论著

基于PERMA模式的综合护理对宫颈癌术后患者性功能、抑郁及主观幸福感的影响

Effect of comprehensive care based on PERMA model on sexual function,depression and subjective well-being of postoperative patients with cervical cancer

:170-175
 
目的 探讨积极综合护理措施对早期宫颈癌术后患者性功能、抑郁和主观幸福感的影响。方法 对我院收治的84例50岁以下宫颈癌患者的临床资料进行回顾性分析,将行常规护理的43例患者作为对照组、行综合护理的41例患者作为治疗组,治疗组除了常规护理内容,还采用幸福理论框架模型下(PERMA模型)的性健康管理多学科团队干预方案。分别在干预前、干预后3个月、干预后6个月采用女性性功能指数、抑郁自评量表评分和幸福感指数,对性功能指数、抑郁评分和幸福指数进行评估。结果 与对照组相比,治疗组干预3个月及6个月患者的性功能改善(F=91.08,P<0.001)。干预3个月及6个月后,治疗组抑郁评分低于对照组(F=1 092.59,P<0.001),幸福感改善指数高于对照组(F=107.90,P<0.001)。Spearman相关分析结果显示,女性性功能指数同抑郁自评量表得分呈负相关(rs=-0.918,P<0.001),同幸福感指数得分呈正相关(rs=0.844,P<0.001)。结论 综合护理在性功能、抑郁和主观幸福感方面均有明显改善。通过PERMA模式下性健康管理的多学科团队干预方案,可以提高患者的性生活质量,降低患者的抑郁程度,及改善患者的主观幸福感。
Objective To explore the effects of active and comprehensive care measures on sexual function,depression and subjective well-being of patients after early cervical cancer surgery.Methods The clinical data of 84 cervical cancer patients(under 50 years old)admitted to our hospital were retrospectively analyzed.There were 43 cases with conventional care in control group and 41 cases with comprehensive care group in treatment group.Besides the conventional care components,the comprehensive care group also adopted a multidisciplinary team intervention program for sexual health management under the framework model of well-being theory(PERMA model).We used the female sexual function index,depression self-rating scale score and happiness index to assess the sexual function index,depression score and happiness index before,3 months and 6 months after the intervention,respectively.Results In comparison with the control group,the patients in the treatment group had a significant improvement in sexual function at 3 and 6 months of intervention(F=91.08,P<0.001).After 3 and 6 months of intervention,the depression score was significantly lower in the comprehensive care group than in the control group(F=1 092.59,P<0.001),and the happiness improvement index was significantly higher than in the control group(F=107.90,P<0.001).Spearman’s correlation analysis showed that the female sexual function index was negatively correlated with the depression self-rating scale score(rs=-0.918,P<0.001)and positively correlated with the well-being index(rs=0.844,P<0.001).Conclusions The comprehensive care group showed significant improvements in sexual function,depression,and subjective well-being.A multidisciplinary team intervention program for sexual health management under the PERMA model can improve the quality of patients’ sexual life,reduce their depression,and improve their subjective well-being.
临床诊疗

柳州市老年骨质疏松性骨折现状及危险因素分析

:94-99
 
目的 探讨柳州市老年骨质疏松性骨折(OPF)现状及其发生的危险因素。方法 回顾性分析2018年1月—2020年12月柳州市工人医院创伤中心收治的5 235例60周岁及以上老年OPF患者的临床资料,并从中随机抽取300例老年OPF患者临床资料作为研究组;选取同时期接诊的老年骨质疏松未骨折的300例患者临床资料作为对照组,通过医院病案管理系统,详细收集2组患者各项临床资料,分析柳州市老年OPF现状及危险因素。结果 5 235例老年OPF患者中,以胸腰椎压缩性骨折占比最高58.19%、其次为股骨颈骨折15.42%;60~74岁年龄段患者以胸腰椎压缩性骨折占比最高77.03%,75~89年龄段患者股骨颈骨折、粗隆间骨折占比均较高分别为43.36%、41.34%,≥90岁患者粗隆间骨折占比最高49.25%;男性、女性均以胸腰椎压缩性骨折占比较高,分别为46.34%、62.47%。经单因素/多因素分析显示,年龄、性别、体质量指数(BMI)、跌倒史、骨折史、骨密度(BMD)、糖尿病、不良生活习惯为老年OPF发生的独立危险因素(P<0.05)。结论 胸腰椎压缩性骨折是柳州市老年OP患者骨折的主要类型;老年OPF的发生与年龄、性别、BMI、跌倒史、骨折史、BMD 、糖尿病、不良生活习惯等因素有关,应采取积极预防措施,降低OPF的发生风险。
论著

大光斑低能量Q开关Nd:YAG激光治疗黄褐斑的疗效观察

Effect of Q-switch Nd:YAG laser with large spot and Low Fluence for the treatment of Melasma

:53-54
 
目的 评估大光斑低能量Q开关Nd:YAG激光治疗黄褐斑的疗效和安全性。方法 采用Q开关Nd∶YAG激光器以波长1064 nm,光斑6~7 mm,能量2.0~2.5 J/cm2,对黄褐斑患者进行治疗,以治疗处呈现微红为治疗终点,每月1次,治疗5次,共治疗黄褐斑36例。结果 36例患者中基本治愈8 例(22.23%),显效15例(41.67%),好转9例(25%),无效4例(11.11%),前两者之和为总有效率,达63.89%。患者耐受性好,无明显副作用。结论 大光斑低能量Q开关Nd:YAG激光为治疗黄褐斑提供了安全有效的方法。
Objective To evaluate the efficacy and security of Q-switched laser with Large Spot and Low Fluence for the treatment of melasma. Methods Thirty-six patients with melasma were enrolled in study. 1064 nm Q-switched Nd:YAG laser was used with light spot of 6-7 mm and 2.0-2.5 J/cm2 in fluence.Treatments are ended when the melasma area turns slight red. Subjects were received a total of 5 treatments at one month intervals. Results Thirty-six patients completed the trial. 22.23% of patients achieved 90% to 100% clearance and 41.67% achieved 60% to 90% clearance. The total efficient rate reached 63.89% .Side effects was minimal and all the patients tolerated the treatment well. Conclusion Q-switched Nd:YAG laser with Large Spot and Low Fluence provides a safe and effective treatment method for melasma.
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