喉癌患者围手术期的护理

我科自1991年4月～2003年12月，共收治喉癌患者30例，经过精心治疗及细心护理，收到良好效果，报告如下。     

股骨颈骨折患者的围术期护理效果观察

目的 探讨老年股骨颈骨折术后康复患者的护理及其效果.方法 将61例老年股骨颈骨折患者随机分为2组.所有患者均实施全髋置换术或人工股骨头置换术,对照组术后给予常规护理,观察组31例除此外,着重开展心理指导,平衡饮食营养,预防并发症和康复锻炼指导等护理.比较2组术后2月疼痛,康复(活动功能)评价和主要并发症,再手术率及术后负重时间,总住院时间.结果 观察组活动功能优良率为96.8%,疼痛好转率为93.6%,高于对照组的86.7%和76.7%(p<0.05).2组之间的主要并发症和再手术率比较,差异有显著性(p<0.05),2组术中出血量、术后负重时间和总住院时间比较也有显著性差异(p<0.05).结论 积极有效的护理有利于老年股骨颈骨折患者术后康复.     

60例胃癌患者围手术期护理体会

目的 探讨胃癌患者围手术期的综合护理对手术疗效和术后并发症的影响.方法 将我院2008年2月至2011年5月收入院的60例患者随机分为对照组和实验组各30例.对照组行常规护理,实验组在围手术期加强心理护理、并发症护理等综合护理,观察两组患者康复率和术后并发症的发生率.结果 实验组患者好转率显著高于对照组(P<0.01).实验组术后吻合口瘘和感染的发生率显著低于对照组(P<0.05).结论 做好胃癌患者围手术期的综合护理,可提高手术成功率及康复率,减少术后并发症的发生.     

1例胰岛素瘤患者的围手术期护理

胰岛素瘤是来源于胰岛B细胞的一种罕见肿瘤,但属常见的胰腺内分泌瘤,约占70%～80%.大多为单发,少数为多发,甚至为无数微小肿瘤,可发生在胰腺各部,胰头体、尾各占1/3.肿瘤直径多在1.0～2.5cm,呈圆形或卵圆形.边界清、质地较正常胰腺组织硬.胰岛素瘤分泌的过多胰岛素可产生胰岛素的代谢效应而出现临床表现[1].     

臂丛神经损伤患者的围术期护理

对24例臂丛神经损伤的患者加强术前心理护理,做好各种准备工作,术后密切观察伤口渗血情况,做好基础生活护理及康复训练护理.通过对臂丛神经术后的精心治疗和护理,促进患者早日恢复自理能力.     

真空负压吸引技术的围手术期护理

报告了13例真空负压吸引(VSD)技术治疗软组织缺损患者的围手术期护理体会.本组引流期间1例患者2d后出现堵塞,及时冲洗后通畅,其余12例患者创面干燥、清洁,引流良好,顺利拆下VSD敷料.认为术前加强心理护理,术后密切观察病情,给予必要的营养支持,尤其对VSD进行局部观察和正确处理是治疗成功的关键.     

系统心理护理对骨折围手术期焦虑的影响

目的:探讨系统心理护理对骨折围手术期焦虑的影响.方法:60例骨折患者随机分为2组,对照组患者采用常规护理及传统的健教方法;实验组采用在常规护理的基础上运用系统心理护理的方法,观察对比2组焦虑的程度.结果:实验组围手术期焦虑程度明显低于对照组,差异有统计学意义(P＜0.05).结论:运用系统心理护理能有效减轻骨折围手术期的焦虑程度.     

重型颅脑损伤患者围手术期整体护理体会

目的:探讨重型颅脑损伤患者围手术期护理.方法:对190例重型颅脑损伤患者严密观察病人,术前充分准备,制定完善护理计划实施,可为手术顺利进行创造前提条件.术后进行多系统监护,术后严密细致观察作为预见性处理,同时尽早给予智能训练及康复护理,防止和减少并发症.结果:I期痊愈92例,II期为中残30例,III期为重残12例,植物人4例,死亡52例,死亡率27.4%.结论:术后严密细致观察作为预见性处理,同时尽早给予智能训练及康复护理减少并发症的发生,是降低死亡率、提高生存质量最重要的因素.     

高龄髋部骨折患者的围手术期护理体会

目的:探讨高龄髋部骨折患者的围手术期护理要点.方法:我科对2006年6月至2010年6月收治的高龄髋部骨折患者120例中的116例手术患者术前实施心理护理、重视合并基础疾病的处理及术前准备,术后密切观察生命体征、积极预防肺部感染、泌尿系感染、便秘、下肢深静脉血栓和压疮等并发症.结果:本组116例髋部骨折手术患者手术后除2例发生肺部感染外,未发生其它并发症.结论:髋部骨折的高龄患者因其自身的生理特点以及因伴有其他疾病而使得护理难度增大,术后并发症增加.因此,做好围手术期护理尤为重要,是减少并发症,提高手术成功率的关键环节之一.     

脊柱结核围手术期护理体会

总结了自2004年～2010年本科32例脊柱结核围手术期的护理要点,包括术前心理护理、用药指导、营养支持,术后严密病情观察、功能锻炼、并发症的预防和正确的出院指导等.认为做好围手术期护理是减轻患者痛苦,降低并发症的发生,提高手术成功率的重要措施.     

子宫切除病人围手术期的心理护理

探讨了子宫切除病人围手术期的心理护理.方法:对患者实施了术前心理护理、解除焦虑心理、术后心理护理等护理措施.结果:358例子宫切除病人无一列产生并发症,术后痊愈出院.结论:通过对子宫切除病人围手术期的心理护理,是病人术前情绪稳定,配合治疗,术后恢复快.     

普胸外科并心肺疾病患者的围术期处理

目的:增强对普胸外科心肺疾病的病理与临床认识.方法:分析患者经检查确诊为心肺疾病病理资料及临床资料.结果:经过检查确诊为心肺疾病.结论:对心肺疾病准确的诊断及时的预防和治疗.     

50例腰椎间盘突出症的围手术期护理干预效果观察

目的:探讨腰椎间盘突出症的护理干预效果.方法:100例腰椎间盘突出症患者根据护理方法不同随机分为干预组和对照组,对照组行常规护理,干预组给予围手术期的护理干预,比较两组的手术疗效及护理观察指标的变化情况.结果:护理干预组的有效率为94%,明显高于对照组的有效率.且干预组的护理满意度明显高于对照组(P<0.05).两组手术疗效比较,差异有统计学意义(P<0.05).经过有效的围手术期护理,与对照组比较,护理干预组的平均手术时间明显缩短,平均术中出血量明显减少,平均住院时间明显缩短(P<0.05).结论:通过围手术期有效的护理干预,提高了手术疗效,缩短了手术时间,减少了术中出血量,提高了护理工作的满意度,促进了患者的早日康复.     

四肢骨折患者的康复护理观察与体会

目的:对四肢骨折患者的康复护理进行观察与分析.方法:将42例四肢骨折患者随机将其分为两组,同时对两组患者实施相应的护理措施,最后对所得数据进行统计与处理和相关分析.结果:康复护理组患者总有效率为98%,明显好于一般护理组患者;而两组患者恢复情况均较护理前显著改善,但护理后康复护理组患者恢复情况则好于一般护理组患者;同时康复护理组患者恢复时间明显比一般护理组短且护理并发症也明显低于一般护理组.结论:康复护理对四肢骨折患者来说至关重要.     

胸腰椎骨折患者的中医康复护理体会

目的:探讨了胸腰椎骨折患者的中医康复护理体会.方法:自2009年8月至2010年10月共收治胸腰椎压缩性骨折患者38例采用疼痛护理、体位护理、饮食护理、心理护理以及并发症等护理方法.结果:38例患者经正确的治疗和精心的整体护理,功能恢复好.结论:对胸腰椎骨折患者采取有效的中医康复护理措施,有利于患者的康复,值得临床推广.     

股骨颈骨折的护理体会

股骨颈骨折是以髋部疼痛,腹股沟中点附近有压痛和纵轴叩击痛为主要表现的股骨头下至股骨颈基底部骨折.是老年常见的骨折之一,尤以老年女性较多.股骨颈骨折大多数是外旋暴力所引起的螺旋形骨折或斜形骨折.高龄患者因年老、体弱、多病、脏器功能减退等多方面原因,股骨骨折后易发生并发症.因此,对这类患者的护理工作极为重要.     

Reimplantation of autoclaved tumour bone in limb salvage surgery

This is a prospective clinical study of 7 patients with malignant bone tumours who were treated by resection of the tumour, followed with reconstruction by reimplantation of the resected autoclaved tumour bone. There were 3 male and 4 female patients between 10 and 36 years of age. All the tumours were Stage IIB. Five of the 7 were in the region of the knee joint. Histologically, 5 were osteosarcomas, 1 a recurrent chondrosarcoma and 1 a recurrent Ewing's sarcoma. All the patients were treated by en bloc resection of the tumour with wide margins. The resected length ranged from 13 cm to 28 cm. After removal of soft tissue and cartilage, the resected bone segment was autoclaved for 5 min at 132 degrees C and 29 pounds per square inch pressure (0.2 mega Pascal). This autoclaved segment of bone was then reimplanted and fixed with an appropriate implant. The average follow-up was 20 months with a range of 14 to 27 months. None of the tumours recurred and, at the most recent follow-up, all the patients were alive, 6 with no evidence of disease and one with a lung metastasis. Six of the 7 patients were available for radiological assessment. Solid bone union was seen in 4 patients, delayed union in 1 and nonunion in 1. This method of reconstruction using an autoclaved tumour bone graft is useful in countries where facilities for allograft or tumour prostheses are not available owing to financial, technical or sociocultural reasons.     

Autologous bone grafting in staged scoliosis surgery. The patient as bone bank

STUDY DESIGN: A prospective clinical study in which autologous rib graft, harvested during the thoracotomy in staged scoliosis correction, is stored within the patient for use during the second stage (posterior intrumentation and fusion). OBJECTIVE: To determine whether the bone stored by this technique is biologically viable and microbiologically safe. SUMMARY OF BACKGROUND DATA: To the authors' knowledge, this method of storage of bone has never been described previously. METHODS: During the first operation, the excised rib was divided into 3-5 cm fragments and stored in a sub-muscular plane adjacent to the posterior elements of the spine before closure. The graft was then retrieved at the second stage. Samples were sent for histologic and microbiologic examination before implantation. RESULTS: On histologic examination, more than 50% of the osteocytes retained their basophilic staining, indicating that they were viable. In addition, osteoclastic activity was notably absent. There was no significant bacterial contamination of the samples. Clinically, all patients achieved satisfactory bone fusion. CONCLUSION: Homeostatic equilibrium in humans provides the ideal environment in which bone graft can be stored. There is no increased risk of infection, and the osteogenic potential of the graft is retained.     

Venous surgery of the lower limb: value of nerve blocks

BACKGROUND: Reduction in intake of dairy products has long been recommended to reduce blood lipids. The value of monounsaturated fatty acids is increasingly recognized. METHODS: We evaluated the effects of a monounsaturate-rich butter and cheese (B) produced by modifying the bovine diet on blood lipid levels of patients with type IIa hyperlipidaemia. We compared their effects with those of normal butter and cheese (A) and polyunsaturate-rich spread and cheese (C). Using a double cross-over design, we studied 30 patients of mean age 56.4 years (23 men, one woman excluded) over 6-week periods. RESULTS: Approximately 35.5 g/day butter/cheese were consumed; no changes in serum total cholesterol, triglycerides, low-density lipoprotein, lipoprotein (a) or cholesterol: high-density lipoprotein (HDL) ratio were observed. HDL levels were higher in B(1.31 mmol/l) than in C (1.22 mmol/l; P < 0.05) and similar to those in A (1.28 mmol/l). HDL2 levels were higher in patients fed diet A(0.23 mmol/l) than they were in those fed diet C (0.19 mmol/l; P < 0.05) and similar to those in patients fed diet B (0.20 mmol/l). Serum HDL3 was significantly higher in patients fed diet B (1.11 mmol/l) than in those fed diet C (1.03 mmol/l; P < 0.05) but similar to that in patients fed diet A (1.06 mmol/l). CONCLUSIONS: Moderate intake of modified dairy products may be of value and deserves further evaluation.