目的 探讨静脉治疗护理亚专科团队的建设和实践效果.方法 我院于2019年7月正式成立静脉治疗护理亚专科,通过建立静脉治疗团队、明确静脉治疗亚专科的工作内容与管理机制来实现静脉治疗亚专科的运行.结果 通过2年的静脉治疗护理亚专科团队构建与管理,临床护士的静脉导管维护能力显著改善(P＜0.05)、科研创新能力较前提高;输液工具选择合理率、输液接头使用正确率、导管固定正确率、敷料维护正确率、穿刺点发红发生率较实施前有所改善,差异有统计学意义(均P＜0.05);项目实施后静脉血管通路门诊工作量较前增加,患者和护士满意度得分显著提高(均P＜0.05).结论 静脉治疗护理亚专科的建设与实践不仅提升了专科护理人员综合水平,在为患者提供安全、优质静脉治疗护理服务的同时也满足了患者多元化治疗需求,进一步提高专科护理质量,深化专科内涵,促进静脉治疗专科不断向纵深发展.

目的:探讨住院患者自杀意念的现状及其影响因素。方法:使用贝克抑郁量表、自杀意念测量条目、心理扭力量表、家庭关怀度指数问卷、社会支持评定量表，采用便利抽样对373名住院患者进行测评。结果:调查对象中7%(26人)具有自杀意念。根据有无自杀意念分为病例组与对照组，通过对两组患者进行一般情况及各量表的单因素分析发现，两组在性别、文化程度、月收入、是否吸烟、是否饮酒、有无疾病史、是否并存疾病等方面分布差异无统计学意义，年龄、单身、使用激素具有统计学意义；心理扭力量表中，期望扭力分量表得分差异有统计学意义( P<0.05)；抑郁情绪分数无统计学差异；在社会支持角度上来看，病例组的3个维度分数均小于对照组，差异有统计学意义。自杀意念和社会支持程度、家庭功能状态之间呈负相关，两组之间有统计学差异( P＝0.005)。家庭功能等级和婚姻状况与自杀意念存在关联。 结论:护理人员应当重视对患者自杀意念及其相关因素的评估，建立自杀预警系统，对住院患者经过相关条目的评测，筛选出具有自杀风险的高危患者，积极实施早期心理干预、争取家庭和社会支持等措施，以减少住院患者自杀现象的发生。

目的:观察采用火针联合"治神"针法治疗中风后痉挛性偏瘫的临床效果.方法:选取2018年11月-2019年11月本院收治的中风后痉挛性偏瘫患者60例.按照随机数字表法将患者分为治疗组和对照组,各30例.对照组予以基础治疗+常规针刺疗法,治疗组予以基础治疗+火针+"治神"针法.通过Fugl-Meyer评定量表(FMA)、Barthel指数量表(BI)、改良Ashworth量表(modified Ashworth scale,MAS)评价并比较两组治疗前后的患肢运动能力、肌张力及日常生活能力,并比较两组疗效.结果:治疗后,两组FMA和BI评分均较治疗前升高,MAS分级均下降,差异均有统计学意义(P<0.05);治疗后,治疗组FMA与BI评分均高于对照组,差异均有统计学意义(P<0.05).治疗后,两组MAS分级比较,差异无统计学意义(P>0.05).治疗组治疗总有效率高于对照组(P<0.05).结论:基于经筋及调神理论,采用火针结合"治神"针法对中风后痉挛性偏瘫的治疗效果可靠,且优于常规针刺疗法,值得进一步推广应用.

目的 探讨小续命汤联合针刺治疗急性期周围性面神经麻痹风寒袭络证的临床疗效及对免疫炎症反应的调节作用.方法 采用随机数字表法将144例急性期周围性面神经麻痹(风寒袭络证)患者随机分为对照组和观察组,每组各72例.对照组给予小续命汤安慰剂颗粒联合针刺治疗;观察组采用小续命汤加减联合针刺治疗,疗程4周.治疗前、治疗后2周和4周进行House-Brackmann(H-B)面神经功能分级量表和面神经功能分级评定;治疗前后进行面部残疾指数(FDI)量表[躯体功能评分(FDIP)和社会生活功能评分(FDIS)]、临床面部评价量表(FaCE)和风寒袭络证积分评价;检测患者治疗前后外周血CD3+、CD4+、CD8+细胞亚群水平、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、IL-6水平,并计算CD4+细胞中辅助性T淋巴细胞17(Th17)和调节性T细胞(Treg)的比例.结果 观察组的临床疗效优于对照组(Z=2.014,P＜0.05);观察组FDIP和FDIS评分高于对照组,风寒袭络证积分低于对照组(P＜ 0.01);观察组在治疗后2周和4周H-B面神经功能分级量表评分和面神经功能评分均高于对照组(P＜0.01);观察组FaCE量表6个维度评分高于对照组(P＜0.01);观察组CD3+、CD4+、Treg水平和CD4+/CD8+高于对照组(P＜0.05),CD8+、Th17水平及Th17/Treg低于对照组(P＜0.05);观察组TNF-α、IL-1β和IL-6水平低于对照组(P＜0.01).结论 小续命汤加减联合针刺治疗急性期周围性面神经麻痹(风寒袭络证)患者有较好的临床疗效,并能调节患者免疫功能和炎性反应,安全性较好.

目的:研究养阴通督针法结合放血疗法治疗肝豆状核变性肌张力障碍的临床疗效.方法:将60例符合纳入标准的肝豆状核变性肌张力障碍患者按随机数字表法分为治疗组30例和对照组30例.两组均接受基础药物治疗,治疗组加用养阴通督针法结合放血疗法治疗,对照组采用常规针刺治疗.两组治疗疗程均为3周.经治疗后,对两组分别运用改良Ashworth量表评定患者肌张力痉挛程度.结果:治疗前,两组患者一般资料比较差异无统计学意义(P>0.05),具有可比性.治疗后,两组患者改良Ashworth量表评分结果均显著低于治疗前(P<0.05),且治疗组比对照组改善更明显(P<0.05).结论:养阴通督针法结合放血疗法能显著缓解肢体的痉挛状态和改善肝豆状核变性患者的运动功能,疗效肯定.

从针灸临床研究及机制研究对近5年针灸治疗后循环缺血性眩晕的文献进行综述.总结近5年后循环缺血性眩晕的针灸治疗临床研究进展,并提出临床科研应注意的问题及发展方向.认为针灸治疗该病方法众多、疗效显著、毒副作用少,但临床研究中还存在一些问题需进一步改进.

Objective To observe the clinical efficacy of acupuncture and bloodletting therapy at triple points in the treatment of posterior circulation ischemic vertigo.Methods Forty patients with posterior circulation ischemic vertigo were randomly and equally divided into treatment group and control group.The treatment group received acupuncture and bloodletting therapy at triple points,while the control group received conventional acupuncture on the cervical spine.The treatment lasted for three consecutive weeks.The improvement in vertigo,Dizziness Handicap Inventory (DHI) score,and changes in hemodynamic parameters of the vertebral-basilar artery were evaluated.Results The treatment group had slightly better treatment outcomes than the control group.However,there was no significant difference in the outcome distribution between the two groups (P＞0.05).Both groups had significantly reduced DHI scores after treatment (all P＜0.05);compared with the control group,the treatment group had significantly greater reductions in scores for all items (all P＜0.05).Both groups had significant changes in hemodynamic parameters of the vertebral-basilar artery after treatment (all P＜0.05);there were significant differences in the changes in all indices after treatment between the two groups (all P＜0.05).Conclusion Acupuncture and bloodletting therapy at triple points can substantially improve clinical outcomes in patients with posterior circulation ischemic vertigo,and it can reduce the influence of vertigo disorder on daily life and improve hemodynamics of the vertebral-basilar artery.

Objective to strengthen the safety management of chemotherapy drugs in the day ward infusion, reduce the in-jury of chemotherapy drugs to the vein. Methods to strengthen the knowledge training for the chemotherapy of nursing staff, the health education for the patients and their families, the quality control of the link and the safety management after chemotherapy. Results of identification, evaluation and treatment of 892 malignant tumor patients with existing and potential safety hazards, only occurred in 7 cases extravasation of chemotherapeutic drugs, incidence was 0.7%, the implementation of systemic chemotherapy drugs by vein transfusion safety management after only one case occurred in patients with extravasa-tion, were not for patients caused serious consequences, no nursing disputes caused by extravasation of chemotherapeutic drugs. Conclusion in order to ensure safety of tumor patients with chemotherapy care, managers should strengthen cancer specialist knowledge training, standard chemotherapy nursing professional and skill operation, strengthen nurse responsibility awareness, safety awareness, strengthen the chemotherapy process quality control, standard chemotherapy nursing process.

Objective:To observe the EA stimulation parameters related indicators of obese patients and insulin resistance,explore acupuncture weight loss the optimal stimulation parameters in order to provide scientific and effective methods for the clinical treatment of obesity.Methods:80 cases with simple obesity in accordance with the principles of randomization,low-frequency electro-acupuncture group and the high-frequency electro-acupuncture group of 40 cases.The main points of the two groups were taken Zhongwan,Tianshu,abdominal junction,a large cross,Liang Qiu,Zusanli,Shangjuxu,mainly.Connected to electro-acupuncture,high-frequency group frequency was 100 Hz,the low group frequency ws 50 Hz,density waves,the intensity that patients could tolerate the degree.Its related indicators and insulin resistance were observed.Results:The index difference of each group before and after treatment were significantly different(P<0.05).The high-frequency electro-acupuncture group and the low-frequency electro-acupuncture group term clinical efficacy,the difference was significant(P<0.05).Conclusion:The high-frequency electro-acupuncture group,and low frequency electrical acupuncture group of obese patients have better clinical efficacy,also are good to improve the role of insulin resistance,the better efficacy of high-frequency electro-acupuncture group.

<正>单纯性肥胖症是指人体摄入热量多于消耗而以脂肪形式储存于体内,导致体质量超常的病症,临床以肥胖为主要症状,作为一种全身内分泌代谢疾病,与高血压、2型糖尿病、高脂血症、心脑血管病等密切相关,严重危害人类健康。因此,防治

<正>心源性肺水肿导致严重低氧血症是急性左心衰病人致死的主要原因之一,病人可以在较短时间内发展为意识丧失、呼吸变慢、点头样呼吸、甚至呼吸心跳骤停。研究证实应用无创正压通气(NIPPV)能迅速纠正低氧血症,改善缺氧症状,对控

目的 总结重度子痫前期的护理方法 ,提高护理质量,使孕产妇身心得到良好恢复.方法 收集自2009年10月～2010年4月,笔者所在科收治的92例子痫前期重度的病历,对其护理方法 进行回顾性分析.结果 经过精心护理92例子痫前期重度的患者均取得满意效果.结论 严密监测神志,生命体征.认真听取患者有无头痛头晕及视物模糊等主诉.及时有效的解痉降压,据病情予以扩容治疗,改善组织缺氧,控制子痫的发生.(积极纠正各脏器功能)观察用药后反应及效果.监测宫内胎儿情况,适时终止妊娠.注重孕、产妇心理护理并加强出院健康指导,对降低孕、产妇和围产儿的病死率至关重要.