目的 分析基于微信平台步行运动训练对慢性充血性心力衰竭(CHF)患者心脏康复水平的影响。方法 本次研究对象来源于梅州市中医医院一内科2020年11月—2021年12月住院的90例CHF患者,根据随机数字表法分组(每组n=45),对比组给予常规药物治疗,观察组在对比组基础上给予基于微信平台步行运动训练治疗,对比两组临床疗效、心脏功能指标、血清NT-proBNP、D-D、6分钟步行距离、日常生活能力评分、明尼苏达心力衰竭生活质量调查表(MLHFQ)评分。结果 观察组临床总有效率(95.56%)高于对比组(66.67%),观察组治疗后左心室舒张末期内径、左心室收缩末期内径均低于对比组,观察组治疗后左室射血分数高于对比组,观察组治疗后血清NT-proBNP、D-D均低于对比组,观察组治疗后6分钟步行距离、日常生活能力评分均高于对比组,观察组治疗后MLHFQ评分低于对比组,P＜0.05(差异均具有统计学意义)。结论 基于微信平台步行运动训练可有效改善CHF患者心功能,抑制NT-proBNP、D-D高表达,提高日常生活能力、生存质量。

Objective To analyze the effect of walking training through Wechat on cardiac rehabilitation of chronic congestive heart failure (CHF) patients. Methods A total of 90 patients with CHF hospitalized in the First Internal Medicine Department of Meizhou Traditional Chinese Medicine Hospital from November 2020 to December 2021 were enrolled in this study. They were divided into two groups according to the random number table method (45 patients in each group).The control group was given routine drug treatment,and the observation group was given walking training through Wechat on the basis of control group. The clinical efficacy,cardiac function indexes,serum NT-proBNP,D-D levels,6-minute walking distance,ability of daily life (ADL) score and Minnesota Living with Heart Failure Questionnaire (MLHFQ) score were compared between two groups. Results The total clinical effective rate of the observation group (95.56%) was higher than that of the control group (66.67%),the LVEDd and LVESd of the observation group were lower than those of the control group after treatment,the LVEF of the observation group was higher than that of the control group after treatment,the serum NT-proBNP and D-D levels of the observation group were lower than those of the control group after treatment,the 6-minute walking distance and ADL score of the observation group were higher than those of the control group after treatment,and the MLHFQ score of the observation group was lower than that of the control group after treatment,P<0.05 (the difference was statistically significant).Conclusions Walking training by Wechat could effectively improve the cardiac function of CHF patients,inhibit the high expression of NT proBNP and D-D,and improve the ability of daily living and quality of life.

目的 探讨弹力带抗阻训练对老年人骨骼肌功能的影响。方法 在我院筛选60例老年人随机分为两组,对照组30例患者采用常规康复训练,观察组30例患者采用弹力带抗阻训练;分别于干预前及干预3月后评价骨骼肌功能,分析跌倒风险指数。结果 对照组干预前后骨骼肌质量指数、握力、歩速以及平衡量表BBS评分比较无差异(P>0.05);观察组干预后骨骼肌质量指数、6 m步速、握力均高于对照组,平衡量表BBS评分低于对照组(P<0.05)。结论 弹力带抗阻训练能够提高老年人骨骼肌质量、改善老年人握力计和歩速,提高平衡能力。

Objective To investigate the effect of elastic band resistance training on skeletal muscle function in the elderly. Methods 60 elderly patients in our hospital were selected and randomly divided into two groups. 30 patients in the control group received conventional rehabilitation training, while 30 patients in the observation group received elastic band resistance training. Skeletal muscle function was evaluated before intervention and 3 months after intervention, and the fall risk index was analyzed. Results There were no significant differences in skeletal muscle mass index, grip strength, pacing and BBS scores of balance scale before and after intervention in the control group (P>0.05). After intervention, the skeletal muscle mass index, 6 m step speed and grip strength of the observation group were all higher than those of the control group, and the BBS score of balance scale was lower than that of the control group (P<0.05). Conclusion The elastic band resistance training can improve the skeletal muscle quality, improve grip strength and pacing, and improve the balance ability in the elderly.

目的 探究客观结构化临床考试(objective structured clinical examination,OSCE)对夜班护士准入培训效果的影响,并总结经验。方法 选取2017年5月—2018年5月期间首次获得执业注册并接受夜班准入培训的护士62名作为研究对象,采用随机数字法划分为观察组和对照组各31例。夜班准入培训时,对照组采用传统的培训考核模式,观察组采用以客观结构化临床考试为理论框架的培训考核模式,考试内容按教学目标设置,并由临床经验丰富的副高级以上导师围绕专业知识、技能、综合能力等对考点进行设计。培训结束后,两组护士均进行客观结构化临床考试、填写教学满意度量表、分析两组护士护理评估能力、健康教育能力、人文关怀、沟通与协调能力、临床思维能力得分的差异。结果 观察组对培训效果的满意度为83.87%,对照组的满意度为54.84%,差异有统计学意义 (P＜0.05);与对照组比较,观察组护士护理评估能力、健康教育能力、人文关怀、沟通与协调能力、临床思维能力及总分上分值明显更高,差异有统计学意义(P＜0.05);6个站点得分中,观察组的平均成绩要高于对照组,对实际临床操作、护理诊断和临床判断方面更具优势,差异有统计学意义(P＜0.05)。结论 客观结构化临床考试培训模式应用在护士夜班准入培训中,有效提高其临床能力及综合能力,提升了护士对培训课程的满意度。

Objective To explore the effect of objective structured clinical examination (OSCE) on the admission training of night shift nurses and to summarize the experience. Methods A total of 62 nurses who received the practice registration and night shift admission training from May 2017 to May 18, 2017 for the first time were selected as the study subjects. They were randomly divided into observation group and control group. For night shift admission training, the control group adopted the traditional training assessment mode, and the observation group adopted the training assessment mode with objective structured clinical examination as the theoretical framework. The examination content was set according to the teaching objectives, and was designed by clinically experienced supervisors at deputy senior level or above revolving the knowledge points of professional knowledge, skills, comprehensive ability. At the end of the trainings, nurses in the two groups took objective structured clinical examinations and filled out the teaching satisfaction scale. The differences in scores of nursing assessment ability, health education ability, humanistic care, communication and coordination ability, and clinical thinking ability in the two groups were analyzed. Results The satisfaction rate in the observation group was 83.87%, higher than that in the control group, which was 54.84%, and the difference was statistically significant (P<0.05). The scores of nursing assessment ability, health education ability, humanistic care, communication and coordination ability, and clinical thinking ability and the total scores in the observation group were higher than those in the control group, and the difference was statistically significant (P<0.05). The average score of knowledge points in the observation group was higher than that in the control group, with the former group boasting more advantages in actual clinical operation, nursing diagnosis and clinical judgment, with statistically significant difference between the two groups (P<0.05). Conclusion The application of objective structured clinical examination in nurse's night shift admission training may help improve their clinical ability and comprehensive ability, as well as their satisfaction to training courses.

目的 探讨实习前护理知识技能评价与实习教学目标相结合的临床护理实习培训效果。方法 选择2018年在我科实习的护理本科实习生40名为对照组,采取传统的带班实习带教方法进行临床带教;2019年在我科实习的40名护理本科实习生为实验组,对实习生在实习前进行护理知识和护理操作能力评估,根据实习生专业知识与护理技术的评估结果,结合实习教学目标进行针对性的临床带教;实习结束对两组同学掌握的护理理论知识、护理操作技术、服务满意度进行评价。结果 实验组掌握的护理知识、护理操作技术得分均高于对照组,两组结果比较差异有统计学意义(P<0.001);服务满意度评价实验组高于对照组,两组结果比较差异有统计学意义(P<0.05);结论 开展实习前护理专业能力评价与教学目标相结合的护理临床实习培训模式管理,有助于带教老师掌握实习生存在的护理知识缺乏和护理技术薄弱问题,利于带教老师制定合理的实习带教计划和带教重点,提高学生临床实习效果和老师的带教质量。

Objective To explore the effect of clinical nursing practice training combined with the evaluation of nursing knowledge and skills and teaching objectives before practice. Methods 40 nursing undergraduates who practiced in our department in 2018 were selected as the control group, and the traditional method of clinical teaching was adopted; 40 nursing undergraduates who practiced in 2019 were selected as the experimental group to evaluate the nursing knowledge and nursing operation ability of the interns before the practice, according to the evaluation results of professional knowledge and nursing technology of the interns, combined with the practice teaching at the end of the internship. The students in the two groups were evaluated on their theoretical knowledge, nursing operation technology and service satisfaction. Results The scores of nursing knowledge and nursing operation technology in the experimental group were higher than those in the control group, and the results of the two groups were statistically significance (P<0.001); the evaluation of service satisfaction in the experimental group was higher than that in the control group, and the results of the two groups were statistically significance (P<0.05); Conclusion To carry out the management of nursing clinical practice training mode combining the evaluation of nursing professional ability with teaching objectives before practice is helpful for the teachers to find out problems of lack of nursing knowledge and weak nursing technology existing in the interns. It helps the teachers to formulate reasonable practice teaching plan and key points, and improves the effect of students' clinical practice and the quality of teaching.

目的 分析融合功能训练在大龄人群行斜视矫正术后建立双眼三级视功能及巩固术后效果的可能性。方法 回顾性研究2008年10月—2016年12月在广州爱尔眼科医院被诊断为共同性斜视并进行手术矫正的患者174例,术后进行融合功能训练。根据术前诊断斜视的类型分成共同性内斜视组、共同性外斜视组、间歇性外斜视组,根据两眼最佳矫正视力差别分为＞2行、≤2行组,训练时对单眼抑制及交叉抑制者先采用脱抑制训练再扩大融合功能训练,具有较小融合范围的矫正术后的患者直接从扩大融合功能开始训练,对比观察斜视手术矫正前和矫正后进行融合训练后融合功能及双眼视情况。结果 斜视矫正术后128例建立了正常的融合范围,随访1年斜视无复发,无视疲劳症状发生。其中共同性外斜视组、共同性内斜视组、间歇性外斜视组进行训练后治疗的有效率分别为32.35%、28.57%、100%,两眼最佳矫正视力相差＞2行和≤2行的有效率分别为11.54%、100%。结论 大龄斜视患者尤其是间歇性外斜视或双眼最佳矫正视力相差在2行以内的患者,经过融合训练均获得良好的双眼视,视疲劳得到改善,斜视手术效果得到巩固。

Objective To analyze the possibility of fusion function training to establish binocular tertiary vision function and consolidate the effect of postoperative strabismus correction in elderly people. Methods Conduct a retrospective study about 174 patients who were diagnosed with common strabismus and had corrective surgery at Guangzhou Aier Eye Hospital from October 2008 to December 2016, and those patients was performed after the fusion function training. According to the type of preoperative diagnosis of strabismus, they were divided into common esotropia group, common exotropia group, intermittent exotropia group. According to the difference of the best corrected visual acuity between the two eyes, they were divided into>2 lines group and ≤2 lines group. Monocular-suppression and cross-suppression patients firstly used de-inhibition training and then expand the fusion-range training. Patients with a smaller fusion range started training directly by expanding the fusion function. We compared and observed the fusion function and binocular condition between before and after strabismus surgery. Results The normal fusion range was established in 128 cases after strabismus correction, and there was no recurrence of strabismus and visual fatigue symptoms after 1 year of follow-up. Among them, the effective treatment rates of the common exotropia group, the common esotropia group, and the intermittent exotropia group after training are 32.35%, 28.57%, and 100%, respectively. The two groups which are divided into>2 lines group and ≤2 lines group are 11.54% and 100%, respectively. Conclusion Elderly patients with strabismus, especially those with intermittent exotropia or within two lines of best corrected visual acuity, have achieved good binocular vision after fusion training, have been improved visual fatigue, and the effect of strabismus surgery is consolidated.

目的 在糖尿病尿失禁女性患者中使用盆底肌功能训练手册,了解该手册对改善糖尿病女性尿失禁的作用。方法 将260例糖尿病尿失禁患者随机分为观察组、对照组,2组均进行常规盆底肌功能训练,每月提醒患者坚持训练,观察组在此基础上发放盆底肌功能训练手册,指导患者及家属填写方法, 每月检查填写记录情况;在治疗前、后评价2组患者尿失禁改善、观察心理健康改善情况。结果 观察组患者在干预后尿失禁改善、心理健康改善优于对照组。盆底肌功能训练手册准确真实反映患者治疗的落实情况,可督促患者落实治疗,从而提高治疗效果,提高患者生活质量。结论 盆底肌功能训练手册对糖尿病尿失禁患者实用性高,尤其对于记忆力下降的糖尿病患者实用性高。

随着时代的发展,医学模式更具综合性,预防医学专业特性不仅体现其医学范畴,其综合性特点日益突出。因此预防医学专业医学生综合素质及创新能力的培养显得愈发重要。为了提高预防医学学生的综合素质及创新能力,我们从预防医学理论教学及实验教学开展了教学改革探讨。

目的 探讨早期功能训练对环状软骨上喉部分切除术后喉癌患者吞咽功能的影响效果。方法 将54例患者按入院时间的先后分为对照组26例和干预组28例,对照组按常规护理,干预组进行早期吞咽功能训练,于患者出院前、出院后1个月和3个月进行效果测评。结果 干预组于出院前、出院后1个月、出院后3个月吞咽功能恢复正常和SSA评分下降优于对照组,两组比较差异均有统计学意义(P＜0.05)。结论 对环状软骨上喉部分切除术后喉癌患者实施早期功能训练可改善患者吞咽功能障碍、促进快速康复。

Objective To investigate the effect of early functional training on the swallowing function of laryngectomy patients after partial laryngectomy with cricoid. Methods According to the admission time, 54 patients were divided into control group (26 cases) and intervention group (28 cases). The control group was given routine nursing, while the intervention group received early swallowing function training. The effect was evaluated before and after discharge, 1 months and 3 months after discharge. Results In the intervention group, the swallowing function returned to normal and the SSA score in the intervention group before discharge, 1 months after discharge and 3 months after discharge was lower than that in the control group. The difference between the two groups was statistically significant (P<0.05). Conclusion Early functional training for laryngectomy patients after partial laryngectomy may improve the patient's swallowing dysfunction and promote rapid rehabilitation.

目的 探讨中药熏洗与膝关节自我锻炼管理对改善老年骨性膝关节炎功能康复效果。方法 选择90例在本院就诊的老年骨性关节炎患者,按数字表法分为观察组和对照组各45例,对照组采用膝关节康复护理知识教育、膝部中药熏洗与揉搓按摩等治疗,观察组在此治疗护理上加强对患者进行膝关节功能训炼和自我活动行为管理;随访6周,评价两组患者膝关节肿胀、疼痛、训练依从性、膝关节功能。结果 膝关节疼痛缓解、肿胀消退观察组优于对照组;膝关节功能康复效果观察组优于对照组,活动训练依从性观察组高于对照组。结论 应用中药熏洗与加强患者膝关节自我活动训炼管理,可缓解膝关节疼痛、减轻膝关节肿胀,改善患者膝关节功能,提高患者自我功能训练的依从性和生活质量。

Objective To explore the effect of traditional Chinese medicine fumigation and knee joint exercise management on the rehabilitation of senile osteoarthritis of the knee. Methods 90 cases in our hospital for treatment of senile osteoarthritis were randomly divided into observation group and control group with 45 cases in each group, the control group used the knee joint rehabilitation nursing knowledge education, herbal fumigation and massage knee treatment; the observation group on the treatment and nursingwith strengthening the function of knee joint training and self behavior management for the patients; 6 weeks of follow-up, we have evaluation of two groups of patients with knee joint swelling, pain, and knee joint function training compliance. Results The knee joint pain, swelling, knee joint function rehabilitation effect in the observation group were better than that of control group; training compliance in the observation group was better than that of control group. Conclusion The application of herbal fumigation and strengthen the self training of patients with knee joint activity management, may relieve the pain of knee joint, swelling and improve knee function. Theirtraining compliance and quality of life have been increased.

目的 探讨精神科急救培训用护士作为标准化病人的培养方法。方法 2013年9月挑选了4名精神科护士参加标准化病人系统培训,考核合格后成为护士标准化病人在2013年10月—11月对30名新护士自缢、噎食急救培训和考核中使用。结果 对急救培训中使用护士标准化病人,30名新护士中认为“新颖,第一次接触”19人(63%)、“满意”的26人(87%);4名作为标准化病人的护士都认为“非常有意义”。结论 精神科急救培训应用护士标准化病人丰富了培训的形式和内涵,得到了绝大部分参与人员的肯定。

Objective To explore the methods of training nurses as standardized patients for psychiatric first aid. Methods 4 nurses were selected to participate in the psychiatric standardized patient training program and all passed the examination. Using these nurse standardized patients to train the 30 new nurses for psychiatric first aid. Results After the first aid training, 19 of the 30 new nurses(63%) felt that it was “novelty and interesting”. 26 nurses(87%) felt “being satisfied”. And those 4 standardized patients felt “very meaningful”. Conclusion Training and application of nurses as standardized patients for psychiatric first aid may enrich the form and content of training program, and gains most of the participants affirmation.