论著

基于Caprini量表评估的干预模式联合充气加压泵预防慢性阻塞性肺疾病急性加重期患者静脉血栓的效果

Effect of intervention mode based on Caprini score combined with inflatable pump in preventing VTE in patients with AECOPD

:507-512
 
      目的 观察慢性阻塞性肺疾病急性加重期(AECOPD)患者应用基于Caprini量表评估的干预模式联合充气加压泵(IPC)预防静脉血栓(VTE)的效果。方法 选取河南省人民医院在2023年11月—2024年11月收入的82例AECOPD患者作为研究对象,经随机数表法分为对照组41例予以VTE常规干预,观察组41例在对照组的基础上接受基于Caprini量表评估的干预模式联合IPC预防。比较两组AECOPD患者肢体情况及深静脉血栓(VTE)发生情况、凝血指标及股静脉血流速度。结果 观察组肢体肿胀率、肢体疼痛率及VTE发生率均低于对照组(P<0.05)。干预前,两组AECOPD患者凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体水平比较差异无统计学意义(P>0.05);干预后,两组患者TT、PT、APTT、D-二聚体水平均降低,观察组较低(P<0.05)。干预前,两组AECOPD患者平均流速、血流峰速及阻力指数比较差异无统计学意义(P>0.05);干预后,两组患者平均流速、血流峰速均升高,观察组高于对照组(P<0.05);阻力指数均降低,观察组低于对照组(P<0.05)。结论 AECOPD患者应用基于Caprini量表评估的干预模式联合IPC能有效降低肢体肿胀率、肢体疼痛率及VTE发生率,改善凝血指标与股静脉血流速。
   Objective To observe the effect of a Caprini score?based intervention model combined with intermittent pneumatic compression(IPC)in preventing venous thromboembolism(VTE)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 82 AECOPD patients admitted to Henan Provincial People’s Hospital from November 2023 to November 2024 were selected as subjects and randomly divided into a control group(41 cases)and an observation group(41 cases)using a random number table.The control group received routine VTE prevention,while the observation group received the Caprini score?based intervention combined with IPC in addition to the routine care.The extremity conditions,occurrence of VTE,coagulation parameters,and femoral venous blood flow velocity were compared between the two groups.Results The rates of extremity swelling,extremity pain,and VTE incidence in the observation group were lower than those in the control group(P<0.05).Before the intervention,there were no statistically significant differences in thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),or D?dimer levels between the two groups(P>0.05).After the intervention,TT,PT,APTT,and D?dimer levels decreased in both groups,with lower values in the observation group(P<0.05).Before the intervention,there were no statistically significant differences in mean flow velocity,peak flow velocity,or resistance index between the two groups(P>0.05).After the intervention,mean flow velocity and peak flow velocity increased in both groups,with higher values in the observation group(P<0.05),while the resistance index decreased,with a lower value in the observation group(P<0.05).Conclusions The application of a Caprini score?based intervention model combined with IPC in AECOPD patients can effectively reduce the rates of extremity swelling,extremity pain,and VTE incidence,and improve  coagulation parameters and femoral venous blood flow velocity.

基于“治未病”理论探讨肛周脓肿术后防瘘策略

Postoperative anti-fistula strategy for perianal abscess based on the theory of "prevention and treatment of diseases"

:-
 
肛周脓肿术后防瘘是临床的关注点,本文基于“治未病”思想,提出覆盖肛周脓肿术后防瘘全周期的防治策略,包括未病调体质、调摄饮食、优化手术、加强创面管理降低风险,既发截断病势、辨证防治并发症及局部干预防蔓延,康复期整体调养与随访促愈防复,为中医药在肛周脓肿术后防瘘的临床实践应用方面提供参考。
Prevention of fistula formation after perianal abscess surgery is a clinical concern. Based on the concept of "treating disease before it arises," this paper proposes a comprehensive prevention and treatment strategy covering the entire cycle of fistula prevention after perianal abscess surgery, including regulating constitution before disease onset, adjusting diet, optimizing surgery, strengthening wound management to reduce risk, interrupting disease progression after onset, treating complications based on syndrome differentiation, and local intervention to prevent spread. During the rehabilitation period, holistic recuperation and follow-up are emphasized to promote healing and prevent recurrence, providing a reference for the clinical application of traditional Chinese medicine in preventing fistula after perianal abscess surgery.

基于口腔-肠道微生物轴探讨中医药防治动脉粥样硬化的研究进展

Research Progress on the Prevention and Treatment of Atherosclerosis by Traditional Chinese Medicine Based on the Oral-Gut Microbiota Axis

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动脉粥样硬化(AS)是心血管疾病的病理基础,口腔与肠道通过菌群移位、代谢互作及免疫联动共同构成口腔-肠道微生物轴,其稳态失衡通过菌群易位、代谢紊乱和屏障损伤等促进AS发生发展。中医药以整体观念与辨证论治为指导,多靶点调控口腔-肠道微生物平衡,抑制血管炎症与脂质沉积,发挥抗AS效应。本文系统阐述口腔-肠道微生物与AS的关联,探讨中医药调控微生态防治该病的研究进展,分析当前研究存在的局限并展望未来方向,为中医药防治AS提供新的思路与理论依据。
Atherosclerosis (AS) is the pathological basis of cardiovascular diseases. The oral cavity and the gut together constitute the oral-gut microbial axis through microbial translocation, metabolic interactions, and immune crosstalk. Dysbiosis of this axis promotes the occurrence and development of AS via bacterial translocation, metabolic disorders, and barrier damage. Guided by the holistic concept and syndrome differentiation-based treatment, traditional Chinese medicine (TCM) exerts anti-AS effects by multi-target regulation of the oral-gut microbial balance, inhibiting vascular inflammation and lipid deposition. This article systematically elaborates the association between the oral-gut microbiota and AS, explores the research progress of TCM in modulating microecology for the prevention and treatment of AS, analyzes the limitations of current studies, and prospects future directions, so as to provide new insights and theoretical basis for TCM in preventing and treating AS.
论著

自发性脑出血患者静脉血栓栓塞症的危险因素及预防措施

Spontaneous intracerebral hemorrhage and venous thromboembolism:Risk factors and preventive strategies

:214-220
 
       目的 探讨自发性脑出血(SICH)患者静脉血栓栓塞症(VTE)的独立危险因素,并评估针对性分层预防措施的有效性及安全性, 为临床优化防治策略提供依据。方法 回顾性纳入2022年1月—2025年1月收治的86例SICH患者, 根据下肢深静脉超声结果分为深静脉血栓(DVT)组(n=16)与非DVT组(n=70)。采集患者基线资料、临床特征及实验室指标, 采用单因素及多因素Logistic回归分析VTE危险因素, 并基于独立危险因素制定分层预防方案。结果 多因素分析显示, 体质指数(BMI)升高(OR=1.22, 95%CI:1.06~1.41)、中心静脉置管(OR=5.23, 95%CI:1.37~19.95)、止血药物使用(OR=4.80, 95%CI:1.21~19.01)及NIHSS评分升高(OR=1.20, 95%CI:1.02~1.42)是VTE的独立危险因素(均P<0.05)。因此需针对SICH患者进行针对性干预, 包括基于BMI的个体化干预、中心静脉置管的精细化管控、止血药物的动态调控及神经功能保护与早期康复。结论 SICH患者VTE发生与代谢、医源性及神经功能损伤多因素交互作用密切相关, 应针对患者构建基于BMI、中心静脉管理及凝血监测的分层预防策略。
       Objective To explore the independent risk factors for venous thromboembolism(VTE)in patients with spontaneous intracerebral hemorrhage(SICH)and to assess the effectiveness and safety of targeted stratified prophylaxis to provide a basis for optimizing prevention and treatment strategies in the clinic.Methods A retrospective analysis was conducted on 86 SICH patients admitted between January 2022 and January 2025.Based on lower-extremity venous ultrasound findings, patients were divided into a deep venous thrombosis(DVT)group(n=16)and a non-DVT group(n=70).Baseline characteristics, clinical features, and laboratory indicators were collected.Univariate and multivariate Logistic regression analyses were performed to identify VTE risk factors, and a stratified prevention protocol was developed based on independent risk factors.Results Multivariate analysis revealed that elevated body mass index(BMI)(OR=1.22, 95%CI:1.06-1.41), central venous catheterization(OR=5.23, 95%CI:1.37-19.95), hemostatic drug use(OR=4.80, 95%CI:1.21-19.01), and higher NIHSS scores(OR=1.20, 95%CI:1.02-1.42)were independent risk factors for VTE(all P<0.05).Consequently, targeted nursing interventions should be implemented for SICH patients, including BMI-based personalized care, refined management of central venous catheters, dynamic regulation of hemostatic drugs, and neuroprotective early rehabilitation.Conclusions VTE in SICH patients is closely associated with the interplay of metabolic, iatrogenic,and neurological injury factors.A stratified prevention strategy incorporating BMI monitoring, central venous catheter management, and coagulation surveillance is critical for reducing thrombotic risk while ensuring safety.
论著

非酒精性脂肪肝老年人体质辨识及中医治未病服务对其治疗效果探讨

Identification of the constitution of the elderly with nonalcoholic fatty liver disease and discussion on the therapeutic effect of preventing disease before arising

:63-69
 
       目的   研究非酒精性脂肪肝老年人体质辨识及中医治未病服务对其治疗效果。方法   选择2023年1月—2024年1月贵州中医药大学第一附属医院就诊的非酒精性脂肪性肝病老年患者70例作为研究对象,根据患者就诊顺序分配为两组。对照组35例,接受常规干预;观察组35例,其在对照组基础上予中医“治未病”理念下体质辨识干预模式。比较两组干预效果,以及干预前后血脂水平、肝功能、生存质量的变化。结果   观察组的治疗总有效率91.43%,高于对照组的68.57%,差异有统计学意义(P<0.05)。治疗前,两组各项血脂水平、肝功能、慢性肝病问卷(CLDQ)评分比较,差异无统计学意义(P>0.05);治疗后,两组各项血脂水平优于治疗前,各项肝功能低于治疗前,CLDQ评分高于治疗前,差异有统计学意义(P<0.05);治疗后,观察组的各项血脂水平优于对照组,各项肝功能低于对照组,CLDQ评分高于对照组,差异有统计学意义(P<0.05)。结论   对非酒精性脂肪性肝病老年患者而言,中医“治未病”理念下体质辨识干预服务能够提高其治疗效果,调节血脂水平的异常,改善肝功能及生存质量,值得应用。
       Objective  To study the physical identification of nonalcoholic fatty liver in the elderly and the therapeutic effect of traditional Chinese medicine on preventing disease before arising.Methods  A total of 70 elderly patients with nonalcoholic fatty liver disease treated in the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2023 to January 2024 were selected as the study objects.Patients were assigned to two groups,control group(35 cases)received  routine intervention,observation group(35 cases)received physical identification intervention based on preventing disease before arising of traditional Chinese medicine additionally.The effect of intervention and the changes of blood lipid levels,liver function and quality of life before and after intervention were compared between the two groups.Results  The total effective rate of the observation group was 91.43%,higher than that of the control group(68.57%),the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in blood lipid levels,liver function and CLDQ scores between the two groups(P>0.05).After treatment,the levels of blood lipids were better than those before treatment,liver function was lower than that before treatment,CLDQ score was higher than that before treatment,the difference was statistically significant(P<0.05).After treatment,the blood lipid levels of the observation group was better than that of the control group,the liver function was lower than that of the control group,and the CLDQ score was higher than that of the control group,with statistical significance(P<0.05).Conclusions  For elderly patients with nonalcoholic fatty liver disease,the intervention service of body constitution identification under the concept of preventing disease before arising of traditional Chinese medicine can improve the therapeutic effect,regulate the abnormal blood lipid levels,improve liver function and quality of life,which is worthy of application.
综述

中医药调控 CD4+ T 细胞亚群防治动脉粥样硬化的研究进展

Research progress on the regulation of CD4+ T cell subsets by traditional Chinese medicine for the prevention and treatment of atherosclerosis

:24-29
 
       动脉粥样硬化(AS)是一种起始于炎症介导的内皮损伤的慢性血管疾病,其本质是免疫炎症驱动的病理过程,是众多心血管疾病的病理基础。CD4+  T细胞亚群[包括辅助性T细胞1型(T helper 1 cell,Th1)、Th2、Th17、调节性T细胞等]通过分泌特异性细胞因子参与AS的炎症反应,其中促炎性CD4+  T细胞与抗炎性CD4+  T细胞的抗炎功能失衡是推动斑块进展的关键环节,在AS斑块形成与发展中起关键作用。近年来,多项研究表明某些中药单体、经典复方及其有效成分,具有多靶点、多层次机制调控CD4+  T细胞分化及功能,这些作用共同减轻血管内皮炎症反应、抑制巨噬细胞泡沫化及平滑肌细胞迁移等,延缓AS斑块形成与发展,为AS防治提供了新思路,展现了中医药在该领域的研究展现出独特优势与广阔前景,本文综述了中医药通过干预CD4+  T细胞亚群平衡防治AS的最新研究进展,及其影响相关细胞因子网络及关键信号通路的作用机制,为开发具有多靶点协同优势的创新中药与中西医结合治疗方案提供了关键理论依据与实践方向。
       Atherosclerosis(AS)is a chronic vascular disease that originates from inflammation mediated endothelial 
damage.Its essence is a pathological process driven by immune inflammation,and it is the pathological basis of many cardiovascular diseases.CD4+  T cell subsets(including Th1,Th2,Th17,Treg,etc.)participate in the inflammatory response of AS by secreting specific cytokines.The imbalance of anti-inflammatory function between pro-inflammatory CD4+  T cells and anti-inflammatory CD4+T cells is a key link in promoting plaque progression and playing a crucial role in the formation and development of AS plaques.In recent years,a number of studies have shown that the monomers,classic prescriptions and their effective ingredients of Chinese herbs have the effect of multi-target,multi-level mechanism to regulate the differentiation and function of CD4+  T cells.These effects together reduce the inflammatory reaction of vascular endothelium,inhibit the foam formation of macrophages and smooth muscle cell migration,delay the formation and development of AS plaque,provide new ideas for the prevention and treatment of AS,and make the research of Chinese medicine show unique advantages and broad prospects in this field.This article  reviews the latest  research progress of Chinese medicine in the prevention and treatment of AS by intervening in the balance of CD4+  T cell subsets,as well as the mechanism of its effects on related cytokine networks and key signal pathways.This provides a key theoretical basis and practical direction for the development of innovative traditional Chinese medicine and integrated traditional Chinese and Western medicine treatment plans with multi-target synergistic advantages.
论著

新型穿戴式气压治疗仪预防深静脉血栓的非劣效性临床研究

Evaluation of new type of wearable pneumatic compression pump in prevention of deep vein thrombosis:A non-inferiority study

:1663-1668
 
       目的   评价新型穿戴式气压治疗仪预防深静脉血栓的临床疗效及安全性。方法   将156例脑梗死患者随机分为对照组和试验组,各78例。试验组使用新型穿戴式气压治疗仪(邦普医疗/VW100)进行气压治疗。对照组使用韩国元金压力治疗仪进行气压治疗。两组疗程均为10 d,观察临床疗效及安全性,比较两组深静脉血栓形成率、医护人员和患者的使用满意度。结果   治疗10 d后,试验组与对照组深静脉血栓未发生率差值为1.2%,相应的95%置信区间为–5.3%~7.9%,下限高于–10%,医护人员和患者对试验组的评价优于对照组(P<0.001)。结论   新型穿戴式气压治疗仪预防深静脉血栓形成的临床疗效不劣于市面上已有的气压治疗仪,治疗过程中未见明显不良反应,临床使用安全有效。
        Objective  To  evaluate the  effectiveness  and  safety  of  new wearable  pneumatic  compression  pump in preventing deep vein thrombosis.Methods  One hundred and fifty-six patients with cerebral infarction were randomly divided into control and study group with 78 cases in each group.Study group was treated with the new wearable pneumatic compression pump(Bangpu Medical / VW100).Control group was treated with pneumatic compression pump(Wonjin-POWER).The course of both groups was 10 days,comparing the deep vein thrombosis  rate and useage satisfaction of patients and staffs between the two groups.Results  After 10 days of treatment,the difference between the incidence of deep venous thrombosis in the study and control group was 1.2%.The corresponding 95% confidence interval was(-5.3%,7.9%),and the lower limit was greater than -10%.The appraisal from medical staffs and the patients of study group was better than that of the control group(P<0.001).Conclusions  The clinical effect of the new wearable pneumatic compression pump to prevent deep vein thrombosis is not inferior to the existing pneumatic compression pump,which clinical practice experience is better.There is no obvious adverse reactions in the treatment process,and the clinical practice is also safe and effective.
论著

2021—2022年洛阳市涧西区作业场所职业病危害因素的监测结果及具体防控策略研究

Monitoring results and specific prevention and control strategies for occupational disease hazards in workplaces in Jianxi District,Luoyang City from 2021 to 2022

:35-40
 
目的 统计洛阳市涧西区各作业场的职业病危害因素,分析职业病发生的主要原因,并探讨具体防控策略。方法 收集洛阳市涧西区内2021年1月—2022年12月期间针对各作业场的职业病危害因素监测信息,录入Excel 2010进行数据统计;随机抽取辖区内200名重点职业从业人员,开展回顾性分析,结合职业健康检查结果,将确认存在职业病的115名从业人员列为病例组,其余未发生职业病的85名从业人员列为对照组,比较2组一般资料、临床资料,经统计学单因素、Logistic多因素回归分析归纳可导致职业病发生的影响因素,结合分析结果,探讨具体防控措施。结果 针对辖区内15家厂矿企业,2021年共设立584个监测点,共测得68处锰及其化合物危害、48处矽尘危害、4处苯及其苯系物危害、12处噪声危害,超标率为22.60%(132/584);2022年共设立1 575个监测点,共测得158处粉尘危害、154处锰及其化合物危害、10处矽尘危害、13处噪声危害,超标率为21.27%(335/1 575);单因素分析结果显示,2组从业人员的年龄、工作年限、职业类型、体检频率、体检结果等比较差异均存在统计学意义;Logistic多因素回归分析显示,年龄≥50岁,工作年限≥10年,从事制造业、采矿业,未规律体检,血常规异常,免疫力差,X线胸片异常,双耳高频听力阈值≥40 dB均是发生职业病的重要原因(均P<0.05)。结论 洛阳市涧西区的职业危害因素以粉尘、锰及其化合物为主,高龄、工作年限长的制造业、采矿业人员发生职业病的风险相对较高,优化职业病防治措施并规范上述重点人群的职业健康体检能实现对职业病的有效防控。
Objective To analyze the occupational disease hazards in various workplaces in Jianxi District,Luoyang City,and to analyze the main causes of occupational disease occurrence,explore specific prevention and control strategies.Methods Monitoring information on occupational disease hazards in various workplaces within the jurisdiction from January 2021 to December 2022 was collected,Excel 2010 was used for data statistics.Two hundred key occupational employees within the jurisdiction were selected randomly for retrospective analysis.Based on the results of occupational health examinations,115 employees confirmed to have occupational diseases were included in the case group,while 85 employees who did not have occupational diseases were included in the control group.General and clinical data of the two groups were compared,and the influencing factors that could lead to the occurrence of occupational diseases were summarized through statistical single factor and multivariate logistic regression analysis. Combined with the analysis results,specific prevention and control measures were discussed.Results For 15 factories and mining enterprises within the jurisdiction,a total of 584 monitoring sites were established in 2021,and a total of 68 manganese and its compound hazards,48 silica dust hazards,4 benzene and its benzene series hazards,and 12 noise hazards were measured,which the exceeding rate was 22.60%(132/584).In 2022,a total of 1 575 monitoring sites were established,with a total of 158 dust hazards,154 manganese and its compounds hazards,10 silica dust hazards,and 13 noise hazards detected,which the exceeding rate was 21.27%(335/1 575).The results of statistical univariate analysis showed that there were certain differences in the age,years of work,occupational type,frequency of physical examinations,and results of physical examinations between the two groups of employees.Multivariate logistic regression analysis showed that age≥50 years old,working experience≥10 years,engaged in manufacturing and mining industries,irregular physical examinations,abnormal blood routine,immune differences,chest X-ray abnormalities,and binaural high-frequency hearing threshold≥40 dB were all important reasons for the occurrence of occupational diseases.Conclusions The occupational hazards in this jurisdiction are mainly dust,manganese,and their compounds.The risk of occupational diseases among elderly manufacturing and mining workers with long working years is relatively high.Optimizing occupational disease prevention and control measures and standardizing occupational health examinations for the above-mentioned key populations can achieve effective prevention and control of occupational diseases.
论著

托烷司琼预处理配合丙泊酚全身麻醉对预防PONV的价值

The value of tropisetron preconditioning combined with propofol general anesthesia in preventing PONV

:146-150
 
目的 观察托烷司琼预处理配合丙泊酚全身麻醉对预防术后恶心呕吐(PONV)的应用价值。方法 采用前瞻性研究,纳入融通集团信阳154医院在2021年6月—2022年12月期间收治的接受腹腔镜手术治疗的122例患者,所有患者均实施含丙泊酚的全身麻醉辅助手术,采用随机数字表法对入组患者进行分组,分别列为预处理组(61例)和常规组(61例),常规组术后予以常规止吐,预处理组采用托烷司琼预处理,比较两组患者术后6 h、术后12 h、术后24 h及术后48 h等不同时间点的PONV发生率、呕吐症状改善情况,麻醉苏醒后的疼痛、镇静情况,以及术后48 h内的麻醉相关不良反应发生情况。结果 预处理组术后6 h的PONV发生率为3.28%(2/61),术后12 h的PONV发生率为4.92%(3/61),术后24 h的PONV发生率为3.28%(2/61),术后48 h的PONV发生率为0.00%(0/61),均低于常规组[16.39%(10/61)、18.03%(11/61)、16.39%(10/61)、13.11%(8/61)],差异有统计学意义(P<0.05)。预处理组术后6 h的恶心呕吐干呕症状评估量表(INVR)评分为(20.15±5.41)分,术后12 h的INVR评分为(17.66±4.42)分,术后24 h的INVR评分为(13.29±4.17)分,术后48 h的INVR评分为(10.22±3.35)分,均低于常规组[(23.32±5.13)分、(20.12±4.35)分、(16.33±4.24)分、(12.75±3.06)分],差异有统计学意义(P<0.05)。预处理组苏醒后的视觉模拟疼痛量表(VAS)评分为(4.04±1.06)分,Ramsay镇静评分为(3.11±0.25)分,与常规组[(3.87±0.25)分、(3.06±0.35)分]比较差异无统计学意义(P>0.05)。术后48 h内,预处理组的麻醉相关不良反应发生率为9.84%(6/61),与常规组8.20%(5/61)比较差异无统计学意义(P>0.05)。结论 托烷司琼预处理辅助含丙泊酚腔镜全身麻醉腹手术可有效降低PONV发生风险并改善患者PONV相关症状,联合应用此药未对麻醉镇静、镇痛效果产生明显影响,且未明显增加术后麻醉相关不良反应发生风险,安全性较高。
Objective To observe the application value of tropisetron preconditioning combined with propofol general anesthesia in the prevention of postoperative nausea and vomiting(PONV).Methods This is a prospective cohort study.The patients were included from June 2021 to December 2022.The subjects of the study were 122 patients who received laparoscopy.All patients received general anesthesia assisted surgery containing propofol.The enrolled patients were divided into preconditioning group(61 cases)and conventional group(61 cases)by random number table.The conventional group was given routine antiemesis after surgery,and the preconditioning group was given tropisetron preconditioning.The incidence of PONV,improvement of vomiting symptoms,pain and sedation after anesthesia awakening,and occurrence of anesthesia related adverse reactions within 48 hours after surgery were compared between two groups of patients at different time points,including 6 hours,12 hours,24 hours,and 48 hours after surgery.Results Under different treatment regimens,the PONV incidence rates in the preconditioning group were 3.28%(2/61)after 6 hours,4.92%(3/61)after 12 hours,3.28%(2/61)after 24 hours,and 0.00%(0/61)after 48 hours.Compared with the conventional group [16.39%(10/61),18.03%(11/61),16.39%(10/61),and 13.11%(8/61)],the incidence rates were lower(P<0.05).The preconditioning group had an Index of Nausea and Vomiting and Retching(INVR)score of(20.15±5.41)points after 6 hours,(17.66±4.42)points after 12 hours,(13.29±4.17)points after 24 hours,and(10.22±3.35)points after 48 hours.Compared with(23.32±5.13)points,(20.12±4.35)points,(16.33±4.24)points,and(12.75±3.06)points)of the preconditioning group ,the INVR score at each time point was lower(P<0.05).Under different treatment regimens,the VAS score of the preconditioning group after awakening was(4.04±1.06)points,and the Ramsay score was(3.11±0.25)points,which was similar to the conventional group [(3.87±0.25)points,(3.06±0.35)points](P>0.05).Within 48 hours after surgery,the incidence of anesthesia related adverse reactions in the preconditioning group was 9.84%(6/61),which was similar to 8.20%(5/61)in the conventional group(P>0.05).Conclusions Tropisetron preconditioning assisted laparoscopy under general anesthesia with propofol can effectively reduce the risk of PONV and improve the PONV related symptoms of patients.The combined use of this drug has no significant impact on the sedation and analgesia effects of anesthesia,and does not significantly increase the risk of postoperative anesthesia related adverse reactions,with high safety.
论著

营养指导联合预防护理在小儿癫痫意外预防中作用观察

Observation on the role of nutritional guidance combined with preventive nursing in the prevention of epilepsy accidents in children

:667-672
 
目的 观察营养指导联合预防护理在小儿癫痫意外预防中作用。方法 抽取焦作市妇幼保健院2021年1月—2023年1月收治的116例小儿癫痫患儿,按照护理方法分为两组,每组各58例。对照组行常规护理,联合组患儿在常规护理基础上给予营养指导联合预防护理干预,对比两组家属满意度、患儿依从率、蒙特利尔认知评估量表(MoCA)评分。结果 经过护理干预,联合组家属满意率98.28%,依从率96.55%,比对照组87.93%、82.76%高(P<0.05);住院至出院居家三个月内,相较于对照组,联合组患儿外伤发生次数、发病持续时间、癫痫发作次数较少(P<0.05);护理后,联合组MoCA评分高于对照组(P<0.05)。结论 在小儿癫痫意外预防中联合应用营养指导和预防护理可改善患儿遵医行为,优化小儿癫痫意外预防效果,减少患儿外伤、癫痫发生次数,缩短患儿发病持续时间,提升患儿生活质量和家属满意度。
Objective To observe the effect of nutritional guidance combined with preventive nursing on the prevention of epilepsy accidents in children.Methods A total of 116 cases of pediatric epilepsy admitted in Jiaozuo Maternal and Child Health Care Hospital from January 2021 to January 2023 were selected.They were divided into two groups according to the nursing method,with 58 cases in each group.The control group was given usual care,while the combined group was given nutritional guidance combined preventive nursing intervention.The satisfaction,the compliance rate and MoCA score were compared between two groups.Results After nursing intervention,the satisfaction rate of the combined group was 98.28%,and the compliance rate of the combined group was 96.55%,which were higher than 87.93% and 82.76% in the control group(P<0.05).Within three months from hospitalization to discharge,compared with the control group,number of injuries,duration and frequency of seizures were less in the combined group(P<0.05).After nursing,the MoCA score of the combined group was higher than that of the control group(P<0.05).Conclusions The combined application of nutritional guidance and preventive nursing in the prevention of pediatric epileptic accidents can improve the compliance behavior of children,optimize the prevention effect of pediatric epileptic accidents,reduce the incidence of trauma and epilepsy in children,shorten the duration of illness,and improve the quality of life of children and family satisfaction.
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