目的 探讨科学的出院后营养管理对肠道术后新生儿体格追赶的效果,分析影响体格追赶的相关因素。方法 通过营养门诊对出院术后婴儿及社区婴儿进行个体化营养喂养指导和营养咨询,比较两组每月体质量、身长及头围,并随访至生后9月龄。两组生后半年生长趋势行重复测量检验。结果 第1月龄时,手术组患儿体质量、身长、头围均落后于对照组婴儿(P<0.001, P=0.004, P=0.008),第2月龄时,手术组患儿体质量、头围仍落后于对照组(P=0.003,P=0.031),第4月龄时,手术组体质量低于对照组(P=0.012),第5～9月龄,两组体格指标均无明显差异。生后半年内两组的生长趋势差异无统计学意义。前半年身长的增长与出生身长、父母文化以及父亲的不良习惯存在负相关关系,头围的增长与住院天数呈明显负相关关系、与出生以及首诊时的体格状况呈正相关关系。结论 合理喂养对新生儿肠道术后体格追赶有利,帮助其接近正常生长曲线。再次手术可能是导致体质量增长下降的主要因素,但未明显影响身长、头围的正常增长。出生时和就诊时的体格状况、父母教育程度和不良习惯以及住院天数均是影响体格追赶的相关因素。

Objective To investigate the effect of scientific nutrition management after discharge on neonatal physical catch-up after intestinal operation, and to analyze the related factors affecting physical catch-up. Methods Individualized nutritional feeding instruction and nutrition consultation were performed on infants and community infants after discharge from hospital through nutrition clinic. The monthly body weight, body length and head circumference were compared between the two groups, and followed up to 9 months old. The growth trend of the two groups in half a year after birth was tested by repeated measurement. Results At the first month of age, the body weight, body length and head circumference of the patients in the operation group were lower than those in the control group (P<0.001, P=0.004, P=0.008). At the second month, the body weight and head circumference of the operation group were still behind those of the control group (P=0.003, P=0.031), and at the fourth month of age, the weight and head circumference of the patients in the operation group were still lower than those in the control group. The body weight of the operation group was lower than that of the control group (P=0.012), and there was no diffence in the physical indexes between the two groups at the age of 5~9 months. There was no statistical significance in growth trend between the two groups within half a year after birth. The growth of body length in the first half of the year had a negative correlation with the length of birth, parents' culture and father's bad habits. The growth of head circumference had a negative correlation with the length of stay in hospital, and had a positive correlation with the physical condition at birth and at first visit. Conclusion Reasonable feeding is beneficial to the physical catch-up of the newborn after intestinal operation and helps them approach the normal growth curve. Reoperation may be the main cause of weight loss, but it does not affect the normal growth of body length and head circumference. The physical condition at birth and medical visit, parents' education level, bad habit and hospitalization days were all related factors of physical catch-up.

目的 探究全程介入护理对慢性阻塞性肺疾病（COPD）和哮喘患者管理的治疗效果。方法 选取我院2016年4月—2018年4月收治的200例COPD患者组和100例哮喘患者作为研究对象。采用单双号数字分组法,将COPD患者和哮喘患者各随机分为两组,即A组和B组,COPD患者A组和B组各100例,哮喘患者A组和B组各50例。A组采用药物治疗配合全程介入护理,B组采用药物治疗配合住院期间常规护理,比较两组治疗前后的肺功能指标、六分钟步行试验和ACT测试。结果 治疗前,COPD患者和哮喘患者中,A组和B组的FEV1、FVC、FEV1%等肺功能指标和六分钟步行试验、ACT测试差异,无统计学意义（P>0.05）;治疗后,COPD患者和哮喘患者中,A组和B组的FEV1、FVC、FEV1%等肺功能指标和六分钟步行试验、ACT测试差异有统计学意义（P<0.05）。结论 全程介入护理应用在COPD和哮喘患者的管理中,效果显著,值得推广。

目的 对江门市新会区会城街道的严重精神障碍患者监护人进行守护APP干预并评价干预效果影响。方法 以会城街道辖区内登记在国家精神障碍信息系统1 488在册精神障碍患者作为研究对象,随机抽取分为安装守护APP组1 084例和无安装守护APP组404例。安装组通过监护人使用守护APP实现责任医生对患者进行动态监护和实时监护,提供免费咨询、心理干预、服药指导及随访管理服务;无安装组采用常规随访康复管理措施干预。干预满一年后对比分析两组患者康复措施落实情况、服药依从性（治疗率）、病情及社交改善情况、复发住院率、肇事肇祸率及家属疾病知识知晓情况等指标。结果 安装守护App组患者服药依从性（治疗率）及康复措施落实率高于无安装组,家属对精神疾病知识知晓良好率较高;干预后安装组患者的SCL-90评分及心理社交功能评估表评分改善情况优于无安装组,复发住院率和肇事肇祸率明显较低,以上差异均有统计学意义。结论 守护APP平台帮助医生与监护人把严重精神障碍患者的监护工作真正落到实处,康复效果优于传统的康复方法,值得进一步推广应用。

Objective Guardianship APP intervention was conducted for the guardians of severe mental disorders in Huicheng,Xinhui district,Jiangmen city and the effect of intervention was evaluated. Methods 1 488 psychiatric patients in the unit area were taken as the research objects,which were randomly divided into the guardian APP installation group of 1084 cases and the non - installation group of 404 cases. The installation group uses guardian APP to realize the dynamic guardianship and real-time monitoring of the patients,and we provided free charge consultation,psychological intervention,medication guide,case tracking and follow-up management services. The non installation group adopted the routine rehabilitation management measures after discharge. After a year the implementation of rehabilitation measures,compliance,condition and social improvement,relapse rate of hospitalization,accident rate and knowledge of family disease between the two groups of patients were compared and analyzed. Results The compliance and rehabilitation measures of the patients in the App group were higher than those in the non installation group. The rate of knowledge about mental illness was higher in family members,and the improvement of SCL-90 score and psychosocial function assessment score after intervention was better than that of non installation group. The rate of relapse hospitalization and cause trouble were lower. The differences above were statistically significant. Conclusion The guardian APP platform helps doctors and guardians to make the monitoring work of patients with severe mental disorder really practical,and the rehabilitation effect is better than the traditional rehabilitation method,which is worthy of further promotion and application.

目的 研究中山市南部镇区医院人员关于继续医学教育的政策知悉程度、参加继续医学教育的途径、障碍因素及动机,为完善继续医学教育管理工作提供决策依据。方法 采用简单随机抽样的方法,选取中山市南部镇区医院200名医务人员,采用问卷调查方法,了解中山市南部镇区医务人员继续教育的参与情况,接受继续教育的主要途径与障碍。结果 24～40岁年龄段、初级职称人员知悉程度较高,而40～48岁年龄段、中高职称人员参与程度较高;晋升和发展是主要参与动机,时间和空间因素是主要参与障碍。结论 医院应根据不同层次专业技术人员继续教育的需要开展继续教育,并创造有利条件,克服时间上和空间上的障碍,更好地使继续教育的效果转化为知识结构的不断优化。

目的 探讨个体化健康管理对超高龄结直肠癌患者希望水平的影响效果。方法 对66例超高龄结直肠癌患者实施个体化健康管理,3个月后对患者进行希望水平、肛门括约肌功能、生活质量的测评。结果 3个月后患者排便功能恢复良好的达90.91%,与出院前比较差异有统计学意义(P＜0.01);3个月后患者HHI各维度和SF-36各维度的得分明显提高,与干预前比较差异均有统计学意义(P＜0.01)。结论 对超高龄结直肠癌患者实施个体化健康管理,可提高其生存希望水平,改善生活质量。

Objective To explore the effect of individualized health management on the hope level of patients with advanced colorectal cancer. Methods Using individualized health management for 66 elderly patients with colorectal cancer for 3 months, the level of hope, anal sphincter function and quality of life were evaluated. Results After 3 months, the defecation function of the patients recovered well to reach 90.91%, and the difference was statistically significant (P<0.01); After 3 months, the scores of each dimension of Herth Hope Index (HHI) and SF-36 were significantly improved, and the difference was statistically significant (P<0.01). Conclusion The implementation of individualized health management for the elderly patients with colorectal cancer may improve the survival level and improve the quality of life.

目的 探究自我管理干预对慢性阻塞性肺疾病(COPD) 稳定期患者的临床疗效影响。方法 选取2013年6月—2014年6月我院诊断的COPD稳定期患者90例,随机分为对照组(45例)和观察组(45例)。对照组只给予常规治疗,观察组在常规治疗基础上给予自我管理干预,包括健康教育和康复训练,之后通过比较两组患者肺功能、6MWD、生活质量问卷(SGRQ)评分、急性发病频率、依从性等方面的变化来探讨自我管理干预对COPD治疗的临床意义。结果 观察组患者肺功能和6MWD较对照组有改善,观察组的SGRQ得分、急性加重频率显著低于对照组,而其依从性比例明显高于对照组,两组间差异在统计学上均有意义(P<0.05)。结论 加强COPD稳定期自我管理干预能够改善COPD的预后,值得在临床上进行应用。

目的 探讨糖尿病自我管理支持对社区2型糖尿病患者生化指标控制的影响。方法 2015年1月1日前已确诊为2型糖尿病患者,随机分为对照组和干预组,对照组303例按照广州市基本公共卫生服务包要求进行定期随访、体检及健康教育,干预组130例进行自我管理支持干预,观察两组生化指标的变化。结果 与对照组比较,自我管理支持组的空腹血糖、总胆固醇、甘油三酯、谷丙转氨酶、尿酸控制效果较好,差异有统计学意义(P<0.05)。结论 自我管理支持对社区2型糖尿病患者生化指标控制的效果良好,值得推广。

Objective To evaluate the control effect of biochemical criterion in patients with type 2 diabetes under diabetes self-management support in community. Methods 130 patients with type 2 diabetes in community from January 2015 to December 2015 accepting the diabetes self-management support were chosen as research group, another 303 diabetic patients without the diabetes self-management support were set as control group, the effect of management was analyzed. Results There was statistically significant difference (P<0.05) in biochemical criterion including blood sugar (BS), total cholesterol (TC), triglyceride (TG), alanine aminotransferase (ALT) and uric acid (UA). Conclusion Control effect of biochemical criterion was good in the diabetes self- management support for people with type 2 diabetes, which was worth to be popularized.

目的 探讨分析品管圈在提高腔镜肾癌术后护理流程管理中的应用,以提高肾癌术后患者的存活率也避免术后并发症出现。方法 对我院肾癌术后护理流程管理的现状进行分析,并将目前我院在肾癌术后护理流程管理当中出现的问题进行分析探讨和总结,并制定出详细的工作目标拟定可行的工作计划,并组织人员进行实施,并将实施之后的结果与预期的结果进行对比分析总结。结果 在实施了品管圈活动之后,我院对腔镜肾癌术后护理流程的管理得到了显著的提升,其中人员操作不规范的发生率由实施活动之前的13.2%(5/38)减低到了5.3%(2/38),同时患者发生术后并发症的例数也由之前的7例降低到了3例,结果对比较之前的差异有统计学意义。结论 使用品管圈活动不仅能够有效的提高对腔镜肾癌术后护理流程管理中的效力,而且还能够减少患者术后并发症的发生几率。

目的 探讨运用目标管理法优化妇科病人的临床护理路径的应用效果。方法 采用历史对照研究,以腹腔镜子宫切除术病人作为研究对象,将2014年1月—2014年12月采用临床护理路径的98例病人作为对照组;2015年1月—2015年12月运用目标管理法优化临床护理路径的105例病人作为研究组,比较两组护理缺陷发生情况、病人满意度、住院时间和住院费用。结果 研究组健康知识知晓水平高于对照组,术后首次功能锻炼时间短于对照组(P＜0.05)。研究组护理缺陷发生率为3.81%,对照组发生率为14.29%(P＜0.05)。研究组对健康教育和基础护理满意度高于对照组(P＜0.05)。结论 目标管理法优化的临床护理路径可使各项操作更加规范细化,提高工作质量,减少护理缺陷,护理质量有一定程度的提高,同时对病人满意度的提高有积极的促进作用。

目的 探讨应用家庭访视护理与中医体质辨识相结合的方式提高居民健康管理能力,改善居民体质。方法 随机抽取广州市越秀区某社区的128例居民为研究对象,通过体检和中医体质辨识了解居民健康状况,责任护士开展家庭访视护理和具有中医特色的干预措施,通过干预前、后研究对象的中医体质量化计分、生存质量变化和健康知识共3个方面评价项目效果。结果 中医体质平和质得分显著升高,气虚质、痰湿质、湿热质、血瘀质、气郁质共5种偏颇体质的得分均降低(P<0.05),阳虚质、阴虚质、特禀质3种体质的得分差异无统计学差异(P>0.05)。简明健康状况调查问卷评分(MOS SF-36)在PCS领域和MCS领域的生命质量得分比干预前增高(P<0. 05)。健康教育知识在中医保健养生、慢性疾病防治、药物使用规范以及家庭护理知识评分有提高(P<0. 05)。结论 家庭访视护理结合中医体质调理措施可以拉近居民与医护人员距离,增强居民健康管理观念和能力,促进居民关注自身体质状况,达到“未病先防”的效果。