Objective To explore the effect of hierarchical authorization of nurses in management of iatrogenic skin injury in hospita-lized patients.Methods Inpatients at risk of iatrogenic skin injury were divided into a control group（173 237 cases in 2018） and an observation group（205 511 cases in 2019 and 236 742 cases in 2021） in chronological order, respectively subjected to routine ma-nagement or management by hierarchically authorized nurses.Results After implementing hierarchical authorization of nurses in management of iatrogenic skin injury, 81 nurse specialists were trained and authorized.There were significant differences in the incidence rate, degree and outcomes of iatrogenic skin injury between the two groups（all P＜0.05）.Conclusion Implementation of hierarchical authorization of nurses could effectively reduce the incidence rate of iatrogenic skin injury in hospitalized patients, improve the outcome of skin injury, and improve the quality of nursing care.

Objective To explore the learning outcome of multi-disciplinary team ( MDT ) plus problem-based learning( PBL) model in the training of emergency nursing . Methods A total of 270 students majoring in nursing enrolled in 2013, 2014 and 2015 in Renmin Hospital, Wuhan University were selected as research objects, 126 intership trainees selected from December 2016 to June 2017 as control group and 144 from July 2017 to February 2018 as experimental group. The control group used lecture-based learning methods and the experimental group used MDT mode combined with PBL. Results The experimental group theory test (36.96±2.56), emergency assessment(35.44±2.28) and comperehensive ability assessment (18. 48±1. 06) were significantly higher than the control group(35. 92±2. 48), (34. 05±2. 16), (17. 32± 1. 02). The trainees' satisfaction of in the experimental group (35. 18±3. 98) was significantly higher than that in the control group was(28.22±2.94). Conclusions MDT combined with PBL mode improve the students' achievement and comprehensive ability, and cultivate students' emergency capacity, so as to enhance the analysis and problem solving ability, to lay the foundation for the furure clinical work.

目的 探讨直肠癌患者术前加强营养护理的应用效果.方法 选取2014年2月至2015年2月间收治的60例直肠癌手术患者,按照随机数字表法分为观察组和对照组,每组各30例.观察组患者术前采用肠内营养剂加强营养,对照组患者术前采用传统流质饮食.比较两组患者的肠道清洁度、手术情况、术后营养情况和并发症.结果 两组患者肠道清洁度、手术时间、术中出血量差异均无统计学意义(均P ＞0.05).观察组患者术后肛门排气时间、半流质饮食时间、住院时间短于对照组,术后3天的血清白蛋白和血清总蛋白水平高于对照组,胃肠功能紊乱和并发症发生率少于对照组,差异均有统计学意义(均P ＜0.05).结论 术前加强营养护理可提高直肠癌患者术后的营养状况,减少胃肠功能紊乱和术后并发症,且不影响肠道清洁度.

Objective To investigate the efficacy of individualized nursing intervention in postoperative nursing of rectal cancer stoma patients.Methods From December 2013 to Decenber 2014 in Wuhan University People's Hospital,70 rectal cancer stoma patients were enrolled in the study and randomly divided into the observation group and the control group,with 35 cases in each group.The observation group accepted postoperative individualized nursing intervention based on postoperative routine nursing and the control group accepted postoperative routine nursing.The self-care postoperative ability and self-esteem of the two groups were compared.Results The scores of self-concept,self-responsibility and self-care skill after nursing in the observation group were significantly higher than those in the control group,with significant differences (P ＜ 0.05).The scores of self-esteem,behavior self-esteem and social self-esteem in the observation group were significantly higher than those in the control group,with significant differences (P ＜ 0.05).Conclusion Individualized nursing intervention can improve self-care ability and self-esteem level of rectal cancer stoma patients.It is conducive to physical and mental rehabilitation.

从护士科研能力的含义、临床护士科研能力的现状、存在的问题以及提高护士科研水平有效途径的研究进展等方面进行综述，旨在帮助医院及各级护理人员了解国内外临床护士科研能力的进展，为提升临床护士科研能力提供理论依据。

目的 在肠粘连形成过程中,测定分离粘着肠管之间的牵拉力,探讨不同大小的力牵拉肠管所致的肠壁病理学变化.方法 70只Wistar雄性大鼠随机分为7组(n=10)构建肠粘连模型,分别测定肠粘连形成后第1～7天分离肠管之间粘连的牵拉力,动态分析其变化.另取正常肠管分别加载不同的力于肠管两侧进行牵拉,检测不同的牵拉力所致肠管的病理学变化.结果 术后第1～7d分离大鼠肠管间粘连的牵拉力分别为F1(58.672±13.286)g、F2(83.260±10.066)g、F3(103.280±16.389)g、F4(121.330±17.643)g、F5(145.180±17.454)g、F6(172.900±22.074)g、F7(191.900±20.838)g,(F=77.282,P＜0.01),牵拉力与粘连形成时间呈线性正相关(r=0.9973,P＜0.01).肠管间加载的牵拉力越大肠壁的病理学损伤越明显.结论 肠粘连形成过程中,分离肠管之间的粘着的牵拉力随着时间的推移逐渐增加,过大牵拉力强行分离可损伤肠管.

Objective To investigate the causes,diagnosis and treatment of small intestine bleeding.Methods Sixty-eight cases of small intestine bleeding from January 2000 to June 2010 were retrospectively analyzed.Among all cases,4 underwent routine hemostatic treatment under colonoscopy,40treated with open surgery and 24 patients with laparoscopic therapy.Among them,57 cases underwent part resection for some small intestine,completely laparoscopic resection of diverticula was performed in 7patients.Results Neoplasms was the leading cause of small intestine bleeding,accounting for 48.5％ (33/68)in these patients,followed by small intestine diverticulum accounted for 29.4％ ( 20/68 ),intestinal infective diseases accounted for 14.7％ ( 10/68 ) and vascular disease accounted for 7.4％ ( 5/68 ).Conclusion The clinical manifestations of small intestinal bleeding showed no specific signs.Neoplasm,intestine diverticulum and intestinal infective diseases are the most common causes of small intestinal bleeding.Small intestinal bleeding can be diagnosed in intraoperative colonoscopy.Surgery is the most effective treatment for small intestinal bleeding.

目的探讨帕金森病患者行MRI定位立体定向手术的术后护理措施。方法 2008年7月—2009年7月本院对27例帕金森病患者行MRI定位立体定向手术,术后密切观察其生命体征变化,并积极给予术后临床护理和指导措施,防止各种并发症的发生。结果 27例患者经合理的护理后均安全渡过术后恢复期,并发症发生少,术后恢复时间缩短。结论术后护理措施尤其是术后心理护理和康复训练指导是使患者临床症状显著改善,促使患者早日康复的重要措施。

[目的]分析急性中毒的流行病学特点,探讨急性中毒的护理措施。[方法]对2005年1月—2007年12月1079例急性中毒病例进行回顾性流行病学分析。[结果]在调查病人中中毒高发年龄段为21岁～30岁,男女比例为1.34∶1;职业分布中工人比例最高(35.7%);毒物类型中酒精中毒(48.9%)最常见,其次是治疗药物中毒(17.2%)、有毒气体中毒(9.5%)、农药中毒(6.6%);发病高峰月份是3月、6月、12月。[结论]针对中毒特点采取相应的护理措施,以减轻症状、改善预后。

目的比较静脉留置针与钢针在临床护理使用过程中的优缺点。方法选择100例在临床中既使用过静脉留置针又使用过钢针的患者,对这100例患者进行2组同项目问卷调查。从各个方面观察患者对这2种穿刺方法的接受程度和满意率。结果静脉留置针在使用过程及护理上与钢针有显著性差异。结论钢针简单快捷,感染发生率较低,留置针更适用于危重抢救的患者。