目的:調查分析神經外科護士工作壓力因素,采取相應對策以減輕壓力,積極應對工作。方法:采用問卷調查法,對在神經外科工作的護士工作壓力程度,工作壓力源,壓力源前五位,與其它科室護士進行比較,并通過統計學方法進行分析。結果:神經外科護士工作壓力程度以重度壓力為主。排序前5位的壓力源為:工作量大,擔心工作出差錯,社會地位低,上班護士數量少,護理的患者病情過重。結論:正確分析神經外科護士工作壓力因素,采取有效的對策,對于提高護理質量,保障護理安全,具有十分重要的意義。
Objective To evaluate the accuracy of preoperative 64 multidetector spiral computed tomography (MDCT) in the diagnosis of stage Ⅳ gastric cancer. Methods The data of patients with stage Ⅳ gastric cancer between July 2007 and April 2008 were collected. Twenty-nine patients underwent preoperative 64 MDCT were retrospectively analyzed. All computed tomography scans were prospectly analyzed by 2 abdominal radiologists separately. Pathological tumor stage was based on TNM stage according to the revised Japanese Classification of Gastric Carcinoma from the Japanese Gastric Cancer Association. All CT results were compared with clinical, surgical and histopathologic results. Results The 65.2% (15/23), 47.8% (11/23) and 70.8% (17/24) of the stage Ⅳ patients were accurately predicted of T, N and M stage, respectively. Moreover, 58.6% (17/29) of the stage Ⅳ patients were accurately predicted of TNM stage. But 6/9 cases with peritoneal metastases were not detected by preoperative 64 MDCT. Conclusion The 64 MDCT is a promising technique for detection and preoperative staging of stage Ⅳ gastric cancer. It was difficult to detect peritoneal metastases, but it may not increase the rate of exploratory laparotomy.