Objective To investigate the effect of psychological intervention under the theory of root cause analysis on perioperative emotion, coping style and self-care ability of patients with pathological fracture of limbs. Methods A total of 126 patients with pathological fractures of limbs were divided into study group and control group according to random number table method, with 63 cases in each group. Both groups were given routine intervention, and the study group was given psychological intervention under the theory of root cause analysis on this basis. The rehabilitation of the two groups was compared. Before and after the intervention, the emotional state of the two groups was assessed by symptom check list 90（SCL-90）, the coping style of the two groups was assessed by simplified coping style questionnaire（SCSQ）, and the self-care ability of the two groups was assessed by exercise of self-care agency scale（ESCA）. The incidence of complications and the score of service quality（SERVQUAL） were compared between the two groups. Results The swelling disappearance time, pain disappearance time and hospitalization time in the study group were significantly shorter than those in the control group（P＜0.01）. After the intervention, the dimension scores of interpersonal sensitivity, depression, somatization, anxiety and horror of SCL-90 in the two groups were significantly lower than those before the intervention（P＜0.01）,and the study group was significantly lower than the control group（P＜0.01）.After the intervention,the positive coping scores of SCSQ in the two groups were significantly higher than those before the intervention（P＜0.01）,and the negative coping scores were significantly lower than those before the intervention（P＜0.01）,and the changes in the study group were more significant than those in the control group（P＜0.01）.After the intervention,the scores of each dimension of ESCA in the two groups were significantly higher than those before the intervention（P＜0.01）,and the study group was significantly higher than the control group（P＜0.01）.The incidence of complications in the study group was significantly lower than that in the control group（P＜0.05）,and the scores of each dimension of SERVQUAL were significantly higher than those of the control group（P＜0.01）.Conclusions Psychological intervention under the theory of root cause analysis can effectively improve the perioperative emotional state of patients with pathological fractures of limbs,prompt patients to take active coping styles,improve self-care ability,reduce the incidence of complications,promote patient recovery,and improve the quality of nursing.

目的 探讨应用加速康复外科(ERAS)理念行经尿道钬激光前列腺剜除术(HoLEP)的效果和安全性.方法 回顾性分析郑州大学第一附属医院手术部2018-11—2021-02行HoLEP治疗的92例良性前列腺增生患者(BPH)的临床资料.以ERAS理念的引入时间为分组依据,其中2020-01—2021-02的46例围术期予以ERAS护理方案(ERAS组);选择2018-11—2019-12围术期采用传统护理方案的46例患者为常规组.观察2组患者术后首次肛门排气时间,首次进食时间、VAS评分,以及术后并发症发生率和患者及家属对临床护理工作的满意度.结果 ERAS组患者术后首次肛门排气时间和进食时间,持续膀胱冲洗时间、留置尿管时间,以及住院时间均短于常规组,术后24 h和72 h时的VAS评分低于常规组,差异均有统计学意义.ERAS组术后并发症发生率低于常规组,患者及其家属对护理工作的满意度高于常规组,差异均有统计学意义(P<0.05).结论 对行HoLEP治疗的BPH患者围手术期应用ERAS理念指导下各项护理干预,可有效缓解患者术后疼痛程度、减少术后并发症风险、缩短康复时间,以及提高临床护理工作质量.

目的:探究接触-介绍-沟通-询问-回答-离开沟通模式(CICARE)在原发性肝癌(PLC)患者术前访视中的应用效果.方法:选取于郑州大学第一附属医院2018年1月—2020年6月间的PLC患者128例,按建档时间不同分成两组,每组各64例.常规组接受常规护理干预,研究组于常规组基础上接受CICARE沟通模式护理干预.对比两组入室前、入室5 min焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、心率(HR)、收缩压(SBP)、舒张压(DBP)、护理满意度.结果:研究组入室5 min SAS、SDS评分较常规组低(P<0.05);研究组入室5 min HR、SBP、DBP较常规组低(P<0.05);研究组护理满意度96.88％(62/64)较常规组82.81％(53/64)高(P<0.05).结论:PLC患者术前访视应用CI-CARE沟通模式可有效调节心理状态,缓解生理应激反应,提高护理满意度.

目的 探讨腹腔镜辅助远端胃癌根治术手术时间延长的影响因素.方法 回顾性分析行腹腔镜辅助远端胃癌根治术治疗的142例胃癌患者临床资料,按手术时间不同分为长时间组63例和短时间组79例.收集患者资料,分析腹腔镜辅助远端胃癌根治术手术时间延长的影响因素.结果 长时间组体质量指数(BMI)≥25 kg/m2、男性、肿瘤分化、消化道重建方式毕Ⅱ、手术经验<100比例高于短时间组,差异有统计学意义(P<0.05);2组年龄、肿瘤部位、合并内科疾病、肿瘤大小、淋巴结转移、浸润深度、淋巴结清扫数量、术中出血量相比,差异无统计学意义(P>0.05).多因素Logistic回归分析显示,BMI≥25 kg/m2、男性、手术经验<100是腹腔镜辅助远端胃癌根治术手术时间延长的独立影响因素(P<0.05且OR≥1).结论 腹腔镜辅助远端胃癌根治术手术时间延长与性别、BMI和术者经验密切相关,临床需加以重视.

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