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广州医药杂志服务号
论著

早产儿语言-社会行为发育差异的回顾性研究

A retrospective study of language-social behavior developmental differences in preterm infants

:1054-1059
 
目的 探讨早产儿语言-社会行为情况及其影响因素,研究语言-社会行为发育与智能发育之间的关系,为早产儿保健提供指导。方法 采用自制的一般情况问卷对125例早产儿开展随访、追踪,直至2岁时,采用盖泽尔发展量表(GDS)进行语言-社会行为及智能发育评估。结果 早产儿语言发育正常43例(34.4%),社会行为发育正常40例(32%)。早产儿语言发育商平均为(67.99±25.75),社会行为发育商平均为(67.75±23.98),处于发育低下水平。性别、脑出血病史、定期随访史、康复干预史、家庭干预史在语言、社会行为方面比较差异均无统计学意义(P>0.05)。不同胎儿期安胎史、胎龄、出生体质量在语言、社会行为方面比较差异有统计学意义(P<0.05);且胎儿期反复安胎,胎龄小,出生体质量低,语言及社会行为发育较差。与出生时无中-重度窒息史的患儿相比,出生时有中-重度窒息的患儿存在更多的语言发育异常,比较差异有统计学意义(P<0.05);但在社会行为发育方面比较差异无统计学意义(P>0.05)。语言-社交行为发育落后的同时,早产儿的大运动、精细动作、适应性行为也存在落后,五大能区比较差异并均有统计学意义(P<0.05)。结论 多数早产儿存在语言-社会行为发育落后,其同时可能伴有更多的运动和适应行为发育问题;语言-社交行为发育落后的患儿在胎儿期存在反复安胎且胎龄较小、出生体质量更低或有中-重度窒息史。对早产儿的语言-社会行为要及时给予关注,早期发现并早期干预,改善预后。
Objective To explore the language-social behavior of preterm infants and its influencing factors,to study the relationship between language-social behavior development and intellectual development,and to provide guidance for preterm infants' health care.Methods A self-administered general questionnaire was used to follow up 125 preterm infants until the age of 2 years,and Gesell development scale(GDS)was used to assess their language-social behavior and intellectual development.Results Preterm infants had normal language development in 43 cases(34.4%)and normal social behavioral development in 40 cases(32%).The mean language development quotient of preterm infants was(67.99±25.75)and the mean social behavioral development quotient was(67.75±23.98),which was at the low developmental level.There were no significant differences in gender,history of cerebral hemorrhage,regular follow-up,rehabilitation intervention,family intervention and language or social behavior(P>0.05).Infants with different fetal age history,gestational age,and birth weight varied significantly in language and social behavior(P<0.05);and with repeated miscarriage,small gestational age,low birth weight,showed poor language and social behavior development.Compared the children with and without moderate to severe asphyxia at birth,there was statistically significant differences in language development(P<0.05),but in social behavior there was no significant difference(P>0.05).The backward development of language-social behavior was accompanied by backwardness in gross motor,fine motor,and adaptive behavior in preterm infants,and the differences in the five major domains were all present and statistically significant(P<0.05).Conclusions A major of preterm infants have poor language-social behavior development,which may be accompanied by more motor and adaptive behavior development problems;children with poor language-social behavior development have repeated miscarriage prevention at younger gestational ages,lower birth weights,or a history of moderate-to-severe asphyxia during the fetal period.It is important to give timely attention to language-social behavior in preterm infants for early detection and early intervention to improve prognosis.
论著

早产儿经胃管喂养后采用空气冲管的应用评价

Evaluation of flushing gastric tube by air after feeding in premature infants

:1038-1042
 
目的 评价早产儿经胃管喂养后采用空气冲管的应用效果。方法 选择2021年1月–2021年12月广州市第一人民医院收治的经胃管喂养后采用温水冲管的60例早产儿为对照组,选择2022年1月–2022年12月收治的经胃管喂养后采用空气冲管的57例早产儿为研究组。喂养1周后,比较两组患儿体质量增加量、血清白蛋白浓度增加量、大便量、喂养不耐受发生率、胃管堵塞率等指标的差异。结果 无患儿发生胃管堵塞。研究组的血清白蛋白浓度增加量[(2.86±5.61)g/L]高于对照组[(0.84±5.27)g/L](P<0.05),而两组患儿在体质量增加量、大便量、喂养不耐受发生率等方面比较差异无统计学意义(P>0.05)。多元线性回归分析结果显示空气冲管为血清白蛋白浓度增加量的影响因素(P<0.05)。结论 采用空气进行胃管冲管的方法可改善早产儿的营养状态。
Objective To evaluate the effects of flushing gastric tube by air after feeding in premature infants.Methods A total of 60 premature infants admitted to Guangzhou First People's Hospital from January 2021 to December 2021 whose gastric tube were flushed with water after feeding were selected as the control group,while 57 admitted from January 2022 to December 2022 whose gastric tube were flushed with air after feeding were selected as the study group.After 1 week of feeding,the differences of weight increase,serum albumin concentration increase,stool volume,feeding intolerance incidence and gastric tube blockage rate were compared between the 2 groups.Results No gastric tube blockage occurred.The increase of serum albumin concentration in the study group[(2.86±5.61)g/L] was significantly higher than that in the control group[(0.84±5.27)g/L](P<0.05),but there were no significant differences in weight increase,stool volume and feeding intolerance incidence between the 2 groups.Multiple linear regression analysis showed that the flushing gastric tube with air was an independent influencing factor for the increase of serum albumin(P<0.05).Conclusions Flushing gastric tube with air can improve the nutritional status of premature infants,which is worthy of clinical application.
论著

时机理论的护理干预在三叉神经痛微血管减压术中的应用效果评估

Evaluation of the application effect of timing theory nursing intervention in microvascular decompression surgery for trigeminal neuralgia

:1033-1037
 
目的 探讨时机理论的护理干预在三叉神经痛微血管减压术中的应用效果。方法 选取2020年7月—2023年6月厦门大学附属第一医院神经外科三叉神经痛患者85例,均实施微血管减压术治疗,通过奇偶数抽签的方式分组,即对照组(n=43,予以常规护理)与观察组(n=42,实施常规护理基础上给予基于时机理论的护理干预),通过专业调查表对两组患者疼痛、负面情绪及生活质量进行全面评估。结果 观察组出院时数字分级评分表(NRS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)评分分别为(2.13±0.57)(42.45±3.17)(42.45±3.17)分,低于对照组的(3.23±0.78)(52.34±4.45)(48.23±3.23)分(P<0.05);观察组术后1个月简明健康状况调查表(SF-36)生理功能、生理职能、躯体功能、活力、社会功能、情感职能、心理健康及总体健康状态等维度评分分别为(38.12±8.27)(42.22±9.12)(52.34±8.23)(64.11±8.92)(70.12±9.03)(34.46±6.18)(71.34±8.17)(75.24±8.46)分,高于对照组的(35.23±8.13)(38.56±9.23)(45.03±8.11)(60.57±8.23)(65.23±8.78)(30.14±6.13)(66.23±8.08)(72.12±8.35)分(P<0.05)。结论 三叉神经痛患者实施微血管减压术治疗的同时,采取基于时机理论的护理干预不仅可减轻其疼痛程度,改善其负面情绪,还可全面提高其生活品质。
Objective To explore the application effect of timing theory nursing intervention in microvascular decompression surgery for trigeminal neuralgia.Methods The research period was from July 2020 to June 2023.The study subjects were 85 patients with trigeminal neuralgia selected from the Neurosurgery Department of the First Affiliated Hospital of Xiamen University,all of whom underwent microvascular decompression surgery.They were divided into a control group(n=43,receiving routine care)and an observation group(n=42,receiving timing based nursing intervention on the basis of routine care)through odd and even number drawing.A preliminary assessment of pain,negative emotions,and quality of life for two groups of patients were conducted through a professional questionnaire.Results The scores of NRS,SDS and SAS in the observation group at discharge were(2.13±0.57),(42.45±3.17)and(42.45±3.17)respectively,which were significantly lower than those in the control group(3.23±0.78), (52.34±4.45)and(48.23±3.23).The scores of physiological function,physiological function,physical function,vitality,social function,emotional function,mental health and general health status in the observation group one month after operation were(38.12±8.27),(42.22±9.12),(52.34±8.23), (64.11±8.92), (70.12±9.03), (34.46±6.18), (71.34±8.17) and(75.24±8.46), which were significantly higher than those of the control group(35.23±8.13), (38.56±9.23), (45.03±8.11), (60.57±8.23), (65.23±8.78), (30.14±6.13), (66.23±8.08)and(72.12±8.35)(P<0.05).Conclusions While implementing microvascular decompression surgery for patients with trigeminal neuralgia,nursing interventions based on timing theory can not only alleviate their pain,improve their negative emotions,but also comprehensively improve their quality of life.
护理研究

基于信息-动机-行为模型的护理干预对造口患者并发症及生活质量的影响

Effects of nursing intervention based on information-motivate-behavior model on complications and quality of life of patients with stoma

:1220-1225
 
目的 探讨与分析基于信息-动机-行为(IMB)模型的护理干预对造口患者并发症及生活质量的影响。方法 选择2021年5月—2023年4月本院进行结直肠癌行肠造口患者84例作为研究对象,根据1∶1随机电脑抽签分配原则把患者分为IMB组42例与常规组42例。常规组给予常规护理干预,IMB组在常规组护理的基础上给予基于IMB模型的护理干预,IMB组与常规组护理观察时间为3个月,观察与记录IMB组与常规组患者并发症、生活质量、心理状况、自我管理能力评分变化情况。结果 IMB组护理3个月期间的腹腔脓肿、肠梗阻、肺部感染、造口感染等并发症发生率为4.8%,与常规组的19.0%相比降低更多(P<0.05)。IMB组护理3个月期间的遵医依从性为100.0%,与常规组的90.5%相比提高更多(P<0.05)。护理3个月后IMB组的症状识别、症状处理、处理后评价等自我管理能力评分与常规组相比提高更多(P<0.05)。IMB组与常规组护理3个月后的焦虑评分与抑郁评分与护理前相比都有统计学意义的降低(P<0.05),护理3个月后IMB组的焦虑评分、抑郁评分与常规组对比降低(P<0.05)。护理3个月后IMB组的总生活质量量表、症状子量表、症状量表、功能量表评分都与常规组相比提高(P<0.05)。结论 基于IMB模型的护理干预在造口患者的应用能提高遵医依从性,缓解焦虑与抑郁情绪,提高患者自我管理能力,从而可有效减少患者并发症的发生,促进提高患者的预后生活质量。
Objective To explore and analysis the effects of nursing intervention based on Information-Motivation-Behavioral(IMB)model on complications and quality of life of patients with stoma. Methods Eighty-four cases of patients with colorectal cancer undergoing enterostomy in our hospital from May 2021 to Aprilt 2023 were selected as the study subjects.According to the principle of 1∶1 random computer lottery,the patients were divided into IMB group(42 cases)and traditional group(42 cases).The traditional group were given routine nursing intervention,and the IMB group were given nursing intervention based on the IMB model on the basis of the traditional group.The nursing observation time of the traditional group and IMB group were 3 months,the changes in complications,quality of life,psychological status,and self-management ability scores of patients were observed and recorded. Results The incidence of complications such as abdominal abscess,intestinal obstruction,pulmonary infection and stoma infection in IMB group during nursing were 4.8%,which were significantly lower than 19.0% in the traditional group(P<0.05).The compliance of IMB group during nursing were 100.0%,which were significantly higher than 90.5% in the traditional group(P<0.05).After nursing of 3 months,the scores of self-management ability such as symptom recognition,symptom treatment and post-treatment evaluation in IMB group were significantly higher than those in the traditional group(P<0.05).The scores of anxiety and depression in the traditional group and IMB group after nursing of 3 months were significantly lower than those before nursing(P<0.05),and the scores of anxiety and depression in the IMB group after nursing of 3 months were also significantly lower than those in the traditional group(P<0.05).After nursing of 3 months,the scores of IMB group on function scale,symptom scale,symptom subscale and total quality of life scale were significantly higher than those of the traditional group(P<0.05). Conclusions The application of nursing intervention based on the IMB model in patients with stoma can improve the compliance with medical treatment,reduce the occurrence of complications,improve the self-management ability of patients,relieve anxiety and depression,and continue to improve the prognosis and quality of life of patients.
护理研究

基于计划行为理论的妊娠期糖尿病患者自我管理行为意向的质性研究

A qualitative study of self-management behavior intention in patients with gestational diabetes mellitus based on the theory of planned behavior

:1215-1219
 
目的 基于计划行为理论探讨妊娠期糖尿病(GDM)孕妇自我管理行为意向,为促进其孕期良好的自我管理提供依据。方法 运用质性研究中的现象学研究方法,对12例GDM孕妇进行深度半结构式访谈,并用Colaizzi七步内容分析法对主题进行归纳。结果 根据计划行为理论对主题进行归纳,共提炼出3种类别:①行为态度:认知不足,积极态度,消极态度;②主观规范:家庭影响,医护压力,人际压力;③知觉行为控制:知识技能获取受限,客观条件束缚共8个主题。结论 GDM患者在自我管理过程中存在对疾病认知不足的问题GDM,自我管理行为受到家庭、医护人员、人际关系等外界压力对自我管理态度的影响,且存在知识技能欠缺,客观条件制约多方面阻碍。医护人员应加强对GDM孕妇的自我管理教育,适时提供支持,提高其自我管理效率。
Objective To explore the self-management behavior intention of pregnant women with gestational diabetes mellitus(GDM)based on the theory of planned behavior,and to provide a basis for promoting good self-management during pregnancy. Methods Using the phenomenological research method in qualitative research,12 pregnant women with GDM were interviewed in an in-depth semi-structured interview,and then the themes were summarized by Colaizzi's seven-step content analysis. Results According to the theory of planned behavior,the themes were summarized into three categories and eight themes including(1)Behavioral Attitudes:cognition deficiency,positive attitude,and negative attitude,(2)Subjective norms:family influence,medical pressure,interpersonal pressure,and(3)Perceptual behavior control:self-management knowledge acquisition limitations,self-management Objective conditions constraint. Conclusions Most of the respondents have insufficient awareness of self-management of gestational diabetes,different patients have different attitudes towards self-management,and self-management behavior is affected by external pressures such as family,medical staff,and interpersonal relationships,and there are many obstacles due to a lack of knowledge and skills,Objective conditions.Medical staff should strengthen the self-management education of pregnant women with gestational diabetes,provide timely support,and improve their self-management efficiency.
护理研究

SBAR沟通模式交接班联合护理质量指标管理对胆管结石患者护理质量、不良事件及并发症影响

Effect of SBAR communication mode combined nursing quality index management on nursing quality,adverse events and complications of patients with bile duct stones

:1210-1214
 
目的 探讨标准化沟通(SBAR)模式交接班联合护理质量指标管理在胆管结石患者中的应用效果及护理质量、不良事件及并发症影响。方法 选取天津市人民医院2021年1月—2022年12月收治的80例胆管结石患者,应用抽签法分为观察组与对照组,每组各40例。所有患者均采取手术治疗,其中对照组患者实施常规护理,观察组患者在对照组基础上增加SBAR沟通模式交接班联合护理质量指标管理。对比两组患者的护理质量、护理不良事件发生率、护理满意度及术后并发症发生率。结果 观察组基础护理、护理态度、护理责任心、风险识别能力、风险防范能力护理质量评分高于对照组(P<0.05);两组注射、口服给药差错、换药、抽血差错、病例书写错误以及执行医嘱不及时等护理不良事件发生率对比差异无统计学意义(P>0.05),观察组患者护理满意度高于对照组(P<0.05);观察组患者压疮、感染、静脉血栓等并发症发生率均低于对照组(P<0.05)。结论 SBAR沟通模式交接班联合护理质量指标管理针对胆管结石患者应用效果显著,可改善临床护理质量,同时患者护理满意度较高,进一步降低患者术后并发症发生率。
Objective To investigate the application effect of SBAR communication mode shift combined with the management of care quality indicators on patients with bile duct stones and their influence on postoperative complications. Methods Eighty patients with bile duct stones admitted to our hospital from January 2021 to December 2022 were selected,and divided into observation group and control group by drawing lots,40 cases each.All the patients were treated by surgery,and the control group patients received routine care,and the observation group patients added the SBAR communication mode.The quality of care,incidence of adverse events,satisfaction with care and incidence of postoperative complications of the two groups were compared. Results The quality of care values of basic care,nursing care,nursing responsibility,risk identification and risk prevention in the observation group were significantly higher than in the control group(P<0.05).There was no difference in the incidence of nursing side effects such as injection and oral administration errors,dressing changes,blood sampling errors,case clerk errors and delayed execution of medical orders between the two groups(P>0.05).Patient satisfaction in the observation group was significantly higher than that in the control group(P<0.05).The incidence of complications such as pressure ulcers,infections and venous thrombosis in the observation group was significantly lower than that in the control group(P<0.05). Conclusions SBAR communication mode and combined nursing quality index management for patients with bile duct stones,which can improve the quality of clinical nursing and patient nursing satisfaction,and further reduce the incidence of postoperative complications in patients.
论著

角膜胶原交联术围术期体验的质性研究

A qualitative study of corneal collagen cross-linking during perioperative period

:1264-1268
 
目的 了解行角膜胶原交联术患者围术期的体验感受,为角膜胶原交联术的顺利进行及术后康复提供参考依据。方法 采用目的抽样法,于2023年8月—2023年10月在中山大学中山眼科中心选取12例行角膜交联术的患者进行半结构式访谈,采取Colaizzi七步法进行整理分析资料。结果 通过分析得出患者在围手术期的5种感受:焦虑、疼痛、恐惧、紧张、盲目乐观。结论 分析角膜交联手术患者在围术期不同感受,做好围术期护理,希望有利于提高手术效果。
Objective To understand the perioperative experience of patients undergoing corneal collagen cross-linking surgery,and provide reference for the smooth progress of corneal collagen cross-linking surgery and postoperative rehabilitation.Methods Using purposive sampling method,12 patients who underwent corneal cross-linking surgery were selected from the Sun Yat-sen Ophthalmology Center of Sun Yat-sen University from August 2023 to October 2023 for semi-structured interviews.The data were analyzed using the Colaizzi seven step method.Results Through analysis,five feelings of patients during the perioperative period were identified:anxiety,pain,fear,tension and blind optimism.Conclusion sAnalyzing the different feelings of patients undergoing corneal cross-linking surgery during the perioperative period and providing good perioperative care can help achieve satisfactory results in the surgery.
论著

真武汤联合八段锦对老年冠心病患者心肺运动功能及生存质量的影响

Clinical effects of Zhenwu Decoction combined with Baduanjin Qigong on the cardiopulmonary function and quality of life in older adults with coronary heart disease

:1470-1475
 
目的 探讨真武汤联合八段锦在老年冠状动脉粥样硬化性心脏病(冠心病)患者中的应用效果。方法 将96例75岁以上冠心病患者按照随机数字表法分为对照组与干预组,每组各48例。在12周的临床研究期间,对照组用规范的冠心病二级预防药物治疗;干预组在规范的冠心病二级预防药物治疗基础上,增加真武汤以及八段锦运动处方。结果 治疗后干预组中医临床疗效(P=0.023)和中医证候积分(P<0.001)均优于对照组。两组患者的心肺运动试验指标均有改善,且干预组在升高峰值摄氧量(Peak VO2,P=0.005)、最大摄氧量(VO2max,P=0.001)、氧脉搏(VO2/HR,P=0.002)和无氧阈值时最大代谢当量(MET,P=0.001),以及降低无氧阈值(AT,P<0.001)和二氧化碳通气当量(VE/VCO2,P=0.020)方面比对照组更明显。两组患者在36项简明健康状态调查表(SF-36)评分的8个维度中评分均有所升高,其中在生理机能(P=0.001)、生理职能(P<0.001)、一般健康状况(P=0.018)、精力(P=0.007)、社会职能(P=0.010)、精神健康(P=0.004)方面,干预组效果优于对照组;而在躯体疼痛、情感职能维度改善方面,两组间结果相近,差异无统计学意义(P>0.05)。两组患者的匹兹堡睡眠质量指数(PSQI)均有所改善,且干预组效果优于对照组(P<0.001)。结论 真武汤联合八段锦能够进一步增强老年冠心病患者中医证候疗效,改善心肺运动试验Peak VO2、VO2max、VO2/HR、MET、AT、VE/VCO2等指标,并提高SF-36评分多个维度的生活质量及睡眠质量。
Objective To explore the therapeutic effects of Zhenwu Decoction combined with Baduanjin Qigong in older adults with coronary heart disease(CHD).Methods Ninety-six patients with CHD aged ≥75 years were randomly divided into a treatment group and a control group,with 48 patients in each group.Within the 12-week period,the control group received standard secondary prevention therapy for CHD,while the treatment group received Zhenwu Decoction and Baduanjin Qigong prescription,in addition to the standard treatment.Results After treatment,both groups showed improvement in the traditional Chinese medicine(TCM)clinical efficacy,TCM syndrome,SF-36 scores and Pittsburgh Sleep Quality Index(PSQI)scores;increase in Peak VO2,VO2max,VO2/HR,and metabolic equivalent(MET);and decrease in AT and VE/VCO2.However,the treatment group had a more pronounced improvement in the TCM clinical efficacy(P=0.023),TCM syndrome(P<0.001),PSQI scores(P<0.001),and cardiopulmonary exercise testing(CPET)indicators including Peak VO2(P=0.005),VO2max(P=0.001),VO2/HR(P=0.002),MET(P=0.001),AT(P<0.001)and VE/VCO2(P=0.020),compared to their control counterparts. For the SF-36 scores,in comparison to the control group,the treatment group presented better outcomes in enhancing physical functioning(P=0.001),role limitations due to physical health(P<0.001),general health(P=0.018),vitality(P=0.007),social functioning(P=0.010)and mental health(P=0.004),but not in pain or role limitations due to emotional problems.Conclusions The Zhenwu Decoction combined with Baduanjin Qigong can enhance the TCM syndrome,improve various CPET indicators such as Peak VO2、VO2max、VO2/HR、MET、AT and VE/VCO2,and elevate both quality of life and sleep quality among older adults with CHD.
论著

DCE-MRI多参数定量特征对乳腺癌腋窝淋巴结转移风险的预测研究

Prediction of risk of axillary lymph node metastasis in breast cancer by DCE-MRI multi-parameter quantitative feature

:1450-1455
 
目的 探讨动态对比增强磁共振成像(DCE-MRI)多参数定量特征对乳腺癌腋窝淋巴结转移(ALNM)风险的预测价值。方法 回顾性收集2020年3月—2022年11月在佛山市高明区人民医院经手术病理确诊的155例乳腺癌患者临床资料,根据患者是否发生ALNM分为ALNM 组(n=39)和无ALNM 组(n=116)。采用单因素分析和多因素Logistic回归分析乳腺癌发生ALNM的影响因素。结果 ALNM组和无ALNM 组患者的肿块质地、肿块直径、肿块部位、肿块形状、肿块内部强化特征等指标比较差异无统计学意义(t/χ2=2.249、0.977、1.369、0.524、2.158,P>0.05)。两组患者肿块表观扩散系数(ADC)值、腋窝淋巴结(ALN)短径、肿块边缘、动态增强时间-信号强度曲线(TIC)曲线等指标比较,差异有统计学意义(t/χ2=6.573、9.873、29.441、2.031,P<0.05)。二元Logistic回归模型结果显示,肿块ADC值、ALN 短径(≥5 mm)、TIC曲线(流出型)为乳腺癌ALNM发生的危险因素(OR=0.251、0.106、0.002,P<0.05)。结论 DCE-MRI多参数定量特征中,乳腺癌患者的肿块ADC值低、ALN 短径(≥5 mm)、TIC曲线(流出型)为乳腺癌ALNM发生的危险因素。
Objective To investigate the predictive value of multi-parameter quantitative features of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the risk of axillary lymph node metastasis(ALNM)in breast cancer.Methods Clinical data of 155 patients with breast cancer diagnosed by surgery and pathology in Foshan Gaoming District People's hospital from March 2020 to November 2022 were retrospectively collected.According to whether the patients had ALNM,they were divided into ALNM group(n=39)and non-ALNM group(n=116).Univariate analysis and multiple Logistic regression models were used to explore the influencing factors of ALNM in breast cancer.Results There was no significant difference in mass texture,mass diameter,mass location,mass shape and internal enhancement between the ALNM group and the non-ALNM group(t/χ2=2.249,0.977,1.369,0.524,2.158,P>0.05).There were significant differences in ADC value,ALN short diameter,tumor margin and TIC curve between the two groups(t/χ2=6.573,9.873,29.441,2.031,P<0.05).Binary Logistic regression model showed that ADC value,ALN short diameter(≥5 mm)and tumor margin(blur)were risk factors for the occurrence of breast cancer ALNM(OR=0.251,0.106,0.002,P<0.05).Conclusions Among the multi-parameter quantitative features of DCE-MRI,the ADC value of breast cancer,the short diameter of ALN(≥5 mm),and the edge of the tumor(blur)are the risk factors for the occurrence of ALNM in breast cancer.
论著

护理人员对预防住院患者跌倒相关知识掌握度的现状调查探究

Investigation on the current situation of nursing staffs' knowledge on prevention of falls in hospitalized patients

:1414-1420
 
目的 调查护理人员对预防跌倒知识掌握的情况,以提高其对防跌倒相关知识的认知水平,减少住院患者跌倒的发生。方法 用自编住院患者跌倒相关知识掌握量表对护理人员进行问卷调查。结果 护理人员对跌倒知识的掌握正确率最高为跌倒分级64.04%、最低为跌倒后干预措施17.10%。外科护理人员对患者跌倒风险评估时机的把握为88.69%,妇儿科护理人员的正确率(71.11%)高(χ2=21.319,P=0.003),住院患者发生跌倒后的处理正确率急诊为76.67%,高于门诊的42.67%(χ2=27.651,P<0.001);在把握患者跌倒风险评估的时机方面工作年限<5年的护理人员为 89.81%,比工作年限>20年的护理人员(64.15%)更容易把握患者跌倒风险评估的时机(χ2=18.921,P<0.001),工作年限11~20年的护理人员对住院患者预防跌倒的干预措施正确率为24.66%,比工作年限<5年的护理人员(11.46%)高(χ2=9.678,P=0.022);工作年限>20年的护理人员对住院患者发生跌倒后的处理正确率为58.49%比工作年限<20年以下的护理人员(34.25%)高(χ2=12.787,P=0.005)。结论 护理人员跌倒预防相关知识掌握度总体较低,应加强对护理人员关于患者跌倒预防知识的系统培训,减少住院患者跌倒的发生。
Objective To investigate the mastery of falls prevention knowledge among nursing staffs,in order to improve their cognitive level of falls prevention related knowledge and reduce the occurrence of falls in hospitalized patients.Methods A questionnaire survey was conducted among nursing staffs with a self-designed questionnaire on the mastery of falls related knowledge among hospitalized patients.Results The highest accuracy rate of nursing staffs' mastery of falls knowledge was 64.04% for falling classification,and the lowest was 17.10% for falls intervention measures.Nursing staffs' accuracy of the timing of patient fall risk assessment was 88.69% in surgery,which was higher than 71.11% in nursing staff in obstetrics,gynecology,and pediatrics(χ2=21.319,P=0.003).The accuracy of emergency treatment for hospitalized patients after falls was 76.67%,which was higher than 42.67% in outpatient treatment(χ2=27.651,P<0.001).The accuracy of the timing of patient fall risk assessment in nursing staffs with less than 5 years of work experience was 89.81%,which was better than nursing staff with more than 20 years of work experience(64.15%)(χ2=18.921,P<0.001).Nursing staff with 11-20 years of work experience had a correct intervention rate for preventing falls in hospitalized patients of 24.66%,which was higher than nursing staffs with less than 5 years of work experience(11.46%)(χ2=9.678,P=0.022).The accuracy rate of handling falls in hospitalized patients by nursing staffs with more than 20 years of work experience was 58.49%,which was higher than that of nursing staff with less than 20 years of work experience,which is 34.25%(χ2=12.787,P=0.005).Conclusions Overall,nursing staff had a low level of falls prevention knowledge,and systematic training on patient fall prevention should be strengthened to reduce the occurrence of falls in hospitalized patients.
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