibility system in interventional nursing care which is carried out based on the “Henan Province Model”. Methods From November 2003 to April 2014 at authors’ hospital, medical coordination and hierarchical responsibility system was executed through setting up a ranking system of nursing position , optimizing shift process , dividing physician-nurse medical liability groups , strengthening medical training , implementing medical coordination service mode, etc. The clinical results were compared with those of conventional nursing care that were recorded during the period from May to Oct. of 2013. Results After implementation of medical coordination and hierarchical responsibility system, the quality of medical care, the patent’s satisfaction, the cooperation satisfaction of physicians and nurses were significantly improved. Compared with those before implementation of medical coordination and hierarchical responsibility system , the differences in the above indexes were statistically significant(P<0.01 or P<0.05). Conclusion Based on multidisciplinary joint diagnosis and treatment, and combined with coordination physician-nurse service mode, the enthusiasm of nursing staff can be motivated and the tacit understanding between physicians and nurses as well as the quality of nursing service can be improved. All of the above will promote the development of nursing discipline.

ObjectiveTo study impacts of the new healthy education mode on patients with cerebral angiography.MethodsRandomly split 964 patients into observation group and control group (482 patients in each group). Arrange these two groups of patients into two different nursing unit areas: nursing unit area one and nursing unit area two. We treat patients in the nursing unit area one with our new healthy education mode, and we treat patients in nursing unit area two with the regular healthy education mode. We want to compare them with their compliance during operation and their satisfaction.ResultsPatients in nursing unit area one have a signiifcantly higher compliance rate and higher satisfaction level than patients in nursing unit area two.ConclusionsOur new healthy education mode can ease patients’ tension, increase the operation compliance rate, and improve patients’ satisfaction level.

目的 改变脑卒中病房护理交接班模式,减少护士工作时间的消耗.方法 在传统的交接班模式的基础上进行改良,采用选择性参加晨会集体交接班.要求责任护士每天提前15 min进入病房了解病情,制定计划,护理患者;交班护士依次与接班护士分段床头交接分管区域患者的病情;护士长将原来晨会后提问,改变为下班前总结和布置明天工作,做到全程跟踪、指导、监督和控制.结果 改良后的护理交班模式,至少每天前移治疗时间45 min,缓解了中午时段的治疗压力;同时使护士掌握患者病情的熟练程度提升7％左右,住院患者满意度在原来的基础上提升3.2％左右.结论 改良后的护理交接班模式有效缩短了交班的时间,增加了护士的工作效率,满足了患者及家属的需求,提高了患者满意度.

目的总结介入治疗布加综合征的护理体会。方法对96例患者进行术前、术中、术后相应的护理。结果 96例患者中治愈95例,1例因无法开通而失败。结论术前心理护理,术后严密观察、精心护理、及时发现并发症和有效的健康教育是确保手术成功的关键。

目的 探讨氩氦刀治疗肝癌的护理效果.方法 对2012年4月至2012年6月应用氩氦刀冷冻消融治疗的10例肝癌患者的护理情况进行分析.结果 术后并发发热8例,体温最高达38.8℃；8例肿瘤缩小,2例肿瘤保持不变.经精心治疗护理,患者住院5～9d好转出院.结论 氩氦刀治疗肝癌后的并发症少,术后护理可提高其生存质量和治疗效果.

目的:探讨下肢动脉硬化闭塞症介入术后并发症的观察重点及措施。方法:对138例下肢动脉硬化闭塞症患者,将血管成形、内支架置入、血栓及斑块旋切、溶栓、血栓抽出等介入治疗术后出现的并发症进行分类、分析,针对性实施护理。结果:本组138例患者有32例出现术后并发症,其中穿刺部位巨大血肿9例、下肢过度灌注综合征2例、假性动脉瘤3例、消化道出血3例、支架内急性闭塞4例、支架再狭窄10例,造影剂迟发型变态反应1例,占手术的23.2%。结论:下肢动脉硬化闭塞症介入治疗并发症发生率较高,认真细致的观察护理,及早发现问题,及时地采取有效的措施对疾病的预后非常关键。