【目的】探讨集束化护理干预对皮下低分子肝素注射治疗患者应激反应及预后的影响。【方法】选择2016年1月至2017年6月于本院进行皮下低分子肝素注射治疗的患者120例为研究对象,原发疾病包括冠心病74例,心肌梗死46例。随机分为观察组和...【目的】探讨集束化护理干预对皮下低分子肝素注射治疗患者应激反应及预后的影响。【方法】选择2016年1月至2017年6月于本院进行皮下低分子肝素注射治疗的患者120例为研究对象,原发疾病包括冠心病74例,心肌梗死46例。随机分为观察组和对照组各60例。对照组给予常规护理干预,观察组给予集束化护理干预,比较两组患者应激反应、不良反应、患者满意度。【结果】观察组患者焦虑自评量表(SAS),抑郁自评量表(SDS)、疼痛视觉模拟评分(VAS)等评分明显低于对照组(P <0.05);并发症发生率明显低于对照组(11.67% vs 28.33%, χ^2 =5.208, P <0.05);患者满意度明显高于对照组(96.67% vs 85.00%,χ^2 =4.904, P <0.05)。【结论】集束化护理干预有助于缓解皮下低分子肝素注射治疗患者心理应激反应,减轻疼痛程度,预防不良反应发生,增强患者满意度。展开更多
Background End-of-life care is not usually a priority in cardiology departments. We sought to evaluate the changes in end-of-life care after the introduction of a do-not-resuscitate （DNR） order protocol. Methods ＆ ...Background End-of-life care is not usually a priority in cardiology departments. We sought to evaluate the changes in end-of-life care after the introduction of a do-not-resuscitate （DNR） order protocol. Methods ＆ Results Retrospective analysis of all deaths in a cardiology department in two periods, before and after the introduction of the protocol. Comparison of demographic characteristics, use of DNR orders, and end-of-life care issues between both periods, according to the presence in the second period of the new DNR sheet （Group A）, a conven- tional DNR order （Group B） or the absence of any DNR order （Group C）. The number of deaths was similar in both periods （n = 198 vs. n = 197）. The rate of patients dying with a DNR order increased significantly （57.1% vs. 68.5%; P = 0.02）. Only 4% of patients in both periods were aware of the decision taken about cardiopulmonary resuscitation. Patients in Group A received the DNR order one day earlier, and 24.5% received it within the first 24 h of admission （vs. 2.6% in the first period; P 〈 0.001）. All patients in Group A with an implantable cardioverter defibrillator （ICD） had shock therapies deactivated （vs. 25.0% in the first period; P = 0.02）. Conclusions The introduction of a DNR order protocol may improve end-of-life care in cardiac patients by increasing the use and shortening the time of registration of DNR orders. It may also contribute to increase ICD deactivation in patients with these orders in place. However, the introduction of the sheet in late stages of the disease failed to improve patient participation.展开更多
This ten-year retrospective study was designed to examine the morbidity and mortality of three cases of Cantrell＇s syndrome between 1998 and 2008. The three patients showed different degrees of Cantrell＇s pentalogy ...This ten-year retrospective study was designed to examine the morbidity and mortality of three cases of Cantrell＇s syndrome between 1998 and 2008. The three patients showed different degrees of Cantrell＇s pentalogy including abdominal ectopia cordis, thoracic-abdominal ectopia cordis and left ventricular diverticulum. Of the three, the 5-month-old boy suffering from complicated congenital heart disease with abdominal ectopia cordis received a successful single stage repair and reconstruction of the abdominal wall. The 33-week-old premature girl with thoracic-abdominal ectopia cordis underwent two stage correction of tetraology of Fallot. The 4-year-old girl underwent ectomy of left ventricular diverticulum and thoracoabdominal wall repair. Twenty-four to thirty-five months follow-up were satisfactory. We hold that two-stage repair are technically feasible for Cantrell＇s syndrome, especially for those with complex congenital heart diseases. Post-operative ventilatory support and multiple post-operative care should be prolonged. Malnutrition, infection and arrhytbmia are central problems in medical care and surgery should be considered if there was progressive heart failure or hemodynamic instability.展开更多
文摘【目的】探讨集束化护理干预对皮下低分子肝素注射治疗患者应激反应及预后的影响。【方法】选择2016年1月至2017年6月于本院进行皮下低分子肝素注射治疗的患者120例为研究对象,原发疾病包括冠心病74例,心肌梗死46例。随机分为观察组和对照组各60例。对照组给予常规护理干预,观察组给予集束化护理干预,比较两组患者应激反应、不良反应、患者满意度。【结果】观察组患者焦虑自评量表(SAS),抑郁自评量表(SDS)、疼痛视觉模拟评分(VAS)等评分明显低于对照组(P <0.05);并发症发生率明显低于对照组(11.67% vs 28.33%, χ^2 =5.208, P <0.05);患者满意度明显高于对照组(96.67% vs 85.00%,χ^2 =4.904, P <0.05)。【结论】集束化护理干预有助于缓解皮下低分子肝素注射治疗患者心理应激反应,减轻疼痛程度,预防不良反应发生,增强患者满意度。
文摘Background End-of-life care is not usually a priority in cardiology departments. We sought to evaluate the changes in end-of-life care after the introduction of a do-not-resuscitate （DNR） order protocol. Methods ＆ Results Retrospective analysis of all deaths in a cardiology department in two periods, before and after the introduction of the protocol. Comparison of demographic characteristics, use of DNR orders, and end-of-life care issues between both periods, according to the presence in the second period of the new DNR sheet （Group A）, a conven- tional DNR order （Group B） or the absence of any DNR order （Group C）. The number of deaths was similar in both periods （n = 198 vs. n = 197）. The rate of patients dying with a DNR order increased significantly （57.1% vs. 68.5%; P = 0.02）. Only 4% of patients in both periods were aware of the decision taken about cardiopulmonary resuscitation. Patients in Group A received the DNR order one day earlier, and 24.5% received it within the first 24 h of admission （vs. 2.6% in the first period; P 〈 0.001）. All patients in Group A with an implantable cardioverter defibrillator （ICD） had shock therapies deactivated （vs. 25.0% in the first period; P = 0.02）. Conclusions The introduction of a DNR order protocol may improve end-of-life care in cardiac patients by increasing the use and shortening the time of registration of DNR orders. It may also contribute to increase ICD deactivation in patients with these orders in place. However, the introduction of the sheet in late stages of the disease failed to improve patient participation.
文摘This ten-year retrospective study was designed to examine the morbidity and mortality of three cases of Cantrell＇s syndrome between 1998 and 2008. The three patients showed different degrees of Cantrell＇s pentalogy including abdominal ectopia cordis, thoracic-abdominal ectopia cordis and left ventricular diverticulum. Of the three, the 5-month-old boy suffering from complicated congenital heart disease with abdominal ectopia cordis received a successful single stage repair and reconstruction of the abdominal wall. The 33-week-old premature girl with thoracic-abdominal ectopia cordis underwent two stage correction of tetraology of Fallot. The 4-year-old girl underwent ectomy of left ventricular diverticulum and thoracoabdominal wall repair. Twenty-four to thirty-five months follow-up were satisfactory. We hold that two-stage repair are technically feasible for Cantrell＇s syndrome, especially for those with complex congenital heart diseases. Post-operative ventilatory support and multiple post-operative care should be prolonged. Malnutrition, infection and arrhytbmia are central problems in medical care and surgery should be considered if there was progressive heart failure or hemodynamic instability.
