目的 探究甲状腺癌患者对健康知识了解详情和需求,同时提出合理健康教育方案。方法 随机抽取本院2017年11月—2019年5月期间收治的122例甲状腺癌患者为研究对象,通过本院自制的调查问卷对其进行调查,分析和掌握患者对健康知识了解详情和具体需求,同时根据其特点提出合理的健康宣教方式。结果 患者对疾病和生活习惯的联系、定期入院复诊的重要性、临床治疗对疾病的控制详情、具体治疗方案和疗效、疾病临床特征以及疾病详细信息等甲状腺癌相关知识不了解率分别为50.00%、51.64%、72.95%、74.59%、77.87%、8.19%;健康教育内容需求评分较高,需求占比全部高于40%;患者对不同的健康教育形式有着不同的需求,其中需求最高的为护患会议交流,占比98.36%,其次为微信科普知识,占比96.72%,之后依次为播放视频和音频(94.26%)、创建专题讲座(93.44%)、个体指导(91.80%)、电话随访(83.60%)、相同疾病患者经验介绍(80.32%)、宣传栏和宣传册(63.90%)。结论 甲状腺癌患者对健康知识了解较少且需求较大,因此可对患者采取多元化健康知识教育方案,满足不同患者的需求,进而增加患者对疾病的重视程度,有利于患者树立治疗信心、提升其生活质量。

Objective To explore the health knowledge of thyroid cancer patients to understand the details and needs, and put forward a reasonable health education program. Methods 122 patients with thyroid cancer admitted to our hospital from November 2017 to May 2019 were randomly selected as the research objects. Through the questionnaire made by our hospital, we investigated the patients, analyzed and mastered the patients' understanding details and specific needs of health knowledge, and proposed reasonable health education methods according to their characteristics. Results The rates of patients' ignorance about thyroid cancer related knowledge, such as the relationship between disease and lifestyle, the importance of regular admission to hospital, the control details of the disease in clinical treatment, the specific treatment plan and effect, the clinical characteristics of the disease and the detailed information of the disease, were 50.00%, 51.64%, 72.95%, 74.59%, 77.87% and 8.19%, respectively. The score of demand for health education content was high, accounting for more than 40% of the total demand.Patients with different forms of health education had different needs, one of the highest requirements for meeting communication, nurses and patients accounted for 98.36%, followed by WeChat popular science knowledge, accounted for 96.72%, followed by after playing video and audio (94.26%), creating a seminar (93.44%), individual guidance (91.80%), telephone follow-up (83.60%), experience introduction (80.32%),patients with the same disease, publicity column and brochure (63.90%). Conclusion Patients with thyroid cancer have less knowledge of health knowledge and need more health knowledge. Therefore, we may take diversified health knowledge education programs to meet the needs of different patients, and then increase the attention of patients to the disease, which is conducive to the patients to establish treatment confidence and improve their quality of life.

目的 回顾分析我医院近9年产妇行剖宫产术治疗的患者的住院病历资料,探索术后出现切口脂肪液化的危险因素。方法 选取我医院2011年1月—2019年8月期间行剖宫产术治疗的产妇患者1 018例,分成术后切口脂肪液化组和甲级愈合组,比较2组间的差异,分析其相关危险因素。结果 1 018例产妇患者中出现切口脂肪液化的为34例,发生率为3.34%(34/1 018);单因素分析结果显示,糖尿病、体质指数超重、7 cm以上切口长度是术后出现切口脂肪液化的相关因素,差异有统计学意义;多因素Logistic回归分析结果显示,糖尿病、体质指数超重、7 cm以上切口长度是术后出现切口脂肪液化的独立危险因素。结论 产妇患者行剖宫产术治疗出现切口脂肪液化率较高;围手术期控制患者血糖,以及孕期控制体质指数、缩小剖宫产手术切口长度可能有效地减少切口脂肪液化发生率。

Objective To retrospectively analyze the medical records of patients undergoing cesarean section in our hospital in recent 9 years, and explore the risk factors of incision fat liquefaction after operation. Methods 1 018 patients undergoing cesarean section in our hospital from January 2011 to August 2019 were divided into two groups: incision fat liquefaction group and grade A healing group. The differences between the two groups were compared and the risk factors were analyzed. Results Among 1 018 parturients, 34 had incision fat liquefaction, and the incidence was 3.34% (34/1018). Univariate analysis showed that diabetes mellitus, overweight body mass index and incision length of more than 7 cm were risk factors for incision fat liquefaction after operation, and the difference was statistically significant. Multivariate logistic regression analysis showed that diabetes mellitus, overweight body mass index and incision length over 7 cm were independent risk factors for incision fat liquefaction. Conclusion The incision fat liquefaction rate is higher in patients undergoing cesarean section. Controlling blood sugar level, body mass index during pregnancy and shortening the length of incision during perioperative period may effectively reduce the incidence of incision fat liquefaction.

目的 探讨近期大咯血对支气管镜诊疗操作相关出血的影响。方法 回顾性分析2015年12月—2019年12月我院支气管镜操作导致出血超过30 mL患者的临床资料,根据近1周是否发生大咯血,分为观察组(大咯血组)和对照组(无大咯血组),比较2组间的出血量以及大出血、血凝块、窒息的发生率。结果 观察组的出血量以及大出血的发生率高于对照组,2组间差异有统计学意义,血凝块、窒息的发生率两组间差异无统计学意义。结论 近期大咯血的患者支气管镜操作发生大出血的风险高。

Objective To explore the effect of short-term massive hemoptysis on the procedure-related bleeding of bronchoscopy. Methods The clinical data of patients with more than 30 mL bleeding caused by bronchoscopy operation in Guangzhou Chest Hospital from December 2015 to December 2019 were analyzed retrospectively. According to whether massive hemoptysis occurred in the past week, the patients were divided into observation group (massive hemoptysis group) and control group (no massive hemoptysis group). The bleeding volume, the incidence of massive hemorrhage, blood clot and asphyxia were compared between the two groups. Results The amount of bleeding and the incidence of massive hemorrhage in the observation group were higher than those in the control group, that there was a statistical significance between the two groups. There was no statistical significance between the two groups in the incidence of blood clots and asphyxia. Conclusion Patients with recent massive hemoptysis have a higher risk of massive haemorrhage due to bronchoscopy.

目的 了解我院药品不良反应(ADR)发生的规律和特点,为临床合理用药提供参考。方法 收集广州市第一人民医院南沙医院2015年1月1日—2019年12月31日上报国家药品不良反应监测中心的224例ADR,统计分析发生ADR的患者性别、年龄、药品种类、剂型、给药途径、累及系统等情况。结果 224例ADR报告中,女性报告数(51.79%)高于男性(48.21%),50岁以上的病人报告数占48.6%,其中60岁以上属于高发年龄段(30.8%);抗感染药ADR报告数最多(43.3%),其次是心血管系统用药(12.95%),第三是中枢神经系统用药(12.50%);静脉给药ADR报告数最多(57.14%),其次是口服给药(40.18%),剂型因素中,最高为注射液(32.59%),其次为普通片剂(28.57%),第三位粉针剂(24.55%);ADR累及系统中,皮肤及附件损害最多(26.43%),其次是胃肠系统损害(20.70%)和中枢及外周神经系统损害(18.06%);上报来源以药师上报为主(72.77%),护士上报率为0。结论 临床应加强合理用药,尤其抗菌药物使用,减少静脉给药途径,重点关注50岁以上ADR高发人群,加强ADR监测医护宣教,提高ADR上报率和报告质量。

Objective To investigate the occurrence and distribution of adverse drug reaction ADR from 2015 to 2019 in our hospital and provide relevant information for clinical rational usage of medication. Methods 224 ADR reported to National Center were collected from Nansha hospital of Guangzhou First People's Hospital monitoring during 2015~2019.Those ADR were analyzed in terms of gender and age of patients,type of drugs, route of administration,dosage form,etc. Results Among 224 ADR reports,the occurrence rate of ADR in female(51.79%)was higher than male,patients over the age of 50 accounted for 48.6% and age over 60 were at high risk of ADR.The top three of medicine were anti-infectious agent(43.3%),cardiovascular medicine(12.95%)and central nervous system medication(12.50%). Intravenous administration and oral medication accounted for 57.14%,40.18% respectively.For the dosage form factor,the top three were injection (32.59%), ordinary tablet (28.57%) and powder-injection (24.55%).Major systems involved in ADR were lesion of skin and its appendages(26.43%),gastrointestinal system(20.70%),central and peripheral nervous systems(18.06%).Sources of ADR were mainly composed of pharmacist(72.77%)and the nurse reported 0. Conclusion Clinical rational drug use should be strengthen especially antibacterial agents. The intravenous route should be decreased.Patients over the age of 50 deserved special attention. It is necessary to enhance awareness and education of medical workers to improve the reported rate and quality of ADR.

目的 评价贝伐单抗联合肝动脉化疗栓塞治疗原发性肝癌的疗效及不良反应。方法 2名评价员通过独立地检索中英文数据库,纳入随机对照研究,其中治疗组为肝动脉灌注贝伐单抗联合肝动脉化疗栓塞组、对照组为单独肝动脉化疗栓塞组,并通过Jadad量表对纳入文献质量进行评分,最后采用Review Manager 5.2软件进行Meta分析。结果 纳入6篇文献,466例病例。结果显示:在疗效方面,治疗组的3、6个月疾病有效率及疾病控制率,12个月的生存率均高于对照组且差异有统计学意义(P<0.05);在安全性方面,两组间关于发热、转氨酶升高、恶心、黑便的发生率之间的比较无统计学意义(P＞0.05)。结论 肝动脉灌注贝伐单抗联合肝动脉化疗栓塞治疗原发性肝癌与单独肝动脉化疗栓塞比较,能有效提高肝癌患者近期及远期疗效,且并不增加不良反应发生率。

Objective To evaluate the efficacy and side effects of bevacizumab combined with thanscatheter artierial chemoembolzation in the treatment of primary liver cancer. Methods Two reviewers collected data about clinical trials that the combination of bevacizumab and thanscatheter artierial chemoembolzation for treatment of primary liver cancer from data bases. Jadad Score and Review Manager 5.2 software were respectively used to assess the quality of included studies and analyze the obtained data. Results Six randomized controlled trials involving 466 patients were included in this paper. The results of the meta-analysis showed that compared with thanscatheter artierial chemoembolzation group alone, bevacizumab combined with thanscatheter artierial chemoembolzation improved the response rate and disease control rate, prolonged 12 month survival rate (P<0.05). As for side effects, there were no statistically different of those about fever, level of transaminase, nausea and melena between two groups(P>0.05). Conclusion Compared with simple thanscatheter artierial chemoembolzation group, and Bevacizumab combined with thanscatheter artierial chemoembolzation group, the later may improve short-term and long-term effects, and side effects were under control.

目的 分析广州血液中心以“生日献血纪念章”(下称生日纪念章)个性化专属纪念品对献血者的招募保留效果进行分析和研究。方法 2017年—2019年期间,广州血液中心生日当天献血者共11 790名,每半年生日当天献血的献血者人数,绘制折线图,分析2018年7月起“生日纪念章”活动前后,生日当天献血的献血者人数变化;卡方检验对比2组献血人群特征差异,分析该活动敏感人群。结果 2017年—2019年每半年生日当天献血人数总体持续增长,其中2018年7—12月较2018年1—6月,生日当天献血人数增长了406%,增长比例最大。活动前后2组人群性别、年龄、职业及既往献血次数分布差异均有统计学意义(P<0.05)。活动后男性、35岁及以上献血者、工人/职员及其他职业,固定献血者比例增加。结论 广州血液中心的“生日纪念章”活动对生日当天献血有明显的促进效果,其中,男性,年龄35岁及以上,工人/职业/其他职业及固定献血者对该活动更敏感,更可能选择生日当天献血。今后针对女性、25岁以下、学生及初次献血者,注意增加其他招募保留措施。

Objective To analyze the effect of the “Birthday Blood Donation Medal” (hereinafter referred to as the Birthday Medal) personalized souvenir to the blood donor recruitment and retention effect of blood donors in Guangzhou Blood Center. Methods From 2017 to 2019, there were a total of 11 790 blood donors donated blood on their birthday in Guangzhou Blood Center. Aline chart was drawn of the number of blood donors who donated blood on birthday to observe the trends every half a year from 2017 to 2019; Chi-square test was used to compare the characteristics of blood donors in two groups (before and after the “Birthday Blood Donation Medal” activity) and we analyzed the sensitive population of the activity. Results The number of blood donors on the birthday every half year from 2017 to 2019 continued to increase. Among them, the number of blood donors donated on birthday on July-December 2018 increased by 406% compared to the first six months of 2018, which was the largest increase. The differences in gender, age, occupation, and previous blood donation times between the two groups were statistically significant (P<0.05). After the activity, the percentage of male, 35-year-old and above blood donors, workers/clerks and other occupations, and regular blood donors increased. Conclusion The “Birthday Blood Donation Medal” activity in Guangzhou Blood Center has a significant promotion effect on blood donation on birthday. Among them, males, aged 35 and above, workers/occupations/other occupations and regular blood donors are more sensitive to this activity and are more likely to donate blood on birthday. In the future, other recruitment and retention measures should be taken to pay attention to women, under 25 years old, students and first-time blood donors.

目的 探讨影响孕晚期死胎伴胎动减少延迟就诊的临床因素,加强围产期宣教。方法 回顾性分析2017年1月—2019年10月广州市妇女儿童医疗中心住院分娩的孕晚期(孕周≥28周)单胎死胎病例的相关临床资料。结果 在79例死胎中,有59例(74.68%)孕妇感知胎动减少,但只有27人(45.76%)在感知胎动减少后24小时内就诊。妊娠未合并胎儿生长受限可能会导致延迟就诊(P=0.03<0.1)。结论 胎动减少和死胎发生密切相关,但大部分孕妇可能会出现延迟就诊。加强孕期产检,规范孕期宣教,尤其是合并胎儿生长受限等高危妊娠时的孕期严密监测,强调胎动的重要性,在感知胎动减少后强调早期就诊,有助于减少孕晚期死胎风险。

Objective To explore the clinical factors that affect the consultation time of stillbirth after perceptive reduction of fetal movement in the third trimester of pregnancy, and to strengthen the perinatal education. Methods A retrospective analysis of single stillbirth in late pregnancy (gestational weeks≥ 28 weeks) in Guangzhou Women and Children's Medical Center from January 2017 to October 2019 was taken, and the relevant clinical data were summarized and evaluated. Results Out of 79 stillbirth cases, 59 (74.68%) cases had decreased fetal motility. Only 27 pregnant women (45.76%) visited the doctor in 24 hours after they perceived the reduction of fetal movement. Pregnancy without fetal growth restriction may lead to delayed consultation (P=0.03<0.1). Conclusion Perception of decreased fetal movement is closely related to the occurrence of stillbirth, but most pregnant women may have delayed visits. To strengthen the prenatal examination, standardize the propaganda and education during pregnancy, especially the close monitoring of high-risk pregnancy such as fetal growth restriction, emphasize the importance of fetal movement, and emphasize the early consultation after perceiving the reduction of fetal movement, are helpful to reduce the risk of stillbirth in late pregnancy.

目的 探讨噻托溴铵喷雾剂(能倍乐)对合并有前列腺肥大(BPH)的慢性阻塞性肺疾病急性加重的影响。方法 2017年9月—2019年9月在我院呼吸与危重症医学科的AECOPD的男性患者167例,年龄51～96岁,平均(74.26±7.6)岁。分别为AECOPD组、AECOPD+噻托溴铵喷雾剂治疗组。比较AECOPD合并BPH与能倍乐的关系。结果 AECOPD患者合并有BPH的45人(52.94%),能倍乐治疗合并有BPH的AECOPD患者48人(58.53%),两组比较差异无统计学意义(P＞0.05)。其中,AECOPD患者合并有BPH患者中有10人(11.76%)出现尿频、夜尿多;尿潴留的4人(4.7%);同时口服哈乐和保列治的16人(18.82%);要置尿管导尿的5人(5.8%)。能倍乐治疗AECOPD患者合并有BPH患者中有7人(8.53%)出现尿频、夜尿多;尿潴留的1人(1.21%);同时口服哈乐和保列治的20人(24.39%);要置尿管导尿的3人(3.6%),比较差异均无统计学意义(P＞0.05)。结论 能倍乐不增加合并BPH的COPD患者的急性加重;也不增加治疗BPH的药物使用。能倍乐对于稳定期合并BPH的COPD患者治疗是安全的。

Objective To investigate the effect of Spiriva Respimat on acute exacerbation of COPD with benign prostatic hyperplasia(BPH). Methods The 167 patients who were hospitalized for acute exacerbation of chronic obstructive pulmonary disease (COPD)(aged 51～96 years) with an average age of (74.26±7.6) years and the 82 patients treated with Spiriva Respimat in the department of respiratory and critical care medicine of our hospital from September 2017 to September 2019 were reviewed. In our pilot study, 48 AECOPD patients with BPH patients were enrolled as the treatment group and another 45 similar cases as the control group. In the former group Spiriva Respimat was administered and the control group was not. Results There were 45 patients (52.94%) with BPH in AECOPD group and 48 patients (58.53%) with BPH in Spiriva Respimat group. There was no statistical significance between the two groups (P>0.05). Among them, 10 patients (11.76%) with AECOPD and BPH had frequent urination and night urination, 4 patients (4.7%) of urinary retention, 16 patients (18.82%) who had oral Harnal and Finasteride, 5 patients (5.8%) need catheterization. In the AECOPD patients with BPH treated with Spiriva Respimat, 7 patients (8.53%) had frequent urination and night urination, 1 patient (1.21%) had urinary retention, 20 patients (24.39%) had oral Harnal and Finasteride, and 3 patients (3.6%) were managed through catheterization (P>0.05). Conclusion Spiriva Respimat does not increase the acute exacerbation of COPD patients with BPH, nor does it increase the use of drugs to treat BPH. It is safe to treat COPD patients with BPH in stable stage.

目的 探讨经阴道三维容积超声成像在诊断子宫肌瘤FIGO分类的临床应用价值。方法 对本院收治的手术病理结果证实的219例子宫肌瘤,回顾临床资料分组,99例以经阴道三维容积超声成像作为观察组,120例以经阴道二维彩超检查作为对照组。评估经阴道三维容积超声成像在诊断子宫肌瘤FIGO分类的诊断符合率。结果 两组子宫肌瘤FIGO分类诊断符合率分别为:观察组97.93%,对照组78.33%;经阴道三维容积超声成像检查诊断符合率显著高于二维彩超,差异有统计学意义。结论 经阴道三维容积超声成像较二维彩超能获得更为丰富的诊断信息,诊断子宫肌瘤FIGO分类较二维彩超优势显著,有利于提高诊断准确率,为指导临床个性化治疗提供可靠的理论依据,值得临床推广应用。

Objective To investigate the clinical value of transvaginal three-dimensional volumetric ultrasound imaging in the diagnosis of the FIGO classification of hysteromyoma. Methods To retrospectively analysis data of 219 cases hysteromyoma confirmed by the surgical pathological findings in this hospital. 99 cases treated with transvaginal 3D ultrasound were as the observation group, and 120 cases treated with vaginal 2D ultrasound as the control group. To evaluate the diagnostic coincidence rate of transvaginal three-dimensional volumetric ultrasound imaging in the diagnosis of FIGO classification of hysteromyoma. Results The coincidence rates of FIGO classification of hysteromyoma in the two groups were 97.93% in the observation group and 78.33% in the control group; the diagnostic coincidence rate of transvaginal three-dimensional volumetric ultrasound imaging was higher than that of two-dimensional color Doppler ultrasound, and the difference was statistically significant. Conclusion Transvaginal three-dimensional volumetric ultrasound imaging can obtain richer diagnostic information than two-dimensional color Doppler ultrasound. In the FIGO classification of hysteromyoma, it has significant advantages than two-dimensional color Doppler ultrasound, which is conducive to improving the diagnostic accuracy and providing a reliable theory for guiding clinical personalized treatment. The basis is worthy of clinical promotion and application.

目的 探讨产前超声联合磁共振诊断胎儿部分性胼胝体发育不全的价值。方法 收集产前超声联合磁共振诊断为部分性胼胝体发育不全的胎儿15例,对比出生或引产后的检查结果,分析产前超声特征。结果 产前超声直接征象:胼胝体正中矢状切面相应部位缺失12例(12/15,80.0%)。间接征象:透明隔腔形态异常(80.0%)、侧脑室扩张(73.3%)、大脑纵裂池分离(73.3%)、脑中线丘脑后方囊性包块(26.7%)、侧脑室“泪滴状改变”(26.7%)、胼周动脉走行异常(26.7%),合并颅内或其他系统畸形6例。对比出生或引产后随访结果,诊断准确率:产前超声80.0%,产前磁共振93.3%。结论 超声可以诊断胎儿部分性胼胝体发育不全,更精确的诊断建议结合产前胎儿头颅磁共振检查。

Objective To explore the value of prenatal ultrasound in diagnosis of fetal partial agenesis of corpus callosum. Methods 15 fetuses diagnosed as partial agenesis of corpus callosum by prenatal ultrasound combined with magnetic resonance imaging (MRI) were collected. Results of examination after birth or induction of labor were compared to analyze the characteristics of prenatal ultrasound. Results Direct signs were observed in the prenatal sonographic features: 12 cases (12/15, 80.0%) were missing corresponding parts in the midsagittal section of corpus callosum. Indirect signs: transparent partition morphological abnormalities (80.0%), lateral ventricle expansion (73.3%), separation of longitudinal crack on the brain pool(73.3%), posterior thalamic midline cystic mass (26.7%), “teardrop change” of the lateral ventricle (26.7%), abnormal course of pericallosal artery (26.7%), with intracranial and other system deformity in 6 cases, including multiple anomalies. Compared with the follow-up results after birth or induction of labor, the diagnostic accuracy was 80.0% of prenatal ultrasound and 93.3% of prenatal MRI. Conclusion Ultrasonography may diagnose fetal partial agenesis of corpus callosum properly, and more accurate diagnosis could be finished combining with prenatal fetal cranial MRI.