目的 探讨微信群联合微信订阅号在手术室教学中的应用效果 方法 建立微信订阅号,组建微信订阅号运营团队,联合微信群应用于早交班学习、业务学习和护理查房和设备使用学习中,通过统计微信群及微信订阅号发送信息的数据和调查问卷反馈应用效果.结果 90.8％的护士认为此方法可以提高学习效率,92.3％的护士认为此方法可以提高学习的兴趣,88％的护士认为此方法可以更好地提高和巩固自己的专科知识,96.3％的护士认为此方法可以提高学习的便捷性.结论 手术室微信群和微信订阅号平台的使用有助于提高护士学习的便捷性,提高学习的效率和方便知识的巩固.

目的 探讨通过增加粒子源数量提高骨水泥包裹后125I粒子表面放射活度的可行性.方法 制作高1 cm、直径1 cm的骨水泥圆柱体模型15个,根据所包裹125I粒子数量的不同随机分成A、B、C3组(n=5),其中A组包裹2枚粒子、B组6枚、C组10枚.测量骨水泥包裹前125I粒子表面总放射活度,然后将骨水泥填满模型,骨水泥未硬化前于模型中央植入125I粒子,硬化后检测其表面放射活度,观察不同数量125I粒子骨水泥包裹模型表面放射活度的变化.结果 125I粒子骨水泥包裹后模型表面放射活度明显低于包裹前(P＜0.05).A、B、C3组包裹后活度衰减率分别为(98.96±0.13)％、(98.06±0.05)％、(95.11±0.02)％,组间比较差异有统计学意义(P ＜0.05).结论 125I粒子被骨水泥完全包裹后,增加粒子源数量可以在一定程度上提高表面放射活度,但粒子射线的衰减仍非常严重,很难达到肿瘤靶区的有效吸收剂量,提示通过增加粒子源数量提高表面放射活度的方法并不可行.

目的 探讨125I粒子骨水泥(PMMA)包裹后表面放射活度的变化,观察骨水泥对粒子射线的影响,为椎体成形术联合125I粒子植入治疗脊柱转移癌提供实验依据.方法 分别制作A、B两组不同厚度骨水泥包裹125I粒子的圆柱体模型,其中A组高2.0 cm、直径2.0 cm,B组高1.0 cm、直径1.0 cm,每组各5个模型.检测粒子包裹前表面总放射活度,骨水泥未凝固前于10个实验模型中心部各植入4枚125I粒子,观察各模型表面放射活度的变化,分析骨水泥对125I粒子射线的影响.结果 A组125I粒子包裹前、包裹后表面放射活度分别为(2.379±0.075)、(0.013±0.001)mCi,B组为(2.388±0.045)、(0.022±0.002)mCi.两组包裹前表面放射活度相似(P>0.05),骨水泥包裹后均明显降低(P<0.05),说明两组模型骨水泥对粒子射线均产生阻挡作用,其中A组模型(直径2.0 cm)表面放射活度较B组模型(直径1.0 cm)下降得更快(P<0.05),阻挡效应更明显.结论 PMMA骨水泥对包裹于其内的125I粒子会产生明显的阻挡效应,这种阻挡效应随着骨水泥厚度的增加而逐渐加强,提示椎体成形术联合125I粒子植入治疗脊柱转移癌过程中,应考虑植入粒子与骨水泥填充区域的位置关系,尽可能降低骨水泥对粒子射线的影响.

Objective To summarize the nursing experiences of operating room nurses in unicompartmental knee arthroplasty.Methods Clinical and nursing coordination data of unicompartmental knee arthroplasty(UKA)in 39 cases of patients were retrospectively analyzed.Results All the patients lived through the successful operations and the postoperative rehabilitation were in good condition without postoperative complications.Conclusion Careful preoperative preparation and the skilled surgery cooperation is the key of the successful cooperation in UKA.

[目的]探讨术中放疗和非术中放疗两种方式对脊柱转移癌经皮椎体成型术病人术中及术后恢复的影响.[方法]对22例脊柱转移癌经皮椎体成型术病人按术中放疗和非术中放疗两种方式分为放疗组(n=11)和非放疗组(n=11).观察两组病人手术进程中生命体征变化、术前术后血常规及电解质变化、术后疼痛评分等.[结果]两组病人术后第1天钾较术前低;放疗组病人术中手术时间短于非放疗组,术后的疼痛评分低于非放疗组(P＜0.05).[结论]脊柱转移癌经皮椎体成型术病人在术中放疗对病人无明显影响,病人可耐受并可降低术后病人疼痛发生率.

目的：：探讨应用经颅电刺激运动诱发电位( TES-MEP )和皮层体感诱发电位( CSEP )联合监护脊髓型颈椎病( CSM)手术中脊髓功能的护理要点。方法：回顾性分析2012年3月至2014年10月本院行CSM手术同时监测双侧三角肌、肱二头肌、大鱼际肌、小鱼际肌和胫前肌TES-MEP以及双侧正中神经CSEP 196例患者的临床资料,分析术中诱发电位阳性变化的相关因素及术后并发症情况。结果：术中TES-MEP、CSEP、联合监护的成功率分别为95.4％(187/196)、98％(192/196)和99.5％(195/196)。联合监护阳性6例,其中5例与脊髓功能符合,1例不符合,无假阴性。术中诱发电位阳性9次,2次与体位有关,2次与患者体温下降有关,5次与手术操作不当相关。术后神经损伤1例。患者术后无发生皮肤烧灼伤、红肿热痛、舌咬伤等监护并发症。结论：TES-MEP和CSEP联合监护可安全用于颈椎手术做脊髓功能的监测,降低术后皮肤感染发生率,阳性电位能保证及时正确的护理监护。

目的:探讨METRxⅡ系统结合经皮椎弓根钉技术治疗单间隙腰椎退行性疾病的护理经验,提高手术配合效率.方法:回顾性分析2014年1～10月我院收治20例METRxⅡ系统结合经皮椎弓根钉技术治疗单间隙腰椎退行性疾病的护理配合情况.结果:20例手术顺利完成,术后康复良好.结论:术中实施安全有效的体位管理、熟悉手术相关步骤、密切配合手术医师,并注意严格无菌操作,是保障患者安全、手术顺利完成的关键.

Objective To investigate the bacterial contamination rates of suction tip in total knee arthroplasty ( TKA).Methods Fifty-two knees undergone TKA in the operating room of the First Affiliated Hospital of Guangzhou Medical University from Feb 2015 to May 2015 were enrolled in this controlled study.Two sets of suction tubes were used in every TKA procedure, of which one was used in the control group without contacting the surgical field and the other was used routinely in the experimental&nbsp;group.Specimens were taken by swabs and sent for culture from inner wall of the suction tips one hour after the incision and at the end of the surgery.The bacterial contamination rates of the suction tip were compared between the two groups.Results In the control group, no flora was found in the laboratory.In the experimental group, the samples from the two suction tips presented positive culture results with identical staphylococcus epidermidis both one hour after the incision and at the end of TKA. The contamination rate of the experimental group was 3.8%, not significantly higher than the control group ( x2=2.039, P >0.05).Conclusion As the low contamination rate of suction tip in TKA, it is not suggested suction tip changing in every 60 minutes as a compulsory sterile protocol in TKA.

目前腹腔镜辅助结直肠癌手术常需要通过腹部切口取出标本，术后伤口疼痛，且有切口感染等并发症发生的风险，是目前外科医生着力改进的热点。经自然通道取出标本可能是一个较好的改进方法[1]。我院胃肠外科完成了经肛门取出标本的肛内镜辅助全腹腔镜下直肠癌根治术28例，近期疗效满意。现将手术中的护理配合介绍如下。

Objective To investigate the effects of gelatin decompression pad applied in prone-position patients for pressure sores prevention.Methods Two hundred surgical patients of prone position were randomly selected into the experimental group using gelatin decompression pad and the control group using cotton cushion,100 cases in each group.The pressure sores and comfort level were observed and recorded.Results No pressure sores occurred in the experimental group,while pressure sores occurred in 8 patients in the control group.The rate of pressure sores in the experimental group was lower than that in the control group(P < 0.05),while the comfort level of the experimental group was better than that in the control group(P < 0.05).Conclusion Gelatin decompression pad can effectively prevent the pressure sores during the prone-position operation.

目的探讨膝关节镜下盘状半月板成形术的手术配合。方法回顾分析22例膝关节镜下盘状半月板成形术的手术配合情况。结果22例手术均顺利完成,手术时间每膝不超过60min,平均35min。结论掌握患者情况,医护人员熟练操作,密切配合,可以取得满意效果。

目的探讨人工肩胛骨肩关节置换术的手术护理配合技术,以确定手术达到满意效果.方法对10例肩胛骨恶性肿瘤患者予心理支持,手术器械准备,肿瘤切除及人工肩胛骨肩关节置换的护理配合.结果10例术后均获满意效果,无发生感染、肩关节脱位、松动,无肿瘤复发和其他护理并发症.结论护士熟知肩胛骨的解剖特点及全肩关节置换手术器械性能及特点,认真做好术前准备和术中配合方能提高手术效果及治愈率.

目的提高膝关节镜手术配合的技术水平.方法对100例膝关节镜的手术配合操作,总结经验及教训.结果95例膝关节镜手术顺利完成,2例注水系统注水不良,观察欠清晰,1例关节镜折断,2例刨削打磨系统出现故障.结论手术护士对器械定期检测、维护,以及术中有效的配合,对手术顺利完成有重要作用.