目的 分析影响接受夫精宫腔内人工授精(IUI)助孕患者临床妊娠率的有关因素。方法 选择225例接受IUI助孕共400周期的不孕症患者,回顾分析女方年龄、治疗方案、hCG日子宫内膜厚度、IUI周期数与临床妊娠率的关系。结果 女方年龄>38岁的临床妊娠率(8.22%)低于年龄<30岁(21.74%)和30~38岁(17.48%),P<0.05;促排卵方案(CC、HMG、CC+HMG)临床妊娠率分别为19.05%、19.66%和14.71%,高于自然周期的临床妊娠率7.14%,P<0.05;hCG日子宫内膜厚度≥8 mm组的临床妊娠率(23.56%)高于内膜<8 mm组的临床妊娠率(13.27%),P<0.05;第1至第5周期的IUI临床妊娠率分别为21.30%、15.60%、9.38%、0%和0%,多次重复IUI周期数差异有统计学意义(P<0.05)。结论 女方年龄、hCG日子宫内膜厚度、治疗方案均会影响IUI的临床妊娠率,但增加IUI的治疗周期数并不能提高临床妊娠率,应综合各种因素再次评估患者的妊娠率,必要时进一步查找多次助孕失败的原因或改行IVF-ET助孕治疗。

Objective To analyze the relative factors which influence the clinical pregnancy rates of patients accepted intrauterine insemination with husband's sperm. Methods 225 cases of infertile patients accepted IUI treatment were selected, 400 cycles were included and the clinical data were analyzed retrospectively. Observing the relationship between the age of women, treatment options, endometrial thickness on hCG injection day, cycles of IUI and pregnancy rates. Results The clinical pregnancy rates of women less than 30 years old(21.74%) were higher than aged between 30 to 38 years old(17.48%) and more than aged 38 years old(8.22%), P<0.05.The clinical pregnancy rates of ovulation induction options(CC、HMG、CC+HMG) were 19.05%, 19.66% and 14.71%, higher than the pregnancy rates of natural cycle 7.14% significantly, P<0.05. The pregnancy rates of the group of endometrial thickness ≥8mm on hCG injection day were 23.56%, higher than the group of endometrial thickness <8 mm 13.27%, P<0.05. The clinical pregnancy rates of 1 to 5 cycles IUI were 21.30%, 15.60%, 9.38%, 0% and 0% respectively, the difference of repeating the IUI cycles’ number was statistical significance (P<0.05). Conclusion The ages of women, endometrial thickness on hCG injection days and treatment options can affect the clinical pregnancy rates. Extending the number of IUI treatment cycles can not increase the pregnancy rates of IUI. All the factors should be comprehensive to assess the patient's pregnancy rates again, to find more reasons further for the failure of assisted reproduction or turn to IVF-ET assisted reproduction treatment when it is necessary.

目的 探讨系统性红斑狼疮(SLE)患者并发感染的影响因素并提出相应对策。方法 统计2012年1月—2015年12月在风湿免疫科住院的SLE患者,依据是否存在感染分为两组:感染组和非感染组。查电子病历记录感染组患者感染部位、所感染病原体的种类、免疫抑制治疗方案、病程、住院次数、血液生化指标、红细胞沉降率、肝肾功能以及补体C3、C4 水平,分析SLE患者发生感染的危险因素。结果 近三年风湿免疫内科共收治SLE患者302例,合并感染44例,发生感染63例次,感染发生率7.32%,高于全院感染发生率2.82%,差异有统计学意义(P<0.05)。呼吸系统感染有43例次,占68.25%,是患者最常见的感染部位。单因素分析显示,激素的冲击治疗、血红蛋白降低、白蛋白降低和血清肌酐水平异常(P<0.01)及ESR异常(P<0.05)是医院感染的危险因素。结论 SLE患者感染发生率高,免疫抑制剂冲击治疗、有合并症患者更易发生感染。应合理使用免疫抑制剂,密切留意患者感染症状,并定期检测血红蛋白、白蛋白及ESR等各项实验室指标,及时发现感染并进行病原学培养,做到尽早、合理治疗。

目的 探讨老年2型糖尿病患者牙周病发生情况及相关因素,为开展综合预防和治疗措施提供参考。方法 选取到我院住院治疗的老年2型糖尿病患者273例,检查其牙周病患病情况,同时收集年龄、性别、文化程度、体重指数、病程、吸烟、空腹血糖、糖化血红蛋白、刷牙习惯等资料,比较牙周病患病组与未患病组之间上述资料的差异,探讨导致牙周病发生的影响因素。结果 273例研究对象中患有牙周病154例(56.41%),其中,牙龈炎60例,牙周炎94例。牙周病组平均存留牙数(18.54±6.31)颗,未患牙周病组平均存留牙数(21.62±7.48)颗(t=3.679,P<0.001)。年龄较大(P<0.001)、病程较长(P<0.001)、吸烟(P<0.001)、空腹血糖(P<0.001)和糖化血红蛋白(P<0.001)水平较高是老年2型糖尿病患者发生牙周病的危险因素,而文化程度高(P=0.017),刷牙>1次/d(P<0.001),竖刷(P=0.004),使用牙线(P=0.004)是其保护因素。结论 老年2型糖尿病患者中牙周病患病率较高,临床上应做好三级预防措施,降低牙周病发生风险因素的暴露。

Objective To explore the periodontal disease occurrence and its factors for elderly type 2 diabetes patients, providing reference for comprehensive prevention and treatment measures. Methods 273 cases of elderly in-patients with type 2 diabetes in our hospital were enrolled. We checked their periodontal disease conditions, collected information including age, sex, educational level, body mass index, disease duration, smoking, fasting blood glucose, glycosylated hemoglobin, brushing habits. These values were compared between periodontal disease group and no periodontal disease group. Results People with periodontal disease in 273 cases of the object of study included 154 patients (56.41%), among them, gingivitis 60 cases, 94 cases of periodontitis. The teeth number was (18.54±6.31) for periodontal disease group on average, with (21.62 ±7.48) for no periodontal disease group (t=3.679, P<0.001). Older (P<0.001), longer course of disease (P<0.001), smoking (P<0.001), higher fasting blood glucose (P<0.001) and higher glycosylated hemoglobin (P<0.001) were risk factors of periodontal disease for elderly patients with type 2 diabetes. And well-educated (P=0.017), brushing teeth frequency > 1 / d (P<0.001), vertical brush mode (P=0.004), the use of dental floss (P=0.004) were the protective factors. Conclusion Periodontal disease prevalence is high in elderly patients with type 2 diabetes. The three level preventive measures should be strengthened to reduce the exposure of the periodontal disease risk factors.

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 通过研究4CH8的健康管理模式对社区更年期女性冠心病危险因素的干预效果,为制定慢病防控对策提供依据。方法 选择我社区,具有完整个人档案的更年期女性400例,经三甲医院确诊为冠心病患者为对照组134例,未患冠心病的266例为干预组,并进行危险因素分析。对未患冠心病的更年期女性进行4CH8健康管理模式干预,随访1年后对冠心病的危险因素进行前后对比分析。结果 对照组与干预组的BMI、高血压、糖尿病、低密度脂蛋白、高密度脂蛋白及空腹血糖相比较,差异有统计学意义(P<0.05)。年龄、尿酸及糖尿病两组相比较,差异无统计学意义。冠心病的危险因素与BMI、高血压、糖尿病、冠心病、低密度脂蛋白水平及空腹血糖呈正相关,与高密度脂蛋白呈负相关。干预组干预一年后BMI、高血压、低密度脂蛋白及空腹血糖水平与干预前相比较,差异有统计学意义(P<0.05),干预前各指标异常人数比干预后少。结论 4CH8模式对社区更年期女性冠心病危险因素管理效果较好,值得推广应用。

目的 探讨内科治疗的高血压基底节区出血的疗效及预后相关的因素。方法 回顾性分析2005年4月—2014年12月贵阳市第二人民医院神经外科收治的174例高血压脑出血患者的临床资料,所有患者均采用内科保守治疗,对疗效及影响患者预后的因素进行分析。结果 174例患者中,死亡50例,持续植物生存状态4例,对124例存活患者进行随访,随访时间2~117个月,随访ADL分级Ⅰ级43例,Ⅱ级53例,Ⅲ级21例,Ⅳ级3例,Ⅴ级4例,预后较好者(ADL分级Ⅰ~Ⅱ级)96例,预后不良者(ADL分级Ⅲ~Ⅴ级)28例。χ²检验显示入院 GCS评分和出血量是影响患者预后的因素。结论 影响高血压基底节区脑出血患者的预后因素较多,GCS评分较高、出血量少的患者可采用内科治疗,多数患者预后较好。

Objective To investigate treatment efficacy and the factors influencing prognosis of conservative treatment of hypertensive intracerebral hemorrhage in basal ganglia. Methods A retrospective analysis was conducted on the clinical data of 174 patients with hypertensive intracerebral hemorrhage in basal ganglia who were admitted to our hospital during the period from April 2005 to December 2014. All the patients were given internal medicine conservative treatment and followed up to observe the clinical curative effect to analyze the prognosis. Results Of the 174 patients, 50 patients died and 4 patients were persistent vegetative state. 124 patients were followed up for 2-117 months and they were classified according to ability of daily life(ADL) prognosis scale: 43 cases were in I grade, 53 cases in II grade, 21 cases in III grade, 3 cases in IV grade, 4 cases in V grade. 96 cases achieved favourable outcomes and 28 cases got poor outcomes.The results of Chi square test revealed that GCS scale and intracerebral hemorrhage volume were the factors influencing prognostic of hypertensive intracerebral hemorrhage in basal ganglia. Conclusion There were many prognosis factors related with hypertensive intracerebral hemorrhage. The curative effect and prognosis in patients with conservative treatment is obvious in these patients with high GCS scale and less intracerebral hemorrhage volume.

目的 探讨脉管炎围手术期出现焦虑症状及影响因素和护理以提高在围手术期的生活质量。方法 通过对脉管炎患者进行问卷调查焦虑发生及影响因素。结果 脉管炎围手术期患者出现焦虑是十分常见的,生活质量下降直接或间接影响手术的成功率。结论 有效的护理干预能改善各方面的焦虑因素,使患者在围手术期保持心情舒畅,从而适应截肢形象的改变,提高生活质量。

目的 探讨影响机采双份血小板质量的因素,以提高机采血小板的制品质量。方法 收集本站2014年3月—9月机采双份血小板献血者资料,观察分析其一般情况,血细胞分离机运行参数及采前血常规对血小板采集质量的影响。结果 采集前血小板计数是影响机采双份血小板质量的重要因素,与血小板采集量成正相关(P<0.05)。而血小板平均体积、血小板体积分布宽度、大血小板比率则与血小板采集量成负相关(P<0.05)。结论 需正确分析献血者采前血常规,作出最优选择,保证机采双份血小板质量。

目的 了解化脓性脑膜炎患儿常见后遗症的种类及发生率,探讨可能导致化脓性脑膜炎患儿预后不良的高危因素。方法 选取129例化脑性脑膜炎患儿,患儿分为预后不良组及预后良好组,统计各种后遗症的发生率,并寻找预后不良的危险因素。结果 随访的80例患儿中,有较轻后遗症者12例,有严重后遗症者13例,包括智力低下11例,运动障碍8例,双侧听力障碍4例,继发性癫痫4例,10例患儿合并有两种或以上严重后遗症,最常见为智力低下合并运动障碍。行为问题共检查48例患儿,有行为问题患儿17例。预后不良组和预后良好组在发热总时间>7天、入院后反复抽搐≥3次、昏迷(Glasgow昏迷评分<8分)、感染性休克、瞳孔异常、肢体活动障碍为出现预后不良的危险因素,两组比较差异有统计学意义(P＜ 0.05)。结论 本研究发现,化脓性脑膜炎患儿的后遗症表现多种多样,提示患儿应该进行系统的随访;同时,本研究还发现昏迷、感染性休克等临床症状是导致预后不良的危险因素。早期识别这些症状,并给予早期干预,将对患儿的预后有着重要意义。

Objective To investigate the types and incidence of common sequelae in children with bacterial meningitis.To investigate the risk factors for adverse outcome of childhood bacterial meningitis. Methods Selected 129 children with bacterial meningitis all cases were divided into adverse outcome group and favorable outcome group.According to the incidences of different kinds of sequelae,The risk factor effecting bad prognosis were studied. Results A total of 80 children were successfully followed.Of them,12 might only have mild sequelae and 13 had serious sequelaes.Among these children who had serious sequelae,11 of them had mental retardation,8 of them had motor deficit,4 of them had bilateral hearing loss and 4 of them had secondary epilepsy.10 children had multiple serious sequelae,thes most common multiple impairment combinations were mental retardation plus motor deficit.48 parents of the children completed the Child Behaviour Checklist and found out 17(35.42%)of their children had behavioral disorders.Adverse outcome group and favorable outcome group,the length of fever(>7 days),repeated convulsions after admission(≥3 times),coma(Glasgow coma scale score <8 points),septic shock,abnormal pupils,limb movement disorder.There were significantly difference between the two groups(P＜ 0.05). Conclusions This study showed that there are different kinds of sequelaes of children with bacterial meningitis,it indicated that these children should be follow-up to track the effect.On the other hand,this study found out that the high risk factors with adverse outcome might be coma,septic shock and so on.It indicated that if we could identify the high risk factors in the early stage and then interpose them immediately,it might beneficial to improve the quality of life of the children.

目的 了解老年患者医院感染的发生情况及相关因素,为有效降低医院感染提供临床依据。方法 对我院2010年6月—2014年6月452例60岁以上的老年患者医院感染情况进行回顾性分析,调查并分析其年龄、住院天数、医院感染部位及相关因素。结果 老年患者医院感染的发生与年龄增长、住院天数延长、感染部位、基础病及抗生素不合理应用等因素密切相关。结论 根据医院感染的相关因素,对老年人加强病房管理及基础护理,不仅改善治疗操作中易感染的环节,减少感染途径,还可以降低医院感染发生率。