目的 探讨老年综合评估及个体化干预在预防老年人跌倒、降低跌倒风险及发生率方面的作用.方法 选择2015年10月至2016年9月在华北理工大学附属医院老年病科住院患者,应用跌倒风险量表筛选出高风险患者共224例,按随机数字表法随机均分为干预组和对照组,其中对照组患者给予常规的入院疾病治疗、健康教育和临床护理,干预组在此基础上同时进行老年综合评估,并对评估后发现的问题实施科学的个体化干预方案.结果 研究前干预组和对照组跌倒风险评分相比差异无统计学意义(P=0.103);研究后干预组跌倒风险评分相比对照组下降更为明显,差异有统计学意义(P=0.000);干预组跌倒发生率明显低于对照组(P=0.030).结论 综合评估及个体化的干预措施能有效降低老年人的跌倒风险,减少老年人跌倒的发生.

Objective To investigate the influence of comprehensive review and intervention in elderly patients with hypertension complicated by anxiety.Methods The patients with hypertension complicated by anxiety (n=152, male 73, female 79 and aged from 60 to 90) were chosen from the Department of Geriatrics of the Affiliated Hospital of North China University of Science and Technology from Oct. 2015 to Apr. 2016. All patients were randomly divided into intervention group (n=75) and control group (n=77). The control group was given standard anti-hypertensive therapy and psychological counseling, and intervention group was additionally given geriatric comprehensive review and pertinent intervention. The scores of self-rating anxiety scale (SAS) and 24-h ambulatory blood pressure were detected, and indexes of heart rate variability (HRV) were analyzed including SDNN, SDANN, RMSSD and PNN50 at hospitalization time and after intervention for 2 months.Results All SAS scores were improved in 2 groups after intervention, and the improvements were more significant in intervention group (allP<0.05). The percentages of patients with geriatric syndrome (chronic pain, dyssomnia, uroclepsia, constipation, malnutrition, and seeing and hearing disorders) decreased in intervention group compared with control group (allP<0.05). The activities of daily living (ADL) were promoted and risk of falling was reduced in intervention group after intervention. The 24-h mean systolic blood pressure (SBP) and diastolic blood pressure (DBP), daytime mean SBP and DBP, and nighttime mean SBP and DBP were all significantly improved in 2 groups after intervention, and the improvements were more significant in intervention group (allP<0.05). The indexes of SDNN, SDANN, RMSSD and PNN50 were all significantly improved in 2 groups after intervention, and the improvements were more significant in intervention group (allP<0.05).Conclusion Geriatric comprehensive review and intervention can significantly relieve the symptoms of anxiety, and improve blood pressure level and HRV in patients with hypertension complicated by anxiety.

Objective To investigate the effect of track daily behavior intervention for early progress in the control of diabetes mellitus.Methods Totally 150 cases came from health examination center from Feb. 2012 to Oct.2012 in author's hospital identified as prediabetes were randomly divided into intervention group and control group with 75 cases in each group,the intervention group treated with daily behavior in-tervention on the basis of routine health outpatient disease knowledge guidance,while the control group no-ly received conventional disease outpatient health knowledge guidance.Results The patients in the inter-vention group on diabetes health knowledge known as significantly better than the control group,the differ-ence was statistically significant (P <0.05).In the intervention group,monitoring level on fasting blood glucose,postprandial 2h blood glucose,total cholesterol,triglyceride,body mass index were significantly lower than the control group (P <0.05).Conclusion The daily behavior intervention mode for patients with diabetes can strengthen their basic knowledge,improve their life style,effectively control blood glu-cose,stop the progression of early diabetic,and it is worthy in clinical application.

Objective To evaluate the effect of health education by follow -up with telephone for diabetes patients .Methods Four hundred and six discharged diabetes patients were randomly divided into control group and intervention group .Patients in control group received traditional health education .Except for traditional health education ,patients in intervention group received health education on follow -up by doc-tors with telephone .The questionnaire survey was carried out in all patients on their return visit after half year .The common sense ,compliance of treatment on diabetes mellitus ,and satisfaction of hospital service were evaluated in the survey .Results Patients'common sense on diabetes mellitus in intervention group was higher than control group ,and the defference of awareness rate was statistically significant between the two groups(P<0 .05) .The compliance of drug ,controlling diet ,keeping sports ,quit smoking ,and limit alcohol in intervention group were higher than them in control group (P<0 .05) .There was no significant difference on that keeping calm could reduce blood sugar in two groups (P>0 .05) .The satisfaction rate on hospital service in intervention group was significantly higher than that in control group .Conclusion Health education by follow -up with telephone improves patients'common sense ,compliance of treatment on diabetes mellitus ,and satisfaction of hospital service .

[Objective]To investigate the situation of nurses on their consciousness of legal protection.[Methods]Carried on the questionnaire survey to investigate 264 cases of clinical nurses who worked in polyclinics.[Results]In the daily nursing activities,68.2% of the nurses sometimes or usually carried out the doctor's oral advice;54.5% of the nurses sometimes or usually carried out the doctor's advice before the doctor wrote down his advice in medical history record or when the doctor was late in giving the advice or when the doctor forgot giving the advice,and they could not remind the doctor to write down his advice when the doctor forgot giving advice.In the daily nursing activities,25.7% of the nurses sometimes or usually cannot communicate well with the patients in time;28.8% of the nurses sometimes or usually did not apologize to the patients when nursing activities did not work well;59.1% of the nurses sometimes or usually altered a nursing record and could not modify it according to the medical rules.[Conclusion]Clinical nurses' behaviors in daily nursing activities need to be further standardized and improved so as to reduce the law disputes resulting from the non-standard nursing.

<正>随着社会的进步,病人(包含家属)维权意识的提高,医疗纠纷的发生率呈不断上升趋势[1]。临床护士的职业环境变得比以往更加复杂,护士在执业过程中,除了要防护一些物理、化学和微生物因素对护士身体健康造成的伤害外,还要防范医疗护理

<正>抗肿瘤药物大多数是细胞毒制剂,具有致突变、致癌、致畸性[1],在杀伤癌细胞的同时,对人体的正常组织细胞也具有杀伤或抑制作用[2]。如果防护不当,会对接触抗肿瘤药物的护士的健康产生危害。调查显示综合医院护士对接触抗肿瘤药物相关知识的认知和职业防护行为较差[3]。本课题旨在探索一种具有可行性的干预手段,提高护士的防护意识,改变护士的防护行为,维护其身体健康。1资料与方法1.1一般资料随机选取的本市某综合医院接触抗肿瘤药物

目的 了解临床护士在工作中法律风险防范意识现状.方法 采用自行设计的调查问卷,对综合医院264名临床护士进行问卷调查.结果 有68.2%的护士时有或经常在日常护理行为中执行口头医嘱;有54.5%的护士时有或经常在医生迟、漏、停、改医嘱时,执行在前或没有请医生补开医嘱;有25.7%的护士时有或经常不能在日常护理行为中及时与患者沟通;有28.8%的护士时有或经常不能在护理操作失败时诚恳地向患者表示歉意;有59.1%的护士时有或经常涂改,不按要求修改护理记录;有24.2%的护士时有或经常不能做到于患者拒绝某项治疗、护理操作时有记录.结论 临床护士的法律风险防范意识淡薄,日常护理行为有待进一步规范和完善,以减少医疗护理纠纷的发生.

[Objective] To investigate the value of laparoscopic treatment before pregnancy to prevent recurrent ectopic pregnancy.[Methods] A retrospective case-control study was carried out to analysis the reproductive outcome of 126 women after laparoscopic management of tube pregnancy.The patients were divided into experimental and control groups.Laparoscopic surgery was carried in experimental group to evaluate the circumstance of pelvic cavity,release the pelvic adhesion and repair the tube if necessary before next pregnancy.The control group only takes anti-infective treatment.The Chi-square criterion was performed to determine the difference of fertility between the groups.[Results] The recurrent ectopic rate was 7.1% and the interuterine pregnancy rate was 64.3% in the experimental group.There was significance difference between the groups of the two indexes(21.4% and 36.9%)(P﹤0.05).The infertility rates in experimental and control groups were 28.6% and 41.7%,respectively(P﹥0.05).[Conclusion] Laparoscopic treatment for the pregnancy of patients with previous ectopic pregnancy is benefit for reducing the recurrent ectopic pregnancy.

①目的探讨老年妇科肿瘤患者术后并发深静脉血栓(DVT)的诊治及预防。②方法回顾性分析我院9例老年妇科肿瘤患者术后下肢DVT的临床资料。③结果9例DVT患者体重指数均明显高于非DVT者,心血管疾病、糖尿病及恶性肿瘤的比率明显高于非DVT者。9例患者均同时给于溶栓治疗,8例治疗2~3周症状体征明显改善,下肢静脉再通,无并发症发生。1例死于肺栓塞。④结论恶性肿瘤、肥胖、术后离床活动时间延迟是老年妇科肿瘤患者术后DVT的高危因素。围手术期应积极预防DVT的发生,一旦发生,及早诊断,立即治疗。

护理美学是护理科学的一个重要组成部分,它是将美学基本理论应用于护理实践的一门新兴的边缘科学,有着极其广泛的应用价值和研究价值[1].在妇科护理工作中,我们应运用美学知识,提高护理水平和自身修养,为患者提供人性化服务,让患者在治疗的过程中感受到美,欣赏到美,从而促进了患者身心健康的恢复,收到了良好的效果.

化疗在妇科恶性肿瘤的治疗中占有重要地位,但多数抗肿瘤药物缺少理想的选择性抑制肿瘤作用,故在杀伤肿瘤细胞的同时对正常细胞都有影响,在出现疗效的同时,常伴有不同程度的毒性反应.2003年1月～2006年6月,我科对146例妇科恶性肿瘤患者进行化疗,护理体会报告如下.