目的 分析影响广州青少年自杀行为的因素。方法 选取100例自杀行为青少年为观察组,选100例健康青少年为对照组,对比两组青少年家庭结构、家庭教育方式、自身人格特征等指标。多因素Logistic回归分析其自杀行为危险因素。结果 观察组青少年抑郁量表、焦虑量表、攻击性人格及冲动性人格量表分值均高于对照组高;单亲家庭或父母常年在外、家庭教育方式不当、学校无健康心理教育课、抑郁或焦虑、冲动或攻击性人格、负面事件、消极应对是青少年自杀行为独立危险因素,P均＜0.05。结论 家长及学校应正确引导青少年处事方式,积极面对生活,打消自杀意念。

Objective To analyze the factors influencing the suicide behavior of adolescents in Guangzhou. Methods The 100 cases of adolescent suicide behavior were selected as the observation group, 100 healthy adolescents were selected as control group, compared with two groups of adolescent family structure, family education, personality traits and other indicators. Multivariate logistic regression analysis of risk factors was taken for suicidal behavior. Results In the observation group adolescent depression scale, anxiety scale, attack impulse personality and personality amount scores were higher than those in the control group, single parent family or parents staying outside, improper family education, school health psychological education, depression or anxiety, impulsivity, or aggressive personality, negative events, negative coping were independent risk factors for adolescent suicide, P<0.05. Conclusion Parents and schools should have guide to adolescents, toface life positively, and give up thought of suicide.

目的 探讨结肠粪性穿孔的发病原因、临床特点、诊断和治疗方法。方法 回顾性分析广州市第一人民医院2012年1月—2015年1月收治的12例结肠粪性穿孔病人的临床资料。结果 本组病人共12例,均因腹膜炎体征行剖腹或腹腔镜探查术,术中根据Maurer标准诊断为结肠粪性溃疡穿孔。本组病人术后治愈出院10例,治愈率为83.3%,2例80岁以上病人因感染中毒性休克、多器官功能衰竭分别于术后第2天及第3天在重症监护病房死亡,死亡率为16.7%,术后主要合并症为肺炎(10例,83.3%)及胸腔积液(12例,100%)。结论 在临床工作中,了解结肠粪性穿孔发生的危险因素,及时进行有针对性的辅助检查,快速手术干预是降低病死率的关键。

Objective To explore the causes, clinical characteristics, diagnosis and treatment of stercoral perforation of colon. Methods The clinical data of 12 cases of stercoral perforation of colon from Jan 2012 to Jan 2015 were retrospectively analyzed. Results There were twelve patients who were diagnosed stercoral perforation of colon according to accurate diagnostic criteria during the open or laparoscopic operation. Of the 12 cases, 10 cases (83.3%) were cured, 2 cases (16.7%) died because of septic shock and multiple organ failure in the intensive care unit. After operation 10 cases (83.3%) had pulmonary infection and 12 cases (100%) had pleural effusion. Conclusion The key of improve the prognosis of stercoral perforation of colon depends on the full understanding of risk factors, proper preoperative examination and prompt surgical procedures.

目的 调查分析注射剂药品说明书中有关老年人用药描述,为完善和修订注射剂药品说明书提供参考依据。方法 收集某医药公司经营300个品种注射剂的药品说明书,按药理作用、国内外生产厂家和所含成份等统计药品说明书中老年人用药内容的标注情况。结果 在所调查的注射剂药品说明书中,284份(95%)注射剂说明书标注有老年用药项,其中48份(17%) 标注老年人具体用量;236份(83%)标注模糊,标注有“老年人药代动力学”仅39份(占13%);国内外厂家的注射剂在老年人用药标注情况有差异(P<0.01)。结论 注射剂药品说明书在老年人用药方面描述不足,需引起政府和各方面的关注,相关部门应加强对注射剂药品说明书的安全监管,完善说明书的内容,以保证药品说明书的科学性、合理性和有效性。

目的 探讨心理健康干预对复治肺结核患者在整个治疗过程中生活质量影响,为加强结核病的宣教奠定坚实的基础。方法 选取广州市结核病防治所在治的复治肺结核病人72例,随机分成宣教组和普通组,选取2名有丰富经验的主管护师,经专业心理师培训指导,护长考核,负责宣教组的工作,而普通组则由轮班护士进行,无作特别要求。对比两组心理健康干预前后的变化。结果 两组症状自评量表(SCL-90)测评相比较,宣教组优于普通组,差异有统计学意义(P<0.05)。宣教组的生理健康总评及精神健康总评比对照组好,差异均有统计学意义(P<0.05)。结论 通过对门诊复治结核病患者进行心理健康干预,能有效改变复治病人的心理和生理健康,提高生活质量。

目的 观察慢性荨麻疹特异性免疫治疗(SIT)的早期疗效,同时对患者的不良反应及依从性做相应调查。方法 对206例在我院进行特异性免疫治疗的慢性荨麻疹患者资料进行汇总分析,比较治疗16周及24周两组患者的荨麻疹活动评分(UAS)及症状积分下降指数(SSRI)以判断两组的有效率,同时对脱落患者进行电话访问。结果 特异性免疫治疗24周组与治疗16周组相比RRSI下降明显(P<0.05),有效率较高(P<0.05);206例患者中有62例脱落,脱落率较高(30.1%)。结论 特异性免疫治疗对于慢性荨麻疹的症状改善明显,但脱落率高,治疗24周相比治疗16周效果更佳。

目的 探讨重症急性胰腺炎诊治特点。方法 回顾性分析13例重症急性胰腺炎患者临床资料,包括一般资料、生化检测及影像资料、治疗措施与预后结果,纳入标准为急性胰腺炎合并器官衰竭＞48 h(改良Marshall评分≥2分)。结果 重症急性胰腺炎患者一般资料中普遍突出存在心率增快(121.07±28.09)次/分、APACHE II评分偏高(18.92±7.34),病因排序则是高脂血症(38.5%)＞胆石症(30.8%)＞酒精性(23.1%),SAP合并ARDS发生率可达46.2%,合并AKI则高达69.2%;WBC(12.60±5.57)×10⁹/L、CRP(138.16±67.06)mg/L及PCT(15.76±27.33)ng/L等炎症指标升高提示SAP普遍存在炎症反应,影像学中69.2%患者合并发生肺炎及腹腔积液则提示多处感染部位,其他脏器指标异常升高也提示SAP患者心肺肝肾均存在不同程度的受损;接受CRRT治疗及呼吸支持可分别达46.2%及76.9%,7天内死亡例数为1例(7.7%),28天内死亡例数为4例(30.8%),ICU及总住院时间为(10.77±7.38)及(19.61±13.40)天。结论 重症急性胰腺炎是全身及局部性的炎症反应累及全身各个脏器的急性复杂病变,以合并发生ARDS及AKI为临床特征,需要多器官功能保护与替代、外科干预等多学科综合协作治疗。

Objective To evaluate characteristics of diagnosis and treatment on severe acute pancreatitis. Methods To respective analysis clinical data of 13 patients with severe acute pancreatitis. The data included baseline characteristics, biochemical tests and imaging data, treatment and prognosis, inclusion criteria for acute pancreatitis with organ failure > 48 h (modified Marshall score > 2). Results Higher heart rate(121.07±28.09) times/min and APACHEII scores(18.92±7.34) were universally found in SAP, which primary disease contained hyperlipidemia (38.5%) > cholelith disease (30.8%) > alcohol (23.1%) with incidence of ARDS and AKI being 46.2% and 69.2%; Higher inflammatory biomarkers including WBC(12.60±5.57)×10⁹/L, CRP(138.16±67.06)mg/L and PCT(15.76±27.33)ng/L indicated widespread inflammation with many infection sites revealing by 69.2% pneumonia and peritoneal effusion on imaging; Other abnormally biochemical index prompted some injury of viscera including heart, lungs, kidney and liver; 1 case suffered death within 7 days and 4 cases also did within 28 days, ICU and total length of hospital stay was (10.77±7.38) and (19.61±13.40) days, CRRT treatment and respiratory support respectively reached 46.2% and 46.2%. Conclusion Severe acute pancreatitis is a acute complex pathological changes on various organs induced by acute systemic and local inflammation with feature of mergence with the ARDS and AKI, which need the multidisciplinary integrated collaborative treatment on organ function protection and sustain and surgical intervention.

目的 探讨信息预警系统在住院患者压疮风险管理中的运用。方法 应用描述性分析,χ²检验和t检验方法,对实施信息预警系统前后的院内压疮发生率、压疮护理质量管理指标以及使用纸质版和电子版Waterlow量表评估患者压疮危险的平均时间进行比较。结果 试行信息预警系统后,院内压疮发生率下降至0.11‰;护士对压疮危险患者评估率、动态评估率和预防压疮措施落实率都明显升高;护士使用电子版Waterlow量表评估患者压疮危险耗时显著减少。结论 信息预警系统在住院患者压疮风险管理中起到重要作用,为临床护理和护理管理提供了良好的工具,保障患者安全。

Objective To explore the application of risk management information system in the inpatients' risk management of pressure ulcers (PUrs). Methods A descriptive analysis, Chi-square test and T-test were used to analyze the incidence of inpatients' PUrs and indicators of the nursing quality control before and after applying the risk management information system. Results After using this information system, incidence of PUrs decreased to 0.11‰ . Rate of registered nurses' assessment on inpatients' with PUrs risk and dynamically assessment rose obviously. The rate of prevention of PUrs went up as well. The mean time to assess inpatients' PUrs risk with electronic Waterlow scale was significantly less than the mean time of paper Waterlow scale. Conclusion The risk management information system played a vital role in the inpatients' PUrs risk management. It could provide an effective tool for the clinical nursing's quality control, improve registered nurses' efficiency and protect inpatients'safety.

目的 观察康复路径在髋关节置换术后的临床应用效果,探讨其临床应用价值 。方法 将广州市第一人民医院2014年10月—2015年10月收治行髋关节置换术患者100例为研究对象,随机分为对照组与观察组各50例。对照组采取常规围手术期护理,观察组按照康复路径护理,比较两组患者术后并发症、住院时间、费用、患肢功能以及日常生活自理能力。结果 观察组住院时间和住院费用均少于对照组(P<0.01);两组术后并发症发生率、患肢功能评分及日常生活自理能力比较,差异均有统计学意义(P<0.01 )。结论 康复计划护理用于髋关节置换术后效果显著,可明显降低患者术后并发症,缩短住院时间,降低住院费用,有利于促进患者术后功能以及自理能力的恢复。

Objective To observe the effect of clinical application of rehabilitation in the path of a hip replacement, and to explore its clinical application value. Methods October 2014 to October 2015 in Guangzhou First People's Hospitalhip arthroplasty cases werecollected of 100 patients as the research object, randomly divided into control group and observation group with 50 cases in each group. The control group adopted conventional perioperation period nursing care, observation group in accordance with the recovery paths. We compared two groups of patients complications, hospitalization time, expense, limb function and activities of daily living. Results In the observation group, the hospitalization time and cost of hospitalization were significantly less than that of the control group (P<0.01); The incidence of limb function score, ability of daily living and postoperative complications were compared between the two groups, the differences were statistically significant (P<0.01). Conclusion Rehabilitation nursing care plans for after hip replacement effect is significant. It can significantly reduce the postoperative complications, shorten the time of hospitalization, reduce hospitalization expenses, and is beneficial to the recovery of the function of promoting postoperative and self-care ability.

目的 观察体重管理对轻型代谢综合征患者的体重指数、血糖、血压、甘油三酯等指标的影响。方法 将40例新诊断的轻型代谢综合征患者随机分成体重管理组和对照组,每组20例。两组患者分别于干预前、干预3月、干预6月检测体重指数、血糖、血压、甘油三脂等治疗,并比较两组患者上述指标。结果 干预6月后,体重管理组的体重指数、甘油三酯均显著性低于对照组,差异有统计学意义(P均＜0.05);体重管理组的高密度脂蛋白高于对照组,但无统计学差异。干预6月,体重管理组中血压、血糖达标率高于对照组,差异有统计学意义。结论 体重管理能改善轻型代谢综合征患者的体重指数、血糖、血压、甘油三脂等指标。

Objective To investigate the influence of weight management to body index, blood glucose, blood pressure and triglycerides in mild metabolic syndrome. Methods 40 mild metabolic syndrome patients were randomly divided into weight management group (20 patients) and control group (20 patients). The body index, blood glucose, blood pressure and triglycerides were observed and compared before intervention, 3 months and 6 months after intervention. Results After 6 months intervention, the body index and triglycerides in weight management group were significantly lower than the control group (P＜0.05). High density lipoprotein cholesterol in the weight management was higher than the control group, but there was no significant. The success rate of blood glucose and blood pressure were significantly higher than the control group. Conclusion Weight management can significantly improve the body index, blood glucose, blood pressure and triglycerides in patients with mild metabolic syndrome.

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.