目的 探讨乳腺癌术后疼痛综合征（PMPS）的发生率及影响因素。方法 选择2021年1月—2023年2月医院收治的82例乳腺癌患者为研究对象,采取手术治疗,统计PMPS发生率,分析PMPS的特征,比较PMPS患者和非PMPS患者的临床资料,采用 Logistic 逐步回归分析。结果 82例中有20例患者术后发生PMPS,发生率为24.39%,其中患侧腋窝45.00%、麻木样疼痛35.00%、中度疼痛60.00%、术后即刻疼痛50.00%、每日发作疼痛50.00%占比较高。PMPS患者和非PMPS患者的体质指数、教育程度、病理分期、肿瘤占位、手术方式、术前使用非甾体抗炎药、术前化学治疗、术后化学治疗比较差异均无统计学意义（P>0.05）。PMPS患者年龄低于非PMPS患者,负性情绪率30.00%高于非PMPS患者8.06%,清扫腋窝淋巴结率95.00%高于非PMPS患者72.58%,术后放射治疗率30.00%高于非PMPS患者6.45%（P<0.05）。年龄、负性情绪、清扫腋窝淋巴结、术后放射疗为PMPS发生的危险因素（P<0.05）。结论 乳腺癌术后较容易发生PMPS,主要表现为术后即刻腋窝疼痛、麻木,发作频率较高,疼痛较重,其中年龄小、术前焦虑、清扫腋窝淋巴结、术后放疗为引发PMPS的危险因素,需加强监测和针对性处理,研究价值较高。

Objective To investigate the incidence and influencing factors of post-mastectomy pain syndrome（PMPS）in breast cancer patients．Methods A total of 82 patients with breast cancer admitted to our hospital from January 2021 to February 2023 were selected as the research objects,and underwent surgical treatment．The incidence of PMPS was counted,the characteristics of PMPS were analyzed,and the clinical data of PMPS patients and non-PMPS patients were compared．Results Among the 82 patients,20 patients had PMPS after surgery,with an incidence of 24.39%．Among them,the affected axilla accounted for 45.00%,numbness pain 35.00%,moderate pain 60.00%,immediate postoperative pain 50.00%,and daily pain 50.00%．There were no significant differences in body mass index,education level,pathological stage of disease,tumor location,surgical method,preoperative use of non-steroid anti-inflammatory drugs,preoperative chemotherapy and postoperative chemotherapy between PMPS patients and non-PMPS patients（P>0.05）．The age of PMPS patients was significantly higher than that of non-PMPS patients,the rate of negative emotion was 30.00%,the rate of axillary lymph node dissection was 95.00%,and the rate of postoperative radiotherapy was 30.00%,which was significantly higher than that of non-PMPS patients（P<0.05）．Age,negative emotion,axillary lymph node dissection and postoperative radiotherapy were independent risk factors for PMPS（P<0.05）．Conclusions PMPS is prone to occur after breast cancer surgery,mainly characterized by immediate postoperative axillary pain and numbness,with a high frequency and severe pain．Young age,preoperative anxiety,axillary lymph node dissection,and postoperative radiotherapy are independent risk factors for PMPS,which need to be strengthened monitoring and targeted treatment．

目的 探讨快速康复外科理念对降低子宫全切术后患者下肢深静脉血栓形成的应用效果。方法 采用方便抽样的方法,将185例子宫全切术后患者分为观察组(95例)和对照组(90例)。观察组实施快速康复外科护理路径,对照组实施常规护理路径。结果 两组患者术后的下肢深静脉血栓发生率、D-二聚体水平、日常生活活动能力评分的比较差异均有统计学意义(P<0.05);观察组下肢深静脉血栓形成的发生率和D-二聚体水平低于对照组(P<0. 01),观察组日常生活活动能力评分低于对照组(P<0.05)。结论 快速康复外科理念应用于子宫全切术后患者,可降低患者下肢深静脉血栓的发生率,提高患者自理能力,使患者尽快恢复健康水平。

Objective To explore the effect of fast-track surgery on the treatment of lower extremity deep venous thrombosis in patients after total hysterectomy. Methods A total of 185 patients with hysterectomy were divided into observation group(n=95) and control group (n=90) randomly. The observation group implemented a rapid rehabilitation surgical care path, and the control group implemented routine nursing path. Results There were significant differences in the incidence of deep venous thrombosis, D-dimer level and daily living activity score between the two groups (P<0.05). The incidence of deep venous thrombosis and the level of D-dimer in the lower extremity of the observation group were significantly lower than those in the control group (P<0.01). The score of the daily living activity was lower in the observation group than that of control group (P<0.05). Conclusion Fast-track surgery for patients after total hysterectomy could reduce the incidence of postoperative deep venous thrombosis and improve the self-care abilities of patients, so that patients may return to health as soon as possible.

目的 对86例青春期多囊卵巢综合症(polycystic ovary syndrome,PCOS)患者进行随访,探讨患者长期治疗的依从性。方法 选择2009年11月—2012年6月在我院门诊首次诊断为青春期PCOS患者进行前瞻性队列研究。按随诊方法不同分为常规随访组和可及与连贯病人服务(ACC)组,前瞻随访6个月。分别在初次就诊时、3个月及6个月后对比两组的身体质量指数(Body Mass Index, BMI)、复诊率和遵医嘱服药率。结果 共86名患者入组,其中常规随访组43人,ACC组43人。两组基线资料基本一致。随访3月时,两组的BMI、复诊率和遵医嘱服药率的差异无统计学意义(P>0.05)。随诊6月时,ACC组的复诊率和服药依从性均优于常规随访组分别为(97.7% 比 81.4%,97.7% 比 76.7%,P＜0.05),BMI比常规随访组下降(22.33±7.31 比 24.59±7.8 kg/m²,t<0.05)。结论 可及与连贯的病人服务可以改善青春期PCOS患者BMI及长期随诊的复诊率和服药依从性。

Objective To investigate the compliance of adolescent patients with polycystic ovary syndrome (PCOS) in long-term treatment by access to care and continuity of care(ACC) on 86 cases. Methods A prospective cohort study was taken for 6 months on adolescent patients diagnosed as PCOS for the first time in out-patient department from November 2009 to June 2012. These patients were selected and divided into ACC group and regular follow-up group according to the different modes of follow-up visit. The relevant data including body mass index (BMI), clinic visit rate and rate of medication adherence were compared in the first visit and 3rd, 6th month in the follow-up visit. Results 86 patients were enrolled with 43 in ACC group and 43 in regular follow-up group. The baseline information was similar between the two groups. There were no statistically significant difference between groups in BMI, clinic visit rate and rate of medication adherence after 3 months (P>0.05). However, after 6 months, BMI, clinic visit rate and rate of medication adherence were significantly improved in the ACC group compared to the regular follow-up group (22.33±7.31 vs 24.59±7.8 kg/m², 97.7% vs 81.4%, 97.7% vs 76.7%, P＜0.05, respectively). Conclusion ACC could improve BMI, clinic visit rate and medication adherence of adolescent patients with polycystic ovary syndrome in long-term treatment.