脑卒中是一种临床常见病，具有发病率高、致残率高、病死率高等特点。近年来，人们饮食结构、生活方式发生改变，摄入大量高脂肪、高胆固醇饮食，却缺乏运动锻炼，导致脑卒中发病率明显升高。即便是抢救成功的脑卒中患者，也存在不同程度神经功能受损，日常生活能力降低，给社会及家庭带来了沉重负担。有效、科学的健康管理，可降低脑卒中发生的风险，故对脑卒中的健康管理展开详细论述，具有重要意义。

知识经济时代的到来决定了人力资源在健康中的重要价值和地位,同时也决定了各个地区健康产业的发展.中国拥有庞大的卫生人力资源部门,但是在卫生人力资源部门信息化建设并不强大.如何将人力资源管理信息化,为经济社会发展作出贡献,是信息化人力资源管理的重要任务.该文以卫生人力资源管理信息化建设为论述主题,阐述了卫生人力资源信息化的意义、现状以及改进策略,以期为卫生人力信息化管理的完善提供一定的理论基础.

目的 探究医务人员对流感及接种流感疫苗的态度与接种意愿.方法 以该院已接种流感疫苗医护人员100名为对象,视为研究组,研究时间为2019年8月—2020年8月,选取同期未接种流感疫苗医护人员100名,视为参照组,对比两组流感及流感疫苗认知水平,并发放调查问卷,分析流感疫苗接种现状,掌握接种流感疫苗态度与接种意愿.结果 研究组流感及流感疫苗认知水平高于参照组,差异有统计学意义(P<0.05).两组的接种态度中:担心流感季节患病、相信国家疾控指导意见、极易感染流感、不接种疫苗会后悔相比较,差异有统计学意义(P<0.05).使用Logistic回归分析,疫苗接种与以下接种意愿和态度有关:不接种疫苗以及认为流感疫苗不良反应少会后悔、认为极易感染流感、相信国家疾控部门指导意见、担心流感季节患病(P<0.05).针对医护人员实施强制接种疫苗政策,流感疫苗的接种可能性较大以及非常可能占比为71.00％;若流感疫苗免费,护士的接种可能性较大以及非常可能医护人员占比52.00％.结论 流感疫苗接种意愿对接种行为产生直接影响,医护人员接种意愿越强烈,接受疫苗态度将更积极,应当加强医护人员的流感疫苗健康教育,推行强制接种或者免费接种政策,促使医务人员的流感疫苗接种率提高,预防流感.

Objective:To explore the application of root cause analysis(RCA) in assessing basic activities of daily living(BADL)of patients in neurology department.Method:RCA was used to determine the proximal cause and root cause of the defects in assessing BADL of patients in neurology department.Improvement measures were developed and implemented,the effects of the application of RCA were evaluated.Result:The incidence rate of defects in assessing BADL of patients in neurology department after the application of RCA was lower than that before the application of RCA,the difference was statistically significant(P<0.01).Conclusion:RCA is an effective method for reducing the defects in assessing BADL of patients in neurology department.

目的：探讨窦性心律震荡在发生交感风暴患者中的预测价值.方法：对52例发生交感风暴患者的心电图或动态心电图进行窦性心律震荡分析，测量其震荡初始(TO)、震荡斜率(TS)作为治疗组.同时将符合心电图条件且年龄、性别、基础疾病相匹配的心血管病高危患者50例作为对照组.观察二组之间TO、TS的变化规律及在交感风暴患者的敏感性、特异性、阳性预测值和阴性预测值.结果：TO≥0发生交感风暴患者中的敏感性、特异性、阳性预测价值、阴性预测价值分别是80.77%、76.00%、77.78%、79.17%；TS≤2.5 ms/RR时敏感性、特异性、阳性预测价值、阴性预测价值分别是92.31%、70.00%、76.19%、89.75%.结论：窦性心律震荡是预测交感风暴发生的良好指标.

总结了12例急性心肌梗死并发交感风暴患者的护理经验,包括:详细了解病情,严密观察生命体征,在心电监护中运用评判性思维,及时发现问题,留取心电图样本,配合医生有效抢救,保护脑组织,镇静等。认为经有效的治疗和护理,能够有效提高患者的生存率。

[目的]观察高危压疮病人实施三级监控流程管理的效果。[方法]建立三级监控组织,实施压疮流程管理,即压疮高危筛查、报告、预防、追踪、会诊、护理质量考评。[结果]实施三级监控流程管理后,难免压疮上报率增加,难免压疮发生率下降,院外带入压疮治愈率提高。[结论]三级监控流程管理是对高危压疮病人进行护理质量监控、防治压疮的有效管理手段。

Objective To investigate the chronic obstructive pulmonary disease with acute exacerbation(AE-COPD) of eonseiousneas. Methods For January 2004 to June 2008, AECOPD clinical data were reviewed retroepec-tively. Results 5 yeats treated 310 eases with AECOPD,impaired consciousness occurred in 16. 8% (52/310) : 29cases of pulmonary encephalopathy, hypotonic encephalopathy 12 cases ,5 cases of cerebral infarctinn,4 cases of drug-induced;clinical symptoms often show a variety,may be characteristic,but the cause of death by up to 55.6% of the total number of deaths(10/18). Conclusion AECOPD had high incidence of disturbance of eonseiousneas,and it isdiflleult to avoid completely;should pay attention to identify,first perform head CT or MR/examination to exclude or-ganic brain disease,according to arterial blood gas analysis,bloed electrolyte,to further determine the cause.

Objective To investigate pulmonary heart disease acute exacerbation of changes in the characteristics of thyroid function and significance. Methods Pulmonary heart disease with acute exacerbation of 200 cases as the observation group,in the same period 200 cases of healthyas control group, observation euthyroid sick syndrome (euthyroid sick syndrome, ESS) occurred, compared the observe and control groups, observer group in the survival group died with the group,ESS thyroid hormone treatment before and after the test results,ESS and death. Results Pulmonary heart disease with acute exacerbation of ESS incidence of 42. 5% (85/200) ;section observe the admission T3 ,FT3 lower than the control group;observer group in the survival group died and TSH group no significant difference,the group died T3 ,FT3 ,T4 ,FT4 were lower than the survival group( P＜0. 05 ) ;improvement in the treatment of primary disease, thyroid hormone, or return to near normal ; ESS mortality occurred in 30. 59% higher than a change of 13.04% mortality rate. Conclusion Serum thyroid hormone levels to reflect changes in the pulmonary heart disease in patients with acute exacerbation of the state of the body and severity of the dynamic serum levels of thyroid hormone can observe the development of pulmonary heart disease and prognosis.

绘画体温单是临床护理工作中不可缺少而经常性的操作,护士每天至少花费5～20min在这项工作上,对于不熟悉操作的护士花费的时间会更长.在临床实践中,我科利用体温单上的线条确定纵座标、横座标进行定位的方法对绘画体温单方法进行改进,现报告如下.

Objective To investigate the significance of D-dimer (DD) in predicting thrombosis in the patients who had been carried out cardiovascular intervention. Methods The DD levels were tested before, and 1 day, 2 days, and 3 days after the operation in 892 patients who had been carried out cardiovascular intervention. Results The DD level increased significantly after the intervention in patients of all groups(P 0.01); in 128 patients that the DD levels increased significantly (≥1 000mg/L), and in 8 of these patients the DD levels maintained very high for two weeks, and all of these patients were found to have thrombosis. Conclusions Cardiovascular intervention can lead to the increase of DD level in patient's blood, but it is not persisting in most patients. If the DD level maintains at a high level, thrombosis may occur. Monitoring the changes of DD level, may be helpful to predict the risk of thrombosis.

射频导管消融(RFCA)已经成为一项成熟的技术.术后发生血栓栓塞事件是其并发症之一.D-二聚体(DD)作为反映血栓疾病的敏感指标,在临床上已经得到公认.能否将DD作为RFCA术后栓塞事件的预测指标,以及如何根据DD的变化预防血栓栓塞事件的发生,是电生理医生值得关注的问题.笔者总结了156例行RFCA的患者术后DD的变化,初步探索了预防术后栓塞事件的可能措施.

永久性心脏起搏器,是治疗各种原因引起的不可逆的心脏起搏和传导功能障碍性疾病的主要方法.在安置术后可能会出现一些并发症和起搏故障.这是患者最担心又最缺乏知识的一部分,如何让患者了解并防护这些并发症,最大限度地降低伤害,同时,正确地认识起搏器,减少不必要的顾虑,是护理人员必须掌握并向患者宣教的保健知识.患者掌握了这些知识,一方面可以消除一些不必要的顾虑,以积极正确的心态面对今后的生活,另一方面让患者了解一些防范措施,可主动地预防意外情况的发生.