【摘要】 目的 探討腫瘤科護士銳器傷發生原因及預防管理對策。 方法 2006年6月-2008年5月，采用醫療銳器傷登記表收集護士銳器傷情況，并對相關數據資料進行統計分析。 結果 24名護士（5.71人次/100張床）發生銳器傷，主要發生于護齡≤1年的護士（66.67%）；發生時間多集中在上午8:30～11:00之間（41.67%）；地點多為病房床旁（70.83%）；銳器傷集中發生在操作后處理廢棄物過程中（50.00%）；而傷害發生率最高的器具為輸液器頭皮針（59.26%）；通過追蹤調查，發現所有銳器傷人員經處理后均未發生血源性感染。 結論 加強防范知訓培訓，提高護士自我防護意識；規范護理操作行為和廢棄銳器的處理等是預防或降低護士工作時段被感染的重要措施與方法。【Abstract】 Objective To discuss the causes and preventive measures of sharp instrument injuries among oncology nurses. Methods Sharp Instrument injuries were collected with the guide of Roll Call of Sharp Instrument Injuries in Medicine from June 2006 to May 2008. Related data were statistically analyzed. Results Sharp instrument injuries occurred to 24 nurses (5.71 per 100 beds), most of whom had just been in the post for less than one year (66.67%). Most injuries happened at 8:30 am-11:00 am during the morning (41.67%) and at, the bed side (70.83%). A half of the injuries occurred during medical waste disposal and most injuries were caused by scalp acupuncture (59.26%). No hematogenous infection occurred after proper treatment of the injuries. Conclusion Strengthening the knowledge of self-protection, stipulating and monitoring procedures of operating and disposing of sharp instruments are the most important measures to prevent the nurses from being injured during their working.
目的 了解成都市腫瘤科醫護人員經外周靜脈留置中心靜脈導管術（PICC）認知現狀，為今后開展PICC相關知識培訓提供科學依據。 方法 2009年12月－2010年1月采用自行設計的問卷對成都市5家三甲醫院的腫瘤科醫護人員309名（醫生134名，護士175名）進行PICC認知態度現狀調查。 結果 成都市三甲醫院腫瘤科醫護人員PICC認知呈中等偏低的水平，護士PICC知識的掌握高于醫生（P＜0.05），護士PICC態度得分優于醫生（P＜0.05）。94.84%的醫護人員知道PICC技術；只有8.38%的腫瘤科醫護人員接受過PICC專業培訓。不同文化程度、年齡、工齡、職業與PICC認知之間的差異存在統計學意義（P＜0.05）。 結論 三甲醫院腫瘤科醫護人員對PICC技術有一定的了解，但總體認知仍有待提高，需加強PICC相關知識培訓，進一步提高醫護人員PICC認知水平，以利于腫瘤專科開展PICC技術，促進腫瘤護理的專業化發展。
Objectives To systematically review the efficacy of polytetrafluoroethylene (PTFE) covered stent grafts vs. bare stent grafts in transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension. Methods PubMed, EMbase, The Cochrane Library, and ClinicalTrial.gov were searched online to collect randomized controlled trials (RCTs) and cohort studies of PTFE-covered stent grafts vs. bare stent grafts for portal hypertension from inception to Jan 11th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software. Results A total of 4 RCTs and 11 cohort studies involving 2 422 patients (1 070 PTFE-covered stent grafts patients and 1 352 bare stent grafts patients) were included. The results of meta-analysis showed that compared with the bare stent grafts group, the PTFE-covered stent grafts group had higher patency rate of intrahepatic shunt (HR=0.38, 95%CI 0.31 to 0.47, P<0.000 01) and survival rate (HR=0.59, 95%CI 0.44 to 0.79,P=0.000 5), lower postoperative complications rate (including gastrointestinal bleeding and refractory ascites) (HR=0.44, 95%CI 0.33 to 0.58, P<0.000 01) and encephalopathy rate (HR=0.76, 95%CI 0.57 to 0.99,P=0.05). Conclusions Current evidence shows that compared with the bare stent grafts, the PTFE-covered stent grafts could effectively improve patency rate of intrahepatic shunt and survival rate with less postoperative complications rate and encephalopathy rate. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Peripheral inserted central catheter (PICC) is the most commonly used central venous catheter in hospitalized patients, and catheter-related bloodstreams infection (CRBSI) is one of the most serious complications during PICC retention, which can affect patient prognosis and treatment. Reducing the incidence of intravascular CRBSI is one of the goals of medical quality and safety management, which continues to attract the attention of domestic and foreign experts and scholars. Authoritative institutions at home and abroad have successively issued a series of prevention and control guidelines and expert consensus, and related research on risk assessment of CRBSI is also rapidly developing. This article reviews the risk assessment, prevention and control measures, and information monitoring and feedback of PICC-related bloodstreams infection, in order to provide reference for building a PICC-related bloodstreams infection prevention and control system.
Objective To explore the effect of motivational interviewing (MI) on anxiety and depression in patients with lung cancer undergoing initial chemotherapy. Methods From May 2015 to April 2016, patients with lung cancer who underwent initial chemotherapy after operation were collected and randomly divided into the control group and the MI group. The patients in the control group received traditional health education, psychological care, and post-discharge follow up; while the patients in the MI group were given routine nursing cares and three motivational interviews and one telephone follow up. At the admission and one month after chemotherapy, all patients were evaluated by the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Distress Thermometer (DT). Results At the admission, the SAS, SDS, and DT scores of patients in the two groups had no significant differences (P>0.05). After one month of chemotherapy, the SAS, SDS, and DT scores in the MI group were much better compared to the admission (P<0.05). The differences in the SAS, SDS, and DT scores between the two groups were significant (P<0.05). Conclusion MI can significantly alleviate anxiety and depression of patients with lung cancer undergoing initial chemotherapy.
Objective To investigate the clinical features and prognosis of acute isolated corpus callosum infarction. Methods The clinical and imaging data of patients with acute isolated corpus callosum infarction diagnosed in the Department of Neurology of Beijing Geriatric Hospital and the Department of Neurology of China-Japan Friendship Hospital from February 2017 to February 2021 were retrospectively selected. Patients were divided into groups according to infarction location, infarction size and prognosis. According to the infarction location, the patients were divided into single-site lesion group and multi-site lesions group. According to the infarction size, the patients were divided into large lesion group and small lesion group. According to the prognosis, the patients were divided into good prognosis group and poor prognosis group. The clinical characteristics, etiology and prognosis of these diseases were observed and analyzed. Results A total of 52 patients were included. Among them, there were 32 males (61.5%) and 20 females (38.5%), with an average age of (65.4±7.1) years. The most common risk factors were hypertension (44 cases, 84.6%), hyperlipidemia (32 cases, 61.5%), and diabetes (28 cases, 53.8%). The most common infarction site was splenium in the single-site lesion group (24 cases, 46.2%). The vast majority of patients (92.3%) had nonspecific clinical symptoms, and only 4 (7.7%) had corpus callosum disconnection syndrome. In the TOAST etiological classification, Large-artery atherosclerosis (LAA) was the most common (25 cases, 48.1%), followed by small-artery occlusion (14 cases, 26.9%), the responsible vascular lesions were the most common in the P1/P2 segment of posterior cerebral artery (10 cases) and the A1/A2 segment of anterior cerebral artery (9 cases). There was no significant difference in etiology between the groups with different infarction location and the groups with different infarction size (P>0.05). Forty-four cases (84.6%) had a good prognosis, and 8 cases (15.4%) had a poor prognosis. Combined with multiple risk factors, multiple involvement of lesions and large infarction size were associated with poor prognosis (P<0.05). Conclusions Acute isolated corpus callosum infarction is a rare type of ischemic stroke, with the most common involvement of splenium. Its clinical manifestations are mostly nonspecific, and a few may be manifested as disconnection syndrome. The etiology is mostly LAA, and the overall prognosis of such patients is good, and the poor prognosis may be related to the combination of multiple risk factors and the wide range of infarcts.