Objective To investigate the efficacy of improved clinical nursing path for day surgery of laparoscopic cholecystectomy (LC). Methods The clinical data of 3 274 patients who underwent day surgery of LC following the clinical pathway between January 2011 and December 2015 were collected. The rate of adverse events including pain, postoperative nausea and vomiting (PONV), retention of urine and staxis before and after the improvement of clinical nursing path was analyzed and compared. Results For adverse event rate before and after the improvement of clinical nursing path, the difference in the incidence of pain and PONV was statistically significant (P < 0.05), while the difference in retention of urine and staxis was not statistically significant (P > 0.05). Conclusions Through the improvement of clinical nursing path for LC during day time, the procedure of nursing becomes more standardized. It is more feasible for clinical work and postoperative adverse reactio n rate becomes lower. It can also help shorten postoperative rehabilitation time and ensure perioperative medical quality and safety.
ObjectiveTo explore the effect of clinical nursing pathway on rehabilitation indicators in patients who had undergone transurethral resection of prostate (TURP). MethodsA total of 241 patients underwent TURP between July 2010 and March 2014 were randomly divided into path group (121 cases) and control group (120 cases). The nursing results of the two groups were observed. ResultsThe complication rate of bladder spasm, secondary hemorrhage, urethral stricture in path group were lower than those in the control group with significant differences (P<0.05). ConclusionThe performance of clinical nursing pathway on TURP patients may reduce the complications rate, and promote the health economics indicators and quality of care.
ObjectiveTo explore the clinical treatment measures and etiology analysis of lower urinary tract and penile foreign bodies. MethodsWe retrospectively analyzed the etiology and diagnosis of 48 cases of lower urinary tract and penile foreign body in the Department of Urology of our hospital between 1993 and 2012. ResultsNine bladder foreign bodies were removed successfully by using cystoscopy; nine were removed through suprapubic cystotomy; urethral foreign bodies in 10 patients were successfully taken out by urethrascope; five foreign bodies were extracted by hand and forceps; rubber bands in 2 patients were cut off under local anesthesia; fretsaw was used to cut through the nested rings in 7 patients; dental drill was used to cut nesting materials in 3 patients; and 3 patients underwent penis skin circumcision overturn stripping ring extraction. No complications after urethral foreign body extraction occurred. ConclusionThe lower urinary tract and penile foreign bodies are easy to diagnose, but patients often conceal the etiology, so the natural history collection is very important in the diagnosis, and doctors should take appropriate methods to remove the foreign body after the diagnosis is confirmed.
【摘要】 目的 分析胃肠道间质瘤（gastrointestinal stromal tumors，GIST）的螺旋CT（multi-detector row spiral computeel Tomography，MSCT）表现，评价其对该病的诊断价值。 方法 回顾性分析2000年3月—2010年10月经手术病理证实的32例GIST的MSCT表现，并将其与病理的生物学危险性进行对比研究。 结果 病理高、中、低及极低危险性GIST依次为15、6、7、4例。GIST主要CT表现，肿块腔外生长为主，大部分病灶边界清楚，呈类圆形或分叶状，密度均匀或不均匀，3例可见钙化，GIST增强静脉期强化较动脉期更明显，局部均无淋巴结转移，转移到肝脏的4例，同时伴前腹壁转移1例。15例肿块长径≥5 cm，密度多不均匀，可有囊变、坏死、出血等，增强不均匀强化，其中11例病理为高风险性；17例肿块长径lt;5 cm的病灶中，大多中度均匀强化，其中13例为中度及以下危险性。 结论 GIST患者的MSCT表现具有一定的特征性，MSCT对准确定位、术前估计肿瘤的风险级别、术后随访有重要价值。【Abstract】 Objective To investigate the imaging features of multi-slice spiral CT (MSCT) for gastrointestinal stromal tumors (GIST) and its diagnostic value. Methods We retrospectively analyzed the MSCT manifestations of 32 cases of GIST confirmed by operation and pathology between March 2000 and October 2010. Comparative study was then carried out between MSCT manifestations and patho-physiological risks. Results Of the 32 GIST lesions, 15 presented with high biological risks, six moderate risks, seven low risks and four very low risks. The MSCT results manifested the following main features. Exophytic growth was predominating; Most lesions were with well-defined margins, and were rotund or lobular in shape with homogeneous or heterogeneous density. Three lesions manifested calcification. The enhancement degree of GIST in portal vein phase was more obvious than in arterial phase. There was no metastasis to local lymph nodes. Hepatic metastasis occurred in four cases, one of which was accompanied with anterior abdominal wall metastasis. Of the 15 lesions with maximal diameter longer than 5 cm, MSCT showed obvious cystic changes, necrosis or hemorrhage within the mass most of which was in heterogeneous density, and heterogeneous enhancement; Eleven out of the 15 lesions were at high risk. Among the 17 lesions with maximal diameter shorter than 5 cm, MSCT showed homogeneous enhancement, and 13 of them were at moderate risk or below. Conclusion The MSCT imaging of GIST manifests some certain characteristics. It is valuable in locating the lesion precisely, estimating the risk level of the tumor, and postoperative follow-up for patients with GIST.
Objective To explore the relationship of self-efficacy and coping styles with parenting styles in patients with schizophrenia, and provide the theory and practical basis for family-interventions of rehabilitation of patients with schizophrenia. Methods From January to June 2015, General Self- Efficacy Scale, Simplified Coping Style Questionnaire and Egma Minnen av Bardndosnauppforstran were used to evaluate 60 inpatients with schizophrenia and in good rehabilitation in a grade A tertiary general hospital. Results The scores of self-efficacy, parental emotional warmth and father’s over protection were lower in patients with schizophrenia than the norms (P<0.01). The scores of parental punishment and rejection and father’s over intervention were higher in patients with schizophrenia than the norms (P<0.01). In patients with schizophrenia, the active coping domain was positively correlated to parental emotion warmth (P<0.05); the negative coping domain was positively correlated to parental rejection, father’s over protection and mother’s over intervention (P<0.05); self-efficacy was positively correlated to father’s emotion warmth and preference of parents (P<0.05). Conclusions Active family-interventions is important in the rehabilitation of patients with schizophrenia. The parents should be instructed to correctly educate the children, to improve the patients’ general self-efficacy, and help the patients successfully solve the problem with good coping style.
摘要:目的:探讨口腔颊黏膜尿道背侧镶嵌补片法治疗长段前尿道狭窄围术期的护理措施。 〖方法:术前做好口腔、会阴部及肠道准备,重视患者心理护理;术后重视尿管护理,维持吻合口低压状态,做好口腔及饮食护理,适当限制活动,注重并发症的观察与及时处理。结果:术后2～3月手术成功率达到92.4%,仅7.5%患者复发。结论:保证围手术期护理措施的质量对尿道成形手术的效果起到了重要的作用。 Abstract: Objective: To explore the perioperative nursing measures for the patients who underwent urethroplasty with dorsal onlay autogenetic oral ducal mucosa. Methods: Preoperative preparation includes oral cavity, perinea region,bowel cleansing and psychological nursing. Postoperatively, urinary catheter nursing is crucial to keep the anastomosis tension acceptablely low. Other postoperative care includes oral cleansing, activity restricting, discovering and dealing promptly with the complications. Results: Success rate was 92.4% 23 months after operation .Only 7.5% patients relapsed. Conclusions: Intensive perioperative nursing care was obviously helpful in improving the outcome of urethroplasty.