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Nursing Experiences of Invasive Blood Pressure Monitoring for Patients Having Undergone Open-heart Surgery

風濕性心臟病合并慢性粒細胞白血病圍手術期護理一例

房間隔缺損修補術后體外膜肺聯合體位療法的觀察及護理一例

脈波輪廓溫度稀釋連續心排量測量技術在心臟直視術后的臨床監測及應用

目的探討脈波輪廓溫度稀釋連續心排量測量技術（PICCO）在心臟直視術后患者血流動力學參數監測中的應用及效果。 方法2011年1月－2012年6月采用PICCO監測20例術后危重患者的心功能指數（CI），全心舒張末期容積指數（GEDI），血管外肺血指數（ELWI），對監測結果為CI＜3 L/（min·m2）、GEDI＜700 mL/m2、ELWI＞10 mL/kg的患者，治療上慎重增加容量，同時增加兒茶酚胺類藥物劑量的對策；對CI＜3 L/（min·m2）、GEDI＞700 mL/m2、ELWI＞10 mL/kg的患者，治療上予以增加兒茶酚胺類藥物劑量同時嚴格控制容量，每日嚴格泵入液體量及管喂量的處置方式；對CI＞3 L/（min·m2）、GEDI＜700 mL/m2、ELWI＞10 mL/kg、SVRI＜900 kPa·s/（min·m2）的患者，則采取容量增加慎重同時增加兒茶酚胺類藥物劑量，調節去甲腎上腺素用量的方式。 結果經PICCO嚴密監測以及藥物和容量調整，19例患者循環逐漸穩定，均拔除氣管插管后轉出重癥監護室（ICU）回病房繼續治療，1例因全心功能衰竭，搶救無效死亡。 結論通過應用PICCO對心臟直視術后患者血流動力學參數進行監測，能更直觀有效、及時精確的找準血流動力學不穩定因素，對癥下藥，改善患者心功能情況，減少ICU住院天數，提高患者治愈率。

Investigation and analysis of nutritional risk and dietary intake of patients with coronavirus disease 2019

ObjectiveTo explore and analyze the nutritional risk and dietary intake of patients with coronavirus disease 2019 (COVID-19), and provide data support for nutritional intervention.MethodsCOVID-19 inpatients were investigated in Wuhan Wuchang Hospital and the People’s Hospital of Wuhan University (East Area) from March 9th to 16th, 2020 by Nutrition Risk Screening 2002 (NRS 2002) scale and designed questionnaire. The energy and protein requirements were calculated according to the standard of 30 kcal/(kg·d) and 1.2 g/(kg·d). The nutritional risk, energy and protein intake, body weight and body mass index and their changes in the mild and severe patients were analyzed. The energy and protein intake of the two types of nutritional risk patients was analyzed.ResultsA total of 98 patients with COVID-19 completed the investigation, in whom 46 (46.94%) had nutritional risk, including 32 (39.02%) with mild type and 14 (87.50%) with severe type; and the difference was statistically significant (P<0.001). Compared with the usual condition, the body weight and body mass index of the two types of patients significantly decreased (P<0.01 or P<0.001); the energy and protein intake in mild type patients were significantly higher than those in the severe type patients (P<0.001); compared with the requirement, the protein intake in the two types of patients were significantly lower than the demand, while the energy and protein intake in the mild type patients were significantly lower than the requirement (P<0.05 or P<0.01). The proportion of energy and protein intakes in patients with nutritional risk was significantly higher than that in patients without nutritional risk (P<0.001 or P<0.01); the energy and protein intakes in patients without nutritional risk was significantly higher than that in patients with nutritional risk (P<0.001); the protein intakes in patients with nutritional risk was obviously insufficient (P<0.001); while the energy intake of the patients without nutritional risk was higher than the requirement (P<0.001).ConclusionsCOVID-19 patients has high incidence of nutritional risk which was higher in the severe patients compared with the mild patients. Higher incidence and lower intake of energy and protein are in the severe patients compared with those in the mild patients. Patients with nutritional risk has a higher proportion of energy and protein inadequate intake and lower intake compared with the patients without nutritional risk.

Recommendations on infection prevention and control of resident from medical team for aiding Hubei of West China Hospital of Sichuan University in the period of coronavirus disease 2019 outbreak

Coronavirus disease 2019 has been widespread in Hubei province since the beginning of 2020. Many medical teams went to aid Hubei from the whole country. The medical team of West China Hospital of Sichuan University arrived in Jianghan district of Wuhan on January 25, 2020. As one of the earliest teams arriving Hubei, we explored the measures for infection prevention and control of resident, in order to reduce the risk for infection of medical team. The infection prevention and control experiences on the establishment of infection control team, process management, behavior management, clean disinfection, infection monitoring and emergency response and emergency response to exposure of the medical team of West China Hospital were summarized in this article.