目的 探讨纳洛酮联合亚低温对急性CO中毒迟发性脑损伤脑神经功能改善的作用。方法 选取本院诊治的急性CO中毒迟发性脑损伤患者63例,采用随机数字表法分为A、B、C三组,采用相关工具评定患者的昏迷状况、日常生活能力及患者的运动功能,比较三组患者的治疗效果、不良事件情况。结果 治疗后,三组患者GCS评分、日常生活能力评分、运动功能评分均升高。治疗效果:B组高于A组,C组高于A组和B组,不良事件发生率:B组低于A组,C组低于A组和B组,差异均有统计学意义(P＜0.05)。结论 纳洛酮联合亚低温治疗可明显改善急性CO中毒迟发性脑损伤患者的脑神经功能,可提高患者的日常生活能力与运动功能,治疗效果好且不良事件少,有较高的安全性,值得临床推广使用。

目的 探讨良性前列腺增生(BPH)并急性尿潴留(AUR)后血清肌酐、前列腺特异抗原(PSA)及其膀胱尿道功能的相关性及其临床意义。方法 对随机选择的36例已留置尿管48h以上的BPH并AUR患者进行尿流动力学检查,且同日行血清肌酐、PSA检测并分为两组:DI(逼尿肌不稳定)组(22例)和无DI组(14例),分析血清肌酐、PSA与膀胱功能各因素的相关性。结果 36例患者中逼尿肌收缩力很弱(VW)占10例,其游离PSA(fPSA)均<1.0 ng/mL,DI组中血清肌酐与膀胱顺应性、总PSA(tPSA)有相关性(r分别为0.406、-0.340,P值分别<0.01、0.05);DI幅度与膀胱顺应性、逼尿肌收缩力、tPSA有相关性(r分别为-0.309、0.677、0.304,P值分别<0.05、0.01、0.05);DI组与无DI组的fPSA与逼尿肌收缩力均有相关性(r分别为0.375、0.464,P值均<0.05)。DI组血清肌酐与fPSA、DI幅度、逼尿肌收缩力无相关性(r分别为-0.282、-0.301、-0.184,P值均>0.05);无DI组tPSA与血清肌酐、膀胱顺应性、逼尿肌收缩力无相关性(r分别为0.278、0.348、0.365,P值均>0.05)。结论 BPH并AUR患者的血清fPSA越低(<1.0 ng/mL),间接反映逼尿肌收缩力受损越严重,DI影响tPSA及肌酐水平。

目的 探讨儿童肾病综合征(NS)的红细胞分布宽度(RDW)与肾功能损害的关系。方法 收集168例NS患者作为观察组,根据eGFR分期分为三组,按照起病时长4月为界限分为两组;选健康儿童100例为对照组。检测各组血常规、肝肾功能等,采用SPSS 21.0软件进行统计分析。结果 ①与对照组相比,NS患儿的RBC[(4.86±0.69)vs(4.32±0.48)],RDW[(13.39±1.69)vs(12.99±1.04)]升高,差异有统计学意义(P<0.05);②RDW在肾功能3期(14.60±1.36)较2期(12.84±0.79)升高,在起病时长≤4月患儿(13.66±1.78)较健康儿童(12.99±1.04)上升,差异有统计学意义(P<0.05);红细胞平均容积(MCV)在起病时长≤4月较对照组下降,起病时间>4月组较起病时长≤4月上升,差异有统计学意义(P<0.05)。结论 儿童NS患者的RBC、RDW较健康儿童升高,RDW在肾功能3期较2期升高。

Objective To investigate the relationship between red cell distribution width(RDW) and renal function damage in children with nephrotic syndrome(NS). Methods 168 NS patients were chosen as the observation group, divided into three groups by eGFR level, while also divided into two groups by onset duration of 4 months. 100 healthy children were included as the control group. The blood routine, biomedical function of liver and kidney were detected. Data were analyzed by SPSS 21.0. Results ① Compared to control group, NS patients have higher levels of RBC[(4.86±0.69) vs (4.32±0.48)] and RDW[(13.39±1.69) vs (12.99±1.04)], P<0.05; ② RDW is higher in the third phase of renal function than the second [(14.60±1.36) vs(12.84±0.79)], and also higher in the onset duration of less than 4 months group than the control group [(13.66±1.78) vs (12.99±1.04)], P<0.05; Mean corpuscular volume is lower in the onset duration group of less than 4 months than the control group, and higher in the onset duration group more than 4 months than the onset duration group of less than 4 months, P<0.05. Conclusion The RBC, RDW are higher in children NS patients than in the healthy children; RDW is higher in the third renal function than the second renal function.

目的 探讨功能训练在Haglund病伴轻度认知障碍患者中的应用效果。方法 成立功能训练培训小组对46例关节镜Haglund病伴轻度认知障碍术患者实施功能训练,干预时间6个月。训练前后对患者Baird-Jackson踝关节评分、自我效能和临床疗效评估进行测评。结果 训练后,患者Baird-Jackson踝关节评分、自我效能优于训练前,临床疗效优良率升高,训练前后比较,差异均有统计学意义(P＜0.01)。结论 功能训练能促进关节镜Haglund病伴轻度认知障碍术患者踝关节功能康复和提高自我效能。

Objective To investigate the effects of application of functional training to Haglund disease patients with mild cognitive impairment. Methods The functional training group was built and gave functional training to 46 patients of Haglund disease with mild cognitive impairment. The period of intervention lasted 6 months. Before and after the training, We assessed patients in terms of scores of Baird-Jackson ankle joint, self-efficacy and clinical efficacy. Results After the training, scores of Baird-Jackson ankle joint and self-efficacy became higher and the excellent rate of clinical efficacy has risen. Compared with those before the training, the difference had statistic significance (P<0.01). Conclusion Functional training has a positive impact on the recovery of ankle joint function of Haglund disease patients with mild cognitive impairment and improve their self-efficacy.

目的 探索利伯曼康复治疗对慢性精神分裂症患者社会功能的影响。方法 选取长期住院的慢性精神分裂症患者130例,随机分为研究组65例和对照组65例,研究组实施利伯曼康复治疗,在康复训练前与训练后的第1、3月末分别采用护士用住院病人观察量表(NOSIE)和住院精神病人康复疗效评定量表(IPROS)对患者进行评价。结果 患者通过利伯曼康复治疗后,NOSIE量表总积极分、社会能力、社会兴趣、个人整洁等得分有明显提高;IPROS量表的工疗情况生活能力社交能力讲究卫生能力都有较明显的提高(T、P<0.01)。结论 利伯曼康复治疗对患者的社会功能的改善有积极的意义。

Objective To explore the impacts of Lieberman rehabilitation technique on chronic schizophrenic patient's quality of life. Methods 130 patients diagnosed with chronic schizophrenia with over 5-year long hospitalization were divided into two groups randomly, with 65 samples at either study group or control group. Team to implement a lieberman rehabilitation. NOSIE and IPROS were used by nurse to assess the performance of all samples in one month after the beginning of the study and three months after the beginning study. Results After intervention, the performance of samples in study group indicated that patients had significantly higher score in NOSIE total score, social ability, social interest, individual tidiness. Patient's total negative points including irritability, mental performance, retardation and depression were decreased. IPROS living ability and social ability has improved significantly(P≤0.01). Conclusion Lieberman rehabilitation technique can improve patients'social function.

目的 研究限制会阴切开及会阴不同切口对产妇产后出血、疼痛及性功能的影响。方法 选取我院2012年4月—2013年4月头位自然分娩产妇480例,抽签随机分为三组,每组160例,实施限制会阴切开的为限制组,实施会阴侧切的为侧切组,实施会阴正中切开的为正切组,比较三组产妇产后2 h出血量、产后住院时间、产妇会阴阴道裂伤率、产后疼痛程度和性功能满意程度。结果 产后2 h产妇出血量限制组(203.65±76.68)mL较侧切组(241.41±80.63)mL和正切组(239.15±85.19)mL少(P＜0.05);侧切组(1.64±0.87)d产后住院时间较限制组(1.37±0.64)d较长(P＜0.05);限制组会阴Ⅰ/Ⅱ°裂伤率为86.25%较侧切组1.25%和正切组6.88%较高(P＜0.05);侧切组2.50%和正切组3.13%会阴Ⅲ/Ⅳ°裂伤较限制组0%较高(P＜0.05);女性性功能指数限制组(22.69±2.65)分较侧切组(19.12±2.05)分与正切组(18.96±2.16)分较高(P＜0.05)。结论 实施限制会阴切开的产妇术后出血量少,会阴重度裂伤率低,保证了会阴完整性,产后性功能满意度高,值得临床上应用推广。

目的 探讨功能康复训练与心理干预对全髋关节置换手术患者髋关节功能康复的影响。方法 对2014年3月—2015年12月先后在本院行全髋关节置换手术90例患者,按入院时间分为观察组45例和对照组45例。对照组按全髋关节置换手术功能康复护理要求给予康复护理;观察组在此功能康复护理基础上,同时对患者进行心理评估和相应的心理护理干预;对两组患者在干预前后的心理情况、生活自理能力、髋关节功能和生活质量进行评价。结果 干预前两组患者均有不同程度的焦虑和抑郁反应,不积极的应对方式和自理能力下降;干预后观察组在应对心理反应,降低焦虑和抑郁,主动进行功能锻炼,自理能力和髋关节功能评分均优于对照组。结论 功能康复训练与心理护理干预相结合,对减轻患者心理压力,提高患者心理应对能力、生活自理能力,提高患者生活质量,促进髋关节功能康复有一定的效果。

Objectives To explore the effect of function rehabilitation training and psychological intervention on patients of hip joint function recovery undergoing THA. Methods 90 patients were chosen who were admitted to the hospital from March 2014 to December undergoing THA,2015. These patients were divided into control group and intervention group according to the sequence of admission. The patients in control group were cared by total hip replacement surgery functional rehabilitation; At the same time, the patients in observation group were cared by psychological training. The psychological condition, self-care ability, hip function and quality of life for all patients were evaluated. Results Before the intervention, two groups of patients had some degrees of anxiety and depression, and negative coping style. Their self-care ability were decreased; The response to psychological reaction, reduction for anxiety and depression, initiative exercise, self-care ability and hip function scores of patients in the intervention group were better than that of the control group. Conclusion Combination of rehabilitation training and psychological nursing intervention can relieve the psychological pressure, improve mental health and promote recovery of hip function.

目的 探讨婚恋家庭取向心理干预对系统性红斑狼疮患者家庭功能和幸福感指数的效果。方法 将2012年6月1日—2014年5月31日就诊于东莞康华医院内分泌及风湿免疫中心的62名15~58岁的系统性红斑狼疮患者作为研究对象,根据随机化原则将其分成两组,其中30名为干预组,参加本研究设计的婚恋家庭取向的心理干预,余32名为对照组,采用家庭功能评定量表、幸福指数量表及狼疮活动指数量表,对两组进行干预前、干预后、干预后3月和干预后6月作问卷调查。采用重复测量的方差分析进行评估。结果 家庭功能中的问题解决、情感反应、情感介入、总的功能分量表和总分两组干预后重复测量的方差分析两两比较均有统计学差异(P<0.05)。幸福感指数总分两组重复测量的方差分析无统计学意义,但如扩大置信空间至P<0.1,则两组重复测量的方差分析两两比较中干预后3月及6月有一定统计学意义(P=0.08<0.1)。结论 本研究中婚恋家庭取向的心理干预对SLE患者即家庭功能中问题解决、情感反应、情感介入、总的功能及家庭功能总分均有显著的改善作用,对幸福感指数总分则有一定的增进作用,而对已通过心身疾病方式表达了的SLEDAI没有干预作用。

Objective To explore the effect of marital family-based psychological intervention in SLE patients on family assessment device FAD and index of well-being. Methods A total of 62 SLE patients, aged between 15 and 58, who were treated in out-patient of endocrine immune rheumatism center of Dongguan Kanghua hospital from June 1,2012 to May 31,2014. The experimental group was made up of 30 patients who, at random, volunteered to participate in an added marital family-based psychological intervention and the control group was composed of rest 32 cases. At the time of pre-intervention,post-intervention,3 months and 6 months after intervention, both groups were investigated with questionnaires of family assessment device, index of well-being, index of general affect, and systemic lupus erythematosus disease activity index. The results were analyzed with repeated measure variance analysis to explore the effect. Results There were significant multiple-comparison differences by repeated measure variance analysis in the score of FAD's total and sub-scale problem solving, affective responsiveness, affective involvement, general functioning(P<0.05) between experimental and control group after intervention. There were no significant repeated measure variance analysis differences in the score of index of well-being' total, but if enlarging confidence space to P<0.1, there were partial multiple-comparison differences between experimental and control group at the time of 3 months and 6 months after intervention(P=0.08<0.1). Conclusion Marital family-based psychological intervention may significantly improve FAD's problem solving, affective responsiveness, affective involvement, general functioning, and sum of FAD, and partially improve index of well-being, but can not improve SLEDAI which had developed by psychosomatic disease.

目的 探讨妊娠期甲亢患者血清甲状腺功能和免疫含量变化及其临床应用价值。方法 分别取妊娠期与非妊娠期甲亢病例各250例,于孕15周、孕25周以及孕35周时测定两组血清甲状腺功能各项指标与免疫含量。结果 与对照组相比,观察组患者整个妊娠期T3、T4水平明显更高(P＜0.05);孕中晚期两组FT3、FT4水平差异并无统计学意义(P＞0.05)。结论 血清T3、T4在妊娠合并甲亢患者整个妊娠过程中呈高水平表达,临床应高度重视TRAb阳性率、FT3、FT4表达水平,以明确诊断。

目的 研究中药熏洗、中药离子导入加CPM综合疗法对膝关节功能障碍患者的作用效果。方法 从2014年4月—2016年4月,于我院共有78例膝关节功能障碍病患就诊。以数字法随机分成观察组(39例)和对照组(39例)。观察组给予中药熏洗以及中药离子导入再加以CPM综合疗法进行护理,对照组仅给予CPM综合疗法护理。观察两组患者护理后膝关节疼痛程度以及活动范围。结果 观察组患者膝关节功能优者占比51.28%,总有良率为84.62%,均高于对照组的25.64%,51.28%;观察组患者膝关节活动范围优者占比51.28%,总优良率为89.74%,均高于对照组的28.21%,66.67%;观察组患者WOMAC评分中膝关节疼痛以及膝关节僵硬和膝关节功能得分均低于对照组,WOMAC总分也低于对照组,差异均有统计学意义(P均＜0.05)。结论 中药熏洗、中药离子导入加CPM综合疗法能显著改善患者膝关节功能,增加活动度数,减轻疼痛等级,值得临床推广使用。

Objective To study the effect of traditional Chinese medicine fumigation, traditional Chinese medicine iontophoresis combined with CPM combined therapy on patients with knee joint dysfunction. Methods From April 2014 to April 2016, in our hospital there were a total of 78 cases of knee joint dysfunction disease patient treatment. With digital method they were randomly divided into observation group (39 cases) and control group (39 cases). The observation group was treated with Chinese herbal fumigation and washing and Chinese medicine iontophoresis and CPM combined therapy nursing, control group only received CPM combined therapy nursing. Observation of nursing care of the patients in the two groups were knee pain and range of motion. Results The observation group of patients with knee joint function was accounted for than 51.28%. The total yield was 84.62%. They were significantly higher than those in the control group of 25.64%, 51.28%; Observation group of patients with knee joint range of motion was accounted for than 51.28%. The total excellent and good rate was 89.74%, were significantly higher than those in the control group of 28.21%, 66.67%; Observation group, WOMAC score of knee pain and knee stiffness and knee joint function score were significantly lower than those of the control group. WOMAC score was significantly lower than that of the control group. The differences were statistically significant (P<0.05). Conclusion Traditional Chinese medicine fumigation, traditional Chinese medicine iontophoresis combined with CPM therapy could significantly improve the patient's knee function, increase the degree of activity, reduce the pain level. It is worth to have clinical application.