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心血管内科护理常规

2017-10-13 50页 doc 165KB 38阅读

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心血管内科护理常规心血管内科护理常规 第一节 循环系统一般护理常规 第二节 循环系统疾病监护常规 第三节 心力衰竭护理常规 一、慢性心力衰竭 二、急性心力衰竭 第四节 心律失常护理常规 心脏瓣膜病护理常规 第五节 第六节 冠心病护理常规 第七节 原发性高血压护理常规 第八节 病毒性心肌炎护理常规 第九节 心肌疾病护理常规 一、扩张型心肌病 二、肥厚型心肌病 第十节 感染性心内膜炎护理常规 一、亚急性感染性心内膜炎 二、急性感染性心内膜炎 第十一节 心包炎护理常规 一、急性心包炎 二、收窄性心包炎 第十二节...
心血管内科护理常规
心血管内科护理常规 第一节 循环系统一般护理常规 第二节 循环系统疾病监护常规 第三节 心力衰竭护理常规 一、慢性心力衰竭 二、急性心力衰竭 第四节 心律失常护理常规 心脏瓣膜病护理常规 第五节 第六节 冠心病护理常规 第七节 原发性高血压护理常规 第八节 病毒性心肌炎护理常规 第九节 心肌疾病护理常规 一、扩张型心肌病 二、肥厚型心肌病 第十节 感染性心内膜炎护理常规 一、亚急性感染性心内膜炎 二、急性感染性心内膜炎 第十一节 心包炎护理常规 一、急性心包炎 二、收窄性心包炎 第十二节 主动脉夹层护理常规 心血管介入性诊疗护理常规 第十三节 一、经皮穿刺球囊二尖瓣成形术护理常规 二、心导管射频消融术的护理常规 三、冠状动脉造影术的护理常规 四、经皮穿刺冠状动脉支架植入术的护理常规 五、先心病介入术的护理常规 六、人工心脏起搏器的护理常规 七、主动脉夹层术后的护理常规 第一节 循环系统一般护理常规 1(按内科一般护理常规护理。 2(根据患者病情给予相应体位如平卧位、半坐卧位、端坐卧位,合理安排活动与休息, 避免一切不良刺激。 3(遵医嘱给予营养平衡的健康膳食,避免暴饮暴食,吃八分饱。 4(指导患者保持大便通畅,排便时切勿过度用力,便秘时及时处理。 5(根据患者病情给予氧气吸入。 6(根据患者病情或遵医嘱调整输液速度,密切观察药物的疗效和不良反应。 7(应用洋地黄制剂者,每次用药前测脉率、心率与心律。观察疗效和中毒现(如倦 怠、食欲缺乏、恶心、呕吐、脉搏缓慢<60次/分、室性心律失常、黄视或绿视等)。发现中 毒表现,立即停药,并报告医生处理。 8(心律失常患者测脉率、心率时,至少计数1分钟。对心动过速、过缓、节律不规则及时报告医师。 9(注意观察患者的病情变化,如胸痛、胸闷、心悸、气促、水肿、发绀、咳嗽、咳痰、咯血等症状及生命体征变化。发现异常,及时报告医师。 10(常规备用并熟悉各种抢救用物与药品。如氧气、心电监护仪、处颤仪、吸痰器、呼吸机和各种抢救药品。 11(做好患者的心理护理。 12(做好患者的出院指导:急救药的使用、出院带药的用法、膳食的基本原则、运动的强度及复诊。 第二节 循环系统疾病监护常规 1(按循环系统疾病一般护理常规护理。 2(向患者介绍监护的意义和仪器使用过程中的注意事项。 3(遵医嘱进行心电、血压、呼吸等监测,随时记录异常心电、血压、呼吸变化,必要时记录全导联心电图。及时准确地向医师报告病情动态。 4(及时记录患者病情变化。 5(针对不同病种分别执行其护理常规。 6(做好消毒隔离工作,预防医院感染。 第三节 心力衰竭护理常规 一、慢性心力衰竭 (一)、病因 1、长期心脏负荷过重 (1)前负荷过重:可由于二尖瓣关闭不全、主动脉瓣关闭不全、全身性血容量增多(甲状腺功能亢进、慢性贫血、妊娠)引起。 (2)后负荷过重:见于高血压、肺动脉高压、主动脉瓣狭窄等。 2、心肌损害 各种原发心血管疾病所致心力衰竭。 3、心室舒张充盈受限 如缩窄性心包炎、肥厚性心肌病。 (二)、临床表现 1、早期表现 初期可无症状,或仅出现心动过速、面色苍白、出汗、疲乏和活动耐量减低等。 2、左心衰竭 主要表现为肺循环淤血 (1)呼吸困难 最早出现的是劳力性呼吸困难,经休息后缓解;最典型的是阵发性夜间呼吸困难,严重者可发生急性肺水肿;晚期出现端坐呼吸。 (2)咳嗽 干咳或咳出大量带泡沫和血丝的痰。 (3)疲乏无力 心排出量减少,肌体供血不足,且组织缺氧,代谢废物堆积,股病人容易疲倦。 (4)发绀 主要为中心性发绀。 体征:左心室增大为主伴左心房扩大。心尖搏动增强且向左下移位。可有窦性心动过速、奔马律和交替脉。肺底部可问及湿性啰音,也可有干啰音和哮鸣音。 3、右心衰竭 主要表现为体循环淤血。 症状为食欲减退、恶心、呕吐、少尿、夜尿和肝区胀痛等。 体征: (1)水肿:早期在身体的下垂部位出现凹陷性水肿,重者以足背、内踝和胫前明显,长期卧床的病人以腰背部和骶尾部明显。严重的右心衰竭病人可出现全身水肿,并伴有胸腔积液、腹部和阴囊水肿。 (2)颈静脉怒张和肝颈静脉回流征阳性。 (3)肝脏肿大和压痛。 (4)发绀。 、全心衰竭 病人同时有左心衰竭和右心衰竭的表现。但当右心衰竭后,肺淤血的临4 床表现可减轻。 二、急性心力衰竭 (一)、病因 急性广泛心肌梗死、高血压急症、严重心律失常、输液过多过快等。 (二)临床表现 重度呼吸困难,频率30—40次/分,咳嗽、咯大量粉红色泡沫痰,病人常极度烦躁不安、大汗淋漓、口唇青紫、面色苍白,被迫采取坐位,两腿下垂,双臂支撑以助呼吸。查体可见心率和脉率增快,两肺布满湿罗音和哮鸣音,心尖区可闻及舒张期奔马律。 潜在并发症:心源性休克、呼吸道感染、下肢静脉血栓形成。 三、心力衰竭护理常规 1(按循环系统疾病一般护理常规护理。 2(患者急性期卧床休息,取舒适的半座、端坐卧位。缓解期鼓励患者做动态运动,重度心衰患者可在床边小坐,其他不同程度的心衰患者可每日多次步行,每次3~5分钟。 3(给予低盐、低脂饮食,重度心衰患者限制入水量。 4(遵医嘱严格控制输液速度。 5(遵医嘱记录患者24小时出入水量、尿量及尿相对密度。每日称体重以早期发现液体潴留。利尿过程中,注意低钾、低钠的表现。 6(根据患者病情给予持续低流量或高流量吸氧。 7(遵医嘱进行心电和生命体征监测。严密观察病情变化并做好记录。 8(患者急性肺水肿时,配合医师进行紧急抢救。 9(根据心衰的诱因,针对性地做好出院指导。 第四节 心律失常护理常规 心律失常 各种原因引起心脏冲动起源或冲动传导的异常导致心脏的节律和频率的改变,称为心律失常。 一、窦性心律失常 (一)窦性心动过速 成人窦性心律在100—150次/分(一般不超过160次),称窦性心动过速。大多属心理现象。常见原因为:吸烟、饮用含咖啡因的饮料、剧烈运动、情绪激动,在某些疾病时也可发生(发热、贫血、甲亢等)。其心电图特征为:窦性p波规律出现,频率>100次/分,p-p间期<0.6秒。大多不需要特殊治疗。 (二)窦性心动过缓 成人窦性心律<60次/分(一般为每分钟40—60次),称为窦性心动过缓。多位迷走神经张力增高所致,见于健康的青年人、运动员、老年人;病理情况下可见于颅内压增高、器质性心脏病、洋地黄过量、心肌炎等。其心电图特征为:窦性p波规律出现,频率<60次/分, p-p间期>1秒。窦性心动过缓一般无症状也不需要治疗;病理性心动过缓应针对病因采取相应治疗。 (三)窦性心律不齐 窦性心律在60—100次/分,快慢不规则称为窦性心律不齐。心电图特征为:窦性P波,p-p(或R-R)间期长短不一,相差>0.12秒以上。 二、期前收缩 (一)病因 期前收缩是异位起搏点兴奋性增高,过早发出冲动引起的心律失常。过度劳累、情绪激动、大量吸烟和饮酒、进食咖啡、器质性心脏病、电解质紊乱等可引起期前收缩,可偶尔出现或频繁出现。 (二)临床表现 偶发性期前收缩大多无症状,可有心悸或感到一次心跳加重或有心跳暂停感。频发期前收缩使心排出量降低,引起乏力、头晕、胸闷等。脉搏检查可有脉搏不齐、或脉搏短绌。 心电图主要特征: 1.房性期前收缩 提早出现P’波,其形态与窦性P波不同;P’-R间期?0.12秒,QRS波群形态与正常窦性心律的QRS波群相同,期前收缩后有不完全代偿间歇。 2(房室交界性期前收缩 QRS波群提前出现,其形态与窦性心律相同;QRS波群前或中或后有逆行的P’波(P’-R间期<0.12秒,R-P’间期<0.20秒),期前收缩后的代偿间歇大多完全。 3(室性期前收缩 QRS波群提前出现,形态宽大畸形,QRS时限>0.12秒,其前无相关的P波;T波常与QRS波群的主波方向相反;期前收缩后有完全代偿间歇。 三、阵发性心动过速 (一)病因 1(阵发性室上性心动过速 常见于无器质性心脏病的正常人,也可见于各种心脏病病人,如冠心病、高血压、风心病、甲亢、洋地黄中毒等病人。 2(阵发性室性心动过速 多见于器质性心脏病病人,如冠心病,特别是心肌梗死。 (二)临床表现 1(阵发性室上性心动过速 突发停止,持续数分钟至数小时或数天不等。发作时有心悸、胸闷、乏力、头痛等。心脏听诊心率快而规则,常达150—250次/分。心电图主要特征:连续3次或以上快而规则的房性或交界区性期前收缩(QRS波群形态正常),频率每分钟在150—250次,P波不易分辨。 2(阵发性室性心动过速 由于快速心率及心房、心室收缩不协调而导致心排出量降低,血流动力学明显障碍,心肌缺血,可出现呼吸困难、心绞痛、血压下降和晕厥。心脏听诊心率增快,心律可有轻度不齐,第一心音强弱不一。心电图主要特征:连续3次或以上室性期前收缩(QRS波群宽大畸形,>0.12秒,T波常与QRS波群主波方向相反),心室率100—250次/分,节律可略不规则。 四、颤动 (一)心房颤动 1(病因 常发生于器质性心脏病病人,如风湿性心瓣膜病、冠心病、高血压性心脏病、甲亢、心力衰竭、心肌病等。 2.临床表现 心室率不快者,病人仅有心悸、气促、心前区不适等;心室率极快者(>150次/分),可因心排出量降低而发生晕厥、急性肺水肿、心绞痛或休克。心脏听诊时心律绝对不规则、第一心音强弱不一致,脉搏亦快慢不均、强弱不等,发生脉搏短绌现象。持久性房颤,易形成左心房附壁血栓,若脱落可引起动脉栓塞。心电图主要特征:窦性P波消失,代之以大小形态及规律不一的基线波动(f波)。频率350—600次/分,QRS波群形态正常,R-R间期完全不规则,心室率极不规则,通常在100-160次/分。 (二)心室颤动 1(病因 常见于急性心肌梗死,洋地黄中毒、严重低血钾、心脏手术、电击伤等也可引起。 2(临床表现 室颤一旦发生,表现为意识丧失、发绀、抽搐,体检心音消失;脉搏触不到,继而呼吸停止,瞳孔散大甚至死亡。心电图改变:QRS波群与T波消失,呈形状、频率、振幅高低各异、完全无规则的波浪状曲线。 五、房室传导阻滞 (一)病因 多见于器质性心脏病,如冠心病、心肌炎、心肌病、原发性高血压、电解质紊乱、药物中毒等,偶见于迷走神经张力过高者。 (二)临床表现 1(第一度房室传导阻滞:多无自觉症状。心电图主要特征:P-R间期>0.20秒,无QRS波群脱落。 2(第二度房室传导阻滞:第二度?型(文氏型房室传导阻滞)病人常有心悸和心搏脱落感;第二度?型(莫氏?型)病人心室率较慢时,可有心悸、头晕、气急、乏力等症状,脉搏可不规则或慢而规则。心电图主要特征:文氏型房室传导阻滞的特征为:P-R间期逐渐延长,直至P波后QRS波群脱落,之后P-R间期又恢复以前时限,如此周而复始;莫氏?型的特征为P-R间期固定(正常或延长),每隔1、2或3个P波后有QRS波群脱落。 3(第三度房室传导阻滞:如心率30—50次/分,则病人心跳缓慢,脉率慢而规则,出现心力衰竭和脑供血不全表现,可有心悸、头昏、乏力的感觉,当心率<20次/分,可引起阿-斯综合征,甚至心跳暂停。心电图主要特征:心房和心室独立活动,P波与QRS波群完全脱离关系,P-P距离和R-R距离各自相等,心室率慢于心房率。 六、心律失常护理常规 1(按循环系统疾病一般护理常规护理。 (遵医嘱进行心电监测,即时记录异常图形,必要时记录全导联心电图。 2 3(患者出现恶性心律失常,如多发多源室性期前收缩、成对或连续出现的室性期前收缩、室性期前收缩落在前一个心搏的T波上(R-on-T)短暂性或持续性心动过速、严重心动过缓(心率<45次/分)、高度房室传导阻滞、窦性停搏等立即报告医师,并备好抢救药物和用物,及时进行抢救。 第五节 心脏瓣膜病护理常规 一、病因 1、风湿热引起的瓣膜病便,即风湿性心脏病,是链球菌感染后继发的自身免疫性疾病,主要引起瓣膜的进行性纤维化,增厚,甚至发生钙化。 2、感染性心内膜炎,常见于细菌和霉菌感染,主要引起瓣膜穿孔,撕裂,甚至毁损。 3、缺血性心脏病,多见于心肌梗塞后,由于瓣膜乳头肌缺血坏死,或发生断裂,导致二尖瓣关闭不全。 4、瓣膜退行性病变,多见于老年人,瓣膜发生纤维化,钙化的改变,近年有增加趋势。 5、先天性的瓣膜畸形,瓣膜的先天畸形多种多样,可以是缺如、狭窄、闭锁、裂缺等等。 6、 其它如肿瘤侵犯、外伤等也可以导致瓣膜病变。 二、常见临床类型临床表现 (一)二尖瓣狭窄 劳力性呼吸困难为最常出现的早起症状,伴有咳嗽、咯血,随着瓣膜口狭窄加重,出现阵发性夜间呼吸困难,严重时可致急性肺水肿,此时咳大量粉红色泡沫痰。因心律失常(尤其是房颤)可致心悸。因心功能减退,心排出量减少可致乏力、疲劳。右心衰竭时,可因肠道淤血和体循环淤血,出现食欲减退、腹胀、肝区疼痛、下肢浮肿。体检:在心尖区可触及舒张期震颤;心尖部可闻及舒张期隆隆样杂音是最重要的体征;心尖区第一心音亢进及二尖瓣开放拍击音;肺动脉瓣区第二心音亢进、分裂;此外,尚可出现面颊 紫红;口唇轻度发绀,称“二尖瓣面容”。 (二)二尖瓣关闭不全 轻者可无症状,较重者出现疲倦、心悸、劳力性呼吸困难等左心功能不全的表现,后期可出现右心功能不全的表现。体检:心尖区全收缩期粗糙吹风样杂音是最重要的体征;心尖搏动增强并向左下移位;第一心音减弱;肺动脉瓣区第二心音亢进。 (三)主动脉瓣关闭不全 早期因心排出量增加、病人常诉心悸,头部强烈震动感,亦可出现心绞痛,病情发展到最后可发生全心衰竭。体检:第二主动脉瓣区可听到舒张早期叹气样杂音,颈动脉搏动明显,脉压增大而产生周围血管征,如毛细血管搏动征、水冲脉、大动脉枪击音等。 (四)主动脉瓣狭窄 因左心室排出量显著降低,是冠状动脉及脑的血流量减少,可出现心绞痛、眩晕、昏厥甚至猝死。当左心功能不全时,出现疲乏、劳力性呼吸困难。体检:主动脉瓣区可听到响亮、粗糙的收缩期吹风样杂音是主动脉瓣狭窄最重要的体征,可向颈部传导。主动脉瓣区触及收缩期震颤。 (五)联合瓣膜病 同时具有两个或两个以上瓣膜受损时,称为联合瓣膜病,风湿性心瓣膜病以二尖瓣狭窄伴主动脉瓣关闭不全较常见。 三、心脏瓣膜病护理常规 1(按循环系统疾病一般护理常规护理。 2(患着风湿活跃或有心力衰竭时卧床休息。加强皮肤及关节的护理,注意保暖,防寒、防湿。 3(给患者高蛋白、高热量、丰富维生素易消化的饮食,心力衰竭合并水肿者限制钠盐和入水量。 4(指导患者正确服药(如:抗风湿、护胃制剂及肾上腺皮质激素等),观察其不良反应。 5(严密观察患者病情变化,观察呼吸困难、咳嗽、咯血、心绞痛等症状,注意有无脑、心、脾、肾、肠系膜和四肢的栓塞症状,发现异常及时报告医师。 6(出院时指导患者系统治疗及用药,预防感染 第六节 冠心病护理常规 一、心绞痛护理常规 (一)、病因 冠状动脉粥样硬化所致的冠脉管腔狭窄和痉挛是心绞痛发生的最主要原因。劳累、情绪激动、饱餐、受寒、急性循环衰竭是其发生的诱因。 (二)临床表现 1(症状 发作性胸痛或胸部不适是典型心绞痛的特点。 (1)疼痛部位:一胸骨体中段或上段之后常见,其次为心前区,可波及约手掌大小范围,可放射至左肩、左臂内侧,甚至可达左手无名指和小指,向上可放射至颈、咽部和下颌部。老年人疼痛部位可不典型。 (2)持续时间:躲在3—5分钟内,很少超过15分钟。 (3)疼痛性质:压迫性、发闷、紧缩性或烧灼感,病人可因疼痛而停止原来的活动。 (4)诱发因素:多于体力劳动时或情绪激动、饱餐、受冷、吸烟、心动过速等情况而诱发。 2(体征 发作是大多无特殊体征,或有面色苍白、冷汗、心率增快、暂时性血压升高等。疾病时心电图检查可见心肌缺血性改变ST段压低>0.1mV,T波低平或倒置,缓解期可无任何表现。 (三)心绞痛护理常规 1(按循环系统疾病一般护理常规护理。 2(给予患者低盐饮食。 3(心绞痛发作时或心电图提示心肌严重缺血或冠脉造影提示有严重狭窄时患者应卧床休息。 4(密切观察患者的疼痛部位、性质、持续时间、伴随症状、心电图的变化、面色、肢体温度及血压等。 5(了解心绞痛发作的诱因,以指导解除诱因、预防复发。 (指导患者随身携带和正确使用硝酸甘油等急救药品。 6 二、急性心肌梗死护理常规 (一)、病因 在冠状动脉严重狭窄的基础上,心肌需血量猛增或冠脉血供锐减,使心肌缺血达一小时以上,即可发生急性心肌梗死。 (二)临床表现 1.先兆表现 约半数病人发病数日或数周有新发生的心绞痛,或原有心绞痛发作频繁且程度加重、持续时间长、硝酸甘油效果不好,或有乏力、胸闷、心悸、发作时伴恶心、呕吐、大汗、血压波动、心律失常等症状。 2.主要表现 (1)疼痛:为最早出现、最突出的症状,其性质和部位与心绞痛相似,但程度更剧烈,难以忍受,伴有烦躁、大汗、恐惧、濒死感,多雾明显的诱因,疼痛可持续数小时或数天,经休息和含服硝酸甘油无效,多数病人症状不典型,疼痛可位于上腹部或颈背部,甚至无疼痛表现。 2)心源性休克:疼痛时血压可下降,如疼痛缓解时,收缩压<80mmHg,同时病人烦躁( 不安、面色苍白或青紫、皮肤湿冷、脉搏细速、尿量减少、反应迟钝,则为休克表现,常见于心肌梗死后数小时至一周内发生。 (3)心律失常:发生于75%—95%的病人,是急性心肌梗死病人死亡的主要原因。多发生于病后1—2天,而以24小时内发生率最高,也最危险。 (4)胃肠道症状:可有恶心、呕吐、上腹胀痛、严重者可有呃逆。 (5)发热:与发病24—48小时起有发热,体温38?左右,多在一周内恢复正常。 3.体征 心率增快或变慢,心尖部可闻及舒张期奔马律,心音减低,血压下降,有左心衰竭和休克的相应指针。 (三)急性心肌梗死护理常规 1(按循环系统疾病一般护理常规护理。 2(保持安静、舒适的环境,避免患者情绪波动及一切不良刺激。 3(患者绝对卧床休息1~3天,对病情不稳定及高危患者卧床时间适当延长。预防卧床并发症。 4(遵医嘱给予患者低脂、易消化的流质、半流质或软食,少食多餐。 5(预防便秘。 6(高流量吸氧。 7(严密监测患者生命体征和心电示波的变化,并做好记录。警惕心律失常、心源性休克、心力衰竭等并发症的发生。 8(建立静脉通道,保持给药途径通畅。遵医嘱给予镇静、止痛、扩血管、降低心肌耗氧量、抗心律失常、溶栓、抗凝等治疗。 9(遵医嘱记录24小时出入水量、尿量及尿相对密度。 10(病情平稳1~2周后,指导患者进行康复锻炼。 第七节 原发性高血压护理常规 一、病因 可能的发病因素有:遗传因素、年龄增大、脑力活动过度紧张、环境因素、摄入钠盐较多及体重超重等。 二、临床表现 (一)一般表现 头晕、头痛、耳鸣、眼花、乏力、失眠等,有时有心悸和心前区不适感。 (二)并发症 血压持续性升高,可导致脑、心、肾、眼底等靶器官受损的表现。 1.脑血管意外 长期血压升高使血管硬化,在此基础上可发生脑动脉血栓形成和微笑动脉瘤,血压骤然升高可引起破裂而致脑出血。 2.心力衰竭 长期血压升高使左心室后负荷加重,心肌肥厚与扩大,逐渐进展可出现心力衰竭。长期血压升高有利于动脉粥样硬化的形成而发生冠心病。 3(肾衰竭 长期血压升高使肾小动脉硬化,肾实质缺血。可出现蛋白尿、肾功能损害。 4,视网膜改变 视网膜动脉狭窄、出血、渗出。 5.血管疾病 夹层动脉瘤、症状性动脉疾病。 三、原发性高血压护理常规 1(按循环系统疾病一般护理常规护理。 2(给予低盐、低脂饮食,肥胖者限制热量。多摄入含钾、钙的食物。 3(监测血压,掌握血压波动的特点及用药后血压的变化。密切观察患者病情变化,若出现高血压急进重危的表现,及时配合医师紧急处理。 4(高血压病出现心、脑、肾、血管并发症时按相应的护理常规护理。 5(出院指导:稳定的情绪、规律的生活、饮食指导、用药指导、定期复查。 第八节 病毒性心肌炎护理常规 一、 病因 病因以引起肠道和呼吸道感染的各种病毒最常见,如:柯萨奇病毒A和B、埃可病毒、脊髓灰质炎病毒、流感和疱疹病毒,尤其是柯萨奇病毒B。病毒直接侵犯心肌,造成心肌细胞溶解。免疫反应同时存在,在病变的晚期,免疫反应成为造成心肌损伤的主要因素。 二、 临床表现 1.病前1—4周有呼吸道或胃肠道感染病史,轻者可无症状,多数病人疲乏、胸闷、心悸、心前区隐痛等心肌受累表现,与体温不成正比的心动过速等;重症者可发生严重心率失常、心力衰竭、心源性休克,甚至猝死。 2.有关检查 心脏扩大,第一心音低钝,心尖区可闻及舒张期奔马律,有交替脉。血清心肌酶增高,病毒中和抗体效价测定恢复期较急性期增高4倍。 三、病毒性心肌炎护理常规 1(按循环系统疾病一般护理常规护理。 2(指导患者注意身心休息,预防呼吸道感染。 3(给予患者高蛋白、高维生素、易消化饮食,避免过饱。 4(遵医嘱及时准确的给药,观察用药后的效果及副作用。 5(严密观察患者病情变化,出现心力衰竭或心律失常时按相应护理常规护理。 6(指导患者避免精神紧张和剧烈运动,注意劳逸结合,可进行适量体育锻炼,提高和增强机体抗病能力。 第九节 心肌疾病护理常规 一、扩张型心肌病 (一)病因 病因尚不完全清楚,除家族遗传因素外、近年认为病毒感染是其重要原因。此外,酒精中毒、抗肿瘤药物、代谢异常等因素亦可引起本病。 (二)临床表现 起病缓慢,早起病人可有心脏扩大,但多无明显症状。当病人有明显气急甚至端坐呼吸、浮肿、肝大等充血性心力衰竭的表现时才被诊断。常合并各种心律失常如期前收缩、心房颤动、传导阻滞等,晚期病人常发生室速甚至室颤,可导致猝死。此外,可见心、脑、肾等器官的栓塞现象。主要体征为心浊音界向两侧扩大及左、右心衰竭的体征。75%的病人可听到第三或第四心音奔马律。 二、肥厚型心肌病 (一)病因 约1/3有明显家族史,常染色体显性遗传病。 (二)临床表现 部分病人可无完全自觉症状,茵猝死或在体检中才被发现。非梗阻性肥厚型心肌病的病人的临床表现类似扩张型心肌病。梗阻性肥厚性心肌病病人可有劳累性呼吸困难、心悸、乏力、头晕、晕厥、甚至猝死。突然站立、运动、应用硝酸脂类药物等均可使外周阻力降低,加重左心室流出道梗阻,结果导致上述症状加重。部分病人茵肥厚性心肌病耗氧增多而致心绞痛,但用硝酸甘油和休息多不能缓解。主要体征有心脏轻度增大。部分病人可在胸骨左缘或心尖部听到收缩中、晚期粗糙的吹风样杂音,屏气、剧烈运动、含服硝酸甘油时,此杂音可增强。心尖部可闻及第四心音。 三、心肌疾病护理常规 1(按循环系统疾病一般护理常规护理。 (指导患者注意身心休息,预防呼吸道感染。 2 3(给予患者易消化饮食,避免过饱。 4(使用洋地黄类药物时,特别注意有无洋地黄中毒表现。 5(严密观察患者病情变化,出现心力衰竭或心律失常时按相应护理常规护理。 6(指导患者避免精神紧张和剧烈运动,以防猝死。 第十节 感染性心内膜炎护理常规 一、亚急性感染性心内膜炎 (一)病因 主要发生于器质性心脏病,首先为风湿性心瓣膜病(尤其是二尖瓣和主动脉瓣关闭不全),其次为先天性心血管病如室间隔缺损、动脉导管未闭、法洛四联症和主动脉夹层等。此外,心脏手术、心脏有创检查术后感染心内膜炎比例上升。 (二)临床表现 1(全身性感染的表现 起病隐匿,可有全身不适、乏力、食欲不振、面色苍白、体重减轻等非特异性症状。弛张性低热,体温多在37.5—39?之间,午后和晚上较高,伴寒战和盗汗。头痛、背痛、肌肉关节痛亦常见。 2.心脏受累表现 绝大多数(60%)病人有病理性杂音,杂音性质的改变仍为本病特征性表现,与赘生物的生长和分裂、脱落有关,但并不多见。腱索断裂或瓣叶穿孔是迅速出现新杂音的重要因素。主要的并发症是充血性心力衰竭。 3.周围体征 多为非特异性,包括瘀点、指(趾)甲下出血,Osler结节、Janeways结节、杵状指(趾) 4(栓塞 多见于病程后期,但在约1/3的病人中是首发症状。 5.其他 贫血较为常见。 二、急性感染性心内膜炎 (一)病因 主要由金黄色葡萄球菌引起,少数有肺炎球菌、淋球菌、A族链球菌和流 感杆菌所致。病原菌多来自皮肤、肌肉或肺等部位的活动性感染灶,细菌量大,毒力强,具有高度侵袭性和粘附于内膜的能力,故病程短,未经治疗的急性病人几乎均在4周内死亡。 (二)临床表现 常有急性化脓性感染、近期手术、外伤、产褥热、器械检查史。呈爆发性败血症过程,起病急骤,进展迅速,有高热、寒战、呼吸急促等毒血症症状,常述头痛、背痛、肌肉关节痛。突发心力衰竭常见,心脏原无杂音,起病后可出现杂音,或原有杂音轻,二发病后短期内杂音性质迅速变为高调粗糙。 三、感染性心内膜炎护理常规 1(按循环系统疾病一般护理常规护理。 2(给患者高蛋白、高热量、丰富维生素易消化的饮食。 3(遵医嘱正确采集血标本,在使用抗生素前连续3次采集血标本或高热时采集血标本做培养和药敏试验。合理使用抗生素。 4(严密监测患者生命体征和贫血情况,注意有无脑、心、脾、肾、肠系膜和四肢的栓塞症状,发现异常及时报告医师。 5(高热者按高热护理常规护理。 第十一节 心包炎护理常规 一、急性心包炎 (一)病因 1(感染性 有病毒、细菌(如结核杆菌)、真菌、寄生虫、立克次体等感染引起。 2.非感染性 常见的有急性非特异性心包炎,自身免疫性(如风湿热、系统性红斑狼疮、类风湿关节炎)、肿瘤性、内分泌及代谢性(如尿毒症、通风)心包炎,心肌梗死后综合症,外伤性、放射性心包炎等。 (二)临床表现 症状 急性心包炎常见症状为心前区痛和呼吸困难。 1. (1)心前区痛 多见于急性非特异性心包炎和感染性心包炎,缓慢进展的结核性或肿瘤性心包炎疼痛可能不明显。疼痛可位于心前区,性质呈尖锐性,与呼吸运动有关,常因咳嗽、深呼吸或变换体位而加重;疼痛也可为压榨痛,位于胸骨后。 (2)呼吸困难 是渗液性心包炎最突出的症状,可能与肺、之气管受压或肺淤血有关。严重时可有端坐呼吸,伴身体前倾、呼吸浅快、面色苍白、发绀等。也可因压迫气管、食管二产生干咳、嘶哑、吞咽困难等。 (3)其他症状 如发热、出汗、乏力、烦躁不安等。 2.纤维蛋白性心包炎体征 心包摩擦音是纤维蛋白性心包炎的典型体征。 3.渗液性心包炎体征 心尖搏动减弱或消失;心浊音界向两侧扩大,皆为绝对浊音区;心率快,心音低而遥远。大量心包积液可使收缩压下降,二舒张压变化不大,股脉压减小;可累及静脉回流,出现颈静脉怒张、肝大、水肿及腹水等。 4.心脏压塞 急性心脏压塞表现为急性循环衰竭、休克等。如积液积聚较慢,可出现亚急性或慢性心脏压塞,表现为体循环淤血、奇脉等。 二、收窄性心包炎 (一)病因 在我国,仍以结核性心包炎最常见,其次为非特异性心包炎,少数为化脓性心包炎、肿瘤性心包炎、外伤性心包炎等。 (二)临床表现 起病缓慢,心包缩窄的表现多于急性心包炎后1年内形成,少数可长达数年。 1(症状 早期为劳累后呼吸困难,随着腹水的出现及增加,或合并胸腔积液时,休息时也可出现呼吸困难,甚至出现端坐呼吸。由于静脉淤血,可有上腹胀满或疼痛、食欲不振 等。 2(体征 心浊音界正常或稍增大,心尖搏动减弱或消失,心率快、心音减低,可触及奇脉。约有半数病人可在胸骨左缘第3—4肋间听到心包叩击音。此外心脏受压的表现有颈静脉怒张、肝大、腹水、胸腔积液、下肢浮肿等体征。 三、心包炎护理常规 1(按循环系统疾病护理常规护理。 (给患者高蛋白、高热量、丰富维生素易消化的饮食,水肿者限制钠盐摄入。 2 3(遵医嘱测量体重、腹围与下肢周径,记录出入水量。 4(密切观察患者有无心包填塞症状(如:面色苍白、发绀、脉搏快或出现奇脉,呼吸急促,颈静脉怒张,动脉压下降,脉压差变小,心音遥远或减弱等),备好心包穿刺用物。 5(心包穿刺后患者卧床休息,注意血压、脉搏的变化。 第十二节 主动脉夹层护理常规 一、 病因 主动脉夹层动脉瘤, 是指主动脉壁内不规则的剥离病变, 主动脉腔内血液通过内膜的破口进入动脉中层而形成的血肿。一是主动脉滋养血管压力升高,破裂出血导致主动脉内层分离;二是由于主动脉内压升高,特别是老年人的主动脉弹性低,内膜破裂,血液从破入口进入,使内膜分裂、积血而成血肿。 多见于40,70岁的中老年人,约有70%的病人有高血压病史。此外,动脉粥样硬化,结缔组织遗传性疾病,妊娠,严重外伤和重体力劳动也是常见原因。 二、临床表现 主要取决于病变范围、累及主动脉分支的程度以及是否合并主动脉瓣关闭不全和向外溃破及其部位。 (1)胸痛 90%病人首发症状为突然发生的、持续性、进行性加重的剧烈胸痛,呈刺痛、撕裂样或刀割样疼痛,病人往往不能忍受,此时大汗淋漓,含服硝酸甘油无效。心电图检查排除急性心肌梗塞。 (2)休克 病人出现面色苍白,大汗,精神紧张或晕厥,四肢末端湿冷,但血压多能维持高血压范围或略有下降,这时多见于夹层血肿破溃到空腔脏器中。 (3)胃肠道症状 若夹层波及主动脉远端,病人可有腹痛,呕吐,呕血及便血。系夹层血肿压迫肠系膜动脉引起缺血性结肠炎所致。 (4)精神神经系统症状 若血肿累及颈动脉或无名动脉开口处,可表现一时性脑缺血,甚至脑卒中。 (5)肢体无脉或脉搏减弱 此系血肿累及无名动脉或左锁骨下动脉,或髂总动脉并压迫其开口处所致。 (6)其他 血肿压迫临近脏器而出现相应器官受压的症状,如声音嘶哑、呼吸困难、咯血、哮喘等。如果血肿发生在主动脉的近端,可引起主动脉瓣的相对关闭不全,胸骨左缘第二肋间可闻及舒张期杂音。有时主动脉夹层血肿向脏器溃破可出现心包积液、胸腔积液等。 三、主动脉夹层护理常规 1(按循环系统疾病护理常规护理。 2. 注意卧床休息,易低脂低盐,高维生素及富含纤维素,多饮水, 保证大便通畅,需要时口服缓泻剂,防止用力排便、强烈咳嗽等。 3.密切观察病情变化 ,注意心率、血压变化及疼痛的部位,程度等 4.加强心理护理 ,减轻恐惧感,使病人配合治疗 5.手术护理见主动脉术后护理常规 第十三节 心血管介入性诊疗护理常规 一、经皮穿刺球囊二尖瓣成形术护理常规 1. 按循环系统疾病护理常规护理。 2. 术前需训练床上排尿,备皮、碘过敏试验,术前2小时禁食、禁饮,但不禁药。 3. 术后股静脉穿刺部位按压10分钟,以彻底止血,加压包扎,术肢制动12小时,卧床休息24小时。 4.注意观察穿刺部位有无出血、血肿、及足背动脉搏动情况,观察心率、血压及心电图变化。 二、心导管射频消融术的护理常规 1. 按循环系统疾病护理常规护理。 2. 术前需训练床上排尿,备皮、碘过敏试验,术前2小时禁食、禁饮,但不禁药。 3. 术后股动脉穿刺部位按压15-20分钟,以彻底止血,加压包扎,沙袋压迫6小时,术肢制动12小时,卧床休息24小时。静脉穿刺部位压迫止血10分钟,可不压沙袋。 4.注意观察穿刺部位有无出血、血肿、及足背动脉搏动情况,观察心率、血压及心电图变化。 三、冠状动脉造影术的护理常规 1(按循环系统疾病护理常规护理。 2(术前需训练床上排尿及连续咳嗽动作,备皮、碘过敏试验,术前2小时禁食、禁饮,但不禁药。 3.术后股动脉穿刺部位按压15-20分钟,以彻底止血,加压包扎,沙袋压迫6小时,术肢制动12小时,卧床休息24小时。嘱患者多饮水,以利造影剂的排出。 4.注意观察穿刺部位有无出血、血肿、及足背动脉搏动情况,观察心率、血压及心电图变化。 四、经皮穿刺冠状动脉支架植入术的护理常规 1. 按循环系统疾病护理常规护理。 2.对患者进行全身情况的评价,遵医嘱指导口服抗凝剂。 3. 术前需训练床上排尿及连续咳嗽动作,备皮、碘过敏试验,术前2小时禁食、禁饮,但不禁药。 4.术后有专人护送至病房,立即行心电监护、测血压、记录全程心电图;并询问患者有无不适或胸痛,出现异常及时处理,备好抢救药品。 5(检查双侧足背动脉搏动情况及鞘管留置部位有无出血、渗血,及时更换敷料,重新包扎。 6. 术后股动脉穿刺部位按压15-20分钟,以彻底止血,加压包扎,沙袋压迫6小时,术肢制动12小时,卧床休息24小时。嘱患者多饮水,以利造影剂的排出。 7.拔管时可由于疼痛刺激,使迷走神经张力增加,造成心动过缓、血压下降,患者出现恶心、呕吐症状,严重时可出现晕厥。一旦出现迷走神经反射现象,遵医嘱及时给以处理。 五、先心病介入术的护理常规 1. 按循环系统疾病护理常规护理。 2(术前需训练床上排尿及连续咳嗽动作,备皮、碘过敏试验,术前2小时禁食、禁饮,小儿全麻的禁食12小时,禁饮8小时。 3. 术后股动脉穿刺部位按压15-20分钟,以彻底止血,加压包扎,沙袋压迫6小时,术肢制动12小时,卧床休息24小时。 4.注意观察穿刺部位有无出血、血肿、及足背动脉搏动情况,观察心率、血压及心电图 变化。 六、人工心脏起搏器的护理常规 1. 按循环系统疾病护理常规护理。 2.术前准备及配合:向病人解释,常规备皮,开放静脉通道。按医嘱注射镇静剂,备好抢救药物及仪器设备。 3.术后护理 1)持续24小时心电监护:重点观察心率、心律,有无不起搏、不感知等现象。 2)平卧24小时,禁止术侧卧位,术侧上肢制动72小时。 3)沙袋压迫4-6小时,观察伤口渗血情况和炎症征象。遵医嘱给与抗生素,更换敷料,观察体温变化。 4)术后第四天开始协助并鼓励病人做术侧肩部活动,防止肩关节僵硬。 4(健康宣教:教会病人数脉搏、起搏器故障的识别、电池耗尽的表现等。定期返院复查。避免到有磁场的场所。 七、主动脉夹层术后的护理常规 1. 按循环系统疾病护理常规护理。 2(术前需训练床上排尿及连续咳嗽动作,备皮、碘过敏试验,禁食12小时,禁饮8小时。 3. 术后股动脉穿刺部位按压15-20分钟,以彻底止血,加压包扎,沙袋压迫6小时,术肢制动12小时。6-12小时后方可进食,24小时后可下床。 4.控制收缩压于100-130mmHg。 5. 4.注意观察切口渗血和穿刺部位有无出血、血肿及足背动脉搏动情况,观察心率、血压及心电图变化。 (英文版 ) Two regulations promulgated for implementation is in the party in power for a long time and the rule of law conditions, the implementation of comprehensive strictly strategic plan, implementation in accordance with the rules and discipline to manage the party, strengthen inner-party supervision of major initiatives. The two regulations supporting each other, the < code > adhere to a positive advocate, focusing on morality is of Party members and Party leading cadres can see, enough to get a high standard; < rule > around the party discipline, disciplinary ruler requirements, listed as "negative list, focusing on vertical gauge, draw the party organizations and Party members do not touch the" bottom line ". Here, the main from four square face two party rules of interpretation: the first part introduces two party Revised regulations the necessity and the revision process; the second part is the interpretation of the two fundamental principles of the revision of laws and regulations in the party; the third part introduces two party regulations modified the main changes and needs to grasp several key problems; the fourth part on how to grasp the implementation of the two regulations of the party. < code > and < Regulations > revised the necessity and revised history of the CPC Central Committee the amendment to the Chinese Communist Party members and leading cadres honest politics several guidelines > and < Chinese Communist Party discipline and Punishment Regulations > column 1 by 2015 to strengthen party laws and regulations focus. Two party regulations revision work lasted a Years, pooling the wisdom of the whole party, ideological consensus, draw historical experience, respect for the wisdom of our predecessors, which reflects the unity of inheritance and innovation; follow the correct direction, grasp the limited goals, adhere to the party's leadership, to solve the masses of the people reflect a focus on the problem. The new revision of the < code > and < rule >, reflects the party's 18 and the eighth session of the third, the spirit of the fourth plenary session, reflecting the experience of studying and implementing the General Secretary Xi Jinping series of important speech, reflects the party's eighteen years comprehensive strictly practice. (a) revised two regulations of the party need of < the ICAC guidelines > in < in 1997 Leaders as members of the Communist Party of China clean politics certain criteria (Trial) > based on revised, the promulgation and implementation of January 2010, to strengthen the construction of the contingent of leading cadres play an important role. But with the party to manage the party strictly administering the deepening, has not been able to fully meet the actual needs. Content is too complicated, "eight prohibition, 52 are not allowed to" hard to remember, and also difficult to put into practice; the second is concisely positive advocated by the lack of prohibited provisions excessive, no autonomy requirements; the third is banned terms and discipline law, both with the party discipline, disciplinary regulations repeat and Criminal law and other laws and regulations repeat; the fourth is to "clean" the theme is not prominent, not for the existing problems, and is narrow, only needle of county-level leading cadres above. < rule > is in 1997 < Chinese Communist Party disciplinary cases (Trial) > based on revision, in December 2003 the promulgation and implementation, to strengthen the construction of the party play very important role. Along with the development of the situation, which many provisions have been unable to fully meet the comprehensive strictly administering the practice needs. One is Ji law, more than half of the provisions and criminal law and other countries laws and regulations Repetition; two is the political discipline regulations is not prominent, not specific, for violation of the party constitution, damage the authority of Party Constitution of misconduct lack necessary and serious responsibility to pursue; third is the main discipline for the leading cadres, does not cover all Party members. Based on the above situation, need to < the criterion of a clean and honest administration > and < rule > the two is likely to be more relevant regulations first amendment. By revising, really put the authority of Party discipline, the seriousness in the party tree and call up the majority of Party members and cadres of the party constitution of party compasses party consciousness. (II) two party regulations revision process the Central Committee of the Communist Party of China attaches great importance to two regulations revision . Xi Jinping, general books recorded in the Fifth Plenary Session of the eighth session of the Central Commission for Discipline Inspection, on the revised regulations < > made clear instructions. According to the central deployment, the Central Commission for Discipline Inspection from 2014 under six months begin study two regulations revision. The Standing Committee of the Central Commission for Discipline Inspection 4 review revised. Comrade Wang Qishan 14 times held a special meeting to study two regulations revision, amendment clarifies the direction, major issues of principle, path and target, respectively held a forum will listen to part of the province (area) secretary of the Party committee, Secretary of the Discipline Inspection Commission, part of the central ministries and state organs Department The first party committee is mainly responsible for people, views of experts and scholars and grassroots party organizations and Party members. Approved by the Central Committee of the Communist Party of China, on 7 September 2015, the general office of the Central Committee of the Party issued a notice to solicit the provinces (autonomous regions, municipalities) Party, the central ministries and commissions, state ministries and commissions of the Party (party), the General Political Department of the military, every 3 people organization of Party of two regulations revision opinion. Central Commission for Discipline Inspection of extensive solicitation of opinions, careful study, attracting, formed a revised sent reviewers. In October 8 and October 12, Central Committee Political Bureau Standing Committee and the Political Bureau of the Central Committee After consideration of the two regulations revised draft. On October 18, the Central Committee of the Communist Party of China formally issued two regulations. Can say, two laws amendment concentrated the wisdom of the whole party, embodies the party. Second, < code > and < Regulations > revision of the basic principles of two party regulations revision work and implement the party's eighteen, ten eight plenary, the spirit of the Fourth Plenary Session of the Eleventh Central Committee and General Secretary Xi Jinping important instructions on the revised < low political criterion > and < Regulations >, highlighting the ruling party characteristics, serious discipline, the discipline quite in front of the law, based on the current, a long-term, advance as a whole, with Bu Xiuding independent < rule > and < rule >. Main principle is: first, adhere to the party constitution to follow. The constitution about discipline and self-discipline required specific, awaken the party constitution of party compasses party consciousness, maintaining the authority of the constitution. General Secretary Xi Jinping pointed out that "no rules, no side round. Party constitution is the fundamental law, the party must follow the general rules. In early 2015 held the eighth session of the Central Commission for Discipline Inspection Fifth Plenary Session of the 16th Central Committee, Xi Jinping again pointed out that constitution is the party must follow the general rules, but also the general rules." the revision of the < code > and < rule > is Method in adhere to the regulations established for the purpose of combining rule of virtue is to adhere to the party constitution as a fundamental to follow, the constitution authority set up, wake up the party constitution and party rules the sense of discipline, the party constitution about discipline and self-discipline specific requirements. 4 second is to adhere to in accordance with the regulations governing the party and the party. The Party of rule of virtue "de", mainly refers to the party's ideals and beliefs, excellent traditional style. The revised the < code > closely linked to the "self-discipline", insisting on the positive initiative, for all members, highlight the "vital few", emphasized self-discipline, focusing on the morality, and the majority of Party members and the ideological and moral standards. The revised < > Ji method separately, Ji, Ji Yan to Method, as a "negative list", emphasizing the heteronomy, focusing on vertical gauge. Is this one high and one low, a positive reaction, the strict party discipline and practice results transformation for the integration of the whole party to observe moral and discipline requirements, for the majority of Party members and cadres provides benchmarking and ruler. Third, insist on to. In view of the problems existing in the party at the present stage, the main problems of Party members and cadres in the aspect of self-discipline and abide by the discipline to make clearly defined, especially the party's eighteen years strict political discipline and political rules, organization and discipline and to implement the central eight provisions of the spirit against the four winds and other requirements into Disciplinary provisions. Not one pace reachs the designated position, focusing on in line with reality, pragmatic and effective. After the revision of major changes, major changes in the < code > and < rule > modified and needs to grasp several key problems (a) < code > < code > adhere to according to regulations governing the party and party with morals in combination, for at the present stage, the leadership of the party members and cadres and Party members in existing main problems of self-discipline, put forward principles, requirements and specifications, showing Communists noble moral pursuit, reflected at all times and in all over the world ethics from high from low 5 common requirements. One is closely linked to the "self-discipline", removal and no direct relation to the provisions of . the second is adhere to a positive advocate, "eight prohibition" 52 are not allowed to "about the content of the" negative list moved into synchronization amendment < cases >. Three is for all the party members, will apply object from the leadership of the party members and cadres to expand to all Party members, fully embodies the comprehensive strictly required. The fourth is prominent key minority, seize the leadership of the party members and cadres is the key, and put forward higher requirements than the ordinary Party members. Five is to simplify, and strive to achieve concise, easy to understand, easy to remember. The revised < code > is the ruling Party since the first insists on a positive advocate forAll Party members and the self-discipline norms, moral declaration issued to all members of the party and the National People's solemn commitment. > < criterion of a clean and honest administration consists of 4 parts, 18, more than 3600 words. After the revision of the < code >, a total of eight, 281 words, including lead, specification and Party member cadre clean fingered self-discipline norms, etc. Part 3 members low-cost clean and self-discipline, the main contents can be summarized as "four must" "eight code". Lead part, reiterated on ideal and faith, fundamental purpose, the fine traditions and work style, noble sentiments, such as "four must" the principle of requirements, strong tone of self-discipline, The higher request for 6 and supervised tenet, the foothold in permanent Bao the party's advanced nature and purity, to reflect the revised standards requirements. Members of self-discipline norms around the party members how to correctly treat and deal with the "public and private", "cheap and rot" thrifty and extravagance "bitter music", put forward the "four norms". Party leader cadre clean fingered self-discipline norms for the leadership of the party members and cadres of the "vital few", around the "clean politics", from civil servant of the color, the exercise of power, moral integrity, a good family tradition and other aspects of the leadership of the party members and cadres of the "four norms" < > < norm norm. "The Party member's self-discipline norms" and "party members and leading cadre clean fingered self-discipline norms," a total of eight, collectively referred to as the "eight". "Four must" and "eight" of the content from the party constitution and Party's several generation of leaders, especially Xi Jinping, general secretary of the important discussion, refer to the "three discipline and eight points for attention" statements, and reference some embody the Chinese nation excellent traditional culture essence of epigrams. (2) the revised regulations, the main changes in the revised Regulations > to fully adapt to the strictly requirements, reflects the according to the regulations governing the law of recognition of deepening, the realization of the discipline construction and Jin Ju. < rule > is party a ruler, members of the basic line and follow. And the majority of Party members and cadres of Party organizations at all levels should adhere to the bottom line of thinking, fear discipline, hold the bottom line, as a preventive measure, to keep the party's advanced nature and purity. 1, respect for the constitution, refinement and discipline. Revised < rule > from comprehensive comb physical constitution began, the party constitution and other regulations of the Party of Party organizations and Party discipline requirements refinement, clearly defined in violation of the party constitution will be in accordance with regulations to give the corresponding disciplinary action. The original 10 categories of misconduct, integration specification for political discipline, discipline, honesty and discipline masses Ji Law and discipline and discipline and other six categories, the content of < rule > real return to Party discipline, for the majority of Party members and listed a "negative list. 7 2, highlighting the political discipline and political rules. > < Regulations according to the stage of the discipline of outstanding performance, emphasizing political discipline and political rules, organization and discipline, in opposition to the party's leadership and the party's basic theory, basic line, basic program and basic experience, the basic requirement of behavior made prescribed punishment, increase the cliques, against the organization such as violation of the provisions, to ensure that the central government decrees and the Party of centralized and unified. 3, adhere to strict discipline in the law and discipline In front, Ji separated. Revised < Regulations > adhere to the problem oriented, do Ji separated. Any national law existing content, will not repeat the provisions, the total removal of 79 and criminal law, repeat the content of the public security management punishment law, and other laws and regulations. In the general reiterated that party organizations and Party members must conscientiously accept the party's discipline, die van comply with national laws and regulations; at the same time, to investigate violations of Party members and even criminal behavior of Party discipline and responsibility, > < Regulations distinguish five different conditions, with special provisions were made provisions, so as to realize the connection of Party discipline and state law. 4, reflect Wind building and anti-corruption struggle of the latest achievements. < rule > the party's eighteen years implement the spirit of the central provisions of the eight, against the requirements of the "four winds" and transformation for disciplinary provisions, reflecting the style construction is always on the road, not a gust of wind. In the fight against corruption out of new problems, increase the trading rights, the use of authority relatives profit and other disciplinary terms. Prominent discipline of the masses, the new against the interests of the masses and ignore the demands of the masses and other disciplinary terms and make provisions of the disposition and the destruction of the party's close ties with the masses. Discipline to protect the party's purpose. 8 of these regulations, a total of three series, Chapter 15, 178, more than 24000 words, after the revision of the regulations a total of 3 series, Chapter 11, 133, 17000 words, divided into "general" and "special provisions" and "Supplementary Provisions" Part 3. Among them, add, delete, modify the provisions of the proportion of up to nearly 90%. 1, the general general is divided into five chapters. The first chapter to the regulations of the guiding ideology, principles and scope of application of the provisions, highlight the strengthening of the party constitution consciousness, maintenance the authority of Party Constitution, increase the party organizations and Party members must abide by the party constitution, Yan Centralized centralized, would examine at all levels of the amended provisions implementing and maintaining Party discipline, and consciously accept the party discipline, exemplary compliance with national laws and regulations. The second chapter of discipline concept, disciplinary action types and effects of the regulations, will be a serious warning from the original a year for a year and a half; increase the Party Congress representative, by leaving the party above (including leave probation) punishment, the party organization should be terminated its representative qualification provisions. The third chapter of the disciplinary rules of use prescribed in the discipline rectifying process, non convergence, not close hand classified as severely or heavier punishment. "Discipline straighten "At least eighteen years of five years, these five years is to pay close attention to the provisions of the central eight implementation and anti -" four winds ". The fourth chapter on suspicion of illegal party disciplinary distinguish five different conditions, with special provisions were made provisions, to achieve effective convergence of Party and country 9 method. < rule > the provisions of Article 27, Party organizations in the disciplinary review found that party members have committed embezzlement, bribery, dereliction of duty dereliction of duty and other criminal law act is suspected of committing a crime shall give cancel party posts, probation or expelled from the party. The second is < Regulations > Article 28 the provisions of Party organizations in the disciplinary review But found that party members are stipulated in the criminal law, although not involved in a crime shall be investigated for Party discipline and responsibility should be depending on the specific circumstances shall be given a warning until expelled punishment. This situation and a difference is that the former regulation behavior has been suspected of a crime, the feeling is quite strict, and the latter for the behavior not involving crime, only the objective performance of the provisions of the criminal code of behavior, but the plot is a crime to slightly. < Regulations > the 29 provisions, Party organizations in the discipline review found that party members and other illegal behavior, affect the party's image, the damage to the party, the state and the people's interests, we should depend on the situation Seriousness given disciplinary action. The loss of Party members, seriously damaging the party's image of behavior, should be given expelled from the party. At this article is party member is in violation of the criminal law outside the other illegal acts, such as violates the public security administration punishment law, customs law, financial laws and regulations behavior. The fourth is < cases > Article 32 stipulates, minor party members and the circumstances of the crime, the people's Procuratorate shall make a decision not to initiate a prosecution, or the people's court shall make a conviction and exempted from criminal punishment shall be given within the party is removed from his post, probation or expelled from the party. Party members and crime, sheets were fined in accordance with For acts; the principal Ordinance amended the provisions of the preceding paragraph. This is the new content, in order to achieve Ji method effective convergence. Five is < > the thirty third article 10 of the provisions, the Party member due to an intentional crime is sentenced to criminal law (including probation) sheets or additional deprivation of political rights; due to negligence crime and was sentenced to three years or more (excluding three years) a penalty, shall give expelled punishment. Due to negligence crime is convicted and sentenced to three years (including three years) in prison or be sentenced to public surveillance, detention, shall in general be expelled from the party. For the individual may not be expelled from the party, should control Approval. This is followed and retained the original > < Regulations the provisions of punishment party authorization rules and report to a level party organizations. For is "party members with criminal acts, and by the criminal punishment, generally should be expelled from the party". The fifth chapter of probationary Party member of the discipline and discipline after missing members of the treatment and punishment decisions, such as the implementation of the provisions, clear the related party discipline and punishment decision made after, for duties, wages and other relevant alteration formalities for the longest time. 2, sub sub section will the original regulations of 10 categories of acts of violation of discipline integration revised into 6 categories, respectively, in violation of the punishments for acts of political discipline "in violation of discipline behavior of punishment" in violation of integrity of disciplinary action points "of violation punishments for acts of mass discipline" "the violation of work discipline, punishment" in violation of discipline of life behavior punishment "6 chapters. 3, annex" Supplementary Provisions "clear authority making supplementary provisions of, cases of interpretative organ, as well as regulations implementation time and retroactivity etc.. 11 (3) learning understanding > < regulations needs to grasp several key problems The first problem -- about the violation of political discipline behavior > < new ordinance chapter 6 the political discipline column for the six disciplines, that is the main opposition to Party leadership and the opposition of the basic theory, basic line, basic program and basic experience, basic requirements of misconduct made provisions of the disposition, especially the eighteen since the CPC Central Committee put forward the Yan Mingzheng treatment of discipline and political rules requirements and practical achievements transformation for Discipline article, increase the false debate central policies, cliques, against the organization review, make no discipline of the principle of harmony terms. These are the party's eighteen years in comprehensive strictly Process combined with the practice of rich content. (1) false debate the central policies and undermine the Party of centralized and unified the problem is made in accordance with the provisions of the party constitution. Constitution in general programme requirements adhere to democratic centralism is one of the requirements of the construction of the party must adhere to the four cardinal. Application of this principle is not only the party the basic organization principle and is also the mass line in party life, it requires that we must fully develop inner-party democracy, respect for the dominant position of Party members, safeguarding the Party member democratic rights, give full play to the enthusiasm and creativity of the party organizations at all levels and Party members, at the same time, also must implement the right concentration, ensure the party's mission < the chaos in unity and concerted action to ensure that the party's decision to get quickly and effectively implementing. The Party Central Committee formulated the major principles and policies, through different channels and ways, fully listen to the party organizations and Party members of the opinions and suggestions, but 12 is some people face to face not to say back blather "" will not say, after the meeting said, "" Taiwan does not say, and nonsense ", in fact, not only disrupt the people thought, some causing serious consequences, the damage to the Party of the centralized and unified, hinder the central policy implementation, but also a serious violation of the democratic system of principles. There is no doubt that shall, in accordance with the Regulations > 4 Specified in Article 6 to give the appropriate punishment. For did not cause serious consequences, to give criticism and education or the corresponding tissue processing. (2) about the destruction of the party's unity < New Regulations > the forty eighth to fifty second article, to damage Party's unity unified and violation of political discipline, punishment situation made explicit provisions. Article 52 of the new "in the party get round group, gangs seek private gain, cliques, cultivate private forces or through the exchange of interests, for their own to create momentum and other activities to gain political capital, given a serious warning or withdraw from their party posts disposition; if the circumstances are serious, to give Leave a party to observation or expelled from the party. (3) on against the organization review of the provisions of the constitution, party loyalty honesty is party members must comply with the obligations. Members must obey the organization decision, shall not violate the organization decided encounters by asking questions to find organization, rely on the organization, shall not deceive the organization, against the organization. For example, after the investigation does not take the initiative to explain the situation, but to engage in offensive and defensive alliance, hiding the stolen money is against survey organization, is a violation of the behavior of political discipline. Article 24 of the original > < Regulations, although the provisions of the interference, hinder group review the behavior of the fabric can be severely or 13 Aggravated punishment, but did not put this kind of behavior alone as a discipline for qualitative amount of discipline. > < new regulations increase the Article 57, "anti organization review, one of the following acts, given a warning or serious warning; if the circumstances are relatively serious, giving removed from or placed on probation within the party post; if the circumstances are serious, give expelled from the party: (a) on supply or forged, destroyed, transfer, conceal evidence; (II) to prevent others expose, providing evidence Material; (III) harboring co personnel; (4) to the organization to provide false information, to hide the fact; (5) the him against the acts of the organization review. "< rule > add this clause to the Constitution requires more specific, the previous no punishment in accordance with the definite list and put forward clear punishment in accordance with. (4) about organizing or participating in superstitious activities as < Regulations > about engage in activities of feudal superstition obstruction of social management order" violations of Article 164 the provisions, but according to the original < rule > only in disrupting production, work, social life order The case to be disciplinary treatment, in other words, alone make the feudal superstition, organize or participate in the activities of feudal superstition of, does not constitute a violation. Which is not consistent with the requirements of our party's political party. > < new regulations in this change is, superstitious activities on the political discipline, increase the Article 58, is the organization of Party members, in superstitious activities included in violation of the negative list of political discipline deserves punishment, which and Party members should adhere to the correct political principle, political standpoint and viewpoint is consistent. 14 the second question about organization and discipline violation behavior of democratic centralism is our The party's fundamental organizational system. < New Regulations > Chapter 7 "in violation of the behavior of organizational discipline punishment" mainly for violation of democratic centralism, contrary to the "four obey the discipline behavior for source classification rules. Increased not in accordance with the relevant provisions or requirements to the organization for instructions to report on major issues; do not report truthfully report about personal matters; falsify personal archives; hide before joining the party serious mistakes; leading cadres in violation of the relevant provisions of the organization, will participate in the spontaneous formation of the old Xiang, Alumni Association, comrades in arms; to obtain illegal country residence abroad or foreign nationality, illegal for private frontier Documents such as discipline terms. (1) on the report truthfully report personal matters in 2010 the Central Committee of the Communist Party of China office, office of the State Council introduced < provisions on issues related to the leading cadres to report personal >, is clear about the request, deputy division level and above leading cadres should truthfully report changes in my marriage and spouse, children, moved to the country (territory), practitioners, income, real estate, investment and other matters, for failing to report, do not report, concealed and unreported, according to the seriousness of the case, giving criticism and education, and to make a correction within a time limit, shall be ordered to make a check, the commandment Jiemian conversation, informed criticism or jobs, free Post processing, constitute violations, in accordance with the relevant provisions shall be given a disciplinary sanction. But since the original < Regulations > and there is no corresponding specific terms, the violation of the regulations, do not report, as a false report about personal matters, there is no corresponding disciplinary action terms, in practice it is difficult to operate. In this regard, in order to solve is not reported, as a false report about personal matters 15 asked censure, the new < Regulations > add the Article 67 of violation of personal matters related to reporting requirements, report truthfully report the clear punishment basis, making this kind of violation behavior is no longer free drilling for Exhibition on matters of personal checks to verify and supervision of cadres, discipline review provides a powerful discipline guarantee. (2) about the illegal organization, to fellow, alumni, friends of the war will < regulations stipulated in Article 68 of >, leading cadres of the party in violation of relevant provisions of the organization, will participate in the spontaneous formation of fellow, Alumni Association, comrade in arms to give the punishment according to the seriousness of the case. Here special needs note is three points: this provision for only the leading cadres ", reflecting the high requirements of leading cadres; second violation in 2002, the Central Commission for Discipline Inspection, the central Organization Department and the The relevant provisions of the General Political Department jointly issued the < off in leading cadres not to participate in the initiative to set up "the villagers would be" alumni "" comrades in arms organization notice >. That is to say, to the spontaneous formation of fellow, Alumni Association, comrades in arms will constitute the premise of discipline is a violation of the provisions of this. The notification specified, leading cadres are not allowed to participate in the spontaneous incorporation of fellow, alumni, between comrades association would like the organization and shall not bear the sorority Human and the organizer shall not hold the corresponding position in the sorority; shall not borrow machine woven "network" and engage in kiss sparsely, round and round the gangs, but not "align" "Jieyi Gold Orchid" behavior. The third is to emphasize here that shall be organized to participate in the initiative to set up the villager, Alumni Association, comrades in arms. The so-called 16 spontaneous was established mainly means without registration. Therefore, Party members include leading cadres in the normal range of fellow, alumni, comrades in the party is not a violation of the rules of Party discipline. The three problem about integrity violations discipline Lian Jie discipline has been eighteen years clean government and anti The focus of the work of corruption. This Ordinance to amend, honesty and discipline this biggest adjustment, the new content, most of which prescribed by the original < criterion of a clean and honest administration > 8 ban and 52 are not allowed into the basic this part. (1) the central eight provisions of the spirit and requirements into < New > in the regulations of the party's eighteen years, central resolutely implement the provisions of the eight and pay close attention to the node and intensive briefing, on public funds, private bus, public funds tourism, gifts of public funds, the big parade and lavish weddings and festive, illegal payment allowances and subsidies, illegal construction of buildings such as the original masses reflects the relatively strong, "four winds" problem of the Resolute rectification. But original < Regulations > to eat and drink, super standard reception and no clear and specific expression, new < rule > will implement eight Central provisions of the spirit of the problem increased to "clean cheap self-discipline" chapter, clear to exceed the standard, beyond the scope of the reception or borrow machine eating and drinking etc. some in violation of the provisions of the spirit of the eight central relevant persons responsible for punishment, once the violation will be according to the < rule > severely punished, binding, enhanced significantly. One is to add Article 87, about to obtain illegal, hold, and the actual use of the sports card, golf ball cards and other consumer card. Illegal access to private clubs made the punishment provisions. The second is increase the Article 97, has made provisions of the disposition of illegal self pay or 17 spamming allowances, subsidies and bonuses. The third is added to the Article 99, on violation of super standard, beyond the scope of the reception or borrow machine eat and drink to make the provisions of punishment. The fourth is to increase the Article 101, on the management of conference activities in violation of the provisions made sanctions regulations. The fifth is the increased Article 102, for violation of office space management provisions made the punishment provisions. Six is to split the original < rule > Article 78, formed article 98, Article 100 of public Models of tourism, violate the provisions on the administration of the use of discipline of the bus through the list of made a more detailed provisions, apply more operational. Seven is increased the article 96, in violation of the relevant provisions of the, to participate in public funds to pay for dinner, high consumption of entertainment, fitness activities and public funds to buy gift, send gifts to make the provisions of the disposition. On the violation of the central provisions of the spirit of the eight, in addition to > < new regulations into "violation of honesty and self-discipline" misconduct outside, is different with the original < Regulations >, revised < rule > clearly defined not only to disposition of the directly responsible persons, but also dispose of collar Guide responsibilities. (2) increased trading rights, use of authority or position influence as relatives and close to profit violation of the terms of the < New Regulations > absorption < clean politics several guidelines > the relevant provisions spirit, increase the "negative list, including trading rights, the functions and powers or duties of influence as relatives and staff around profit. Increase Article 81" mutual use of office or authority ring for each other and their spouses, children and their spouses and other relatives, around 18 personnel and other specific relationship between the people to seek benefits engage in trading rights, given a warning or serious warning Sanctions; if the circumstances are relatively serious, giving removed from or placed on probation within the party post; if the circumstances are serious, shall be expelled from the party. Increase Article 82 "connivance, acquiescence to the spouse, children and spouse etc. relatives and staff around the effect of Party members and cadres personal authority or position for personal gain, if the circumstances are relatively minor, given a warning or a serious warning; if the circumstances are relatively serious, giving removed from or placed on probation within the party post; if the circumstances are serious, the given Expelled from the party. Party members and cadres of the spouses, children and their spouses does the actual work and get salary or although the actual work but to receive significantly beyond the same rank salary standard, Party members and cadres informed fails to correct, in accordance with the provisions of the preceding paragraph. "(3) about the gifts, gifts misconduct from handling practices in recent years, engaged in official cadres received gifts, gifts problems more prominent. This has seriously affected the image of Party members and cadres, damaged the relations between the party and the masses, and is a hotbed of corruption, is really necessary for this kind of behavior to be disciplined. < rule > no on accepting gifts, gifts, Card consumption behavior to engage in simple "one size fits all", but the difference between the different separately. One is in accordance with the provisions of Article 83, accepting may affect the impartial enforcement of the official gifts, gifts, consumer cards to depending on the seriousness of the case shall be given disciplinary sanctions. That is to say, for may affect the fair execution of business gifts, gifts, consumer cards are not allowed to accept. 19 is in accordance with the provisions of Article 83, accepting was significantly higher than normal ceremony is still exchanges of gifts, gifts, consumer card to disciplinary action. This is new regulations that daily life is purely reciprocity, accepting the same thing, boys , fellow friends gifts, gifts, shopping cards, although and fair execution of business has nothing to do, also want to as the case shall be dealt with, the situation is obviously beyond normal reciprocity ". The so-called" reciprocity ", one is emphasizes the reciprocal in protocol. In other words is you to me how, I to you how, not only does not go. The second is to significantly exceeded the normal local economy level, customs and habits, economic capacity of individual gifts, gift value. Specific sanctions to according to the processing of a variety of factors to consider, as appropriate. The third is the root according to the provisions of Article 84," to Engaged in public service personnel and their spouses and children, children's spouses and other relatives and other specific relationship presented Ming Xianchao normal reciprocity of gifts, gifts, consumer card, if the circumstances are relatively serious, given a warning until probation. "In accordance with the above provisions, gift giving significantly beyond the normal reciprocity, giver constitute the discipline. (4) on illegal trading of stocks or of other regulations of securities investment < > Article 88 is engaged in punishment regulation of camp and activity in violation of the relevant provisions on. Among them, 3 will" buying and selling stocks or in other securities investment "column as one of disciplinary cases Out. First need to be clear, > < regulations did not change the provisions of the Ordinance. The ordinance of the provisions of the second paragraph of Article 77 provisions "who, in violation of the provisions of the sale of stocks" is one of the violation, and at the beginning of the first paragraph of this article "violation of 20 against the relevant provisions of the" textual representation of the repeat revision. In, just from the legislative technique removed the "personal" in violation of the provisions, content and not to change the original provisions. Need to clear is, "buy or sell a stock or of other securities investment" refers to violation of the relevant provisions refers to in April 2001, the Party Central Committee, the State Council promulgated the On the work of the party and government organs staff's personal investment in securities if dry provisions >. According to the provisions of Article 3, use of work time, office facilities, the sale of stocks and securities investment fund belongs to illegal behavior. The fourth question, about the violation of the masses of the disciplinary actions < new regulations > would violate public discipline behavior of a single set of a class of restored "three rules of discipline and eight note" in the discipline of the masses of excellent traditional. < New Regulations > Chapter 9 "to violate the masses of disciplinary action", mainly the destruction of the party's close ties with the masses of misconduct made provisions on disciplinary; enrich and perfect the super standard, beyond the scope of Xiang Qun < All to raise fund and labor, in for involving the public affairs deliberately, chinakayao, in social security, policy support, disaster relief funds and materials and other matters assigned any kind and affectionate friends, obviously unfair acts against the interests of the masses of the disciplinary terms; increase the terms not in accordance with the provisions of the public party provided, government, factory and village (neighborhood) provided etc. violation of the people's right to know the behavior of the discipline. The fifth issue, on the violation of work discipline violation of work discipline added "negative list, including Party organizations carry out strictly Main responsibility for poor discipline terms. (1) the new party organization comprehensive strictly the main responsibility of the party does not fulfill the 21 or perform poor disciplinary terms < New Regulations > has a lead people to pay attention to the new terms, that is, in chapter ten "on the violation of work discipline behavior punishment" increase in the one hundred and fourteenth "party fail to perform comprehensive strictly the main responsibility of the party or to perform comprehensive strictly the main responsibility for administering the ineffective, resulting in serious damage or serious adverse effects, to the person directly responsible and the responsibility of leadership and give a warning or serious warning. The situation is serious, giving removed from their party posts or on probation Punishment. "Here the changes. For the first time, the main responsibility write < rule >. (2) new shall report does not report or false reporting discipline shall increase the 117 bar" in the higher level units to check to inspect the work or report to the parent unit, work report of shall report the matters do not report or do not report, cause serious damage or serious adverse effects of, to the person directly responsible and the responsibility of leadership, to give warning or a serious warning; if the circumstances are serious, giving removed from their party posts or placed on probation. "For example, during the tour visits to the region, the unit Members the obligation to the inspection teams to reflect the true situation, to conceal not reported or intentionally to the inspection teams to provide false information, causing serious damage or serious adverse effects of, the person directly responsible and the responsibility of leadership should be in accordance with the provisions of < rule > Article 117 to give the appropriate punishment. (3) the new not granted in accordance with the provisions of punishment, not according to the provisions of the implementation of disciplinary measures 22 violation of the provisions of Article 115 "Party organizations have one of the following circumstances, the direct leadership responsibility. Probation: members were sentenced punished, in accordance with the provisions give disciplinary action or in violation of state law Rules of behavior should be given disciplinary punishment and dispose of; disciplinary punishment by decision or complaint review the decision made, not in accordance with the provisions of the implementation decisions on punishment of the party, position, rank, and the treatment of the matters; Party members subject to disciplinary action, not in accordance with the cadre management authority and organizational relationships of by dispose of Party members to carry out education and supervision of daily management. "What needs to be pointed out is," cliff "demoted with cars, housing, secretary problem, implementation is not a discipline and party posts and ranks treatment by the organization department is responsible for the implementation, with cars, housing by the logistics department is responsible for the implementation of, Ji Commission responsible oversight responsibilities. The six questions, about the acts violating the discipline of life "in violation of discipline of life behavior punishment", mainly to "four winds" problems and a serious violation of social morality, family virtue acts of misconduct made provisions on disciplinary, an increase of extravagant life, contrary to the social public order and good customs disciplinary terms. Worth mentioning is, > < Regulations in Article 150 about "adultery" "mistress (Cardiff) formulation in the new < rule > is removed, to expand the scope of Article 127 provisions" and others hair improper sexual relations, let face disciplinary action Wider more strict. Four, and earnestly do a good job in the < code > and < rule > implement system of life lies in execution. < code > and < Regulations > is 23 Party organizations at all levels of a strong constraint and all Party members follow. Learning and implementing the < code > and < rule > is party committees (party), commission for discipline, discipline inspection group), the majority of Party members and cadres of the common responsibility, must party caught together, the party one execution. () Party committees (party) and play and implement comprehensive strictly the main responsibility, pays special attention to the two party regulations learning cross penetration. One is to Adhere to the party constitution is fundamental to follow, and resolutely safeguard the authority of the Party Chapter. The second is to adhere to the problem oriented, to strictly political discipline and political rule moments in the first place. The third is to adhere to the discipline and rules quite in front must not allow the bottom line to break the discipline. The fourth is to seriously organize the study of propaganda and education, in the city party members to create a disciplined, about the rules of the strong atmosphere. (II) Commission for Discipline Inspection at all levels (Discipline Inspection Group) to an important basis for the revised two party regulations as, adhere to easily blame, strengthen supervision and enforcement And early method in combining Ji, increase accountability efforts. One is to two regulations within the party important basis, adhere to the party constitution duties, with strict discipline to maintain the constitution authority. The second is to adhere to high standards and keep the bottom line, adhere to Ji Yan in law and discipline, the discipline and rules quite in front, grasping grasping small, easily blame, comprehensive use of supervision and discipline of "four kinds of form" in the discipline embodies the strict requirements and care for the discipline, tighten up, Yan. According to discipline in accordance with regulations to carry out disciplinary review. Increase the violations punishment, clues can initiate an investigation on the trial of cases According to the discipline on the provisions of the proportion of processing and control manager maintains discipline. To focus on investigating non convergence, don't accept hand serious disciplinary violations at the same time, pay more attention to the general review of discipline 24 behavior, and gradually increase the lighter punishment. Four is to illuminate two party regulations, combined with the local district of the Department of party conduct Lianzheng to relevant laws and regulations system clean, timely research proposes to establish, change, waste release opinion, avoid conflict, and the fasten system of cage, and gradually formed not rot, not rot, not want to rot system and working mechanism. (3) the leadership of the party members and cadres should play an exemplary role. The rate of higher consciousness of the front of the Ordinance to lead practice self-discipline norms, leading to maintain discipline of seriousness and authority. One is the above rate, demonstration and guidance, take the lead in learning and mastering the < code > and < > the requirements and regulations, do the deep understanding, learning to use. The second is to play an exemplary role in abiding by discipline rate, take the lead in practicing self-discipline norms, firmly establish before the discipline are equal, the system has no privilege, discipline is no exception, and consciously do standards, require more strict measures more practical. Third is to consciously accept supervision, conscientiously participate in the democratic life and debriefing honesty responsibility, such as Real to the party organization to report personal matters, and to accept the supervision of the work and life of the normal, habits under the supervision of the exercise of power, to carry out the work. The fourth is to set an example for the strict enforcement of discipline. Leading cadres should take the lead in the maintenance of discipline of seriousness and authority, to dare to seriously, dare to struggle, dare to offend people, for misconduct not laissez faire, but do not indulge, not tolerate to ensure the party constitution of party compasses party put in place. (4) the majority of Party members and cadres to set high standards and hold the bottom line, consciously abide by the < code > and < rule >. One is to control the < standard > and < 25 cases >, tight Close connection with their own thoughts, practical work and life, efforts to solve the problems, to enhance the study and implement of the effectiveness and pertinence. The second is to establish a high standard and hold the bottom line, consciously in the self-discipline pursuit of high standards, strictly in the party away from the red line discipline, discipline, about the rules and know fear, distrust, the formation of the honor system, comply with the system, safeguard system of good habits. Regulations and discipline regulations of < < New Revision of the Communist Party of China clean fingered self-discipline criterion > and < Chinese Communist Party Disciplinary Regulations > is the Party Central Committee in the new situation to promote the comprehensive strictly root of the lift, the regulations of the party construction of keeping pace with the times. We should study and implement the Standards > and < > as the primary political task, adhere to the party constitution duties, adhere to the discipline of, Ji Yan in law, the full implementation of supervision and discipline accountability responsibilities for coordination and promotion "four overall" strategic layout in XX District vivid practice to provide a strong guarantee. - Si Jian Wu, and effectively enhance the implementation of the implementation of the < code > < > The consciousness of General Secretary Xi pointed out that the party is in charge of the party, to manage the party; strictly, it can cure good party. Criterion > and < rule > keep pace with the times is our party to form a new potential strictly rules, to deepen understanding of the ruling law, is a comprehensive strictly, and strengthen the supervision within the party important grasper. Criterion > closely linked to the theme of self-discipline, self-discipline intensity-modulated, focusing on morality, for the majority of Party members and cadres set to see, feel the high standard, show the Communists noble moral sentiment; District Ordinance < < rule > the constitution of discipline integration into a political discipline, organization and discipline, honesty and discipline, discipline of the masses, work discipline, discipline, emphasize discipline, focusing on established rules, to draw the party organizations and Party members do not touch the bottom line. Party committees (party) to effectively strengthen the study and publicize the implementation of the < code > and < rule > the organization and leadership of criterion > and < > a full range, multi angle, deep publicity, the formation of study and publicize and implement the boom, in order to consolidate the development of good political environment to create a positive environment and atmosphere. The majority of Party members and cadres to strict requirements, the < rule > and < Ordinance cases > as a guide to action and behavior criterion, adhere to the moral standards and discipline of the bottom line, to maintain the discipline of worship and awe, learning, compliance, and maintain party discipline and rules of the model. The discipline inspection and supervision organs and cadres to the < code > and < > as the deepening of the "three", and strengthen supervision and discipline of accountability is important to follow correctly grasp the use of supervision and discipline of "four types", promote the comprehensive strictly in new roots. Strict discipline, adhere to the discipline and rules quite in front of the enterprise in the implementation of expensive to implement to execute. The discipline inspection and supervision organs to implement the < code > and < Efforts to investigate cases > as an opportunity, adhere to the party should manage the party strictly, serious performance of their duties to promote two regulations implementation. Change discipline concept. From the simple "investigation of illegal" to a comprehensive "stare at violate discipline"; from the business case to prosecute the big cases and timely solve the signs of tilt to. From the orientation to the normal supervision; from the tube "minority" to resist the "most". Guide Party members and cadres to seriously implement the < code > and < rule >, consciously abide by the political, organizational, honest people, work, life six discipline. Urge the leadership cadres sent to play an exemplary role, take the lead in strictly enforced. Relaxation and rest Strong wind is Su Ji, closely linked to the "four winds" prone to multiple, the masses reflect the strong important nodes and, glued to the four winds "new form, new trends, seriously investigate and deal with violations of the central eight provisions of the spirit, to increase the bulletin exposure intensity, the formation of Chajiu" four winds "loudly, continue to release and discipline must be strict signal. At the same time, extended supervision tentacles, through the development of the rural and fishery party conduct Lianzheng construction inspection, issued in a timely manner, Chajiu occurred in grassroots side of corruption and unhealthy, and earnestly safeguard the interests of the masses and social stability. The creativity and discipline. Grasp and make good use of the supervision and discipline of" four types ", to ensure the Promoting clues to lots of discipline and the law of the vacuum tube, strict together. Not only to the "less" and "very few" thorough investigation severely punished, but also the "most" to maintain zero tolerance trend through layers of conductive pressure, let the discipline about the rules for each party members and cadres consciously follow. At present, it is necessary to implement the "list" management, strictly follow the clues to the disposal of five standards, make the classification of disposal, dynamic cleanup. Zadok Party committees at all levels to implement the main responsibility, comprehensive use of disciplinary action and tissue processing and other means to effectively curb the commonplace, used to see do not blame the "small problem", not because of "practice" and "exception". Prominent Discipline characteristics, the problems of violation of discipline and rules into the focus of supervision and discipline and disciplinary review. At the same time, increase case double check the intensity, the serious problems of discipline violations or "four winds" ban but not absolutely, not only to be held directly responsible, but also held leadership responsibility; not only to pursue studies the main responsibility of the Party committee, and to pursue Commission for Discipline Inspection and supervision responsibilities and promote accountability to become the new norm. The implementation of supervisory responsibility. Maintain < code > and < rule > the seriousness and authority of the discipline and rules and truly become the party's ruler. Discipline as supervision within the party the specialized agency, we must strengthen the responsibility to act, adhere to the Impartial discipline accountability, earnestly will be strict discipline, discipline must be punished, and severely punish the acts in violation of rules and regulations.
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