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临床护理路径在脑卒中患者康复中的应用

目的　讨论临床护理路径（CNP）在脑卒中患者康复中的应用。 方法　将2010年1月－12月收治的80例脑卒中患者随机分为对照组和试验组，对照组采用功能制护理方法，试验组按照设计的CNP图实施护理。对两组患者住院期间健康知识掌握程度、护理工作满意度和住院天数进行比较。 结果　试验组对健康知识的掌握程度和满意度明显高于对照组，住院时间明显缩短，两组比较差异有统计学意义。 结论　CNP的应用可以提高脑卒中患者对疾病和康复知识的认识与掌握程度，提高患者对护理工作的满意度，有效缩短患者的住院时间，值得推广。

预防与康复模式在震后脊髓损伤伤员康复中的应用

目的：探讨预防与康复模式在震后脊髓损伤伤员康复治疗过程中的应用价值。方法：应用对象是对5·12汶川地震后我科收治的35例脊髓损伤伤员；模式组成成员有康复医生、脊髓损伤治疗师、康复护理人员、心理咨询师、社会各界的工作者、伤员、家属及陪护等；治疗干预方法是治疗小组成员共同参与对应用对象实施康复评估，制定康复治疗的近期和远期目标、康复治疗措施、反馈康复治疗效果的循环上升工作方式。结果：接受综合治疗干预后，35例震后脊髓损伤伤员在心理方面、小便处理能力方面、相关功能训练技巧和相关知识、矫形器和辅助器具使用能力等方面均有显著性提高（P＜0.05）。结论：在震后脊髓损伤伤员康复治疗过程中应用预防与康复模式，可明显提高伤员的整体康复效果，最大限度发挥伤员的残存功能，明显提高伤员的生存、生活和工作能力。

疑难血液透析用长期留置带涤纶套双腔导管置管一例

Application of liver venous deprivation before two-stage radical hepatectomy in liver cancer patients

ObjectiveTo explore the application of the technique of liver venous deprivation (LVD) for two-stage radical hepatectomy in patient with liver cancer underlying hepatitis B virus infection.MethodsA 53 years old patient diagnosed with central primary liver cancer (Ⅴ/Ⅷ segment) could not receive standard right hepatectomy since his future liver remnant was insufficient, so the LVD was performed to induce FLR growth. The general condition and CT scan were repeated at 1-, 2- and 3-week after LVD, the FLR and FLR weigh/ body weight ratio were calculated.ResultsThe FLR and FLR weight/body weight ratio before LVD were 24.2% and 0.459%, the FLR at 1-, 2- and 3-week after LVD were 29.5%, 38.3% and 44.4% respectively, the FLR weight/body weight were 0.545%, 0.707% and 0.820% at 1-, 2- and 3-week after LVD. The standard right hepatectomy was undertaken successfully at 25 days after LVD and discharged safely.ConclusionThe LVD technique could induce a rapid and large FLR volume and offer opportunity for patients with insufficient FLR to receive two-stage radical hepatectomy, is a novel method to induce FLR growth effectively.