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风湿性心脏病合并慢性粒细胞白血病围手术期护理一例

Nursing Experiences of Invasive Blood Pressure Monitoring for Patients Having Undergone Open-heart Surgery

脉波轮廓温度稀释连续心排量测量技术在心脏直视术后的临床监测及应用

目的探讨脉波轮廓温度稀释连续心排量测量技术（PICCO）在心脏直视术后患者血流动力学参数监测中的应用及效果。 方法2011年1月－2012年6月采用PICCO监测20例术后危重患者的心功能指数（CI），全心舒张末期容积指数（GEDI），血管外肺血指数（ELWI），对监测结果为CI＜3 L/（min·m2）、GEDI＜700 mL/m2、ELWI＞10 mL/kg的患者，治疗上慎重增加容量，同时增加儿茶酚胺类药物剂量的对策；对CI＜3 L/（min·m2）、GEDI＞700 mL/m2、ELWI＞10 mL/kg的患者，治疗上予以增加儿茶酚胺类药物剂量同时严格控制容量，每日严格泵入液体量及管喂量的处置方式；对CI＞3 L/（min·m2）、GEDI＜700 mL/m2、ELWI＞10 mL/kg、SVRI＜900 kPa·s/（min·m2）的患者，则采取容量增加慎重同时增加儿茶酚胺类药物剂量，调节去甲肾上腺素用量的方式。 结果经PICCO严密监测以及药物和容量调整，19例患者循环逐渐稳定，均拔除气管插管后转出重症监护室（ICU）回病房继续治疗，1例因全心功能衰竭，抢救无效死亡。 结论通过应用PICCO对心脏直视术后患者血流动力学参数进行监测，能更直观有效、及时精确的找准血流动力学不稳定因素，对症下药，改善患者心功能情况，减少ICU住院天数，提高患者治愈率。

房间隔缺损修补术后体外膜肺联合体位疗法的观察及护理一例

Investigation and analysis of nutritional risk and dietary intake of patients with coronavirus disease 2019

ObjectiveTo explore and analyze the nutritional risk and dietary intake of patients with coronavirus disease 2019 (COVID-19), and provide data support for nutritional intervention.MethodsCOVID-19 inpatients were investigated in Wuhan Wuchang Hospital and the People’s Hospital of Wuhan University (East Area) from March 9th to 16th, 2020 by Nutrition Risk Screening 2002 (NRS 2002) scale and designed questionnaire. The energy and protein requirements were calculated according to the standard of 30 kcal/(kg·d) and 1.2 g/(kg·d). The nutritional risk, energy and protein intake, body weight and body mass index and their changes in the mild and severe patients were analyzed. The energy and protein intake of the two types of nutritional risk patients was analyzed.ResultsA total of 98 patients with COVID-19 completed the investigation, in whom 46 (46.94%) had nutritional risk, including 32 (39.02%) with mild type and 14 (87.50%) with severe type; and the difference was statistically significant (P<0.001). Compared with the usual condition, the body weight and body mass index of the two types of patients significantly decreased (P<0.01 or P<0.001); the energy and protein intake in mild type patients were significantly higher than those in the severe type patients (P<0.001); compared with the requirement, the protein intake in the two types of patients were significantly lower than the demand, while the energy and protein intake in the mild type patients were significantly lower than the requirement (P<0.05 or P<0.01). The proportion of energy and protein intakes in patients with nutritional risk was significantly higher than that in patients without nutritional risk (P<0.001 or P<0.01); the energy and protein intakes in patients without nutritional risk was significantly higher than that in patients with nutritional risk (P<0.001); the protein intakes in patients with nutritional risk was obviously insufficient (P<0.001); while the energy intake of the patients without nutritional risk was higher than the requirement (P<0.001).ConclusionsCOVID-19 patients has high incidence of nutritional risk which was higher in the severe patients compared with the mild patients. Higher incidence and lower intake of energy and protein are in the severe patients compared with those in the mild patients. Patients with nutritional risk has a higher proportion of energy and protein inadequate intake and lower intake compared with the patients without nutritional risk.

Recommendations on infection prevention and control of resident from medical team for aiding Hubei of West China Hospital of Sichuan University in the period of coronavirus disease 2019 outbreak

Coronavirus disease 2019 has been widespread in Hubei province since the beginning of 2020. Many medical teams went to aid Hubei from the whole country. The medical team of West China Hospital of Sichuan University arrived in Jianghan district of Wuhan on January 25, 2020. As one of the earliest teams arriving Hubei, we explored the measures for infection prevention and control of resident, in order to reduce the risk for infection of medical team. The infection prevention and control experiences on the establishment of infection control team, process management, behavior management, clean disinfection, infection monitoring and emergency response and emergency response to exposure of the medical team of West China Hospital were summarized in this article.