目的 探讨七氟烷复合静脉诱导在脑动脉瘤栓塞术中的临床效果。方法 分析2013年1月—2015年12月在我院接受脑动脉瘤栓塞术80例患者的临床资料,根据随机数字表法分为研究组(n=40)和对照组(n=40),对照组采用全凭静脉诱导插管方法,研究组采用七氟烷复合静脉诱导插管方法,比较两组患者的应用效果。结果 两组患者血流动力学、血浆E及NE、呛咳反应发生率、阿托品及血管活性药物使用率比较,研究组均明显优于对照组(P＜0.05)。结论 七氟烷复合静脉诱导用于脑动脉瘤栓塞术对患者血流动力学和应激反应的影响较小,具有较高的安全性和可靠性,可应用于临床。

Objective To explore the clinical effect of sevoflurane combined with intravenous induction in the treatment of cerebral aneurysm embolization. Methods The clinical data of 80 patients with cerebral aneurysm embolization in our hospital from January 2013 to December 2015 were analyzed and divided into study group (n=40) and control group (n=40) according to the random number table. The control group was treated by intratracheal intubation with total intravenous induction. In the study group, sevoflurane combined intravenous induction with intratracheal intubation was used to compare the effect of the two groups. Results Compared with the control group, the hemodynamics, the plasma E and NE, the incidence of cough reaction, atropine and vasoactive drug use were significantly better than those in the control group (P<0.05). Conclusion Sevoflurane combined with intravenous induction for cerebral aneurysm embolization in patients with less impact on hemodynamics and stress response, with high safety and reliability, can be used clinically.

目的 探讨机采血小板献血者流失原因,为建立一支稳固的机采血小板献血者队伍提供参考。方法 选择2009年1月1日—2012年12月31日河源市中心血站首次机采血小板献血者共382例为研究对象,根据其首次机采血小板献血后3年内是否再次参加机采血小板献血分为实验组和对照组,分别对研究对象进行电话回访调查。结果 3年内未再次参加血小板献血流失者118例,总流失率为30.89%;不同献血动机组流失率差异有统计学意义 (χ²= 18.552,P=0.000),其中动机不明确组流失率(52.49%)最高,寻求社会荣誉组流失率(15.79%)最低。发生过献血反应组(63.64%)流失率显著高于未发生献血反应组流失率(26.63%),两组间差异有统计学意义(χ²=8.501,P=0.004);对献血过程不满意组流失率(39.77%)显著高于满意组流失率(28.23%),两组间差异有统计学意义(χ²=16.413,P=0.000);认为机采时间过长组机采血小板献血者流失率(49.40%)显著高于不认为机采时间过长组流失率为(25.75%),两组间差异有统计学意义(χ²=17.014,P=0.000)。健康状况(体检结果)不合格组流失率(43.84%)显著高于合格组流失率(27.83%),两组间差异有统计学意义(χ²=9.022,P=0.030)。媒体(或网络)负面的宣传与献血者是否方便对机采血小板献血者流失率的影响不显著(χ²=1.579,P=0.209;χ²=2.130,P=0.144)。结论 机采血小板献血者流失主要与献血动机、献血过程感受以及自身健康等因素有关。

目的 探讨吸烟对稳定期COPD患者炎症反应和肺功能的影响。方法 选取2013年8月—2016年9月我院门诊收治的稳定期COPD患者70例为研究对象,其中吸烟35例(X1组)、不吸烟35例(X2组),另选取同期入院的不吸烟健康志愿者35例纳入健康组,采用酶联免疫吸附试验(ELISA)测定血清白介素-6(IL-6)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平,以肺功能检测仪测定三组一秒用力呼气容积(FEV1)、一秒用力呼气容积/用力肺活量比值(FEV1/FVC)、FEV1占预计值百分比(FEV1％),并采用自拟症状评分表及简明健康调查简表(SF-36)评价呼吸困难程度及生活质量。结果 X1组IL-6、IL-8及TNF-α依次为(135.27±1.24)pg/mL、(189.45±1.14)pg/mL、(39.39±1.14)pg/mL,明显高于X2组、健康组(P均<0.05);X1组FEV1(0.75±0.14)L、FEV1/FVC(3.65±1.87)％、FEV1％(3.45±0.12)％低于X2组、健康组(P均<0.05);X1组症状积分(10.17±1.02)分较X2组、健康对照组高(P<0.05),而其SF-36评分(54.27±1.46)分明显低于X2及健康组(P<0.05);X2组上述指标与健康组比较亦有统计学意义(P均<0.05)。结论 吸烟可明显增加稳定期COPD患者IL-6、IL-8、TNF-α等炎症因子水平,同时降低肺功能,临床应采取措施进行有效干预,防止患者病情恶化。

目的 探讨行动导向法在原位新膀胱患者康复中的应用效果。方法 选取36例新膀胱术后回归社区的患者,自出院当天起按“提出任务、计划制订、计划实施、自我反馈”4个完整的行动进行健康教育,6个月后评价患者尿失禁或尿潴留的发生率、新膀胱控尿效果、健康知识知晓率。结果 干预后患者尿失禁的发生率为2.78%、尿潴留为8.33%,新膀胱控尿效果和健康知识知晓率均为100%,与干预前比较差异均有统计学意义(P<0.05 )。结论 行动导向法对原位新膀胱患者进行健康教育,有利于提高患者学习积极性和依从性,促进理想自主排尿早日恢复。

Objective To explore the effect of action oriented method in the rehabilitation of patients with orthotopic neobladder. Methods Select 36 cases of patients who return to the community after the new bladder surgery, from the day of discharge, according to“ the objective, plan making, plan implementation, self feedback” these 4 complete actions to implement health education. After 6 months the evaluation for the patients with urinary incontinence or urinary retention including the incidence of new bladder continence, awareness of health knowledge were taken. Results The incidence of urinary incontinence was 2.78% and urinary retention was about 8.33%. The awareness rate of urinary continence and health knowledge was 100%, and the difference was statistically significant (P<0.05). Conclusion It is helpful to improve the learning interesting and compliance of the patients with bladder cancer, and to promote the early recovery of the ideal autonomous urination.

目的 探讨标准化沟通模式在重症孕产妇院前转运前评估与交接环节中的应用效果。方法 设计转运前标准化沟通信息登记表,用以标准化转运前评估与交接环节,护士按照登记表中的项目逐条交接,对方未交代的项目护士进行主动评估,并将结果登记并汇报接诊医生。结果 运用标准化沟通模式后,有效缩短了转诊的通话时间和抵院后的处理时间,护士评估信息的错漏率由13.84%降低至4.23%,交接不清导致的不良事件发生率由7.41%降至1.21%,并在改善母婴结局等方面均取得较好效果。结论 SBAR 沟通模式在重症孕产妇孕前转运的评估和交接环节中保证了重要信息的准确传递,为重症孕产妇的救治争取宝贵时间,值得临床上推广应用。

Objective To explore the application effects of SBAR (situation, background, assessment and recommendation) communication mode in the transfer of critically ill obstetric women. Methods A transfer from based on SBAR communication mode was designed and used to assess the psychological status and illness condition of critically ill obstetric women. Results After the application of SBAR communication transfer model, the communication time and hospital action time were both shortened and the occurrence of transfer problems decreased,while the pregnancy outcomes were improved (P＜0.05). Conclusion Applying SBAR communication mode in the transfer of critically ill obstetric women is helpful to reduce the transfer time and the occurrence of transfer problems,and improve the quality of patient handover.

目的 应用Synapsys人体姿势平衡系统对早期帕金森病(Parkinson's disease, PD)患者姿势障碍定量测试评价效果分析。方法 收集我院神经内科2015年7月-2016年7月收治的早期PD患者52例,随机分为试验组和对照组,每组26例。两组患者均给予常规治疗措施,试验组在常规治疗基础上给予康复治疗措施,最后两组均使用Synapsys人体姿势平衡系统和Berg平衡量表对患者进行评估和训练,观察测试结果。结果 干预前动态和静态异常比例组间差异无统计学意义(P>0.05);干预后试验组动态和静态异常分别为34.62%、30.77%,低于对照组的69.23%、73.08%,差异有统计学意义(P<0.05);干预前Berg平衡量表评分组间差异无统计学意义(P>0.05),干预后试验组评分高于对照组,差异有统计学意义(P<0.05);干预后两组Berg平衡量表评分均升高,其中试验组干预前后比较差异有统计学意义(P<0.05)。结论 应用Synapsys人体姿势平衡系统对早期PD患者姿势障碍准确定量测试,以评价康复效果,并且对于康复治疗具有重要作用。

Objective To analyze the clinical effects of quantitative test on early Parkinson's patients who suffering in postural disorders by using synapsys posturography system (SPS). Methods 52 cases of early Parkinson's patients who treated in our department of neurology from July 2015 to July 2016 were collected and divided into experimental and control groups randomly, 26 cases in each group. During the treatment, cases in experimental group and control group received the same conventional treatments. Meanwhile, on the base of conventional treatments, the cases in experimental group also received recovery therapy. Finally, the clinical effects of different treatments in two groups were evaluated by using SPS and Berg balance scale (BBS). Results Before intervention, the dynamic and static abnormal proportion between two groups had no significant difference (P>0.05); However, after the intervention, dynamic and static abnormal proportion in experimental group were 34.62%、30.77%, respectively, which was lower than those in control group (Dynamic: 69.23%; Static:73.08%), and the difference was significant (P<0.05); In addition, the result of BBS showed there was no difference between the experimental group and control group before intervention (P>0.05), while the scores of BBS in experimental group was higher than that in control group after intervention, and the difference was significant (P<0.05); At the same time, the scores of BBS in each group were both increased after the intervention, especially in the experimental group, and the difference in experimental group was significant (P<0.05). Conclusion The quantitative test on early Parkinson's patients who suffering in postural disorders can perform accurately by using synapsys posturography system. And the synapsys posturography system can also evaluate the recovery effects, which is important for the recovery treatment.

目的 分析2014年482例广州登革热患者的X线胸片特点,探讨X线胸片对登革热患者的临床诊断价值。方法 选取广州市第一人民医院2014年收治的482例登革热患者作为研究对象,观察分析其X线胸片检查结果的特征。结果 登革热患者X线胸片影像学特点以非特异性的肺纹理增多增粗和斑片渗出灶为主要表现,另有胸膜增厚、胸腔积液和间质性改变。结论 X线胸片检查可以经济、便捷地了解登革热患者的肺部改变,为临床诊断和治疗提供帮助。

Objective To analyze the characteristics of chest X-ray in 482 cases of dengue fever in Guangzhou 2014, and to discuss the diagnostic value of chest X-ray in dengue fever patients. Methods 482 patients of dengue fever patients admitted in Guangzhou First People's Hospital were selected as the research object. The characteristics of the chest X-ray were observed and analyzed. Results The characteristics of chest X-ray images included lung markings thickening increased, exudation, and might lead to pleural thickening, effusion and interstitial change. Conclusion Chest X-ray was a convenient examination for dengue fever patients which had an important diagnostic and therapeutic value.

目的 分析他汀致肌病的影响因素,使临床更加合理的使用他汀类药物,减少不良反应的发生。方法 对1例口服阿托伐他汀钙片治疗5天后出现双大腿肌肉酸痛伴CK升高患者的病理生理因素、联合用药等情况进行分析,探讨他汀致肌病的相关因素及药学监护要点。结果 临床药师判断他汀导致肌病可能性大,提出治疗建议和监护计划,促进了患者病情好转。结论 他汀类药物导致肌病的影响因素较多,临床药师参与患者的临床治疗过程并加强药学监护,可促进药物治疗的安全性和有效性。

Objective To analyze the influencing factors of myopathy caused by statins, to make the clinical use of statins more rational and reduce the incidence of adverse reactions. Methods The pathophysiologic factors and combined medication of patients with both thigh muscle soreness and CK increase after five days of oral atorvastatin calcium therapy were analyzed. The related factors of statin- induced myopathy and the points of pharmacy care were discussed. Results Clinical pharmacists determined the possibility of statin lead to myopathy, and put forward treatment recommendations and monitoring program to promote the patient's condition improved. Conclusion There are many influencing factors of myopathy caused by statins. Clinical pharmacists participate in the clinical treatment of patients and strengthen the medical care, which can promote the safety and effectiveness of drug treatment.

目的 分析社区综合干预对小儿反复呼吸道感染的影响,为社区临床治疗小儿反复呼吸道感染性疾病提供理论依据。方法 采用随机抽签方式,从我社区2012年10月—2014年10月期间收治的小儿反复呼吸道感染患儿中,随机抽取60例纳入本项研究,依据就诊单双顺序,分为研究组30例(社区综合干预方式)和对照组30例(常规性治疗和常规措施进行干预),对两组患儿干预结果进行对比分析。结果 研究组治疗总疗效高于对照组(93.33% vs 76.67%),差异有统计学意义(P<0.05)。对比治疗干预过程中疾病发作次数、就诊次数状况,研究组优于对照组,差异有统计学意义(P<0.05)。干预后研究组小儿呼吸道感染致病因素改善情况(除滥用抗生素外)优于对照组,差异有统计学意义(P<0.05)。结论 针对小儿反复呼吸道感染疾病可采用社区综合干预方式,可显著提升治疗有效率,缓解病情,降低反复感染发生率,效果突出,具有广阔应用前景。

目的 研究鼻内镜下三线减张矫正术治疗鼻中隔偏曲的疗效及安全性。方法 纳入2010年9月—2015年9月我院120例鼻中隔偏曲患者作为研究对象,采用随机数表法分为两组,各60例。观察组行鼻内镜下三线减张鼻中隔偏曲矫正术,对照组行鼻内镜下传统鼻中隔黏膜下切除术。比较两种手术方法对患者鼻塞、头痛、鼻出血等临床症状的改善情况,随访记录两组术后疼痛、鼻阻力及并发症发生情况,评价疗效和安全性。结果 观察组术后鼻塞、头痛及鼻出血症状评分分别为(1.05±0.16)分、(1.3±0.14)分及(1.63±0.14)分,均显著低于对照组和术前水平(P＜0.05)。观察组术后1周、2周及4周各时间点VAS评分和鼻阻力值均显著低于对照组(P＜0.05)。观察组术后鼻中隔血肿和黏膜撕裂发生率均为1.67%,无鼻中隔穿孔和外形改变病例,发生率显著低于对照组,差异有统计学意义(P＜0.05)。结论 鼻内镜下三线减张矫正术能显著改善鼻中隔偏曲患者鼻塞、头痛及鼻出血症状,促进鼻腔通气功能恢复,有效降低术后并发症发生率,安全性高。