Nursing Strategy for Multidisciplinary Team Comprehensively Treating Three Children with Fulminant Myocarditis

[Objectives]To explore nursing strategy for comprehensive treatment of children with fulminant myocarditis by multidisciplinary team(MDT),and clarify the nursing emphasis and difficulties in the treatment of fulminant myocarditis in children.[Methods]Retrospective analysis was made on three cases of fulminant myocarditis in children treated in Taihe Hospital of Shiyan City from January 2021 to January 2022.The different clinical characteristics and treatment plans were analyzed and compared,and the nursing emphasis and difficulties in comprehensive treatment of fulminant myocarditis in children were discussed.[Results]The minimum age of three children with fulminant myocarditis was 11 days old,and the remaining two children were 9-12 years old.All three children were successfully treated,in which two cases were treated with extracorporeal membrane oxygenation(ECMO)combining with mechanical ventilation(MV),including one case of neonatal explosive myocarditis.One case was treated with temporary cardiac pacing implantation.The psychological counseling and nursing of children with fulminant myocarditis and their guardians were also critical to the successful treatment and good prognosis of the disease.[Conclusions]The condition of fulminant myocarditis in children is dangerous,and it should closely observe the changes of the illness condition.The key to successful treatment is to start a comprehensive treatment plan based on life support as early as possible.The key point of nursing is to closely assist in observing the condition at the early stage,assist in maintaining and operation during advanced life support period,and avoid complications.At the same time,strengthening the psychological care of pediatric patients and guardians and health education after leaving hospital are the key and difficult points of nursing.

Individualized Sellar Floor Reconstruction Method and Nursing Strategy for the Intraoperative Cerebrospinal Fluid Leakage Caused by Neuroendoscopic Transsphenoidal Pituitary Adenoma Resection

Objective: To explore the clinical effect of and the method and nursing strategy for sellar reconstruction for intraoperative cerebrospinal fluid (CSF) leakage in pituitary adenoma resection under neuroendoscopy. Methods: The data from 20 cases of intraoperative CSF leak caused by transsphenoidal pituitary adenoma resection were retrospectively analyzed. Six patients were treated with mucosal flap and artificial dural reconstruction of sellar (simple sellar floor reconstruction). In 45 patients, autologous fat, fascia lata, and artificial dura were used to repair and reconstruct the sellar floor (multilayer sellar floor reconstruction). After the operation, all patients underwent follow-up for 6 - 24 months. Results: Fifty patients were followed up without CSF leakage. One patient was cured after leakage of CSF through the lumbar cistern 1 month after discharge. Conclusion: For patients with CSF leakage during neuroendoscopic transsphenoidal pituitary adenoma resection, individualized sellar floor reconstruction should be adopted according to the degree of CSF leakage and the size of the sellar floor defect. Strict nursing measures can effectively prevent CSF leakage and reduce postoperative complications.

Community Health Management and Nursing Strategies for Elderly Hypertension

Objective:To explore the therapeutic effects of community health management and nursing strategies for elderly hypertensive patients.Methods:A total of 64 elderly hypertensive patients who were treated in our hospital from March 2020 to March 2021 were selected.The control group took conventional care and guidance.The research group carried out community health management and nursing strategy guidance on the basis of the control group.Then compare the blood pressure levels of the two groups of patients before and after nursing and the patients’satisfaction with nursing.Results:Through comparison,it can be seen that the diastolic and systolic blood pressure levels of the study group and the control group are not significantly different before nursing.After nursing,the diastolic blood pressure of the patients in the study group was 81.22.1 mmHg and the systolic blood pressure was 126.58.7 mmHg.The diastolic blood pressure of the control group was 90.55.4 mmHg and the systolic blood pressure was 136.412.9 mmHg.There are obvious differences in the comparison of the two sets of data.By comparing the two groups of patients’satisfactions with nursing care,it can be seen that among the 32 patients in the study group:31 were very satisfied and basically satisfied,with a satisfaction rate of 96.87%.Among the 32 patients in the control group,28 were very satisfied and basically satisfied,with a satisfaction rate of 87.5%.The data of the two groups of patients are clearly comparable.Conclusion:Through community health management and nursing strategies,the satisfaction and treatment effect of elderly hypertensive patients can be improved,thereby contributing to the recovery of patients.