目的:调查临床护士抗凝剂皮下注射护理规范的知信行现状并探索影响因素,旨在为临床护士的培训提供依据.方法:采用便利抽样法,选取2021年11月—2021年12月河北省某三级甲等综合医院541名临床科室护士为研究对象,采用临床护士抗凝剂皮下注射护理规范知信行调查问卷进行调查,采用多元线性回归分析其影响因素.结果:临床护士抗凝剂皮下注射护理规范知信行总分、知识维度、态度维度、行为维度得分分别为(145.36±18.03)分、(19.26±3.93)分、(43.35±4.94)分、(81.78±12.81)分.多元线性回归结果显示,临床护士抗凝剂皮下注射护理知识的影响因素为工作年限及是否接受过抗凝剂皮下注射培训,态度的主要影响因素是工作年限,行为的影响因素为知识、态度及是否接受过抗凝剂皮下注射培训.结论:临床护士关于抗凝剂皮下注射护理的态度积极,但知识水平和行为情况有待提高.管理者应该根据临床护士的不同特征加强抗凝剂皮下注射临床技能培训和学习,以多种方式提高护士的参与度和积极性,做好抗凝剂皮下注射的质控管理,力求做好病人的安全保障.

二尖瓣返流(Mitralregurgitation,MR)可分为原发性MR及继发性MR(功能性MR).2016年来自复旦大学中山医院基于该院超声科的数据调查研究表明,42.44％为轻度MR,1.63％为中度MR,1.44％为重度MR.在LVEF＜30％的人群中重度MR占比22.14％.在1948例重度MR中,原发性MR占比49.9％[1].2017年浙江二院结构性心脏病团队文献显示[2],超声检出MR在所有心脏瓣膜疾病中的占比最 高(0.68％).

Objective:To evaluate the effect of evidence-based nursing practice for functional rehabilitation of post-stroke neurogenic bladder (PSNB) .Methods:From October 2020 to July 2021, 136 PSNB patients admitted to the Department of Neurology, Jiangyin People's Hospital were selected by convenience sampling as the research object. According to the random number table method, the patients were divided into the study group and the control group, with 68 cases in each group. The control group received routine rehabilitation nursing, while the study group was given evidence-based rehabilitation nursing based on the control group. The urodynamics, rates of bladder balance, urinary incontinence and urinary retention after intervention were compared between the two groups.Results:After three months of intervention, bladder compliance and bladder balance rate in the study group were higher than those in the control group, and the residual urine volume was less than that in the control group, with statistical differences ( P<0.05) . After three months of intervention, urinary retention rate in the study group was lower than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Evidence-based rehabilitation nursing can help to promote the rapid recovery of bladder balance in PSNB patients and improve the prognosis of patients.

目的 探讨经导管主动脉瓣植入术(TAVR)围手术期护理中应用以个案管理为主导的多学科管理团队的效果.方法 以新疆维吾尔自治区人民医院于2018年4月至2020年4月收治的90例行TAVR患者为研究对象,按随机数字表法分为对照组和观察组,各45例.对照组实施临床护理路径管理,观察组实施以个案管理为主导的多学科团队管理.对比2组患者的总住院时间、6分钟步行距离(6MWT)、再住院率、心功能及术后并发症.结果 观察组的总住院时间短于对照组,6MWT长于对照组(P均<0.05);2组的再住院率对比无统计学差异(P>0.05).术后3个月,2组的左室射血分数(LEVF)均高于术前,左室舒张期末内经(LVEDD)均大于术前,肺动脉收缩压(PAPs)均低于术前,差异均有统计学意义(P均<0.05);观察组的LEVF、LVEDD及PAPs均优于对照组(P均<0.05).观察组的并发症总发生率(17.78％)低于对照组(40.00％,P<0.05).结论 在TAVR围手术期护理中应用以个案管理为主导的多学科管理团队,可缩短患者的住院时间,促进其心功能的康复,并减少术后并发症的发生.