目的 分析曲普瑞林联合腹腔镜下卵巢囊肿剥除术治疗卵巢子宫内膜异位囊肿(OEC)患者的效果。方法 选取我院2019年1月—2020年5月期间收治的OEC患者108例,采用随机抽签法分成研究组与对照组,各54例。对照组行腹腔镜下卵巢囊肿剥除术治疗,研究组基于对照组加用曲普瑞林治疗,统计对比2组疗效、妊娠率以及术前、术后6个月、1年血清性激素水平[卵泡刺激素(FSH)、黄体生成素(LH)、抗苗勒管激素(AMH)]、血清高迁移率组蛋白B1(HMGB1)、视黄醇结合蛋白4(RBP4)、糖类抗原125(CA125)水平。结果 研究组治疗总有效率92.59%高于对照组75.93%(P＜0.05);术后6个月、1年研究组LH、FSH低于对照组,AMH高于对照组(P＜0.05);术后6个月、1年研究组CA125、RBP4、HMGB1低于对照组(P＜0.05);研究组妊娠率59.26%高于对照组29.63%(P＜0.05)。结论 曲普瑞林联合腹腔镜下卵巢囊肿剥除术治疗OEC患者时,可改善性激素水平,提高妊娠率,降低血清CA125、RBP4、HMGB1水平。

目的 了解精神科护士的临床决策意识与其情绪智力水平的相关性。方法 采用护理临床决策量表(CDMNS),情绪智力量表(WLEIS)对来自广州市3家医院的230名精神科护士进行问卷调查,并对结果进行相关性分析。结果 精神科护士临床决策意识得分为(133.25±14.68)分,情绪智力得分为(74.15±11.77)分,精神科护士临床决策意识总分与情绪智力能力总分呈显著正相关(r=0.413,P＜0.05)。结论 精神科护士临床决策意识、情绪智力为中等水平,提高情绪智力水平有助于提高精神科护士的临床决策能力。

Objective To understand the correlation between the clinical decision-making awareness of psychiatric nurses and their emotional intelligence. Methods Using the clinical decision-making in nursing scale (CDMNS) and Wong & Law emotional intelligence scale (WLEIS), a questionnaire survey was conducted among 230 psychiatric nurses in 3 hospitals in Guangzhou, and correlation analysis was performed on the results. Results The clinical decision consciousness score of psychiatric nurses was (133.25±14.68), and the emotional intelligence score was (74.15±11.77). The total score of clinical decision consciousness of psychiatric nurses was significantly positively correlated with the total emotional intelligence ability score (r=0.413, P<0.05). Conclusions The clinical decision-making awareness and emotional intelligence of psychiatric nurses were at a medium level. Increasing the level of emotional intelligence can help improving the clinical decision-making ability of psychiatric nurses.

目的 了解高职医学生职业决策困难现状及其主要影响因素,提出改善对策。方法 采用分层整群抽样方法,选取广州市某职业院校740名全日制医学生进行问卷调查。结果 被调查高职医学生职业决策困难总平均分值为(3.55±0.647),其中职业规划探索维度均分最低为(3.42±0.797),其它维度均分从低到高分别是职业目标探索(3.49±0.766)、职业信息探索(3.58±0.678)和职业自我探索(3.69±0.659);单因素方差分析结果显示,不同专业、所在专业是否为第一志愿、不同家庭所在地的高职医学生职业决策困难分值均存在差异(P<0.05);多元逐步回归分析结果显示,家庭所在地、学校职业规划指导课程、兼职或见习的经历、学校活动(就业指导讲座、职业规划大赛等)、对所学专业的就业前景很乐观、学校提供了充足的就业信息、曾参加过创新创业大赛,是医学生职业决策困难的预测因素(P<0.05)。结论 高职医学生职业决策困难程度处于中等水平,学校可通过开展有针对性的职业指导,建立系统的职业决策困难测评与干预体系,搭建实践、就业服务平台等方法改善高职医学生职业决策困难状况,为学生提供强有力的支持与保障;政府可加大政策导向,引导高职医学生面向基层就业。

Objective To understand the current situation and main influencing factors of career decision-making difficulties of higher vocational medical students, and put forward improvement countermeasures. Methods The method of stratified cluster sampling was adopted, with 740 full-time medical students from a vocational college in Guangzhou being investigated. Results The average score of career decision-making difficulty of medical students surveyed in higher vocational colleges was (3.55±0.647), in which the average score of the career planning exploration was the lowest (3.42±0.797), and the average scores of other dimensions from low to high were career goal exploration (3.49±0.766), career information exploration (3.58±0.678) and career self-exploration (3.69±0.659). The results of one-way analysis of variance (ANOVA) showed that there were significant differences in the scores of career decision-making difficulties of medical students in higher vocational colleges among different majors, the major being the first choice or not, and different living places (P<0.05). The results of multiple stepwise regression analysis showed that family location, school guidance courses for career planning, part-time or trainee experience, school activities (employment guidance lectures, career planning competitions, etc.), being optimistic about the employment prospects of their majors, schools providing sufficient employment information, and having participated in innovation and entrepreneurship competitions were predictors of difficulties in career decision-making for medical students (P<0.05). Conclusions The difficulty of career decision-making of medical students in higher vocational colleges was in the middle level. Schools can establish a systematic evaluation and intervention system aiming at career decision-making difficulties by carrying out targeted career guidance, and build practice and employment service platform to improve the career decision-making difficulties of medical students in higher vocational colleges, and to provide strong support and security for students. The government can enhance policy guidance for medical students in higher vocational colleges to apply for primary hospital.

目的 针对胆结石手术患者,评价应用快速康复外科(ERAS)理念辅助护理的实践效果,同时分析其对患者术后并发症以及机体康复情况的影响。方法 选取本院在2019年8月—2020月5月间收治的84例胆结石手术患者为研究对象,采取随机数字表法对纳入患者进行随机分组:实施常规护理干预的患者作为本研究的对照组,实施快速康复外科护理干预的患者作为本研究的干预组;对比术后患者并发症发生情况及恢复情况。结果 干预组患者术后拔管、首次肛门排气、排便及住院时间较对照组均有缩短(P<0.05);且干预组穿孔、感染、胰腺炎等总并发症发生几率低于对照组(2.38% vs 14.28%,P<0.05)。结论 在护理胆结石手术患者中,采取快速康复外科护理干预可有效预防多种术后并发症的发生,并能够有效加快患者术后康复进程,建议推广。

Objective To evaluate the practical effect of assisted nursing with the concept of enhanced recovery after surgery (ERAS) for patients underwent cholelithiasis surgery, and analyze its impact on postoperative complications and physical rehabilitation. Methods Eighty-four patients underwent cholelithiasis operation in our hospital from August, 2019 to May,2020 were selected as the research objects, and the patients were randomly divided into two groups by random number table. The control group was given routine nursing intervention, while the observation group was given nursing intervention based on ERAS.The postoperative complications incidence and recovery of patients were compared. Results Data showed that the postoperative extubation time, first anal exhaust, defecation time and hospitalization time in the observation group were significantly shorter than those in the control group (P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group (2.38% vs 14.28%, P<0.05). Conclusions In nursing patients undergoing cholelithiasis surgery, ERAS nursing intervention can effectively prevent the occurrence of a variety of postoperative complications, and can effectively speed up the process of postoperative rehabilitation, which is recommended to popularize.

目的 观察龙氏正骨手法配合浮针临床上治疗颈源性头痛的疗效。方法 将本院80例颈源性头痛患者按1:1随机分为观察组和对照组,观察组采用龙氏正骨手法配合浮针治疗,对照组采用龙氏正骨手法治疗,于1疗程后比较2组临床疗效、疼痛视觉模拟评分(VAS)和颈椎活动度评分(ROM)情况。结果 治疗后两组VAS较治疗前均有改善(P<0.05),观察组较对照组明显(P<0.05)。2组ROM较治疗前均有改善(P<0.05),组间差异无统计学意义(P>0.05)。治疗组的愈显率高于对照组(P<0.05)。结论 龙氏正骨手法配合浮针治疗颈源性头痛能更好地减轻疼痛程度,方便高效。

Objective To observe the clinical effect of Long's bone-setting manipulation combined with floating acupuncture therapy on cervicogenic headache. Methods A total of 80 patients with cervicogenic headache in our hospital were randomly divided into observation group and control group evenly. The observation group was treated with Long's bone-setting manipulation combined with floating acupuncture therapy, and the control group was treated with Long's bone-setting manipulation only. After one course of treatment, the clinical efficacy,pain visual analogue score (VAS) and cervical joint range of motion (ROM) in the two groups were compared. Results After treatment, the VAS of the two groups was improved compared with that before treatment (P<0.05), and the VAS of the observation group was significantly higher than that of the control group (P<0.05). ROM in the two groups was improved compared with that before treatment (P<0.05), and there was no significant difference between the two groups (P>0.05). The effective rate of the treatment group was higher than that of the control group (P<0.05). Conclusions Long's bone-setting manipulation combined with floating acupuncture therapy in the treatment of cervicogenic headache can better reduce the degree of pain, which is convenient and efficient.

目的 探讨胰岛素联合乌司他丁在高脂血症性重症胰腺炎中的临床疗效。方法 研究资料来自广州市花都区人民医院肝胆胰外科自2018年—2020年收治的72例高脂血症性重症胰腺炎患者资料,所有患者按照不同治疗方案随机分为3组,每组各24例。对照组采用急性胰腺炎常规治疗(即生长抑素+液体疗法);乌司他丁组则于常规组上联用乌司他丁;而研究组在常规及联合乌司他丁治疗基础上加用胰岛素强化治疗,比较3组患者腹痛及胃肠功能恢复的时间、甘油三酯下降的水平,治疗前、治疗后第3天、7天的APACHE Ⅱ评分的变化情况。结果 研究组患者腹痛症状缓解及胃肠功能恢复时间均较对照组明显缩短、腹痛症状缓解时间较乌司他丁组缩短,且研究组甘油三酯下降水平较对照组和乌司他丁组快,而研究组第3天和第7天的APACHE-Ⅱ评分较常规组及乌司他丁组低,以上差别均有统计学意义(P<0.05)。结论 胰岛素联合乌司他丁可明显改善高脂血症合并重症急性胰腺炎腹部症状、缩短胃肠功能恢复时间、迅速降低血清甘油三酯水平,对患者近期疗效确切。

Objective To explore curative effect of insulin combined with ulinastatin in therapy of severe hyperlipidemic pancreatitis. Methods A total of 72 patients with hyperlipidemia complicated with severe acute pancreatitis were randomly divided into three groups according to different treatment plans, 24 cases in each group. The regular treatment of acute pancreatitis (somatostatin+liquid therapy) was carried out in control group. Base on the regular treatment of acute pancreatitis, ulinastatin was added in ulinastatin group. Base on the treatment of ulinastatin group, insulin was added in study group, and the time of abdominal pain and gastrointestinal function recovery, glycerin level and the APACHE Ⅱ score before and after treatment among three groups were compared. Results Compared with the control group and ulinastatin group, the time of abdominal pain relief and gastrointestinal function recovery in the study group were significantly shorter, the time of triglycerides level back to normal in the study group was shorter than the other two groups, while at the third and seventh day, the APACHE Ⅱ score of the study group was lower than that of other two groups, with statistical significance (P<0.05). Conclusions Insulin combined with ulinastatin could significantly improve abdominal symptoms of hyperlipidemia complicated with severe acute pancreatitis, promote the recovery of gastrointestinal function, and rapidly reduce the level of serum triglyceride.

目的 探讨自拟补肝益肾壮腰汤联合脊柱推拿、牵引对腰椎间盘突出症(LDH)患者肌电图和腰椎功能的影响及临床效果。方法 选取106例LDH患者采用随机数字表法分为观察组和对照组各53例。对照组行脊柱推拿及牵引治疗,观察组在此基础上加用自拟补肝益肾壮腰汤。记录2组患者治疗前及治疗3个月后的腰椎功能程度[Oswestry功能障碍指数(ODI)]、肌电图[平均功率频率(MPF)、中位频率斜率(MFs)、平均肌电波幅(AEMG)]、运动功能障碍程度[日本骨科协会下腰痛量表(JOA)]及疼痛程度[视觉模拟评分法(VAS)]评估结果差异。结果 治疗3个月后,2组JOA评分、VAS评分及各项肌电图参数(MPF、MFs、AEMG)均较治疗前有提升,且观察组均高于对照组(P均＜0.05);ODI评分则较治疗前下降(P均＜0.05),且观察组低于对照组(P＜0.05)。结论 自拟补肝益肾壮腰汤联合脊柱推拿及牵引能明显改善LDH患者腰椎功能,促进肌力恢复、缓解肌肉疲劳、减轻疼痛,有较高的临床实用价值。

Objective To investigate the effect of self-made Bugan Yishen Zhuangyao decoction combined with spinal massage and traction on electromyography and lumbar function and clinical efficacy in patients with lumbar disc herniation (LDH). Methods A total of 106 patients with LDH were randomly divided into observation group and control group. The control group was treated with spinal massage and traction, and the observation group was treated with self-made Bugan Yishen Zhuangyao decoction on this basis. The degree of lumbar spine function [Oswestry disability index (ODI)], electromyography [mean power frequency (MPF), median frequency slope (MFS), average EMG amplitude (AEMG)], the degree of motor dysfunction [Japanese Orthopaedic Association (JOA) score] and the degree of pain [visual analog scale (VAS)] before and 3 months after treatment were recorded and compared. Results After 3 months of treatment, JOA score, VAS score and EMG parameters (MPF, MFS and AEMG) in the two groups were significantly higher than those before treatment, and those in the observation group were higher (P<0.05); ODI score was significantly lower than that before treatment (all P<0.05), and the observation group was significantly lower than the control group (P<0.05). Conclusions The self-made Bugan Yishen Zhuangyao decoction combined with spinal massage and traction can significantly improve the lumbar function of patients with LDH, promote the recovery of muscle strength, relieve muscle fatigue and pain, and with high clinical practical value.

目的 研究羌活胜湿汤对风湿外感头痛患者的疗效。方法 选择2018年1月—2020年12月我院收治的62例风湿外感头痛患者,随机分为2组。对照组服用5 mg的氟桂利嗪胶囊,每晚1次;观察组联用羌活胜湿汤。比较2组风湿外感头痛患者的有效率,治疗前后的睡眠质量评分和视觉模拟评分法(VAS)评分。结果 观察组风湿外感头痛患者的有效率(96.77%)高于对照组(80.64%) (P<0.05);治疗前,2组风湿外感头痛患者的VAS评分无差异(P>0.05),治疗后,2组风湿外感头痛患者的VAS评分降低(P<0.05),且观察组风湿外感头痛患者的VAS评分更低(P<0.05);治疗前,2组风湿外感头痛患者的夜间苏醒、入睡时间、睡眠深度、早醒、白天情绪、梦境情况、气色和白天身体状况评分无差异(P>0.05),治疗后,2组风湿外感头痛患者的夜间苏醒、入睡时间、睡眠深度、早醒、白天情绪、梦境情况、气色和白天身体状况评分降低(P<0.05),且观察组风湿外感头痛患者的夜间苏醒、入睡时间、睡眠深度、早醒、白天情绪、梦境情况、气色和白天身体状况评分低于对照组(P<0.05)。结论 羌活胜湿汤对风湿外感头痛患者有显著的疗效,与其能明显减轻疼痛程度和改善睡眠质量有关。

Objective To investigate the effect of Qianghuo Shengshi decoction on patients with wind-damp headache. Methods A total of 62 cases of patients with wind-damp headache who were treated in our hospital from January 2018 to December 2020 were selected and divided into two groups randomly. The control group took 5 mg of flunarizine capsules once a night; the observation group took Qianghuo Shengshi decoction additionally. The effective rate, sleep quality score and visual analogue scale(VAS) score before and after treatment were compared between the two groups of patients. Results The effective rate of the observation group (96.77%) was significantly higher than that of the control group (80.64%, P<0.05). Before treatment, the VAS scores of the two groups of patients with exogenous wind-damp headache were not significantly different (P>0.05). After treatment, the VAS scores of the two groups were significantly reduced (P<0.05), and the score drop of the observation group was significant (P<0.05). Before treatment, there were no significant differences in night awakening, sleep time, sleep depth, early awakening, daytime mood, dream condition, complexion and daytime physical condition score between the two groups (P>0.05), after treatment, the scores of night awakening, sleep time, sleep depth, early awakening, daytime mood, dream condition, complexion and daytime physical condition in patients with wind-damp headache in both groups were significantly decreased (P<0.05), and the scores of night awakening, sleep time, sleep depth, early awakening, daytime mood, dream condition, complexion and daytime physical condition in patients with wind-damp headache in the observation group were significantly lower than those in the control group (P<0.05). Conclusions Qianghuo Shengshi decoction had a significant effect on patients with wind-damp headache, and its was related to its ability of significant pain reduction and sleep quality improvement.

目的 探究血清C反应蛋白与白蛋白比值(CRP/ALB)、中性粒细胞与淋巴细胞比值(NLR)、血糖不稳定指数(GLI)水平对重症肺炎患者预后的预测价值。方法 将我院2020年1月—2021年5月收治的126例重症肺炎患者作为研究对象,根据入院治疗28 d的预后情况,分为存活组(93例)和死亡组(33例)。对比2组患者的一般资料,采用多因素Logistic分析重症肺炎患者高危因素,应用ROC曲线评估血清CRP/ALB、NLR、GLI水平对重症肺炎患者预后的预测价值。结果 2组患者一般资料对比,NEU、CRP、APACHEⅡ、CRP/ALB、NLR、GLI水平差异有统计学意义(P<0.05);多因素Logistic回归分析显示APACHEⅡ评分、血清CRP/ALB、NLR、GLI水平是重症肺炎患者死亡的危险因素;ROC曲线分析结果显示,CRP/ALB、NLR、GLI曲线下面积分别为0.837,0.826,0.837。结论 CRP/ALB、NLR、GLI水平对重症肺炎患者预后均具有较高的预测价值,其中以CRP/ALB的预测价值最佳。

Objective To explore the prognostic predictive value of serum CRP/ALB, NLR and GLI in patients with severe pneumonia. Methods A total of 126 patients with severe pneumonia treated in our hospital from January 2020 to May 2021 were divided into survival group (93 cases) and death group (33 cases) according to the prognosis of 28 days of hospitalization. The general data of the two groups were compared, the high-risk factors of patients with severe pneumonia were analyzed by multivariate logistic, and the predictive value of serum CRP/ALB, NLR and GLI levels on the prognosis of patients with severe pneumonia was evaluated by ROC curve. Results There were significant differences in the levels of NEU, CRP, APACHE Ⅱ, CRP/ALB, NLR and GLI between the two groups (P<0.05); multivariate logistic regression analysis showed that APACHE Ⅱ score, serum CRP/ALB, NLR and GLI were the risk factors of death in patients with severe pneumonia; ROC curve analysis showed that the areas under CRP/ALB, NLR and GLI curves were 0.837, 0.826 and 0.837 respectively. Conclusions The levels of CRP/ALB, NLR and GLI had high predictive value in the prognosis of patients with severe pneumonia, among which CRP/ALB had the best predictive value.

目的 探讨艾灸联合五禽戏治疗颈型颈椎病的疗效。方法 选择我院2019年3月—2020年11月收治的116例颈型颈椎病患者作为研究对象,随机分为实验组和对照组,各58例。其中对照组患者给予艾灸常规治疗,观察组患者在上述治疗的基础上外加五禽戏康复治疗。比较2组患者治疗前后的颈部症状积分、颈椎活动度(ROM)评分、McGill疼痛问卷(MPQ)、Northwick Park颈部疼痛量表(NPQ)评分,观察2组疗效、不良反应及预后情况。结果 实验组治疗有效率高于对照组,预后复发率低于对照组(P<0.05)。与治疗前相比,2组患者治疗后的NPQ评分、MPQ 评分、颈部症状积分、ROM评分均降低,且实验组降低更明显(P<0.05)。结论 颈部症状积分、颈椎活动度及NPQ评分可以较好地对五禽戏联合艾灸治疗颈型颈椎病的疗效进行反映评价,具有一定的临床应用价值。

Objective To explore the efficacy of moxibustion combined with Wuqinxi in treating cervical spondylosis. Methods The 116 patients with cervical spondylosis admitted to our hospital from March 2019 to November 2020 were selected as the research objects, and they were divided into experimental group and control group by random number method, with 58 cases in each group. The patients in the control group were given conventional moxibustion treatment, and the patients in the observation group were treated with Wuqinxi rehabilitation therapy on the basis of moxibustion. The scores of neck symptom, cervical spine range of motion (ROM), McGill pain questionnaire (MPQ), Northwick Park neck pain questionnaire(NPQ) scores before and after treatment were compared between the two groups, and the differences in clinical efficacy and prognosis of the two groups were observed. Results The effective rate of treatment in the experimental group was significantly higher than that of the control group, and the recurrence rate was significantly lower than that of the control group (P<0.05). Compared with that before treatment, NPQ score, MPQ score, neck symptom score, ROM score were significantly reduced in both groups after treatment, and the reduction of these indicators was more significant in the experimental group, with statistically significant differences (P<0.05). Conclusions The neck symptom score, cervical ROM and NPQ score could better reveal and evaluate the efficacy of Wuqinxi combined with moxibustion in the treatment of cervical spondylosis, and had certain clinical application value.