论著

PENG阻滞使用低浓度罗哌卡因对衰弱患者在髋关节手术的应用

The application of PENG block using low concentration ropivacaine in hip joint surgery for frail patients

:425-432
 
       目的 探讨低浓度罗哌卡因行超声引导下髋关节囊周围神经(PENG)阻滞联合椎管内麻醉对衰弱患者髋关节手术的应用优势。方法 选择行髋关节手术的衰弱患者76例,随机分为两组,A 组(38例)行PENG阻滞联合椎管内麻醉,C 组(38例)行椎管内麻醉。比较两组入室(T0)、摆放体位时(T1)、术后6 h(T2)、术后12 h(T3)、术后24 h(T4)静息和活动状态的数字等级评定量表(NRS)疼痛评分;术后非甾体抗炎药及阿片类药物补救次数;术后 6 h、24 h患侧股四头肌徒手肌力分级(MMT);首次下床活动时间、住院时间。结果 A组T1~T4时刻静息状态NRS疼痛评分分别为2(1,3)分、1(1,2)分、2(1,2)分、3(2,4)分均低于C组的5(4,7)分、4(3,5)分、5(3,6)分、4(2,6)分,比较差异有统计学意义(均P<0.001);A组T1~T4时刻活动状态NRS疼痛评分分别为5(4,7)分、3(2,4)分、4(3,5)分、6(4,7)分均低于C组的10(9,10)分、8(6,9)分、8(7,9)分、9(8,10)分,比较差异有统计学意义(均P<0.001)。A组在T1~T4时的静息状态NRS疼痛评分低于T0时的(均P<0.01);C组在T1~T4时的静息状态NRS疼痛评分低于T0时的(均P<0.05);A组在T1~T4时的活动状态NRS疼痛评分均低于T0时的(均P<0.001);C组在T1、T2时的活动状态NRS疼痛评分均低于T0时的(均P<0.01)。A组术后非甾体抗炎药及额外阿片类药物补救次数为4(0,8)、2(0,3)次,均低于C组的15(7,19)、5(3,7)次,比较差异有统计学意义(均P<0.001)。两组术后 6 h和24 h患侧股四头肌MMT分级、首次下床活动时间和住院时间比较差异无统计学意义(P>0.05)。结论 低浓度罗哌卡因PENG阻滞可以有效减轻衰弱患者髋关节手术术后疼痛,不影响其术后下肢肌力。

   Objective To explore the application advantages of low-concentration ropivacaine for ultrasound-guided pericapsular nerve group(PENG)block combined with spinal-epidural anesthesia in hip joint surgery for frail patients.Methods Seventy-six frail patients undergoing hip surgery were randomly divided into two groups:Group A(38 cases)received PENG block combined with intraspinal anesthesia,while Group C(38 cases)received only intraspinal anesthesia.The numerical rating scale(NRS)pain scores of resting and active states were compared between the two groups at the time of entering the room(T0),placing the position(T1),6 hours after surgery(T2),12 hours after surgery(T3),and 24 hours after surgery(T4).Postoperative non-steroidal drugs and opioids remedy times,muscle strength grading(MMT)of quadriceps femoris at 6 hours and 24 hours after operation,and the first time out of bed activity time,hospitalization time were also compared.Results The resting NRS pain scores at T1-T4 in Group A were 2(1,3),1(1,2),2(1,2)and 3(2,4),respectively,which were lower than 5(4,7),4(3,5),5(3,6)and 4(2,6)in Group C,and the difference was statistically significant(all P<0.001).The NRS pain scores at T1-T4 in Group A were 5(4,7),3(2,4),4(3,5)and 6(4,7),respectively,which were lower than 10(9,10),8(6,9),8(7,9)and 9(8,10)in Group C,and the difference was statistically significant(all P<0.001).The resting NRS pain score of Group A at T1-T4 was lower than that at T0(all P<0.01);the resting NRS pain score of Group C at T1-T4 was lower than that at T0(all P<0.05).The NRS pain scores at T1-T4 in Group A were lower than those at T0(all P<0.001);the NRS pain scores at T1 and T2 in Group C were lower than those at T0(all P<0.01).The number of postoperative non-steroidal drugs and additional opioids in group A(4[0,8],2[0,3])was lower than that in Group C(15[7,19],5[3,7]),and the difference was statistically significant(all P>0.001).There was no significant difference in the MMT grade of the affected quadriceps femoris at 6 h and 24 h after operation,the first time of getting out of bed and the number of days of hospitalization between the two groups(P>0.05).Conclusions Low concentration ropivacaine PENG block can effectively reduce the postoperative pain of hip joint surgery in frail patients without affecting the postoperative lower extremity muscle strength.
专家述评

胰岛自身抗体检测——厘清实验特异度和疾病特异度的误解

Islet autoantibody detection:Clarifying the misconceptions of assay specificity and disease specificity

:264-269
 
       1型糖尿病(T1DM)是一种免疫介导的胰岛β细胞特异性破坏的自身免疫性疾病,全球发病率逐年上升。胰岛自身抗体(IAbs)是T1DM最可靠的生物标志物,用于早期预测和诊断。然而,传统的放射配体法(RBA)虽然具有高实验特异度,但在疾病特异度方面存在局限性,尤其是单抗体阳性的预测价值较低。近年来,电化学发光法(ECL)作为一种无放射性污染的新方法,能够区分高亲和力和低亲和力的IAbs,显著提高了疾病特异度。多项研究表明,ECL法在预测T1DM风险方面优于RBA法,特别是在单抗体阳性的情况下。本文综述了IAbs检测方法的进展及其在T1DM预测和诊断中的应用,强调了ECL法在提高疾病特异度方面的优势。
       Type 1 diabetes mellitus(T1DM)is  an  autoimmune  disease  characterized  by the immune-mediated destruction of pancreatic β-cells,with a rising global incidence.Islet autoantibodies(IAbs)are the most  reliable biomarkers for early prediction and diagnosis of T1DM.However,the traditional radio-binding assay(RBA),despite its high experimental specificity,has limitations in disease specificity,particularly in the predictive value of single autoantibody positivity.Recently,the electrochemiluminescence(ECL)method,a non-radioactive approach,has been developed to distinguish high-affinity from low-affinity IAbs,significantly improving disease specificity.Multiple studies have shown that the ECL method outperforms RBA in predicting T1DM risk,especially in cases of single autoantibody positivity.This review discusses the advancements in IAbs detection methods and their applications in T1DM prediction and diagnosis,highlighting the advantages of the ECL method in enhancing disease specificity.
论著

育龄期乳腺癌患者子代健康担忧与遗传风险认知对生育意愿的影响

The influence of health concerns for offspring and genetic risk perception on fertility intentions among women of childbearing age with breast cancer

:1754-1760
 
       目的   了解育龄期乳腺癌患者对子代健康和遗传风险担忧现状及其对癌症诊断前后生育意愿改变的影响。方法   于2019年11月—2020年9月,采用中文版癌症后生育忧虑量表(RCAC)-子女健康亚量表对广州市某三甲医院的230例育龄期乳腺癌患者进行调查,应用SPSS 26.0及PSM插件对结果进行统计分析。在进行子女健康亚量表得分低分组和中高分组患者的生育意愿改变率的比较时,应用倾向性评分匹配法控制混杂因素。结果   育龄期乳腺癌患者对子代健康和遗传风险担忧得分为(11.40±2.99)分;匹配前后不同子女健康亚量表得分分组的患者在癌症诊断前后生育意愿改变率的差异均不具有统计学意义(P>0.05)。结论   育龄期乳腺癌患者对子代健康和遗传风险的担忧虽然没有显著影响其生育意愿的改变,但其对子代健康和遗传风险担忧处于较高水平,临床医护人员应提高对这一现象的重视,可通过多渠道科普相关知识,开展遗传咨询服务以减轻患者的担忧。
      Objective  To explore the current status of childbearing age breast cancer patients’  concerns  about their children’s health and genetic risk and its influence on the change of fertility intention before and after cancer diagnosis.Methods  From November 2019 to September 2020,the Chinese version of the Reproductive Concern After Cancer Scale(RCAC)- Children’s Health Sub-scale was used to interview 230 patients with breast cancer of childbearing age in a tertiary hospital in Guangzhou,and SPSS 26.0 and PSM plug-in were used to analyze the results statistically.The  propensity  score matching method was used to control confounding factors when comparing the change  rate of fertility intention of patients with low scores and those with medium and high scores in the children health subscale.Results  The score of concern for the health and genetic risk of children in breast cancer patients of childbearing age was(11.40±2.99).There was no statistically significant difference in the change  rate of fertility intention before and after cancer diagnosis among patients with different subscale scores of children’s health.Conclusions   Despite not significantly impacting fertility intentions,the notably high level of concern regarding children’s health and genetic risks among childbearing-age breast cancer patients necessitates increased clinical awareness.It is recommended that healthcare professionals address this through multi-channel education and genetically focused counseling within a collaborative model to mitigate patient distress.
论著

MTHFR基因多态性与成人急性淋巴细胞白血病患者大剂量甲氨蝶呤毒性反应及血药浓度关系

Relationship among MTHFR polymorphism and high dose methotrexate toxicity and blood concentration in adult patients with acute lymphoblastic leukemia

:1390-1397
 
目的 明确亚甲基四氢叶酸还原酶(MTHFR)C677T、A1298C基因多态性与成人患者使用大剂量甲氨蝶呤(MTX)治疗急性淋巴细胞白血病(ALL)毒性反应和24、48、72 h MTX血药浓度关系。方法 收集2014年6月—2020年6月就诊于新疆医科大学第一附属医院成人急性淋巴细胞白血病75例患者血样检测MTHFR C677T及A1298C基因多态性, 根据抗癌药物常见毒性反应分级标准对毒性反应进行分级,采用非条件Logistic回归分析MTHFR C677T、A1298C基因多态性与HD-MTX毒性反应及血药浓度的关系。结果 MTHFR 677TT型发生贫血风险显著高于CC型(P=0.027, OR=4.694, 95%CI:1.195~18.438); 未发现MTHFR C677T与白细胞减少、血小板计数减少、中性粒细胞计数减少、淋巴粒细胞计数减少、骨髓抑制、谷丙转氨酶升高、谷草转氨酶升高、肝功能损伤、急性肾损伤及黏膜损伤、24 h、48 h及72 h MTX血药浓度有相关性(P>0.05); 未发现MTHFR A1298C与HD-MTX毒性反应及血药浓度有相关性(P>0.05)。结论 MTHFR C677T基因多态性与成人急性淋巴细胞白血病患者大剂量MTX化学治疗后血液毒性存在相关性。
Objective To determine the relationship among C677T and A1298C gene polymorphisms of methyltetrahydrofolate reductase(MTHFR)and adult acute lymphocytic leukemia(ALL), the relationship between the toxicity of high-dose methotrexate(HD-MTX)after chemotherapy and the MTX blood concentration of 24 h, 48 h and 72 h in patients with ALL.Methods Blood samples were collected from 75 adult patients with ALL who were treated at the First Affiliated Hospital of Xinjiang Medical University from June 2014 to June 2020.The samples were used to detect the genetic polymorphisms of MTHFR C677T and A1298C, and the toxic reactions were graded according to the common toxic reaction classification criteria of anti-cancer drugs.Unconditional Logistic regression was used to analyze the relationship between MTHFR C677T and A1298C gene polymorphisms and HD-MTX toxic reactions and blood drug concentration.Results The risk of anemia in MTHFR 677TT was significantly higher than that in CC type(P=0.027, OR=4.694, 95% CI:1.195-18.438).No correlation was found between MTHFR C677T and leukopenia, thrombocytopenia, neutropenia, lymphogranulocytopenia, bone marrow suppression, elevated alanine aminotransferase, elevated aspartate aminotransferase, liver function injury, acute kidney injury and mucosal injury, 24 h, 48 h and 72 h MTX plasma concentrations(>0.05).No correlation was found among MTHFR A1298C and HD-MTX toxicity and blood concentration(P>0.05).Conclusions MTHFR C677T gene polymorphism is associated with hematotoxicity after HD-MTX chemotherapy in adult patients with ALL.
论著

单克隆免疫球蛋白血症患者M蛋白质量浓度检测的临床意义

Clinical significance of detecting M protein concentration in patients with monoclonal gammopathy

:669-674
 
目的 探讨单克隆免疫球蛋白血症患者M蛋白质量浓度检测的临床意义。方法 选取2018年6月—2023年6月龙岩人民医院收治的88例单克隆免疫球蛋白血症患者为研究对象,其中意义未明单克隆免疫球蛋白血症(MGUS)21例,具有肾脏意义单克隆免疫球蛋白血症(MGRS)50例,血液系统恶性肿瘤17例。对比其M蛋白质量浓度及临床实验室相关指标表达水平,采用Spearman相关分析法分析临床实验室相关指标的与M蛋白的相关性,对所有患者进行半年随访,以预后情况作为因变量,纳入Logistics回归模型分析M蛋白质量浓度对单克隆免疫球蛋白血症预后的预测价值。结果 不同病种M蛋白水平分别为(2.42±0.55)(2.57±0.64)(4.36±0.64)g/L、24 h尿蛋白分别为(1.45±0.16)(2.98±0.68)(2.43±0.44)g/24 h、血清白蛋白质量浓度分别为(31.01±3.06)(35.03±5.04)(39.05±7.08)g/L、总胆固醇水平分别为(3.42±1.25)(3.87±0.64)、(4.16±0.64)mmol/L、血肌酐水平分别为(114.35±23.23)(81.18±12.12)(146.36±21.12)μmol/L、血红蛋白质量浓度分别为(148.12±15.26)(141.69±12.15)(133.34±15.31)g/L,组间对比差异均有统计学意义(F分别为23.890,19.700,12.044,25.767,36.572,10.267,P<0.05)。MGUS患者24h尿蛋白与M蛋白有相关性(r=-0.384,P=0.033),24 h尿蛋白、血清白蛋白、总胆固醇、血肌酐与MGRS患者M蛋白有相关性(r=-0.586,P=0.006;r=0.431,P=0.018;r=-0.457,P=0.020;r=0.523,P=0.009),血清白蛋白、总胆固醇、血红蛋白与血液系统恶性肿瘤患者M蛋白有相关性(r=0.374,P=0.029;r=-0.617,P=0.001;r=-0.414,P=0.024);年龄、M蛋白为单克隆免疫球蛋白血症患者预后的影响因素(P<0.05)。结论 不同单克隆免疫球蛋白血症患者M蛋白水平存在差异,其中血液系统恶性肿瘤患者的M蛋白水平最高,且M蛋白为单克隆免疫球蛋白血症预后的独立影响因素。
Objective To explore the clinical significance of detecting M protein concentration in patients with monoclonal gammopathy.Methods From June 2018 to June 2023,88 patients with monoclonal gammopathy admitted to the hospital were selected as the study subjects.Among them,21 cases of monoclonal gammopathy with undetermined significance(MGUS),50 cases of monoclonal gammopathy with renal significance(MGRS),and 17 cases of hematological malignancies were selected. Concentration of M protein and the expression levels of clinical laboratory related indicators were compared,Spearman correlation analysis was used to analyze the correlation between clinical laboratory related indicators and M protein.All patients were followed up for six months,with prognosis as the dependent variable,included in the logistic regression model to analyze the predictive value of M protein concentration on the prognosis of monoclonal gammopathy.Results There were significant differences in the expression levels of M protein([2.42±0.55],[2.57±0.64],[4.36±0.64])g/L,24-hour urine protein([1.45±0.16],[2.98±0.68],[2.43±0.44])g/24 h,serum albumin([31.01±3.06],[35.03±5.04],[39.05±7.08])g/L,total cholesterol([3.42±1.25],[3.87±0.64],[4.16±0.64])mmol/L,blood creatinine([114.35±23.23],[81.18±12.12],[146.36±21.12])μmol/L,and hemoglobin([148.12±15.26],[141.69±12.15],[133.34±15.31])g/L among different diseases(F=23.890,19.700,12.044,25.767,36.572,10.267;P<0.05).There was a significant correlation between 24 h urinary protein and M protein in MGUS patients(r=-0.384,P=0.033).Urinary protein,serum albumin,serum cholesterol and blood creatinine were significantly associated with M protein in MGRS patients(r=-0.586,P=0.006;r=0.431,P=0.018;r=-0.457,P=0.020;r=0.523,P=0.009),Serum albumin,total cholesterol,and hemoglobin were significantly associated with M protein in patients with hematological malignancies(r=0.374,P=0.029;r=- 0.617,P=0.001;r=-0.414,P=0.024;P<0.05).Age and M protein were independent risk factors for the prognosis of patients with monoclonal gammopathy(P<0.05).Conclusions There are significant differences in the concentration of M protein among patients with different levels of monoclonal gammopathy,with the highest level observed in patients with hematological malignancies.M protein is an independent prognostic factor for monoclonal gammopathy.
论著

低浓度布比卡因联合全身麻醉对腹腔镜下直肠癌根治术患者体征及苏醒质量的影响

Clinical study on the effect of low concentration bupivacaine combined with general anesthesia on the physical signs and recovery quality of patients undergoing laparoscopic radical resection of rectal cancer

:295-299
 
目的 观察低浓度布比卡因联合全身麻醉在腹腔镜下直肠癌根治术中的应用及对患者体征及苏醒质量的影响。方法 选择2020年1月—2021年6月在信阳一五四医院实施腹腔镜镜下直肠癌根治术治疗的126例直肠癌患者为研究对象,通过抽签法对患者进行分组,将其中63例列为全麻组,术中单纯实施全身麻醉,其余63例列为联合组,术中采用低浓度布比卡因联合全身麻醉,比较两组患者体征变化情况,苏醒质量,麻醉相关不良反应,并开展为期1.5年的随访,评估两组患者远期生存质量。结果 联合组术中、术后的心率、平均动脉压均低于全麻组(P<0.05);术后,联合组的Steward麻醉苏醒评分略低于全麻组、麻醉恢复室停留时间略高于全麻组(P>0.05);但联合组的视觉模拟疼痛评分、镇静评分均低于全麻组(P<0.05);联合组的麻醉相关不良反应发生率略高于全麻组(P>0.05);随访期间,联合组的肠癌患者生存质量测定量表各维度评分均高于全麻组(P<0.05)。结论 低浓度布比卡因联合全身麻醉的麻醉效果更加平稳、安全性高。
Objective To observe the application of low concentration bupivacaine combined with general anesthesia in laparoscopic radical resection of rectal cancer and its effect on the physical signs and recovery quality of patients. Methods In this study,126 rectal cancer patients who underwent laparoscopic radical resection of rectal cancer in Xinyang 154th Hospital from January 2020 to June 2021 were selected as the research subjects.The patients were divided into groups by drawing lots.Among them,63 patients were included in general anesthesia group,and the rest 63 patients were included in combined group.Low-concentration bupivacaine combined with general anesthesia was used in combined group during the operation.The changes of physical signs and the quality of recovery were compared between the two groups.Anesthesia related adverse events,and the long-term quality of life of the two groups of patients was evaluated through one-year and a half follow-up. Results The heart rate and mean arterial pressure during and after surgery in the combined group were lower than those in the general anesthesia group(P<0.05).After surgery,the Steward anesthesia recovery score of the combined group was slightly lower than that of the general anesthesia group,and the PACU stay time was slightly higher than that of the general anesthesia group(P>0.05).However,the VAS score and Richmond Agitation-Se dation Scale score of the combined group were lower than those of the general anesthesia group(P<0.05).The incidence of anesthesia related adverse reactions in the combination group was slightly higher than that in the general anesthesia group(P>0.05).During the follow-up period,the FACT-C scores of all dimensions in the combination group were higher than those in the general anesthesia group(P<0.05). Conclusions The anesthesia effect of low concentration bupivacaine combined with general anesthesia is significant and safe.
护理研究

以整合照护理念为基础的综合干预体系对稳定性冠心病患者衰弱的影响

Effects of comprehensive intervention based on integrated care concept on frailty in stable CHD patients

:432-436
 
目的 探讨以整合照护理念为基础的综合干预体系对稳定性冠心病患者衰弱的影响。方法 选择2021年8月—2022年6月在驻马店市中医院诊治的老年稳定性冠心病患者78例,根据1∶1随机数字表法分为两组,每组各39例。常规组给予常规护理,整合组在常规组护理的基础上给予以整合照护理念为基础的综合干预体系,记录两组患者的预后情况。结果 两组患者在护理3个月后的平衡测试评分、座椅站立测试评分均低于护理前,整合组护理3个月后的平衡测试评分、座椅站立测试评分与常规组相比也降低(P<0.05)。整合组护理3个月后的躯体、心理、社会、精神等维度的生活质量评分均高于常规组(P<0.05)。整合组随访1年的靶血管重建、心肌梗死、心源性死亡、冠状动脉再狭窄等主要心血管事件不良事件发生率为5.13%,常规组为25.64%,整合组低于常规组(P<0.05)。结论 以整合照护理念为基础的综合干预体系能缓解老年稳定性冠心病患者的衰弱状况,改善患者的生活质量,降低主要心血管事件不良事件发生率。
Objective To explore and analyze the effects of a comprehensive intervention based on integrated care on the frailty of elderly stable coronary heart disease(CHD)patients.Methods From August 2021 to June 2022,78 cases of elderly stable CHD patients who were diagnosed and treated in Zhumadian City Hospital of Traditional Chinese Medicine were selected.According to a 1:1 random number table method,78 patients were divided into the integrated group and the traditional group,with 39 cases of each group.The traditional group was given routine care,while the integrated group was given a comprehensive intervention based on integrated care concepts on the basis of the traditional group's care,and the patients' prognosis was recorded.Results The balance test scores and chair stand test scores of both groups after 3 months of nursing care were lower than those before nursing care.The balance test scores and chair stand test scores of the integrated group after 3 months of nursing care were also significantly lower than those of the traditional group(P<0.05).After 3 months of nursing care,the quality of life scores in physical,psychological,social,and spiritual dimensions in the integrated group were significantly higher than those in the traditional group(P<0.05).The incidence of major cardiovascular adverse events such as cardiac death,myocardial infarction,target vessel reconstruction,and coronary artery restenosis during a one-year follow-up in the integrated group was 5.13%,compared to 25.64% in the traditional group.The integrated group was significantly lower than the traditional group(P<0.05).Conclusions The application of a comprehensive intervention based on integrated care concept in elderly stable CHD patients can alleviate frailty,improve quality of life,and reduce the incidence of major cardiovascular adverse events.
论著

快速康复理念联合腹腔镜手术治疗对小儿腹股沟疝疗效观察

Observation on the therapeutic effect of rapid rehabilitation concept combined with laparoscopic surgery for inguinal hernia in children

:781-785
 
目的 探讨快速康复理念联合腹腔镜手术治疗对小儿腹股沟疝疗效观察。方法 选取焦作市妇幼保健院2021年1月—2023年1月收治的86例腹股沟疝患儿进行分析与研究,应用随机数字表法将其分为观察组与对照组,各组均为43例。所有患儿均采取腹腔镜手术治疗,对照组采取常规护理,观察组采取快速康复理念护理。对比两组围术期恢复情况,术后4、12、24、48 h疼痛程度,并发症及护理满意度情况。结果 观察组首次下床时间、首次肛门排气时间、进食时间、住院时间短于对照组(P<0.05);两组患儿术后4、12、24、48 h视觉模拟量表(VAS)评分逐渐降低,观察组低于对照组(P<0.05);两组恶心呕吐、尿潴留、腹胀腹痛、感染并发症发生率对比差异无统计学意义(P>0.05);观察组患儿及家长健康教育、住院环境、专科护理、检查指导、病情观察相关护理满意度评分高于对照组(P<0.05)。结论 快速康复理念联合腹腔镜手术治疗小儿腹股沟疝效果显著,可进一步促进患儿早日康复,缩短住院时间,术后疼痛水平低,同时可提升患儿及家长护理满意度。
Objective To explore the therapeutic effect of rapid rehabilitation concept combined with laparoscopic surgery on pediatric inguinal hernia.Methods A total of 86 children with inguinal hernia admitted to Jiaozuo Maternal and Child Health Care Hospital from January 2021 to January 2023 were selected for analysis and study,and divided into observation group and control group by random number table method,with 43 cases in each group.All patients were treated with laparoscopic surgery,while the control group received routine care,while the observation group received rapid recovery concept care.The perioperative recovery,pain level,complications,and nursing satisfaction at 4,12,24,and 48 hours after surgery were compared.Results The first discharge time,first anal exhaust time,feeding time,and hospitalization time were shorter than the control group(P<0.05).The VAS scores decreased after 4 h,12 h,24 h and 48 h,and the observation group was lower than the control group(P<0.05).The incidences of nausea and vomiting,urinary retention,abdominal distension,abdominal pain and infectious complications between the two groups were significantly insignificant(P>0.05).The health education,inpatient environment,specialized care,nursing examination guidance and condition observation were significantly higher than that of the observation group(P<0.05).Conclusions The combination of rapid recovery concept and laparoscopic surgery for the treatment of inguinal hernia in children has a significant effect,which can further promote early recovery,shorten hospital stay,lower postoperative pain levels.At the same time,it can improve the nursing satisfaction of children and parents.
论著

基于护理目标执行理念的护理方式在支气管哮喘患儿治疗中的应用效果研究

The value of nursing goals execution concept intervention in the treatment of children with asthma

:1078-1083
 
目的 探讨护理目标执行理念护理在哮喘患儿治疗中的价值。方法 前瞻性选取泉州市妇幼保健院于2021年8月—2023年8月收治的100例支气管哮喘患儿,应用随机数字表法将其分为两组,每组均为50例。对照组采取常规护理,观察组在常规护理基础上给予护理目标执行理念护理。3个月后,对比两组家属对患儿的疾病管理能力、哮喘控制状况、生活质量。结果 护理后两组患儿家属相关家庭管理测量量表(FaMM)评分均升高,且观察组高于对照组(P<0.05);观察组患儿哮喘控制率高于对照组(P<0.05);护理后两组患儿情感、活动、症状相关标准儿童哮喘生活质量评分表(PAQLQ)评分均升高,且观察组高于对照组(P<0.05)。结论 护理目标执行理念护理可改善哮喘患儿家属对患儿疾病的管理能力,改善哮喘控制效果,提升患儿生活质量。
Objective To explore the value of nursing goal execution concept intervention in the treatment of children with asthma.Methods From August 2021 to August 2023,100 children with bronchial asthma admitted to Quanzhou Maternal and Child Health Hospital were Prospective selected.They were randomly divided into observation group and control group,with 50 cases in each group.The control group of children received routine care,while the observation group of children received intervention based on the nursing goals execution concept in addition to routine care.After 3 months of intervention,The disease management ability,compliance,asthma control and quality of life of the two groups were compared.Results Family-related FaMM scores were increased in all two groups after the intervention,and the observation group was higher than the control group(P<0.05).The asthma control rate of the children in the observation group was higher than that in the control group(P<0.05);after nursing,the PAQLQ score increased,and the observation group was higher than the control group(P<0.05).Conclusions Intervention based on the nursing goals execution concept can improve the management ability of family members of asthma patients towards their diseases,and enhance their quality of life,which is worthy of clinical application and promotion.
论著

帕利哌酮在精神分裂症患者中剂量校正浓度影响因素分析

Analysis of the factors influencing the dose-corrected through concentration of paliperidone in schizophrenic patients

:46-49
 
目的 探究精神分裂症患者应用帕利哌酮后剂量校正浓度(C/D)的影响因素,旨在为精神分裂症患者的临床用药提供参考。方法 选择2021年9月–2022年5月在我院择期接受帕利哌酮治疗的122例精神分裂症患者作为研究对象,收集患者的年龄、性别、给药剂量、给药频次以及合并用药等状况。结果 不同性别间帕利哌酮C/D存在差异,其中女性的C/D明显比男性的C/D更高。在关于年龄、性别、给药剂量、给药频次以及合并用药对帕利哌酮C/D的影响分析中,合并用药阿立哌唑、性别对帕利哌酮C/D有影响。结论 帕利哌酮应用在精神分裂症患者治疗中,性别、合并应用阿立哌唑会对帕利哌酮C/D产生显著影响。
Objective To explore the influencing factors of dose-corrected through concentration(C / D)of paliperidone in patients with schizophrenia,in order to provide reference for clinical medication of patients with schizophrenia.Methods A total of 122 patients with schizophrenia treated with paliperidone in our hospital from September 2021 to May 2022 were selected as the research objects.The patient's age,gender,dosage,frequency of administration and combined medication were collected.Results There were differences in the C / D of paliperidone between different genders,and the C / D of women was significantly higher than that of men.In the analysis of the effects of age,gender,dosage,frequency of administration and combined medication on the C / D of paliperidone,the combined medication of aripiprazole and gender had effect on the C / D.Conclusions The application of paliperidone in the treatment of patients with schizophrenia,gender and combined application of aripiprazole can have significant impact on C / D.
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