目的 探讨心理健康干预对复治肺结核患者在整个治疗过程中生活质量影响,为加强结核病的宣教奠定坚实的基础。方法 选取广州市结核病防治所在治的复治肺结核病人72例,随机分成宣教组和普通组,选取2名有丰富经验的主管护师,经专业心理师培训指导,护长考核,负责宣教组的工作,而普通组则由轮班护士进行,无作特别要求。对比两组心理健康干预前后的变化。结果 两组症状自评量表(SCL-90)测评相比较,宣教组优于普通组,差异有统计学意义(P<0.05)。宣教组的生理健康总评及精神健康总评比对照组好,差异均有统计学意义(P<0.05)。结论 通过对门诊复治结核病患者进行心理健康干预,能有效改变复治病人的心理和生理健康,提高生活质量。

目的 观察健康促进诊疗管理模式对社区慢性病的干预效果。方法 选取社区的慢性病患者268例,对他们实施慢性病健康促进诊疗管理,主要的方向有健康干预、诊疗管理、随访管理等。结果 干预后患者的体质指数、血压、血糖、血脂的达标率、健康知识、用药依从率等都比干预前有所提升。组间比较差异具有统计学意义(P＜0.05)。干预治疗后患者的满意度为87.3%,治疗有效率为85.8%,显著高于干预治疗前的70.1%和59.0%。结论 对社区慢性病患者采取健康促进诊疗管理模式进行干预,能够提高社区慢性病的综合防治效果,对提高患者的生活质量具有一定的促进作用。

目的 探讨早期干预对早产儿运动水平及技能的影响。方法 2013年3月—2014年3月在惠州市出生的283例有早产背景的高危儿,按照家长意愿分为两组,早产儿干预组143例及早产儿对照组140例。选择同时期出生的145例正常足月新生儿作为正常对照组。早产儿干预组根据评估结果制定干预训练方案,并按照评估—干预—评估的模式调整干预方案,早产儿对照组和正常对照组按健康检查的顺序进行体检并给予相关指导。在月龄3、6、9、12、18月时对三组婴儿行AIMS评估和神经系统相关检查。结果 早产儿干预组的运动发育水平明显高于早产儿对照组(P<0.01),神经系统异常率低于早产儿对照组(P<0.01),而早产儿干预组的神经系统异常率高于正常对照组(P<0.05)。但运动发育水平与正常对照组相比差异无统计学意义(P>0.05)。结论 早期干预能提升早产儿运动发育水平,改善运动技能,减少神经系统异常发生率,提高早产儿生存质量。

目的 探讨自我效能干预对于手术室护士的压力能够起到的调节效果。方法 通过对66名手术室护士的压力来源进行总结,并根据压力来源渠道分别进行自我效能护理干预一个月,并进行自我效能感以及工作倦怠方面对比评定,应用自我效能量表(USES量表)、工作倦怠量表( MBI量表)进行测算,将结果进行归纳总结。结果 经过自我效能护理干预的手术室护士的自我效能感评分显著提高,经过自我效能护理干预的手术室护士的MBI量表评分显著提高,干预前:手术室护士自我效能感以非常低的为主,占54.55%;干预后以非常高的为主,所占比例为48.48%;经过自我效能护理干预的手术室护士的MBI量表评分显著提高,干预前主要以中重度的工作倦怠护士为主,重度43例、中度21例;干预后主要以轻度和无倦怠的护士为主(P＜0.05)。结论 通过自我效能护理干预可以显著提高手术室护士的自我效能感、减少工作倦怠情绪,提高工作效率。

目的 研究并探讨产前优生筛查对出生缺陷的干预作用。方法 于2013年1月—2015年12月,选取69 183例孕产妇的临床资料进行回顾性研究,胎儿总数为69 262例,所有孕产妇在妊娠期均进行产前优生筛查,对产前筛查结果进行分析,统计胎儿异常例数,采取相应的产前干预措施,并对未检出胎儿异常的孕产妇进行跟踪随访,观察其妊娠结局,统计出生缺陷儿娩出例数及产前筛查漏检率。结果 69 262例胎儿中,共有7 470例胎儿检出异常,其胎儿异常率为10.79%,其中2013年检出1 910例,2014年检出2 569例,2015年检出2 991例,其检出率分别为9.15%、10.70%、12.17%,最终经产前诊断检查确定为出生缺陷的胎儿共98例,均采用引产术以终止妊娠。对未检出异常的61 792例胎儿进行跟踪随访后发现,其中17例胎儿在孕期流产,有9例出生缺陷儿娩出,其出生缺陷发生率为0.1 457‰,其产前筛查漏检率为0.1 456‰。结论 在产前对孕产妇进行产前优生筛查,并根据产前筛查结果进行相应的干预,可有效检出异常胎儿,及时终止异常妊娠,有利于减少缺陷儿的出生,促进优生优育。

Objective To study and discuss intervention effects of prenatal eugenic screening in birth defects. Methods From January 2013 to December 2015, we did retrospective study on the clinical data of 69 183 cases of pregnant in which there were 69 262 fetal cases, made prenatal eugenic screening for all pregnant women. Prenatal screening results were analyzed, fetal abnormal cases were calculated. We took appropriate prenatal intervention measures, and followed up pregnant women who had no detection of fetal abnormal. We observed the pregnancy outcome, and calculated the defected childbirth cases and prenatal screening miss rates. Results 69 262 cases of fetus, a total of 7 470 cases of fetal abnormalities were detected. The fetal abnormality rate was 10.79%, of which 1 910 cases were in 2013, 2 569 cases in 2014, 2 991 cases in 2015. The detection rates respectively were 9.15%, 10.70%, 12.17%. 98 cases were determined as fetal birth defects by the final prenatal diagnosis examination, in which all adopted induction of labor to terminate pregnancy. 61 792 cases who were not detected anomalies were followed up in which 17 cases of fetus were found and had abortion during pregnancy, and 9 cases of fetal birth defects were delivered . The incidence of birth defects was 0.1 457 ‰, the prenatal screening miss rate was 0.1 456 ‰. Conclusion Pregnant women were made prenatal eugenic screening and according to the result of prenatal screening we took corresponding intervention, which is effective detect abnormal fetus. We may have timely termination of abnormal pregnancy,and reduce birth defects. It may promote human eugenics.

目的 调查分析病案首页疾病诊断存在的问题,以提出针对性的干预对策。方法 由病案科编码员根据《卫生部关于修订下发住院病案首页的通知》相关规定,对抽取的4200份病案首页的疾病诊断进行检查,对疾病诊断问题分类记录,同时对其发生原因进行问卷调查,建立相应数据库,应用Excel统计工具进行统计分析。结果 共748份的疾病诊断存在问题,发生率高达17.8%,包括疾病诊断中主要诊断选择错误8.3%、疾病诊断的名称不规范7.6%,以及漏诊问题1.8%。疾病诊断存在问题发生率较高的临床科室为内分泌科38.0%,骨科科32.8%,肿瘤科31.6%。在读研究生最容易出现疾病诊断问题,发生率高达48.0%。结论 对疾病诊断存在问题的高发临床医师群体和临床科室进行针对性干预对策,有望降低病案首页疾病诊断问题的发生率。

Objective To investigate the defects analysis and targeted intervention on the diseases diagnosis in the home pages of medical records. Methods To conduct an inspection analysis on the four thousand and two hundred medical records according to the related requirements of “Notification on Standard writing in Home Pages of Hospitalization Medical Records announced by the Ministry of Health” by professional medical records staff.They found out and classified the defects on the diseases diagnosis in the home pages of medical records,at the same time,questionnaire survey were carried on to investigate the related causes,and the corresponding database establish ed.Excel statistical tools were applied for statistical analysis. Results There were defects on the diseases diagnosis in a total of seven hundred and forty-eight cases,the incidence of which was 17.8%,including 8.3% of mistakes of main diagnosis,7.6% of lack of standardization in diagnosis names,1.8% of missed diagnosis respectively.Defects on the diseases diagnosis occurred in a higher rate in the clinical departments,such as department of endocrine with 38.0%,department of orthopedics with 32.8%,and department of oncology with 31.6%.Graduate students most prone to make mistakes with defects on the diseases diagnosis,the incidence of which was 48.0%. Conclusion Targeted interventions to clinician groups and clinical departments with high incidence of defects on the diseases diagnosis,is expected to reduce the incidence of which in the home pages of medical records.

目的 研究低视力儿童“学校-社区-家庭”三位一体综合康复干预工作的具体效果。方法 2013年1月,选择广州市盲人学校新入学80名低视力儿童,随机分为两组,为期二年的跟踪研究。其中A组执行“学校-社区-家庭”三位一体综合康复干预,B组执行传统康复干预。就知识积累、心理健康、生活能力三个方面对两组儿童的具体数据收集,研究“学校-社区-家庭”三位一体综合康复干预与传统干预方式之间的区别。结果 A组低视力儿童较B组儿童的文化知识积累与生活能力训练成绩均有提高,两者差距在正常分布带内,A组低视力儿童的心理素质优于B组低视力儿童。A组低视力儿童的综合评价效果高于B组儿童。结论 低视力儿童“学校-社区-家庭”三位一体综合康复干预工作的具体效果优于传统康复干预方式。

目的 探讨综合中医护理措施在无痛人工流产术后调复中的效果。方法 将100例无痛人流病人随机分为观察组和对照组各50例,对照组手术前后予常规护理。观察组在对照组的基础上,采取综合中医护理措施。结果 观察组术后阴道出血量、出血时间、腹痛持续时间等少于对照组,月经按时复潮率高于对照组(P<0.05)。结论 综合中医护理干预对无痛人工流产病人具有良好的调复作用,可以有效地提高患者术后舒适度,促进患者早日康复,值得临床推广应用。

目的 通过分析6例阴茎折断患者术后主要护理的要点,以提高阴茎折断患者术后的护理水平。方法 回顾性分析阴茎折断患者术后护理。对6例术后患者进行心理辅导,病情观察,正确体位的摆放,出院指导等护理干预。结果 6例患者在明确诊断后均急诊行阴茎血肿清除加白膜修补术,其中1例另外行尿道修补术。住院时间10~15天,平均9天,住院期间伤口愈合良好,无出现术后并发症。术后随访2~12个月,平均8个月。5例患者阴茎外观正常,性生活满意,无阴茎弯曲、痛性勃起、尿道狭窄等并发症。1例阴茎外观有轻度弯曲,但不影响性生活。结论 目前阴茎折断治疗的方法主要是手术治疗,护理人员帮助患者消除手术顾虑保持良好心态积极面对手术是手术成功的关键, 重视术后局部的护理以及病情观察,预防并发症的发生;指导患者积极进行功能锻炼和配合治疗,促进患者恢复。

Objective To summarize the experience of nursing intervention in diagnosis and treatment of penile fracture, and to improve the level of nursing of penile fracture. Methods The clinical data of 6 cases with penile fracture were retrospectively analyzed, the nursing intervention mode and significance in diagnosis and treatment were evaluated. 6 patients have emergency surgery after the diagnosis, and one patient urethra accepted surgical repair. Results The hospitalized period varied from 10 to15 days(average 9 days), and the patients were followed up for 2~12 months(average 8 months). 5 patients showed a very good outcome without complications, such as the penile deviation, pain, ED and urethral stricture, and 1 patient with penile deviation did not impede sexual activity. Conclusion Prompt surgical intervention of penile fracture showed a satisfied long-term outcome and get better therapeutic effects. Nursing intervention is important to improve the success rate of surgical, and targeted nursing after surgical can reduce complications.

目的 探讨社区护理干预指导在糖尿病中的临床护理效果。方法 采取回顾分析法对我市3个街道的居民资料,选取其中有分析价值的100例糖尿病患者资料进行临床分析,根据不同护理方法将患者分为对照组和观察组,对照组实施常规护理,观察组进行社区护理干预指导,比较两组护理效果。结果 实验组体重指数为(22.9±2.48)kg/m²、FBG指标为(7.24±1.68)mmol/L、2hBG指标为(9.72±2.14)mmol/L、HbALc指标为(7.26±1.08)%,低于对照组(P<0.05);实验组96%合理饮食、98%生活具有规律性,92%患者能够定期运动,94%患者能够自我监测病情,高于对照组(P<0.05)。结论 对社区糖尿病患者进行护理指导时,常识性问题、危险性因素、并发症预防问题认识不足是护理督促的要点。因此应提升社区糖尿病患者的自我管理能力,对糖尿病患者进行心理护理、饮食治疗、运动养生、定期服药等方面的进行护理干预,提高社区居民的预防意识和督促指导。

Objective To investigate the guidance of community nursing intervention in diabetes clinical care effect. Methods A retrospective analysis of the city's three neighborhood offices resident data to be analyzed, select one of the analytical value of 100 patients with diabetes clinical data analysis, according to the different methods of care patients were divided into a control group and observation group.Control implementation of routine care group, observation group of community nursing intervention guidance, care and effect between the two groups. Results Body mass index in the experimental group (22.9±2.48) kg/m², FBG indicators (7.24±1.68) mmol/L, 2hBG indicators (9.72±2.14) mmol/L, HbALc indicators (7.26±1.08)%, significantly were lower than the control group (P<0.05); the experimental group, 96% of a reasonable diet, 98% had a regular life, 92% of patients can do exercise regularly, 94% of patients were able to self-monitoring disease.It was significantly higher (P<0.05). Conclusion Diabetic patients in community care and guidance, common sense, risk factors, lack of awareness of the issue of prevention of complications is the point of care supervise, and also one of the main problems exist. It should enhance self-management of diabetes, psychological care, diet therapy, exercise regimen, regular medication and other aspects of nursing intervention guidance. It should be increasing community awareness of prevention, improve supervision and guidance role.