目的 探讨健康儿童的个体因素对超声测量下腔静脉内径的影响。方法 使用超声测量210例健康儿童的下腔静脉呼气末内径及腹主动脉内径,并记录他们的个体特征,包括性别、年龄、身高、体质量、腰围、体表面积等,进行相关与回归分析。结果 年龄、身高、体质量、腰围、体表面积与下腔静脉和腹主动脉内径呈正相关。年龄是女性儿童下腔静脉内径唯一的独立影响因素,身高是男性儿童下腔静脉内径唯一的独立影响因素。无论男性或女性,年龄是儿童腹主动脉内径的独立影响因素,而下腔静脉和腹主动脉内径的比值不受这些个体因素的影响。结论 下腔静脉和腹主动脉内径易受个体因素影响,而它们的比值不易受个体因素影响,可以更好的用于预测儿童的容量特征。

Objective To explore the impact of individual characteristics on inferior vena cava diameter ( IVC ) in healthy children. Methods IVC_max and abdominal aorta (AO) diameters were measured by ultrasound in 210 healthy children. The individual characteristics including gender, age,height,weight, waist circumference of each child were recorded. Then the surface area(BSA) and IVC_max/AO were calculated to discuss the relationship between them with multivariate analysis. Results Age, height, weight,waist circumference, and BSA were positively correlated with IVC_max and AO. Multivariate linear regression showed that age was the only independent variable for IVC_max in female children, height was the only independent variable for IVC_max in male children, and age was the only independent variable for AO in both females and males. IVC_max/AO was not significantly influenced by the subjects' characteristics. Conclusion IVC_max and AO were more susceptible to subjects' characteristics than IVC_max/AO. IVC_max/AO could be a reliable and practical parameter in children as it was independent of age, height, and weight.

目的 探讨延续性健康指导联合预见性干预对慢性脑卒中患者脑功能影响。方法 选取2019年6月—2020年6月我院收治的慢性脑卒中患者118例,使用随机数字表法将其分为两组,对照组进行预见性干预,研究组进行延续性健康指导联合预见性干预。比较两组效果、神经运动功能、不良反应。结果 研究组效果大于对照组(P＜0.05);研究组神经运动功能大于对照组(P＜0.05);研究组不良反应少于对照组(P＜0.05)。结论 慢性脑卒中护理中,延续性健康指导联合预见性干预效果较好,值得应用。

Objective To investigate the effects of continuous health guidance and combined predictive intervention on cerebral function in patients with chronic stroke. Methods A total of 118 patients with chronic stroke admitted to our hospital from June 2019 to June 2020 were selected and divided into two groups using the random number table method. The control group received predictive intervention, and the study group received continuous health guidance combined predictive intervention. The effects, neuromotor functions and adverse reactions of the two groups were compared. Results The effect of the study group was greater than that of the control group (P<0.05). The neuromotor function of the study group was higher than that of the control group (P<0.05). The adverse reactions in the study group were less than those in the control group (P<0.05). Conclusion In the nursing of chronic stroke, the effect of continuous health guidance combined with predictive intervention is good, and it is worth applying.

目的 通过探讨发病机制和结合1例蛛网膜下腔出血并发脑耗盐综合征病例分析,提高临床上对此类少见疾病的认识。方法 回顾性分析蛛网膜下腔出血并发脑耗盐综合征病例,运用“阴阳”、“六经”理论阐述疾病的中医病机及五苓散的中西医作用机制。结果 通过回顾性对比,使用五苓散组的患者明显比其他患者的病程短(五苓散组7.83±2.25天,对照组11.84±2.51天,P＜0.05),差异有统计学意义,说明五苓散能够缩短脑耗盐综合征的病程。结论 五苓散治疗蛛网膜下腔出血合并脑耗盐综合征有良好的前景,未来可以通过前瞻性病例对照研究进一步明确其疗效。

Objective By investigating the pathogenesis and analyzing a case of subarachnoid hemorrhage complicated with cerebral salt wasting syndrome, to improve the clinical understanding of this rare disease. Methods A retrospective analysis of cases of subarachnoid hemorrhage complicated with cerebral salt wasting syndrome was made, using the theory of “yin and yang” and “six classics” to explain the pathogenesis of the disease and the mechanism of Chinese and Western medicine of Wuling powder. Results Through retrospective comparison, patients in the Wuling powder group had a shorter course of disease than other patients [(7.83±2.25) days in the Wuling powder group, (11.84±2.51) days in the control group, P<0.05], and there was a significant statistical difference, indicating that Wuling powder can shorten the course of cerebral salt wasting syndrome. Conclusion Wuling powder has a good prospect in the treatment of subarachnoid hemorrhage complicated with cerebral salt wasting syndrome, and its efficacy can be further clarified through prospective case-control studies in the future.

目的 探讨以家庭为中心的患教模式对糖尿病患者代谢控制水平的影响。方法 选取168例2016年9月—2017年8月在我院治疗的糖尿病患者,根据不同的健康教育模式干预将其分为观察组和对照组,每组各84例。对照组患者采用传统的综合患教模式,观察组患者在对照组的基础上采用以家庭为中心的患教模式,比较两组患者的自我管理水平及血糖、血脂控制效果。结果 干预后,观察组自我管理总得分、饮食控制、运动锻炼、血糖监测、足部护理、高低血糖处理均优于对照组(P＜0.05);观察组的FBG、PBG、HbA1C、TC、TG、LDL-C水平均低于对照组(P＜0.05)。结论 以家庭为中心的患教模式可辅助患者规范自己的行为,加强自我管理,改善血糖控制水平。

Objective To study the effects of two health education models on the level of metabolic control in diabetic patients. Methods 168 patients with diabetes admitted to our hospital from September 2016 to August 2017 were selected as subjects. According to different health education model interventions, they were divided into observation group and control group, with 84 cases in each group. The patients in the control group adopted a comprehensive health education model, and the patients in the observation group adopted a family-centered health education model based on the control group. The self-management level and blood glucose and blood lipid control effects of the two groups were compared. Results After intervention, the observation group self-management total score, diet control, exercise, blood glucose monitoring, foot care, high and low blood glucose treatment were better than that of control group (P<0.05); observation group FBG, PBG, HbA1C, TC, TG, LDL-C level were lower than that of the control group (P<0.05). Conclusion A family-centered health education model may help patients regulate their behavior, strengthen self-management, and improve their blood sugar control levels.

目的 探究基于微信平台的健康管理对糖尿病老年患者焦虑、抑郁、主观幸福感、血糖水平和生存质量的影响。方法 采取便利抽样方法选取我院老年病科2型糖尿病患者106例,随机分为干预组和对照组各53例。干预组进行基于微信平台的健康管理,主要包括心理干预和健康宣教,对照组实施传统心理干预和健康宣教,比较2组患者的焦虑、抑郁、主观幸福感、空腹血糖、餐后2 h血糖、HbA1C和生存质量。结果 干预后,干预组焦虑发生率低于对照组(P＜0.05),而抑郁发生率与对照组比较,差异无统计学意义(P＞0.05);干预组患者SAS评分、GDS评分、主观幸福感总分空腹血糖、餐后2 h血糖水平、HbA1C、PCS和MCS评分降低或升高效果优于对照组,差异有统计学意义(t=2.823,3.231,-18.956,5.152,7.401,7.528,-3.165,-3.232;P＜0.05)。结论 基于微信平台的健康管理能有效控制糖尿病老年患者的血糖水平,降低焦虑抑郁症状水平,提升主观幸福感和生存质量。

Objective To explore the effect of health management based on WeChat platform on depressive symptoms and quality of life of elderly patients with diabetes. Methods 106 elderly patients with type 2 diabetes hospitalized in geriatrics department in our hospital were selected by convenient sampling method and divided into two groups randomly, with 53 cases in each group. The intervention group was given psychological nursing and health education based on WeChat platform, while the control group received traditional psychological nursing and health education. Finally, the levels of anxiety and depressive symptoms, subjective well-being, fasting blood-glucose, 2h postprandial blood glucose, HbA1C and quality of life, were compared in both groups. Results After the intervention, the incidence of anxiety in the intervention group was lower than that in the control group (P＜0.05), while the incidence of depression did not have statistical difference compared with that in the control group (P＞0.05). The decrease or evaluation of SAS, GDS, subjective well-being, fasting blood-glucose, 2h postprandial blood glucose, HbA1C, PCS and MCS of the intervention group were greater than those in the control group, (t=2.823,3.231,-18.956,5.152,7.401,7.528,-3.165,-3.232;;P＜0.05). Conclusion Psychological intervention and health education by WeChat may control the blood glucose level of elderly patients with diabetes, reduce the level of anxiety and depression symptoms and improve subjective well-being and quality of life effectively.

目的 探究甲状腺癌患者对健康知识了解详情和需求,同时提出合理健康教育方案。方法 随机抽取本院2017年11月—2019年5月期间收治的122例甲状腺癌患者为研究对象,通过本院自制的调查问卷对其进行调查,分析和掌握患者对健康知识了解详情和具体需求,同时根据其特点提出合理的健康宣教方式。结果 患者对疾病和生活习惯的联系、定期入院复诊的重要性、临床治疗对疾病的控制详情、具体治疗方案和疗效、疾病临床特征以及疾病详细信息等甲状腺癌相关知识不了解率分别为50.00%、51.64%、72.95%、74.59%、77.87%、8.19%;健康教育内容需求评分较高,需求占比全部高于40%;患者对不同的健康教育形式有着不同的需求,其中需求最高的为护患会议交流,占比98.36%,其次为微信科普知识,占比96.72%,之后依次为播放视频和音频(94.26%)、创建专题讲座(93.44%)、个体指导(91.80%)、电话随访(83.60%)、相同疾病患者经验介绍(80.32%)、宣传栏和宣传册(63.90%)。结论 甲状腺癌患者对健康知识了解较少且需求较大,因此可对患者采取多元化健康知识教育方案,满足不同患者的需求,进而增加患者对疾病的重视程度,有利于患者树立治疗信心、提升其生活质量。

Objective To explore the health knowledge of thyroid cancer patients to understand the details and needs, and put forward a reasonable health education program. Methods 122 patients with thyroid cancer admitted to our hospital from November 2017 to May 2019 were randomly selected as the research objects. Through the questionnaire made by our hospital, we investigated the patients, analyzed and mastered the patients' understanding details and specific needs of health knowledge, and proposed reasonable health education methods according to their characteristics. Results The rates of patients' ignorance about thyroid cancer related knowledge, such as the relationship between disease and lifestyle, the importance of regular admission to hospital, the control details of the disease in clinical treatment, the specific treatment plan and effect, the clinical characteristics of the disease and the detailed information of the disease, were 50.00%, 51.64%, 72.95%, 74.59%, 77.87% and 8.19%, respectively. The score of demand for health education content was high, accounting for more than 40% of the total demand.Patients with different forms of health education had different needs, one of the highest requirements for meeting communication, nurses and patients accounted for 98.36%, followed by WeChat popular science knowledge, accounted for 96.72%, followed by after playing video and audio (94.26%), creating a seminar (93.44%), individual guidance (91.80%), telephone follow-up (83.60%), experience introduction (80.32%),patients with the same disease, publicity column and brochure (63.90%). Conclusion Patients with thyroid cancer have less knowledge of health knowledge and need more health knowledge. Therefore, we may take diversified health knowledge education programs to meet the needs of different patients, and then increase the attention of patients to the disease, which is conducive to the patients to establish treatment confidence and improve their quality of life.

目的 探究分析基于互联网平台的健康管理模式对2型糖尿病患者血糖管理的效果及其临床价值。方法 选择2018年3月—2019年3月期间到我院进行治疗的120例2型糖尿病患者作为研究对象,用电脑随机法分为对照组和实验组各60例,对照组患者对其进行常规的护理干预,实验组患者给予基于互联网平台的健康管理模式,测试他们接受护理管理前后的血糖情况,邀请所有患者填写焦虑、抑郁自评量表评分并比较两组患者的心理状态评分,比较两组患者的生活质量和护理满意度。分析它们的护理要点及其结果。结果 实验组患者的护理后的血糖低于对照组;实验组患者焦虑自评量表(SAS)、抑郁自评量(SDS)表得分分别为(45.2±4.3)分和(42.8±6.3)分,这两个表均低于对照组的(56.3±7.5)分、(58.1±3.9)分;实验组患者的生活质量高于对照组;护理满意度高于对照组,差异有统计学意义(P＜0.05)。结论 应用基于互联网平台的健康管理模式有利于提高糖尿病患者血糖控制效果,对改善患者负面情绪、提高其生活质量及维持良好的护患关系也具有积极意义。

Objective To explore the effect and clinical value of health management model based on internet platform on blood glucose management in patients with type 2 diabetes(T2DM). Methods 120 patients with T2DM who came to our hospital for treatment from March 2018 to March 2019 were selected and they were randomly divided into the control group and the experimental group with 60 cases each. The patients in the control group were given routine nursing intervention. The patients in the experimental group were given health management mode based on the internet platform to test their blood glucose before and after receiving nursing management. All patients were invited to filled in the self-rating anxiety scale (SAS) and self-rating depression scale (SDS).The blood glucose level, the psychological state, the self-rating scales and nursing points in the two groups were investigated and compared after intervention. Results The blood glucose of the experimental group was lower than that of the control group, the scores of SAS and SDS were (45.2 ± 4.3) (42.8 ± 6.3) respectively, both of which were lower than those of the control group (56.3 ± 7.5) and (58.1 ± 3.9); the quality of life of patients in the experimental group was higher than that in the control group; nursing satisfaction was higher than that in the control group, the difference was statistically significant (P<0.05). Conclusion The application of health management model based on internet platform is conducive to improving the effect of blood glucose control in diabetes patients, relieving their negative emotions, improving their quality of life and maintaining a good nurse-patient relationship.

目的 观察综合健康教育在门诊长期肌注黄体酮患者的应用效果。方法 选取2018年10月—2019年6月在本院门诊中心注射室进行黄体酮注射的先兆流产患者319例,按患者来门诊的注射顺序,采用随机分组方法,单数位为对照组,双数位为干预组。干预组在肌注黄体酮时实行综合健康教育,而对照组则进行基本指导。注射1个月后观察效果。结果 干预组发生硬结例数77例(48.4%),对照组147例(91.9%);而疼痛程度方面干预组为(1.34±2.125)分,而对照组则为(4.51±2.400)分;干预组的满意度平均分为(9.60±0.975)分,而对照组为(6.65±1.603)分,差异均有统计学意义(P<0.01)。结论 对门诊长期肌注黄体酮患者实行综合健康教育有助于减轻患者疼痛、降低硬结发生率,促进药物疗效,提高患者满意度。

Objective To observe the effect of comprehensive health education on outpatients with long-term intramuscular injection of progesterone. Methods 319 patients were enrolled from October 2018 to June 2019, and were divided into the observation group and control group according to the sequence of patients coming to the outpatient clinic. Comprehensive health education was applied in the intervention group, and general basic education was applied in the control group. Results There were 77 cases (48.4%) of callosity in the intervention group, 147 cases (91.9%) in the control group. In pain degree scores of (1.34±2.125) were in the intervention group, (4.51±2.400) in the control group. In degree of satisfaction, (9.60±0.975) were in the intervention group, and (6.65±1.603) in the control group, with statistically significant difference (P<0.01). Conclusion Comprehensive health education may alleviate pain and callosity in patients with long-term intramuscular injection of progesterone.

目的 开展卫生应急演练并总结经验,探讨演练在提高新发传染病应急处置能力中的作用。方法 以桌面演练和功能性演练为手段,在广州某三甲医疗机构开展演练活动,并对演练效果进行评价。结果 全院共51个科室开展新发传染病防控卫生应急演练,全院演练平均得分4.87。演练为新发传染病应急处置积累了实战经验,达到了锻炼队伍、提高能力的作用。结论 卫生应急演练是检验和提高新发传染病应急处置水平的重要手段,医疗机构通过推进演练活动的制度化、规范化和常态化,可促进新发传染病应急处置工作能力提升。

Objective To carry out health emergency exercises and summarize experiences, and to explore the role of exercises in improving emergency response capabilities for emerging infectious diseases. Methods Using tabletop exercises and functional exercises as means, the exercises were conducted in a tertiary class healthcare facilitie in Guangzhou, and the effects of the exercises were evaluated. Results A total of 51 departments in the hospital conducted health emergency exercises for the prevention and control of emerging infectious diseases, and the average score of the exercises was 4.87. The exercises accumulated actual combat experience for emergency treatment of emerging infectious diseases, and achieved the effect of training the team and improving the capabilities. Conclusion Health emergency exercise is an important mean to test and improve the emergency response capability of emerging infectious diseases. Healthcare facilities can promote the improvement of emergency response capabilities of emerging infectious diseases by promoting the institutionalization, standardization and normalization of exercise activities.

目的 了解医务人员临床工作中血源性职业暴露的情况、暴露后的心理健康状况及其影响因素,采取干预措施,保障医务人员身心健康。方法 对医院2013年1月—2017年12月上报的79例血源性职业暴露者,在1个月内进行现状调查,同时采用自填式问卷症状自评量表(SCL-90)对调查对象进行调查,对其暴露后的心理影响程度进行评估。结果 医务人员在发生血源性职业暴露后其中躯体化因子、人际关系敏感因子、抑郁因子、焦虑因子在职业暴露前后的比较及与未发生职业暴露的医务人员相比较,均有不同程度的提高,差异均有统计学意义(P<0.001)。单因素分析显示影响血源性职业暴露后医务人员的心理健康状况的因素有年龄、职业、工龄、既往发生职业暴露史和患者患传染病种类(P<0.05)。其中年龄在21~25岁年龄的医务人员的得分较高,职业为医生和陪护工人的得分较高,工龄在1~5年的得分较高,既往发生过职业暴露的医务人员得分较高,患者患传染病类型为梅毒及暴露源不明的得分较高。结论 医务人员在发生血源性职业暴露后,其心理健康状态可受到较大影响;工龄、既往发生职业暴露史和患者患传染病种类是医务人员发生血源性职业暴露后心理状况健康的独立影响因素。医院管理者在重视预防及减少职业暴露的同时,更应关注血源性职业暴露后的心理变化,及时提供心理支持和医疗帮助。