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目的 探讨生血宁片对缺铁性贫血孕妇的治疗效果。方法 选取90个缺铁性贫血孕妇为研究对象,随机分为A、B、C三组,每组30人,从孕28周开始治疗,A组服用多糖铁复合物,B组口服生血宁片,C组采用营养科建议的补铁食疗菜谱,一直治疗至分娩前,治疗前后各检测血常规,血红蛋白(Hb)、红细胞比容(HCT)、红细胞平均体积(MCV)、红细胞平均血红蛋白浓度(MCHC)对比治疗效果。结果 服药前各组孕妇的血Hb、RBC、HCT、MCV、MCH无统计学差异,A、B组服药后Hb、RBC、HCT、MCV、MCH均高于服药前,且结果有统计学意义(P<0.05),C组食疗前、后Hb、RBC、HCT、MCV、MCH无统计学差异,A、B、C三组之间Hb、RBC、HCT、MCV、MCH对比结果为,A、B组之间Hb、RBC、HCT、MCV、MCH差异无统计学意义(P>0.05),但均高于C组,差异有统计学意义(P<0.05)。结论 生血宁对孕晚期缺铁性贫血的孕妇有治疗作用,且效果与多糖铁复合物相当。
Objective To investigate the therapeutic effect of Shengxuening tablets on iron deficiency anemia in pregnant women. Methods Selected A total of 90 pregnant women with iron deficiency anemia as the research objects, randomly divided into A, B, C three groups. Each group of 30 people was treated since 28 weeks of pregnancy. Group A was treated with polysaccharide iron complex, group B with Shengxuening tablets, group C with the nutritionist recommended iron diet recipes. They have been treated till delivery. Before and after treatment, blood routine examination, the value of Hb,RBC,HCT,MCV,MCH had contrast treatment. Results There was no significant difference of serum Hb,RBC,HCT,MCV,MCH in the pregnant women before treatment. After treatment, Hb,RBC,HCT,MCV,MCH of group A, B were higher than before, and the results were statistically significant(P<0.05). Before therapy of group C, there was no significant difference, in the three groups, results of Hb,RBC,HCT,MCV,MCH, there was no statistical difference between group A, B (P>0.05), but both were higher than group C, the difference was statistically significant(P<0.05). Conclusion There was therapeutic effect of Shengxuening in late pregnant women with iron deficiency anemia, and it is equal to the effect of Polysaccharide iron complex treatment.
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目的 研究并分析优质护理对消化性溃疡患者的临床疗效以及护理满意度的影响。方法 入选2014年8月—2015年10月收治的184例消化性溃疡患者作为研究对象, 根据电脑随机数字将患者随机分为研究组和对照组,各92例。对照组男50例,女42例,年龄18~60 a,平均年龄(43.7±2.1)a,病程2~10 a,平均(5.2±0.4)a,研究组男48例,女44例,年龄20~59 a,平均(42.3±3.6)a,病程2~10 a,平均(5.2±0.4)a。患者入院后均给予消化性溃疡常规基础治疗(四联疗法),在此基础上给予对照组患者常规护理,研究组患者优质护理,对比两组患者的临床疗效和护理满意度。结果 经研究观察对比,研究组消化性溃疡患者的临床疗效明显优于对照组,研究组消化性溃疡患者的总有效率为95.65%,对照组为79.35%,两组数据对比差异有统计学意义(P<0.05)。研究组患者治疗后烧心、上腹痛、嗳气等症状减轻明显较对照组显著,所需时间更短,胃镜检查显示研究组患者经优质护理处理后溃疡愈合时间明显缩短,愈合明显优于对照组,上述对比差异有统计学意义(P<0.05)。研究组护理满意度为96.74%,对照组护理满意度仅83.69%,研究组高于对照组,差异有统计学意义(P<0.05)。结论 优质护理能够明显缩短溃疡愈合时间,促进患者痊愈,提高消化性溃疡患者的疗效和护理满意度,值得临床推广和应用。
Objective To study and analyze the effect of high quality nursing on curative effect of patients with peptic ulcer and nursing satisfaction. Methods 98 cases of peptic ulcer patients income for treatment from August 2014 to October 2015 were selected as study subjects. The patients were randomly divided into study group and control group, 49 cases in each group. The control group included male 28 case,female 21 case,aged 18~60 years old, average age (43.7±2.1) years, disease duration of(2~10)years, average(5.2±0.4) years.Study group included male 24 cases, female 25 cases, aged 20~59 years old, average age (42.3±3.6) years, disease duration of (2~10) years, average (5.2±0.4) years. After the patient was admitted to hospital, they were treated with digestive ulcer routine treatment (quadruple therapy). On this basis,patients in the control group were given routine nursing care, the study group patients with high quality nursing, compared with the two groups of patients with clinical efficacy and nursing satisfaction. Results Study group patients with peptic ulcer clinical, curative effect was obviously superior to the control group. The study group patients with peptic ulcer, total efficiency was 95.91%, It was 79.59% in the control group, the difference between the data of two groupshad statistical significance (P<0.05). Study group nursing satisfaction was 97.96%, the control group was only81.63%. The study group was significantly higher than the control group, the difference was statistically significant (P<0.05). Quality care may significantly shorten the average length of stay in patients, the difference was statistically significant (P<0.05). Conclusion High quality nursing may significantly shorten the average length of stay in patients with peptic ulcer, improve the curative effect of peptic ulcer patients and nursing satisfaction. It is worthy of clinical popularization and application.
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目的 通过对我院健康体检人群眼科体检的数据分析,探讨眼科健康管理对眼部疾病防治的重要性。方法 分析2015年1月—12月眼科体检人群的数量、来源、性别、年龄。分析各类眼部疾病的检出率及不同年龄、性别的分布情况。结果 眼科疾病主要为屈光不正、结膜炎、白内障、眼底动脉硬化、黄斑变性等。屈光不正多以青壮年为主,结膜炎在中老年人群中检出率较高,白内障及眼底疾病的检出率在中老年人群中随年龄的增加而增加。结论 对于常见病和隐匿性疾病的防治,眼科体检具有较好的指导意义。
Objective Through the data analysis of eye common diseases in our hospital physical examination population to discuss the importance of eye health management for eye common disease prevention and control. Methods To analyze the quantities, source, gender and age of the eye examination population from Jan to Dec 2015.To analyze relevance ratio of all kinds of eye common disease and the distribution of different age and gender. Results Ophthalmic diseases included mainly ametropia, conjunctivitis, cataracts,fundus arteriosclerosis,macular degeneration and so on. Ametropia mainly happened at young adults, conjunctivitis detection rate was higher in the elderly crowd. The detection rate of cataract and retinal diseases in the elderly crowd increased with their ages. Conclusion For the prevention and treatment of common diseases and latent glomerular diseases, ophthalmic examination has a good guiding significance.
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目的 了解近五年某地市级综合医院传染病病例疫情情况,分析其流行病学特征,为探索医院传染病预防控制工作提供科学依据。方法 采用描述性流行病学方法和Excel 2007软件对传染病疫情报告资料进行分析。结果 2010—2014年法定报告的传染病发病例数基本呈持续上升趋势。2010—2014年共报告传染病11 673例次,发病数居前5位的传染病依次为手足口病、乙型肝炎、梅毒、生殖道沙眼衣原体感染、肺结核,分别占21.17%、12.44%、12.16%、8.51%和7.52%;总死亡数为21例,病死率为1.799‰。5年来,不同传染病发病数呈现出不同的变化趋势。结论 及时掌握当地传染病的发病情况,加强对常见传染病的防控力度,提高病原检测力度,做好传染病的筛查工作,防止传染病在医院内传播。
Objective To analyze the characteristic features of notifiable diseases in a general hospital from 2010 to 2014, and provide basis information for notifiable diseases' prevention and control. Methods Using descriptive epidemiological methods and microsoft Excel 2007, the report data of notifiable diseases was statistically analyzed. Results The number of notifiable diseases increased during 2010 to 2014. 11 673 cases of notifiable diseases were reported in the hospital at the same time.The top five reported cases of notifiable diseases were hand-foot-and-mouth disease(HFMD),hepatitis B virus, syphilis, chlamydia trachomatis infection and tuberculosis, account for 21.17%,12.44%,12.16%,8.51% and 7.52% accordingly. Moreover, there are total 21 death cases have been reported and case fatality rate was 1.799‰.Different infectious diseases showed different trend variation during the above mentioned period. Conclusion We should understand and grasp the local incidence of infectious disease, strengthen the prevention and control, improve the pathogen detection, make an effort on screening, and prevent the spread of infectious diseases in the hospital.
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目的 研究探讨重症监护病房(ICU)病原菌的分布及耐药情况,为临床合理使用抗菌药物提供科学依据。方法 回顾性分析2015年ICU住院患者送检细菌分离培养及药敏试验结果。结果 ICU共送检标本1 326份,分离出病原菌554株,其中革兰阴性病原菌462株(83.4%),革兰阳性病原菌48株(8.7%),真菌44株(7.9%)。革兰阴性杆菌前5位依次为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、粘质沙雷菌和大肠埃希菌,且多耐药菌株比例较高。革兰阳性病原菌以金黄色葡萄球菌为主,32株(66.7%),MRSA检出率78.3%(25/32)。结论 加强重症监护病房的细菌及药敏监测,根据病原菌药敏结果指导临床合理使用抗菌药物,控制耐药菌株的产生,预防及控制院内感染及感染暴发。
Objective To investigate the distribution characteristics and drug resistance of pathogenic bacteria in intensive care unit(ICU) and provide scientific evidence for clinically reasonable use of antibiotics. Methods Specimens from hospitalized intensive care unit patients in 2015 were obtained for routine bacterial isolation and culture. Results A total of 554 bacterial strains were isolated from 1326 specimens, in which Gram-negative bacilli accounted for 462 stains (83.4%),Gram-positive cocci accounted for 48 stains (8.7%),and fungi accounted for 44 stains (7.9%). Gram-negative bacilli of the top five were Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae, Serratia marcescens and Escherichia coli,and the rate of multiple resistant bacteria was relatively high.Staphylococcus aureus were the main Gram-positive cocci, including MRSA accounted for 78.3%(25/32). Conclusion The monitoring of ICU clinical pathogens and their resistance should be strengthened. It is a great significance to use antibiotics rationally according to the results of susceptibility testing, in order to control the occurrence of resistant bacteria , prevent and control hospital infection and infection outbreak.
论著
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.
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目的 研究音乐疗法对新生儿喂养不耐受的保护作用,以及对胃动素和胃泌素水平的影响。方法 将2013年3月—2015年6月在我院新生儿科住院治疗的40例喂养不耐受新生患儿随机分为音乐治疗组和常规治疗组,治疗干预后,比较两组的喂养不耐受情况以及GAS和MOT水平。结果 音乐治疗组腹胀缓解时间、吸吮吞咽功能建立时间、达足量喂养时间、静脉营养应用时间明显的短于常规治疗组,体重增加量明显的高于常规治疗组(P<0.05);治疗后,音乐治疗组的GAS和MOT水平明显的高于常规治疗组(P<0.05)。结论 音乐疗法可以促进新生儿喂养不耐受症状改善,提高患儿血清GAS和血浆MOT水平,促进其生长发育。
Objective To study music therapy for neonatal feeding intolerance protection, and the effects of levels of gastrin and motilin. Methods From March 2013 to June 2015 in newborn Department of Pediatrics in our hospital 40 cases feeding tolerance of newborns were randomly divided into music therapy group and routine treatment group, after treatment, compared feeding tolerance and GAS and MOT level in the two groups. Results Abdominal distension relieving time, sucking and swallowing function establishment time, full enteral feeding time, use of the parenteral nutrition in the music therapy group was fewer than the conventional therapy group. Weight gain was higher than that in the conventional treatment (P<0.05). After the treatment, GAS and MOT levels in the music therapy group were higher than conventional treatment group, the difference is statistical significant (P<0.05). Conclusion Music therapy may promote neonatal feeding intolerance symptoms and improve patients serum GAS and plasma MOT levels, promote their growth and development.
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目的 探讨皮罗氏序列征伴先天性心脏病的临床特点。方法 我院2011年1月—2015年12月共收治141例皮罗氏序列征的患儿,将患儿分成单纯皮罗氏序列征组、皮罗氏序列征伴腭裂组及皮罗氏序列征伴听力损伤组,对3组患儿均行心电图及彩色多普勒超声心动图检查,对检查结果进行分析。结果 141例皮罗氏序列征患儿中共检出先天性心脏病19例,总发生率为13.47%,其中单纯皮罗氏序列征组患儿先天性心脏病的发生率为12.82%,伴腭裂组和伴听力损伤组患儿先天性心脏病的发生率分别为13.56%、25%。主要的先天性心脏病为:房间隔缺损(ASD)、室间隔缺损(VSD)、动脉导管未闭(PDA)、肺动脉瓣狭窄(PS)。通过统计学分析,3组患儿先天性心脏病的发生率差异无显著性。结论 先天性心脏病在皮罗氏序列征患儿中发生率较高,心电图及彩色多普勒超声心动图检查能清楚准确地诊断各类型的先天性心脏病,可用于皮罗氏序列征患儿常规检查,做出早期诊断、治疗,可以改善患儿的预后。
Objective To explore the clinical characteristics of congenital heart diseases in patients with Pierre-Robin sequence. Methods From January 2011 to December 2015, Guangzhou Women and Children's Medical Center has treated 141 patients with Pierre-Robin sequence. They were divided into 3 groups: Pierre-Robin sequence group, Pierre-Robin sequence and cleft palate group, and Pierre-Robin sequence and hearing impairment group. Electrocardiogram and colour Doppler echocardiogram was performed in each group and the results were analysed with statistics. Results 19 patients were found to have congenital heart diseases in 141 patients, the occurrence rate was 13.47%. The occurrence rate of congenital heart diseases in the group with Pierre-Robin sequence was 12.82%. The occurrence rate of congenital heart diseases in the group with Pierre-Robin sequence and cleft palate was 13.56%. The occurrence rate of congenital heart diseases in the group with Pierre-Robin sequence and hearing impairment was 25%. Atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA),and pulmonary valve stenosis (PS) were the most common lesions. Through statistical analysis, the occurrence rate of congenital heart diseases has no significant difference among the three groups of patients. Conclusion The occurrence rate of congenital heart diseases in patients with Pierre-Robin sequence is high. Electrocardiogram and colour Doppler echocardiogram are the useful and reliable tool in diagnosing congenital heart diseases in patients with Pierre-Robin sequence.
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目的 探讨胸部良性疾病非计划二次手术的原因,降低非计划二次手术率,研究防止措施。方法 回顾性分析2006年5月—2016年5月间胸部良性疾病患者行外科手术治疗的临床资料574例,其中16例术后因各种原因行非计划二次手术,总结胸部良性疾病外科治疗后非计划二次手术的临床特点、治疗经过及原因,对可能的影响因素进行单因素分析和多因素分析。结果 本组患者行非计划二次手术,无死亡病例,二次手术手术时间为30~215(135.6±47.4) min。术中出血量50~650 (313.6±93.1)mL。术后住院时间7~30(15.7±6.8)d。二次手术原因包括术后出血 (10例)、术后肺持续漏气(4例)、切口感染(2例)。单因素分析首次手术疾病分类,首次手术时间,首次手术方式与胸部良性疾病非计划二次手术相关性有统计学意义(P<0.05),多因素分析结果显示首次手术疾病分类,首次手术时间,首次手术方式是胸部良性疾病非计划二次手术的独立危险因素(P<0.05)。结论 根据胸部良性疾病的不同疾病类别来估计和预防可能出现的并发症,特别是胸部炎症性病变,术前充分准备、术中仔细操作、术后并发症的早期积极处理,能降低胸部良性疾病非计划二次手术的发生率。
Objective To investigate the causes of benign thoracic disease unplanned reoperation,improve the level of diagnosis and treatment and reduce the rate of unplanned reoperation. Methods From May 2006 to May 2016,594 cases of benign thoracic disease were performed thoracic surgery,including 16 patients underwent the unplanned reoperation due to various reasons. The clinical characteristics, therapy course and results of benign thoracic disease unplanned reoperation were analyzed retrospectively. Results The patients underwent the unplanned reoperation were no deaths. The operative time 30~215(135.6±47.4)min, intraoperative blood loss 50~650 (313.6±93.1)mL,postoperation hospitalization duration 7~30(15.7±6.8)d. The causes of benign thoracic disease unplanned reoperation were as follows: postoperative bleeding (10 cases), prolonged air leaks (4 cases),incision infection (2 cases). Univariate analysis showed first-time classification of diseases, operative time and operation method were statistically significant (P<0.05), Multivariate Logistic regression analysis revealed first-time classification of diseases, operative time and operation method were independent factors associated with benign thoracic disease unplanned reoperation. Conclusion According to the different classification of benign thoracic disease to estimate and prevent possible complications, we need to have sufficient preoperative preparation, intraoperative careful operation. Early active processing can be taken in postoperative complications.It can reduce the incidence of unplanned reoperation in benign thoracic disease,especially the chest inflammatory diseases.
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目的 探讨尼莫地平对无症状脑梗塞认知功能障碍的改善作用及安全性。方法 将80例无症状脑梗塞患者随机分为治疗组和对照组,每组40例,于治疗前及治疗后3月分别进行蒙特利尔认知量表(MoCA)、简易智能状态量表(MMSE)、画钟测验(CDT)评估,并比较2组的评分结果。结果 尼莫地平治疗后3月MMSE 评分为(26.35±3.26)分,MoCA评分为(25.53±4.31)分,CDT评分为(6.12±2.23)分,较对照组分别为MMSE 评分为(23.12±3.45)分,MoCA评分为(22.21±3.63)分,CDT评分为(4.35±2.61)分有改善,差异均有统计学意义(P<0.05)。80例患者中MoCA评测异常组在视空间与执行能力、延迟记忆、注意力及计算力、抽象思维等分项得分明显低于MoCA评测正常组(P<0.05)。结论 尼莫地平能有效改善无症状脑梗塞患者的认知功能,且安全性较高。
Objective To explore the role of nimodipine in improving cognitive function in silent cerebral infarction patients and its safety. Methods Eighty SCI patients were divided randomly into 2 groups.MMSE、MoCA and CDT scores were assessed before treatement and after 3 month of treatment.The results were compared between the 2 groups. Results MMSE、MoCA and CDT scores of Nimodipine group(26.35±3.26, 25.53±4.31, 6.12±2.23, respectively), improved when compared with the control(23.12±3.45, 22.21±3.63, 4.35±2.61,respectively),and the difference was statistical significance (P<0.05). The patients with abnormal MoCA had lower scores in several cognitive domains (visuospatial and executive abilities, delayed memory, attention and capacity of calculation, abstract thinking (P<0.05) compared with control group. Conclusion Nimodipine could improve effectively the cognitive function in SCI patients and with a higher safety.