目的 深入了解居家肿瘤患者预防深静脉血栓阻碍因素的感受,为进一步寻求切实有效的静脉血栓防治措施提供参考.方法 采用质性研究中的现象学研究方法对11例下肢深静脉血栓形成的肿瘤患者进行半结构式深入访谈,采用Colaizzi分析法进行资料分析,提炼主题.结果 提炼出居家肿瘤患者预防深静脉血栓行为受患者知识的限制,情绪态度的限制,行为能力的限制3个主题.结论 对居家肿瘤患者预防深静脉血栓阻碍因素行针对性护理干预,可防止深静脉血栓的发生.

目的 探讨Ⅰ期运动康复干预对冠状动脉旁路移植术后病人生活质量的影响.方法 采用方便抽样方法,将2016年11月-2017年6月在我院行冠状动脉旁路移植术的44例病人作为研究对象,分为试验组(23例)与对照组(21例).对照组病人按照心脏外科围术期常规进行活动宣教,试验组实施Ⅰ期运动康复干预.比较两组术后7d、1个月6min步行试验距离(6MWD)和病人出院后1个月、3个月的生活质量.结果 试验组术后7d、3个月6MWD明显长于对照组,差异有统计学意义(P<0.05).试验组住院天数、住院费用均低于对照组(P<0.05).术后1个月试验组健康调查简表(SF-36)中生理功能(PF)、情感职能(RE)、一般健康状况(GH)、精力(VT)评分均高于对照组,差异均有统计学意义(P<0.05);术后3个月试验组SF-36中PF、生理职能(RP)、VT、社会功能(SF)、RE评分均高于对照组,差异均有统计学意义(P<0.05).结论 Ⅰ期运动康复干预能提高冠状动脉旁路移植术后病人6MWD,提高病人生活质量.

Stem cells therapy is an effective treatment for critical limb ischemia diseases (CLI), but is limited to low cells retention and poor target release in severe ischemia tissues. Due to the notable feature of CLI, namely, the temperature of ischemia tissues decreases with the severity of the lesions, a thermoresponsive and reversible hydrogel based on methylcellulose-salt system encapsulating stem cells is facilely prepared and successfully achieved the goal of releasing stem cells in lower temperature areas. The investigations show that the thermogel presents notable biocompatibility, thermoresponsiveness, and cytoprotection. Furthermore, the combined transplantation of hydrogel and stem cells system effectively inhibits the fibrosis and muscular atrophy of lower limb ischemia, accelerates the recovery of lower limb blood flow, and promotes angiogenesis, indicating that the reversible thermogel can promote vascular repair by controlling the release of loaded stem cells in the treatment of CLI.

[目的]探讨流程化进阶管理模式在心脏外科手术病人围术期的应用效果.[方法]采用方便抽样的方法,抽取2018年7月—2018年8月某科室心脏手术病人25例为对照组,运用常规的护理管理模式.选取2018年9月—2018年10月心脏手术病人25例为进阶组,运用流程化进阶管理模式.比较两组病人出院前血清清蛋白、机械通气时间、住院天数、6 min步行距离(6 MWD)等.[结果]两组病人出院前血清清蛋白、住院天数、机械通气时间比较差异有统计学意义(P<0.05).进阶组病人满意度高于对照组.[结论]流程化进阶管理模式使工作内容标准化、规范化、流程化,有利于病人早期康复,提高病人的满意度.

Objective To investigate the efficacy of negative pressure wound therapy (NPWT) using vacuum-assisted closure (VAC) and ozone water flushing for the treatment of diabetic foot ulcers. Methods The present study included 136 consecutive diabetic foot ulcers (DFUs) patients who went to our hospital during April 2016 to August 2017. The patients were randomly divided into two groups: the combined group in which patients received both VAC and ozone water flushing, and the VAC group in which patients received only VAC. Clinical outcomes were recorded and the change of the wound surface area was calculated. The pain condition was evaluated using the visual analogue scale (VAS) scores. Results The duration of the treatment was significantly shorter and the dressing change times and peak VAS scores were both dramatically lower in the combined group than the VAC group. The reduction of the wound surface area was significantly larger after 1-week, 2-week, and 3-week treatment in the combined group; however, no significant difference was found after 1-month treatment. The bacterial clearance rate was significantly higher after 2-week treatment in the combined group compared with the VAC group; however, no significant difference was found after the whole treatment. No significant difference was observed in the recurrence and amputation rates. Conclusion The combination use could enhance the recovery of DFUs, shorten the treatment duration, and reduce the pain during treatment.

随着静脉血栓栓塞症发病率的逐年上升,静脉血栓栓塞症的预防和管理逐渐受到国内外各学科的重视.目前静脉血栓栓塞症患者在疾病相关知识的认知、 院后预防的依从性方面仍存在诸多不足.各医院预防管理措施不一,院后管理缺乏统一规范和标准,未能真正实现以患者为中心的预防.该文旨在对静脉血栓栓塞症的预防现状、患者的认知、依从性和院后管理进行综述.

Objective To investigate the experience of exercise rehabilitation in patients after coronary artery bypass surgery, in order to provide reference for the effective development of exercise rehabilitation. Methods A total of 16 patients undergoing coronary artery bypass surgery in the Tenth People's Hospital of Shanghai from March 2017 to April 2017 were selected. A qualitative study of phenomenological method was used to conduct in-depth interviews on postoperative rehabilitation training demands. Results Four themes for exercise rehabilitation related demands after coronary artery bypass grafting was extracted: the demand of personalized rehabilitation guidance, continuous rehabilitation guidance after discharge, the expectation of family, social care and support, and the hope to establish hospital and community medical institutions joint service mechanism. Conclusions Patients who participate in rehabilitation after coronary artery bypass surgery have high demand for the related knowledge, high dependence on society and family and high demand for post-discharge rehabilitation. Nursing staff should implement targeted nursing measures according to the actual needs of patients so as to promote their early recovery.

对冠状动脉旁路移植术后患者康复训练形式、康复训练强度评估方式、康复训练方案及应用现状进行综述,旨在为临床康复训练过程中选择安全、有效的康复训练方式提供参考.目前康复训练开始时间、训练形式、强度存在差异,患者对康复的风险存在疑义,针对这些问题,还需要进一步客观探索,从而形成科学、便捷、有效的心脏康复模式.

This paper summarizes the development of exercise rehabilitation, the development patterns, sports teams, intervention methods and effects after coronary artery bypass surgery. Advisers of exercise rehabilitation have different jagged currently. Recovery patterns and forms, movement of the time exist similarities and differences. We also need to further explore the objective and scientific exercise rehabilitation modes after coronary artery bypass surgery to solve these problems.

由于护理工作特定的工作性质和职业的高要求,使护士在工作中承受了较大的精神、心理压力。高工作应激状态不仅会降低护士的生活质量和工作绩效,还会使其离职率增高 [1-2] 。近年来,随着医院规模的日益壮大和医疗体制改革的逐步深入,低年资护士在护理队伍中的比例逐年上升,其工作时间短、工作经验相对不足,面对临床中超负荷工作,人际关系冲突和内心期望与现实差距时

<正>脐疝是肠管经脐环向脐部突出于体表的皮下疝[1],成人脐疝除因脐环闭锁不全或脐部结缔组织薄弱引起外,主要还是因腹内压增高的因素的存在,如肥胖、腹水等,脐疝其发病率占所有成人腹壁疝的6%[2-3]。成人脐疝因肠管、大网膜疝出常伴有消化不良,腹部不适和隐痛等症状[4]。成人脐疝不可自愈,且可继续增大,即使起初是可复性的,但由于其内容物多为大网膜,长期的摩擦使得内容物粘连,逐渐变得难复,可能嵌顿或绞窄,故成人脐疝一经发现必须积极手术治疗[5]。采用PROCEED网片作为疝修补材料,对同济大学附