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臨床護理路徑在腦卒中患者康復中的應用

目的　討論臨床護理路徑（CNP）在腦卒中患者康復中的應用。 方法　將2010年1月－12月收治的80例腦卒中患者隨機分為對照組和試驗組，對照組采用功能制護理方法，試驗組按照設計的CNP圖實施護理。對兩組患者住院期間健康知識掌握程度、護理工作滿意度和住院天數進行比較。 結果　試驗組對健康知識的掌握程度和滿意度明顯高于對照組，住院時間明顯縮短，兩組比較差異有統計學意義。 結論　CNP的應用可以提高腦卒中患者對疾病和康復知識的認識與掌握程度，提高患者對護理工作的滿意度，有效縮短患者的住院時間，值得推廣。

預防與康復模式在震后脊髓損傷傷員康復中的應用

目的：探討預防與康復模式在震后脊髓損傷傷員康復治療過程中的應用價值。方法：應用對象是對5·12汶川地震后我科收治的35例脊髓損傷傷員；模式組成成員有康復醫生、脊髓損傷治療師、康復護理人員、心理咨詢師、社會各界的工作者、傷員、家屬及陪護等；治療干預方法是治療小組成員共同參與對應用對象實施康復評估，制定康復治療的近期和遠期目標、康復治療措施、反饋康復治療效果的循環上升工作方式。結果：接受綜合治療干預后，35例震后脊髓損傷傷員在心理方面、小便處理能力方面、相關功能訓練技巧和相關知識、矯形器和輔助器具使用能力等方面均有顯著性提高（P＜0.05）。結論：在震后脊髓損傷傷員康復治療過程中應用預防與康復模式，可明顯提高傷員的整體康復效果，最大限度發揮傷員的殘存功能，明顯提高傷員的生存、生活和工作能力。

疑難血液透析用長期留置帶滌綸套雙腔導管置管一例

Application of liver venous deprivation before two-stage radical hepatectomy in liver cancer patients

ObjectiveTo explore the application of the technique of liver venous deprivation (LVD) for two-stage radical hepatectomy in patient with liver cancer underlying hepatitis B virus infection.MethodsA 53 years old patient diagnosed with central primary liver cancer (Ⅴ/Ⅷ segment) could not receive standard right hepatectomy since his future liver remnant was insufficient, so the LVD was performed to induce FLR growth. The general condition and CT scan were repeated at 1-, 2- and 3-week after LVD, the FLR and FLR weigh/ body weight ratio were calculated.ResultsThe FLR and FLR weight/body weight ratio before LVD were 24.2% and 0.459%, the FLR at 1-, 2- and 3-week after LVD were 29.5%, 38.3% and 44.4% respectively, the FLR weight/body weight were 0.545%, 0.707% and 0.820% at 1-, 2- and 3-week after LVD. The standard right hepatectomy was undertaken successfully at 25 days after LVD and discharged safely.ConclusionThe LVD technique could induce a rapid and large FLR volume and offer opportunity for patients with insufficient FLR to receive two-stage radical hepatectomy, is a novel method to induce FLR growth effectively.