In this paper, we review the literatures related to the pain relief in acute pain patients by Chinese medicine characteristic therapy, and combined with the clinical practice, taking acute pain as the research object, analyze its etiology and pathogenesis. We elaborate the clinical application effect of commonly used characteristic therapy for acute pain, fully demonstrate that Chinese medicine external treatment methods, including acupuncture, acupressure, moxibustion, auricular acupuncture, etc., whether applied alone or combined various means, have certain positive therapeutic effect on patients with acute pain, can significantly reduce the patients' pain, and are simple to use, economical, and worth promoting.

目的:探讨腕踝针与耳穴压豆对经皮肾镜取石术(PCNL)后疼痛及睡眠质量的影响.方法:选取2019年8月至2020年5月就诊于我院接受PCNL干预的90例患者为研究对象,按随机数字法将患者随机分为A组(n=45)和B组(n=45).A组行腕踝针治疗,B组行耳穴压豆治疗,均连续治疗3d,比较两组视觉模拟疼痛评分(VAS)、术后不良反应、镇痛药物应用情况、匹兹堡睡眠质量指数(PSQI)积分等指标的差异.结果:两组术后1h、12h的VAS评分差异无统计学意义(P＞0.05),A组术后24h、48 h、72 h的VAS评分均低于B组,差异有统计学意义(P＜0.05).两组术后1h和72 h均未使用曲马多,A组术后12h、24 h、48 h曲马多应用率低于B组,差异有统计学意义(P＜0.05).A组头晕与呕吐发生率低于B组,差异有统计学意义(P＜0.05),两组恶心发生率差异无统计学意义(P＞0.05),两组不良反应总体发生率差异有统计学意义(P＜0.05).两组入院时PSQI总积分差异无统计学意义(P＞0.05),A组治疗后PSQI总积分高于B组,差异有统计学意义(P＜0.05).结论:相较于耳穴压豆,腕踝针在缓解PCNL术后病人疼痛,降低术后不良反应与镇痛药物应用率方面更具优势.虽然腕踝针对PCNL术后病人睡眠无明显促进作用,但在临床镇痛中更具有效性与安全性.

内容提要:目的:分析一次性膀胱冲洗引流瓶在持续膀胱冲洗(CBI)中的应用效果.方法:选择2019年3月～2020年5月于本院接受尿道前列腺切除术(TURP)及经尿道膀胱肿瘤切除术(TURBT)后行CBI干预的90例患者,按随机数字表法分为对照组(n=45)和试验组(n=45),对照组给予子母式集尿器,试验组给予一次性膀胱冲洗引流瓶.对比两组CBI时间、导尿管堵管发生率、留置尿管时间、患者舒适度与满意度、导尿管相关尿路感染发生率、膀胱痉挛发生率情况.结果:试验组导管留置时间、CBI时间明显短于对照组(P<0.05);试验组患者舒适度、满意度明显高于对照组(P<0.05);试验组膀胱痉挛、导尿管堵管发生率明显低于对照组(P<0.05);对比两组导尿管相关尿路感染发生率,无显著差异(P>0.05).结论:一次性膀胱冲洗引流瓶的应用可减少CBI时间及尿管留置时间,降低膀胱痉挛、堵管并发症,提高患者舒适度及满意度.

目的 探讨自制吸湿造口底盘联合艾条灸在DET评分≥7分的回肠造口周围重度皮炎患者中的应用效果.方法 选取DET评分≥7分的回肠造口周围重度皮炎患者33例,应用自制吸湿造口底盘处理回肠造口周围皮炎,并在更换自制吸湿造口底盘时在皮炎区联合中医艾条灸,观察干预48小时、96小时、144小时造口周围皮炎的愈合情况.统计愈合时间和视觉模拟评分(visual analogue scales,VAS),每天更换造口袋次数.结果 33例DET评分≥7回肠造口周围重度皮炎患者48小时皮炎痊愈率64％,96小时皮炎痊愈率100％.结论 自制吸湿造口底盘应用于造口周围重度皮炎,不仅有效收集粪便,阻隔粪水渗漏刺激造口周围皮肤,还能有效吸收皮炎渗出液,结合应用中医艾条灸,达到加速皮炎的愈合效果.

目的:分析新冠疫情发生后院外带入压疮发生的特点,并为新冠疫情下居家护理预防压疮提供依据,为临床护理制定合理对策.方法:运用回顾性调查分析法,分析某三甲医院2019年与2020年上半年院外带入压疮患者的相关数据资料,并进行统计学分析.结果:两个时间段内的院外压疮患者压疮发生地点、收治科室、压疮分期与转归情况比较,差异有统计学意义(P<0.05).结论:新冠疫情下应该加大对居家压疮患者照护者的健康教育和对急诊科临床护士压疮处理的培训,从源头上预防压疮,促进已有压疮的愈合.

皮肤完整性研究小组(Skin integrity research group)隶属于根特大学护理和助产士中心[1].该研究小组由Dimitri Beeckman[1]教授领导,旨在产生和实施基于证据的实践,在医疗保健中预防和治疗皮肤完整性问题.在2018年1月,该小组发布了一项为期两年的项目的成果:根特全球失禁性皮炎分类工具(GLOBIAD).来自30个国家的22名国际专家和823名临床医生参与了这个项目.本文旨在对GLOBIAD进行详细介绍,GLOBIAD通过对受累的皮肤区域进行肉眼检查,并以此为依据对失禁性皮炎(Incontinence-associated dermatitis,IAD)的严重程度进行分类.它的目的是建立一个国际公认的IAD严重程度的描述,并使临床实践和研究中这种病症的文献记载标准化.

Objective To investigate the effect of quality control circle on the accuracy of nurses′recognition of pressure ulcers. Methods Quality control circle group was founded and the subject "improving the accuracy of identification of pressure ulcers and the staging by nurses" was established, to solve the problem that nurses couldn′t accurately identify pressure ulcers and its staging, and factors that effect the prevention and nursing quality of pressure ulcers. The accuracy rate of nurses in our hospital to identify the pressure ulcers and its staging was investigated before the program. We grasped the current situation, set goal and analyzed the reasons through interviews and on-site investigation, and then we developed countermeasures, and organized the implementation and review. The effect confirmation, standardization, review and improvement were carried out for 8 months, and the accuracy rate was investigated again after the program.Results The accuracy rate of nurses to identify the pressure ulcers and its staging was 39. 5% before the program, and was 90% after the program. Quality control circle also improved the team cooperation ability of nurses, its score was significantly higher than that before the program ( P<0.05) . The standardized quality control circle promoted graphic guide in judgment of pressure ulcer and its staging, guidelines for judgment and training process of pressure ulcers. Conclusions Quality control circle effectively improves the accuracy of recognition of pressure ulcers and its staging by nurses, and also improves their team cooperation ability.

目的：观察补肾健脾安胎饮配合情志疗法治疗早期先兆流产的临床疗效。方法：将108例患者随机分成两组：治疗组54例，对照组54例，治疗组采用补肾健脾安胎饮配合情志疗法治疗，对照组用黄体酮、HCG治疗。观察两组临床疗效和治疗前后症状、体征的积分变化。结果：两组间治愈率差异有统计学意义（P<0.05），两组间总的有效率差异无显著统计学意义（P>0.05）。治疗后两组症状、体征积分，差异均有统计学意义（P<0.05），治疗组积分下降比对照组更为显著，差异有非常显著性意义（P<0.01）。结论：补肾健脾安胎饮配合情志疗法治疗早期先兆流产切中病机，疗效确切，副作用少，值得临床进一步推广应用。

腹胀是食管癌术后胃肠道常见并发症,临床以腹胀、腹痛、肛门不排气等一系列胃肠功能紊乱的表现为主,可直接影响患者术后的恢复,有时甚至可产生严重的后果,故尽早恢复胃肠功能对术后的恢复十分重要.食管癌术后患者的腹胀,中医认为是因为手术影响,气机郁滞导致.我科应用由理气消滞中药组成的药熨法治疗本病60例,取得良好效果,现报告如下.

Objective to investigate the causes of endotracheal intubation again in patients with myasthenia gravis after thymus expanded resection and its nursing strategy.Methods the data of 12 cases with endotracheal intubation again after thymectomy were retrospectively analyzed from August 2008 to February 2013. Results 11 cases survived and 1 case died, with the mortality rate 8%. the main reasons for endotracheal intubation once more were postoperative myasthenia gravis crisis, respiratory failure and pulmonary infection. Conclusion one of the key measures to save the lives of patients is timely re intubation, which will have a direct impact on the prognosis. only adequate preoperative preparation, proper assessment for the patients, intensive care for high risk patients, strictly grasping the indications of extubation, paying attention to postoperative analgesia and the prevention of emergencies could effectively reduce reintubation times, decrease the mortality rate and promote physical rehabilitation of patients.

目的:探讨保持胸腔引流管正常使用,防止其脱出的有效方法。方法:对我院近年置入胸腔闭式引流管后发生脱管6例的临床资料进行分析,并根据发生脱管的原因制定预防对策。结果:胸腔引流管固定方法不正确、留置时间过久、患者缺乏自我保护知识是导管脱出的常见原因。结论:护士应加强工作责任心,掌握固定胸腔引流管的方法和技巧,及时发现胸腔引流管脱出的倾向,及时预防和处理,并教会患者保护胸腔引流管的方法,才能防止胸腔引流管脱出,保持有效的引流通道。

Objective:To explore the instant effect of hypenensive urgency by Balance Acupuncture Treatment.Methods:60 patients were included in the study.We compared the diastolic and systolic blood pressure before and after treatment,and analyzed the effects of treatment.Results:There were 60 patients,of which 21 cases markedly effective,26 cases effective,and 13 cases ineffective.The total effective rate was 78.3%.Systolic and diastolic blood pressure after treatment were both significant decreased after treatment(P0.01)Conclusion:The Balance Acupuncture Treatment has a good instant effect on hypertension urgency.

论述了《金匮要略》治疗风湿病的方剂。以祛邪为主的方剂:以祛风湿为主的方剂主要有麻黄加术汤等;以祛寒湿为主的方剂主要有乌头汤等;以祛风痰为主的方剂主要有藜芦甘草汤;以祛热邪为主的方剂主要有白虎加桂枝汤等;以祛风邪为主的方剂主要有阳旦汤等。以扶正为主的方剂:以扶正祛邪为主的方剂主要有薯蓣丸等;以扶正为主的方剂主要有小建中汤等。《金匮要略》针对胸痹、心痛的方剂:主要有栝蒌薤白白酒汤等。