目的 总结同理心在冠心病重症监护室（CCU）患者家属沟通中的应用及效果。 方法 选择2010年4月－5月入住CCU的患者100例，按入院先后顺序前50例设定为对照组，后50例设定为观察组；对照组采用传统常规方法与患者家属进行沟通，观察组应用同理心理念与患者家属沟通。观察两组患者家属在非探视时间到访次数、纠纷次数和CCU护理工作满意度情况。 结果 观察组患者家属较对照组在非探视时间到访次数、纠纷发生次数少，而满意度较对照组高，两组比较差异有统计学意义（P＜0.05）。 结论 应用同理心与CCU患者家属进行沟通，可增加医患间的理解和信任，减少非探视时间内家属到访次数，有利于维护医院正常的工作秩序，同时减少纠纷的发生，提高了护理服务满意度。
目的 加强对急性左心功能衰竭患者的无创呼吸护理，确保救治安全和提高治疗效果。 方法 对2011年1月－9月收治的急性左心功能衰竭且应用无创呼吸机治疗的57例患者，采取相关应对措施进行系统性护理干预。 结果 5例患者因病情加重改行气管插管，52例经使用无创呼吸机治疗后，其病情稳定转出心脏病监护病房。治疗中2例配合较差，7例出现腹胀，2例发生鼻面部压迫性损伤。 结论 对症有效的护理干预措施对救治急性左心功能衰竭患者生命，提升无创呼吸的舒适感和医从性，降低相关并发症有积极作用。
护理硕士生作为未来专业领域的中坚力量和领军人物，承担着教学、管理、临床实践指导等多重任务，其临床实践中的学习、深化和带教十分重要。而当前国内在对护理硕士生进行临床带教时，仍采用以科研为主的通才培养模式，缺乏针对性和个体化，也未充分体现护理学的应用性特点。以角色为基础的临床带教模式将护理硕士生的专业角色确定为护理教育者、管理者及高级临床实践者，强调以学生专业角色为导向，制定针对性的临床教学目标和计划，以培养具有专科特色的应用性护理人才。
【摘要】 目的 探讨降低冠状动脉支架植入术后拔管所致血管迷走神经反射（vasovagal reflexs，VVR）的护理干预措施及效果。 方法 将2011年1-3月冠状动脉支架植入患者120例随机分为两组，对照组58例，试验组62例，对照组按常规方法拔管，试验组除常规方法外根据患者不同情况予针对性护理干预。 结果 120例患者中共发生VVR 10例，其中对照组发生8例，试验组发生2例。两组比较差异有统计学意义（Plt;0.05）。 结论 冠状动脉支架植入手术患者实施针对性的护理干预可有效降低血管迷走神经反射的发生，提高手术成功率。【Abstract】 Objective To investigate the nursing intervention measures and effects on reducing the vasovagal reflexs (VVRs) after the coronary stent extubation. Methods The clinical data of 120 patients who underwent coronary stenting between January and March 2011 were retrospectively analyzed. Patients were randomly divided into control group (n=58) treated with conventional coronary stent extubation and experiment group (n=62) treated with conventional coronary stent extubation and professional nursing intervention care. Results In 120 patients, VVRs occurred in 10 including 8 in the control group and 2 in the experiment group. The difference between the two groups was significant (Plt;0.05). Conclusion The coronary stent implantation with specific nursing interventions can effectively reduce the vascular vagal reflex, and leads to a higher success rate of the surgery.
To investigate the value of plasma placental growth factor (PlGF) in percutaneous coronary angioplasty and stent implantation. Methods From May 2006 to March 2007, 61 patients (53 males and 8 females, mean age61 years) and 28 normal controls were included. All patients present with acute chest pain and underwent coronary angiography, the lesion severity of coronary arteries was assessed by Gensini coronary scoring system. Of them, 26 patients having serious coronary lesion underwent (percutaneous transluminal coronary angioplasty, PTCA) and stent implantation. Cardiovascular events were recorded after 30 days. Plasma PlGF was determined by ELISA. Results According to the angiography, the patients could be divided into CAD group (n=45) and Non- CAD group (n=16). Plasma PlGF level in CAD group was significantly higher than that in Non-CAD group and control group [(10.70 ± 0.49) ng/L vs (4.53 ± 0.64) ng/L vs (3.64 ± 0.36) ng/L, P lt; 0.001)], and there was no significant difference between the non-CAD group and control group (P gt; 0.05). A significant positive correlation was found between Gensini coronary score and plasma PlGF level (r=0.918, P lt; 0.01). Moreover, patients with cardiovascular events had a higher PlGF level than those without cardiovascular events after PTCA and stent implantation [(13.98 ± 3.39) ng/L vs (7.25 ± 2.96) ng/L, P lt; 0.01)]. Conclusion PlGF level has diagnostic value in patients with acute chest pain. The measurement of plasma PlGF might be helpful for early diagnosis of coronary artery disease. Patients with higher plasma PlGF level may have more severe coronary lesion. PlGF may be one of predictors for cardiovascular events after PCI.
ObjectiveTo investigate the effects of rehabilitation exercise on exercise tolerance and cardiovascular risk factors in patients with non-acute coronary syndrome (non-ACS) after interventional therapy.MethodsA total of 102 patients with coronary heart disease and non-ACS in our hospital from December 2018 to June 2019 were selected and randomly divided into a control group (n=51, 30 males and 21 females with an average age of 56.1±4.8 years) and a trial group (n=51, 34 males and 17 females with an average age of 55.1±4.9 years). The control group received routine treatment, while the trial group received regular supervised rehabilitation exercise on the basis of routine treatment. Patients were followed up for 6 months to compare the differences in cardiovascular risk factors (blood pressure, blood lipid, fasting blood glucose), 6-minute walking distance (6MWD), adverse lifestyle changes and treatment compliance between the two groups after treatment.ResultsThe difference of 6MWD between the two groups was statistically significant (P<0.05). In the trial group, 6MWD increased after intervention compared with that before intervention, and the difference was statistically significant (P<0.05). Comparison of total cholesterol (TC), high density liptein cholesterol (HDL-C), low density liptein cholesterol (LDL-C) and fasting blood glucose in the trial group before and after intervention showed statistically significant differences (P<0.05). The differences in TC, HDL-C and LDL-C in the control group before and after intervention were statistically significant (P<0.05). It was statistically significant in dietary compliance rate, smoking cessation rate and alcohol cessation rate between the two groups (P<0.05); the differences in the dietary compliance and drug compliance of the trial group before and after intervention were statistically significant (P<0.05).ConclusionRegular supervised rehabilitation exercise can significantly improve the exercise tolerance and cardiovascular risk factors of non-ACS patients after coronary intervention treatment, so as to improve the quality of life and long-term prognosis of non-ACS patients, which is worthy of clinical application.
Objective To compare the effect and degree of satisfaction of different analgesic interventions for tubes of pericardium and mediastinum removal after cardiac surgery. Methods From December 2017 to June 2018, 94 patients undergoing open heart cardiac surgery with tubes of pericardium and mediastinum were allocated randomly into three groups including a group A (32 patients), a group B (35 patients), and a group C (27 patients). In the group A, intravenous Dezocine was given as analgesics. In the group B, intravenous Dezocine plus oral ibuprofen were given. In the group C, interventions of group B plus specific nursing guidance were given. With the help of visual analogue scale (VAS), scores of pain during and after the tubes removal were collected. The degree of satisfaction and other adverse effects were also recorded. Results The VAS scores and fading time of pain in the group B were significantly lower than those of the group A (P<0.017). The score of sleeping was better in the group B as well. The VAS scores and fading time of pain in the group C were also significantly lower than those of the group A, and the scores of mood, activity as well as degree of satisfaction were all higher than those in the group A (P<0.017). The scores of activity and degree of satisfaction in the group C were higher compared with the group B (P<0.017). Conclusion Combination of intravenous Dezocine and oral ibuprofen seems to be more effective than each individual. Professional and specific nursing guidance could increase the degree of satisfaction for chest tube removal after cardiac surgery.
目的 分析总结经导管主动脉瓣置入的术中护理要点，以指导临床术中护理。 方法 回顾性分析2012年4月－5月新开展经股动脉逆行法经导管主动脉瓣置入术3例患者的临床资料。术前备齐手术用物及急救药品、术中协助患者正确体位，准确使用临时起搏器、除颤仪、认真做好病情及并发症观察和护理，总结术中临床护理方法。 结果 经导管主动脉瓣置入手术顺利成功，术中护理效果满意，无因物品或药品准备不齐及护理不当而影响手术进程、造成患者意外损伤及并发症发生。 结论 经导管主动脉瓣置入术，术前备齐相应的导管导丝，术中操作规范细致、及时、准确传递用物、认真进行临床观察和护理，手术顺利、成功无不良事件发生及并发症发生。