随着我国国际影响力的日益扩大及高等教育国际化进程的不断深入,来我国学习临床医学的留学生日益增多.然而由于文化差异、语言沟通等问题,影响了来华留学生的学习热情.文章针对留学生的特点及面临的问题,采取了制定管理制度、加强师资队伍建设、丰富教学活动、规范教学管理等一系列措施,以此确保留学生教育的稳步发展.

目的 探讨多种因素对ICU内患者精神障碍的影响.方法 对748例患者进行病例对照研究,其中发生精神障碍组患者126例,未发生精神障碍组患者622例对两组患者在性别、年龄、受教育程度、宗教信仰、住ICU时间、是否手术,有无机械通气,护理质量、有无镇静药物使用,有无高血压、糖尿病病史等方面进行比较.结果 两组患者在宗教信仰、住ICU时间、护理质量等方面不同,差异有统计学意义(P<0.05).结论 多种影响因素对ICU患者精神障碍的发生有不同程度影响,临床工作中应针对各种影响因素采取措施,以减少ICU患者精神障碍的发生.

Objective To study the high-risk factors and nursing strategy of psychonosema on ICU patients.Methods A total of 139 comprehensive ICU patients were evaluated with mini-mental state examination(MMSE)and confusion assessment method(CAM).The influence of all the related factors were analyzed accordingly.Fifty-two psychonosema patients were equally randomized into the control group treated with routine nursing and the observational group treated with routine and comprehensive psychological nursing.The scores of MMSE and CAM of the patients in both groups were compared after 3 weeks' treatment.Results The psychonosema of ICU patients were affected by length of stay(LOS),administration of sedative drugs and occurrence of stroke.The differences in the scores of MMSE and CAM before the treatment had no significance for the two groups.The scores of MMSE and CAM of the two groups after 3 weeks' treatment were significantly different from those before the treatment(P<0.01).After 3 weeks' treatment,the scores of MMSE and CAM of the observational group were significantly different from those of the control group(P<0.01).Conclusion More attention should be attached to psychological nursing and humanism for ICU patients so as to provide early nursing interventions for the high-risk patients.

老年病人由于病程迁延、长期输液、反复静脉穿刺或药物对血管的刺激,导致血管壁通透性增加、管腔狭窄、管壁硬化,甚至阻塞坏死,静脉穿刺的难度增大,穿刺易失败.如何有计划地利用血管,提高穿刺成功率,是值得探讨的问题.

鼻咽通气管是用一种非气管导管性通气管道,插入咽部使舌根前移,达到解除呼吸道阻塞、吸出痰液、保持气道通畅的目的.由于操作简便,易于掌握,不需要特殊器械并能在数秒钟内迅速获得有效通气,所以在临床急救中使用较广泛.

重症和创伤可引起机体代谢的改变,疾病和手术并发症还可以使病人摄食不足或无法进食,这些均可导致病人营养不良.营养不良不仅可削弱机体重要器官的功能,延迟损伤组织的修复,还可降低免疫力.通过胃肠道给予预制的营养物质,可纠正营养不良,同全胃肠外营养(TPN)相比,它可以刺激胃肠道运动,营养要素由肠吸收经门静脉进入肝脏,符合生理要求,具有费用低、使用安全、管理较容易等优点.所以,只要胃肠道功能许可,应选用肠内营养(EN)[1].我科1999年7月-2000年11月收治的重危病人中52例施行EN,现将鼻饲情况报告如下.