目的 观察首诊-复诊-住院-产后管理的模块化护理干预对妊娠期糖尿病(GDM)围产期患者的影响。方法 回顾性收集我院2020年1月—2021年1月GDM患者91例,按照患者意愿及不同护理方案分组。常规护理组45例予以常规护理,模块化管理组46例在常规护理基础上予以首诊-复诊-住院-产后管理的模块化护理。比较2组患者首诊时、分娩后血糖控制水平、围产期患者并发症发生情况、围产期新生儿并发症发生情况、护理工作满意度。结果 分娩前模块化管理组空腹血糖、餐后2 h血糖低于常规护理组(P＜0.05);模块化管理组围产期患者并发症发生率8.70%(4/46)低于常规护理组24.44%(11/45)(P＜0.05);模块化管理组围产期新生儿并发症发生率6.52%(3/46)低于常规护理组22.22%(10/45)(P＜0.05);模块化管理组护理工作满意度93.48%(43/46)高于常规护理组77.78%(35/45)(P＜0.05)。结论 首诊-复诊-住院-产后管理的模块化护理干预可改善GDM患者的血糖水平,降低围产期患者及新生儿并发症发生率,同时能提升患者护理工作满意度。

Objective To observe the effect of modularized nursing intervention on perinatal patients with gestational diabetes mellitus (GDM), including first visit, subsequent visit, hospitalization and postpartum management. Methods Ninety-one patients with GDM in our hospital from January 2020 to January 2021 were retrospectively grouped according to patients' wishes and different nursing plans, and their data were collected. Forty-five patients in the routine nursing group received routine nursing, and 46 patients in the modular management group received modularized nursing in addition to the routine nursing, including first visit, subsequent visit, hospitalization and postpartum management. The blood glucose level at the first visit and after delivery, the incidence of complications in perinatal patients, the incidence of complications in perinatal neonates, and the satisfaction of nursing work were compared between two groups. Results Before delivery, FPG and 2hPG levels in modularized management group were lower than those in routine nursing group (P<0.05). The incidence of perinatal complications in modularized management group was 8.70% (4/46), lower than that in routine nursing group (24.44%, 11/45, P<0.05). The incidence of neonatal complications in the modularized management group was 6.52% (3/46), lower than that in the routine nursing group (22.22%, 10/45, P<0.05). The nursing job satisfaction rate of modular management group was 93.48% (43/46), higher than that of routine nursing group (77.78%, 35/45, P<0.05). Conclusions Modularized nursing intervention of first visit, subsequent visit, hospitalization and postpartum management could improve the blood glucose level of patients with GDM, reduce the incidence of complications in perinatal patients and neonates, and improve patients' satisfaction with nursing work.

目的 对腹腔镜子宫肌瘤切除术围手术期应用抗菌药物的情况进行回顾性分析,并分析腹腔镜子宫肌瘤切除术围手术期感染的影响因素。方法 选择2018年5月—2021年5月在我院行腹腔镜子宫肌瘤切除术的患者72例进行回顾性分析。收集患者一般资料及抗生素使用情况,根据有无术后感染将患者分为2组,比较2组患者上述各资料,并采用多因素分析法判断各因素对腹腔镜子宫肌瘤切除术后感染的综合作用。结果 本次纳入的72例腹腔镜子宫肌瘤切除术患者共有16例出现术后感染,术后感染率为22.22%。多因素Logistic回归分析结果显示:年龄≥50岁、手术时间≥60 min、合并糖尿病为腹腔镜子宫肌瘤切除术围手术期感染的危险因素,预防性使用抗生素、术前≤2 h抗生素使用、术后抗生素使用≤48 h为保护性因素(P<0.05)。结论 腔镜子宫肌瘤切除术患者术后感染率为22.22%,抗菌药物使用时机及使用时间对腹腔镜子宫肌瘤切除术患者术后感染有重要的影响,此外患者年龄、手术时间、合并糖尿病情况也与患者术后感染有关。

Objective To retrospectively analyze the perioperative application of antibacterial drugs during laparoscopic myomectomy, and to analyze the influencing factors of infection during the perioperative period of laparoscopic myomectomy. Methods Seventy-two patients who underwent laparoscopic myomectomy in our hospital from May 2018 to May 2021 were selected for retrospective analysis. The patients were divided into two groups according to postoperative infection status. The above data were compared between the two groups, and the comprehensive effects of various factors on postoperative infection after laparoscopic myomectomy were determined by multivariate analysis. Results There were 16 cases of 72 patients underwent laparoscopic myomectomy had postoperative infection, and the postoperative infection rate was 22.22%. Multivariate Logistic regression analysis showed that age over 50, operation time over 60 minutes, and with diabetes mellitus were the risk factors of perioperative infection in laparoscopic myomectomy. Prophylactic use of antibiotics, preoperative use of antibiotics in less than 2 hours and postoperative use of antibiotics in less than 48 hours were protective factors (P<0.05). Conclusions The infection rate of patients underwent laparoscopic myomectomy was 22.22%. The time and length of antibiotics use had important influence on postoperative infection of patients underwent laparoscopic myomectomy. In addition, age, operation time and complicated with diabetes mellitus were also related to postoperative infection.

目的 探讨慢性阻塞性肺疾病(COPD)并发低氧血症患者抢救中使用小剂量肾上腺素及布地奈德的价值。方法 纳入50例COPD并发低氧血症患者研究(2018年4月—2021年4月),按双盲法分为对照组(n=25,采用布地奈德雾化吸入治疗)、观察组(n=25,在对照组基础上采用肾上腺素治疗),统计2组抢救成功率、临床指标、预后效果。结果 (1)抢救成功率:观察组(96.00%)高于对照组(76.00%),组间对比P<0.05。(2)临床指标:观察组PaCO₂(43.29±4.92 mmHg)低于对照组,PaO₂(86.77±8.25 mmHg)、SpO₂(92.14±2.82%)、pH(7.43±0.12)、FVC(2.41±0.28 L)、FEV1(1.72±0.72 L)、FEV1/FVC(70.95±8.22%)高于对照组,组间对比P<0.05。(3)预后效果:观察组气喘(3.22±1.08 d)、哮鸣音(5.21±1.11 d)消失时间及住院时间(9.61±2.24 d)短于对照组,组间对比P<0.05。结论 小剂量肾上腺素联合布地奈德在COPD并发低氧血症治疗中效果确切,可提高抢救成功率,亦可改善其肺功能及血气指标,值得临床参考。

Objective To explore the value of low dose epinephrine and budesonide aerosol inhalation in the rescue of patients with chronic obstructive pulmonary disease(COPD) complicated with hypoxemia. Methods Fifty patients with COPD complicated with hypoxemia(April 2018 to April 2021)were enrolled and divided into control group(n=25,treated with budesonide aerosol inhalation)and observation group(n=25,treated with epinephrine additionally)according to double-blind method.The rescue success rate,clinical indicators and prognosis of the two groups were statistically analyzed. Results (1)The success rate of rescue of the observation group(96.00%)was higher than that of the control group(76.00%,P<0.05). (2)Clinical indicators:PaCO₂(43.29 1±4.92 mmHg)in the observation group was lower than that of the control group,PaO₂(86.774±8.25 mmHg), SpO₂(92.14±2.82%), pH(7.43±0.12), FVC(2.41±0.28 L), FEV1 (1.72±0.72 L), FEV1/FVC (70.95±8.22%)were higher than that in the control group(P<0.05). (3)Prognosis effect:asthma duration in the observation group(3.22±1.08 d),wheezing disappeared time(5.211±1.11 d)and hospitalization time(9.611±2.24 d)were shorter than that of the control group(P<0.05). Conclusions Low dose epinephrine combined with budesonide in the treatment of COPD complicated with hypoxemia has definite effect, which can improve the success rate of rescue,also improve lung function and blood gas index. It is worthy of clinical reference.

目的 探讨连续性肾脏替代治疗(CRRT)在治疗重症急性胰腺炎(SAP)中的临床意义。方法 回顾分析2018年1月—2019年1月在我院接受救治的SAP患者64例,根据治疗方案的不同分为观察组和对照组, 每组各搜集32例,2组患者基线水平一致。对照组为采用常规内科方案治疗的病例, 观察组为对照组治疗方案基础上联合CRRT的病例,分析对比2组治疗后的各项疗效指标。结果 2组患者治疗后5~7 d内APACHE Ⅱ评分[(11.02±3.14)vs(13.98±3.27)分]、甘油三脂[(4.02±1.05)vs(5.62±1.11)mmol/L]、C反应蛋白[(88.25±6.73)vs(104.41±10.28)ng/L]、降钙素原[(13.12±4.33)vs(18.55±3.96)ng/mL、血尿素氮[(7.33±1.72) vs (11.24±2.76) mmol/L]、血肌酐[(69.51±15.03) vs(91.12±19.17)mmol/L]相较治疗前均降低,观察组患者上述指标水平下降幅度超过对照组,结果分析差异有统计学意义(t=3.693, 5.924, 7.440, 9.362, 5.235, 6.801, 5.018,P均＜0.001)。观察组患者治疗期间疾病症状缓解时间[(3.15±1.26)vs (5.22±1.51) d]、体征指标稳定时间[(2.52±1.38) vs (4.39±1.50) d]、胃肠功能恢复时间[(4.48±1.27) vs (6.21±1.55) d]以及ICU住院时间[(15.03±2.21) vs (18.44±3.27) d]均低于对照组,结果分析差异有统计学意义(t=5.954, 5.190, 4.884,4.888,P均＜0.05)。结论 与常规内科治疗相比,联合CRRT治疗SAP能够显著改善各项炎症指标,有助患者快速脱离重症危险状态,具有积极的临床价值。

Objective To explore the clinical significance of continuous renal replacement therapy (CRRT) in the treatment of severe acute pancreatitis (SAP). Methods Retrospective analysis of 64 patients with SAP in our hospital from January 2018 to January 2019 was carried out. The patients were divided into the observation group and the control group according to different treatment regimens, with 32 cases in each group, and the baseline levels of the two groups were consistent. Patients in the control group were treated with conventional medical treatment, and the patients in the observation group were treated with CRRT on the basis of the control group, and the efficacy of the two groups were analyzed and compared. Results The APACHE II scores [(11.02±3.14) vs (13.98±3.27)]、triglyceride[(4.02±1.05) vs (5.62±1.11) mmol/L], C-reactive protein[(88.25±6.73) vs (104.41±10.28) ng/L], procalcitonin[(13.12±4.33) vs (18.55±3.96) ng/mL], blood urea nitrogen[(7.33±1.72) vs (11.24±2.76) mmol/L], serum creatinine[(69.51±15.03)vs(91.12±19.17)mmol/L] of patients in both groups were significantly decreased within 5-7 days after treatment compared with those before treatment, and the decrease of the above indicators in the observation group was significantly greater than that in the control group, P<0.05. The remission time of symptoms[(3.15±1.26) vs (5.22±1.51) d], the stabilization time of signs[(2.52±1.38) vs (4.39±1.50) d], the recovery time of gastrointestinal function[(4.48±1.27) vs (6.21±1.55) d] and the length of ICU stay[(15.03±2.21) vs (18.44±3.27) d] in the observation group were lower than those in the control group, and the analysis of the results was statistically significant (t=5.954, 5.190, 4.884,4.888,all P＜0.05). Conclusions Compared with conventional medical treatment, additional CRRT treatment can significantly improve the inflammatory indicators of SAP, help patients survive from critical state of SAP, which has positive clinical value.

目的 探究液基细胞学检查联合鳞状上皮细胞癌抗原(SCCA)、癌抗原153(CA153)检测对宫颈癌诊断价值。方法 对子宫颈上皮内瘤变患者54例(内瘤变组)、子宫颈癌患者54例(宫颈癌组)及健康体检者54例(对照组)进行液基细胞学、血清SCCA、血清CA153进行检测,以病理活检诊断为金标准。分析液基细胞学检查、血清中SCCA、血清中CA153对宫颈癌诊断价值,并分析联合液基细胞学检查与血清中SCCA、血清中CA153检测的临床价值。结果 内瘤变组和宫颈癌组血清SCCA、CA153水平均高于对照组,宫颈癌组血清SCCA、CA153水平高于内瘤变组(P均<0.05)。单项检测中,液基细胞学检查阳性率高于SCCA、CA153,联合检测阳性率与其他各单项检测相比明显提高(P<0.05)。结论 宫颈癌患者体内SCCA、CA153水平高,液基细胞学检查联合SCCA、CA153检测对宫颈癌早期阳性检出率高。

Objective To explore the diagnostic value of liquid-based cytology combined with squamous cell carcinoma antigen (SCCA) and cancer antigen 153 (CA153) detection in patients with cervical cancer. Methods Liquid-based cytology, serum SCCA, and serum CA153 were detected on 54 patients with cervical intraepithelial neoplasia (neoplasia group), 54 patients with cervical cancer (cancer group), and 54 healthy subjects (control group). Pathological biopsy diagnosis was used as the gold standard. The diagnostic value of liquid-based cytology, serum SCCA, and serum CA153 in cervical cancer was analyzed, and the clinical value of combining liquid-based cytology with serum SCCA and serum CA153 detection was also analyzed. Results The levels of serum SCCA and CA153 in neoplasia group and cancer group were higher than those in control group, and the serum SCCA and CA153 levels in the cancer group were higher than those in the neoplasia group (P<0.05). In the single detection, the positive rate of liquid-based cytology was higher than that of serum SCCA and CA153, and the positive rate of combined detection was significantly higher than those of the single detection (P<0.05). Conclusions Cervical cancer patients have high levels of serum SCCA and CA153. Liquid-based cytology combined with SCCA and CA153 detection has high positive rate for early cervical cancer.

目的 探究质控预警系统在重症患儿连续性血液净化治疗的应用效果。方法 随机选取于2020年1月—2021年12月在我院进行连续性血液净化治疗的共80例重症患儿作为本次研究对象,将80例患儿随机分成研究组和对照组,对照组进行常规护理,研究组则在常规护理的基础上行预警系统质量控制,对比2组患儿连续性血液净化治疗时长及报警频次、2组患儿在不同治疗时间段内滤器凝血发生率、2组非计划下机发生情况及2组患儿家属的护理满意度。结果 研究组平均报警频次为(8.60±3.35),低于对照组(16.52±7.41)的报警频次。而研究组的治疗时长(32.54±6.73 h)较对照组(21.38±5.61 h)延长,研究组患儿在进行连续性血液净化治疗的过程中,在8小时至24小时之间及大于24小时滤器的凝血发生率低于对照组,研究组和对照组护理满意度分别为92.50%和75.00%,对比差异显著。结论 在对重症患儿进行连续性血液净化治疗过程中应用质控预警系统具有较高的临床使用价值,不仅可以有效降低报警频次及滤器凝血发生率,而且对延长治疗时间有显著的促进作用,值得在今后的治疗过程中大力推广。

Objective To explore the application effect of quality control early warning system in continuous blood purification treatment of critically ill children.Methods A total of 80 critically ill children who underwent continuous blood purification treatment in our hospital from January 2020 to December 2021 were randomly selected as the research object, and were randomly divided into observation group and control group.The control group received routine nursing,and the observation group received early warning system quality control on the basis of routine nursing.The duration and alarm frequency of continuous blood purification treatment,the incidence of filter coagulation in different treatment periods,the occurrence of unplanned quitting and nursing satisfaction of the two groups were compared.Results The average alarm frequency of the observation group was (8.60±3.35),which was significantly lower than that of the control group (16.52±7.41).However,the treatment duration of the observation group (32.54±6.73 h) was significantly longer than that of the control group (21.38±5.61 h).During continuous blood purification treatment,the incidence of blood coagulation in the observation group was lower than that of the control group,and the nursing satisfaction of the observation group and the control group were 92.50% and 75.00% respectively,with significant differences.Conclusions The application of quality control early warning system in the continuous blood purification treatment of critically ill children has a high clinical value,which can not only effectively reduce the alarm frequency and the incidence of filter coagulation,but also significantly prolong the treatment time,and it is worth promoting in the future treatment process.

目的 通过分析胎盘植入检出率、胎盘植入典型声像图特征及胎盘植入患者妊娠结局,探讨彩色多普勒超声检查在前置胎盘合并胎盘植入患者诊断中的应用价值。方法 回顾性分析2016年1月—2020年11月在广州市第一人民医院分娩的100例在产前超声检查中诊断为前置胎盘孕妇的临床资料及超声诊断资料。分析彩色多普勒检查在诊断前置胎盘合并胎盘植入中的灵敏度、特异度等指标;比较分析2组孕妇间年龄、流产和剖宫产次数及是否合并凶险性前置胎盘的情况;对比分析2组孕妇间胎盘分布情况、胎盘超声评分情况,分析胎盘植入的标志性超声声像图特征;分析2组孕妇分娩并发症及结局。结果 胎盘植入检出的灵敏度72%(36/50),特异度92.6%(50/54);胎盘植入组流产和剖宫产次数高于非胎盘植入组(P<0.05),合并凶险性前置胎盘的孕妇发生胎盘植入的概率升高;胎盘植入组超声评分高于非胎盘植入组(P<0.05),胎盘内陷窝征和胎盘后间隙消失是胎盘植入的标志性声像图特征;胎盘植入组产时出血量高于非胎盘植入组(P<0.05),胎盘植入组中出现产后出血的概率也是高于非胎盘植入组(P<0.05)。结论 彩色多普勒超声检查在诊断前置胎盘合并胎盘植入中的灵敏度及特异性度均较高,胎盘内陷窝征和胎盘后间隙消失在胎盘植入诊断的检出较高,可作为判断胎盘是否植入的标志性特征。运用超声评分系统可以更加客观地评价胎盘植入的诊断,对于预测其预后有重要的价值,值得推广。

Objective To explore the value of color Doppler ultrasonography in the diagnosis of placenta previa complicated with placenta implantation by analyzing the detection rate of placenta implantation,the typical sonographic characteristics of placenta implantation and the pregnancy outcome of patients.Methods The clinical data and ultrasonic diagnosis data of 100 pregnant women with placenta previa diagnosed by prenatal ultrasound in Guangzhou First People's Hospital from January 2016 to November 2020 were analyzed retrospectively.The sensitivity and specificity of color Doppler in the diagnosis of placenta previa complicated with placenta implantation were analyzed.The age,the number of abortions and cesarean sections and whether there was dangerous placenta previa between the two groups were compared and analyzed.The placental location and placental ultrasound score between the two groups were compared and analyzed,and the characteristics of landmark ultrasound images of placental implantation were analyzed.The delivery complications and outcomes of the two groups were also analyzed.Results The sensitivity and specificity of placenta implantation were 72% (36/50) and 92.6% (50/54).The number of abortion and cesarean section in placenta implantation group was significantly higher than that in non placenta implantation group (P<0.05).The probability of placenta implantation in pregnant women with dangerous placenta previa was significantly higher.The ultrasound score of placenta implantation group was significantly higher than that of non placenta implantation group(P<0.05),intraplacental lacuna sign and disappearance of retroplacental space were the landmark ultrasonographic features of placental implantation.The amount of intrapartum hemorrhage in placenta implantation group was significantly higher than that in non placenta implantation group (P<0.05).The probability of postpartum hemorrhage in placenta implantation group was also significantly higher than that in non placenta implantation group (P<0.05).Conclusions Color Doppler ultrasonography had high sensitivity and specificity in the diagnosis of placenta previa complicated with placenta implantation,intraplacental lacuna sign and disappearance of retroplacental space had high detection rates in the diagnosis of placental implantation,which can be used as a landmark feature to judge whether placenta is implanted or not.The use of ultrasound scoring system can more objectively evaluate the diagnosis of placental implantation,which has important value in predicting its prognosis and is worthy of popularization.

目的 研究未成熟血小板分数(IPF)、高荧光未成熟血小板比例(H-IPF)指标在血流感染中的早期诊断价值。方法 选取2020年7月—2021年1月广州市第一人民医院的血培养阳性患者100例作为主要的研究对象,重症病人对照50例,健康对照50例。收集各组患者IPF、H-IPF、大型血小板比率(P-LCR)、血小板体积分布宽度(PDW)、粒/淋、粒/单指标的数值,采用单因素方差分析、构建ROC曲线的方法分析比较各组的IPF、H-IPF、P-LCR、PDW、粒/淋、粒/单比值的差异及其与血流感染效能的关系。结果 IPF、H-IPF、粒/淋、粒/单比值在血流感染组高于其他2组,差异有统计学意义(χ²分别是15.190,10.250,39.490,12.850;P<0.05),而 P-LCR、PDW在3组之间无统计学意义。其中,IPF与H-IPF对血流感染诊断效能较高,其中IPF的AUC为0.855(95% CI为0.737～0.973),H-IPF的AUC为0.845(95% CI为0.722～0.968)。结论 IPF、H-IPF与血流感染密切相关,这2个指标对血流感染患者具有一定的诊断价值。

Objective To explore the early diagnosis value of immature platelet fraction (IPF) and high fluorescent immature platelet fraction (H-IPF) in bloodstream infection.Methods A total of 100 patients with positive blood culture result from July 2020 to January 2021 in Guangzhou First People's Hospital were selected as the research objects,in the mean while,50 critically ill patients and 50 healthy patients were enrolled as two control groups.The values of IPF,H-IPF,platelet-large cell rate (P-LCR),platelet distribution width (PDW),neutrophils/lymphocytes,neutrophils/monocyte ratio of patients in each group were collected,and one-way analysis of variance and ROC curve were used to compare the data,to further analyze their relationship with the bloodstream infection.Results The IPF,H-IPF,neutrophils/lymphocytes,neutrophils/monocyte ratio in the bloodstream infection group were significantly higher than control groups,with statistical significance (χ²=15.190,10.250,39.490,12.850; P<0.05),while P-LCR and PDW had no statistical significance.Among them,IPF and H-IPF were highly effective in diagnosing bloodstream infection,the AUC of IPF was 0.855 (95% CI: 0.737-0.973) and the AUC of H-IPF was 0.845 (95% CI: 0.722-0.968).Conclusions IPF and H-IPF were closely related to bloodstream infection,and these two indicators had a certain value in diagnosing patients with bloodstream infection.

目的 探索在全膝关节置换(TKA)围手术期中实施以中医透药+整体针疗法为特色的中西医结合加速康复方案的可行性,考察中医、西医加速康复措施在单独应用和联合应用时的促康复效能。方法 以在我院行首次单侧全膝关节置换术的患者为研究对象。根据围手术期干预差异分为四组:A组12例,根据指南采取传统常规的围手术期处理;B组12例,在A组基础上,采取了西医加速康复措施;C组14例,在A组基础上,采取了中医透药+整体针疗法;D组15例,兼采用西医加速康复措施和中医透药+整体针疗法。统计所有患者术后24小时、术后3天视觉模拟疼痛评分(VAS)和术前、术后2周膝关节功能评分(HSS)。并作以上数据的组间比较。结果 四组患者术后24 h VAS组间差异无统计学意义,术后3 d VAS组间总体差异有统计学意义:组间两两比较,B、C、D组均低于A组(P<0.05),B、C、D组间差异则无统计学意义。四组患者术前HSS组间差异无统计学意义,术后2周HSS组间总体差异有统计学意义:组间两两比较,B、C、D组均高于A组(P<0.05),A、B、C组均低于D组(P<0.05),B、C组间差异无统计学意义。结论 中医透药+整体针疗法在TKA围术期应用切实可行,与加速康复理念有机结合可有效缓解患者围术期疼痛,改善术后膝关节功能。

Objective To explore the feasibility of implementing the accelerated rehabilitation program of integrated traditional Chinese and western medicine featuring TCM and holistic acupuncture in the perioperative period of total knee arthroplasty (TKA),and investigate the effectiveness of accelerated rehabilitation under concept of recovery after surgery ERAS of traditional Chinese medicine and western medicine in single application and joint application. Methods The patients who underwent the first unilateral total knee arthroplasty in our hospital were studied. According to the interventions during the perioperative period, they were divided into 4 groups: 12 cases in group A, which were treated according to the guidelines and traditional perioperative treatment; 12 cases in group B, on the basis of group A, western medicine accelerated rehabilitation measures were taken; for the 14 case in group C, on the basis of group A, TCM penetration combinate with holistic acupuncture therapy was adopted; in group D, the combination of western medicine accelerated rehabilitation measures and the TCM therapy above were implemented in 15 cases. The visual analogue score (VAS)of all patients at 24 hours and 3 days after surgery were counted, and their knee function scores in hospital for special surgery (HSS scores) were recorded before and 2 weeks after the surgery. Comparisons of the data above between different groups were carried out. Results There was no statistically significant difference between the 4 groups in the VAS at 24 h after the operation, but statistically significant difference was found in the comparison of VAS at the 3rd day after the operation;In pairwise comparison, the 3rd day's VAS of group B, C and D were all lower than that of group A (P<0.05). There was no statistically significant difference between the 4 groups in the HSS score before the operation, but statistically significant difference was found in the comparison of HSS score at the 2nd week after the operation;In pairwise comparison, the 2nd week's HSSscore of group B, C and D were all higher than group A (P<0.05),and that of group A,B and C were all lower than that of group D (P<0.05). Conclusion The application of TCM penetration medicine combinated with holistic acupuncture in perioperative period of TKA is practical and feasible. The combination of western medicine accelerated rehabilitation measures and the TCM therapy can effectively relieve patients' perioperative pain and improve postoperative knee function.

目的 观察手指点穴结合利水消散包外敷对癌性腹水的疗效。方法 选择我科收治的癌性腹水患者60例为研究对象,随机分为对照组和治疗组各30例。对照组常规限水、限钠、利尿护理,治疗组在常规护理的基础上,实施手指点穴结合利水消散包外敷腹部,7天为1疗程,共干预3个疗程后进行疗效评价,观察两组患者治疗前后体质量、腹围变化、生活质量评分(KPS)。结果 治疗组总有效率为86.66%,对照组为56.67%,治疗组临床疗效优于对照组(P＜0.05),两组治疗后平均体质量、腹围均比本组治疗前降低,且治疗组治疗前后差值大于对照组(P＜0.05),治疗组治疗后KPS评分也高于对照组(P＜0.05)。结论 手指点穴结合利水消散包外敷对癌性腹水有减轻疗效,能改善患者生活质量,操作简单,成本低,易被患者接受,适宜在临床应用。

Objective To observe the efficacy of finger-pointing combined with the dispersal package of outer application of the water to cancerous ascites. Methods 60 patients with cancerous ascites were selected as study subjects, randomly divided into treatment group and control group, with 30 cases each. The control group of patients using conventional water limit, sodium limit, diuretic car,in treatment group, on the basis of conventional care, the implementation of finger-pointing combined with water dissipation package outside the abdoment was take.We took the navel as the center,7 days for 1 course of treatment.After a total of 3 courses of intervention, the efficacy evaluation was carried out, to observe the two groups of patients before and after treatment in weights, abdominal circumference changes, qualities of life score (KPS). Results The total efficiency treatment group was 86.66%, the control group was 56.67%, the clinical efficacy of the treatment group was better than that of the control group (P <0.05), the average weight and abdominal circumference were lower after treatment in both groups than before treatment, and the difference between treatment group before and after treatment was greater than that of the control group (P <0.05), and the KPS score after treatment group was also higher than that of the control group (P<0.05). Conclusion Finger point slot combination with the ex-envelope of water dissipation has reduced the effect of cancerous ascites, can improve the quality of life of patients, simple operation, low cost, easy to be accepted by patients, suitable for clinical application.