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find Author "许瑞华" 13 results
  • 肝胆胰恶性肿瘤患者术后延迟愈合切口的护理

    【摘要】 目的 总结肝胆胰恶性肿瘤患者术后延迟愈合切口的护理方法和效果。 方法 2009年11月-2010年9月将45例肝胆胰系统肿瘤患者按术后切口愈合情况随机分为实验组和对照组。实验组应用湿性伤口愈合理论和方法行切口换药,对照组使用传统方法行切口换药。 结果 实验组切口换药次数6~11次,平均(8.78±2.39)次后愈合;对照组切口换药次数8~17次,平均(13.55±2.39)次后愈合,两组方法比较有统计学意义(Plt;0.01);切口愈合时间实验组7~13 d,平均(10.30±1.77) d;对照组9~18 d,平均(15.00±2.60) d,两组比较有有统计学意义(Plt;0.01)。 结论 湿性伤口愈合理论是新伤口愈合理论,能促进切口愈合,缩短换药次数和时间,减轻患者的痛苦和经济负担,缩短住院日,值得推广。

    Release date:2016-09-08 09:52 Export PDF Favorites Scan
  • 快速康复法在胆道结石患者术后早期进食中的运用及效果

    目的 探讨快速康复对胆道结石(除单纯胆囊结石外) 患者术后早期进食的安全性和可行性。 方法 将2010年12月-2011年3月86例行胆道结石摘除术患者纳入对照组,术后按照常规专科护理待患者肛门排气后指导进食;将2011年4月-6月77例行胆道结石摘除术患者纳入观察组,指导患者术后早期进食。观察两组患者术后肠鸣音恢复正常的时间,肛门排气时间的差异;比较两组患者发生恶心、呕吐、腹胀等并发症的差异;观察两组术后住院天数及术后输液总量的差异。 结果 与对照组相比,观察组患者肠鸣音恢复正常时间、肛门排气时间均提前,术后总输入液量减少、住院天数缩短,两组比较差异有统计学意义(P<0.05);两组术后发生恶心、呕吐等并发症的差异无统计学意义(P>0.05)。 结论 胆道结石患者术后早期进食安全可行、效果好,有利于患者的早期康复。

    Release date:2016-09-07 02:34 Export PDF Favorites Scan
  • 原发性肝脏神经内分泌癌的围手术期护理

    【摘要】 目的 通过对3例原发性肝脏神经内分泌癌患者的护理,总结该疾病的围手术期护理要点。 方法 2008年11月-2010年6月,在了解及掌握该疾病的原因、临床表现及治疗手段基础上,对3例原发性肝脏神经内分泌癌患者进行精心护理,重点做好术前心理疏导和术后并发症的观察护理。 结果 3例患者术后恢复良好,未发生并发症,顺利出院。 结论 做好原发性肝脏神经内分泌癌患者围手术期护理能有效预防其并发症的发生。

    Release date:2016-09-08 09:52 Export PDF Favorites Scan
  • 腹腔镜胆囊切除围手术期的护理

    目的:探讨1 039例腹腔镜胆囊切除手术的围手术护理体会。方法:通过患者的合理选择,术前的充分准备、心理护理,术后饮食、体位、引流管等的护理,以及并发症的观察和处理,确保手术成功,重点介绍了术后并发症(出血、皮下气肿及肩背部酸痛、胆漏)的观察和护理。结果:本组患者共行LC手术1 039例,1例因腹腔出血,经再次开腹止血后康复出院,1例出现胆漏,其他无并发症,均痊愈出院。结论:腹腔镜胆囊切除术具有创伤小、痛苦轻、恢复快等优点,但应注意围手术期观察护理。

    Release date:2016-09-08 09:56 Export PDF Favorites Scan
  • Transumbilical Endoscopic Cholecystectomy

    目的:探讨经脐入路行腹腔镜胆囊切除术的可行性。方法:对6例患者采用仅在脐部切开一个切口进行腹腔镜胆囊切除术。结果:6例患者手术均获成功,无中转常规腹腔镜手术或开腹手术。手术时间80~130min,无出血、胆管损伤等并发症发生。术后1d出院,术后1月门诊随访,患者恢复顺利,除脐部外,腹壁无手术瘢痕。结论:经脐入路腹腔镜胆囊切除术技术上是可行的,但难度较大,在开展手术初期应慎重选择病例。

    Release date:2016-09-08 09:56 Export PDF Favorites Scan
  • 结肠造口术后并发造口周围脓肿的护理(附1例报告)

    目的:通过病例报告,明确造口患者的护理及教育的重要性。方法:对患者进行全身的抗感染治疗、伤口局部的处理及造口的正确护理,并给予了造口的自我护理知识的健康教育。结果:使患者造口周围脓肿很快康复,且患者一定程度的掌握了正确的造口自我护理知识。结论:合理的护理及教育方法,可改进护理及教育效果,提高造口患者的生活质量。

    Release date:2016-09-08 10:02 Export PDF Favorites Scan
  • 三种镇痛方法用于腹腔镜术后镇痛的疗效观察

    目的观察地佐辛、曲马多、哌替啶3种镇痛方法在腹腔镜术后的镇痛效果。 方法选择2012年4月-7月择期行腹腔镜手术患者120例,美国麻醉医师协会分级Ⅰ~Ⅱ级,随机分为地佐辛组(A组)、曲马多组(B组)及哌替啶组(C组),每组40例。术后患者第1次诉疼痛时,A组肌肉注射地佐辛5 mg,B组肌肉注射曲马多100 mg,C组肌肉注射哌替啶50 mg。 结果3组均有一定的镇痛效果,其中A组和C组患者在术后2 h及4 h的镇痛效果均优于B组,差异有统计学意义(P<0.05)。A组恶心、呕吐发生率低于B组,差异有统计学意义(P<0.05)。 结论3种镇痛方法都是腹腔镜术后较为有效的镇痛技术,其中地佐辛镇痛效果更好、安全性高,因而具有更高的临床推广价值。

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  • 医护一体化无痛管理在胆道结石患者围手术期的应用及效果

    目的 探讨医护一体化无痛管理在胆道结石患者围手术期疼痛控制中的实施及其效果。 方法 选取 2016 年 3 月 1 日— 8 月 31 日四川大学华西医院胆道外科收治的 479 例胆道结石患者,按其入院时间的不同,将 2016 年 3 月 1 日—5 月 31 日入院的 241 例胆道结石患者围手术期疼痛采用传统的疼痛管理(对照组),2016 年 6 月 1 日—8 月 31 日入院的 238 例胆道结石患者围手术期疼痛采用医护一体化无痛管理(观察组)。比较两组患者的疼痛评分、疼痛控制满意度、术后康复指标(下床活动时间、肛门排气时间、术后住院时间)、采用疼痛解救情况的差异。 结果 观察组患者术后当日睡前~术后 3 d、出院前疼痛评分均较对照组低,疼痛控制满意率(99.16%)明显高于对照组(60.17%),术后下床活动时间[(36.27±9.20)h]、肛门排气时间[(50.28±10.50)h]、术后住院时间[(4.68±1.26)d]均短于对照组[(56.57±12.03)h、(74.88±10.22)h、(6.55±1.76)d],采用疼痛解救者[21 例(8.82%)]亦低于对照组[241例( 100.00%)],差异均有统计学意义(P<0.05)。 结论 医护一体化无痛管理在胆道结石患者围手术期的应用能有效减轻患者术后的疼痛程度,使其能早期下床活动,不仅促进了患者胃肠功能的恢复,缩短了住院时间,提高了患者对疼痛控制的满意度,也促进了患者康复;另外,医护一体化疼痛管理也明显减少了对疼痛爆发的解救次数,从而降低了医护人员的应急工作量。

    Release date:2017-06-22 02:01 Export PDF Favorites Scan
  • Bibliometric analysis of the application of mini-clinical evaluation exercise in medical and nursing education in the mainland of China

    ObjectiveTo analyze the research status of mini-clinical evaluation exercise (Mini-CEX) in medical and nursing education in the mainland of China, so as to provide a basis for optimizing medical and nursing teaching evaluation tools and promoting the reform of medical and nursing personnel training mode.MethodsPubMed, Embase, Wanfang, CQVIP, China National Knowledge Infrastructure, and China Biomedical Literature Database were searched. The key words were “mini-clinical evaluation exercise” or “mini-CEX” or “CEX” or “mini clinical exercise evaluation”. The languages were limited to Chinese and English. The address of the first author was in the mainland of China. The retrieval time was from the establishment of the databases to December 31st, 2020. The literature was analyzed bibliometrically after screening and duplicate removal.ResultsA total of 536 articles were included for analysis and summary. The articles originated from 28 provincial-level administrative divisions in China, among which Shanghai, Xinjiang, Guangxi, Liaoning, and Guangdong were the top five in terms of the number of papers published. The annual number of papers published exceeded 60 in 2017, and reached 112 in 2019 and 113 in 2020, respectively. A total of 397 hospitals and universities contributed to the literature, among which 49 institutions published more than 2 papers. The maximum number of articles published by a same author was 5. There were 530 journal papers published in 169 journals. Only 228 articles (42.54%) were supported by funds, and the research type was mainly experimental and quasi experimental research (56.71%). Under the key words co-occurrence network analysis, a total of 321 nodes and 1 013 connections were obtained, with an average of 3.21 connections per node. In addition to “mini-CEX” and “mini-clinical exercise evaluation”, the most prominent research directions were “clinical teaching” “standardized training” “resident” “scenario simulation” and “clinical ability”.ConclusionsThe number of mini-CEX-related medical and nursing articles is increasing year by year, but the distribution of research areas and institutions is uneven, the research quality needs to be improved, the application scope and research types need to be enriched, and the research content needs to be expanded. In the future, teachers and research teams of medical colleges and universities should be mobilized to apply Mini-CEX teaching method to the cultivation of medical and nursing talents in a whole and continuous way, so as to further standardize the localization application of mini-CEX in the mainland of China, and promote the in-depth development of formative evaluation of medical education.

    Release date:2021-07-22 06:28 Export PDF Favorites Scan
  • Effects of High Intensity Focused Ultrasound on AFP mRNA in Peripheral Blood of Patients with Hepatocellular Carcinoma

    ObjectiveTo evaluate the effects of high intensity focused ultrasound (HIFU) on hepatic cancer cells spreading in blood.Methods AFP mRNA in peripheral blood of 19 patients with hepatocellular carcinoma was detected before and after HIFU therapy by RTPCR.Results①Before HIFU therapy, 11 of 19 cases were AFP mRNA positive (57.9%), while the control group were all negative. AFP mRNA was correlated with some clinical parameters such as serum AFP level, tumor size, portal vein embolism and extrahepatic metastasis (P<0.05). ②In 8 cases with preoperative AFP mRNA negative, only 2 cases became AFP mRNA positive immediately after therapy, and one of the 2 cases became negative again after 72 hours. One week after HIFU therapy, the AFP mRNA positive rate (31.6%) was much lower than the preoperative positive rate (57.9%), but there was no statistical significance (Pgt;0.05). ③After one week of HIFU therapy, the AFP mRNA positive rate of the group with tumor size less than 8 cm was much lower than that of tumor size larger than 8 cm (P<0.05). ConclusionHIFU may reduce the spreading of hepatocellular carcinoma cells in blood. It is effective for patients with tumor size less than 8 cm.

    Release date:2016-08-28 04:43 Export PDF Favorites Scan
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