目的:调查分析神经外科护士工作压力因素,采取相应对策以减轻压力,积极应对工作。方法:采用问卷调查法,对在神经外科工作的护士工作压力程度,工作压力源,压力源前五位,与其它科室护士进行比较,并通过统计学方法进行分析。结果:神经外科护士工作压力程度以重度压力为主。排序前5位的压力源为:工作量大,担心工作出差错,社会地位低,上班护士数量少,护理的患者病情过重。结论:正确分析神经外科护士工作压力因素,采取有效的对策,对于提高护理质量,保障护理安全,具有十分重要的意义。
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.