肿瘤患者临终关怀的心理护理研究进展

近年来,随着肿瘤患者的增多,晚期肿瘤临终病人数目也越来越大,这就迫切要求我国临终关怀事业快速发展,而这其中,具有重要地位的临终关怀的心理护理也需要大力改善.笔者拟从临终病人及家属的角度出发,在阐述病人及家属的心理的同时,提出相应的心理护理措施,意在指出心理护理在临终关怀的重要地位,以促进临终关怀事业在我国更好地发展.参16.     

烧伤外科护理实习带教体会

目的:通过总结4年烧伤外科带教体会,我总结了一套对烧伤病人的救治及护理的经验,供广大医学实习生学习.方法:烧伤病人的救治分为现场救护主要目的是:尽快消除致伤原因、脱离现场和施行生命救治；烧伤处理:保护烧伤创面、防止和清除外源性污染,准确评估伤情和程序处理,防治低血容量性休克,防治感染,促进创面愈合、降低致残率；烧伤病人的护理:伤情评估,心理与社会支持状况,治疗后评估三大块.结果:烧伤病人的救治成功率显著提高.结论:对烧伤病人的救治与护理一定要遵循规律,掌握一定的方法与技巧.通过对烧伤病人的救治加强,对烧伤病人的救治成功率将提高,致残率与致死率将显著降低.参8.     

论高职院校护理教育教学改革

高职护理教育是高等医学教育的重要组成部分,对培养高级护理人才,发展护理事业具有极其重要的作用．在以病人为中心,以护理程序为基础的整体护理的新型护理模式的指导下,根据目前我国高职护理教育的目标,分析了当前护理学教学所存在的问题,并提出了相应的改革方法．图1,参8．     

提高静脉穿刺成功率进针方法的探讨

根据临床上的具体情况及经验，本文论述如何改良静脉穿刺的传统进针方法，减轻病人痛苦，以及对待特殊病人采取的特殊处理方法，以提高穿刺成功率，为抢救赢得宝贵时间。     

提高高职护理学基础教学质量的探讨

护理学基础是护理专业的一门主干课程,学好护理学基础对学生以后从事临床工作至关重要.因此,搞好护理学基础的教学必须从提高教师综合素质入手,结合学生的实际情况,充分做好课前准备工作,运用灵活多样的教学方法,加强实习前的培训,让学生牢固地掌握该课程的基本理论和基本技能,打好临床护理工作的基础.参4.     

对围手术期患者访视的实践与体会

以探讨对围手术期患者访视,围手术期患者的心理护理,提高手术室护理质量为目的.通过对1 860例大中型手术患者进行术前术后访视,随机调查其中276例,以了解访视效果的方法得到术中配合满意及能配合253例,术后精神状态、体温、伤口愈合、皮肤等良好,未发现体位性损伤、泌尿系感染及其他并发症.患者及家属对手术前后访视满意率为98%的结果.从而得出术前术后访视可以减轻患者对手术的恐惧,减轻焦虑心理,加强护患关系,提高手术室的护理质量,使病人以最佳的身心状态对待手术结论.表2,参3.     

重症急性胰腺炎手术治疗的护理进展

本文对重症急性胰腺炎患者手术治疗的护理进展进行简要总结，以求对重症急性胰腺炎患者手术治疗中的护理工作提供参考．     

重症胰腺炎手术治疗的护理

本文对我院2001年以来收治的54例重症胰腺炎患者手术治疗的护理进行总结，以求对重症胰腺炎患者手术治疗中的护理工作提供参考．     

呼和浩特市某地慢性砷中毒流行因素探讨

１９９０年以来，在呼和浩特某地的６个自然村，查明以特殊皮肤损害为特征的慢性砷中毒病人１９７例。经用流行病学方法研究，从不同角度分析出，天然富砷水为该病的流行因素。     

循证护理在手术室的应用

为解决手术过程遇到的护理问题,利用进行循征和实施护理干预,通过与未实施循证护理同期比较,护理问题发生率明显下降或消除,得出循证护理能有效解决手术中的护理问题,提高护理质量的结论.     

术后早期急性炎性肠梗阻的观察及护理

目的探讨术后早期急性炎性肠梗阻（EPII）的临床表现、治疗方法及护理．方法回顾性分析86例EPII的临床表现、治疗及护方法．结果EPII发生在术后4-21d,肠蠕动一度恢复,继而又出现呕吐,腹胀,腹痛等肠梗阻表现,大部分病例非手术治愈,仅少部分手术治疗．结论EPII以非手术治疗为主,积极的心理干预及护理有助于疾病康复．表2,参14．     

湖南衡阳地区乙型肝炎患者HBV基因分型与血清HBVDNA水平研究

分析了湖南衡阳地区乙型肝炎病毒基因型分布特征,并探讨HBV各基因型与血清HBVDNA水平之间的关系．采用荧光定量PCR结合TaqmanMGB探针技术,对湖南衡阳地区164份乙型肝炎患者血清中的HBVDNA进行基因分型和定量检测．结果164例血清中,C型110A．（67．1％）,B、C型37人（22．3％）,B型8人（5．1％）,D型1人（0．6％）,A型1人（0．6％）．C型与B、C混合型在HBVDNA水平上存在显著差异（t=2．433,P〈0．05）,B、C混合型的HBVDNA水平明显高于C型．由此得出湖南衡阳地区HBV基因型以C型为主、B、C混合型次之,B型较少,D型、A型极少;B、C混合型患者的HBVDNA数量水平显著高于C型．表1．参11．     

Cadmium and chromium in human lung tissue in relation to smoking and lung cancer

The pulmonary Cd and Cr content was determined from 53 lung cancer patients operated for cancer and from 39 patients who died of non‐malignant diseases. The results were correlated with smoking habits, pulmonary emphysema and occupational history. Both the pulmonary Cd and Cr increased with the amount of smoking. In ex‐smokers the Cr content in lung tissue did not diminish with the time since stopping smoking, but the Cd did follow the half‐life of about 9 years. The pulmonary Cd, compared with smoking habits, behaved similarly in both the lung cancer and control patients, whereas Cr in the lung cancer patients could not be explained solely by smoking, but some of the cancer patients may have been occupationally exposed to Cr. Speciation was not studied.     

Mercury exposure in sporadic amyotrophic lateral sclerosis patients from Ganga plain region in India: A retrospective study

Amyotrophic lateral sclerosis (ALS), a progressive disorder that usually runs a fatal course within 2–5 years of onset, is characterized by loss of motor neurons in the cortex, brain stem, and spinal cord. In this study mercury (Hg) concentrations were determined in blood samples of 40 ALS patients, of whom 24 ALS patients were from the Ganga plain region and their metal levels were found to be significantly higher. In contrast, Hg levels in the 16 ALS patients from non-Ganga plain regions whose levels were similar to those of the control subjects. Mercury in stream water samples and freshly deposited stream sediment were determined in the locations of patients’ native residences along the Ganga plain region and metal levels were found to be higher than the threshold guideline values for Hg in stream waters recommended by WHO. The geo-accumulation index in selected sites of freshly deposited stream sediment ranged from moderate to highly polluted. The high levels of Hg observed in ALS patients may potentially alter the redox status of neuronal cell components and induce cell-death pathways.     

The measurement of intracellular zinc in human intestinal mucosa using x-ray microanalysis

The zinc content of intestinal epithelial cells in human jejunum and ileum has been measured using X-ray microanalysis. The range of values was wide, the highest being found in stem cells and enterocytes. Significant differences were found in jejunum from gastric carcinoma patients and ileum from Crohn's disease patients compared with patients with non malignant, non inflammatory disease.     

Study of trace elements in urine of some Nigerian medical patients

In this study, trace element concentrations were determined in urine samples of patients with kidney and liver conditions from the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife Nigeria. Urine samples from 80 patients whose ages ranged from 15 to 79 were used for the trace metals analysis. Variation of the trace metals including lead (Pb), cadmium (Cd), mercury (Hg), zinc (Zn), copper (Cu), and manganese (Mn) in urine samples were correlated with respect to gender, age, professions, personal habits and patients’ conditions. The levels of Pb in the urine samples of both male and female patients were found to be generally higher than those of Cd, Hg, Zn, Cu, and Mn. Highest levels of Pb and Cd were found in patients who smoked and drank and those with various kidney and liver conditions. Most of the trace metals except Mn occurred at levels that are deleterious to human health as they are above the standard threshold values expected in normal human urine, and raised cause for concern.     

Aluminium metabolism in chronic renat failure: Environmental influences and regional differences in Norway

Many aspects of Al metabolism in chronic renal failure are poorly understood. A longitudinal study of serum Al concentrations in predialysis patients and healthy control subjects revealed very high values during the autumn of 1984 and 1985. Renal Al clearance was low during the autumnal spike in serum Al but increased substantially when the serum Al concentration declined. A second study confirmed that by using citric acid as a chelator, the gastrointestinal absorption of Al from Al(OH)₃ may be considerably augmented as reflected by increases in both serum Al concentrations and renal Al clearance. The individual differences in Al absorption in this study were large.The first study suggests the existence of an unidentified environmental factor, possibly water borne, with profound effects on Al absorption and excretion. The citric acid/Al(OH)₃ experiment suggests that the existence of such a factor is likely. The implications of these results are not known.A histomorphometric study of bone biopsies from 138 hemodialysis and 66 predialysis patients without clinical evidence of Al related disease, revealed Al deposits after staining with aurin tricarboxylic acid in 78% of the biopsies from the former and 24% of the latter patients. Serum Al concentrations did not differ between predialysis and hemodialysis patients with Al positive biopsies. Stratification of the hemodialysis patients, who came from all parts of Norway, revealed that patients living in regions with slightly Al contaminated drinking water (Al <30 g/L) had lower serum Al concentrations than patients from regions with highly contaminated water (Al >100 g/L). The prevalence of Al-positive biopsies was the same in both regions. Patients with Al-positive biopsies did not differ in serum Al level from those with Al-negative biopsies within the same region. Predialysis patients with Al-positive biopsies had significantly higher serum Al levels than predialysis patients with Al negative biopsies.Stainable Al deposits are commonly found in the bone of patients with chronic renal failure. Cross-sectionally obtained serum Al concentrations do not reflect the prevalence of stainable bone Al in renal patients but are related to the degree of Al contamination of water of the region.     

青壮年、老年流行性出血热对比分析40例

结合临床病历资料,应用现代感染病学、诊断学专业知识对近3年我院收治的青壮年、老年流行性出血热患者进行对比分析,并在此基础上,提出了临床诊治不同年龄流行性出血热患者相关建议．表3,参3．     

The assessment of the malignant mesothelioma cases and environmental asbestos exposure in Sivas province, Turkey

One of the most significant diseases related to environmental asbestos exposure is malignant mesothelioma (MM). Sivas province is located in the Central Anatolia where asbestos exposure is common. We aimed to study clinical, demographical and epidemiologic features of the patients with MM in Sivas, along with the history of asbestos exposure. In total, 219 patients with MM who were diagnosed in our hospital between 1993 and 2010 were retrospectively analyzed in terms of demographical and clinical features. Rock, soil and house plaster samples were taken from the habitats of those patients and were evaluated with optical microscopy and X-ray diffraction methods. The age of the patients ranged between 18 and 85 years. The male-to-female ratio was 1.4:1. Most of the patients confirmed an asbestos exposure history. The most frequent symptoms of the patients were chest pain (60 %) and dyspnea (50 %). The gap between the start of first symptoms and the diagnosis date was approximately 4 months in average. The plaster materials used in most of the houses were made up of mainly carbonate and silicate minerals and some chrysotile. Ophiolitic units contained fibrous minerals such as serpentine (clino + orthochrysotile) chiefly and pectolite, brucite, hydrotalcite and tremolite/actinolite in smaller amounts. MM is not primarily related to occupational asbestos exposure in our region, and hence, environmental asbestos exposure may be indicted. Yet, single or combined roles and/or interactions of other fibrous and non-fibrous minerals in the etiology of MM are not yet fully understood and remain to be investigated.     

Frequency of abnormal heavy metal blood levels in Wegener's granulomatosis

Previous studies suggested environmental exposures, including mercury (Hg) and lead (Pb), may be related to Wegener's granulomatosis. In this study, investigations were extended to include the measurement of heavy metals in blood samples from patients diagnosed with Wegener's. Diagnosis was confirmed by using the 1990 Classification Criteria for Wegener's granulomatosis established by the American College of Rheumatology (ACR). Using commercial lab testing, whole blood heavy metal screenings were obtained from patients, and results were then compared with validated subject self-report questionnaire estimates of exposure. Thirty-eight Wegener's patients were enrolled; 10 of the 38 exhibited abnormal lab values. In those 10 subjects 3 had elevated nickel (Ni), 7 with increased cobalt (Co), 3 with higher manganese, 1 with elevated copper, and 1 with increased Hg. Overall, the questionnaire results did not correlate with the blood heavy metal analysis. Approximately 26% of Wegener's subjects in this study displayed abnormal heavy metal levels. These findings are likely underestimates since blood levels are an insensitive means for assessing total body burden of heavy metals. From these preliminary studies it appears that elevated Co is a common finding in Wegener's patients but Ni and Hg were also found to be increased. The proportion of patients with abnormal heavy metal levels is more than expected by chance alone. In order to yield more definitive results, further analysis is needed with a larger data set, more controls and more sensitive measurements (hair, urine, or nail samples).