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Objective To investigate the accuracy and safety of using normal saline as a medium to guide the catheter lumen to assist the localization of the catheter tip. Methods This study included the patients with hematological malignancies in our fully implantable venous port. We enrolled 105 patients from January 2014 to December 2015 as control group, and 220 patients from January 2016 to June 2017 as the experimental group. The control group used the traditional fully implantable venous port after the chest X slice to determine the location of the catheter tip. The experimental group used the intracavitary electrocardiogram location technology to assist the complete implantable venous port catheter tip positioning catheter, then chest X film. Results No catheterization occurred in all the patients. The rate of catheter placement was 100％. In the experimental group, 179 patients (81.36％) had the best placement of catheter tip (i.e., superior vena cava right atrium junction, CAJ), and 35 patients (52.38％) in the control group had the best placement of catheter tip. The proportion of the catheter tip located in the best position (the superior vena cava auricular commissure and CAJ) in the experimental group was higher than that in the control group (χ2=29.615, P < 0.05). Conclusions By the injection of saline guided endocardial mapping real-time monitoring of totally implantable venous transfusion port catheter tip position, can guide the surgeon to grasp the real-time operational direction of totally implantable venous transfusion port catheter tip, accurately positioning the catheter tip position, improve the surgical success rate, worthy of clinical use.
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Objective Based on the three-dimensional quality structure model,to construct the nursing quality evaluation index system for acute leukemia,in order to provide references for clinical evaluation of quality of nursing care for acute leukemia.Methods Based on the theory of Donabedian's structure-process-outcome quality structure model,through literature search,semi-structured interview,expert meeting,expert consultation and analytic hierarchy process,the quality evaluation index system and index weight for acute leukemia were determined.Results After two rounds of expert consultation,questionnaire response rates were 94.74％,100％;expert authority coefficients were 0.848,0.854;Kendall coordination coefficients were 0.273,0.420,and P values were all less than 0.01.The final index system consisted of 3 first-level indicators,8 second-level indicators,and 24 third-level indicators (3 structure indicators,7 process indicators,14 outcome indicators).Each of third-level indicators contained index names,calculation methods,and data collection methods.Conclusion The process of construction of nursing quality evaluation index system for acute leukemia is scientific,the contents are reasonable,which can reflect nursing characteristics of acute leukemia.
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Objective To observe the prevention effect of Hubai powder applied on navel for nausea and vomiting induced by chemotherapy with cisplatin.Methods 97 patients who received chemotherapy with cisplatin (75mg/m2 )were randomly divided into observation group(n =49)and control group(n =48).In the control group, 30min before chemotherapy,the patients were treated with intravenous granisetron 3mg as antiemetic;Based on the control group,the observation group were treated with Hubai powder 10g applied on Shenque point in the night before the chemotherapy until the end of the next morning after chemotherapy.The curative effect of the two groups were observed.Results The acute vomiting rate of the observation group was 83.7%,which was significantly higher than that of the control group(60.4%)(χ2 =5.423,P =0.019);The delayed vomiting rate of the observation group was 85.7%,which was significantly higher than that of the control group(56.3%)(χ2 =8.867,P =0.003);The patient appetite of the observation group was obviously better than that of the control group,0 -Ⅰ degree occurrence rate of the two groups had statistical significance(χ2 =6.469,4.552,P =0.011,0.033);Ⅱ -Ⅲ degree occurrence rate of the two groups did't have statistical significance.Conclusion Hu Bai powder umbilicus can effectively prevent nausea and vomiting induced by chemotherapy with cisplatin.