《广州医药》
点击关注官方服务号追踪稿件状态

【重要服务提醒】《广州医药》杂志服务号已上线稿件查询功能

各位作者、审稿专家:
本刊官方微信服务号新增稿件状态查询服务,无需反复登录投稿系统,微信即可随时查看审稿进度、修回通知、录用结果,稿件更新实时推送提醒,同步接收期刊征稿、学术资讯。

操作方式

微信搜索关注广州医药杂志服务号 → 点击菜单栏「绑定账号」→ 输入投稿邮箱完成账号关联;请关闭微信消息免打扰,避免遗漏稿件通知。

《广州医药》编辑部

广州医药杂志服务号
护理研究

远程药学管理模式联合延续护理在2型糖尿病合并冠状动脉病变患者居家用药中的研究

Study on home medication of type 2 diabetes patients with coronary artery disease by remote pharmaceutical management mode combined with continuous nursing

:427-431
 
目的 探讨远程药学管理模式联合延续护理在2型糖尿病(T2DM)合并冠状动脉病变患者居家用药中的应用效果。方法 选取2021年6月—2023年6月在广州医科大学附属第三医院诊治的200例T2DM合并冠状动脉病变患者为研究对象,根据干预方式不同分为常规组100例和研究组100例。常规组患者给予院内院外常规护理,研究组在常规组的基础上给予远程药学管理模式联合延续护理。评估患者用药依从性、饮食依从性、运动依从性、自我管理能力、生活质量[36条目简明健康量表(SF-36)]及心血管事件发生情况。结果 研究组用药、饮食、运动依从性均高于常规组(P<0.05)。相较于干预前,两组患者在干预后的自我管理机能、自我责任感、自我概念及健康知识分值均升高,且研究组高于常规组(P<0.05)。相较于干预前,两组患者在干预后的活力(VT)、精神健康(MH)、情感职能(RE)、躯体疼痛(BP)、生理功能(PF)、社会功能(SF)、生理职能(RP)、总体健康(GH)分值均升高,且研究组高于常规组(P<0.05)。研究组与常规组患者心血管不良事件发生率分别为2例(2.00%)、15例(15.09%),研究组高于常规组(χ2=10.865,P<0.05)。结论 远程药学管理模式联合延续护理能够提高T2DM合并冠状动脉病变患者的用药管理依从性,提高患者自我管理能力,改善生活质量,降低不良心血管事件的发生率。
Objective To explore the application effect of remote pharmacy management mode combined with continuous nursing in the home medication of type 2 diabetes mellitus(T2DM)patients with coronary artery disease.Methods A total of 200 patients with T2DM complicated with coronary artery diseases who were diagnosed and treated in the Third Affiliated Hospital of Guangzhou Medical University from June 2021 to June 2023 were selected as the study subjects.They were divided into a conventional group of 100 patients and a study group of 100 patients based on different intervention methods.The patients in the conventional group received routine care both in and out of the hospital,while the study group received remote pharmaceutical management mode combined with continuous care on the basis of the conventional group.Patient medication compliance,dietary compliance,exercise compliance,self-management ability,quality of life[36 item concise health scale(SF-36)] and incidence of adverse cardiovascular events were assessed.Results The compliance of medication,diet and exercise in the study group were significantly higher than those in the conventional group(P<0.05).Compared to before intervention,the self-management function,sense of responsibility,self-concept and health knowledge scores of both groups of patients were significantly increased after intervention,and the scores of the study group were significantly higher than those in the conventional group(P<0.05).Compared to before intervention,the Vitality(VT),Mental Health(MH),Emotional Function(RE),Physical Pain(BP),Physiological Function(PF),Social Function(SF),Physiological Function(RP)and Overall Health(GH)scores of both groups of patients were significantly increased after intervention,and the scores of the study group was significantly higher than those of the conventional group(P<0.05).The incidence of cardiovascular adverse events in the study group and the conventional group were 2 cases(2.00%)and 15 cases(15.09%),respectively,with the study group significantly higher than the conventional group(χ2=10.865,P<0.05).Conclusions The combination of remote pharmaceutical management mode and continuous care can significantly improve the medication management compliance of T2DM patients with coronary artery disease,improve their self-management ability,improve the quality of their life and reduce the incidence of adverse cardiovascular events.
论著

间歇经口至食管管饲法联合自创吞咽功能训练在脑卒中吞咽障碍患者的应用研究

Application of intermittent oral to esophageal feeding combined with self created swallowing function training in stroke patients with swallowing disorders

:680-685
 
目的 探讨间歇经口至食管管饲法与自创吞咽功能训练联合应用于脑卒中吞咽障碍患者的效果。方法 选取河南大学淮河医院2022年1月—2023年12月收治的50例脑卒中吞咽障碍患者,应用随机数字表法将其分为两组,每组各25例。对照组采取持续留置鼻饲的同时应用自创吞咽功能训练进行训练,观察组采取间歇经口至食管管饲的同时应用自创吞咽功能训练进行训练。对比两组吞咽障碍改善情况、干预前后营养状况指标及生活质量变化,比较两组并发症发生率。结果 观察组总有效率高于对照组(P<0.05)。干预后两组血清总蛋白、白蛋白和血红蛋白水平和体质量指数均升高,观察组高于对照组(P<0.05)。干预后两组生活质量综合评定量表评分升高,观察组高于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论 对脑卒中吞咽功能障碍患者采取间歇经口至食管管饲法与自创吞咽功能训练,能够更有效改善患者吞咽功能,提升其生活质量,且可降低留置饲管营养支持过程中的并发症发生率。
Objective To explore the application effect of intermittent oral to esophageal feeding combined with self created swallowing function training exercises in stroke patients with swallowing disorders.Methods Fifty stroke patients with swallowing disorders admitted to our hospital from January 2022 to December 2023 were selected and divided into two groups by random number table method,both with 25 cases.Control group patients received continuous nasogastric feeding while using solf created swallowing function training exercises for training,while observation group patients received intermittent oral to oesophageal tube feeding and using solf created swallowing function training exercises for training.The improvement of swallowing disorders,changes in nutritional status indicators and quality of life before and after the intervention were compared,and also the frequency of complications.Results The observation group was generally more effective than the control group(P<0.05).After intervention,the serum total protein,albumin hemoglobin,and BMI levels of both groups of patients increased,with the observation group being higher than the control group(P<0.05).After the intervention,GQOLI-74 score increased in both groups,and the observation group was higher than the control group(P<0.05).The complication rate was lower in the observation group(P<0.05).Conclusions The intervention method of intermittent oral to esophageal tube feeding combined with self created swallowing function training exercises can further improve the swallowing function of stroke patients with swallowing dysfunction,improve their quality of life,and reduce the occurrence of complications during the nutritional support process of feeding tubes.
论著

特发性间质性肺炎(非IPF型)合并弥漫性肺泡出血综合征

Idiopathic interstitial pneumonia(non-IPF type)with diffuse alveolar hemorrhage syndrome:Treatment analysis and literature review

:653-657
 
目的 探讨特发性间质性肺炎(IIPs)[非特发性肺间质性纤维化(IPF)型]合并弥漫性肺部出血综合征患者治疗方案以及应用价值。方法 报道1例IIPs(非IPF型)合并弥漫性肺部出血综合征患者的治疗经过以及结果,结合文献分析治疗IIPs(非IPF型)合并弥漫性肺部出血综合症临床应用价值。结果 该文报道 l 例特发性肺间质肺炎(非IPF型)伴弥漫性肺泡出血综合征的老年男性患者,合并呼吸、循环衰竭,启用静脉-静脉体外膜肺氧合(VV-ECMO)抢救并成功撤机,病情好转出院。结论 IIPs作为病因以及发病机制未明、临床表现多样的一类肺间质性疾病,需临床多学科协作,及早诊断、治疗,才能成功挽救患者。
Objective To explore the treatment plan and application value of idiopathic interstitial pneumonia(non IPF)complicated with diffuse alveolar hemorrhage syndrome.Methods A case of idiopathic interstitial pneumonia(non IPF)complicated with diffuse alveolar hemorrhage syndrome was reported.The clinical application value of treatment of idiopathic interstitial pneumonia(non IPF)complicated with diffuse alveolar hemorrhage syndrome was analyzed combined with the literature.Results A case of idiopathic interstitial pneumonia(non IPF type)with diffuse alveolar hemorrhage syndrome was reported in this paper. Combined with respiratory and circulatory failure,veno-venous extracorporeal membrane oxygenation was used to rescue and successfully wean,and the condition improved and discharged.Conclusions Through the curative effect evaluation of this patient,it is believed that idiopathic interstitial pneumonia,as a kind of pulmonary interstitial disease with unknown etiology and pathogenesis and diverse clinical manifestations,need clinical multidisciplinary cooperation,early diagnosis and treatment,in order to successfully save the patient.
医院管理

价值医疗下公立医院运营管理部门组织架构设计

Research on Organization Structure Design of Operation Management Departments in Public Hospitals from the Perspective of Value-Based Healthcare

:815-819
 
价值医疗下公立医院需转变运营管理模式,建设专门运营管理部门对满足外部政策要求和改善内部运营管理十分必要。通过梳理公立医院开展运营管理的主要任务,确定公立医院专门运营管理部门的职责,设计与承担职责相适应的组织架构,保证专门运营管理部门的职能充分发挥。
Public hospitals need to change the operation management mode under value-based healthcare.It is necessary to build a special operation management department to meet the requirements of external policies and improve internal operation management.By sorting out the operation and management tasks of public hospitals,the responsibilities of the operation management department are determined,and the organizational structure suitable for the responsibilities is designed,so that the construction of specialized operation management department can be effectively implemented.
医院管理

PDCA管理法在医院药事管理中的应用分析

Analysis of the application of PDCA management method in hospital pharmacy management

:810-814
 
目的 分析PDCA管理法在医院药事管理中的应用效果。方法 将我院2 000批药品设置为研究对象,样本纳入的起始、截止时间分别为2022年1月、2022年12月,依据时间对纳入样本开展组别划分,将2022年1月—6月1 000批药品设置为PDCA管理前研究对象,期间接受常规药品管理;将2022年7月—12月1 000批药品设置为PDCA循环法管理后研究对象。对比PDCA管理前后药品不良事件发生率及药事管理质量评分。结果 PDCA循环法管理后药学差错事件发生率低于PDCA循环法管理前,分别为0.30%、1.90%,对比差异有统计学意义(P<0.05);PDCA循环法管理后建立药品质量监控体系、药品调剂制度、抗肿瘤药物分级管理方案和处方管理、临床药师参与四个维度评分较PDCA循环法管理前均有明显提升,分别为18.15±1.83、18.15±1.64、18.22±1.67、18.07±1.84,管理前后评分对比差异具有统计学意义(P<0.05)。结论 医院药事管理采用PDCA管理法可提升药事管理质量,降低药品不良事件发生率,值得应用。
Objective To analyze the application effect of PDCA cycle method in hospital pharmaceutical management.Methods A total of 2 000 batches of drugs in our hospital were included as research objects,the inclusion start and end of samples were January 2022 and December 2022.The included samples were divided into groups according to the time,1 000 batches of drugs from January 2022 to June 2022 were included as research objects before PDCA management,during which they were subjected to routine drug management.1 000 batches of drugs from July 2022 to December 2022 were included as the research objects under management by PDCA cycle method.The incidence of adverse drug events and the quality score of drug administration before and after PDCA administration were compared.Results The incidence of pharmaceutical error events after PDCA cycle management was lower than that before PDCA cycle management,which were 0.30% and 1.90%,respectively,and the differences were statistically significant(P<0.05).After PDCA cycle management,the scores of establishment of drug quality control system(18.15±1.83),drug dispensing system(18.15±1.64),anti-tumor drug grading management scheme and prescription management(18.22±1.67),clinical pharmacist participation(18.07±1.84)were significantly improved compared with those before PDCA cycle management,and the difference between scores before and after PDCA cycle management was statistically significant(P<0.05).Conclusions PDCA cycle can improve the quality of pharmaceutical management and reduce the incidence of adverse drug events,which is worthy of application.
论著

个体化肠内营养支持在胃肠术后早期应用的临床观察

Personalized enteral nutrition support in early-stage postoperative gastrointestinal surgery:A clinical observation

:786-790
 
目的 探讨个体化肠内营养支持在胃肠术后早期应用的可行性及安全性。方法 选取2022年1月—12月安徽省亳州市中医院普通外科收治的胃肠手术患者100例。使用随机数字表法将患者随机为观察组和对照组,每组各50例。观察组在常规治疗基础上实施个体化肠内营养,持续7 d。对照组则接受术后常规处理。术后第7天测定实验室指标,并比较两组胃肠功能的恢复情况。结果 观察组术后肛门首次排气时间短于对照组[(55.41±19.63)h vs (81.46±19.39) h],前白蛋白水平高于对照组[(241.14±65.73)g/L vs(217.35±51.63)g/L],组间比较差异有统计学意义(P<0.05)。血清总蛋白水平[(70.55±18.89)g/L vs (68.16±20.05)g/L]、血清白蛋白水平[(53.22±17.76)g/L vs(50.76±18.54)g/L]、淋巴细胞计数[(1.60±0.54)×109/L vs (1.56±0.55)×109/L]以及肛门排便时间[(89.67±22.31)h vs (97.77±21.27)h ]在组间比较差异无统计学意义(P>0.05)。结论 根据个体情况在胃肠术后早期实施个体化的肠内营养支持是安全可行的,能够促进胃肠功能的快速恢复,从而改善患者的营养状况。
Objective To investigate the feasibility and safety of personalized enteral nutrition support during the early postoperative period of gastrointestinal surgery.Methods A total of 100 patients who underwent gastrointestinal surgery at the Department of General Surgery,Bozhou Hospital of Traditional Chinese Medicine,who were enrolled in this study during January 2022 to December 2022.Patients were randomly allocated into either the observational or control group,with 50 patients in each group.The randomization was performed using a random number table.The observational group received personalized enteral nutrition support in addition to routine treatment for 7 days.The control group received standard postoperative care.Laboratory indicators were measured on the 7th postoperative day to compare recovery of gastrointestinal function between the two groups.Results The observational group exhibited a significantly shorter time to the first passage of flatus from the anus compared to the control group(55.41±19.63 h vs 81.46±19.39 h,P<0.05),as well as higher prealbumin levels(241.14±65.73 g/L vs 217.35±51.63 g/L,P<0.05).However,there were no significant differences between the two groups in terms of serum total protein levels(70.55±18.89 g/L vs 68.16±20.05 g/L),serum albumin levels(53.22±17.76 g/L vs 50.76±18.54 g/L),lymphocyte counts[(1.60±0.54)×109/L vs (1.56±0.55)×109/L],and time to the first defecation from the anus(89.67±22.31 h vs 97.77±21.27 h)(all P>0.05).Conclusions Personalized enteral nutrition support based on individual conditions is safe and feasible in the early postoperative period of gastrointestinal surgery.It can promote the rapid recovery of gastrointestinal function and improve patients' nutritional status.
论著

常见炎性指标与进展性脑梗死病灶损害程度的关联及对预后的预测效能分析

Analysis of the correlation between common inflammatory indicators and the degree of damage to progressive cerebral infarction lesions and their predictive efficacy for prognosis

:764-769
 
目的 分析常规炎性指标与进展性脑梗死(PCI)患者病灶损害程度的关联,及其对预后水平的预测效能。方法 采用回顾性研究,纳入2021年6月—2023年2月平顶山市第二人民医院收治的100例PCI患者,根据入院时神经功能缺损评分(NIHSS)结果,将NIHSS评分≥21分的30例患者列为重度组,将NIHSS评分15~20分的35例患者列为中度组,将NIHSS评分<15分的35例患者列为轻度组,比较三组患者的神经功能血清学指标及炎症指标,经Pearson相关性分析炎症指标与神经功能血清学指标的相关性;根据是否发生不良预后将入组患者分为预后良好组和预后不良组,比较两组患者各炎症指标及改良Rakin量表(mRS)评分间的差异,并通过绘制受试者操作特征(ROC)曲线、曲线下面积(AUC)评估炎症指标对PCI患者预后水平的预测效能。结果 重度组患者的C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)分别为(26.44±5.18)mg/L、(95.28±10.46)ng/L、(45.24±10.31)pg/mL,均高于中度组[(23.12±5.46)mg/L、(90.44±10.17)ng/L、(40.25±10.18)pg/mL],轻度组[(20.28±5.33)mg/L、(84.33±10.27)ng/L、(35.62±8.45)pg/mL],差异具有统计学意义(P<0.05)。重度组的神经元特异性烯醇化酶(NSE)、S100钙结合蛋白β(S100β)分别为(25.45±5.69)μg/L、(60.45±10.31)ng/mL,均高于中度组[(22.18±5.36)μg/L、(55.27±10.46)ng/mL],轻度组[(19.44±5.37)μg/L、(50.49±10.25)ng/mL],差异具有统计学意义(P<0.05)。经Pearson相关性分析,PCI患者的CRP、IL-6、TNF-α等常见炎性指标水平与NSE、S100β等神经功能血清学指标水平正相关(P<0.05)。经检测,预后不良组的CRP、IL-6、TNF-α、mRS分别为(26.62±5.31)mg/L、(96.77±10.24)ng/L、(47.25±10.33)pg/mL、(4.24±1.33)分,均高于预后良好组[(23.75±5.44)mg/L、(91.25±10.37)ng/L、(41.12±10.44)pg/mL,(3.36±0.27)分],差异具有统计学意义(P<0.05)。经ROC曲线验证,CRP、IL-6、TNF-α等常见炎性指标水平越高,PCI患者的mRS评分越高(AUC均>0.85)。结论 CRP、IL-6、TNF-α等常见炎性指标会随PCI患者脑神经功能损伤程度加剧而不断升高,与病灶损害程度正相关;通过检测上述炎性指标能实现对患者不良预后的早期预测。
Objective To analyze the correlation between routine inflammatory indicators and the degree of lesion damage in progressive cerebral infarction(PCI) patients,as well as predictive efficacy of indicators on prognosis levels.Methods This is a retrospective study,with case enrollment from June 2021 to February 2023.The study subjects were 100 PCI patients.Based on the NIHSS score at admission,30 patients with a NIHSS score ≥ 21 were classified as the severe group,35 patients with a NIHSS score of 15~20 were classified as the moderate group,and 35 patients with a NIHSS score <15 were classified as the mild group.The neurological function serological and inflammatory indicators of the three groups of patients were compared.The correlation between inflammatory indicators and neurological serological indicators was verified by Pearson correlation coefficient.According to the occurrence of adverse prognosis,enrolled patients were divided into good prognosis group and poor prognosis group.The differences in inflammatory indicators and mRS scores between the two groups were compared,and the predictive power of inflammatory indicators on the prognosis level of PCI patients was evaluated by plotting ROC and observing AUC.Results After testing,the levels of CRP,IL-6 and TNF in the severe group were(26.44±5.18)mg/L,(95.28±10.46)ng/L and(45.24±10.31)pg/mL,respectively,higher than those in the moderate group[(23.12±5.46)mg/L,(90.44±10.17)ng/L and(40.25±10.18)pg/mL]and the mild group[(20.28±5.33)mg/L,(84.33±10.27)ng/L and(35.62±8.45)pg/mL](P<0.05).NSE and S100β in the severe group were(25.45±5.69)μg/L and(60.45±10.31)ng/mL,all higher than those in the moderate group[(22.18±5.36)μg/L,(55.27±10.46)ng/mL]and mild group[(19.44±5.37)μg/L,(50.49±10.25)ng/mL](P<0.05).According to Pearson correlation coefficient test,CRP,IL-6,TNF-α and mRS in PCI patients positively correlated with NSE,S100β(P<0.05).After testing,CRP,IL-6,TNF-α and mRS in the group with poor prognosis were(26.62±5.31)mg/L,(96.77±10.24)ng/L,(47.25±10.33)pg/mL and(4.24±1.33)scores,respectively,which were higher than those in the group with good prognosis[(23.75±5.44)mg/L,(91.25±10.37)ng/L,(41.12±10.44)pg/mL and(3.36±0.27)scores](P<0.05).Verified by ROC curve,the higher the levels of CRP,IL-6 and TNF- α,the higher the mRS scores of PCI patients(AUC>0.85).Conclusions Common inflammatory indicators such as CRP,IL-6 and TNF- α of PCI will continue to increase with the severity of brain nerve function damage in patients,and are positively correlated with the degree of lesions damage.By detecting the aforementioned inflammatory indicators,early prediction of poor prognosis can be achieved for patients.
医院管理

医科类高校研究生校院二级管理体制现状与对策研究

Research on current situation and countermeasures of secondary management system of graduate students in medical colleges and universities

:1089-1094
 
目的 以临床二级学院附属医院的管理为例,对当下医科类高校研究生校院二级管理存在问题进行探讨。方法 对某医科高校附属医院474名临床医学研究生及9名辅导员进行调查。结果 55.56%的研究生表示导师的约束力最大,但42.56%的学生与导师是不定期沟通;39.83%的学生不认可在培养方式上严格区分培养,其中学术型硕士二年级学生中44.3%认为有一定区别,但区别不大;学院配备的学生工作管理专职人员不足、学院层级的管理制度和机制不健全和二级学院权责不清运行机制不顺畅。结论 明确医科类高校与二级附属医院之间的关系、提高治理效能激活医科类高校二级附属医院人才培养的自主性和内生动力、医科类高校二级附属医院研究生施行差异化培养和整合资源,共同提升医科高校与附属医学院的整体水平。
Objective To discuss the existing problems of secondary management in medical colleges and universities,taking the management of secondary college of affiliated hospital as an example.Methods Through the investigation of 474 clinical medical graduate students and 9 counselors in the affiliated hospital of a medical university.Results There was 55.56% of the graduate students said that the supervisor was the most binding force,but 42.56% of the students communicated with the supervisor irregularly;39.83% of the students do not recognize the strict differentiation of training methods,44.3% of the students in the second year of study believed that there was a certain difference,but the difference was not big.The college was equipped with insufficient full-time staff for student work management,the management system and mechanism at the college level were not perfect,and the power and responsibility of the second-level college were not clear and the operation mechanism is not smooth.Conclusions Clarify the relationship between medical colleges and secondary affiliated hospitals,improve governance efficiency and activate the autonomy and endogenous motivation of talent training in secondary affiliated hospitals of medical colleges and universities,implement differentiated training the graduates of secondary affiliated hospitals of medical colleges and universities,integrate resources,so as to jointly improve the overall level of medical colleges and universities and affiliated medical schools.
论著

早产儿语言-社会行为发育差异的回顾性研究

A retrospective study of language-social behavior developmental differences in preterm infants

:1054-1059
 
目的 探讨早产儿语言-社会行为情况及其影响因素,研究语言-社会行为发育与智能发育之间的关系,为早产儿保健提供指导。方法 采用自制的一般情况问卷对125例早产儿开展随访、追踪,直至2岁时,采用盖泽尔发展量表(GDS)进行语言-社会行为及智能发育评估。结果 早产儿语言发育正常43例(34.4%),社会行为发育正常40例(32%)。早产儿语言发育商平均为(67.99±25.75),社会行为发育商平均为(67.75±23.98),处于发育低下水平。性别、脑出血病史、定期随访史、康复干预史、家庭干预史在语言、社会行为方面比较差异均无统计学意义(P>0.05)。不同胎儿期安胎史、胎龄、出生体质量在语言、社会行为方面比较差异有统计学意义(P<0.05);且胎儿期反复安胎,胎龄小,出生体质量低,语言及社会行为发育较差。与出生时无中-重度窒息史的患儿相比,出生时有中-重度窒息的患儿存在更多的语言发育异常,比较差异有统计学意义(P<0.05);但在社会行为发育方面比较差异无统计学意义(P>0.05)。语言-社交行为发育落后的同时,早产儿的大运动、精细动作、适应性行为也存在落后,五大能区比较差异并均有统计学意义(P<0.05)。结论 多数早产儿存在语言-社会行为发育落后,其同时可能伴有更多的运动和适应行为发育问题;语言-社交行为发育落后的患儿在胎儿期存在反复安胎且胎龄较小、出生体质量更低或有中-重度窒息史。对早产儿的语言-社会行为要及时给予关注,早期发现并早期干预,改善预后。
Objective To explore the language-social behavior of preterm infants and its influencing factors,to study the relationship between language-social behavior development and intellectual development,and to provide guidance for preterm infants' health care.Methods A self-administered general questionnaire was used to follow up 125 preterm infants until the age of 2 years,and Gesell development scale(GDS)was used to assess their language-social behavior and intellectual development.Results Preterm infants had normal language development in 43 cases(34.4%)and normal social behavioral development in 40 cases(32%).The mean language development quotient of preterm infants was(67.99±25.75)and the mean social behavioral development quotient was(67.75±23.98),which was at the low developmental level.There were no significant differences in gender,history of cerebral hemorrhage,regular follow-up,rehabilitation intervention,family intervention and language or social behavior(P>0.05).Infants with different fetal age history,gestational age,and birth weight varied significantly in language and social behavior(P<0.05);and with repeated miscarriage,small gestational age,low birth weight,showed poor language and social behavior development.Compared the children with and without moderate to severe asphyxia at birth,there was statistically significant differences in language development(P<0.05),but in social behavior there was no significant difference(P>0.05).The backward development of language-social behavior was accompanied by backwardness in gross motor,fine motor,and adaptive behavior in preterm infants,and the differences in the five major domains were all present and statistically significant(P<0.05).Conclusions A major of preterm infants have poor language-social behavior development,which may be accompanied by more motor and adaptive behavior development problems;children with poor language-social behavior development have repeated miscarriage prevention at younger gestational ages,lower birth weights,or a history of moderate-to-severe asphyxia during the fetal period.It is important to give timely attention to language-social behavior in preterm infants for early detection and early intervention to improve prognosis.
论著

恶性梗阻性黄疸患者行经皮肝穿刺胆道引流术后出院准备度现状及其影响因素

Current status and influencing factors of discharge readiness in patients with malignant obstructive jaundice undergoing percutaneous liver puncture biliary drainage surgery

:1020-1026
 
目的 分析恶性梗阻性黄疸患者实施经皮肝穿刺胆道引流术后出院准备度情况,探究此类患者出院准备度的影响因素。方法 选择2020年9月—2023年4月于天津市人民医院消化内科接受经皮肝穿刺胆道引流术的80例恶性梗阻性黄疸患者,选择院内系统对入组患者的性别、年龄等资料进行统计,并使用出院准备度量表评估患者出院准备度,应用出院指导质量量表评估患者出院指导质量,选择Pearson相关性分析的措施对影响患者出院准备度和出院指导质量的关联进行分析,并分析患者出院准备度影响因素。结果 合并慢性疾病以及居住方式方面,不同亚组患者间出院准备度得分比较差异具有统计学意义(P<0.05);Pearson相关性分析显示出院准备度量表各维度得分与出院指导质量得分呈正相关(均P<0.05);Logistic回归分析显示,居住方式得分为出院准备度量表得分的独立影响因素(P<0.05)。结论 经皮肝穿刺胆道引流术恶性梗阻性黄疸患者出院准备度得分较低,通过改变患者居住方式、提高患者出院指导质量,将有助于提高患者出院准备度。
Objective To analyze the discharge readiness of patients with malignant obstructive jaundice after percutaneous transhepatic biliary drainage,and explore the influencing factors of discharge readiness of such patients.Methods A total of 80 patients with malignant obstructive jaundice who underwent percutaneous transhepatic biliary drainage in Tianjin People's Hospital from September 2020 to April 2023 were selected as the research objects.The data such as sex and age of the patients were statistically analyzed in the hospital system,and the discharge readiness scale was used to evaluate the discharge readiness of the patients.The discharge guidance quality scale was used to evaluate the discharge guidance quality of patients.Pearson correlation analysis was selected to analyze the relationship between the discharge readiness and the discharge guidance quality,analyze factors influencing patient discharge readiness.Results There was a statistically significant difference(P<0.05)in the comparison of discharge readiness scores between different subgroups of patients with combined chronic diseases and living habits.Pearson correlation analysis showed that the scores of each dimension of the discharge readiness measurement table were positively correlated with the scores of discharge guidance quality(all P<0.05).Logistic regression analysis showed that the residential style score was an independent influencing factor(P<0.05)for the discharge readiness scale score.Conclusions The discharge readiness score of patients with malignant obstructive jaundice undergoing percutaneous liver puncture biliary drainage was low.By changing the patient's living style and improving the quality of discharge guidance,will help to improve the patient's discharge readiness.
出版者信息








《广州医药》公众号