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Objective To explore the clinical intervention effect of Omaha on chronic obstructive pulmonary disease(COPD)patients by comparing the routine nursing measures of COPD and the nursing measures under the Omaha management mode. Methods Using experimental design method research in Omaha based management system, according to the inclusion and exclusion criteria, 70 patients with COPD were collected, and they were divided into observation group and control group of 35 cases by random digits table method. The control group was received routine nursing measures of COPD and the observation group was accepted nursing measures under the Omaha management mode.The incidence rate of nursing problems before and after hospitalization was observed. The chronic obstructive pulmonary disease assessment(CAT)was used to evaluate the patient's disease status at admission,discharge and 1 month after discharge. Results The problems with the incidence rate of not less than 20% were analyzed statistically.Except the role change,mental status,social status,skin,eyesight,substance abuse have no significant difference (P>0.05), the others were statistically significant (t =4.158-55.940, P <0.05).There was no significant difference in CAT score at admission,discharge between two groups(P>0.05). CAT score was (18.14 ± 1.01) points at 1 month after discharge in observation group and (20.17 ± 1.41) points in control group, the difference was statistically significant(t =6.890, P<0.05). Conclusions The application of nursing intervention in patients with COPD of the Omaha system, can achieve improving disease in patients with COPD,and make it easier for the patient's disease level of long-term stability,to provide new ideas and directions for further adjuvant therapy COPD.
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Objective To investigate the application value of modified early warning score (MEWS) for assessment of patients in pre hospital first aid.Methods For patients with MEWS method in 3 478 cases of pre hospital first aid,scored in 0-4,5-9 and ≥ 10 points.Analysis of the relationship between the distribution and severity in patients with different grades,and tracing the fate and the condition of patients after admission.Results In MEWS patients with low 0-4 points was divided into pre hospital first aid,accounted for 69.18％ (2 406/3 478),severe cases accounted for 2.58％ (62/2 406); MEWS 5-9 accounted for 21.54％ (749/3 478),severe patients increased to 37.92％ (284/749); MEWS ≥ 10 points accounted for only 9.29％ (323/3 478),severe patients increased to 87.00％ (281/323).MEWS scores higher ratio in patients with severe more,MEWS 5-9 points,severe patients with MEWS ≥ 10 points 0-4 critical patients proportion (P ＜ 0.01).MEWS 5-9 points,≥ 10 points patients admitted to a specialist ward and intensive care units treatment compared with MEWS 0-4 points patients increased significandy (P ＜ 0.01),the mortality rate was also significandy increased (P ＜ 0.01).Conclusion The MEWS method in pre hospital first aid to early warning of potential in critically ill patients,the higher score,the more serious condition,the higher mortality rate.
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[Objective] To discuss the reasonable treatment and skil of gal bladder calculus.[Method] Select 81 cases of such patients, take their clinical data as examples for analysis foundation;and choose relative documents for evidence of theoretic analysis.[Result] 77 cases were successively operated of laparo-scope, 3 transferred for laparotomy owing to difficult anatomy of Colot triangle, 1 made probe of choledoch because of choledocholithiasis;compared with documents results, the incision length, bleeding, operaiotn time, in-hospital time and complications of laparoscope operation, transferred laparotomy in the study were similar to relative documentary reports, the differences had no statistical meaning;the intranperative bleeding, operation period, in-hopital time, complications were better than documents, the differences had statistical meaning. [Conclusion] The correct pre-operation evaluation of disease condition, operation chance and methods selection, 3 operation points were the key of successful operaiton.
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Objective To compare the changes of serum C reactive protein (CRP) in different lesion site and activity so as to evaluate its worthy of an indicator of disease activity. Methods Forty-two patients with Crohn's disease (CD) were divided into small intestinal group and colonic group according to the involved lesions. Twenty-three cases of UC and 26 cases of inflammatory bowel disease (IBS)were served as controls. The serum level of hs-CRP was tested using latex-enhanced immunoturbidimetery. mg/L and (1.1±1.8)mg/L, respectively. Hs-CRP was elevated significantly in CD group compared to UC and IBS groups (P＜0.001). The ratio of patients whose hs-CRP exceeded 3 mg/L was 76.2%, 30.4% and 7.7% in CD, UC and IBS, respectively (P=0.000). The ratio was significantly higher in CD higher than that of small intestinal group [(11.9±7.6 )mg/L vs (6.8±7.2)rag/L, P =0.04]. The ratio of patients whose hs-CRP exceeded normal value was higher in colonic group than that in small CRP(≥10 rag/L). Among them, 4/17 were in remission, 3/11 in mild, 10/13 in moderate and 1/1 in severe according to the CDAI. The hs-CRP was correlated well with CDAI and ESR (r was 0.52 and 0.70 respectively, P＜0.001). Conclusions CRP can he used as a inflammatory marker for evaluating the disease activity of CD. The patients with small intestinal involvment may have lower CRP than those with colonic affection. The elevation of CRP was paralleled to the disease severity of CD.