论著

综合性医院门诊幽门螺杆菌感染及耐药情况研究

Investigation of Helicobacter pylori infection and antibiotic resistance in outpatients at a general hospital

:1669-1676
 
       目的  调查深圳地区综合性医院门诊幽门螺杆菌(Hp)对8种常见抗菌药物的耐药情况。方法  采集13C呼气试验阳性的患者胃黏膜标本313例,进行Hp分离培养及抗菌药物敏感性试验。结果  313例患者分离培养得到247例Hp菌株,培养阳性率78.91%,不同性别、不同年龄患者Hp分离培养阳性率比较差异无统计学意义(P>0.05)。Hp对甲硝唑、克拉霉素、左氧氟沙星、利福平、阿莫西林、四环素、呋喃唑酮、庆大霉素耐药率依次为88.66%(219/247)、38.46%(95/247)、38.06%(94/247)、4.05%(10/247)、1.21%(3/247)、0.40%(1/247)、0.40%(1/247)、0(0/247)。双重耐药率为38.46%(95/247),其中Hp对克拉霉素+甲硝唑组合耐药率最高(18.62%,46/247),对甲硝唑+左氧氟沙星耐药率居其次(17.00%,42/247)。多重耐药率为19.84%(49/247)。不同年龄、性别患者双重耐药率、多重耐药率比较差异均无统计学意义(P>0.05)。结论  深圳地区分离的Hp菌株对甲硝唑、克拉霉素、左氧氟沙星耐药率相对更高,且双重耐药、多重耐药情况严重。
        Objective  To investigate the antibiotic resistance of Helicobacter pylori(Hp)to eight commonly  used antibiotics in outpatients of general hospitals in Shenzhen.Methods  Gastric mucosal samples were collected from 313 patients who tested positive for the  13C breath test,and Hp strains were isolated and cultured.Antibiotic susceptibility testing was performed on the isolated Hp strains.Results  Of the 313 patients,247 Hp strains were isolated,with a culture-positive rate of 78.91%.There was no significant difference in culture-positive rates between different genders and age groups(P>0.05).The resistance rates to metronidazole,clarithromycin,levofloxacin,rifampicin,amoxicillin,tetracycline,furazolidone,and gentamicin were 88.66%(219/247),38.46%(95/247),38.06%(94/247),4.05%(10/247),1.21%(3/247),0.40%(1/247),0.40%(1/247),0(0/247),respectively.The dual resistance rate was 38.46%(95/247),with the highest combination  resistance observed in clarithromycin + metronidazole(18.62%,46/247),followed by metronidazole + levofloxacin(17.00%,42/247).The multi-drug resistance rate was 19.84%(49/247).There were no significant differences in dual resistance rates(P>0.05)or multiple resistance rates(P>0.05)between different age groups and genders.Conclusions  The Hp strains isolated in Shenzhen exhibited relatively higher resistance rates to metronidazole,clarithromycin,and levofloxacin,with substantial dual and multi-drug resistance.
论著

门诊长期肌注黄体酮患者实行综合健康教育的效果观察

Effect of comprehensive health education on outpatients with long-term intramuscular injection of progesterone

:100-102
 
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.
论著

中医妇科门诊患者焦虑及抑郁状态的现状调查

Investigation of current condition of anxiety and depression in TCM gynecology outpatients

:40-43
 
目的 探讨中医妇科门诊患者的焦虑及抑郁的发生情况,优化诊治工作,更好地服务患者。方法 采用焦虑自评量表(SAS)和 抑郁自评量表(SDS)评定190名中医妇科门诊患者的心理状态。结果 中医妇科患者焦虑均分高于正常常模组(P<0.05),抑郁评分与全国常模相比则无统计学差异(P>0.05),有焦虑及抑郁症状的患者分别为6.3%及10%。结论 中医妇科门诊患者的焦虑症状较正常人群高,医生在临床诊治过程应重视对患者心理状态的评价,并进行相应的心理干预及人文关怀, 以提高患者对治疗的依从性和满意度,为其身体及心理健康打下良好基础。
Objective To explore the occurrences of anxiety and depression in female TCM gynecology outpatients, and thus to make improvements in diagnosis, treatment, and service for the patients. Methods We adopted Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) to evaluate the mental status of 190 TCM gynecology outpatients. Results Anxiety scores in TCM gynecology group were higher than those in the normal group (P<0.05), while there was no statistical difference in depression scores between these two groups (P>0.05). Among the outpatients, 6.3% had symptoms of anxiety, and 10% had symptoms of depression. Conclusion TCM gynecology outpatients show more anxiety symptoms than normal people. We should pay attention to the assessment of those patients' mental status in the process of diagnosis and treatment, and offer psychological intervention and humane care to those patients accordingly. In this way, we could enhance patients' compliance and satisfaction, and help them build a solid foundation in physical health as well as in mental health.
论著

阳性强化法对社区门诊静脉输液患儿穿刺疼痛及依从性的影响研究

Effects of positive reinforcement on pain and compliance of puncture to children in community outpatients with intravenous infusion

:68-71
 
目的 探讨阳性强化法对社区门诊静脉输液患儿穿刺疼痛及依从性的影响。方法 选取社区门诊2014年4月—2016年4月收治的100例行静脉输液治疗的患儿作为研究对象,采取随机数字表法将其分成两组,每组50例。观察组患儿给予阳性强化法干预,对照组给予常规护理干预,对比两组患儿穿刺疼痛相关指标、穿刺效果、患儿静脉输液依从性及患儿家长的满意度。结果 观察组患儿疼痛面容持续时间明显短于对照组,穿刺后心率明显慢于对照组,啼哭时间>30s的患儿占比明显低于对照组(P<0.01)。观察组一次穿刺成功率、穿刺耗时>5min占比分别为94.00%、24.00%,对照组分别为74.00%、62.00%,观察组一次穿刺成功率明显高于对照组,穿刺耗时>5min占比明显低于对照组(P<0.01)。观察组患儿静脉输液依从率为90.00%,与对照组的66.00%对比有明显上升(P<0.01)。观察组患儿家长满意度为96.00%,与对照组的80.00%对比有明显上升(P<0.05)。结论 对社区门诊静脉输液患儿实施阳性强化法干预可有效减轻穿刺疼痛,提高患儿的输液依从性,患儿家长满意度高。
Objective To explore positive reinforcement on pain and compliance of puncture to children in community outpatients with intravenous infusion. Methods Select 100 cases of children who receive intravenous infusion in community outpatients from April 2014 to April 2016 as research objectives and divide them into two groups randomly with each group of 50 cases. Provide positive reinforcement to observation group while provide routine nursing to control group. Compare two groups' puncture pain relevant indicator, puncture effect, children's intravenous infusion compliance and parents' satisfaction. Results Children in observation had less duration of pain face expression, lower heart rate after puncture and less children crying >30s than those in control group (P<0.01). Observation group's first puncture success rate, puncture time duration >5mins rate were 94.00% and 24.00% respectively while control group's data were 74.00% and 62.00%. Observation group's first success rate was significant higher than that of control group. Observation group's puncture time duration >5mins rate was significant lower than that of control group (P<0.01). Children's intravenous infusion compliance rate in observation group was 90.00% which was significant higher than control group's 66.00% (P<0.01). Parents satisfaction rate in observation groups was 96.00% which was significant higher than control group's 80.00% (P<0.05). Conclusion Implementing positive reinforcement on children in community outpatient may help to relieve puncture pain, improve children's compliance to intravenous infusion and increase parents' satisfaction.
临床诊疗

南沙新区三级医院门诊患者健康教育需求调查

Demand investigation of health education outpatients of a grade hospital in Nasha District

:110-112
 
目的 了解南沙新区三级医院门诊患者健康教育需求情况,为制定医院健康教育策略提供科学依据。方法 采用随机抽样的方法,利用自制调查问卷对287名门诊患者进行健康教育需求调查。结果 青年期患者、大专以上文化程度患者健康教育需求率高,需求的健康教育内容最高的为传染病防治健康教育,需求的健康教育方式依次为医患交流、护患交流、微信公众号或网站宣传。结论 南沙新区三级医院门诊患者健康教育需求较高,应根据门诊患者的不同特点,制定有针对性措施进行健康教育,以提高其健康素养水平。
论著

广州综合医院内分泌科门诊抑郁焦虑障碍调查

Survey of depressive and anxiety disorders among the endocrinology outpatients from a general hospital of Guangzhou

:69-71
 
目的 了解广州综合医院内分泌科门诊就诊者中抑郁焦虑障碍的患病率。方法 对广州市第一人民医院的内分泌科门诊就诊的患者进行横断面调查。采用医院焦虑抑郁量表(HADS)对105名入选的患者进行筛查,精神科医生对HADS≥8 分的患者进行国际神经精神科简式访谈问卷( MINI ) 的诊断性评估。结果 MINI诊断的抑郁障碍、焦虑障碍、抑郁和焦虑共病的患病率分别为3.80%、0.95%和2.86%。结论 抑郁和焦虑障碍是综合医院内分泌科门诊就诊者中的常见问题,但识别率和治疗率均不高。
Objective To investigate the prevalence rates of depressive and anxiety disorders of the endocrinology outpatients in a general hospital of Guangzhou. Methods A cross-sectional survey was conducted in the endocrinology outpatient department of Guangzhou First People's Hospital. A total of 105 outpatients were screened with hospital anxiety and depression scale(HADS). The patients with the HADS score of 8 and over were investigated and diagnosed by psychiatrists with the mini-international neuropsychiatric interview(MINI). Results The prevalence rates of MINI-diagnosed depressive disorder, anxiety disorder, and depressive-anxiety co-morbid disorders were 3.80%, 0.95% and 2.86%, respectively. Conclusion Depression and anxiety disorders are common problems in the endocrinology outpatient department of general hospitals,but few outpatients were well-diagnosed and treated.
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