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高原地区手部瘢痕挛缩患者围手术期护理与功能康复训练

目的　探讨高原手部烧伤后瘢痕挛缩围手术期护理和康复训练的措施及效果。 方法　对2007年3月－2010年3月收治的36例手部烧伤致瘢痕挛缩患者术前、术中施行的护理方法及术后康复训练方式进行回顾总结。 结果　36例患者顺利完成手术，经围手术期护理和术前、术后的康复训练，手部外观、功能均明显恢复，患侧手部的活动与健侧比较，指间关节活动度达优者18例（50%）、良12例（34%）、一般6例（17%）。 结论　对症的围手术期心理护理和康复训练，对提高手部瘢痕挛缩患者手术效果和术后手部功能恢复具有重要意义。

全身麻醉下保留自主呼吸的清醒开颅术手术期护理一例

风湿性心脏病合并慢性粒细胞白血病围手术期护理一例

儿童巨大桥小脑肿瘤手术的围手术期护理

目的总结儿童巨大桥小脑肿瘤手术的护理质量控制，保证术中护理质量。 方法回顾性总结2012年1月－2013年3月18例儿童巨大桥小脑肿瘤手术，了解术前家长担心的问题，术前麻醉、皮肤的准备，术中皮肤护理、体温护理等手术室护理质量管理的相关环节，根据围手术期患儿的应激特点及患儿自身特征，以及手术要求，实施有针对性的术前、术中、术后护理。 结果18例儿童巨大桥小脑肿瘤手术体位安全，暴露充分，术者满意，手术时间8.33～11.66 h，平均10.42 h，出血量100～300 mL，未因手术体位的摆放和护理因素而发生并发症。术后1 d恢复良好，格拉斯哥昏迷评分9～12分。 结论在行儿童巨大桥小脑肿瘤手术时，根据围手术期患儿的应激特点及患儿自身特征，以及手术要求，实施有针对性的术前、术中和术后护理，可使手术野暴露充分，保证术中护理质量，减少手术并发症。

血友病患儿合并先天性心脏病的围手术期护理一例

近视角膜屈光手术后睑板腺功能障碍一例

婴幼儿腹腔镜下先天性食管裂孔疝修补术围手术期护理

目的　总结婴幼儿腹腔镜下食管裂孔疝修补术围手术期的护理方法与经验，以提高护理质量。 方法　对2011年6月－2012年10月收治的8例先天性食管裂孔疝患儿行腹腔镜下食管裂孔疝修补术的护理方法及要点进行回顾性分析。 结果　患儿均顺利完成手术，1例术后第2天开始发热，并持续高热伴咳嗽，经补液、抗感染、雾化吸入等治疗，1周后体温恢复正常，伤口愈合良好，但仍有咳嗽，经儿内科会诊以支气管肺炎转入儿内科治疗。其他患儿无并发症发生，痊愈出院。经随访，8例患儿无腹痛腹胀，无疝复发，无食管狭窄等发生。 结论　术前加强饮食指导、体位护理、皮肤护理，术后做好呼吸道管理、胃管护理、积极抗感染治疗，预防肺部并发症等有效护理措施是婴幼儿腹腔镜下先天性食管裂孔疝修补手术成功的关键。

Development and application of a multidisciplinary nursing program for Prader-Willi syndrome with spinal deformity in perioperative period

Objective To develop a multidisciplinary nursing program for Prader-Willi syndrome with spinal deformity and evaluate its effectiveness in clinical practice. Methods In July 2016, a multidisciplinary collaborative team was established before the treatment of children with Prader-Willi syndrome complicated with spinal deformity. For the nursing difficulties in the perioperative period, relevant literature was consulted, and a multidisciplinary collaborative nursing plan was formulated, which included nutrition management and blood glucose control, management of obstructive sleep apnea hypopnea syndrome, behavioral intervention related to mental change, and early identification and management of complications. The developed multidisciplinary collaborative nursing program was applied to three children with Prader-Willi syndrome complicated with spinal deformity in Peking Union Medical College Hospital from July 2016 to October 2018, and their postoperative recovery was evaluated. Results One child had inguinal skin ulceration when admitted to hospital, which was significantly improved after active treatment. The perioperative blood glucose level control of the three children was satisfactory, and there was no postoperative gastrointestinal dysfunction, deep wound infection, respiratory complications, internal fixation failure or other complications, and no asphyxia, fall, loss, or other adverse events. The follow-up compliance after discharge was 100%. Conclusions Multidisciplinary collaboration programs can escort patient’ safety and promote their recovery, improve the professional level of nursing staff, and reflect the nursing value. As a working mode, it can be further popularized and used for reference in the nursing of other difficult diseases.

The Perioperative Nursing Means of the Acute Obstructive Suppurative Cholangipis with Diabetes

目的:探讨糖尿病合并化脓性胆管炎(acute obstructive suppurative cholangipis,AOSC)患者围手术期护理方法。方法:回顾性分析我院2002 年1月至2008 年8 月收治的15 例糖尿病合并化脓性胆管炎患者的临床资料。结果:本组2例术后伤口裂开,1例切口裂开胆道大出血死亡,3 例发生肺部感染,无低血糖休克病例,9例伤口愈合良好,按期拆线。结论:加强围手术期的观察和护理,对糖尿病合并化脓性梗阻性胆管炎患者的治疗起着重要作用。

The Nursing Experience of Preoperative Treatment for Urethral Injury with Ureteroscopic Urethral Realignment

ObjectiveTo explore the nursing experience of preoperative treatment for urethral injury with ureteroscopic urethral realignment. MethodsThe key points of the nursing experience of preoperative treatment for 58 cases of urethral injury with ureteroscopic urethral realignment were retrospectively analyzed. The patients were treated between January 2008 and December 2012. ResultsUrethra catheterization of the 58 patients receiving the ureteroscopic urethral realignment was all successful. The catheter was extracted 4-8 weeks after the treatment, and then the urethra was dilated for two years. All patients had normal urination without any surgery complications during the 5-28-month clinical follow-up. ConclusionUrinary tract infections can be prevented effectively under professional and meticulous preoperative treatment. The incidence of urethral stricture can be reduced greatly. The quality of the patients' life can be improved a lot.