目的 探讨混合式教学在低年资护士灾害护理核心能力培训中的应用效果.方法 2021年7-9月选取某医院低年资护士 317名作为研究对象,按组间基本资料匹配原则分为观察组158名和对照组159名;观察组采取混合式教学进行培训,对照组采取传统课堂教学进行培训.培训前后测评两组护士灾害护理核心能力,培训结束后,比较两组护士理论成绩、实践能力和教学满意度.结果 培训前两组护士灾害护理核心能力得分差异无统计学意义(P＞0.05);培训后,观察组护士灾害护理核心能力得分、理论成绩、实践能力和教学满意度均高于对照组,两组比较差异均有统计学意义(P＜0.05).结论 混合式教学在低年资护士灾害护理能力培训中可充分调动护士的积极性和学习自主性,提高了培训效果和满意度,提升了低年资护士灾害护理核心能力.

目的 研究在胸腰段脊柱骨折手术患者围术期开展基于护理程序的整体护理干预的价值.方法 选取收治的胸腰段脊柱骨折患者 300 例,随机分为对照组和研究组各 150 例.对照组接受围术期常规护理,研究组在对照组基础上接受基于护理程序的整体护理干预,对比两组干预前后焦虑情绪、疼痛程度、日常生活能力对比两组术后恢复指标(肌力开始恢复时间、住院时间),对比两组护理满意度.结果 干预后,研究组SAS、VAS评分低于对照组,ADL评分高于对照组(P<0.05);研究组术后肌力开始恢复时间、住院时间显著短于对照组(P<0.05);研究组护理总满意率显著高于对照组(P<0.05).结论 在胸腰段脊柱骨折手术患者围术期开展基于护理程序的整体护理干预,有助于减轻患者焦虑情绪、疼痛程度,促进日常生活能力及身体恢复,提升护理满意度.

目的 探讨路径式功能训练联合间歇气压装置干预对腰椎融合手术患者康复效果及深静脉血栓形成(DVT)的影响.方法 选取2020年7月至2021年7月该院收治的腰椎融合手术患者120例作为研究对象,采用随机数字表法分为观察组和对照组,每组60例.对照组采用传统干预,观察组采用路径式功能训练联合间歇气压装置干预.分析比对2组患者干预后功能锻炼达标率、Oswestry功能障碍指数(ODI)评分、并发症(切口感染、DVT、便秘和泌尿系感染)发生率、临床指标(住院时间和下床时间)等.结果 观察组患者干预后住院时间、下床时间均明显短于对照组,功能锻炼达标率明显高于对照组,ODI评分、并发症发生率均明显低于对照组,差异均有统计学意义(P<0.05).结论 对腰椎融合手术患者而言,采取路径式功能训练联合间歇气压装置干预有利于功能康复,降低DVT发生率,可大力推广应用.

目的:研究骨折愈合促进的实施方法及在老年骨质疏松症髋部骨折(OHF)术后护理中的应用价值.方法:将某院收治的84例老年OHF患者随机分为C组和C+Y组各42例,C组采用常规护理,C+Y组采用常规护理+骨折愈合促进护理,分别检测两组血清骨折愈合因子(IGF-1、BMP-2),统计骨折愈合时间,评价髋关节功能(Harris评分)、护理满意度.结果:护理后,C+Y组患者血清IGF-1、BMP-2均高于C组(P<0.05),且C+Y组患者骨折愈合时间短于C组(P<0.05);C+Y组患者髋关节功能优良率为88.10％,高于C组的73.81％(P<0.05);分析两组患者分别干预后的护理满意度可见,C+Y组患者的护理满意度明显更高,对比统计学差异明显(P<0.05).结论:于老年OHF术后护理中通过骨折愈合促进干预能有效提高患者骨折愈合效果,加快骨折愈合进程,进而提高髋关节功能.

目的 探讨跟腱断裂切开修复术后发生切口感染的影响因素及病原学特点.方法 回顾性分析2013年1月—2017年12月联勤保障部队第988医院骨科收治的102例跟腱断裂患者.根据是否伴有切口感染分为感染组(16例)与非感染组(86例).感染组男性13例,女性3例;年龄21～74岁,平均41.4岁;合并系统性红斑狼疮1例,合并类风湿性关节炎1例.术后随访2年以上无不良并发症的非感染组男性79例,女性7例;年龄18～68岁,平均36.0岁.收集患者初次跟腱断裂的伤口情况、术后切口感染情况以及伤口分泌物培养与药敏结果进行比较分析.结果 两组患者体质量指数(BMI)、血糖和尿酸方面差异无统计学意义[(24.29±4.20)kg/m2 vs.(24.40±2.67)kg/m2、(4.86±0.21)mmol/L vs.(5.05±0.47)mmol/L、(382.94±85.59)μmol/L vs.(391.35±83.93)μmol/L,P>0.05].感染组有8例(50.0％)为开放性损伤,非感染组3例(3.5％),差异有统计学意义(P<0.001).感染组吸烟患者占比(8例,50.0％)高于非感染组(16例,18.6％),P=0.017.春季发生初次断裂患者非感染组(45例,52.3％)多于感染组(3例,18.7％),P=0.013.冬季发生初次断裂患者感染组(6例,37.5％)多于非感染组(5例,5.8％),P=0.001.Logistic回归结果提示吸烟(OR=9.616,95％CI:1.725～53.600)以及开放性损伤(OR=53.589,95％CI:7.502～382.788)与跟腱断裂术后发生切口感染有关(P<0.05).感染组伤口分泌物培养结果提示有5例(31.3％)为金黄色葡萄球菌,7例(43.8％)伤口分泌物培养阴性,2例(12.5％)提示为铜绿假单胞菌,1例(6.2％)提示为路邓葡萄球菌,1例(6.2％)为粪肠球菌.结论 跟腱断裂术后切口感染多发生在冬季,吸烟及开放性损伤是切口感染的危险因素,切口病原菌以金黄色葡萄球菌为主.

骨科大手术术中深静脉血栓发生的危险因素包括患者个体因素和手术因素;物理预防措施包括间歇性气动加压装置、弹力袜及足底静脉泵的应用.提出需对手术室护士加强针对性培训,以提高护士对术中预防深静脉血栓发生重要性的认知,积极采取防范措施,降低骨科大手术患者术中深静脉血栓的发生风险.

目的 分析关节镜治疗肩袖撕裂合并冻结肩患者术后康复护理方法与效果.方法 以我院2014年8月-2016年9月内行关节镜治疗37例肩袖撕裂合并冻结肩患者为例,术后提供系统康复护理,分析术前、术后3个月疼痛程度、被动活动范围、肩关节功能.结果 术后3个月VAS评分、被动活动范围、肩关节功能较术前明显改善(p<0.05).结论 肩袖撕裂合并冻结肩患者术后及时予以逐步系统康复护理,利于疼痛的缓解、肩关节功能的改善.

Objective To find a tool to assess the psychic reaction of the wounded peacekeeping soldiers in the early period after trauma and to explore the intervention strategy to help their mind and body recover.Methods On the basis of applying early psychological reaction nurse-administered rating scale in the wounded peacekeepers and clinical observation,their psychic reaction and changes were assessed and recorded continuously.Results Both the wounded soldiers were suffering from acute post traumatic stress disorder with mild mental confusion,but having no overcognition and abnormal reaction of mood and behavior.The results and duration of their psychic reaction presented individualized characteristics.Conclusion Nurse-administered rating scale can assess the psychic changes of the wounded after acute trauma rapidly,which can further guide the immediate nursing intervention.Early humanistic care will help the wounded restore their psychosomatic adjustment and social function rapidly.

Objective To assess the relationship between health literacy among the?middle-aged and elderly hos-pitalized patients with coronary heart disease and their health service utilization.Methods A cluster sampling method was used to recruit 414 patients with coronary heart disease in a 3A grade hospital of Urumq city from September 2014 to May 2015.All the participants were reviewed for coronary heart disease health literacy scale and individual traits questionnaire.ANOVA was used to analyze the relationship between health literacy of coronary heart disease with health service utilization,multiple linear regression were used to analyze the influencing factors of health litera-cy of coronary heart disease.Results Their average age among studied patients was (61.65±10.60)years.Their av-erage health literacy of coronary heart disease score was (76.10±30.41),which gave priority to the low level.Uni-variate analysis showed that the health literacy scores was significantly different between age,gender,nationality, education level,occupation,marital status,family population,children number,household income (P < 0.05 ). There were significant difference in health educations and time form the last physical examination (P < 0.01). Multiple linear regression showed that the nationality,education level,former or current occupation,health educa-tions,time form the last physical examinations were the major independent factors affecting health literacy of coro-nary heart disease.Conclusion The health literacy of coronary heart disease is related to their health service utiliza-tion.It is needed to improve the health literacy for patients with coronary heart disease through education and thus increase the scope and utilization rate of available health services.