目的 探讨个体化术前访视在手术室临床护理路径的作用。方法 将167例进入手术室临床护理路径的子宫肌瘤截石位阴式全子宫切除手术患者随机分为实验组和对照组,分别予以或不予个体化术前访视,其他手术室临床护理路径相同,比较两组的护理效果。结果 两组均未出现手术体位并发症,实验组的术中心理应激变化小于对照组,实验组术后首次肛门排气时间、下床活动时间均早于对照组,实验组患者满意度高于对照组(P均<0.05)。结论 手术室临床护理路径应从个体化术前访视开始。

目的 探讨社区老年高血压病人直立性低血压的药物影响。方法 通过对辖区内897例社区老年高血压病人开展体检,将年轻老年和老老年高血压两组分为直立性低血压组和非直立性低血压组两组。分析降压药物对社区老年高血压病人直立性低血压的影响。结果 OH组的降压药物使用率稍高于非OH组的降压药物使用率,经统计分析P>0.05。OH组联合两种以上及联合三种以上降压药物使用率略高于非OH的药物使用率, P>0.05。利尿剂OH发生率稍高于其他组的OH发生率,P>0.05。结论 社区老年高血压OH的发病可能与目前常用的5大类降压药物无关。

目的 了解CHPS患儿经胃镜下幽门肌切开术治疗后幽门部黏膜近期各种并发症的发生情况及对预后的影响。方法 选取2006—2012年我院新生儿科确诊的34例CHPS患儿。以超细胃镜进入十二指肠乳头处,使用电切刀按上行性方向,沿幽门管纵轴切割肥厚狭窄的幽门管黏膜及环形肌以解除幽门部梗阻。术后第1、3、6月复查胃镜。结果 34例CHPS患儿共行胃镜下幽门肌切开术48次,均未发生胃及幽门穿孔、撕裂等严重并发症。24例患儿术后通过胃镜进行了复查,胃镜见幽门部及黏膜改变主要有黏膜充血肿胀、切口未完全愈合、切口疤痕形成、幽门部息肉形成等。结论 经胃镜下幽门肌切开术是一种安全性较高的治疗CHPS的新技术。术后黏膜充血肿胀、切口未完全愈合等幽门部黏膜改变的发生率随时间下降。切口疤痕形成并未影响幽门功能。

目的 探讨黄芪枳术汤结合肠内营养的对颅脑术后患者ALB/PA/TP的影响。方法 将60例颅脑术后患者随机分为观察组(n=30)和对照组(n=30)。观察组给予中药黄芪枳术汤和整蛋白肠内营养液,对照组仅给予整蛋白肠内营养液。通过观察两组病人营养支持前后各项营养指标的变化和胃肠道的并发症,对两种治疗方式的疗效进行比较。结果 观察组病人营养支持后第7,14 天各项营养指标总蛋白(TP),白蛋白(ALB),前白蛋白(PA),血红蛋白(HGb)水平均高于对照组,差异有意义(P均＜0.05),观察组的胃肠道症状的发生率较对照组少。结论 黄芪枳术汤能加强肠内营养疗效,促进胃肠功能恢复及减少术后并发症,黄芪枳术汤结合肠内营养能增加颅脑术后患者的摄入量,提高血清蛋白水平,改善机体的营养状况,促进患者的早日康复。

目的 探索协助式农疗对慢性精神分裂症患者社会功能的影响。方法 选取住院5年以上的慢性精神分裂症患者64例,随机分为研究组32例和对照组32例,实施室外农艺园艺方面的职业康复训练,并实行协助式管理新模式,康复训练前与训练后的第1、3、6月末分别采用护士用住院病人观察量表(NOSIE)对患者进行评价。结果 患者通过协助式农疗后,NOSIE总积极分、社会能力、社会兴趣、个人整洁等得分有明显提高,有统计学意义;总消极分激惹、精神病表现、迟缓、抑郁出现降低,有统计学意义。结论 慢性精神病患者在工作人员协助下参加农艺和园艺技术培训治疗,其症状和社会功能有较显著的改善。

Objective To explore the impact of assisted farming and gardening therapy on social function of patients with chronic schizophrenia. Methods 64 patients with chronic schizophrenia were randomly and equally divided into research group and control group, with 32 cases implemented outdoor farming and gardening vocational rehabilitation training in new management mode. Observe scale evaluation (NOSIE) was applied to assess the patients at the time before the training, one month after the training, three month after the training, and six month after the training. Results Patients received assisted farming therapy scored higher in total positive points, social ability, social interest, individual tidy. The difference was statistically significant. The scores of total negative points irritability, mental performance, slow, depression had reduced with statistical significance. Conclusion Assisted farming and gardening therapy can relieve patients' symptoms and improve patients' function.

目的 观察动静平衡康复训练对胫骨平台骨折术后患者平衡和行走功能的影响。方法 将2012年7月—2014年12月100例胫骨平台骨折患者,随机分为两组,每组50例。对照组术后展开常规康复训练,观察组实施动静平衡康复训练,观察两组膝关节功能、康复效果以及肌力恢复情况。结果 观察组患者的膝关节功能优良率为98.0%,高于对照组的60.0%,差异有统计学意义(P＜0.05)。观察组患者的Lysholm评分,高于对照组(P＜0.05)。观察组患者的肌力恢复情况,优于对照组(P＜0.05)。结论 基于“动静平衡”理念针对胫骨平台骨折患者实施术后康复指导与训练,有利于促进患者关节功能以及肌力恢复,巩固康复疗效,在训练过程中实现动态平衡,具有积极的临床意义。

Objective To investigate the static and dynamic balance rehabilitation training on the tibial plateau fracture patients balance and walking functions. Methods 100 cases of patients with tibial plateau fractures from July 2012 to December 2014, were randomly divided into two groups, 50 cases of each group. The control group was launched conventional rehabilitation, observation group received static and dynamic balance rehabilitation training. The knee function, rehabilitation and muscle recovery of the two groups were observed and statistically analyzed. Results The knee function excellent rate of observation group was 98.0%, significantly higher than control group 60.0%, there was statistical significance(P＜0.05). Lysholm score of observation group was higher than control group(P＜0.05). Muscle recovery of observation group was better than control group(P＜0.05). Conclusion Based on the “static and dynamic balance” concept for tibial plateau fractures postoperative rehabilitation for patients with guidance and training, and it will be promoting joint function in patients with muscle recovery and consolidate the recovery effect, to achieve dynamic equilibrium in the training process, with positive clinical significance.

目的 探讨FLT3及C-kit基因突变在急性髓细胞白血病(AML)中的临床意义。方法 回顾性分析南方医院2010年1月—2013年12月期间初诊AML患者的临床资料,PCR分析FLT3及C-kit基因突变情况。结果 248例初诊AML患者中, FLT3-ITD突变率为16.9%,TKD突变率为3.2%,C-kit8号外显子突变率为1%,17号外显子突变率为5.2%;FLT3-ITD突变更倾向发生于正常染色体核型的AML患者;FLT3突变阳性组及C-kit突变阳性组患者的外周血白细胞数高于基因突变阴性组,染色体核型正常患者的无病生存时间较阴性组缩短(P<0.05)。但是对血红蛋白、血小板及完全缓解率(CR率)并无影响(P>0.05)。结论 FLT3及C-kit突变的AML患者有较差的临床预后。

Objective This study was to investigate the prognostic value of FLT3 and C-kit gene mutations in patients with acute myeloid leukemia (AML). Methods We retrospect and analyzed the data of the 248patients with newly diagnosed AML from January 2013 to December 2010. FLT3 and C-kit gene mutations was detected by Polymerase chain reaction (PCR). Results Among these 248 subjects, the FLT3-ITD mutation rate was 16.9%, FLT3-TKD was 3.2%, C-kit 8 exon mutation rate was 1% and 17exon mutationwas 5.2%. FLT3-ITD mutation likely occurred in AML patients with normal karyotype. The patients with FLT3-ITD mutation or C-kit mutation had significantly higher PWBC and shorter DFS than patients without gene mutations (P< 0.05), but there was no significantly differences in sex, age, Hb, PLT and CR rate of the first course induction chemotherapy among groups (P>0.05). Conclusion Among patients with AML,FLT3-ITD and C-kit mutations were associated with worse prognosis.

目的 回顾分析我院胆石症患者个体化治疗方案的效果。方法 2006年8月—2015年1月,我院治疗不同类型胆石症患者3176例,其中胆囊结石2987例,其他类型胆管结石患者189例,定期复查B超等影像检查并最长随访9年,从并发症和术后主观症状、残石率和结石复发率等情况,了解治疗效果。结果 全组患者均手术成功, 大部分自觉症状明显好转,胆囊结石患者平均手术时间(35.7±14.5)分钟, 平均住院时间(3.5±2.5)天;胆管结石平均手术时间(70.3±31.5)分钟,平均住院时间(9.5±4.7)天。胆囊结石残留率0.1%,保胆术式结石复发率8.1%;胆管结石残留率3.7%和复发率5.5%。结论 胆石症患者病情繁杂多样,尤其是肝内胆管结石,治疗需要个体化。

Objective To retrospective analyze the effect of individualization treatment of calculus of cholelithiasis patients. Methods 3176 patients with different kind of cholelithiasis were treated in our hospital during Aug 2006 to Jan, 2015, including 2987 gallstone patients and 189 calculus of bile duct patients. Periodic review of B ultrasound and follow-up was taken after the surgery for 9 years, recording and analyzing intraoperative and postoperative complications, symptoms, residual stones and stone recurrence rate and other, and to evaluate the therapeutic effect. Results Surgeries of all the patients were performed successfully. Postoperative follow-up indicated that symptoms were relieved. The operative duration of gallstone patients was (35.7 ± 14.5) min, and the average hospitalization time was (3.5±2.5) days. The operative duration of calculus of bile duct patients was (70.3± 31.5) min, and the average hospitalization time was (9.5±4.7) days. And the calculus residual rate and recurrence rate of gallstone patients was 0.1% and 8.1% individually. The calculus residual rate and recurrence rate of calculus of bile duct patients was 3.7% and 5.5%. Conclusion Conditions of calculus of cholelithiasis patients are complicated, especially calculus of intrahepatic duct patient. It is necessary to take individual treatment schedule for them.

目的 分析风险管理在老年患者护理管理中的应用效果。方法 随机抽取于2013年1月—2014年1月来我院治疗的270例老年患者作为研究对象,采用随机数字表法,分为对照组和观察组,每组各135例,对照组采取常规护理管理,观察组在对照组基础上实施风险管理,观察对比两组患者的风险事件发生率及护理满意度。结果 观察组风险事件发生率为10.37%,对照组的风险事件发生率为43.70%,差异有统计学意义(P<0.05);观察组护理满意度为98.52%,对照组护理满意度为79.26%,差异有统计学意义(P<0.05)。结论 老年患者护理管理工作中实施风险管理的临床效果显著,降低事故发生,同时提高护理满意度,在临床中具有良好的应用价值。

目的 探讨老年患者在手部静脉输液后用手握塑料输液瓶固定法的效果及患者手部的舒适度。方法 将160例次手部静脉输液患者随即分为试验组和对照组,试验组在静脉穿刺成功固定后再采用手握塑料输液瓶固定法固定手部,对照组在静脉穿刺成功固定后后再采用传统夹板固定法固定手部。结果 试验组患者在静脉输液中手握输液瓶固定的效果和舒适度高于对照组(P<0.05)。结论 手握塑料输液瓶固定法能减少针头移动或滑脱,减少老年患者在长时间输液时的疲劳感,增加舒适感,满意的固定效果有效地保证静脉输液顺利进行,减少重复穿刺,提高患者满意度。