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地震致胸部严重受损伤员的护理

【摘要】　目的　总结18例地震中致胸部严重受伤者的监护及护理体会。　方法　对2008年5月13日—27日在汶川大地震中收治的18例胸部严重受伤伤员的抢救及护理资料进行回顾性分析。　结果　16例愈合良好，2例因多器官功能衰竭11 d后死亡。　结论　地震中胸部严重受损伤员，病情复杂，变化迅速，只要充分评估病情，严密观察体征，积极预防并发症，就可使伤员顺利渡过危险期，重新获得生命。

肺癌顺铂耐药的分子机制研究新进展

小儿心脏体外循环术后呼吸机相关性肺炎的预防及护理措施

【摘要】　目的　总结小儿心脏体外循环术后呼吸机相关性肺炎的预防及护理措施。　方法　2010年1月—2010年7月，对收治的80例体外循环术后进行机械通气的患儿，通过采取一系列预防呼吸机相关性肺炎的措施，以及对患儿术后情况、痰培养及血培养结果进行收集和总结，对已发生呼吸机相关性肺炎的患儿进行积极的抗感染治疗。　结果　75例患儿顺利转出小儿ICU，2例因心功能衰竭死亡，死亡前无肺部感染表现；3例发生呼吸机相关性肺炎，发生率为3.75%。　结论　体外循环心脏手术易使肺部感染发生率上升，感染的发生可导致拔管、撤机困难，增加死亡风险率。因此，预防呼吸机相关性肺炎的发生，有重要临床意义。

新生儿先天性巨结肠根治术的围术期护理

【摘要】　目的　总结新生儿先天性巨结肠的围术期护理。　方法　对2008年1月-2009年7月收治的30例先天性巨结肠患儿术前、术中及术后的护理资料进行回顾性分析。　结果　30例患儿手术成功，经精心护理均痊愈出院，达到预期的效果。　结论　先天性巨结肠在新生儿时期即行根治手术，手术前后的护理是治疗的重要环节。术前予以肠道的准备充分、术后采取精心对症的护理措施，加强病情观察，加强营养支持，重视肛周护理，是保证手术成功的重要因素。

Predictive accuracy of four risk scores for cardiovascular complications during pregnancy in women with congenital heart disease: a systematic review and meta-analysis

ObjectiveTo explore the predictive value of four risk scoring systems for cardiovascular complications during pregnancy in patients with congenital heart disease (CHD). MethodsComputer searches were conducted in PubMed, EMbase, CENTRAL, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, and China Biology Medicine disc (CBM). Relevant studies on risk scoring systems for cardiovascular complications during pregnancy in CHD patients at home and abroad were comprehensively collected. The retrieval period was from the establishment of the databases to January 1, 2025, and the retrieval was updated on March 26, 2025. After two reviewers independently screened the literature and extracted the data, the quality assessment was carried out, and Meta-analysis was performed using MedCalc software. ResultsA total of 11 studies were included, with a total of 4 987 patients. The incidence of cardiovascular complications during pregnancy in CHD patients ranged from 6.72% to 28.84%. The QUADAS-2 scoring tool results showed that two studies had a risk of bias, and nine studies were determined to have a high risk of bias. The results of the Meta-analysis showed that the CARPREGⅠ score [AUC=0.709, 95%CI (0.672, 0.745), P<0.001], CARPREGⅡ score [AUC=0.757, 95%CI (0.720, 0.794), P<0.001], ZAHARA score [AUC=0.732, 95%CI (0.674, 0.790), P<0.001], and mWHO classification system [AUC=0.681, 95%CI (0.617, 0.745), P<0.001] could independently predict cardiovascular complications during pregnancy in CHD patients. ConclusionThe existing evidence indicates that all four scoring systems can be used to predict cardiovascular complications during pregnancy in CHD patients. Although the CARPREGⅡ score has the highest accuracy, the number of included studies is small. It is recommended to give priority to using the ZAHARA score for risk stratification and pregnancy management of women with CHD before pregnancy. In view of the limitations of the quality of the included studies, this study needs to be further confirmed by high-quality studies.

持续气道正压治疗婴幼儿心脏术后并发低氧血症的护理

【摘要】 目的 总结鼻塞式持续呼吸道正压通气治疗心脏术后婴幼儿低氧血症的效果和护理。 方法 2008年1-12月对26例心脏术后并发低氧血症的患儿使用鼻塞式持续呼吸道正压通气，吸入氧浓度60%～80%，治疗时间24～48 h。 结果 23例治疗24～48 h后临床症状完全缓解。3例患儿由于心功能差，在治疗过程中出现进行性呼吸困难，再次行气管插管机械通气，2例治愈，1例死亡（死于低心排综合征）。 结论 鼻塞式持续呼吸道正压通气是治疗患儿心脏术后低氧血症的有效方法。

Effect of quality control circle in reducing ventilator-associated pneumonia in Pediatric Intensive Care Unit

Objective To investigate the effect of quality control circle in reducing ventilator-associated pneumonia in Pediatric Intensive Care Unit (PICU). Methods A total of 1 249 child patients who underwent mechanical ventilation between January and December 2013 were chosen as the control group, and they accepted routine management. Another 1 208 child patients treated between January and December 2014 were selected as the observation group, and quality control circle was adopted. The compliance of ventilator care bundles, the duration of mechanical ventilation, the length of PICU stay and the incidence of ventilator-associated pneumonia were compared between the two groups. Results Compared with the control group, compliance of ventilator care bundles was higher in the observation group (P<0.01), the duration of mechanical ventilation was shorter [(6.9±2.4) daysvs. (4.6±2.2) days], the length of PICU stay was shorter [(9.2±3.1) daysvs. (7.7±2.4) days], and the incidence of ventilator-associated pneumonia was lower (22.4‰vs. 9.1‰) (P<0.05). Conclusion Application of quality control circle can significantly promote the compliance of ventilator care bundles, and decrease the duration of mechanical ventilation, the length of PICU stay and the incidence of ventilator-associated pneumonia.

自制开启预防呼吸机相关性肺炎之门的钥匙量角器

品质管理圈在降低胸外科患者非计划性拔管中的效果探讨

目的探讨品质管理圈（品管圈）在降低胸外科患者非计划性拔管（UEX）中的应用效果。 方法随机选择2011年6月－12月和2012年1月－6月各1 000例胸外科患者分别作为对照组和观察组，分别采用常规护理和品管圈护理管理，并对比两组患者UEX发生率。 结果对照组和观察组UEX发生率分别为3.8%和2.0%，表明品管圈护理能有效降低患者UEX发生率。 结论对胸外科患者实施品管圈管理，能有效降低患者UEX发生率，从而达到提高护理安全质量，改善患者舒适度与满意度的效果，值得推广。

快通道心脏麻醉应用于冠状动脉旁路移植术的监护体会

目的：探讨快通道心脏麻醉在冠状动脉旁路移植术的监护经验，使冠状动脉旁路移植术后早期拔除气管插管。方法：回顾性总结2004年1月~2006年5月行冠状动脉旁路移植术患者的监护得失。结果：45例患者均在术后6小时内拔除气管插管，3例患者因病情变化二次插管。44例患者好转出院。1例因多器官功能衰竭死亡。结论：快通道心脏麻醉在冠状动脉旁路移植术的使用，可以减少由长期带管给患者带来的呼吸道并发症，减少患者痛苦，减少患者的平均住院日，减少患者住院费用。