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目的 调查良性前列腺增生(BPH)患者对前列腺手术的接受意愿,并分析其影响因素。方法 采用问卷调查法,于2021年3月—2022年10月选取中山大学附属第一院惠亚医院收治的133例BPH患者为研究对象。由调查者床边发放问卷,并当场收回。结果 调查共发放问卷133份,回收有效问卷130份,有效率为97.74%。单因素分析结果显示,经济负担、医保报销、BPH程度、住院陪护、了解BPH对自身的危害等因素与患者接受手术意愿相关(P<0.05)。Logistic多因素回归分析显示,患者的经济负担、医保报销及已存在BPH并发症是影响患者接受手术意愿的因素(P<0.05)。结论 本区域BPH患者由于经济、医保及已存在BPH并发症的问题,直接影响了接受前列腺手术的意愿,不仅影响患者的生理健康,也影响生活质量及家庭和睦关系,应加大疾病认知宣传力度,组建患者互助团体,促进居民对BPH疾病及手术的了解,提高该类患者的生活质量。
Objective To investigate the willingness of patients with benign prostatic hyperplasia(BPH)to accept prostate surgery and analyze its influencing factors.Methods A questionnaire survey method was used to select 133 patients with BPH admitted to a hospital from March 2021 to October 2022.The questionnaires were distributed and collects by the investigator at the bedside.Results A total of 133 questionnaires were distributed during the survey and 130 valid questionnaires were collected,with an effective rate of 97.74%.The results of single factor analysis showed that factors such as financial burden,medical insurance reimbursement,degree of BPH,hospitalization accompaniment,and understanding of the harm of prostate hyperplasia were significantly related to patients’ willingness to receive surgery,with statistical significance(P<0.05).Logistic multifactor regression analysis showed that the patient’s financial burden,medical insurance reimbursement,and existing BPH complications were factors that affected the patient’s willingness to receive surgery.Conclusion sBPH patients in local region have financial burden,medical insurance and existing complications of BPH,which directly affect their willingness to undergo prostate surgery.Those factors not only affect the patients’ physical health but also affect the quality of theirlife and harmonious thier family relationships. Awareness of the disease should be increased to promote publicity,and patient mutual aid groups should be started to improve residents’ understanding of BPH disease and surgery and improve the quality of patients’life.
论著
目的 了解广州市某净水公司职工脂肪肝检出情况,并分析影响因素。方法 选取2023年广州市某净水公司参加职业健康检查的职工为研究对象,收集研究对象的一般情况、个人史、职业史、身体质量指数(BMI)、血压、血生化指标、肝脏彩超等资料。对该人群脂肪肝的患病情况进行描述性分析,对脂肪肝的影响因素进行单因素及多因素Logistic回归分析。结果 共收集研究对象1 217人,检出脂肪肝543例,检出率为44.62%。单因素分析结果表明,脂肪肝的发生与性别、年龄、体质量指数、高血压相关(P<0.05)。接触硫化氢、氨的职工脂肪肝检出率高于非接触者(P<0.05),且职工工龄越长,脂肪肝检出率越高(P<0.05)。患脂肪肝职工的肝功能、脂代谢、血糖及尿酸水平高于非脂肪肝者(P<0.05)。多因素Logistic回归分析提示,年龄、体质量指数、肝功能异常、脂代谢异常、高血糖、高尿酸是脂肪肝的影响因素(P<0.05)。结论 广州市某净水公司职工的脂肪肝检出率较高,脂肪肝的发生主要与年龄、体质量指数、肝功能异常、脂代谢异常、高血糖、高尿酸等因素相关。
Objective To investigate the prevalence of fatty liver disease and influencing factors among employees of a water purification company in Guangzhou.Methods Employees of a water purification company in Guangzhou who participated in occupational health examinations in 2023 were selected as the study subjects.The subjects' general conditions,personal history,occupational history,BMI,blood pressure,blood biochemical indicators,and liver ultrasound images were collected.Descriptive analysis was used to analyze the prevalence of fatty liver disease in this population.The influencing factors of fatty liver were analyzed by single factor and multiple factor Logistic regression.Results A total of 1 217 subjects were included in this study,and 543 were diagnosed as fatty liver disease,with a detection rate of 44.62%.The results of single factor analysis showed that the occurrence of fatty liver was closely related to gender,age,BMI and hypertension(P<0.05).The analysis of occupational hazard factors showed that,the detection rate of fatty liver disease was higher in people exposed to hydrogen sulfide and ammonia compared to non-exposed individuals(P<0.05).The longer the working years,the higher the detection rate of fatty liver(P<0.05).The levels of liver function,lipid metabolism,blood glucose and uric acid in workers with fatty liver were higher than those in workers without fatty liver(P<0.05).Multivariate Logistic regression analysis showed that age,BMI,abnormal liver function,abnormal lipid metabolism,high blood glucose levels and hyperuricemia were independent influencing factors for fatty liver disease(P<0.05).Conclusions The detection rate of fatty liver disease among employees of a water purification company in Guangzhou is high,and the occurrence of fatty liver disease is mainly related to factors such as age,BMI,abnormal liver function,abnormal lipid metabolism,high sugar levels and hyperuricemia.
论著
目的 分析非小细胞肺癌化疗患者骨髓抑制发生状况及其影响因素。方法 回顾性分析2017年2月—2019年8月期间本院进行化疗治疗的80例非小细胞肺癌患者临床资料,统计非小细胞肺癌化疗患者骨髓抑制发生情况,并根据其情况分组;收集所有患者临床资料,分析非小细胞肺癌化疗患者骨髓抑制发生的相关影响因素。结果 80例非小细胞肺癌化疗患者中发生骨髓抑制45例,发生率为56.25%;经单因素及多项Logistic回归分析,年龄≥60岁、化疗方案为紫杉醇联合铂类,TNM分期在Ⅲ-Ⅳ期,发生骨转移是非小细胞肺癌化疗患者发生骨髓抑制的影响因素(OR>1,P<0.05)。结论 年龄≥60岁、化疗方案为紫杉醇联合铂类,TNM分期在Ⅲ-Ⅳ期,发生骨转移会增加非小细胞肺癌化疗患者骨髓抑制的发生风险,临床上可据此来制定合理的干预措施,以降低患者骨髓抑制的发生风险。
Objective To analyze the occurrence and influencing factors of bone marrow suppression in patients with non-small cell lung cancer (NSCLC) undergoing chemotherapy. Methods The clinical data of 80 patients with NSCLC who received chemotherapy in our hospital from February 2017 to August 2019 were retrospectively analyzed, the occurrence of bone marrow suppression in patients with NSCLC under chemotherapy was enrolled and grouped according to the situation; the clinical data of all patients were collected, the related influencing factors of bone marrow suppression in patients were analyzed. Results Among 80 cases of patients with NSCLC, 45 cases occurred bone marrow suppression, the incidence was 56.25%; after univariate and multivariate Logistic regression analysis, age ≥ 60 years old, chemotherapy of paclitaxel combined with platinum, TNM stage in stage III -IV, the occurrence of bone metastasis were the influencing factors of bone marrow suppression in patients with NSCLC under chemotherapy (OR>1, P<0.05). Conclusions Age ≥ 60 years old, chemotherapy of paclitaxel combined with platinum, TNM stage in stage III -IV, the occurrence of bone metastasis will increase the risk of bone marrow suppression in patients with NSCLC chemotherapy. Therefore, reasonable intervention measures can be carried out to reduce the risk.
论著
目的 调查儿科急诊非急诊手术患儿输血后红细胞恢复的影响因素。方法 回顾2020年1月—2020年12月期间广州市妇女儿童医疗中心珠江新城院区儿科急诊1月~18岁患儿的输血情况,其中分为Hb提升达预期组(n=93),Hb提升未达预期组(n=156),根据年龄、性别、体质量、是否恶性肿瘤、是否发热、有无延迟输血、输血前血红蛋白水平、输注红细胞类型情况,分析输血疗效及影响因素。结果 2组患儿的性别、年龄、体质量、有无恶性肿瘤、是否发热、输血等待时间、输血前后血红蛋白值、输注红细胞悬液量以及有无及时输血均无统计学差异;输注红细胞类型组间存在显著差异,Hb提升未达预期组更多输注了洗涤红细胞悬液(13.5% vs 5.4%,P=0.044),输血后 Hb 值较低(中位数,73 g/L vs 84 g/L,P<0.001),变化 Hb 值较小(中位数,18 g/L vs 30 g/L,P<0.001),归因分析未发现影响因素。结论 输注洗涤红细胞可能是降低输血后红细胞提升的影响因素,输注洗涤红细胞时需严格输血指征同时注意红细胞提高预值的设定。
Objective To investigate the influencing factors of blood transfusion efficacy in patients without emergency operations in pediatric emergency.Methods A retrospective analysis of the blood transfusion of pediatric emergency children(1 month~ 18 year of age)in Zhujiang New Town Branch of Guangzhou Women and Children's Medical Center from January 2020 to December 2020 was carried out,patients were divided into Hb elevation up to expectation group(n=93)and Hb elevation not up to expectation group(n=156).The efficacy of blood transfusion and the factors affecting it were analyzed according to age,gender,body mass,with or without malignant tumor,whether fever was present,whether there was delayed transfusion,pre-transfusion hemoglobin level,and the type of red blood cells transfused.Results There were no significant differences in gender,age,weight,malignant tumor,fever,waiting time for blood transfusion,hemoglobin level before and after blood transfusion,infusion volume of red blood cell suspension and whether had timely blood transfusion between the two groups.Significant differences were found between groups of transfused red blood cell types,with more washed red blood cell suspensions transfused in the Hb elevation not meeting expectations group(13.5% vs 5.4%,P=0.044),which had lower post-transfusion Hb values(median,73 g/L vs 84 g/L,P<0.001),and smaller change Hb values(median,18 g/L vs 30 g/L,P<0.001),and attribution analysis did not reveal influencing factors.Conclusions Transfusion of washed red blood cell may be an influencing factor that reduces the RBCs elevation after transfusion.Attention should be paid to strict indications for washed red blood cell transfusion and setting the expected Hb level.
论著
目的 明确上海市闵行区社区老人轻度认知功能障碍(MCI)发生现状,分析MCI发生的影响因素间的交互作用关系。方法 采用横断面研究方法,应用AD-8与CSI-D对该区2021年65岁以上老人MCI发生现状进行双量表评估。应用SPSS 26.0 软件,先后采用χ2检验分析受检老人吸烟、饮酒、慢性病等因素在不同检出情况的构成、二分类非条件Logistic回归分析MCI发生的影响因素,再将各因素依次纳入双因素交互作用分析模型,分析各变量对MCI发生的交互作用。结果 应用AD8与CSI-D双量表评估法具有较高的灵敏度,评估闵行区社区老人MCI阳性率为26.6%,高于其他研究,低年龄(OR=1.09,95%CI:1.04~1.14)、良好的健康心态(OR=1.67,95%CI:1.15~2.42)是减少老人MCI的保护因素,职业类型(OR=1.19,95%CI:1.04~1.38)、照料者类型(OR=1.56,95%CI:1.09~2.22)与老人MCI的发生存在相关关系。家庭月总收入与照料者类型之间、是否饮酒与照料者类型之间对老人MCI的发生存在交互作用(P均<0.05)。结论 保持良好的心态可以降低老人MCI发生风险,不同职业类型、照料者类型与老人MCI的发生具有相关关系,照料者选择保姆可能会增加老人MCI风险。
Objective To clarify the current situation of mild cognitive impairment(MCI)in the community elderly in Minhang District,Shanghai,and analyze the interaction relationship between the influencing factors of MCI.Methods A cross-sectional study method was used,and AD8 and CSI-D were used to evaluate the current situation of MCI in the elderly over 65 years old in this district in 2021.SPSS 26.0 software,chi-square test and binary unconditional Logistic regression model were used to analyze the composition of smoking,drinking,chronic diseases and other factors in different detected conditions and the influencing factors of MCI occurrence in the elderly.A factor interaction analysis model was used to analyze the interaction of each variable on the occurrence of MCI.Results The AD8 and CSI-D double-scale evaluation method had high sensitivity.The positive rate of MCI in the community elderly in Minhang District was 26.6%,which was higher than other studies.Younger age(OR=1.09,95%CI:1.04~1.14),good health mentality(OR=1.67,95%CI:1.15~2.42)were protective factors for reducing MCI in the elderly,occupation type(OR=1.19,95%CI:1.04~1.38),caregiver type(OR=1.56,95%CI:1.09~2.22)were correlated with the occurrence of MCI in the elderly.There were interaction effects between the total monthly household income and the type of caregivers,whether drinking or not and the type of caregivers on the occurrence of MCI in the elderly(all P<0.05).Conclusions Maintaining a good attitude can reduce the risk of MCI in the elderly.Different occupational types and types of caregivers are related to the occurrence of MCI in the elderly.Caregivers choosing nanny may increase the risk of MCI in the elderly.
论著
目的 了解门诊老年患者补充与替代医学(CAM)使用现状及影响因素。方法 采用便利抽样法,选取2020年11月—2021年2月广东省某三甲医院老年科门诊就诊的老年患者作为研究对象,调查方法采用一般资料调查表和CAM使用情况调查表进行横断面调查。应用二元Logistics回归分析探讨门诊老年患者使用CAM的影响因素。结果 参与调查的123例老年患者中,有75例(61.0%)老年患者使用CAM,使用CAM的项目主要为中草药、药膳等中国传统医学项目。支付方式是门诊老年患者是否使用CAM的影响因素,使用医保支付的患者较公费、自费患者更愿意使用CAM(OR=5.054,95%CI:1.452~17.590,P<0.05)。结论 CAM在门诊应用广泛,我们应充分发挥我国传统医学优势,为老年人疾病防治提供更多的思路。政府层面也可进一步提高医保覆盖范围,让更多的患者有经济能力可以接受安全、有效的治疗。
Objective To investigate the current status of complementary and alternative medicine(CAM)use and the influencing factors of elderly patients in outpatient clinic.Methods Using the convenience sampling method,the elderly patients treated in the geriatric outpatient department of a Class A tertiary Hospital in Guangdong from November 2020 to February 2021 were selected.General data and the CAM usage questionnaire were collected.Binary logistics regression analysis was used to explore the factors influencing CAM use in elderly patients.Results Seventy-five(61.0%)of 123 elderly patients used CAM.Chinese herbal medicine and medicinal diet were the most common CAM.Payment method was a factor affecting whether elderly outpatient patients use CAM.Insured patients were more willing to use CAM than self-funded patients(OR=5.054,95%CI:1.452-17.590,P<0.05).Conclusions CAM is widely used in outpatient clinics.We should make full use of our country’s traditional medicine,to provide different thoughts of diseases prevention and treatment in elderly patients.The government can also further enlarge the coverage of health insurance,so that more patients can afford safe and effective treatment.
论著
目的 探讨老年髋部骨折(GHF)患者围术期隐性失血的影响因素及护理措施。方法 回顾性分析2020年3月—2023年3月我院收治的86例老年GHF患者,所有患者均采取手术治疗,计算所有患者围术期失血量,并收集所有患者的一般资料及围术期相关治疗情况,分析不同一般资料患者围术期隐性失血情况,不同手术方式及麻醉方式围术期隐性失血情况,不同术后处理方式围术期隐性失血情况,随后采取Logistic回归分析老年GHF患者围术期隐性失血的影响因素,最后针对结果制定老年GHF隐性失血的护理措施。结果 不同性别和是否合并冠状动脉粥样硬化、高血压患者围术期隐性失血量比较差异无统计学意义(P>0.05),不同年龄、合并糖尿病、骨折类型患者围术期隐性失血量比较差异有统计学意义(P<0.05);不同手术方式、麻醉方式患者围术期隐性失血量比较差异有统计学意义(P<0.05);不同术后引流、使用肝素情况患者围术期隐性失血量比较差异有统计学意义(P<0.05);Logistic回归分析结果表明:年龄、合并糖尿病、手术方式、麻醉方式、术后引流、使用肝素都是造成GHF老年患者围术期隐性失血的影响因素(P<0.05)。患者经相关护理后,恢复较佳。结论 老年GHF患者围术期会存在大量隐性失血情况,同时年龄、合并糖尿病、手术方式、麻醉方式、术后引流、使用肝素与围术期隐性失血量密切相关,临床上可采取针对性措施减少GHF患者隐性失血。
Objective To explore the influencing factors and nursing measures of perioperative hidden blood loss in elderly patients with geriatric hip fractures(GHF).Methods From March 2020 to March 2023,86 elderly patients with GHF admitted to our hospital were selected as the study objects for retrospective analysis.All patients were treated with surgery.The perioperative blood loss of all patients was calculated,general information and perioperative treatment status of all patients were collected,the hidden blood loss of patients with different general information,different surgical and anesthesia methods and different postoperative treatment methods were analyzed.Logistic regression analysis was used to analyze the influencing factors of hidden blood loss of elderly GHF patients during the perioperative period.Nursing measures for hidden blood loss in elderly hip fractures were developed based on the results.Results There was no statistical difference in the amount of perioperative hidden blood loss among patients with different gender,complicated with coronary heart disease and hypertension or not(P>0.05),but there was statistical difference in the amount of perioperative hidden blood loss among patients with different ages,complicated with diabetes and fracture types(P<0.05).There was statistically significant difference in the amount of hidden blood loss during the perioperative period among patients with different surgical and anesthesia methods(P<0.05).There was statistically significant difference in the amount of hidden blood loss during the perioperative period among patients with different postoperative drainage and use of heparin(P<0.05).The results of Logistic regression analysis showed that age,complicated with diabetes,operation methods,anesthesia methods,postoperative drainage and heparin use were independent risk factors for perioperative hidden blood loss in elderly patients with GHF(P<0.05).Conclusions There will be a lot of hidden blood loss in the perioperative period of elderly patients with GHF.At the same time,age,complicated with diabetes,operation methods,anesthesia methods,postoperative drainage and heparin use are closely related to the amount of hidden blood loss in the perioperative period.Targeted measures can be taken clinically to reduce the hidden blood loss in patients with GHF.
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目的 了解广州市社区居民对中医“治未病”的认知现状,分析其影响因素,并为中医“治未病”的进一步发展提出可行建议。方法 采用多阶段整群抽样法,对广州市不同区域的652名居民进行问卷调查,通过描述性分析和χ2检验分别对基本认知情况与影响因素进行阐述。结果 广州市居民对“治未病”服务了解情况不太理想(67.80%),接受“治未病”服务的意愿情况较好(77.91%),对于中医“治未病”服务的认知还比较片面,主要通过手机、网络、社区等方式了解相关内容。影响居民接受意愿的因素主要是年龄、学历、户口、职业类型等。结论 目前广州市社区中医“治未病”服务具有一定群众基础和发展潜力,但是还存在居民认知不足、宣传力度不够、服务能力不足等问题,应当着重从这些方面进行改进。
Objective To understand the current cognitive status of community residents in Guangzhou regarding traditional Chinese medicine(TCM)pre-treatment,analyze its influencing factors,and provide feasible suggestions for the further development of TCM pre-treatment.Methods By multi-stage cluster sampling method,a questionnaire survey was conducted on 652 residents in different regions of Guangzhou.Descriptive analysis and chi-square test were used to elucidate the basic cognitive situation and influencing factors.Results The understanding of TCM pre-treatment services among residents in Guangzhou was not ideal(67.8%),and their willingness to receive TCM pre-treatment services was good(77.91%).Their understanding of TCM pre-treatment services was quite one-sided,mainly through mobile phones,internet,communities and other means.The main factors affecting residents' willingness to accept this service were age,education level,household registration and occupation.Conclusions At present,the TCM pre-treatment service in the community of Guangzhou has a certain mass basis and development potential.However,there are still problems such as insufficient residents' awareness,insufficient publicity,and insufficient service capabilities,which should be improved in the future.
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目的 通过关注追踪中老年人口腔健康问题对生活质量的影响,系统梳理中老年人口腔健康的相关影响因素及其关系,为此类人群的口腔健康及其相关生活质量的活动开展提供调研依据。方法 随机抽取2022年10月—2023年5月之间的266名中老年人参与调查,按照“病因链”收集该类人群的社会学特征、日常口腔保健行为、身体健康状况,分析评价中老年人口腔健康相关生活质量。结果 266名中老年人口腔健康常识和行为得分平均为(30.69±8.98)分,口腔健康评估平均为(8.59±3.68)分,口腔健康相关生活质量GOHAI总分为(25.65±8.10)分。单因素分析显示,人口学特征与一般身体健康状况、口腔健康常识和行为以及口腔健康情况与中老年人的口腔健康相关生活质量的GOHAI得分密切相关(P<0.05)。多因素分析显示,女性、年龄>45岁、患慢性病、日常生活习惯是影响中老年口腔健康和生活质量的独立危险因素(P<0.05或P<0.01)。结论 口腔健康作为全身健康的基础,其影响因素多种多样,通过控制干预主要影响因素来提高社区口腔健康和相关生活质量,以改善社区居民生活幸福值。
Objective By focusing on and tracking the impact of oral health problems of middle-aged and elderly people on the quality of life,the relevant influencing factors and relationships of oral health were systematically sorted out to provide a research basis for the development of oral health and related quality of life of such people.Methods A total of 266 middle-aged and elderly people were randomly selected from October 2022 to May 2023 to participate in the survey,and the sociological characteristics,daily oral health care behaviors and physical health status of this population were collected according to the “etiological chain”,so as to analyze and evaluate the quality of life related to the oral health of middle-aged and elderly people.Results The 266 middle-aged and elderly people had a mean score of(30.69±8.98)for general knowledge and behavioral scores of oral health,a mean score of(8.59±3.68)for oral health assessment,a total score of(25.65±8.10)for oral health-related quality of life GOHAI.The univariate analysis showed that demographic characteristics,general body health state,oral health cognition and behavior and oral health state were closely associated with the GOHAI score related to the oral health associated quality of life in the middle-aged and elderly people(P<0.05).The multivariate analysis indicated that female,age >45 years old,presence of chronic diseases and daily living habits were indepdent risk factors of the oral health and quality of life of the middle-aged and elderly(P<0.05).Conclusions Oral health,as the basis of systemic health,has various influencing factors,by controlling the main influencing factors can improve the community oral health and related quality of life,and improve the happiness of community residents.
论著
目的 比较广东云浮市进行药品专区执行国家药品集中采购(GPO)前后呼吸系统疾病患儿住院医疗费用,分析其住院医疗费用的影响因素。方法 选择云城区2019—2020年0~14岁城乡儿童呼吸系统疾病住院患儿,采用单因素和多元回归统计方法分析住院医疗费用的影响因素。结果 呼吸系统疾病儿童平均住院医疗费用国家集采前(4 872.38元)高于国家药品集采后(4 620.25元,P<0.05),药费分别占参保及参合患儿住院医疗费用的35.35%和27.39%,统筹支付费用参保与参合儿童分别占46.85%和57.59%。年龄、住院天数、转归、有无合并症、疾病分类、应用GPO药物、入院分类为呼吸系统疾病患儿住院医疗费用的共同影响因素,其中住院医疗费用随着患儿年龄增加、转归良好及应用GPO药物费用而减少,为负性联系;余住院天数、有无合并症、疾病分类、入院分类则与住院总费用有着正性联系。结论 提高患儿的转归,缩短平均住院日,做好药品专区及集中采购工作可降低儿童呼吸系统疾病的住院费用。
Objective To compare the inpatient medical expenses of children with respiratory diseases before and after the implementation of national group purchasing organization(GPO) in Yunfu City, Guangdong Province, and analyze the influencing factors of inpatient medical expenses. Methods The hospitalized children aged 0~14 with respiratory diseases from 2019 to 2020 in Yuncheng district implemented the GPO were selected. The influencing factors of hospitalization expense were analyzed by single factor and multiple regression statistical methods. Results The average hospitalization expense of children with respiratory diseases before the GPO implemented (4 872.38 yuan) was higher than after (4 620.25 yuan, P<0.05); the drug expense accounted for 35.35% and 27.39% of the hospitalization expense of the insured urban and rural children, and integrated payment accounted for 46.85% and 57.59%. Age, hospitalization days, outcome, comorbidities, disease classification, application of GPO drugs and admission classification were the common influencing factors of hospitalization expense of children with respiratory diseases. Hospitalization expense decreased with the increase of age, good outcome and application of GPO drugs, which was a negative correlation. And there was a positive relationship between the rest factors and the total cost of hospitalization. Conclusions To improve the outcome of children, shorten the average length of stay, doing a good job in drug zone and group procurement can reduce the hospitalization cost of children with respiratory diseases.