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影響肝移植術后患者服用免疫抑制劑依從性的因素及對策

目的:探討影響肝移植術后患者服用免疫抑制劑依從性的因素,及如何采取相應的對策,為門診隨訪工作提供指導。方法:對我院2003年4月至2005年6月行肝移植術132例患者進行門診隨訪調查。結果:所調查的患者有125例門診隨訪依從性良好,其中10.4%存在服藥不依從現象。結論:建立健全健康教育系統、糾正患者錯誤的認識和態度、促進家庭和社會的支持、建立良好的醫患、護患關系,可以提高肝移植患者的依從性,提升患者生活質量,提高患者遠期存活率。

護患溝通在門診護理工作中的運用

【摘要】 目的 探討門診護理工作中增強護患問題的有效途徑。 方法 提高門診護理服務水平及就診患者的滿意度，創優質服務品牌，制定出一系列增強溝通改進服務措施。 結果 護理人員服務觀念得以強化，為患者服務的意識明顯增強，能正確進行護患溝通，就診患者滿意度提高。 結論 培養和提高護士護患溝通能力是促進醫改護理服務品質的關鍵，有利于醫院的發展和建設。

優質護理服務在日間手術病房實踐效果

目的　展示優質護理活動在日間手術病房臨床實踐的效果。 方法　依據“優質護理示范工程”活動要求，結合日間病房特點，創新護理工作模式。并采用第三方問卷調查方式，對2011年11月－12月225例日間手術出院患者進行優質護理工作效果調查。 結果　有218例患者在日間手術前得到護士的健康教育與指導，占術前護理指導的96.8%。患者對護士的主動介紹、操作技能及病室環境滿意度均達到97.8%以上；對護士的咨詢服務、服務態度、護理工作整體滿意度達到100%，優質護理取得較好成效。 結論　創新日間護理模式，實施優質護理服務，不僅使護理的各項工作落實到位，護理質量得以提高，而且有助于實現優質護理服務示范工程目標。

美鹽治療外科術后感染創面療效觀察

【摘要】　目的　總結美鹽治療外科術后感染創面的效果。　方法　將2010年1-6月收治的59例具有外科術后感染創面的患者作為敷料受試者，并按納入研究時間順序的單雙號分為觀察組和對照組。觀察組30例使用美鹽敷料，對照組29例接受聚維酮碘濕敷。創面0.5 cm×10.0 cm~5.0 cm×10.0 cm，深度0.5~5.5 cm，觀察兩組患者治療過程中創面肉芽組織生長情況、創面及創面周圍炎癥反應、創面面積變化、愈合時間、氣味及滲出物情況。　結果　觀察組創面完全愈合24例，基本愈合4例，有效2例，無效0例；對照組創面完全愈合8例，基本愈合15例，有效3例，無效3例；兩組比較差異有統計學意義（Plt;0.05）。觀察組治愈時間（9.8±1.5） d，對照組（14.2±2.3） d；兩組比較差異有統計學意義（t=-2.171，Plt;0.01）。治療期觀察組7例患者分別在清創、肉芽生長、上皮形成階段發生滲液及出現異味，對照組14例發生滲液及出現異味，兩組比較差異有統計學意義（Plt;0.05）。　結論　美鹽能有效促進外科術后感染創面的愈合。

Clinical Application of Doctor-nurse Collaboration Model for Patients Undergoing Day Surgery of Laparoscopic Cholecystectomy

ObjectiveTo investigate the application and effect of doctor-nurse collaboration model for patients undergoing day surgery of laparoscopic cholecystectomy. MethodsFrom April 2010 to October 2013, we established the day-case laparoscopic cholecystectomy rapid rehabilitation team by day-surgery ward nurses, anesthesiologists, and surgeons. Collaboration was practiced through preoperative health education for the 1 902 patients, perioperative nursing cooperation, postoperative early activity and feeding of the patients, and follow-up. ResultsAfter the operation, there were 8 cases of incision bleeding, 1 case of bile leakage, 8 cases of shoulder and back pain, and 12 cases of nausea and vomiting. All the patients' postoperitive complications were controlled after treatment. ConclusionThe doctor-nurse collaboration model can significantly ensure the medical quality and safety of day surgery and improve the patients' medical experience. All the Patients, hospital and society will benefit from the model.

快速康復理念在日間腹腔鏡膽囊切除術中的應用

【摘要】　目的　總結快速外科康復理念在腹腔鏡膽囊切除術（labaro cholecystectomy，LC）日間手術中的應用效果。　方法　2010年1－10月，通過對日間手術200例LC患者實施快速康復護理，并與同期常規住院LC患者比較兩組間住院時間、費用及患者滿意度的差異。　結果　實施快速康復護理可明顯促進日間LC患者康復，減少住院時間，節省住院費用，滿意度達99.5%。　結論　快速康復外科理念可提高對日間手術LC患者的護理質量，促進患者康復。

Build a multidisciplinary integrated team for the increasing refractory diabetic foot ulcers

The annual incidence of diabetic foot ulcers in China is as high as 8.1%, which ranks first among the causes of chronic wounds in China. Although through the efforts of several generations of podiatrists and the building of multidisciplinary collaboration team, the major amputation rate in patients with diabetic foot ulcers in China has been decreased significantly, it is still far higher than the level of developed countries in Europe and the United States. Therefore, in order to cope with the increasing occurrence and recurrence of refractory diabetic foot ulcers, in addition to further optimizing the construction of multidisciplinary collaboration team, it is an urgent topic for us to explore the construction of a multidisciplinary integrated team to seamlessly connect the diagnosis and treatment of different aspects of foot disease. This article describes the importance and necessity of building a wound repair center with Chinese characteristics, which is a model of multidisciplinary integrated team, aiming at provide a theoretical basis for establishing a multidisciplinary integrated management model and realizing seamless connection between diagnosis and treatment, so as to further improve the cure rate of diabetic foot ulcers.

傷口治療中心-社區一體化在日間手術術后傷口延續護理中的作用

目的探討傷口治療中心-社區一體化在保障日間手術術后傷口的延續護理中的作用。 方法2011年－2014年根據日間手術患者出院后延續護理中傷口照護的需求，在傷口治療中心推廣醫院-社區一體化模式，為社區醫院培訓傷口換藥醫護人員，制定培訓計劃，評估培訓效果。 結果經過培訓后的社區醫護人員100%掌握了換藥、拆線的基本技能，回院后積極開展工作，完善日間手術術后傷口的延續護理，解決了日間手術患者的后顧之憂。 結論構建傷口治療中心-社區一體化，為社區醫院培訓傷口照護專業人員，保障了日間手術患者返回社區后的傷口照護質量，對日間手術的發展有良好的推動作用。

Application of Clinical Nursing Path Improvement for Day Surgery of Laparoscopic Cholecystectomy

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.

日間手術護理發展現狀