Objective To review and analyze the statistics of laboratory critical values in the Department of Cardiovascular Surgery in order to improve the procedures of dealing with these values and provide references for the enhancement of the nursing level. Methods We retrospectively analyzed laboratory critical values of 236 inpatients in the Department of Cardiovascular Surgery from April 2013 to April 2014. General data of the patients including the type of critical values, the critical value, distribution, clinical processing time and complications related to the critical values. Results A total of 208 laboratory critical values of 185 inpatients were analyzed including abnormal blood potassium was involved in 99 (47.60%); abnormal blood glucose was involved in 13 (6.25%); abnormal blood sodium was involved in 11 (5.29%); abnormal blood troponin was involved in 13 (6.25%); and 72 cases had other kinds of critical values (34.62%). A total of 136 critical values were closely related to the Department of Cardiovascular Surgery. Among them, 60 cases had a processing time of 15 minutes or shorter. After re-examination, 16 were confirmed to be fake critical values; and 11 critical values did not need to be treated according to the condition of the patients. There were altogether 27 cases of complications related to critical values, including 23 cases of arrhythmia related to abnormal blood potassium, 2 cases of abnormal muscle strength caused by abnormal blood sodium, and 2 cases of hypoglycemia. After the critical values were handled, related complications disappeared without any recurrence. Conclusions Perfect regulatory regime and process of recording and handling laboratory critical values are important for nurses in our department to carry out more accurate measures in treating these critical values including abnormal blood potassium, blood glucose, blood sodium, and blood troponin, etc. In order to continuously improve medical and nursing quality, nurses should pay more attention to the identification and treatment of laboratory critical values.
目的 提高胸心血管外科患者ICU转出交接班质量，避免护理差错和纠纷。 方法 2010年1月－6月，针对患者转运出现的问题，在查阅文献及专家咨询的情况下，设计制定胸心血管外科ICU患者转出交接单，对患者转出ICU时的病情、用药、并发症等信息进行完善，同时规范交接班签字手续。采用调查问卷方式，对交接单运用效果进行评价。 结果 转出交接单的应用，提高了病房护士对ICU护士交接班质量满意度，除“医嘱单正确执行”、“签字和药物交接班清楚”与运用前满意程度无差异外，其余条目满意程度均有所增加，增加率波动在3.7%～33.4%。 结论 转出交接单使用能够提高ICU患者术后转运交接质量，预防护理差错和纠纷，确保证患者安全。
目的:探讨主动脉夹层患者术前血压控制的护理经验。方法:回顾性分析了我院2007年1月至2008年1月收治的91例主动脉夹层患者血压控制的护理措施。结果:本组病例通过密切的观察和护理,获得了较好的治疗效果。结论:主动脉夹层患者术前血压控制的过程中,应密切观察,综合分析,采取镇静、止痛、扩血管等措施,才能有效地控制血压,为下一步治疗赢得时间和机会。
ObjectiveTo summarize clinicopathologic and immunophenotypic features of hepatic epithelioid angiomyolipoma (HEAML) and to explore its diagnostic and differential diagnostic methods.MethodThe clinical and imaging manifestations, pathological morphology and immunohistochemical features of 5 patients with HEAML from August 2011 to December 2017 in this hospital were retrospectively analyzed.ResultsThere were 2 males and 3 females in the 5 patients with HEAML, aged 38–64 years with an average age of 50 years. There were 2 cases of the left lobe tumors and 3 cases of the right lobe tumors. Three cases were diagnosed as the hepatocellular carcinoma and the other two cases were diagnosed as the hepatic hamartoma and (or) hemangioma by the preoperative imaging examination. The diameter of tumors ranged from 1.5 cm to 7.0 cm, with an average of 3.6 cm. Microscopically, the tumors were composed of more epithelioid smooth muscle cells, parenchyma vessels and a small amount of fat. The immunohistochemical results showed that the melan-A, HMB45, and SMA were positive, while the HepPar-1, AE1/AE3, EMA, CD117, Dog-1, CD10, CgA, Syn, and Desmin were negative. The Ki-67 proliferation index was 2%–10%. The patients were all alive without the tumor recurrence after following up for 2–76 months with an average of 31.4 months.ConclusionsHEAML is a rare primary mesenchymal tumor of liver, which should be misdiagnosed for other benign or malignant tumors for influencing clinical treatment. Diagnosis and differential diagnosis can be made by histopathology and immunohistochemical staining.
Objective To explore the status of women’s quality of life and analyze risk factors related diminished ovarian reserve (DOR). Methods We applied the method of convenient sampling to investigate 61 patients with DOR (DOR group) and 60 women with normal ovarian reserve function (control group) who visited a reproductive centre of a Triple-A hospital from February to May 2013, using a questionnaire which included basic information table, Menopausal Quality of Life Scale (MENQOL) and SF-36 Health Survey for quality of life, and Kupperman Index Scale (KI) for the degree of clinical symptoms. Then, statistical analysis was performed using SPSS 17.0 software. Results Compared with the control group (43.60±16.82), the level of women’s quality of life in the DOR group (73.42±24.15) was significantly lower (Plt;0.01), while the degree of clinical symptoms was significantly higher (Plt;0.01). There were positive associations between quality of life and degree of clinical symptoms. The risk factors related to DOR were various such as age, weight, quality of sleep, menstrual disorders, number of abortion, age of the first pregnancy, gynecologic surgery, economic income, education, family relationship, unsatisfactory sexual life, and psychological factors. Conclusion In order to improve women’s quality of life, effective treatment should be conducted to relieve clinical symptoms of women with DOR. Good life style, harmonious family relationship, healthy mind and avoiding the risk factors, which could effectively help the prevention and treatment of the disease.