鼻内镜下鼻窦开放术围手术期的护理

论文编号:HL166  论文字数:10600.页数:19

论文题目：鼻内镜下鼻窦开放术围手术期的护理
 摘  要

研究背景
 鼻内镜手术是近年来开展的一项新技术，它是在鼻内镜直视下，以尽可能保留鼻腔、鼻窦的结构和功能为前提，以消除病变、改善和重建鼻腔、鼻窦通气引流功能为目的的鼻外科手术。是治疗慢性鼻窦炎及鼻息肉的新方法，具有痛苦小，操作精细，观察准确等优点，在清除发病因素的基础上重建和恢复鼻腔鼻窦的通气和粘膜纤毛的功能，是一种符合鼻腔鼻窦生理的手术方法，把以往根治性或者破坏性手术改变为功能性手术。鼻窦镜手术的目的1.拓宽鼻腔和鼻窦间的联系空间2.最大限度的保留正常的解剖结构和粘膜，对局部生理功能的保护贯穿于整个治疗的过程中。对于慢性鼻窦炎而言，手术只是治疗的开始，术后要经过复杂的处理过程，才能彻底治愈，单纯依靠手术而不注重手术后的处理并不能获得可靠的疗效。特别是手术后的鼻窦冲洗尤其重要，它能有效地去除干痂，增加局部血液循环，促进黏液纤毛清除功能，收缩水肿组织，更加有利于鼻腔和鼻窦的充分通风和引流，从而大大缩短术后治疗时间。系统的鼻内窥镜手术围手术期的护理!对于缩短手术恢复时间、提高治疗效果至关重要。
研究目的
 对鼻内镜下鼻窦开放术治疗慢性鼻窦炎的传统护理及系统化术前术后护理、并发症观察及护理进行探讨，预防和避免并发症的发生，以保证治疗效果，提高治愈率。
研究方法
    选择大学第二附属医院耳鼻喉科2009年8月至2010年08月实施鼻内镜手术病例490例。490例随机分为标准组和对照组，标准组245例，采用系统化护理，包括术前准备、制定有预见性的护理措施、术中配合和术后护理重点及措施、出院指导；对照组245例，采用常规护理。根据疗效标准统计有效率及无效率、并发症发生率。
研究结果
 两组有效率比较有显著性差异（P＜0.05）。标准组有效率为98%，与对照组比较有显著性差异；无效率为2%，与对照组比较有显著性差异；并发症发生率为3%，与对照组比较有显著性差异。。
结论
 鼻内镜下鼻窦开放术是较好的治疗方法，其手术前后的各种护理措施是否到位，直接关系到手术效果和术后复发等并发症发生机会。所以为了提高疗效，根据术后恢复的不同阶段开展规范化的护理及随访非常重要。
关键词：慢性鼻窦炎；内镜手术；护理
论文类型：应用研究论文
    
 Title: Comparison of the effect of different feeding methods to neonates
 ABSTRACT
 
 
Background
 As one kind of nature food, breast-feeds can bring large advantage. It can be absorbed easily, and be of plenty of antibody and immunocyte. At the same time, it can promote the sensation communication. So it is important to mental and physical development of infants. But many mothers have not plenty of latex. Because of latex lack, infants will have hypoglycemia and jaundice easily. So it is necessary to add appendix feeding in good time when latex lack occurs.
Objectives
 To study the influences of two different breast-feeds to neonatal three days after delivery，including jaundice, blood glucose and low weight.
Methods
 118 neonates were randomly divided to experimental group (58 cases) and control group (60 cases), monitored the items of physiology such as: weight, blood glucose, time of fetal feces discharge end, and jaundice index. The neonates in experimental were raised by breastfeeding and mixed feeding, while the neonates in control were raised totally by breastfeeding.
Results:
 The items of physiology between two groups have statistical difference( P＜0.05). Incidence of jaundice , low weight and hypoglycemia in experimental group is lower than that in control group. In experimental group, the number of low weight was 0(0%), the rate of hypoglycemia was 10%, and the incidence of pathological jaundice was 3.4%. compared with ones in control group, there were significant difference. Breastfeeding adding appendix feeding can decrease the incidence of low weight, hypoglycemia and jaundice significantly three days after delivery.
Conclusion
 If breast-feed were not enough, appendix feed should be given to neonates in the first three days, which could decrease jaundice and prevent hypoglycemia of neonates.
KEY WORDS: breast-feed；mixed-feed；neonate；jaundice；hypoglycemia；low weight
TYPE OF THESIS: Research Report
 目  录
1 绪论 1
 1.1研究背景及意义 1
 1.2研究目标 1
 1.3关键词及定义 1
 1.4文献回顾 2
 1.4.1鼻内镜下鼻窦开放术概述…………………………………………………………………2
 1.4.2鼻内镜下鼻内镜下鼻窦开放术围手术期的护理现状………………………………………3
2研究设计 4
 2.1研究类型…………………………………………………………………………….4
 2.1研究对象 4
 2.2研究步骤 5
 2.3研究工具 5
 2.4资料分析 5
3结果与分析 6
 3.1一般资料…………………………………………………………………………...6
 3.2两组有效率人次比较 6
 3.3两组无效率人次比较 6
 3.4两组并发症发生率人次比较 7
4讨论……………………………………………………………………………………….8
 4.1总结讨论…………………………………………………………………………..8
 4.2术前准备及护理制定有预见性护理措施 9
 4.3术中配合 10
 4.4术后护理重点及措施 10
 4.5出院指导………………………………………………………………………12
5结论与展望 14
致    谢 15
参考文献 17