论著

45°半坐卧位对BPH患者膀胱压力容积测定结果的影响

Influence of 45 degree semi-reclining position on filling cystometry in BPH Patients

:48-50
 
目的 探讨45°半坐卧位对良性前列腺增生患者膀胱压力容积测定的影响。方法 按照入选标准和排除标准选取临床确诊为良性前列腺增生(Benign Prostatic Hyperplasia,BPH)患者。按照二阶段交叉设计的方法将入选患者随机分入A、B两组。A组患者先进行45°半坐卧位膀胱压力容积测定(Cystometry,CMG),再进行平卧位CMG,B组患者先进行平卧位CMG,再进行45°半坐卧位CMG。统计以下CMG参数:膀胱初始感觉容量、膀胱初始尿意容量、膀胱最大容量及逼尿肌过度活动发生率。结果 与平卧位相比,45°半坐卧位对膀胱初始感觉容量、膀胱初始尿意容量、膀胱最大容量的测定无影响,且能提高逼尿肌过度活动的检出率(45°半坐卧位37.21% vs.平卧位11.63%,P=0.006)。结论 45°半坐卧位能代替平卧位作为CMG的检查体位。
Objective To investigate influence of 45 degree semi-reclining position in cystometry in patients with benign prostatic hyPerplasia(BPH). Methods Patients with BPH were enrolled according to the inclusion and exclusion criteria. They were divided into two groups randomly by two stage cross-over design. Group A took the 45 degree semi-reclining position firstly then supine position, while group B used a reverse order.CMG parameters included volume of first sensation to void (FS), volume of first urge to void (FU), maximum cystometric capacity (MCC) and detrusor overactivity(DO). Results 45 degree semi-reclining position had no effect on volume of FS、volume of FU、MCC, and could increase the detection rate of DO(45 degree semi-reclining Position 37.21% vs. supine 11.63%,P=0.006). Conclusion 45 degree semi-reclining position may be used as a substitution for supine in FC.
论著

阴道分泌物检查与细菌性阴道病的结果分析

Analysis of Vaginal secretions and bacterial vaginosis results

:46-48
 
目的 探讨妇女阴道健康状况及阴道分泌物清洁度、线索细胞及唾液酸酶法检测细菌性阴道病(BV)的相关性。方法 随机抽取2013年4月—2014年6月本院妇科疑似细菌性阴道病患者标本835例,分别采用生理盐水直接涂片及分泌物直接涂片进行革兰氏染色两者相结合检查清洁度、线索细胞;唾液酸酶法检测BV。结果 清洁度Ⅰ~Ⅱ占27.55%,BV阳性率为2.40%,线索细胞检出率1.32%;清洁度Ⅲ~Ⅳ占72.45%,病原菌阳性率为46.23%,其中BV阳性率为30.55%,线索细胞检出率为23.48%。结论 清洁度异常率比正常率偏高;清洁度正常不一定没有细菌性阴道病; BV的出现严重威胁妇女身体健康,正确的诊断有重要意义,唾液酸酶法检测BV虽有快速、操作简单、显色结果易判断,但温度、时间、取材问题等受多种因素影响。
Objective To explore the correlation between the health of women's vagina and vaginal cleanness, clue cells and bacterial vaginosis(BV)which is tested by the sialic acid enzymatic method. Methods Randomly select 835 suspected cases of bacterial vaginosis in our hospital gynecology department in April 2013-June 2014. Every case was respectively done saline direct smear and vaginal secretion direct smear gram staining to check vaginal cleanness and clue cells. BV is tested by sialic acid enzymatic method. Results The cleanness of I-II accounted for 27.55%, BV positive rate was 2.40%, the positive rate of clue cells was 1.32%;the cleanness of degree III-IV accounted for 72.45%, the positive rate of pathogenic bacteria was 46.23%, the positive rate of BV was 30.55%, the positive rate of clue cells leads to 23.48%. Conclusion The rate of abnormal vaginal cleanness is higher than the normal.The nomal vaginal cleaness does not show no bacterial vaginosis. The emergence of BV seriously affects women's health, so the correct diagnosis is of great importance. Although the of the saliva acid enzyme to test BV is fast, operates easily and the color results are easily to be judged, but it can be influenced by other factors such as temperature, time, materials issues.
临床诊疗

701例经直肠彩超引导前列腺穿刺活检结果及影响因素分析

The Positive Rate and Influencing Factors of Transrectal Ultrasound Guided Prostatic Biopsy in 701 Cases

:96-98
 
目的 分析经直肠彩超引导下不同前列腺穿刺方式的阳性率及其相关因素,探讨安全的穿刺方案。方法 回顾性分析接受经直肠彩超引导下前列腺穿刺的701例患者临床资料,所有患者均接受系统性13点穿刺活检,并假设13点穿刺中减少前列腺中线3个穿刺点为10点穿刺术式,加之标准的6点穿刺术式。比较上述穿刺术式的阳性率,分析T-PSA、前列腺体积、PSA体积密度(PSAD)、有无前列腺结节对穿刺阳性率的影响。结果 随前列腺穿刺针数的增加,活检阳性率增高。同一穿刺方式,不同T-PSA组间、不同前列腺体积组、不同PSAD组阳性率有差异。T-PSA>100 ng/mL时,三种穿刺方式的阳性率无差异;T-PSA<100 ng/mL时,6点穿刺法阳性率较低,而10点穿刺、13点穿刺阳性率无差异。前列腺体积>80 mL时,不同穿刺法阳性率有差异。PSAD<0.5 ng/mL2时,10点、13点穿刺阳性率无差异。结论 前列腺穿刺活检阳性率随穿刺针数增多而增加,可根据PSA水平、前列腺体积、PSAD选择个体化穿刺方案。
临床诊疗

河源市无偿献血者人群结构特征与血液检测结果分析

Analysis of the population structure of voluntary donors and their blood testing results

:77-79
 
目的 了解河源市无偿献血者的人群结构特征及其与血液检测结果的关系,为完善该地区安全血源招募和献血者筛查策略提供依据。方法 收集2014年1月1日—2014年12月31日该市15184例首次无偿献血者登记表及检测结果,统计分析无偿献血者的年龄、性别、职业、文化程度等分布情况及其血液检测结果不合格率。结果 该地区无偿献血者以男性(78.91%)、年龄以35岁以下(63.44%)、在职职员(34.08%)、大学专科以上文化程度(39.59%)为主体;献血模式以个人自愿(53.58%)和团体自愿(38.41%)为主。该市无偿献血者血液检测结果总体不合格率为4.29%,其中不同性别、年龄、职业、文化程度、献血模式的无偿献血者组间不合格率差异有统计学意义(χ2值分别为 19.079、38.103、61.042、41.191、44.079,P值均<0.05);多因素Logistic 回归分析显示性别、年龄、职业、文化程度和献血模式为血液检测结果不合格率的主要影响因素。结论 应根据无偿献血者人群结构特点有效开展献血知识宣传教育,认真做好献血前筛查。
论著

惠州市新生儿眼病筛查结果分析

Analysis of screening results of ocular diseases for neonates in Huizhou

:54-55
 
目的 了解惠州市新生儿眼病的发病状况,探讨新生儿眼病筛查的临床模式。方法 回顾分析我院在2014年1月—2015年3月950例(1900只眼)高危新生儿的眼病筛查资料。结果 950例(1900只眼)新生儿中,检查出新生儿眼病10种,共200例,检出率21.05%;其中家族性渗出性视网膜病变(FEVR)5例(0.526%)、永存原始玻璃体增生症(PHPV)1例(0.105%)、先天性白内障1例(0.105%)、视网膜出血55例(5.789%)、生理性大视杯3例(0.316%)、新生儿鼻泪管阻塞5例(0.526%)、新生儿结膜炎100例(10.53%)、皮样脂肪瘤2例(0.211%)、新生儿泪囊黏液囊肿2例(0.211%)、早产儿视网膜病变26例(2.737%)。结论 新生儿眼病在临床中并不少见,而且部分眼病是可以早期筛查、早期治疗以避免盲的。
Objective To study the incidence of newborn eye diseases and to explore the clinical strategies for the screening of newborn ocular diseases. Methods A retrospective analysis was conducted on 950 newborns from January 2014 to March 2015. Results Among the 950 newborns who were enrolled the screening program,10 different eye diseases(involving 200 cases)were detected,with a prevalence of 21.05%. The eye diseases included familial exudative vitreoretinopathy in 5 cases(0.526%),persistent hyperplastic primary vitreous in 1 case(0.105%),congenital cataract in 1 case(0.105%),retinal hemorrhage in 55 cases(5.789%), physiologic large cup in 3 cases(0.316%),congenital lacrimal duct obstruction in 5 cases(0.526%),neonatal conjunctivitis in 100 cases(10.53%),dermolipoma in 2 cases(0.211%),congenital lacrimal sac mucocele in 2 cases(0.211%),retinopathy of prematurity in 26 cases(2.737%). Conclusion Neonatal eye diseases are not uncomon in clinical, and a part of the eye diseases can be early screening and early treatment to avoid blindness.
论著

基于品管圈活动构建健康体检重要异常结果的追踪管理模式对提高电话随访率的影响

The impact of building a tracking management model for important abnormal results of health check ups based on quality control circle activities on improving telephone follow-up rates

:1232-1237
 
目的 探讨基于品管圈活动构建健康体检重要异常结果的追踪管理模式对提高电话随访率的影响。方法 选取2022年5月—2023年4月在中山大学孙逸仙纪念医院健康管理中心体检重要异常结果的328例受检者作为研究对象。成立品管圈活动小组,实施追踪管理模式。干预后时间段为2022年11月—2023年4月,期间针对不同样本分别实施了干预措施一至四及全面实施措施,分析随访1个月后成功随访人数。比较干预前后圈员综合能力变化及患者对健康管理中心的满意度。结果 电话随访率在干预措施一实施后为85.02%,干预措施二实施后为88.59%,干预措施三实施后为90.23%,干预措施四实施后为95.27%,全面实施干预措施一至干预措施四后为95.80%,均较干预措施实施前电话随访率(75.91%)有所增长;干预成功随访人数中,复诊率为84.34%(210/249),全面实施措施后成功随访人数中复诊率为94.74%(216/228)。相较于干预前,干预后,圈员解决问题能力、责任心、沟通协调、团队凝聚力、积极性、品管手法、自信心、和谐感分值均升高(P<0.05)。干预前患者满意度为85.37%,干预后患者满意度为87.80%,干预后满意度有所升高,差异具有统计学意义(P<0.05)。结论 通过开展品管圈活动,使重要异常结果电话随访率明显提高,有利于提升体检机构的服务质量和服务能力,有利于疾病的早发现、早干预。
Objective Exploring the impact of establishing a tracking and management model for important abnormal results of health check ups based on quality control circle activities on improving telephone follow-up rates. Methods A total of 328 subjects with important abnormal results in Health Management Center of Sun Yat-sen Memorial Hospital of Sun Yat sen University from May 2022 to April 2023 were selected. The quality control circle activity group was set and the tracking management mode was carried out. The post intervention period was from November 2022 to April 2023, during which intervention measures 1-4 and comprehensive implementation measures were implemented for different samples. The number of successful follow-up after 1 month of follow-up was analyzed. Changes in the comprehensive ability of the circle staff before and after the intervention and the patients’ satisfaction with the health management center were compared. Results The telephone follow-up rate after intervention 1 was 85. 02%, 88. 59% after intervention 2,90. 23% after intervention 3,95. 27% after intervention 4 and 95. 80% after all intervention,which was higher than 75. 91% before intervention implementation. Among the single intervention individuals, the re-visit rate was 84. 34%(210/249), and after the comprehensive implementation of measures, the re-visit rate among the successfully intervened individuals was 94. 74%(216/228). After the intervention,the problem solving ability,responsibility, communication and coordination,team cohesion, enthusiasm,quality control techniques,self-confidence,and sense of harmony all significantly increased(P<0. 05). The patient satisfaction rate before intervention was 85. 37%, and after intervention it was 87. 80%. The satisfaction rate increased after intervention, and the difference was statistically significant(P<0. 05). Conclusions Through the quality control circle activities, the telephone follow-up rate of important abnormal results is significantly improved,which is conducive to improving the service quality and service capacity of physical examination institutions,is conducive to the early detection and early intervention of diseases.
论著

输血前不规则抗体鉴定结果分析与临床输血安全

Pre-transfusion irregular antibody identification results and clinical blood transfusion safety

:1087-1093
 
        目的   明确输血前各抗体的分布特点,探讨自身抗体和同种抗体在性别、年龄、输血史、妊娠史和不同疾病中的差异,并根据抗体血型血清学特性制定个体输血方案,以确保临床输血安全。方法    选取2021年6月—2024年8月在广东省第二人民医院输血科申请输注红细胞或手术备血的29 662例患者,采用低离子抗人球蛋白微柱凝胶法进行不规则抗体筛查,结果阳性的标本经科内讨论并送广州血液中心血型参比实验室进行抗体鉴定,通过统计血液中心回报结果分析各抗体的特异性。结果  29 662例患者标本中不规则抗体结果为阳性的有208例,阳性率为0.70%。同种抗体占比47.69%,Rh、MNS和Lewis红细胞血型系统共占同种抗体中的94.50%,其中常见意外抗体:抗-E占31.87%、抗-M占14.29%、抗-Mur占19.78%、抗-C占7.69%和抗-e占7.69%。同种抗体与自身抗体在性别、年龄、妊娠史等方面比较差异无统计学意义(P0.05);在输血史及不同科室疾病等方面比较差异有统计学意义(P<0.05)。结论    输血前进行输血相容性检测是必要的,应对拟申请红细胞的患者进行不规则抗体筛查,阳性者宜进行抗体鉴定,明确其抗体的特异性及临床意义,以确保临床输血安全。
       Objective  To clarify the distribution characteristics of each antibody before transfusion,to explore the differences between autoantibodies and homologous antibodies in gender,age,history of blood transfusion,history of pregnancy and different diseases,and to formulate individual transfusion protocols based on the serological characteristics of antibody blood groups to ensure the safety of clinical blood transfusion.Methods  A total of 29 662 patients who applied for red blood cell transfusion or surgical blood preparation in the hospital from June 2021 to August 2024 were selected for irregular antibody screening by low-ion anti-human globulin microcolumn gel method.The samples with positive results were discussed within the department and sent to the Blood Type Reference Laboratory of Guangzhou Blood Center for antibody identification.The specificity of each antibody was analyzed by blood center reported results.Results  Among 29 662 patients,208 were positive for irregular antibody,the positive  rate was 0.70%.The alloantibodies accounted for 47.69%,Rh,MNS and Lewis erythrocyte blood group system accounted for 94.50% of alloantibodies,among which the common unexpected antibodies were anti-E 31.87%,anti-M 14.29%,anti-MUR 19.78%,anti-C 7.69% and anti-E 7.69%.There were no significant differences between alloantibodies and autoantibodies in gender,age and pregnancy history(P>0.05).There were statistically significant differences in blood transfusion history and diseases in different departments(P<0.05).Conclusions  It is necessary to test the compatibility of blood transfusion before transfusion.Screening for irregular antibodies should be carried out in prospective transfusion patients,and antibody identification should be carried out in positive patients to clarify the specificity and clinical significance of their antibodies to ensure the safety of clinical transfusion.
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