目的 观察集束化护理对于慢性阻塞性肺疾病(COPD)并Ⅱ型呼吸衰竭患者的护理效果.方法 125例临床确诊为COPD并Ⅱ型呼吸衰竭的住院患者,随机分为集束化组65例及对照组60例.对照组采取常规护理措施,集束化组采取集束化综合护理方案.比较两组患者的临床疗效、平均住院天数、对护理工作的满意度和痰标本留取正确率.结果 集束化组有效率达95.4％,高于对照组的85.0％；平均住院天数为(12.6±3.9)d,短于对照组的(15.7±5.5)d；对护理工作的满意度为93.8％,痰标本留取正确率为95.4％,分别高于对照组的81.7％和75.0％.两组比较差异均有统计学意义(P＜0.05或0.01).结论 集束化护理对COPD并Ⅱ型呼吸衰竭患者有较好的护理效果.

Objective To study the correlation between the negative mood and social support in patients with medical thoracoscopy,to seek corresponding nursing strategy.Methods According to the patients'psychological state,they were treated with psychological and social supports.Self-rating anxiety scale (SAS) and self-rating depression scale (SDS),social support rating scale (SSRS) were used to assess the effect of before and after intervention.Results Before intervention the scores of anxiety and depression were all higher than those of control group (P ＜ 0.05),the score of the social support was lower.than that of the control group (P ＜ 0.05).After nursing intervention,all the scores of the patients' anxiety,depression and social support were significantly improved (P ＜ 0.05).Conclusions The patients with medical thoracoscopy have obvious negative mood,the level of social supports is low.It can improve the patients' nursing effects correctly analyzing the patients'psychological state and offering nursing intervention.

Objective To observe the nursing efficacy of cluster-based care for bronchial asthma.Methods 100 cases with bronchial asthma were randomly divided into the study group and the control group with 50 patients in each group.The control group received usual care,and the study group received cluster-based care model.Curative effect,the total of the cases received inhalation therapy correctly,compliance of inhalation therapy,degree of satisfaction to nursing services in the two groups were compared.Results The curative effect in the study group were better significantly than the control group (86％ vs 58％).The cases received inhalation therapy correctly in the study group were more than the control group (92％ vs 72％).The compliance of inhalation therapy in the study group was significantly higher than the control group(90％ vs 80％).The degree of satisfaction to nursing services in the study group were significantly higher than the control group (98％ vs 86％).Conclusions Cluster-based care had good effect on patients with bronchial asthma.

Objective To explore the curative effect of pulmicort respules atomization inhalation in the treatment of acute episode of bronchial asthma in elderly patients.Methods 66 patients from the Affiliated Hospital of Guangdong Medical College,from April 2010 to May 2011,were enrolled in this study.They were randomly divided into 2 groups according to numerical table.All patients were treated with normal regulations for cough,gasping,anti-infection.In addition,routine atomization inhalation was used in the control group and pulmicort respules inhalation was used in the observation group.The effect was evaluated from two aspects: the clinical curative effect and the improvement of pulmonary function.Results The clinical curative effect and the improvement of pulmonary function in the observation group were better than those in the control group,and there were significant differences between them(P<0.05).Conclusions The pulmicort respules atomization inhalation was an effective method in the treatment of acute episode of bronchial asthma in elderly patients.

Objective To explore the effect of nursing intervention on sleep quality and exercise of self - care of COPD patients.Methods A total of 56 COPD patients from the hospital between February 2011 and February 2011 were randomly divided into two groups according to numerical table.The control group ( 28 patients) was received routine nursing,while the experimental group (28 patients) received nursing intervention.The effects were evaluated from two aspects:the sleep quality and the exercise of self - care.Results The sleep quality and the exercise of self-care in the experimental group were better than those in the control group,and there were significant differences.Conclusions Nursing intervention can effectively improve the sleeping quality and the exercise of self - care of COPD patients.

Objective To observe the application effect of the Iodophors hygro-gauze on tracheotomy wound dressing. Methods Fifty patients who underwent tracheotomy with Ⅲ incision, were chosen to be divided into the control group and the observation group with 25 in each group. With saline water cleaning incision and surrounding skin, then disinfection with 0.5% iodophors sanitizers tampon. The observation group applied 0.5% Iodophors hygro-gauze on the wound, the control group used vaseline oil yarn. 24 hours after sample inspection, again samples were sent for bacteria analysis, bacterial colonies number, pathogenic bacteria growth and local situation of wound were observed and analyzed. Results The first results upon disinfection showed that bacterial colonies number, pathogenic bacteria growth between the two groups had no difference. After 24 hours sampling showed that the colony count and pathogenic bacteria growth of the observation group was obviously less than the control group. Local wound infection of the observation group was lighter than the control group. Conclusions 0.5% Iodophors hydro-gauze applied for tracheotomy wound dressing can effectively kill various pathogenic microorganism, prevent secondary infection, and also can prevent and treat wound infection.

Objective To survey and analyze the influence of nurses' health level on performing the social role and their life quality, explore the effect of health concept on nurses' life quality.Methods A total of 200 clinic nurses were randomly divided into two groups: control group and intervention group. 100 cases were in each group. The nurses in intervention group were conducted with a series of targeted health education. Self-designed scale and WHOQOL-100 were used to assess nurses' chronic disease, social role etc. The situation of life quality was compared between two groups before and after education.Results There were statistical differences between two groups in performing social role and life quality after intervention.Conclusions The nurse's health level has an effect on performing the social role and their life quality. The application of health concept can eliminate or reduce the affection of the risk factor of health, set up health life and working manner to improve their life quality.

Objective To investigate how the family health education and nursing intervention reduce asthma attack and improve the life quality of asthma patients.Methods Health education was implemented among50 cases of asthma pstients and their family.The adult asthma quality of life score shect and St o George respiratoty questionnaire(SGRQ)scale were adopted for patients.The life quality of sustained intervention was compared with that of we-intervention after 6 months. Results After 6 months interveatien,the score of life quality and the score of SGRQ were statistically significant(P＜0.05).Cenclusions The family health education and nursing intervention can improve medication compliance,reduce acute attack,cut their charges and improve their life quality.

随着AIDS在全球范围的扩散和蔓延,目前我国AIDS流行形势十分严峻,艾滋病流行正从高危人群向普通人群扩散,到医院就医的AIDS患者和HIV感染者不断增加,护理人员直接或间接地与艾滋病患者的血液及体液接触的机会很多,从而发生HIV职业暴露危险的因素在增加。因此护理人员应充分认识HIV职业暴露的危害性,以及可能造成职业暴露的环节,应采取积极有效的防范措施,妥善保护好自己及其她相关人员,最大限度地减少因HIV暴露所造成的医源性感染。

Objective To understand the nurses' recognition to the continuous scheduling model so as to provide the basis for further implementing the continuous scheduling model. Methods The nurses are investigated by using self-made questionnaires. Results Most of the nurses can recognize the advantages of the continuous scheduling models and provide the continuous, balanced and high-qualified care services for patients.Conclusions The continuous scheduling models make the allotment of nursing human resources more scientific and more rational, and help to improve the care services and its quality.

目的探讨协同护理模式应用于支气管哮喘急性发作期患者护理中的实施效果。方法将62例支气管哮喘急性发作期住院患者随机分为对照组和观察组。两组患者均接受规范的控制哮喘急性发作的治疗,在此基础上对照组接受常规护理,观察组按照协同护理模式进行护理。比较两组患者治疗后的肺功能、对支气管哮喘认知程度的及格率、住院时间及医疗费用等。结果观察组患者肺功能指标有明显改善(P<0.05),对支气管哮喘认知程度的及格率明显高于对照组(P<0.05),观察组住院时间短、医疗费用低,和对照组比较有显著性差异(P<0.01)。结论应用协同护理模式对支气管哮喘急性发作期患者进行护理可提高护理的质效。

Objective To investigate the application of self - efficacy theory in asthmatic patients'nursing Methods 179 bronchus asthma outpatients from respiratory department of our hospital during 2007 - 3 to 2008 - 5 were randomly divided into intervention and control groups, conventional therapy and nursing were given to both groups, the intervention group was applied enhancing self - efficacy's nursing ways and methods on the basis of conventional therapy and nursing. Self - efficacy questionnaire was carried out and lung function was tested at admission and 3 - month post - therapy. Results Two groups had no statistically significant ( P > 0. 05 ) in GSES score at admission. After 3 - month, the GSES score of intervention group was significantly improved ( P < 0. 05 ) compared with that of control group; the levels of FVC, FEV1 and PEFR of both group were significantly increased (P < 0. 05) after intervention. Conclusions Self - efficacy theory can improve therapeutic efficacy of asthmatic patients.

Objective To explore the influence of the health belief model education on the life quality of nurses.Methods 200 nurses were randomly divided into the experimental group and the control group with 100 cases in each,the experimental group received health belief model education while the control group was given no intervention.The life quality of nurses before and after the education was compared.Results The life guality of nurses showed no significant difference between the two groups before the health belief model education,one month after health belief model education,life quality of nurses in the two groups showed significant difference.Conclusions Application of the health belief model education can improve the nurses'quality of life.

目的 探讨健康教育对哮喘患者生命质量的影响.方法 选择103例门诊就诊的支气管哮喘患者,在常规治疗的基础上,进行健康教育:心理护理、家庭支持、饮食指导、体育锻炼、用药指导.健康教育前及健康教育后3个月由专科护士采用交谈法对生命质量进行评估,同时测定肺功能.结果 经过3个月的健康教育,患者的活动受限、回避刺激物、哮喘症状、哮喘症状、心理情绪、刺激物反应、对疾病的担心等指标与健康教育前比较,差异有统计学意义(P＜0.01);健康教育后肺功能FVC、FEV1和PEFR均有显著提高(P＜0.01).结论 健康教育可以提高哮喘患者对于疾病的认识,提高生命质量。

目的 评价拍背结合体位排痰对急性发作期慢性阻塞性肺疾病(COPD)患者的辅助治疗效果.方法 将60例急性发作期COPD患者随机分为排痰组及对照组,对照组接受常规护理和治疗,排痰组在此基础上加用规范的拍背结合体位排痰护理措施,然后评估患者的排痰效果以及血气指标.结果 本护理措施患者耐受良好;可明显改善老年急性发作期COPD患者的排痰效果;第5天,排痰组与对照组的血氧分压[(87.5±4.9),(79.9±5.3)]mm Hg(1 mm Hg=0.133 kPa)、二氧化碳分压[(50.9±7.7),(56.3±6.5)]mm Hg以及pH值[(7.38±0.05),(7.32±0.11)];第7天两组数值的比较依次为:[(90.9±5.4),(82.4±5.9)]mm Hg、[(47.9±7.2),(52.7±8.3)]mm Hg、[(7.40±0.11),(7.31±0.09)].两组比较具有统计学意义.结论 拍背结合体位排痰是COPD患者一简便而行之有效的护理措施,值得推广。

Objective To discuss the method to increase the success rate of stomach tube insertion for patients with indwelling nasotracheal tube in order to shorten the time of insertion operation and reduce the discomfort of patients.Methods Seventy patients with nasotracheal tube were randomly divided into the observation group(38 cases)and the control group(32 cases).When the operator for the observation group inserted stomach tube to 18～22 centimeters deep,the nurse pumped the gas out from the tracheal catheter aerocyst.After the stomach tube reached stomach the tracheal catheter aerocyst was aerified again.The control group did not release the gas from tracheal catheter aerocyst when inserting the stomach tube.The first intubation success rate and time needed for intubation were compared between the two groups.Results The first intubation success rate of the observation group was higher than that of the control group(P＜0.05).While the time needed for intubation was shorter than that of the control group(P＜0.01).Conclusions Method used by the observation group not only increased the first intubation success rate,but also shortened time needed for intubation.This method can alleviated pain of patients and worth applying widely in clinic.

目的 为了更好的配合医生经鼻气管插管抢救重危患者,缩短插管时间,提高插管成功率,减少并发症及减轻患者的不适感,探讨经鼻纤维支气管镜引导气管插管和经咽喉镜引导气管插管的护理配合.方法 符合经鼻气管插管机械通气治疗指征患者50例,随机分为两组,分别经鼻纤维支气管镜引导气管插管(简称纤支镜组)和经咽喉镜引导气管插管(简称喉镜组),人工气道建立成功后,接机械通气治疗.结果 纤支镜组与喉镜组在插管时间[(3.7±1.9),(5.5±2.9)min]、一次插管的成功率(92.6%,69.6%)及损伤性鼻出血(3.7%,26.1%)方面统计结果均有统计学意义(P＜0.05).结论 护士准备气管插管用物时要备好经鼻纤维支气管镜和经鼻咽喉镜引导气管插管用物,确保配合医生缩短插管操作时间、提高插管成功率、减少并发症,从而达到快速、安全、准确建立人工气道的目的 .

目的探讨长期氧疗对慢性阻塞性肺病(COPD)患者的疗效及护理.方法对46例COPD稳定期患者进行3年的长期氧疗,于长期氧疗前及长期氧疗后观察患者住院次数、呼吸困难改善情况、动脉血气分析及血浆白蛋白的变化情况.结果氧疗后1、2、3年与氧疗前基础值比较,患者住院次数减少,呼吸困难等临床症状显著减轻,低氧血症改善,营养状况好转.结论合理使用长期氧疗对COPD患者有良好的治疗作用,可提高患者生活质量;而重视心理护理,加强氧疗的护理及出院指导是护理的关键.

目的探讨胸部经皮针肺组织活检术的护理.方法对677例肺部外周肿瘤的病人,用口述和模拟示练方法,实施术前、术中、术后健康教育内容,病人达到理会、配合并控制呼吸技巧,接受胸部经皮针肺活检术.结果病人接受相关健康教育后,掌握呼吸技巧,控制呼吸好的病人并发症发生率明显低于术中配合不好的病人,尤其是年龄≥60岁的病人,同时伴有COPD的病人气胸并发症明显高于单纯肺部肿瘤患者.结论防范胸部经皮针肺组织活检术并发症的主要措施:病人必须确认呼吸技巧,屏气,避免咳嗽的重要性,同时掌握并控制呼吸,尤其是老年人和伴有COPD的病人术中配合更重要.

为了解住院病人对科室综合管理工作的反馈信息,我们对267例住院病人进行问卷调查,结果是83.2%病人对科室管理工作感到满意,但同时也发现存在不足之处,主要表现在对住院环境方面,对进行健康教育宣传方面以及对病房工人的意见比较大,为此,我们采取了积极有效的改进措施,加强医护服务质量管理,收到良好效果,现总结报道如下.