目的 探讨弹力带抗阻训练对老年人骨骼肌功能的影响。方法 在我院筛选60例老年人随机分为两组,对照组30例患者采用常规康复训练,观察组30例患者采用弹力带抗阻训练;分别于干预前及干预3月后评价骨骼肌功能,分析跌倒风险指数。结果 对照组干预前后骨骼肌质量指数、握力、歩速以及平衡量表BBS评分比较无差异(P>0.05);观察组干预后骨骼肌质量指数、6 m步速、握力均高于对照组,平衡量表BBS评分低于对照组(P<0.05)。结论 弹力带抗阻训练能够提高老年人骨骼肌质量、改善老年人握力计和歩速,提高平衡能力。

Objective To investigate the effect of elastic band resistance training on skeletal muscle function in the elderly. Methods 60 elderly patients in our hospital were selected and randomly divided into two groups. 30 patients in the control group received conventional rehabilitation training, while 30 patients in the observation group received elastic band resistance training. Skeletal muscle function was evaluated before intervention and 3 months after intervention, and the fall risk index was analyzed. Results There were no significant differences in skeletal muscle mass index, grip strength, pacing and BBS scores of balance scale before and after intervention in the control group (P>0.05). After intervention, the skeletal muscle mass index, 6 m step speed and grip strength of the observation group were all higher than those of the control group, and the BBS score of balance scale was lower than that of the control group (P<0.05). Conclusion The elastic band resistance training can improve the skeletal muscle quality, improve grip strength and pacing, and improve the balance ability in the elderly.

目的 观察结直肠癌患者使用联合药物FOLFOX化疗前后左心室应变参数的变化。方法 选取健康人30例作为正常组,收集病理确诊为结直肠癌并采用FOLFOX(5-氟尿嘧啶+奥沙利铂+亚叶酸钙)化疗的患者30例,以自身对照做研究,分别在化疗前、化疗1个周期后、化疗6个周期后、化疗12个周期后48 h内完成心脏超声检查,采集左心室的动态图像,获取常规参数:LVEDd、LVEDs、IVSd、LVPWd、LVEDV、LVESV、LVEF、LVFS;三维参数:SPI、SV、CO、LVEDMass、LVESMass、GAS、GRS、GLS、GCS,并比较化疗前后这些数值的变化。结果 正常组与各化疗组相比对,LVEDd、LVEDs、IVSd、LVPWd、LVPW、LVESV、SPI的变化均无统计学意义(P>0.05);LVEF、LVFS、SV、CO在化疗中、后期出现了降低,差异有统计学意义(P<0.05),HR、LVEDMass、LVESMass略升高,差异有统计学意义(P<0.05);化疗后GLS及GAS较化疗前明显减低(P<0.05),其中GAS的ROC曲线下面积为0.883,P<0.001,选30%为诊断界点,灵敏度为86.7%,特异度为80%;GLS的ROC曲线下面积为0.888,P<0.001,选19%为诊断界点,灵敏度为73.3%,特异度为90.0%。结论 三维斑点追踪技术能够早期发现FOLFOX致结直肠癌患者左心室功能的变化,其中LVGLS、LVGAS是有力的观测指标。

Objective To observe the changes of left ventricular strain parameters in patients with colorectal cancer before and after combined chemotherapy with FOLFOX. Methods 30 healthy people were selected as normal group, and 30 patients with pathologically diagnosed colorectal cancer and FOLFOX (5-fluorouracil +oxaliplatin+calcium leucovorin) chemotherapy were collected. Before, after 1 cycle of chemotherapy, after 6 cycles of chemotherapy, and within 48 hours after 12 cycles of chemotherapy, cardiac ultrasound examination was performed, and dynamic images of the left ventricle were collected to obtain conventional parameters: LVEDd, LVEDs, IVSd, LVPWd, LVEDV, LVESV, LVEF, LVFS; three-dimensional parameters: SPI, SV, CO, LVEDMass, LVESMass, GAS, GRS, GLS, GCS, and the changes of these values before and after chemotherapy were compared. Results Compared with the chemotherapy group, the normal group had no statistically significant changes in LVEDd, LVEDs, IVSd, LVPWd, LVPW, LVESV, and SPI (P>0.05); LVEF, LVFS, SV, CO were in the middle and late stages of chemotherapy. There was a decrease, the difference was statistically significant (P<0.05), HR, LVEDMass, LVEESMass were slightly increased, the difference was statistically significant (P<0.05); LGS and GAS after chemotherapy were significantly lower than before chemotherapy (P<0.05), the area under the ROC curve of GAS is 0.883, P=0.000, 30% is selected as the diagnostic boundary, the sensitivity is 86.7%, and the specificity is 80%; the area under the ROC curve of GLS is 0.888, P=0.000, 19% as a diagnostic boundary, the sensitivity is 73.3% and the specificity is 90.0%. Conclusion Three-dimensional speckle tracking technology can detect the changes of left ventricular function in patients with colorectal cancer caused by FOLFOX in early stage, of which LVLGS and LVGAS are powerful observation indicators.

目的 探讨扩张型心肌病采用诺欣妥治疗的效果及对其心功能的影响。方法 本文将2020年2月—2020年10月收治的扩张型心肌病患者50例作为研究对象,对所有患者按照随机方式进行分组,对照组25例患者以常规抗心衰治疗与依那普利治疗,观察组25例患者在常规抗心衰治疗的基础上给予诺欣妥治疗,统计分析用药后有效率、治疗前后心功能指标、6 min步行距离及炎症因子水平。结果 两组之间炎症因子水平相比,观察组较对照组低;6 min步行距离、用药后有效率相比,观察组较对照组高;心功能指标相比,观察组SV、LVEF较对照组高,LVESD、LVEDD较对照组低,P＜0.05。结论 采用诺欣妥治疗扩张型心肌病效果显著,总有效率较好,可有效改善患者心功能指标,增加6 min步行距离,减轻炎症因子水平,改善患者预后。

目的 探讨延续性健康指导联合预见性干预对慢性脑卒中患者脑功能影响。方法 选取2019年6月—2020年6月我院收治的慢性脑卒中患者118例,使用随机数字表法将其分为两组,对照组进行预见性干预,研究组进行延续性健康指导联合预见性干预。比较两组效果、神经运动功能、不良反应。结果 研究组效果大于对照组(P＜0.05);研究组神经运动功能大于对照组(P＜0.05);研究组不良反应少于对照组(P＜0.05)。结论 慢性脑卒中护理中,延续性健康指导联合预见性干预效果较好,值得应用。

Objective To investigate the effects of continuous health guidance and combined predictive intervention on cerebral function in patients with chronic stroke. Methods A total of 118 patients with chronic stroke admitted to our hospital from June 2019 to June 2020 were selected and divided into two groups using the random number table method. The control group received predictive intervention, and the study group received continuous health guidance combined predictive intervention. The effects, neuromotor functions and adverse reactions of the two groups were compared. Results The effect of the study group was greater than that of the control group (P<0.05). The neuromotor function of the study group was higher than that of the control group (P<0.05). The adverse reactions in the study group were less than those in the control group (P<0.05). Conclusion In the nursing of chronic stroke, the effect of continuous health guidance combined with predictive intervention is good, and it is worth applying.

目的 探讨选择性会阴侧切术对会阴体及产后盆底功能的影响。方法 选取2018年1月—2019年12月在广州市红十字会医院顺产的初产妇作为研究对象,研究组为选择性会阴侧切组、对照组为常规治疗,统计两组的会阴裂伤情况,盆底Ⅰ类肌、Ⅱ类肌肌力分级,POPQ评分的分级,肛提肌裂孔扩张情况。结果 会阴裂伤率:研究组2.5%,对照组为56.22%,连续性校正χ²为53.14,连续性校正P＜0.05。盆底Ⅰ类、Ⅱ类肌力＜3级发生率:研究组分别为30%、23%,对照组分别为 49%、38%,χ²分别为9.03、5.96,P＜0.05。POPQ 0级率:研究组26.25%,对照组12.5%,χ²为4.84,P＜0.05。肛提肌裂孔无扩张率:研究组16.25%,对照组为5%,χ²为5.33,P＜0.05。结论 在本研究中,与对照组相比,研究组会阴裂伤率、盆底肌力<3级发生率更低;盆腔器官无脱垂率、肛提肌裂孔无扩张率更高。选择性会阴侧切术对会阴体及盆底功能具有保护作用。

Objective To investigate the effect of selective lateral episiotomy on perineal body and pelvic floor function. Methods The primiparas who delivered naturally in Guangzhou Red Cross Hospital from January 2018 to December 2019 were selected as the research subjects. The research group were given selective lateral episiotomy, while the control group were given conventional treatment. The incidence of perineal laceration, pelvic floor muscle strength lower than grade 3, the POPQ score and levator ani hiatus dilatation were analyzed. Chi-square test was used to analyze the incidence of the two groups. Results The incidence of perineal laceration in the research group was 2.5% vs 56.22% in the control group(χ²=53.14, P<0.05). The incidence of pelvic floor muscle(group I) strength lower than grade 3 in the research group was 30% vs 49% in the control group(χ²=9.03, P<0.05). The incidence of pelvic floor muscle(group II) strength lower than grade 3 in the research group was 23% vs 38% in the control group(χ²=5.96, P<0.05). The rate of the incidence of POPQ 0 in the research group was 26.25% vs 12.5% in the control group (χ²=4.84,P＜0.05). The incidence of levator ani hiatus dilatation in the research group was 16.25%, while 5% in the control group (χ²=5.33, P<0.05). Conclusion Compared with conventional treatment group, selective lateral episiotomy group has a lower incidence of perineal laceration and pelvic floor muscle strength lower than grade 3. Selective lateral episiotomy group has a higher incidence of POPQ 0 and no levator ani hiatus dilatation. Selective lateral episiotomy can protect the perineal body and pelvic floor function.

目的 分析慢性肾衰竭患者接受肾衰康方治疗对其血清微炎症状态的影响及肾功能的保护作用。方法 将2020年1月—2020年12月作为研究时间段,选取期间广东祈福医院接诊的50例慢性肾衰竭患者,另将随机数字表法作为分组依据,将全部病例分为对照组(行常规治疗,纳入25例)、观察组(加用肾衰康方治疗,纳入25例),对组间中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标展开分析。结果 组间中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标在治疗前无明显差异,P>0.05;观察组中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标在治疗后优于对照组,P<0.05。结论 肾衰康方对改善慢性肾衰竭患者血清微炎症状态、氧化应激水平、临床症状均有较好效果,且能保护肾功能,值得推广。

Objective To analyze the effect of Shenshuaikang decoction on serum microinflammation and renal function in patients with chronic renal failure. Methods From January 2020 to December 2020, 50 patients with chronic renal failure treated by Clifford Hospital were selected, and the random number table method was used for grouping. All cases were divided into control group (n=25) and observation group (n=25). The TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index were analyzed. Results There were no significant differences in TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index between the two groups before treatment, P>0.05; the TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index of the observation group were better than those of the control group after treatment, P<0.05. Conclusion Shenshuaikang decoction has good effect on improving serum microinflammation, oxidative stress level and clinical symptoms of patients with chronic renal failure, and also can protect renal function, which is worthy of promotion.

目的 探讨肝硬化患者临床凝血功能检验中全自动血凝仪测定的应用及临床价值。方法 选取2018年1月—2020年1月我院收治的64例肝硬化患者(肝硬化组),并纳入同期来我院接受健康体检者64例(对照组),应用全自动血凝仪对肝硬化患者临床凝血指标检测。再将肝硬化组患者分为出血组与无出血组,比较对照组与肝硬化组、出血与无出血组、不同肝功能分级患者血小板参数与PT检测结果。结果 与对照组比较,肝硬化组PDW、PT、MPV、INR水平更高,PCT、PLT水平更低(P＜0.05);与肝硬化无出血组比较,肝硬化出血组PDW、PT、MPV、INR水平更高,PCT、PLT水平更低(P＜0.05);与Child-Pugh A级患者比较,肝硬化Child-Pugh B级与C级患者PDW、PT、MPV、INR水平更高,PCT、PLT水平更低(P＜0.05)。结论 在肝硬化患者病情评价中凝血功能检验发挥重要作用,可为患者临床治疗提供有效理论依据,诊断准确率较高,有利于临床治疗措施制定。因此,凝血功能检验应在肝硬化疾病诊断中广泛应用。

Objective To explore the application and clinical value of automatic blood coagulation apparatus in clinical coagulation function test of patients with cirrhosis. Methods A total of 64 patients with cirrhosis admitted to our hospital from January 2018 to January 2020 (cirrhosis group) were selected, and 64 healthy subjects admitted to our hospital during the same period (control group) were included. The clinical coagulation indexes of patients with cirrhosis were detected by automatic blood coagulation apparatus. Patients in cirrhosis group were divided into bleeding group and non-bleeding group; platelet parameters and PT test results were compared between control group and cirrhosis group, bleeding group and non-bleeding group, and patients with different liver function grades. Results Compared with the control group, the levels of PDW, PT, MPV and INR in cirrhosis group were higher, and the levels of PCT and PLT were lower (P＜0.05). Compared with liver cirrhosis non-bleeding group, the levels of PDW, PT, MPV and INR were higher in liver cirrhosis with bleeding group, and the levels of PCT and PLT were lower (P＜0.05). Compared with Child-Pugh A patients, the levels of PDW, PT, MPV and INR in Child-Pugh B and C patients with cirrhosis were higher, and the levels of PCT and PLT were lower (P＜0.05). Conclusion The test of coagulation function plays an important role in the evaluation of patients with cirrhosis, and can provide effective theoretical basis for the clinical treatment of patients with high diagnostic accuracy, which is conducive to the formulation of clinical treatment measures. Therefore, the test of coagulation function should be widely used in the diagnosis of cirrhosis.

目的 探讨糖尿病肾病患者肾功能恶化的危险因素。 方法 采用回顾性队列研究分析山东省立第三医院2017年1月—2020年5月108例患者的临床数据。将病人分为糖尿病肾病肌酐翻倍组和不翻倍组,比较两组间临床数据的变化。结果 糖尿病肾病肌酐翻倍组的BUN、胱抑素C和ACR水平均高于肌酐不翻倍组;eGFR、CO₂、ALB、HGB均低于肌酐不翻倍组,差异有统计学意义(P<0.05)。而UA、GLU、血脂、糖化血红蛋白,糖尿病和高血压病史差异无统计学意义(P>0.05)。相关分析表明血肌酐与BUN、eGFR、胱抑素C、ACR呈正相关;与ALB,HGB和CO₂呈负相关。多元线性回归分析结果显示,eGFR,胱抑素C,ACR, ALB和HGB是糖尿病肾病肾功能恶化的影响因素(P<0.05)。结论 糖尿病肾病除检测肾功能的常规指标外,还可观察ACR、ALB和HGB水平的变化,对判断患者肾功能是否恶化有一定价值。

Objective To investigate the risk factors of renal function deterioration in patients with diabetic nephropathy. Methods Retrospective cohort study was used to analyze the clinical data of 108 patients from January 2017 to May 2020 in the Third Hospital of Shandong Province. Patients were divided into diabetic nephropathy creatinine doubling group and non-doubling group. The changes of clinical data in two groups were compared and the risk factors of renal function deterioration were analyzed. Results The levels of BUN、cystatin C and ACR in the creatinine doubling group were higher than those in the creatinine non-doubling group, and the levels of eGFR、CO₂、ALB、 HGB were lower than those in the creatinine non-doubling group, the differences were statistically significant (P<0.05). However, there were no significant differences in the levels of UA, blood glucose, blood lipid, glycosylated hemoglobin, the history of diabetes and hypertension (P>0.05). The correlation analysis showed that serum creatinine was positively correlated with BUN、 eGFR、cystatin C and ACR and negatively correlated with CO₂、ALB and HGB. The results of multiple regression analysis showed that eGFR、cystatin C、ACR、ALB and HGB were independent influencing factors of renal function deterioration(all P<0.05). Conclusion Diabetic nephropathy can not only notice the routine indexes of renal function, but also observe the changes of ACR、ALB and HGB levels, which has certain value for awareing the renal function deterioration in patients.

目的 探讨将宫腔镜电切手术与高效孕激素治疗相联合,治疗青年女性子宫内膜癌的临床效果以及对患者生育功能的影响。方法 选取2018年5月—2020年5月我院收治的70例青年子宫内膜癌患者作为本次研究对象,根据患者入院时间单双号将患者分为对照组(n=35)和实验组(n=35),对照组患者应用高效孕激素治疗,实验组患者则在对照组的基础上联合应用宫腔镜电切术进行治疗。比较两组患者的临床疗效、再次妊娠的成功率,及血清CA125水平变化情况。结果 研究组患者在治疗后3个月的治疗有效率为94.2%,高于对照组患者治疗有效率74.2%,差异具有统计学意义(P<0.05);研究组在治疗后一年内成功受孕率91.4%高于对照组51.4%,差异具有统计学意义(P<0.05);治疗后,研究组血清CA125水平低于对照组(P<0.05)。结论 将宫腔镜电切术与高效孕激素治疗方式相结合,对治疗青年子宫内膜癌患者效果显著,能够保留患者生育功能的同时,降低血清CA125水平。

目的 观察四通道FES对脑卒中患者下肢运动功能的影响,为其临床应用及推广提供依据。方法 将入组的49例脑卒中患者随机分为四通道FES组(17例)、单通道FES组(16例)和对照组(16例),三组患者均进行(除电刺激)综合康复训练,四通道FES组模仿正常人行走时肌肉收缩的时序刺激患侧下肢的股四头肌、胫骨前肌、腓肠肌及腘绳肌。单通道FES组患者仅在迈步时刺激患侧下肢的胫骨前肌,而股四头肌、腓肠肌、腘绳肌三块肌肉仅作安慰刺激。对照组患者在上述四块肌肉处做安慰刺激(即仅在这四处肌肉贴电极片,但没有电流)。治疗时间为每周5次,持续2周共10次,在治疗前、治疗后1周、治疗后2周分别进行患侧下肢运动功能评定及平衡功能评估。结果 组内前后比较:两组患者治疗前、治疗后一周、治疗后两周下肢功能(FMA)及平衡功能(Berg)逐步提高(P＜0.05)。组间比较:治疗后一周三组差异无统计学意义(P＞0.05);治疗后两周三组有统计学意义,经过两两比较发现,只有四通道组与对照组之间差异有统计学意义(P＜0.05),其他两组之间均无统计学意义。结论 应用基于正常行走模式四通道FES治疗可以改善患者的下肢功能及平衡功能。