RESUMO
Objective To explore how to reduce and quickly deal with all kinds of alarm in the dialysis process, to ensure the safety of dialysis, improve the coping ability of nurses, improve the quality of nursing and the satisfaction of patients. Methods Various kinds of alarm and nurse processing time in hemopurification center of our hospital from 2013 to 2014 were recorded and analyzed, the emergency treatment measures were found out, the coping methods were developed, the coping process were improved, and the training of nurses was strengthened. The various parameters were rerecorded and compared after training (2015 to 2016). Results The most common alarm in dialysis process was venous pressure alarm, accounting for 16.45%(15925/96831) of the total alarm, the lowest limit was 10.34%(10020/96831), and the highest limit was 6.11%(5905/96831). The total conductivity alarm was 10.33%(9969/968310), the nurse' s alarm processing time of the lowest limit was (53.11 ± 12.84) s, the highest limit was (136.77 ± 42.88 ) s, the conductivity alarm was (54.17 ± 33.55) s. After the training of nurses, the alarm frequency was reduced (χ2=3.164, P<0.05), the venous pressure alarm accounts for 14.69% (15415/104913) of the total alarm , the lowest limit was 9.52% (9985/104913),and the highest limit was 5.18%(5430/104913), the total conductivity alarm was 7.54%(7913/104913). The alarm processing time was shortened:the lowest limit was (40.94 ± 10.38) s, the highest limit was (119.15 ± 38.79) s (t=3.944, 3.304, P<0.05). The work efficiency and patient satisfaction degree were improved. Conclusions Through the summary and training of all kinds of alarm in the dialysis process, it can effectively reduce the alarm frequency of the dialysis process, improve the work efficiency of nurses, and improve the satisfaction degree of patients.
RESUMO
Objective To explore how to reduce and quickly deal with all kinds of alarm in the dialysis process, to ensure the safety of dialysis, improve the coping ability of nurses, improve the quality of nursing and the satisfaction of patients. Methods Various kinds of alarm and nurse processing time in hemopurification center of our hospital from 2013 to 2014 were recorded and analyzed, the emergency treatment measures were found out, the coping methods were developed, the coping process were improved, and the training of nurses was strengthened. The various parameters were rerecorded and compared after training (2015 to 2016). Results The most common alarm in dialysis process was venous pressure alarm, accounting for 16.45%(15925/96831) of the total alarm, the lowest limit was 10.34%(10020/96831), and the highest limit was 6.11%(5905/96831). The total conductivity alarm was 10.33%(9969/968310), the nurse' s alarm processing time of the lowest limit was (53.11 ± 12.84) s, the highest limit was (136.77 ± 42.88 ) s, the conductivity alarm was (54.17 ± 33.55) s. After the training of nurses, the alarm frequency was reduced (χ2=3.164, P<0.05), the venous pressure alarm accounts for 14.69% (15415/104913) of the total alarm , the lowest limit was 9.52% (9985/104913),and the highest limit was 5.18%(5430/104913), the total conductivity alarm was 7.54%(7913/104913). The alarm processing time was shortened:the lowest limit was (40.94 ± 10.38) s, the highest limit was (119.15 ± 38.79) s (t=3.944, 3.304, P<0.05). The work efficiency and patient satisfaction degree were improved. Conclusions Through the summary and training of all kinds of alarm in the dialysis process, it can effectively reduce the alarm frequency of the dialysis process, improve the work efficiency of nurses, and improve the satisfaction degree of patients.
RESUMO
Objective To explore the clinical effect of two different connecting tubes in hemodialysis combined with hemoperfusion. Methods A total of 25 patients were selected and divided into observation group and control group by self- control method. In the observation group, the hemodialysis combined with hemoperfusion was used 8 times, and the control group was treated with hemodialysis combined with hemoperfusion 8 times using conventional connecting tube. The time of the unloading of the perfusate and the amount of physiological saline required were compared between the two groups. There was no blood spillover during the unloading of the perfusate, the number of cases of allergic reaction during the treatment, and the coagulation of the dialyzer and the pipeline after the treatment. Results There was no allergic reaction in both groups. There was no significant difference between the two groups in the amount of saline needed to return blood (t=46.412, P=0.307). In the control group, there was 15 cases of blood spillover, while the observation group did not show blood spillover. There was significant difference between the two groups in unloading perfusion time(4.43±0.14)min vs. (3.02±0.11) min (t=10.784, P=0.003). The level Ⅰ and Ⅱ blood coagulation of dialyzer and pipeline was 12, 2 cases in the control group after the treatment and 5, 0 case in the observation group, no level Ⅲ blood coagulation cases, and there was a significant difference between the two groups (χ2=10.667, P<0.01). Conclusion In the hemodialysis combined with hemoperfusion therapy, multi-function group of the application effect is superior to conventional piping, is worthy of clinical application.
RESUMO
Objective To investigate the effects of individual and collective health education on hemodialysis patients with hyperkalemia. Methods Thirty hyperkalemia patients treated with maintenance hemodialysis from Mar. 2013 to Mar. 2014 were set as the control group, in which the patients were given pre-established individual health education by the hemodialysis nurse weekly. Another 30 patients of the same sort, as the experiment group, were treated with individual health education combined with collective health education weekly from Apr. 2014 to Apr. 2015. The two groups were compared in term of serum potassium before and after intervention. Result Serum potassium of the experiment group after the intervention were significantly lower than the control group and the experiment group after the intervention (P<0.001). Conclusion Individual health education combined with collective health education can change traditional indoctrination one-way communication to the two-way communication conversion , make the patients consciously change their incorrect dietary behaviors, and reduce the serum potassium levels in the hemodialysis patients with hyperkalemia.
RESUMO
Objective To evaluate the efficacy and toxicity of induction chemotherapy with nedaplatin and docetaxel plus concurrent intensity?modulated radiotherapy ( IMRT) with nedaplatin or cisplatin in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods A total of 223 patients with pathologically diagnosed locally advanced NPC in five treatment centers from 2011 to 2012 were randomly divided into two groups. In the test group, one hundred and thirteen patients received two cycles of induction chemotherapy with docetaxel (65 mg/ m2 on day 1) and nedaplatin (80 mg/ m2 on day 1) plus concurrent IMRT with nedaplatin (40 mg/ m2 on day 1). In the control group, 110 patients received two cycles of induction chemotherapy with the same regimens plus concurrent IMRT with cisplatin (40 mg/ m2 on day 1). The survival rates were calculated with the Kaplan?Meier method and the differences in the survival rates between the two groups were analyzed using the log?rank test. Comparison of the incidence rates of adverse reactions between the two groups was made by the chi?square test. Results The follow?up rate was 99?? 1%.The response rates at 3 months after treatment in the two groups were both 100%. The 2?year local recurrence?free, regional recurrence?free, distant metastasis?free, and overall survival rates were 94?? 0%, 94?? 2%, 88?? 2%, and 90?? 3%, respectively, in the test group, versus 93?? 4%, 94?? 1%, 86?? 7%, and 87?? 3% in the control group ( P= 0?? 757、 0?? 478、 0?? 509、 0?? 413). The incidence rates and severity of leucopenia, neutropenia, and thrombocytopenia were significantly higher in the test group than in the control group ( P= 0?? 027 , 0?? 028 , 0?? 035 ) . The incidence rates and severity of hemoglobin reduction and nausea /vomiting were significantly lower in the test group than in the control group (P= 0?? 000,0?? 023). There were no significant differences in the incidence rates of mucositis and xerostomia between the two groups ( P=0?? 483,0?? 781). Conclusions The short?term efficacy of induction chemotherapy with nedaplatin and docetaxel plus concurrent IMRT with nedaplatin is similar to that with cisplatin in the treatment of locally advanced NPC. The mild gastrointestinal reactions can be tolerated by patients. However, the severe myelosuppression should be closely monitored during the treatment.
RESUMO
Objective To investigate the sleep quality of maintenance hemodialysis (MHD) patients and analyze its associated factors. Methods The convenience sample method was used to choose 424 MHD patients from 7 hospitals.A set of questionnaires were used in this investigation,including demographic data form,Pittsburgh sleep quality index (PSQI),restless legs syndrome (RLS),social support rate scale (SSRS),subjective global assessment (SGA),family APGAR index (APGAR) and family burden scale of disease (FBS). Results PSQI score of 395 MHD patients (93.2％) was ≥5.APGAR and social support total points were negatively correlated with sleep quality (r=-0.133,P=0.006; r=-0.105,P=0.031).Family burden total point was positively correlated with sleep quality (r=0.215,P=0.000).Nutrition (F=46.123,P=0.000),restless legs syndrome (F=9.392,P=0.000) and sleep apnea syndrome (F=5.645,P=0.001) were closely associated with sleep index scores. Conclusions Incidence of poor sleep quality in MHD patients of our study is quite high.Sleep quality of MHD patients is correlated with lots of factors,such as family concern,social support.
RESUMO
Objective: To investigate the relationship between type 2 diabetes mellitus (T2DM) and the pathogenesis and metastasis of colorectal cancer. Methods: A case-control study was performed to compare 852 colorectal cancer patients with 940 controls (patients without cancer) recruited from 2001 to 2006, with respect to their sex, cancer subsite, the course of T2DM, hepatic metastasis, smoking and drinking. Correlated risk factors were analyzed. Results: The risk of colorectal cancer was increased in patients with T2DM and the relative risk (OR) was 2.466. The OR of male patients was higher than that of female patients, but with no significant difference (2.775 vs 2.070, P=0.394). The incidence of T2DM in patients with left hemicolon cancer was higher than that in those with right hemicolon cancer and rectal cancer, but with no significant difference between them. The colorectal cancer risk in T2DM patients with a DM course of 10 ～ 20 years was the highest, and the OR was 4.696. The rate of hepatic metastasis was higher in T2DM patients with colorectal cancer than that in celorectal cancer patients without T2DM and the OR was 2.888. Conclusion: T2DM may be one of the important pathogenic risk factors for colorectal cancer. The OR is increased with the extension of DM course within 20 years. Colorectal cancer patients with T2DM may be more prone to hepatic metastasis.
RESUMO
Objective To observe the clinical effect of Sarcandra glabra extracts against oxida-tive damage. Methods 46 patients diagnosed as nasopharyngeal careinoma stage Ⅲ and Ⅳ a were ran-domly divided into control group (n=25) and study group (n=21). All patients underwent combined chemoradiotherapy treatment. Besides, the patients in study group were given Sarcandra glabra 20 g/d orally. The total activity of superoxide dismutase (SOD) and plasma eontent of malonaldehyde (MDA) were measured before and after treatment. The tumor regression and aeute chemoradiotherapy side reaction were observed after treatment. Results All patients fulfilled the whole range treatment, After treatment, the total plasma SOD activity decreased and plasma MDA level was elevated in con-trol group, while both SOD aetivity and MDA level were reduced in study group (P<0. 05). When the therapy ended, the SOD of study group was higher and MDA was lower than that of control group (P<0.05). There was no difference in tumor local control rate after radiotherapy between two groups (P>0.05). The incidence rate and severity of acute chemoradiotherapy side reaction were slighter in study group than those in control group (P<0. 05). Conclusion Sarcandra glabra extracts exerts obvious inhibitory effect on oxidative damage. Combined with chemoradiotherapy, Sarcandra glabra contributes to the tumor regression of patients with stage Ⅲ and Ⅳa nasopharyngeal carcinoma and at-tenuation of chemoradiotherapy side reaction.