目的 探讨优化术前肠道准备流程,细化禁食禁饮及口服碳水化合物环节对妇科恶性肿瘤行择期手术患者的影响.方法 选取收治的妇科恶性肿瘤手术患者143例,2018年3～12月的72例术前肠道准备沿用传统方法作为对照组,2019年1～10月的71例患者作为观察组,术前肠道准备取消经肛门灌肠,优化术前禁食禁饮时间,补充碳水化合物饮料.观察2组患者术前30 min主观感受、术后第1天血钾、血钠、血清白蛋白、血红蛋白水平的差异及对患者术后恢复的影响.结果 2组患者术前30 min焦虑、口渴、饥饿主观感受比较,观察组优于对照组(P<0.05);术后第1天血钾、血钠水平比较,观察组优于对照组(P<0.05),血清白蛋白及血红蛋白水平比较无差异(P>0.05);2组患者术后肛门首次排气时间、术后首次排便时间及首次下床活动时间比较,观察组均短于对照组(P<0.05).结论 优化术前肠道准备流程,缩短术前禁食禁饮时间及口服碳水化合物,改善了患者术前30 min的主观感受,防止患者发生脱水及电解质紊乱,促进患者术后康复.

目的 本研究旨在对比牙周内窥镜辅助超声龈下刮治时,强、弱负压吸唾同时使用与仅使用弱负压对减少气溶胶的效果.方法 选取诊断为重度牙周炎患者26例,其中男性12例,女性14例.试验组同时使用强、弱负压吸唾,对照组仅使用弱负压吸唾,于患者口腔正前方30cm、100cm处采用空气自然沉降法采集细菌样本,培养后进行菌落计数.结果 t检验分析结果显示,强、弱负压吸唾管路同时使用组各采样距离处空气细菌菌落数量均低于仅使用弱负压吸唾组(均P＜0.05);t检验分析结果显示,使用相同负压吸唾强度情况下,30cm处空气细菌菌落数量高于100cm处(均P＜0.05).结论 在行牙周内窥镜辅助超声龈下刮治术中,使用弱负压吸唾同时利用好强负压吸唾,可有效降低交叉感染风险.

目的 探讨四手操作护理配合应用于甘氨酸喷砂术全过程的效果.方法 选取2018年8月至2019年10月牙周疾病维护期进行甘氨酸喷砂治疗的患者120例作为研究对象,随机分为2组,对照组采取传统护理技术,试验组采取四手操作技术,2组分别进行甘氨酸喷砂治疗,比较2组医师对护理满意度、治疗时长、患者疼痛评分及就诊满意评分、比较2组空气细菌菌落总数等数据.结果 甘氨酸喷砂治疗,2组医师对护理满意度、治疗时长、患者疼痛评分及就诊满意评分、比较2组空气细菌菌落总数差异均有统计学意义(P<0.05).结论 四手操作应用于甘氨酸喷砂全过程,可有效缩短患者治疗时间、提升医生对护士满意度及患者就诊满意度、有效预防交叉感染.

牙周内窥镜是微创的牙周非手术治疗方法,其使用相比传统SRP可以取得更好的临床效果.现本文报告了1例Ⅲ期B级牙周炎伴有错牙合畸形(安氏Ⅱ类)的患者基础治疗后仍有较多深牙周袋(PD≥5 mm),辅助牙周内窥镜治疗后正畸治疗取得良好效果的病例.

This article explains the concept, emotional recovery process, and coping strategies of the second victim after the occurrence of medical adverse events, in order to effectively identify and manage the second victim and obtain effective support. This article aims at providing a theoretical reference for constructing a positive patient safety culture and organizational support system under China's national conditions to reduce the second victim's injury.

目的 探讨Er:YAG激光治疗牙周病过程中的护理配合.方法 选择2017年3月至2018年5月收治的50例针对牙周袋深度>5 mm的患牙应用Er:YAG激光治疗仪进行治疗的慢性牙周炎患者为研究对象,在传统牙周炎治疗的基础上,根据Er:YAG激光治疗仪的操作要求配合医师完成治疗,评价疗效.结果 本组患者应用Er:YAG激光进行治疗,提高了牙周治疗的舒适度,作为牙周病的治疗手段或辅助应用效果较好,对仪器精心养护,与医师默契配合.结论 应用Er:YAG激光技术治疗牙周病,通过护理配合技术可协助医师提高治疗效率.完善的健康教育能提高患者的依从性,从而更好的发挥Er:YAG激光治疗牙周病的优势.

Objective To investigate the related factors of early postoperative urine retention (UR) of patients with cervical carcinoma and effective nursing intervention measures.Methods A total of patients with cervical carcinoma at stageⅠA2~ⅡA2 who were admitted and treated by surgery in our hospital from November 2014 to Decdember 2015 were enrolled in the study. These patients were treated by nursing intervention at perioperative period,and the the related factors with incidence of early postoperative urine retention were retrospectively analyzed.Results Among the 103 patients with cervical cancer after surgical treatment,40 patients had postoperative urinary retention,with incidence rate being 38.83%. The single factor analysis showed that patient's age,operation mode and clinical stage were risk factors of urinary retention(P<0.05). Conclusion The early urinary retention after surgery in patients with cervical cancer is a transient form of bladder dysfunction that is affected by multiple factors. To select individualized surgical methods and emphasize on three early periods,to strengthen perioperative care and continuous care after discharge from hospital, and to control urinary tract infections are effective measures to reduce incidence of early postoperative urinary retention.

Objective To investigate the effects of continuous nursing on indwelling urinary catheter outside hospital in patients with cervical cancer after surgery. Methods Seventy-eight patients with cervical cancer who received surgical treatment in our hospital from October 2016 to March 2017 were divided into control group and observation group according to annual basis.The patients in control group were treated by routine postoperative health education and guidance on discharging from hospital,however,the patients in observation group,on the basis of control group,were treated by continuous nursing,and on the first review, the situations about indwelling urinary catheter-related complications,pelvic floor muscle exercise compliance,nursing satisfaction degree,self-care ability score were investigated.Results The incidence rates of complication of indwelling catheter in observation group were significantly lower than those in control group(P<0.05),and the proportions of pelvic floor muscle exercise compliance and nursing satisfaction degree in observation group were significantly higher than those in control group (P<0.05). The scores of self-care ability in every dimension in observation group were significantly higher than those in control group (P <0. 05). Conclusion The continuous nursing can reduce the complications of postoperative indwelling urinary catheter of patients with cervical cancer after surgery,improve pelvic floor muscle exercise compliance and nursing satisfaction degree,improve patient's individual cognitive levels,at the same time,which can improve self-care ability of patients.

下颌骨占据面下1／3，极易受意外打击，发生在下颌骨的骨折约占颅面骨折病例的近2／3［1］，目前下颌骨骨折主要采用手术切开复位内固定术和牙弓夹板固定术，手术治疗适合复杂性、多发性、粉碎性骨折，具有效果好、骨折愈合快等优点，但手术创伤大，需二次手术取出内固定物，面部切口易留瘢痕，儿童可能损伤牙胚及费用昂贵等使很多患者望而却步。而外固定法主要为牙弓夹板颌间固定、小环结扎及骨间螺钉颌间固定，普通牙弓夹板均为金属板条制成，具有固位不稳，易造成骨折延期愈合及错位愈合；需按牙弓形态现场弯制夹板，费时、费力尤其是牙冠短小、乳牙，新生恒牙容易滑脱，结扎丝易刺破黏膜等缺点［2-5］，骨间螺钉颌间固定及小环结扎有复位固定力不足，且多用于坚固内固定术后辅助治疗［6-8］，针对以上不足，我们应用模型外科方法制作牙合板，对下颌骨骨折作单颌外固定术，恢复正常咬合关系。

口腔门诊管理对于预防和控制院内感染十分重要,提高护理队伍的素质教育,建立明确的无菌概念,重视洗手,严格遵守操作流程,加强消毒灭菌隔离制度和科学的效果监测是医患卫生健康的重要保证。

例1,男性,25岁.因查体发现右肺阴影1.5个月入院.1.5个月前胸透发现右肺阴影,经静脉滴注青霉素后,再次胸透仍有阴影,无咳嗽、咯血等症状.X线胸片:右下肺卵圆形密度增高阴影约3 cm×4 cm,边缘欠整齐,周围有炎性灶.