目的 探讨婚恋家庭取向心理干预对系统性红斑狼疮患者家庭功能和幸福感指数的效果。方法 将2012年6月1日—2014年5月31日就诊于东莞康华医院内分泌及风湿免疫中心的62名15~58岁的系统性红斑狼疮患者作为研究对象,根据随机化原则将其分成两组,其中30名为干预组,参加本研究设计的婚恋家庭取向的心理干预,余32名为对照组,采用家庭功能评定量表、幸福指数量表及狼疮活动指数量表,对两组进行干预前、干预后、干预后3月和干预后6月作问卷调查。采用重复测量的方差分析进行评估。结果 家庭功能中的问题解决、情感反应、情感介入、总的功能分量表和总分两组干预后重复测量的方差分析两两比较均有统计学差异(P<0.05)。幸福感指数总分两组重复测量的方差分析无统计学意义,但如扩大置信空间至P<0.1,则两组重复测量的方差分析两两比较中干预后3月及6月有一定统计学意义(P=0.08<0.1)。结论 本研究中婚恋家庭取向的心理干预对SLE患者即家庭功能中问题解决、情感反应、情感介入、总的功能及家庭功能总分均有显著的改善作用,对幸福感指数总分则有一定的增进作用,而对已通过心身疾病方式表达了的SLEDAI没有干预作用。

Objective To explore the effect of marital family-based psychological intervention in SLE patients on family assessment device FAD and index of well-being. Methods A total of 62 SLE patients, aged between 15 and 58, who were treated in out-patient of endocrine immune rheumatism center of Dongguan Kanghua hospital from June 1,2012 to May 31,2014. The experimental group was made up of 30 patients who, at random, volunteered to participate in an added marital family-based psychological intervention and the control group was composed of rest 32 cases. At the time of pre-intervention,post-intervention,3 months and 6 months after intervention, both groups were investigated with questionnaires of family assessment device, index of well-being, index of general affect, and systemic lupus erythematosus disease activity index. The results were analyzed with repeated measure variance analysis to explore the effect. Results There were significant multiple-comparison differences by repeated measure variance analysis in the score of FAD's total and sub-scale problem solving, affective responsiveness, affective involvement, general functioning(P<0.05) between experimental and control group after intervention. There were no significant repeated measure variance analysis differences in the score of index of well-being' total, but if enlarging confidence space to P<0.1, there were partial multiple-comparison differences between experimental and control group at the time of 3 months and 6 months after intervention(P=0.08<0.1). Conclusion Marital family-based psychological intervention may significantly improve FAD's problem solving, affective responsiveness, affective involvement, general functioning, and sum of FAD, and partially improve index of well-being, but can not improve SLEDAI which had developed by psychosomatic disease.

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 了解和改善南沙区某制鞋厂甲苯的职业危害情况。方法 采用劳动卫生学调查方法。 结果 车间空气中甲苯浓度督导前为26.00~315.00 mg/m³,督导后浓度降至4.60~46.40 mg/m³;作业工人自觉症状在督导后有不同程度的改善,与督导前的情况相比,两者差异有统计学意义(P<0.01);暴露组白细胞减少情况与对照组间的差异有统计学意义(采用Fisher确切概率法,P<0.01);督导后血红蛋白含量下降得到明显改善,并与对照组基本接近。结论 加强职业卫生监督、定期进行职业危害因素监测和工人健康监护,对于甲苯作业的职业卫生防护具有重要意义。

目的 探讨多措施协作在中药注射剂药物警戒工作的应用效果。方法 2012年1月—2014年12月,采取建立多措施协作,应用于中药注射剂药物警戒工作中。通过对中药注射剂的用药频度(DDDs)、日用金额(DDC)、有效率及引起不良反应(ADR)变化等进行比较分析,以评价中药注射剂使用的安全性和有效性变化情况。结果 2012—2014年,中药注射剂使用有效率从76.5%上升至91.2%,不良反应发生率则由3.12%下降至0.72%,没有重大不良反应事件发生。中药注射剂用药频率DDDs则呈下降趋势,在医院药品总DDC上升的情况下,中药注射剂DDC反而下降。结论 多措施协作有助于建立有效的药物警戒体系,有效地降低了中药注射剂不良反应发生率,提高监测工作数据分析效率和发现药物警戒信号的能力,为中药注射剂的“合理,安全,有效,经济”提供有力的保障。

目的 观察康复路径在髋关节置换术后的临床应用效果,探讨其临床应用价值 。方法 将广州市第一人民医院2014年10月—2015年10月收治行髋关节置换术患者100例为研究对象,随机分为对照组与观察组各50例。对照组采取常规围手术期护理,观察组按照康复路径护理,比较两组患者术后并发症、住院时间、费用、患肢功能以及日常生活自理能力。结果 观察组住院时间和住院费用均少于对照组(P<0.01);两组术后并发症发生率、患肢功能评分及日常生活自理能力比较,差异均有统计学意义(P<0.01 )。结论 康复计划护理用于髋关节置换术后效果显著,可明显降低患者术后并发症,缩短住院时间,降低住院费用,有利于促进患者术后功能以及自理能力的恢复。

Objective To observe the effect of clinical application of rehabilitation in the path of a hip replacement, and to explore its clinical application value. Methods October 2014 to October 2015 in Guangzhou First People's Hospitalhip arthroplasty cases werecollected of 100 patients as the research object, randomly divided into control group and observation group with 50 cases in each group. The control group adopted conventional perioperation period nursing care, observation group in accordance with the recovery paths. We compared two groups of patients complications, hospitalization time, expense, limb function and activities of daily living. Results In the observation group, the hospitalization time and cost of hospitalization were significantly less than that of the control group (P<0.01); The incidence of limb function score, ability of daily living and postoperative complications were compared between the two groups, the differences were statistically significant (P<0.01). Conclusion Rehabilitation nursing care plans for after hip replacement effect is significant. It can significantly reduce the postoperative complications, shorten the time of hospitalization, reduce hospitalization expenses, and is beneficial to the recovery of the function of promoting postoperative and self-care ability.

目的 观察体重管理对轻型代谢综合征患者的体重指数、血糖、血压、甘油三酯等指标的影响。方法 将40例新诊断的轻型代谢综合征患者随机分成体重管理组和对照组,每组20例。两组患者分别于干预前、干预3月、干预6月检测体重指数、血糖、血压、甘油三脂等治疗,并比较两组患者上述指标。结果 干预6月后,体重管理组的体重指数、甘油三酯均显著性低于对照组,差异有统计学意义(P均＜0.05);体重管理组的高密度脂蛋白高于对照组,但无统计学差异。干预6月,体重管理组中血压、血糖达标率高于对照组,差异有统计学意义。结论 体重管理能改善轻型代谢综合征患者的体重指数、血糖、血压、甘油三脂等指标。

Objective To investigate the influence of weight management to body index, blood glucose, blood pressure and triglycerides in mild metabolic syndrome. Methods 40 mild metabolic syndrome patients were randomly divided into weight management group (20 patients) and control group (20 patients). The body index, blood glucose, blood pressure and triglycerides were observed and compared before intervention, 3 months and 6 months after intervention. Results After 6 months intervention, the body index and triglycerides in weight management group were significantly lower than the control group (P＜0.05). High density lipoprotein cholesterol in the weight management was higher than the control group, but there was no significant. The success rate of blood glucose and blood pressure were significantly higher than the control group. Conclusion Weight management can significantly improve the body index, blood glucose, blood pressure and triglycerides in patients with mild metabolic syndrome.

目的 探讨注射用黄芪多糖对宫颈癌化疗患者骨髓抑制的影响。方法 选取2012年11月—2015年10月于我院接受治疗的宫颈癌患者110例,随机分为对照组和观察组,每组各55例,两组患者均接受紫杉醇联合顺铂同步放疗,而观察组患者在此基础上接受每日静脉滴注注射用黄芪多糖治疗,连续应用10天。对比分析两组患者的临床疗效以及治疗前后的血象。结果 经过治疗后,观察组的治疗总有效率为61.81%,明显高于对照组的38.18%,差异有统计学意义(P<0.05);两组患者经过放化疗后其白细胞、红细胞和血小板计数均有不同程度的降低,而与对照组相比,观察组患者下降不明显。结论 注射用黄芪多糖可以减轻宫颈癌放化疗所致的骨髓抑制,对骨髓具有一定的保护作用,在临床治疗宫颈癌的过程中值得推广应用。

Objective To explore the clinical effect of astragalus polysaccharides on protecting marrow suppression of cervical carcinoma after chemotherapy. Methods 110 cases of patients with cervical carcinoma treated in our hospital from November 2012 to October 2015 in our hospital were selected and divided into control group and observation group, each group contains 55 cases. Both groups of patients received radiotherapy and chemotherapy of paclitaxel combined with cisplatin, and the observation group additionally received intravenous injection of astragalus polysaccharides for 10 days, to compare the hemogram before and after treatments between two groups. Results After treatments, the total effective rate of the observation group was 61.81%, significantly higher than that of the control group, the difference was statistically significant (P<0.05); The white blood cell, red blood cell and platelet count reduced in two goups after treatment. Compared with the control group, there was no significant decrease in the observation group. Conclusion Astragalus polysaccharides injection may reduce the marrow suppression induced by radiotherapy and chemotherapy in the treatment of cervical cancer, and it has a protective effect on the bone marrow.

目的 研究中药熏洗、中药离子导入加CPM综合疗法对膝关节功能障碍患者的作用效果。方法 从2014年4月—2016年4月,于我院共有78例膝关节功能障碍病患就诊。以数字法随机分成观察组(39例)和对照组(39例)。观察组给予中药熏洗以及中药离子导入再加以CPM综合疗法进行护理,对照组仅给予CPM综合疗法护理。观察两组患者护理后膝关节疼痛程度以及活动范围。结果 观察组患者膝关节功能优者占比51.28%,总有良率为84.62%,均高于对照组的25.64%,51.28%;观察组患者膝关节活动范围优者占比51.28%,总优良率为89.74%,均高于对照组的28.21%,66.67%;观察组患者WOMAC评分中膝关节疼痛以及膝关节僵硬和膝关节功能得分均低于对照组,WOMAC总分也低于对照组,差异均有统计学意义(P均＜0.05)。结论 中药熏洗、中药离子导入加CPM综合疗法能显著改善患者膝关节功能,增加活动度数,减轻疼痛等级,值得临床推广使用。

Objective To study the effect of traditional Chinese medicine fumigation, traditional Chinese medicine iontophoresis combined with CPM combined therapy on patients with knee joint dysfunction. Methods From April 2014 to April 2016, in our hospital there were a total of 78 cases of knee joint dysfunction disease patient treatment. With digital method they were randomly divided into observation group (39 cases) and control group (39 cases). The observation group was treated with Chinese herbal fumigation and washing and Chinese medicine iontophoresis and CPM combined therapy nursing, control group only received CPM combined therapy nursing. Observation of nursing care of the patients in the two groups were knee pain and range of motion. Results The observation group of patients with knee joint function was accounted for than 51.28%. The total yield was 84.62%. They were significantly higher than those in the control group of 25.64%, 51.28%; Observation group of patients with knee joint range of motion was accounted for than 51.28%. The total excellent and good rate was 89.74%, were significantly higher than those in the control group of 28.21%, 66.67%; Observation group, WOMAC score of knee pain and knee stiffness and knee joint function score were significantly lower than those of the control group. WOMAC score was significantly lower than that of the control group. The differences were statistically significant (P<0.05). Conclusion Traditional Chinese medicine fumigation, traditional Chinese medicine iontophoresis combined with CPM therapy could significantly improve the patient's knee function, increase the degree of activity, reduce the pain level. It is worth to have clinical application.

目的 观察健康促进诊疗管理模式对社区慢性病的干预效果。方法 选取社区的慢性病患者268例,对他们实施慢性病健康促进诊疗管理,主要的方向有健康干预、诊疗管理、随访管理等。结果 干预后患者的体质指数、血压、血糖、血脂的达标率、健康知识、用药依从率等都比干预前有所提升。组间比较差异具有统计学意义(P＜0.05)。干预治疗后患者的满意度为87.3%,治疗有效率为85.8%,显著高于干预治疗前的70.1%和59.0%。结论 对社区慢性病患者采取健康促进诊疗管理模式进行干预,能够提高社区慢性病的综合防治效果,对提高患者的生活质量具有一定的促进作用。

目的 对比观察罗哌卡因及布比卡因应用于患有妊娠期高血压的产妇行剖宫产时腰麻联合硬膜外麻醉的临床效果。方法 将103例择期行剖宫产手术的妊娠期高血压患者随机分为罗哌卡因组51例及布比卡因组52例分别采用对应药物进行麻醉,研究两组阻滞效果、心血管系统变化情况及不良反应发生情况。结果 两组间麻醉镇痛效果及优良率比较,差异没有统计学意义(P>0.05)。罗哌卡因组感觉及运动阻滞起效时间较布比卡因组长,运动阻滞恢复时间较布比卡因组短(P<0.05)。心血管系统变化情况比较,麻醉5min、10min时两组收缩压及平均动脉压均降低,但布比卡因组波动更大,两组间比较差异显著(P<0.05),心率及血氧饱和度比较无差异(P>0.05)。罗哌卡因组不良反应出现时间较布比卡因组晚,同时其不良反应发生率较布比卡因组低(χ²=4.1599,P<0.05)。结论 罗哌卡因及布比卡因在阻滞时间上略有差异,麻醉镇痛效果相当,但鉴于妊高症产妇本身心血管系统存在基础问题,运用罗哌卡因对心血管系统的影响较小,安全性更高,更值得推荐使用。