目的 探讨地塞米松联合西咪替丁导管预处理对老年肿瘤患者经外周中心静脉置管(PICC)所致机械性静脉炎的预防作用.方法 选取451例拟行PICC的老年恶性肿瘤患者,采用随机数字表法分为生理盐水(NS)组155例、地塞米松(DXMS)组149例和地塞米松与西咪替丁联合用药(DC)组147例;3组均按PICC标准程序操作置入导管.在预处理导管时,NS组采用生理盐水预冲激活、浸泡导管;DXMS组采用0.125 mg/ml地塞米松溶液预冲激活、浸泡导管;DC组采用0.125 mg/ml地塞米松与0.125 mg/ml西咪替丁混合溶液预冲激活、浸泡导管,每组导管浸泡5 min.比较3组机械性静脉炎的发生情况.结果 3组静脉炎发生率差异有统计学意义(P<0.01),且DXMS组DC组低于NS组,DC组低于DXMS组,差异均有统计学意义(均P<0.05).结论 在预防PICC所致机械性静脉炎方面,地塞米松与西咪替丁具有协同作用,二者联合应用预处理导管的效果优于单一使用地塞米松.

目的 了解急诊抢救患者急性应激障碍状况及抢救经历.方法 选取就诊于华北理工大学附属医院急诊科经历抢救的患者,于病情平稳后采用斯坦福急性应激反应问卷进行急性应激障碍状况调查.结果 急诊抢救患者急性应激障碍得分为(45.64±31.407),中度应激障碍者78例,占18.1％,重度应激障碍者144例,占33.3％,合计占51.4％.单因素分析显示急诊分级重、治疗方式为急诊手术、经历心肺复苏、心理弹性水平低、疼痛程度重、抢救时间长、不同疾病种类中胆囊炎、多发伤、心肌梗死的急诊抢救患者急性应激障碍得分高,差异有统计学意义(P<0.05).多因素分析显示,急诊分级、心理弹性、疼痛、抢救时间、不同病种是急诊患者急性应激障碍的影响因素(P<0.05).结论 急诊抢救患者急性应激障碍率较高,与抢救经历有关,应重视有抢救经历患者的心理治疗与护理.

目的 了解经抢救急危重症患者急性应激障碍(ASD)现状,分析ASD的影响因素并基于结构方程探索危险因素模型.方法 选取2018年10月至2019年9月于华北理工大学附属医院急诊科经历抢救结束后进入病情稳定的康复期的患者作为研究对象.应用斯坦福急性应激反应问卷(SASRQ)、医院焦虑抑郁量表(HADS)和自行设计的影响因素问卷进行测评.使用线性相关、探索性因子分析和结构方程确定ASD的危险因素模型.结果 共发放问卷440例,回收有效问卷432例,有效回收率为98.2％.经抢救急危重症患者急性应激反应得分为(45.64±31.40)分,ASD患病率为33.1％.对医生、护士满意度低、急救不及时、救治效果差、急诊分级高、抢救所用时间长、疼痛、焦虑是ASD的危险因素.结论 经抢救急危重症患者ASD患病率较高,结构方程模型可应用于ASD危险因素的探讨.

Objective To discuss about application effect on the practical teaching of assisted medical nursing of Tencent class and student satisfaction, so as to provide the basis for the practical skill and ability cultivation of undergrad-uate student nurses under network environment. Methods A total of 218 undergraduates of the year of 2013 were select-ed as the control group, and 202 undergraduates of the year of 2014 were selected as experimental group. Tencent class was assisted to have a part of practical teaching in experimental group, and traditional teaching was still conducted to con-trol group. After the class was finished, the self-designed scale was used to have teaching effect evaluation. Results The class practice testing result of students in experimental group was higher than it in control group, and the difference was statistically significant (P<0. 05). The satisfaction of students in experimental group at the teaching effect and teach-ing form was higher than it in control group, and the difference was statistically significant (P<0. 05). Conclusions The application effect of Tencent class on the practical teaching of medical nursing is fine, and the student satisfaction is high. Tencent class can be used as one of the auxiliary practical teaching methods of medical nursing.

Objective Survey on nursing students'carry on correctly of multi - check on IV fluid replacement .Methods Randomly take 100 NCUST's nursing students who on the occupational experi‐ence in NCUST affiliated hospital ,using hospital designed questionnaire ,put all 21 multi - check con‐tents in the questionnaire .Nursing department members composed as a survey team ,randomly check the nursing students on IV fluid replacement .Results Nursing students'total multi - check accuracy rate is 4 .7% ,pre - operation 15 .9% ,in - operation 12 .6% ,after - operation 11 .2% in these 3 multi -check parts ,the check on drug concentration is the lowest ,the check on patient number is the highest as check on patient's name .Conclusion During the IV fluid replacement ,multi - check was not totally car‐ried on by students ,there will be security risk as they do not change the way they work .

[目的]探讨综合救护技能模拟训练在《急救护理学》实验课程中的应用效果。[方法]对照组为2008级本科护生,采用传统教学方法,观察组为2009级本科护生,采用综合救护技能模拟训练教学方法。采用自行设计调查量表结合理论与技能操作考核等方式对教学效果进行综合评价。[结果]观察组考试成绩明显高于对照组（P＜0.05）,观察组护生认为,知识、技能、评判性思维、学习满意度、自信心等得到了提高。[结论]综合救护技能模拟训练模式有助于提高实践教学效果。