论著
目的 比较喀什地区和广州地区健康体检儿童维生素D3水平和缺乏率。方法 纳入2019年1月—2020年12月喀什地区第一人民医院、广州市番禺区中心医院健康体检儿童,比较汉族儿童不同地区间以及比较喀什儿童不同民族间的维生素D3水平和缺乏率,分析了性别、年龄和季节对血清维生素D3水平的影响。结果 喀什汉族儿童维生素D3低于广州汉族儿童,缺乏率更高(均P<0.05)。喀什维族儿童的维生素D3水平低于喀什汉族儿童,缺乏率更高(均P<0.05)。同一地区、同一民族不同年龄段儿童间维生素D3缺乏率和水平比较差异均有统计学意义(均P<0.05),维生素D3缺乏率随年龄增加而升高,水平则显著下降。同一地区、同一民族儿童不同季节间维生素D3缺乏率和水平比较差异均有统计学意义(均P<0.05),冬季的缺乏率最高、水平最低。同一地区、同一民族儿童不同性别间维生素D3缺乏率和水平比较差异均无统计学意义(P>0.05)。结论 健康体检儿童血清维生素D3水平,喀什维族低于喀什汉族,喀什汉族低于广州汉族,缺乏率间差异明显。健康体检儿童血清维生素D3水平和缺乏率与年龄、季节有关,与性别无关。
临床诊疗
目的 通过分析2019—2021年广州地区保密性弃血工作情况,完善献血者献血后回告受理和保密性弃血管理。方法 通过分析广州市血液中心2019年1月—2021年12月期间受理的无偿献血者献血后保密性弃血回告记录,统计分析无偿献血者要求保密性弃血的各种原因,以及保密性弃血施行程序中出现的新情况。结果 2019年、2020年、2021年保密性弃血人数分别占当年献血人数的0.156‰,0.090‰,0.091‰。2020年之后出现接触或疑似接触新型冠状病毒患者的回告案例;在这3年间,87.6%的保密性弃血在72小时内完成回告。结论 无偿献血者保密性弃血回告以及血液屏蔽是保障血液用血安全的重要举措之一,目前广州市回告率相对较低,提示要强化血液保密性弃血回告及方法途径指引宣传,注意对新回告原因的收集以有针对性开展献血前征询工作,从源头筛选出合格、低风险的无偿献血者,同时完善长时间(72小时以上)才回告的血液保密性弃血处理程序。
论著
目的 了解急诊科综合病区患者疾病分类构成的特点,为护士进行有针对性的培训,并为合理调配护理人员提供依据。方法 对2020年1月—2021年12月我院急诊科综合病区收治的1 901例患者疾病分类、收治时间等进行回顾性调查分析。结果 研究期间急诊综合病区共收治患者1 901例,收治患者以呼吸系统的患者居多,占比47.71%;以循环系统疾病的患者平均发病年龄最高,为(66.434±11.691)岁;全年各月以1月、12月收治病人居多。结论 根据调查分析,有针对性地对护士进行呼吸系统疾病护理技能培训,并在收治高峰期,合理调配护理人员,实施弹性排班,保障患者安全,提高护理质量。
Objective To understand the characteristics of disease classification and composition of patients in Comprehensive Ward of Emergency Department, provide targeted training for nurses, and provide basis for rational deployment of nursing staff. Methods A total of 1 901 patients in the Comprehensive Ward of Emergency Department of our hospital from January 2020 to December 2021 were investigated and analyzed retrospectively according to different diseases and time of admission. Results A total of 1 901 patients were treated in the Emergency Comprehensive Ward during the study period. Most of the patients were with respiratory system disease, accounting for 47.71%. The average onset age of patients with circulatory diseases was the oldest, which was (66.434±11.691). Most patients were admitted in January and December. Conclusions According to the investigation and analysis, nurses should be trained with the skills of respiratory diseases nursing, nursing staff should be reasonably allocated and flexible shift should be scheduled during the peak period of admission, so as to ensure the safety of patients and improve the quality of nursing.
论著
目的 了解并分析白云区不同年龄段男性精液质量现状。方法 选取2020年1月—2021年12月在我中心就诊的已婚孕前体检男性为研究对象,开展常规精液检测,采集精液标本进行分析。结果 白云区育龄男性精液各项指标均在正常范围仅有3 176例(占比57.52%),随年龄的增加,精液指标总活力、存活率和精子前向运动指标逐渐降低(P<0.05)。结论 26~30岁年龄段男性的精液质量各项指标正常率较其他年龄组更好(P<0.05),是男性生育的黄金年龄。
Objective To understand and analyze the status of semen quality in men of different ages in Baiyun District of Guangzhou. Methods From January 2020 to December 2021,married men who received pre-pregnant physical examination in our center were selected as the research subjects.Routine semen testing was conducted,and samples were collected for semen analysis. Results Only 3176 cases(57.52%)of male semen data of childbearing age in Baiyun District were within the normal range.With the increase of age,total semen motility,survival rate and sperm forward motility decreased gradually(P < 0.05). Conclusions Men in the age group of 26-30 years had higher normal rates of all indicators of semen quality than other age groups(P < 0.05),which is the golden age of male fertility.
论著
目的 了解广州市白云区医护人员对艾滋病感染者/患者(PLWHA)的歧视态度情况,分析其影响因素,并为降低医护人员对PLWHA的歧视态度提供建议。方法 以Lau等设计的AIDS歧视态度量表和张燕等研制的医护人员对PLWHA治疗意愿量表为主设计的调查问卷,对广州市白云区的医护人员进行随机抽样调查,对结果进行描述,研究两量表得分与HIV知识水平的相关性。结果 广州市白云区7家医疗机构并接受培训议会的医护人员AIDS歧视态度量表和治疗意愿量表平均得分分别为(46.66±10.23)分和(32.74±5.89)分,医护人员性别和接受HIV培训的AIDS歧视量表得分存在统计学差异(P<0.01),单位、性别和接受HIV培训与否的治疗意愿量表得分存在统计学差异(P<0.05);HIV知识水平与AIDS歧视量表得分和治疗意愿量表得分存在相关性,相关系数值rs分别为-0.301(P<0.001)和-0.219(P<0.001)。结论 广州市白云区医护人员的性别、接受培训与否和HIV知识水平对AIDS歧视量表和治疗意愿量表得分均有影响。应加强白云区医护人员的艾滋病知识培训和各人群的权益保护,以降低医护人员对PLWHA的歧视态度。
Objective To understand the discriminatory attitudes of medical staff to people living with HIV/AIDS(PLWHA)in Guangzhou Baiyun District,analyze the influencing factors,and provide suggestions for reducing the discriminatory attitudes of medical staff to PLWHA.Methods Based on Lau's AIDS Discrimination Attitude Scale and Zhang Yan's Medical Personnel's Adjustment Questionnaire for PLWHA Treatment Willingness Scale,the questionnaire was designed to do a random sampling survey among medical personnel in Guangzhou Baiyun District,and the results were described by regression analysis,to study the correlation between the scores of the two scales and the level of HIV knowledge.Results The average scores of AIDS Discrimination Attitude Scale and Treatment Willingness Scale of medical staff in 7 medical institutions with training in Guangzhou Baiyun District were(46.66±10.23)and(32.74±5.89)respectively.There were statistical differences in AIDS discrimination scale scores of medical staff's gender and whether they received training or not(P< 0.01),and there were statistical differences in Treatment Willingness Scale scores among institutions,gender and whether they received training or not(P< 0.05).HIV knowledge level was correlated with the scores of AIDS Discrimination Scale and Treatment Willingness Scale,and the correlation coefficients were -0.301(P < 0.001)and -0.219(P < 0.001).Conclusions Gender,training or not,and HIV knowledge level of medical staff in this area have an impact on the scores of the AIDS Discrimination Scale and the Treatment Willingness Scale.In order to reduce the discriminatory attitude of medical staff towards PLWHA,the AIDS knowledge and the protection of rights and interests of all groups should be strengthened.
临床诊疗
目的 观察广州花都地区新冠疫情发生前后呼吸道肺炎支原体(MP)感染的流行病学特征,分析2018年—2019年(疫情前)和2020年—2021年(疫情后)期间的流行病学特点,为降低本地区的MP感染提供预防医学依据。方法 收集2018年1月—2021年12月于广州市中西医结合医院就诊的呼吸道感染患者51 005例,采用胶体金法检测血Mp- IgM抗体,对疫情前后年度、季节、性别和年龄段MP感染情况进行回顾性分析。结果 51 005例呼吸道感染患者中,MP感染总阳性率12.03%(6 134/5 1005),新冠疫情发生前(2018—2019)阳性率为19.11%(5 161/27 010),高于新冠疫情后(2020—2021)MP阳性率为4.06%(973/23 995)(χ2=2 721.32,P<0.001)。2018年和2019年(疫情前)不同季节MP检出率分别为:春季11.87%和17.76%,夏季13.26%和22.21%,秋季17.93%和24.59%,冬季14.20%和14.47%,以夏秋季阳性率高于春季和冬季;疫情后两年四季MP感染率均低于疫情前(P<0.001),春季和冬季阳性率略高于夏秋季节。4年来呼吸道感染患者中MP感染率男性(13.87%)与女性(14.09%)比较差异无统计学意义。且疫情前(18.91%,19.28%)显著高于疫情后(2.49%,2.69%),同时期不同性别阳性率比较差异无统计学意义。婴幼儿组(0~6岁),学龄儿童组(>6~14岁),青少年组(>14~30岁),中青年组(>30~60岁)及老年组(>60岁)MP阳性检出率分别为20.89%、29.98%、9.29%、5.55%和4.57%,不同年龄组间MP感染率差异有统计学意义(P<0.05),以学龄期儿童多见,其次为婴幼儿。结论 新冠疫情前后4年MP感染流行特点为:新冠疫情前后MP感染无性别差异;学龄期儿童和婴幼儿是高发人群;一年四季均可发病,疫情前两年夏秋季高发,疫情后两年四季发病率均较低且差异变小;新冠疫情下广州花都地区MP感染率显著低于疫情前,2019-nCov防控措施(佩戴口罩等)也减少了MP感染。
论著
目的 了解广州市某三甲综合医院2016—2022年住院病例的疾病分布特征,探究新型冠状病毒感染(新冠)疫情对疾病谱的影响,为医院合理配置医疗资源、提高医院医疗水平提供参考。方法 回顾性收集广州市某三甲综合医院2016—2022年间住院病例的病例数据,按照ICD-10国际统计分类标准进行分类,建立Joinpoint回归模型对不同类别疾病构成比的时间变化趋势进行分析。结果 2016—2022年间,前12顺位的疾病种类不变,构成比呈上升趋势的有4种,分别是循环系统疾病、肿瘤、消化系统疾病以及眼和附器疾病,构成比呈下降趋势的有3种,分别是呼吸系统疾病、肌肉骨骼系统和结缔组织疾病以及妊娠、分娩和产褥期。对这7类系统疾病进行不同性别、不同年龄段和不同居住地(广州市内/市外)的亚组分析,结果显示,除眼和附器疾病与妊娠、分娩和产褥期外,其余5种系统疾病在男性和女性中变化趋势比较差异无统计学意义(均P>0.05)。25岁以上人群循环系统疾病、肿瘤和消化系统疾病比例呈上升趋势。45岁以上人群眼和附器疾病的住院比例逐年上升。呼吸系统疾病的下降趋势集中出现在0~5岁和65岁以上人群,肌肉骨骼系统和结缔组织疾病的下降趋势可在45岁以上人群中被观测到,妊娠、分娩和产褥期的下降趋势则可在45岁以下人群中被观测到。总体和市内来源的住院病例的各系统疾病构成比变化趋势均未发现有2019年的连接拐点。但对于居住地在广州市外的病例,有6种系统疾病均存在一个2019年的连接拐点,与2016—2019年相比,2020—2022年增长趋势普遍减弱或者略有降低,但均无统计学意义,2022年市外来源住院病例的多种疾病占比低于2019年。≤24岁年龄组的病例因妊娠、分娩和产褥期住院的比例在2019年以后降低趋势加快,但也无统计学意义,2020—2022年≤24岁人群因妊娠、分娩和产褥期住院的比例低于2019年水平。结论 2016—2022年期间住院病例疾病谱有较大变化,这种变化趋势在不同性别、不同年龄段和居住地间效应存在差异。2020—2022年的新冠疫情流行主要降低了居住地在广州市外的住院病例多个系统疾病的比例以及24岁及以下患者因妊娠、分娩和产褥期住院的比例。
Objective To understand the disease distribution characteristics of inpatients in a 3-A-grade general hospital in Guangzhou from 2016 to 2022,to explore the impact of the COVID-19 on the disease spectrum,and to provide reference for hospitals to reasonably allocate medical resources and improve medical level. Methods Inpatient case data of a 3-A-grade general hospital from 2016 to 2022 were retrospectively collected and were classified according to the ICD-10 international statistical classification standard. A Joinpoint regression model was established to analyze the temporal trend of disease composition ratios in different categories. Results From 2016 to 2022,the type of top 12 diseases remained unchanged. There were 4 diseases showing an upward trend in composition,namely circulatory system diseases,tumors,digestive system diseases and eye and accessory organ diseases. There were 3 diseases showing a downward trend in composition,namely respiratory system diseases,musculoskeletal system and connective tissue diseases,as well as pregnancy,childbirth and postpartum period. A subgroup analysis was conducted on these 7 types of systemic diseases by gender,age group and place of residence(within/outside Guangzhou). The results showed that except for eye and accessory organ diseases and pregnancy,childbirth and postpartum period,there was no significant difference in the trend of changes in the other 5 systemic diseases between males and females(all P>0. 05). The upward trend of circulatory system diseases,tumors and digestive system diseases could be observed in people over the age of 25. The hospitalization rate of eye and accessory organ diseases among people over 45 years old was increasing year by year. The downward trend of respiratory diseases was concentrated in people aged 0~5 and over 65 years old,while the downward trend of musculoskeletal and connective tissue diseases could be observed in people aged 45 and above. The downward trend of pregnancy,childbirth and postpartum period could be observed in people under 45 years old. The trend of changes in the proportion of systemic diseases among inpatient cases from both overall and within Guangzhou had not been found to have a joinpoint in 2019. However,for cases residing outside of Guangzhou,there were six systemic diseases that all had a joinpoint in 2019. Compared with the growth trend from 2016 to 2019,the growth trend from 2020 to 2022 generally weakened or showed a slightly downward trend,but none of them were statistically significant. In 2022,the proportion of multiple diseases in hospitalized cases from outside Guangzhou was lower than that in 2019. The proportion of cases in the age group ≤24 years old who are hospitalized due to pregnancy,childbirth and postpartum period has been decreasing rapidly since 2019,but there was no statistical significance. The proportion of cases hospitalized due to pregnancy,childbirth and postpartum period in the population ≤24 years old from 2020 to 2022 was significantly lower than the level in 2019. Conclusions The disease spectrum of inpatients had undergone significant changes between 2016 and 2022,and these trends of changes were different among different genders,age groups and places of residence. The prevalence of the COVID-19 from 2020 to 2022 mainly reduced the proportion of inpatients with multiple systemic diseases living outside Guangzhou,and the proportion of inpatients aged 24 and under hospitalized for pregnancy,childbirth and puerperium.
论著
目的 了解越秀区助产机构医务人员对艾滋病母婴阻断知识及患者相关权益知识掌握情况,为更好地贯彻落实消除艾滋病母婴传播工作提供下一步工作策略和措施依据。方法 于2022年7月—8月,对广州市越秀区5家助产机构妇产科、保健科和医务科的医务人员进行艾滋病母婴阻断知识政策及HIV感染孕产妇相关权益知识的问卷调查。结果 465名医务人员对个别艾滋病母婴阻断政策了解不足,包括“人类免疫缺陷病毒(HIV)感染孕产妇到定点医疗机构终止妊娠或住院分娩时可以获得一定的减免”(知晓率79.78%)、“HIV感染孕产妇的宝宝可以免费领取一定数量的奶粉”(知晓率66.88%);医务人员对HIV感染孕产妇的生育相关权益认识严重不足,对HIV感染孕产妇生育权益认识正确的仅有45.59%。临床护士群体对上述艾滋病母婴阻断政策及HIV感染孕产妇相关权益的知晓率低于临床医生及其他医务人员,组间比较差异有统计学意义(P<0.05)。结论 越秀区助产机构医务人员对艾滋病母婴阻断知识有一定的了解,但掌握不够完整、全面,对HIV感染患者的生育权认识严重不足,应进一步加强对助产机构医务人员、尤其是护士群体关于艾滋病母婴阻断政策知识及患者相关权益的培训,以更好地贯彻落实消除艾滋病母婴传播工作,保障HIV感染患者的权益。
Objective To understand the knowledge of medical staff of midwifery institutions in Yuexiu District about AIDS prevention of mother-to-children transmission(PMTCT)and patients' rights and interests,in order to provide the basis for the following work strategy and measures for better implementation of the elimination of mother-to-child transmission of HIV.Methods From July to August in 2022,a questionnaire survey about knowledge and policies of AIDS PMTCT and rights of HIV infected pregnant women was conducted among the medical staff of obstetrics and gynecology department,health care department and medical department in five midwifery institutions in Yuexiu District of Guangzhou City.Results A total of 465 medical workers had insufficient understanding of some policies on PMTCT of AIDS,including HIV-infected pregnant women can obtain certain fee waiver when they go to designated medical institutions to terminate pregnancy or hospitalized deliver(awareness rate of 79.78%),HIV-infected pregnant women's babies can receive a certain amount of free milk powder(awareness rate of 66.88%).There was a serious lack of awareness of reproductive rights of HIV-infected pregnant women among medical staff,and only 45.59% of them had correct understanding.The awareness rate of the PMTCT and the rights and interests of HIV-infected pregnant women among clinical nurses was significantly lower than that among clinicians and other medical staff.Conclusions The medical staff of midwifery institutions in Yuexiu District have some knowledge about the PMTCT of AIDS,but their knowledge is not complete and comprehensive,and their understanding of the reproductive rights of HIV-infected patients is seriously inadequate,so it is necessary to further strengthen the training of medical staff in midwifery institutions,especially nurses,on the policy knowledge of PMTCT of AIDS and the related rights and interests of patients,in order to better implement the elimination of mother-to-child transmission of AIDS and protect the rights and interests of infected patients.
论著
目的 了解广州市社区居民对中医“治未病”的认知现状,分析其影响因素,并为中医“治未病”的进一步发展提出可行建议。方法 采用多阶段整群抽样法,对广州市不同区域的652名居民进行问卷调查,通过描述性分析和χ2检验分别对基本认知情况与影响因素进行阐述。结果 广州市居民对“治未病”服务了解情况不太理想(67.80%),接受“治未病”服务的意愿情况较好(77.91%),对于中医“治未病”服务的认知还比较片面,主要通过手机、网络、社区等方式了解相关内容。影响居民接受意愿的因素主要是年龄、学历、户口、职业类型等。结论 目前广州市社区中医“治未病”服务具有一定群众基础和发展潜力,但是还存在居民认知不足、宣传力度不够、服务能力不足等问题,应当着重从这些方面进行改进。
Objective To understand the current cognitive status of community residents in Guangzhou regarding traditional Chinese medicine(TCM)pre-treatment,analyze its influencing factors,and provide feasible suggestions for the further development of TCM pre-treatment.Methods By multi-stage cluster sampling method,a questionnaire survey was conducted on 652 residents in different regions of Guangzhou.Descriptive analysis and chi-square test were used to elucidate the basic cognitive situation and influencing factors.Results The understanding of TCM pre-treatment services among residents in Guangzhou was not ideal(67.8%),and their willingness to receive TCM pre-treatment services was good(77.91%).Their understanding of TCM pre-treatment services was quite one-sided,mainly through mobile phones,internet,communities and other means.The main factors affecting residents' willingness to accept this service were age,education level,household registration and occupation.Conclusions At present,the TCM pre-treatment service in the community of Guangzhou has a certain mass basis and development potential.However,there are still problems such as insufficient residents' awareness,insufficient publicity,and insufficient service capabilities,which should be improved in the future.
论著
目的 探索老龄化形势下广州市白云区西部卒中防治工作的新模式。方法 通过完善组织结构、管理架构、建立稳定高效运行的(1+1+N)紧密型医联体模式,创建优质高效的卒中救治区域联盟,实现高质量的基层首诊,双向转诊,快速响应的卒中绿道急救和全程管理。结果 初步完成构建广州市白云区西部区域性卒中救治中心,区域内卒中患者及时救治,溶栓效率,血管再通等均有显著提升,整体提升白云区西部医疗机构的卒中救治水平。结论 区域性的协同救治是提高卒中救治水平的重要举措。(1+1+N)紧密型医联体模式能提高卒中患者救治率,具有可行性和必要性。
Objective To explore the effectiveness of a new stroke prevention and treatment pattern in the western part of Baiyun District, Guangzhou city, under an aging situation. Method We aim to build a high-quality and efficient stroke treatment regional alliance based on a (1+1+N) compact medical consortium, expecting to improve the overall abilities of stroke treatment in the western part of Baiyun District through high-quality primary care, two-way referrals, rapid response to stroke greenway emergency and full-process management. Results We have initially established a regional stroke treatment center in the western part of Baiyun District, Guangzhou. Stroke patients in that region can be treated in time, and the efficiency of thrombolysis and vascular recanalization have been significantly improved. Conclusion Regional coordinated treatment is an effective measure to reduce the disability and fatality rate of stroke. The (1+1+N) compact medical consortium model can improve the treatment effect in stroke patients, which is feasible and necessary.