目的 分析社区综合干预对小儿反复呼吸道感染的影响,为社区临床治疗小儿反复呼吸道感染性疾病提供理论依据。方法 采用随机抽签方式,从我社区2012年10月—2014年10月期间收治的小儿反复呼吸道感染患儿中,随机抽取60例纳入本项研究,依据就诊单双顺序,分为研究组30例(社区综合干预方式)和对照组30例(常规性治疗和常规措施进行干预),对两组患儿干预结果进行对比分析。结果 研究组治疗总疗效高于对照组(93.33% vs 76.67%),差异有统计学意义(P<0.05)。对比治疗干预过程中疾病发作次数、就诊次数状况,研究组优于对照组,差异有统计学意义(P<0.05)。干预后研究组小儿呼吸道感染致病因素改善情况(除滥用抗生素外)优于对照组,差异有统计学意义(P<0.05)。结论 针对小儿反复呼吸道感染疾病可采用社区综合干预方式,可显著提升治疗有效率,缓解病情,降低反复感染发生率,效果突出,具有广阔应用前景。

目的 观察比较术中及术前化疗干预对进展期胃恶性肿瘤手术患者p53、ki-67表达及预后的影响,为临床化疗时间的选择提供理论依据。方法 自2014年8月—2015年5月,我院共收入胃恶性肿瘤患者40例,将40例患者随机分为两组,每组各20例,保证两组患者在性别、年龄、胃癌分期等方面可比,无统计学差异(P＞0.05),标记为Ⅰ组和Ⅱ组。Ⅰ组20例患者于术前进行化疗干预,Ⅱ组在术中给予化疗干预。观察比较两组患者p53、ki-67表达状况及预后。结果 Ⅰ组及Ⅱ组治疗后p53及ki-67均比治疗前升高,差异有统计学意义(P<0.05)。但是治疗后,Ⅰ组和Ⅱ组的p53表达状况组间差异不明显,无统计学意义(P>0.05)。治疗前后,AI差异有统计学意义(P<0.05)。Ⅰ组效果明显好于Ⅱ组,两者差异有统计学意义(P <0.05)。术后六个月、一年随访时发现两组复发率、死亡率差别不大,无统计学意义(P>0.05),术后两年随访发现Ⅱ组复发率、死亡率明显低于Ⅰ组,差异有统计学意义(P<0.05)。结论 术中化疗的疗效优于术前化疗,患者预后较术前化疗好。

Objective To observe the effect of intraoperative and preoperative chemotherapy on the expression of p53, Ki-67 and prognosis in patients with advanced gastric cancer. Methods 40 cases of advanced gastric cancer in our hospital from Aug 2014 to May 2015 were enrolled in the study, and were divide into 2 groups randomly. In group I, 20 patients received chemotherapy intervention befoerer operation, and the other group received chemotherapy intervention during operation. The expressions and prognosis of p53 and Ki-67 were observed and compared between the two groups. Results Group Ⅰ and group Ⅱ after treatment, p53 and Ki-67 were higher than that before treatment, with statistical significance(P<0.05). However, there was no significant difference in the expression of p53 between group Ⅰ and group Ⅱ after treatment, and there was no significant difference(P>0.05). Before and after treatment, the difference of AI was significant, with statistical significance (P<0.05). The effect of group Ⅰ was obviously better than that of group Ⅱ, the difference was statistically significant(P<0.05). Six monthse after the operation and one year follow-up found two groups of recurrence rate and mortality rate had no significant difference(P>0.05). After two years follow-up found the group Ⅱ recurrence rate, mortality was lower than in group Ⅰ (P<0.05). Conclusion The effect of intraoperative chemotherapy is better than that of preoperative chemotherapy, and the prognosis is better than that of preoperative chemotherapy.

目的 探讨心理干预联合补佳乐在绝经后妇女宫内节育器(IUD)取出术中的临床效果。方法 选取2012年10月—2015年9月在本站施行IUD取出术的绝经后妇女200例,随机分为观察组和对照组各100例,对照组在手术前给予口服补佳乐1 mg 每日1次 连服7天,第8天施行取出术,观察组在对照组的基础上配合心理干预,观察两组在手术过程中的疼痛程度、宫颈松弛度、心理紧张度的差异。结果 IUD取出术中疼痛程度,观察组:0级 53%,1级40.0%, 2级7.0%,3级0%;对照组:0级14.0%,1级27.00%,2级44.0%,3级15.0%。观察组患者IUD取出术中成功率、满意度分别为87%、96%,与对照组比较,两者差异均有统计学意义(P<0.05)。结论 心理干预联合补佳乐应用于绝经后IUD取出术,可有效改善生殖器的施术条件,减少受术者痛苦,安全、有效,效果满意。

目的 评价综合营养干预措施与传统的单纯药物治疗对花都区老年原发性骨质疏松 (OP)患者生命质量的影响。方法 采用随机法将符合标准的OP患者随机分配到干预组(A组)和对照组(B组)接受相应的干预处理。干预组给予综合营养干预措施,而对照组只给予单纯的抗骨质疏松药物。结果 干预组人群干预前后生命质量的8个维度中的6个维度得分与干预前比较,差别有统计学意义(P<0.05)。 对照组人群生命质量的8个维度中只有2个维度与干预前比较,得分间差别有统计学意义(P<0.05)。结论 综合营养干预措施可以提高老年OP患者的生命质量。

目的 探讨一种适合社区糖尿病患者健康素养的干预方法,并进一步探讨提高糖尿病患者健康素养对社区卫生服务利用的影响。方法 选择2014年—2015年在我社区卫生服务中心建档的210例糖尿病居民为调查研究对象,对糖尿病患者进行健康素养干预后,比较其健康素养、基本医疗服务利用、社区卫生服务利用情况。结果 对社区糖尿病人进行健康素养干预后,患者的健康理念、传染病预防、健康行为、基本医疗知识、安全素养得分均比干预前高,差异有统计学意义(P<0.05)。首次就诊医疗机构首选社区率及区县级医疗机构就诊的比例干预后比干预前高(P<0.05),最近两周内在社区医疗机构就诊率、签约全科医生率均比健康素养干预前高,差异有统计学意义(P<0.05)。而糖尿病患者过去1年住院例数干预前后无差别,差异没有统计学意义(P>0.05)。患者参与社区健康教育活动的次数干预后比干预前多(P<0.05),参加免费体检及接受社区医生健康生活方式的指导的比例比干预前高(P<0.05)。结论 利用健康促进模式可提高糖尿病患者的健康素养,健康素养的提高可使其对卫生服务的利用有所增加,使其自身的健康状况得以改善。

目的 探究自我管理干预对慢性阻塞性肺疾病(COPD) 稳定期患者的临床疗效影响。方法 选取2013年6月—2014年6月我院诊断的COPD稳定期患者90例,随机分为对照组(45例)和观察组(45例)。对照组只给予常规治疗,观察组在常规治疗基础上给予自我管理干预,包括健康教育和康复训练,之后通过比较两组患者肺功能、6MWD、生活质量问卷(SGRQ)评分、急性发病频率、依从性等方面的变化来探讨自我管理干预对COPD治疗的临床意义。结果 观察组患者肺功能和6MWD较对照组有改善,观察组的SGRQ得分、急性加重频率显著低于对照组,而其依从性比例明显高于对照组,两组间差异在统计学上均有意义(P<0.05)。结论 加强COPD稳定期自我管理干预能够改善COPD的预后,值得在临床上进行应用。

目的 社区干预在颈动脉斑块伴脂代谢紊乱人群中的应用。方法 选取我院2012年3月—2014年3月186例颈动脉斑块伴脂代谢患者为研究对象,将患者抽签随机分为观察组与对照组,每组93例。对照组给予基础治疗及运动生活方式指导,观察组给予基础治疗以及强化社区健康管理综合干预,观察并记录两组Crouse积分,总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C )水平及遵医行为。结果 治疗1、2年后观察组颈动脉斑块积分(3.46±2.13)cm、(3.07±2.49)cm低于对照组(4.56±2.26)cm、(4.43±2.51)cm,两组差异有统计学意义(P＜0.05)。观察组治疗1年、2年后TC、TG、LDL-C水平低于对照组,HDL-C水平高于对照组,两组差异有统计学意义(P＜0.05)。观察组遵医行为优于对照组(P＜0.05)。结论 社区健康管理综合干预能显著提高患者遵医行为,改善生活方式,从而使血脂达到正常水平,延缓颈动脉斑块发展。

Objective To study the application of community intervention in population with carotid plaque complicated with dyslipidemia. Methods 186 cases of patients with carotid plaque complicated with dyslipidemia who were admitted in our hospital from March 2012 to March 2014 were selected as the study objects and were randomly divided into the observation group and the control group according to random sampling method, with 93 cases in each group. The control group was given basic treatment and guidance of exercise lifestyle. The observation group was given basic treatment and strengthened community health management integrated intervention. The crouse integral, total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) levels and treatment compliance in the two groups were observed and recorded. Results After 1 and 2 years of treatment, the carotid artery plaque score in the observation group [(3.46±2.13) cm, (3.07±2.49) cm] was lower than that in the control group [(4.56± 2.26) cm, (4.43±2.51) cm](P<0.05). TC, TG and LDL-C levels in the observation group were lower than those in the control group while HDL-C level was higher than that in the control group (P<0.05). The treatment compliance in the observation group was significantly better than that in the control group (P<0.05). Conclusion Community health management integrated intervention can significantly improve the treatment compliance of patientsand their life style, so as to achieve the normal level of blood lipids and carotid plaque will be postponed.

目的 探讨功能康复训练与心理干预对全髋关节置换手术患者髋关节功能康复的影响。方法 对2014年3月—2015年12月先后在本院行全髋关节置换手术90例患者,按入院时间分为观察组45例和对照组45例。对照组按全髋关节置换手术功能康复护理要求给予康复护理;观察组在此功能康复护理基础上,同时对患者进行心理评估和相应的心理护理干预;对两组患者在干预前后的心理情况、生活自理能力、髋关节功能和生活质量进行评价。结果 干预前两组患者均有不同程度的焦虑和抑郁反应,不积极的应对方式和自理能力下降;干预后观察组在应对心理反应,降低焦虑和抑郁,主动进行功能锻炼,自理能力和髋关节功能评分均优于对照组。结论 功能康复训练与心理护理干预相结合,对减轻患者心理压力,提高患者心理应对能力、生活自理能力,提高患者生活质量,促进髋关节功能康复有一定的效果。

Objectives To explore the effect of function rehabilitation training and psychological intervention on patients of hip joint function recovery undergoing THA. Methods 90 patients were chosen who were admitted to the hospital from March 2014 to December undergoing THA,2015. These patients were divided into control group and intervention group according to the sequence of admission. The patients in control group were cared by total hip replacement surgery functional rehabilitation; At the same time, the patients in observation group were cared by psychological training. The psychological condition, self-care ability, hip function and quality of life for all patients were evaluated. Results Before the intervention, two groups of patients had some degrees of anxiety and depression, and negative coping style. Their self-care ability were decreased; The response to psychological reaction, reduction for anxiety and depression, initiative exercise, self-care ability and hip function scores of patients in the intervention group were better than that of the control group. Conclusion Combination of rehabilitation training and psychological nursing intervention can relieve the psychological pressure, improve mental health and promote recovery of hip function.

目的 探讨婚恋家庭取向心理干预对系统性红斑狼疮患者家庭功能和幸福感指数的效果。方法 将2012年6月1日—2014年5月31日就诊于东莞康华医院内分泌及风湿免疫中心的62名15~58岁的系统性红斑狼疮患者作为研究对象,根据随机化原则将其分成两组,其中30名为干预组,参加本研究设计的婚恋家庭取向的心理干预,余32名为对照组,采用家庭功能评定量表、幸福指数量表及狼疮活动指数量表,对两组进行干预前、干预后、干预后3月和干预后6月作问卷调查。采用重复测量的方差分析进行评估。结果 家庭功能中的问题解决、情感反应、情感介入、总的功能分量表和总分两组干预后重复测量的方差分析两两比较均有统计学差异(P<0.05)。幸福感指数总分两组重复测量的方差分析无统计学意义,但如扩大置信空间至P<0.1,则两组重复测量的方差分析两两比较中干预后3月及6月有一定统计学意义(P=0.08<0.1)。结论 本研究中婚恋家庭取向的心理干预对SLE患者即家庭功能中问题解决、情感反应、情感介入、总的功能及家庭功能总分均有显著的改善作用,对幸福感指数总分则有一定的增进作用,而对已通过心身疾病方式表达了的SLEDAI没有干预作用。

Objective To explore the effect of marital family-based psychological intervention in SLE patients on family assessment device FAD and index of well-being. Methods A total of 62 SLE patients, aged between 15 and 58, who were treated in out-patient of endocrine immune rheumatism center of Dongguan Kanghua hospital from June 1,2012 to May 31,2014. The experimental group was made up of 30 patients who, at random, volunteered to participate in an added marital family-based psychological intervention and the control group was composed of rest 32 cases. At the time of pre-intervention,post-intervention,3 months and 6 months after intervention, both groups were investigated with questionnaires of family assessment device, index of well-being, index of general affect, and systemic lupus erythematosus disease activity index. The results were analyzed with repeated measure variance analysis to explore the effect. Results There were significant multiple-comparison differences by repeated measure variance analysis in the score of FAD's total and sub-scale problem solving, affective responsiveness, affective involvement, general functioning(P<0.05) between experimental and control group after intervention. There were no significant repeated measure variance analysis differences in the score of index of well-being' total, but if enlarging confidence space to P<0.1, there were partial multiple-comparison differences between experimental and control group at the time of 3 months and 6 months after intervention(P=0.08<0.1). Conclusion Marital family-based psychological intervention may significantly improve FAD's problem solving, affective responsiveness, affective involvement, general functioning, and sum of FAD, and partially improve index of well-being, but can not improve SLEDAI which had developed by psychosomatic disease.

目的 通过研究4CH8的健康管理模式对社区更年期女性冠心病危险因素的干预效果,为制定慢病防控对策提供依据。方法 选择我社区,具有完整个人档案的更年期女性400例,经三甲医院确诊为冠心病患者为对照组134例,未患冠心病的266例为干预组,并进行危险因素分析。对未患冠心病的更年期女性进行4CH8健康管理模式干预,随访1年后对冠心病的危险因素进行前后对比分析。结果 对照组与干预组的BMI、高血压、糖尿病、低密度脂蛋白、高密度脂蛋白及空腹血糖相比较,差异有统计学意义(P<0.05)。年龄、尿酸及糖尿病两组相比较,差异无统计学意义。冠心病的危险因素与BMI、高血压、糖尿病、冠心病、低密度脂蛋白水平及空腹血糖呈正相关,与高密度脂蛋白呈负相关。干预组干预一年后BMI、高血压、低密度脂蛋白及空腹血糖水平与干预前相比较,差异有统计学意义(P<0.05),干预前各指标异常人数比干预后少。结论 4CH8模式对社区更年期女性冠心病危险因素管理效果较好,值得推广应用。