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Jingdong book

现代儿科护理手册（护理用书）

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Jingdong book

现代儿科护理手册（护理用书）

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Content Description

《现代儿科护理手册（护理用书）》是一本儿科临床护理参考书。全书共分7章和附录，内容包括常用儿科护理技术、常用儿科实验室检查及护理、常用儿科治疗技术及护理、新生儿重症监护、儿科常见病患儿的护理、儿童保健等。《现代儿科护理手册（护理用书）》每章节均以护理为重点，全面系统地介绍了有关现代儿科护理各方面的知识。
《现代儿科护理手册（护理用书）》可作为儿科专业护理人员和护理专业学生在临床工作中的工具及学习参考书。
Author Description

王勤环，曾任北京大学一院感染疾病科副主任、主任，北京大学医学部传染病学系主任，现为传染病学系名誉主任教育情况1955-1960年在北京医科大学医学系学习，1971~1972年在北京中医研究院学习，1991.10~1992.2在美国艾因斯坦医学院肝病研究中心学习。
Catalogue

第一章 常用儿科护理技术
第一节 沟通交流技巧
一 沟通交流技巧
二 其他沟通方式
第二节 生命体征测量
一 体温的测量
二 脉搏的测量
三 呼吸的测量
四 血压的测量
第三节 皮肤护理
第四节 脐部护理
第五节 口腔护理
第六节 喂养技术
一 母乳喂养
二 人L喂养
三 混合喂养
四 胃管喂养
第七节 给药法
一 服给药法
二 吸入法
三 直肠给药法
四 静脉输液法
五 注射法
第八节 药敏实验
一 青霉素过敏试验
二 链霉素过敏试验
三 结核菌素试验
……

第二章 常用儿科实验室检查及护理
第三章 常用儿科特殊诊断检查及护理
第四章 常用儿科治疗技术及护理
第五章 新生儿童症监护
第六章 儿科常见病患儿的护理
第七章 儿童保健
Book Abstract

（一）传染源
甲型肝炎和戊型肝炎的传染源是急性期患者和亚临床型感染者。HAV病毒血症始于黄疸前2～3周，持续至黄疸出现为止，此期血液有传染性。甲型肝炎患者在起病前2周和起病后1周从粪便中排出HAV的量最多，但至起病后30天仍有少数患者从粪便中排出HAV。戊型肝炎志愿者实验感染HEV后，28～45天（发病前9天至发病后8天）可从粪便中检出HEv，黄疸出现后4天粪便中HFAg开始出现。
乙型、丙型、丁型肝炎的传染源分别是急、慢性（含肝炎后肝硬化）肝炎患者和病毒携带者。急性乙型肝炎患者的传染期从起病前数周开始，持续整个急性期。HBsAg阳性的慢性患者和无症状携带者的传染性与e抗原、HBVDNA及DNAP是否阳性有关。丙型肝炎患者的传染期从临床症状出现前1至数周开始，传染性的大小与肝病是否活动，尤其是病毒学指标是否阳性有关，但由于血中HcV浓度很低，HcVRNA的检出，固然代表传染性，但HcVRNA阴性不能排除有传染性。急性HDV感染时，HDAg血症持续5～25日（平均15日），此期传染性最强。
（二）传播途径
甲型、戊型肝炎以粪一口传播为主。日常生活接触传播多致散发性发病。
经水和食物的传播特别是水生贝类如毛蚶等，常是爆发流行的主要传播方式。经血液、血制品和静脉用药传播甲型肝炎的方式在国内少见，何在发达国家时有发生。
乙型肝炎主要通过血液和血制品传播，慢性感染及病毒携带者血液中HBV浓度很高．微量血液进入易感者体内即可引起感染，因此，由于使用未经消毒或消毒不彻底的被HBV污染注射器、针头等均可造成传染。此外，皮肤划痕、针灸、纹身，共用剃刀、牙刷等均极易经破损的皮肤黏膜传播HBV。接触（日常生活密切接触和性接触）传播和母婴传播，包括经胎盘、分娩和哺乳等亦是乙型肝炎的传播方式。
丙型肝炎亦主要经血液和血制品传播，国外90％以上输血后肝炎为丙型肝炎。但国内大量的流行病学资料显示丙型肝炎除经输血、血制品传播外，还存在着经皮传播的主要途径。例如，陕西省对2005人的调查表明，抗-HCV阳性者中，有供受血史者仅占总体的12．6％（9／71）。在目前对献血员进行严格筛查的情况下，经皮传播（包括医源性传播）的作用更不容忽视。虽已证实内型肝炎亦可经母婴传播，但不如乙型肝炎多见。家庭密切接触及性传播虽有报道，但尚待进一步证实。丁刑肝炎传播与乙型肝炎相似。
（三）人群易感性、免疫力与流行特征
没有自然感染HAV的人对甲型肝炎病毒普遍易感，隐性感染率高，而感染后可产生持久的免疫力，再感染者极少见，甲型肝炎的分布是世界性的，但抗HAV阳性率的差异很大。在发达国家甲型肝炎的发病率逐年下降，且发病年龄逐渐由低年龄组儿童转向高年龄组。如美国近年高年龄组已为20～39岁，且15～39岁病例约占60％，15岁以下仅占25％；在发展中国家人群抗一HAV的阳性率高，10岁时80％以L有抗HAV。我国甲型肝炎发病可分为人群高免疫屏障区和人群低免疫屏障区。前者主要指广大乡镇和农村地区，其人群感染率高，10岁的儿童80％已感染HAV，发病以学龄儿童及学龄前儿童为主；有秋冬流行的季节规律。

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