[目的]探讨医院和社区以家庭为核心的照料性护理在慢性病病人中的应用效果.[方法]根据随机数字表法将104例慢性病病人分为观察组和对照组各52例,对照组采取医院为指导、家庭为核心的照料性护理,观察组采取社区为指导、家庭为核心的照料性护理.比较两组病人健康知识知晓情况及基本护理技能情况、护理依从性、护理前后生活质量及临床指标达标情况.[结果]观察组病人护理后知识知晓情况和基本护理技能掌握情况优于对照组(P<0.05);观察组病人规律锻炼、规律用药、规律生活的依从性高于对照组病人(P<0.05);观察组病人护理后活动受限、疾病影响评分低于对照组(P<0.05);观察组病人护理后血糖达标率、血脂达标率、血压达标率高于对照组(P<0.05).[结论]对慢性病病人采取以家庭为核心的照料性护理,能够使病人更加了解自身的情况,改善医患关系,提高老年慢性病病人的生活质量.

目的:探讨高血压脑出血微创手术患者应用快速康复外科护理在临床中的效果.方法:选择2016年12月至2019年1月收治的86例采用微创手术的高血压脑出血患者作为研究对象并分为观察组和对照组,各43例,对照组采用外科常规护理方式,观察组在对照组基础上采用快速康复外科护理,观察比较两种不同护理手段的临床效果.结果:与对照组比较,观察组NIHSS评分降低更显著,ADL量表-Barthel指数升高更明显,并发症的发生概率更低,据具有显著性差异,P<0.05;结论:快速康复外科护理在高血压脑出血微创手术患者临床应用中的效果显著,值得临床推广.

Objective To explore the effect of head nurses′tutoring and commenting on nursing ward round. Methods The nursing ward rounds performed during August 2013 to July 2014 were assigned as the control group and those nursing ward rounds during August 2014 to August 2015 as observation group: in the former group routine nursing ward rounds were done once a week and in the latter the rounds were performed by head nurses′tutoring and commenting once every week. The two groups were compared in terms of examination performances of nursing ward rounds, doctors′ and nurses′ satisfaction degree, nurses′ and student nurses′evaluation on the ward rounds and their critical thinking ability. Results The examination performances and the satisfaction degree in the observation group were significantly higher than those of the control group (P<0.05). The nurses in the observation group thought the head nurse′s commenting at ward rounds could be more effective than those from the control group in their improvement of theoretical knowledge and clinical ability (P<0.05). In terms of critical thinking by California Critical Thinking Disposition Inventory-Chinese Version), the total score and the scores on its dimensions in the observation group were significantly higher than those of the control group. Conclusion The nursing ward rounds by head nurses′tutoring and commenting can help the nurses to strengthen their ability in nursing ward rounds and improve their theory and clinical practice so that the nursing quality is improved.

目的探讨全身型重症肌无力患者误吸的预防方法及护理对策。方法通过对36例全身型重症肌无力患者误吸预防护理方法的总结归及归纳总结。结果36例全身型重症肌无力患者中IIA型患者无发生误吸，IIB型及 III型患者均发生轻度误吸1例，经处理后无出现窒息，无因误吸引起吸人性肺炎。结论正确的护理措施是预防全身型重症肌无力患者误吸、减少并发症发生的关关键因素。

目的探讨分层次分阶段带教模式在神经科护理教学中的应用效果。方法我科运用分层次分阶段带教方法，与外科二区传统的教学模式的效果进行对比，统计分析护生出科成绩及护生满意度。结果分层次分阶段的带教模式提高护生实习效果，接受分层次分阶段的带教模式的护生在理论、操作成绩以及满意度上都优于传统组（p＜0．05）。结论分层次分阶段带教模式，有利于提高神经科护理的实习教学水平，增加护生对带教老师的满意度，值得推广。

目的探讨通过改变开胸术后患者的体位，提高患者咳嗽排痰的有效率。方法将80例开胸术后患者随机分为观察组和对照组，观察组患者咳嗽时取90°体位，背部离开床垫进行咳嗽；对照组取半坐卧位进行咳嗽，观察两组患者咳嗽排痰的有效率及肺部并发症发生率。结果观察组患者咳嗽排痰有效率高于对照组（P＜0．01），肺部并发症发生率低于对照组（P＜0．05）。结论开胸术后患者咳嗽时取90°坐位，能提高咳嗽排痰的有效率，减少肺部并发症的发生，促进疾病的康复。