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find Author "刘逸文" 3 results
  • 巴林特小组在重症监护病房护理工作中的应用

    目的 探讨巴林特小组在重症监护病房护理中的应用效果。 方法 2015 年 6 月在心理卫生中心协助下成立巴林特小组,按流程开展活动,报告人汇报案例,组长与成员协助分析梳理,采用倾听、提问、回答等方式,最后进行总结。对 1 例典型病例进行详细分析。 结果 在典型案例中,汇报人在巴林特小组组长与成员的引导下主动表述其感受,能换位思考患者情况,不良情绪得到逐渐缓解,认识得到提高,并在之后的护患沟通中体现良好的持续影响,取得了患者的信任与理解。 结论 通过巴林特小组的活动,能搭建相互支持、交流、学习的平台,提高护士自我觉察、倾听、观察和沟通能力,促进护士个人成长,改善职业倦怠,和谐护患关系。

    Release date:2017-04-19 10:17 Export PDF Favorites Scan
  • 神经重症监护病房导管相关感染目标性监测与干预

    目的了解神经重症监护病房导管相关感染情况,采取有效的综合干预措施,以期降低导管相关感染率,为专科重症监护病房感控的实施和防控重点提供参考。 方法采用目标性监测方法对2011年3月-12月神经重症监护病房患者进行导管相关感染的目标监测,包括使用呼吸机、中心静脉插管和泌尿道插管的使用情况及呼吸机相关性肺炎、导管相关血流感染及导尿管相关尿路感染的感染率进行监测,并将监测分成2个阶段,2011年3月-7月为干预前阶段,2011年8月逐步实施综合干预措施,对存在的问题采取综合控制措施并进行持续质量改进,比较干预前后的导管相关感染率。 结果932例患者中,发生医院感染253例次,发生率为27.15%。排在医院感染部位前3位的分别为下呼吸道(56.52%)、泌尿道(18.19%)、血流相关感染(11.46%)。在干预手段介入后,有创呼吸机相关性肺炎感染率由55.73‰降至27.96‰,差异有统计学意义(P<0.05);尿管相关感染率由8.88‰降至3.69‰,差异有统计学意义(P<0.05);中心静脉导管相关血流感染率由7.30‰降至0.89‰,差异无统计学意义(P>0.05)。 结论神经重症监护病房由于患者疾病特点,导管易发生相关感染,在实践过程中采取多种预防措施可以显著降低导管相关感染率。

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  • Evaluation of the Effectiveness of Mifepristone Concomitant with Misoprostol for Medical Abortion

    Objective To evaluate the effectiveness of mifepristone concomitant with misoprostol for medical abortion. Methods We searched the related original studies worldwide, and controlled prospective studies and systematic reviews based on randomized controlled trials (RCTs). Nine electronic databases were searched. Ten journals and reference lists of eligible studies were handsearched. Two reviewers independently screened the studies for eligibility, evaluated the quality, and extracted the data from eligible studies, with confirmation by cross checking. Any disputes were decided by a third person. Meta-analysis was conducted using statistical software RevMan 4.2. After heterogeneity test was done (α=0.05 ) , data without heterogeneity were pooled using a fixed effect model, and those with heterogeneity could be solved by sensitivity" analysis, subgroup analysis or random effect model. Results We found eight original trials (n = 3 348 ) that compared medical abortion with surgical abortion, nine trials (n =6 116) that investigating the effect of gestational ages on medical abortion, five trials (n = 1 934) on the use of mifepristone and two trials (n =2381 ) on intervals of administration of mifepristone and misoprostol were located. Quality of foreign studies was better than that of Chinese studies. Therate of complete abortion was higher in surgical abortion group than that in medical abortion group with odds ratio (OR) 0. 18 and 95% confidence interval (CI) 0. 11 to 0.27. The rate of incomplete abortion and abortion failure was higher in medical abortion group with OR 3.32, and 95% CI 1.79 to 6.17, OR 7.36, 95% CI 4. 17 to 12.98, respectively. The rate of complete abortion in the group with gestational age over 49 days was lower than that with gestational age under 49 days with OR 0.51 and 95% CI 0.43 to 0.61. The rate of incomplete abortion and abortion failure was higher in the group with gestational age over 49 days with OR 1.66, 95% CI 1.32 to 2.09 and OR 3.37, 95% CI 2.30 to 4. 94.There were no significant differences observed in the rates of complete abortion, incomplete abortion, abortion failed, time of expelling pregnant sac and time of menses recovery between the single and multi-dosage of mifepristone. Except for the rate of complete abortion, which was higher in 〈48h group, there was a comparable effectiveness for different intervals of mifepristone and ntisoprostol. Conclusions This review showes that it is important to improve the quality of Chinese original studies. Although the effectiveness is better in the surgical abortion group, the rate of complete abortion of medical abortion achieved is 91.6% (1 648/1 800). This is acceptable for clinicians and women who do not want to be pregnance. The rate of complete abortion is lower in the gestation over 49 days, which had a statistically difference, but little clinical significance. It is necessary to consider increasing the gestational age of medical abortion, especially for those women who have contradictions of surgical abortion or are afraid of operation. Effectiveness of single dosage of mifeprostone is similar to that ofmulti-dosage, but single dosage might be more convenient. This review suggests that shortening the interval ofmifepristone and misoprostol administration should be considered and the best and shortest interval time need to be identified with better evidence.

    Release date:2016-09-07 02:26 Export PDF Favorites Scan
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