目的 通过比较治疗组服药前、后骨密度及骨代谢指标的变化情况,并将治疗组、对照组分别作对比,观察壮骨颗粒治疗绝经后女性骨量减少及骨质疏松、改善其骨代谢的临床疗效。方法 将研究对象随机分为两组,治疗组服用壮骨颗粒＋迪巧,对照组只服用迪巧。结果 壮骨颗粒组治疗后血清中的PINP、β-Crosslaps及N-MID下降(P＜0.05);与治疗前相比,腰椎(L2-L4)BMD提高(P＜0.05);壮骨颗粒能改善绝经后女性骨代谢及提高骨密度的效果优于迪巧组。结论 壮骨颗粒是治疗绝经后女性骨量减少及骨质疏松、提高骨量、改善骨代谢情况的安全有效药物。

目的 探讨群组管理对老年前列腺术后患者下肢活动依从性的效果。方法 将60例患者分为干预组和对照组,对照组按常规护理,干预组实施1周的群组管理活动。结果 干预后干预组患者对预防DVT发生的知晓度、进行下肢主动活动的依从性高于对照组,双下肢皮肤温度、颜色、胀痛等改变显著小于对照组,比较差异均有统计学意义(P＜ 0. 01)。结论 群组管理是一种有效的管理模式,可增强患者的自我效能,提高患者下肢活动的依从性,达到预防DVT发生的作用。

Objective To explore the influence of group management on compliance of lower extremities of elderly patients who underwent prostatectomy. Methods 60 patients were divided into the intervention group and the control group. While the control group was accepted normal nursing, the intervention group was accepted one-week group management. Results The intervention group performed better than the control group in awareness on the prevention of DVT and compliance of activities of lower extremities, and experienced less changes than the control group in skin temperatures, colors and ache of both lower extremities. These changes had statistical significant (P＜0.01). Conclusion Group management is an effective management mode, and improves parents' self-efficacy and compliance of lower extremities, is helping prevent DVT.

目的 探讨压力管理对改善中年高血压患者生活质量的效果。方法 采用便利抽样法,把首次在我院住院的中年高血压患者115例按时间段分为实验组60例和对照组55例,对照组给予常规护理,实验组采用压力管理干预,分住院期和出院后康复期两阶段进行。使用抑郁自评量表和SF-36量表分别在出院前和出院后1个月进行测评。结果 干预后实验组患者抑郁标准分降低,SF-36量表各维度分及总分升高,与对照组比较差异均有统计学意义(P＜0.05)。结论 对中年高血压患者实施有针对性、整体性、延续性和激励性的压力管理,可提高其生活质量。

Objective To explore the influence of stress management on the improvement of quality of life of middle-aged patients with hypertension. Methods According to convenience sampling, 115 middle-aged patients with hypertension who were the first time admitted to our hospital were divided, on the basis of different periods, into the test group (60 patients) and the control group (55 patients). The control group was accepted normal nursing, while the test group was accepted the stress management intervention that performed during hospitalization and after patients discharged from the hospital. Both groups were assessed, by using self-rating depression scale and SF-36 scale, before discharging from hospital and one month after discharging from hospital. Results After the intervention, the test group experienced reductions in depression standard score and increases in dimension scores and total scores of SF-36 scale.compared with those of the control group, these changes had statistical significant (P＜0.05). Conclusion Selective, integrated, continuous and stimulating stress management can help middle-aged patients with hypertension to improve the quality of life.

目的 本研究通过检测吸入布地奈德治疗支气管哮喘患儿前、后气道重塑、肺功能及外周血TGF-β浓度的变化,探讨布地奈德在哮喘患儿气道重塑早期干预的作用。方法 将2013年1月—2014年10月在我院确诊为支气管哮喘患儿18例,给予规律吸入布地奈德治疗6个月,分别于治疗前、后检测肺功能、外周血TGF-β浓度以及通过高分辨CT(HRCT)测量支气管管壁厚度(T)并计算管壁面积(WA)、支气管管壁厚度与气管外径之比(WT%)、气道壁横截面面积占气道总截面积的的百分比(WA%)。结果 吸入布地奈德治疗治疗6个月后,哮喘患儿WT%、WA%、肺功能以及TGF-β浓度均明显改善,与治疗前比较差异有统计学意义(P<0.05)。结论 规律吸入布地奈德治疗能减轻支气管哮喘患儿早期气道重塑,改善肺功能,可能通过下调细胞因子TGF-β的表达有关。

Objective We detected the changes of Airway remodeling,lung function and peripheral blood concentrations of TGF-β in asthmatic children before and after inhaled budesonide, and explored the role of budesonide in airway remodeling before early intervention in asthmatic children. Methods 32 cases of children were diagnosed asthma in our hospital,and given treatment of inhaled budesonide for 6 months, and to detect lung function,pheral blood TGF-β concentration as well as measuring the bronchial wall thickness (T) and calculate the wall area (WA), the outer diameter of the trachea and bronchial wall thickness ratio (WT%), the cross-sectional area of the airway wall accounted for airway percentage (WA%) of the total cross-sectional area by high-resolution CT (HRCT) before and after treatment. Results After treatment with inhaled budesonide in six months, the asthma WT%, WA%, lung function, and TGF-β concentrations were significantly improved, the differences compared with that before treatment were statistically significant(P<0.05). Conclusion The treatment of inhaled budesonide can alleviate asthmatic airway remodeling in early, improve lung function,possibly related to down the expression TGF-β.

目的 通过比较利伐沙班、依若肝素和非抗凝治疗对全膝关节表面置换术后的疗效,分析全膝关节置换术后抗凝治疗的必要性、有效性及安全性。方法 选取2010年1月—2013年8月我科收治的全膝关节表面置换术的患者154例,按治疗方式分成利伐沙班组(A组)、依若肝素钠组(B组)及非抗凝组(C组)。观察各组术后静脉血栓栓塞发生率;术前及用药后凝血功能指标的变化;术后总失血量、显性失血量、隐性失血量;伤口情况;膝关节功能HSS评分。结果 A组与B组术后无静脉栓塞症发生,C组出现静脉栓塞症3例;A、B、C三组术前与术后凝血功能指标差异均无统计学意义(P>0.05);B组术后显性失血量高于A组(P<0.05);三组患者术前及术后各回访时间点膝关节功能HSS评分差异无统计学意义(P>0.05)。结论 抗凝药物预防全膝关节置换术后静脉血栓栓塞症的效果确切,利伐沙班与依若肝素疗效相当;抗凝治疗不会增加术后失血量及伤口并发症的发生率,且对术后膝关节中期功能恢复无影响。全膝关节表面置换术后使用抗凝治疗效果良好,安全性可。

Objective To compare the influence of anticoagulant therapy on the curative effect after total knee arthroplasty and evaluate the necessity, effectiveness and safety of anticoagulant therapy. Methods 154 patients after total knee arthroplastyfrom January 2010 to August 2013 in our department were divided into the rivaroxaban group (group A), the enoxaparin group (B group) and non anticoagulation group (group C) according to the treatments. It was observed that the postoperative venous thromboembolism incidence; changes of blood coagulation indexes before and after the operation; the total blood loss、dominant blood loss and hidden hemorrhage; the wound; the HSS score of knee function. Results None of postoperative venous thromboembolism occurred in group A and B, three cases of venous thromboembolism in group C;The differences of between preoperative and postoperative coagulation indexes in three groups had no statistical significance (P>0.05); Dominant blood loss in group B was significantly higher than that of group A (P<0.05); No statistical significance in the HSS scores of knee function of three group (P>0.05). Conclusion The effect of anticoagulant drugs on the prevention of venous thromboembolism after total knee arthroplasty is effective, same efficacy in the treatment with rivaroxaban or enoxaparin; anticoagulant therapy does not significantly increase the postoperative blood loss and the incidence of wound complications, does not influence the recovery of postoperative mid-term knee function. The use of anticoagulation therapy after total knee arthroplasty has good effect and be safety.

目的 探讨群组管理对儿童特应性皮炎患儿生活质量的影响。方法 采用随机数字法将72例患儿分为干预组和对照组各36例,对照组不给予任何干预,干预组实施1个月的群组管理活动。结果 干预后干预组的瘙痒程度显著好转、总疗效率达100%、生活质量评分改善,与对照组比较差异均有统计学意义(P＜0.05)。结论 群组管理是一种有效的管理模式,增强了患儿的自我效能,降低了疾病严重程度,提高了患儿的生活质量。

Objective To explore the influence of group management on quality of life of children with atopic dermatitis. Methods According to random number table, 72 children with atopic dermatitis were randomly divided into the experiment group and the control group. While the control group was not accepted any intervention, the experiment group was accepted one-month group management. Results After the intervention, the pruritus of the intervention group was improved, the total effective rate was 100% and scores of life quality were improved obviously.compared with those in the control group, these changes had statistical significance (P＜0.05). Conclusion Group management is an effective management mode, it improves children's self-efficacy, relieve the seriousness of illness and improve children's quality of life.

目的 观察术前宣教对支撑喉镜喉肿物摘除患者全麻苏醒期的影响。方法 选择择期支撑喉镜喉肿物摘除全身麻醉手术的患者72例。随机分成两组进行效果对比,一组为接受常规护理的对照组,另一组为本次接受术前宣教观察组。分别对两组患者术后苏醒期躁动发生情况、心血管变化及配合性进行对比。结果 观察组患者通过术前宣教,有效减少全麻苏醒期患者躁动相关情况的发生,其心率、血压水平也较稳定,与对照组相比较差异有统计学意义(P<0.05);两组患者配合性相比较,差异有统计学意义(P<0.05)。结论 对支撑喉镜喉肿物摘除行全麻手术的患者进行术前宣教护理,可以有效减少苏醒期患者躁动的发生率,减轻气管拔管对心血管影响。提高整体治疗护理效率,达到更高的满意度,该方法切实可行,值得临床广泛运用。

Objective To obeserve the effect of preoperative education on the recovery period of general anesthesia after suspension laryngoscopic surgery. Methods Seventy-two adult patients undergoing suspension laryngoscopic surgery were randomly divided for the effect contrast.Routine nursing were adopted for control-group while the only difference for the observation group was the preoperative education. The occurrence of emergence agitation, hemodynamic, and compliance degree were compared between the two groups. Results Through preoperative education,observation group can significantly reduce the occurrence of agitation effectively and keep hemodynamics more stable than control group.Moreover,the compliance degree in two groups also has statistical significance (P<0.05). Conclusion Preoperative education can succeed in reducing the incidence of emergence agitation,inhibiting the responses to endotracheal extubation after suspension laryngoscopic surgery. Thus, preoperative education is feasible to enhance the overall effectiveness of treatment and nursing care. It is worth in popularization and application in clinical practice.

目的 观察肌内效贴技术对桡骨远端骨折内固定术后手功能的影响,并与对照组进行比较。方法 随机选取36例桡骨远端不稳定骨折内固定术后患者,随机分为治疗组与对照组,治疗组18例患者采用肌内效贴扎及腕关节主动活动康复训练,对照组18例采用腕关节主动活动康复训练。所有患者在治疗前及治疗后1周、2周均采用Gartland-Werley进行腕关节功能评价;容积法测量腕关节远端肿胀程度、视觉模拟疼痛评分(visual analog scale,VAS)进行疼痛评价。结果 治疗后1周,后2周治疗组的腕关节功能Gartland-Werley评定,腕关节远端肿胀程度和VAS优于对照组,差异有统计学意义(P＜0.05)。结论 肌内效贴技术对改善桡骨远端骨折术后肿胀,促进患者手功能恢复,改善患肢疼痛方面疗效显著,值得推广。

Objective To observe the effect of Kinesio taping on hand function after internal fixation of distal radius fracture, comparing to the control group. Methods Using randomized controlled methods, 36 cases of unstable distal radius fracture after internal fixation were randomly divided into two groups, 18 cases in the treatment group were treated by Kinesio taping and wrist active rehabilitation training. The control group (18 cases) only got wrist active rehabilitation training. All patients were evaluated before and after treatment in 1 week and 2 weeks, including the function assessment of wrist joint by Gartland-Werley, swelling measurement of distal wrist joint by volumetric method, pain evaluation by visual analogue scale (visual analog scale, VAS). Results In the twice evaluation after treatment, Gartland-Werley assessment of wrist joint, distal swelling degree and VAS of the treatment group were superior to that of the control group, the difference had statistical significance(P<0.05). Conclusion Kinesio taping can improve the distal radius fracture postoperative swelling, promote the recovery of hand function in patients, and improve the curative effect of limb pain significantly. It's worthy of promotion.

目的 探讨生长抑素对腹部手术后早期肠内营养支持顺应性的影响。方法 选择在本院接受中等以上腹部手术的住院病人60例,随机分成实验组和对照组各30例,手术后12 h开始给予早期肠内营养支持,连续5 d,实验组按常规使用生长抑素5 d,而对照组未使用生长抑素;比较两组在术后5 d内胃肠道不适的发生与否,胃肠减压的引流量,肠蠕动功能恢复情况,以及术后7 d的血液常规、肝、肾功能及血糖等血液生化指标。结果 与对照组比较,实验组在手术后胃肠道不适的发生,鼻胃管(胃肠减压)引流量,肠蠕动功能恢复时间等差异有统计学意义;术后7 d的血液常规、肝、肾功能及血糖等指标比较差异无统计学意义。结论 生长抑素有助于机体对腹部手术后肠内营养支持的顺应性,并安全可行。

Objective To study the clinical effects of somatostatin on compliance of early enteral nutrition after abdominal surgery. Methods 60 cases who accepted above medium abdominal operations were randomized into two groups including 30 cases of treatment group with somatostatin on the bases of early enteral nutrition and 30 cases of control group with early enteral nutrition, continued for 5 days after abdominal surgery. The promotion of clinical manifestations and signs, gastrointestinal decompression, blood routine examination, liver and renal function, blood glucose and so on were compared between the two groups. Results As for clinical manifestations and signs promotion, there were statistically significance in the alleviation of pain and distension of the abdominal and the average volume gastrointestinal decompression and the time of recovering peristalsis and passing flatus (P<0.05).As for blood routine examination, liver and renal function, blood glucose there were no statistically significance between the two groups. Conclusion Somatostatin can effected on compliance of early enteral nutrition after abdominal surgery.

目的 观察隔药壮灸神阙穴治疗女性黄褐斑的临床疗效及对血清性激素水平的影响。方法 将72例患者随机分为2组,治疗组38例和对照组34例,治疗组予隔药壮灸神阙穴治疗,对照组予口服维生素C、维生素E治疗,10次为1个疗程,第2、4、6疗程末观察疗效,治疗前后测定月经第2～3天血清雌二醇(E2)、孕酮(P)、泌乳素(PRL)、卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)水平。结果 第6疗程末治疗组总有效率为83.33％,对照组总有效率30.30%,治疗组疗效优于对照组(P＜0.05),治疗组治疗前后E2、LH下降水平有统计学意义(P＜0.05)。对照组治疗前后E2、P、PRL、FSH、LH、T水平变化不明显(P＞0.05)。治疗后2组E2、LH比较,差异有统计学意义(P＜0.05)。结论 隔药壮灸神阙穴治疗女性黄褐斑临床疗效较好,可能通过调节性激素而起到治疗作用。

Objective To observe the clinical efficacy on female chloasma treated with acupuncture of Zhuang minority medicine at Shengque xue and its influence on sex hormone levels. Methods 72 cases were divided randomly into a treatment group(38 cases) and a control group(34 cases). In treatment group, acupuncture of Zhuang minority medicine at Shengque xue was applied. In control group, oral administration of vitamin C and vitamin E were given. The cases of treatment group were treated ten times as one session. At the end of 2,4,6 treatment session efficacy were analyzed respectively. The levels of serum estradiol(E2), progesterone(P), prolactin(PRL), follicule stimulating hormone(FSH), luteinizing hormone(LH) and testosterone(T) were detected on day 2-3 of menstruation. Results At the end of 6 treatment session the total effective rate was 83.33％ in treatment group and was 30.30% in control group, the efficacy in treatment group were superior to that in control group, with significant difference(P＜0.05). In treatment group, the levels of LH and E2 after treatment were lower as compared with those before treatment(P＜0.05). In control group, there were no obvious changes in E2,P, PRL, FSH, LH and T before and after treatment(P＞0.05). The levels of LH and E2 after treatment were significantly different in comparison of two groups(P＜0.05). Conclusion Acupuncture of Zhuang minority medicine at Shengque xue achieves a definite efficacy on female chloasma in clinic and its pharmacological mechanism may be relevant with its regulation on sex hormone levels for the patients.