目的 调查老年人照护服务需求现状并分析其影响因素,为构建基于需求为导向的老年照护服务体系提供参考依据。方法 采用便利抽样法,选取广州市某三甲医院212名老年人作为调查对象,采用日常生活能力量表、Fried衰弱评估量表及自行编制的老年人需求评估问卷进行调查。结果 老年人对运动与营养(1.96±0.90分)、心理慰藉(2.63±0.85分)、安宁服务(2.73±1.07分)的需求水平较高。多因素线性回归分析结果显示养老方式、日常生活活动能力、爱好数量、性别、衰弱等级、有无主要照顾者是照护服务需求的影响因素(P均<0.05),可解释61.5%的变异量。结论 老年人的照护服务需求受多种因素的影响。应根据老年人的不同特征,构建供需匹配的多元化,多层次照护体系。
Objective To investigate the status quo of care service needs of the elderly and analyze its influencing factors,so as to provide a reference for the construction of a needs-oriented care service system for the elderly.Methods A total of 212 elderly people from a tertiary hospital in Guangzhou were selected by convenience sampling method and investigated with the Activity of Daily Living scale,Fried frailty scale and the self-designed elderly needs assessment questionnaire.Results Elderly patients had higher demands for exercise,nutrition,psychological comfort and hospice services.The results of multivariate analysis showed that the influencing factors of care service demand included pension style,activities of daily living,number of hobbies,gender,frailty level,and having main caregivers(all P<0.05),which could explain 61.5% of the variation.Conclusions The care needs of elderly patients are affected by many factors.A diversified and multi-level care system with matching supply and demand should be constructed according to the different characteristics of the elderly.
目的 探究认知行为疗法联合治疗性沟通在对内镜黏膜下剥离(ESD)术患者心理及治疗依从性的效果。方法 前瞻性选取2023年3月至2025年3月鹰潭市一八四医院收治的122例行ESD术的患者作为研究对象,采用随机数字表法将患者分为A、B组,B组56例患者采取治疗性沟通干预,A组66例患者采用认知行为疗法联合治疗性沟通干预,两组均连续干预2个月。比较两组患者干预前后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、心理弹性量表(CD-RISC)评分、Herth希望指数量表(HHI)评分差异,对比两组干预依从性。结果 干预后,两组SAS、SDS评分均下降且A组低于B组(t分别为12.096、10.326,P<0.05);干预后,两组CD-RISC量表各项评分均提高且A组高于B组(t分别为18.483、12.060、13.622,P<0.05);干预后,两组HHI量表各项评分均上升且A组高于B组(t分别为1.289、11.568、12.527、13.794,P<0.05);A组患者总依从率96.97%(64/66)高于B组80.36%(45/56)(χ 2 =8.782,P<0.05)。结论 认知行为疗法联合治疗性沟通在ESD术患者中干预效果理想,能够明显改善患者负性情绪,提高心理弹性及对疾病康复的希望水平,有效提升依从性。
Objective To explore the effect of cognitive behavioral therapy combined with therapeutic communication on psychological health and therapy compliance of patients undergoing endoscopic submucosal dissection(ESD).Methods Prospectively,122 patients who underwent ESD at Yingtan 184 Hospital from March 2023 to March 2025 were selected as the research subjects.These patients were randomly divided into Group A and Group B using the random number table method,and 56 patients in group B were treated with therapeutic communication,66 patients in group A were treated with cognitive behavioral therapy combined with therapeutic communication,and both groups were continuously intervened for 2 months.The scores of Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Connor-Davidson Resilience Scale(CD-RISC)and Herth Hope Index(HHI)were compared between the two groups before and after treatment.Therapy compliance between the two groups was compared.Results After treatment,the SAS and SDS scores of the two groups were decreased,and the scores of group A was lower than that of group B(t=12.096,10.326,P<0.05)after the intervention,the scores of the CD-RISC scale of the two groups were improved,and the score of group A was higher than that of group B(t=18.483,12.060,13.622,P<0.05).After intervention,the scores of HHI scale in both groups increased and score of group A was higher than that ofgroup B(t=11.289,11.568,12.527,13.794,P<0.05).The total compliance rate of patients in group A was 96.97%(64/66),which was significantly higher than 80.36%(45/56)in group B(χ 2 =8.782,P<0.05).Conclusions Cognitive-behavioral therapy combined with therapeutic communication has an ideal effect in ESD patients,which can significantly improve patients’ negative emotions,psychological resilience and hope for disease recovery,and also therapy compliance.
目的 探讨经颅多普勒超声(TCD)参数联合屏气指数在颈内动脉(ICA)狭窄或闭塞所致急性脑梗死的评估价值。方法 选择2022年1月—2024年12月,在广州市花都区人民医院连续入组发病72 h内ICA狭窄或闭塞所致的急性脑梗死患者。记录患者人口统计学资料、临床资料及TCD相关参数,包括搏动指数(PI)、阻力指数( RI)、大脑中动脉平均血流速度(Vm)及屏气指数等。依据患者数字减影血管造影(DSA)结果分为侧支循环良好组及侧支循环不良组。比较两组人口统计学、临床资料及TCD相关参数,采用单因素分析、多因素Logistic回归分析及ROC曲线。结果 共纳入ICA狭窄或闭塞所致急性脑梗死共136例,其中侧支循环良好组46例,侧支循环不良组90例。单因素分析提示:侧支循环良好组与侧支循环不良组在PI[0.95(0.80,1.03)vs 1.01(0.88,1.13)]、RI[0.58(0.51,0.62)vs 0.60(0.54,0.65)]、Vm[57(44,65)vs 50.5(41,63)]及屏气指数[0.78(0.75,0.85)vs 0.72(0.59,0.79)]方面,差异具有统计学意义(P<0.05)。多因素Logistic回归分析提示Vm(OR=1.029,95%CI:1.006~1.053,P=0.014)、屏气指数(OR=723.401,95%CI:14.524~3 6031.859,P<0.001)是侧支循环不良的独立危险因素。屏气指数和Vm评估侧支循环情况的ROC曲线下面积(AUC)分别为0.713(95%CI:0.627~0.799)和0.605(0.505~0.705),两者的AUC值比较差异无统计学意义(P>0.05)。结论 屏气指数和Vm可以评估ICA狭窄或闭塞所致急性脑梗死的侧支循环,屏气指数和Vm的评估效能相当。
Objective To explore the evaluation value of transcranial Doppler ultrasound(TCD)in acute cerebral infarction caused by internal carotid artery(ICA)stenosis or occlusion.Methods From January 2022 to December 2024,patients with acute cerebral infarction caused by ICA stenosis or occlusion within 72 hours of onset were enrolled in our hospital.Patient’s demographic data,clinical data,and TCD related parameters,including pulsatility index(PI),resistance index(RI),average blood flow velocity(Vm)of the middle cerebral artery,and breath holding index(BHI)were recorded.According to the results of digital silhouette angiography(DSA),patients were divided into good collateral group and poor collateral group.Demographic,clinical data,and TCD related parameters were compared between two groups using univariate analysis,multivariate Logistic regression analysis and ROC curve.Results A total of 136 cases of acute cerebral infarction caused by ICA stenosis or occlusion were included,including 46 cases in the collateral good group and 90 cases in the collateral poor group.Univariate analysis showed that the good collateral group and the poor collateral group were different in PI(0.95[0.80,1.03]vs 1.01[0.88,1.13]),RI(0.58[0.51,0.62]vs 0.60[0.54,0.65]),Vm(57[44,65]vs 50.5[41,63]),BHI(0.78[0.75,0.85] vs 0.72[0.59,0.79])(P<0.05).Multivariate Logistic regression analysis showed that Vm(OR=1.029,95%CI:1.006-1.053,P=0.014)and BHI(OR=723.401,95%CI:14.524-36 031.859,P<0.001)were independent risk factors for collateral circulation disorders.The area under the ROC curve(AUC)for predicting collateral circulation using BHI and Vm were 0.713(95%CI:0.627~0.799)and 0.605(0.505~0.705),respectively.There was no statistically significant difference in AUC values between the BHI and Vm.Conclusions The BHI and Vm can predict the collateral circulation of acute cerebral infarction caused by ICA stenosis or occlusion,and their predictive power is comparable.
目的 识别经皮冠状动脉介入治疗(PCI)后恐动症患者抑郁、焦虑和压力的影响因素。方法 采用横断面研究,纳入780例行PCI术后恐动症患者。应用系列量表评估恐动症患者的不良心理健康状况、生活质量、自我感受负担、社会支持和运动自我效能,并通过问卷收集了患者的社会人口学数据。线性回归和Logistic回归用于识别抑郁、焦虑和压力等不良心理状态的影响因素,应用中介分析探索潜在的中介机制。结果 271例(34.7%)、304例(39.0%)和153例(19.6%)恐动症患者存在不同程度的抑郁、焦虑和压力。恐动症患者的抑郁、焦虑和压力水平呈正相关。线性回归和Logistic分析结果表明,较高的家庭月收入与较高的抑郁水平相关(线性回归:β为0.908和1.937;Logistic:OR为2.05和5.47),社会支持程度与抑郁水平呈负相关(线性回归:β=-0.079;Logistic:OR=0.93)。单身/离异/寡居患者的焦虑水平显著高于已婚患者(线性回归:β=1.613;Logistic:OR=2.28)。与家庭月收入低于5 000元者相比,家庭月收入为5 000~10 000元之间的患者的压力水平较高(线性回归:β=1.065;Logistic:OR=3.14)。此外,自我感受负担较重的患者具有更高的压力水平(线性回归:β=0.077;Logistic:OR=1.05)。中介分析结果表明,焦虑和压力是社会支持/自我感受负担与抑郁之间关联的潜在中介因子。结论 PCI术后恐动症患者广泛存在心理健康问题,其家庭月收入、年龄、婚姻状况、生活方式和病史等因素对患者的不良心理健康状态具有显著影响。医务人员应关注这些患者的心理健康状况及影响因素,制定综合管理策略以改善其预后。
Objective To identify the risk factors associated with depression,anxiety and stress in patients with kinesiophobia after percutaneous coronary intervention(PCI).Methods In this cross-sectional study,780 patients who developed kinesiophobia after undergoing PCI were enrolled.A series of scales were used to assess the psychological health status,quality of life,self-perceived burden,social support,and exercise self-efficacy of patients with kinesiophobia,and socio-demographic data of the patients were collected through a questionnaire.Linear regression analyses and Logistic regression analyses were used to identify risk factors of adverse psychological outcomes,including depression,anxiety,and stress.Furthermore,mediation analysis was employed to explore the potential mediating mechanisms.Results Among the 780 patients with kinesiophobia,271(34.7%),304(39.0%)and 153(19.6%)were found to have varying degrees of depression,anxiety,and stress,respectively.The levels of depression,anxiety and stress in patients with kinesiophobia were positively correlated with each other.The results of both linear regression and Logistic regression analyses indicated that higher levels of family monthly income were associated with higher levels of depression(linear:β=0.908 and 1.937;Logistic:OR=2.05 and 5.47),while the degree of social support was negatively correlated with depression levels(linear:β=-0.079;Logistic:OR=0.93).For patients who were single,divorced or widowed,their levels of anxiety were significantly higher than those of married patients(linear:β=1.613;Logistic:OR=2.28).Compared to patients with a monthly household income of less than 5 000 yuan,those with a monthly income between 5 000 and 10 000 yuan reported higher levels of stress(linear:β=1.065;Logistic:OR=3.14).Additionally,patients who perceived a higher personal burden also experienced greater stress(linear:β=0.077;Logistic:OR=1.05).Mediation analysis indicated that anxiety and stress were potential mediating factors in the relationship between social support/self-perceived burden and depression.Conclusions This study reported the widespread psychological health issues among patients with kinesiophobia after PCI and the interactions between these issues.Factors such as monthly household income,age,marital status,lifestyle and medical history were found to be significantly associated with these negative psychological outcomes.Clinicians and nurses should focus on the psychological health and influencing factors of these patients and develop comprehensive management strategies to improve their prognosis.
目的 通过对急性深静脉血栓形成(DVT)患者经导管接触性溶栓治疗(CDT)中,影响血管导管相关感染(VCAI)危险因素及病原菌分析,为VCAI的预防提供合理、有效的措施。方法 收集2019年1月—2022年12月徐州市肿瘤医院介入科行CDT治疗的急性DVT患者的临床资料,回顾性调查患者诊疗相关资料及血培养结果,并对发生VCAI和病原菌情况进行分析。结果 本研究共调查急性DVT行CDT治疗的患者437例,发生VCAI的患者共21例,千日感染率为0.543‰。多因素Logistic回归分析结果显示:溶栓频率>3次/天[OR=3.49(95%CI:1.86~6.45)]、导管留置时间>7 d[OR=3.86(95%CI:1.26~10.18)]和有导管回送[OR=8.67(95%CI:4.83~12.65)]是患者发生VCAI的危险因素(P<0.05)。发生VCAI的21例患者,血培养共培养出24株病原菌,有3例患者出现复合病原菌感染情况。其中以革兰阳性球菌最为常见,共培养出13株,占比54.17%,革兰阴性菌9株,占比37.5 %。结论 导管留置时间>7 d、溶栓频率>3次/天和有导管回送是急性DVT患者CDT治疗中发生VCAI的危险因素。VCAI的病原菌以单一病原菌为主,可合并其他病原菌感染,其中以革兰阳性球菌为主。
Objective By analyzing the risk factors and pathogens of vessel catheter associated infection(VCAI)in patients with acute deep vein thrombosis(DVT)undergoing catheter directed thrombolysis(CDT),to provide reasonable and effective measures for the prevention and treatment of VCAI .Methods Clinical data of patients undergoing CDT treatment for acute DVT in the interventional department of the hospital from January 2019 to December 2022 was collected,patient diagnosis and treatment related data and blood culture results were retrospectively investigated and organized,and the occurrence of VCAI and pathogenic bacteria was statistically analyzed.Results This study investigated 437 patients undergoing CDT treatment for acute DVT,and a total of 21 patients developed VCAI,with an infection rate of 0.543‰.The results of multiple Logistic regression analysis show that thrombolysis frequency>3 times/day(OR=3.49[95%CI:1.86-6.45]),catheter retention days>7 days(OR=3.86[95%CI:1.26-10.18]),and the presence of catheter return(OR=8.67[95%CI:4.83-12.65]) were risk factors for the occurrence of VCAI in patients.Among the 21 patients with VCAI,a total of 24 strains of pathogenic bacteria were discoveredin blood culture,and 3 patients developed composite pathogen infections.Among them,Gram positive cocci were the most common,with a total of 13 strains cultured,accounting for 54.17%,9 strains of Gram negative bacteria,accounting for 37.5%.Conclusions The duration of catheter retention>7 days,thrombolysis frequency>3 times/day,and the presence of catheter return are risk factors for VCAI in acute DVT patients undergoing CDT treatment.The pathogen of VCAI is mainly single pathogen,which can be combined with other pathogens,among which Gram positive cocci are the main pathogen.
目的 探讨一种保护型的上肢约束衣在儿童洗胃中的应用。方法 自制并获得实用新型专利“一种保护型的上肢约束衣”,包括背单和两条前襟连接单,三条可调节性约束带,以及下肢延伸固定。选取2023年1月—2023年12月在我院急诊科因急性中毒施行洗胃的患儿为研究对象,依据住院时间,将2023年1月—2023年6月收治患儿为对照组(58例),将2023年7月一2023年12月收治患儿为观察组(58例)。观察组使用本研究发明的保护型上肢约束衣进行约束,对照组则采用传统的约束方法。对两组患儿的洗胃时间、协助人员数量和重复置管次数进行了记录和比较。结果 观察组协助洗胃人数、洗胃时间、重复置管次数分别为1.00(1.00,1.00)人、28.00(26.00,32.00)min、0.00(0.00,0.00)次,均低于对照组的3.00(3.00,3.00)人、32.00(29.00,35.25)min、0.00(0.00,0.00)次,差异有统计学意义(P<0.05)。结论 儿童洗胃中应用保护型上肢约束衣,能显著减少协助洗胃人数和重复置管次数,缩短洗胃时间,提高了洗胃效率。
Objective To explore the application of a protective upper extremity restraint in gastric lavage in children.Methods A new patent for“A protective upper extremity restraint garment” was designed,which includes a back sheet and two front-flap connecting sheets,three adjustable restraint bands,and an extension fixation of lower extremity.From January 2023 to December 2023,children who underwent acute gastric lavage due to accidental ingestion in the emergency department of a hospital were selected as the research subjects,according to the admission date,the control group(58 cases)was selected from January 2023 to June 2023,and the observation group(58 cases)was selected from July 2023 to December 2023.The observation group was restrained by the protective upper extremity restraint garment,while the control group was restrained by the traditional restraint method.The time of gastric lavage,the number of assistants and the times of repeated intubation were recorded and compared between the two groups.Results The gastric lavage assistance,lavage time,and number of repeated intubations in the observation group were 1.00[1.00,1.00]person,28.00[26.00,32.00]min,and 0.00[0.00,0.00]times,lower than in the control group(3.00[3.00,3.00]person,32.00[29.00,35.25]min,0.00[0.00,0.00]times),the differences were statistically significant(P<0.05).Conclusions The application of a protective upper extremity restraint suit during pediatric gastric lavage significantly reduces the number of required assistants,decreases repeated intubation attempts,shortens lavage time,and enhances procedural efficiency.
目的 探讨慢性阻塞性肺疾病急性加重期血嗜酸性粒细胞(EOS)、血清白细胞介素-5(IL-5)水平与第一秒用力呼气容积(FEV1)、第一秒用力呼气容积与用力肺活量的比值(FEV1/FVC)、用力肺活量(FVC)的相关性。方法 纳入2023年3月—2024年3月于佛山市顺德区第五人民医院住院的73例慢性阻塞性肺疾病急性加重期患者,以2%作为外周血EOS比例(EOS%)截断值分为两组,研究组(EOS%≥2%)34例,对照组(EOS%<2%)39例,收集两组患者的一般临床资料、实验室检查结果、肺功能检查结果(FEV1、FVC、FEV1/FVC),比较组间差异,分析指标间的相关性。结果 对照组与实验组患者EOS%分别为0.5(0.1,0.9)%、5.15(2.60,10.05)%,两组患者EOS%差异有统计学意义(P<0.05)。对照组与实验组患者IL-5水平分别为0.98(0.56,1.78)ng/L、3.6(1.73,6.77)ng/L,两组IL-5水平差异有统计学意义(P<0.05)。对照组FEV1(L)、FVC(L)、FEV1/FVC水平分别为1.32(1.18,1.58)、2.07(1.92,2.62)、0.62(0.57,0.67);实验组分别为1.24(1.00,1.52)、2.22(1.94,2.56)、0.58(0.47,0.67),两组FEV1、FVC、FEV1/FVC水平差异均无统计学意义(P>0.05)。Spearman等级相关检验结果显示,EOS%与IL-5水平呈正相关(rs=0.870,P<0.001);按组别进行分层后结果显示,对照组、试验组EOS%与IL-5水平均呈正相关(rs=0.820,P<0.001;rs=0.938,P<0.001)。EOS%、IL-5水平与FEV1、FEV1/FVC呈负相关(P<0.05),与FVC不相关(rs=0.039,P>0.05)。对照组EOS%、IL-5水平与FEV1、FEV1/FVC、FVC不相关(P>0.05);实验组EOS%、IL-5水平与FEV1、FEV1/FVC呈负相关(P<0.05),与FVC不相关(P>0.05)。结论 慢性阻塞性肺疾病急性加重期血EOS%与血清IL-5水平呈正相关,外周血EOS%≥2%时血EOS%、血清IL-5与FEV1、FEV1/FVC呈负相关,与FVC无关。
Objective To explore the correlation among blood eosinophil levels,serum interleukin-5(IL-5)levels,and forced expiratory volume in one second(FEV1),the ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC),and forced vital capacity(FVC)during the acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods From March 2023 to March 2024,73 patients hospitalized for AECOPD at Shunde District Fifth People’s Hospital of Foshan City were included,and divided into two groups based on a cutoff value of 2% for peripheral blood eosinophil(EOS%).The experimental group(EOS%≥2%)included 34 patients,while the control group(EOS%<2%)included 39 patients.General clinical data,laboratory test results,and pulmonary function test results(FEV1,FVC,FEV1/FVC)were collected from both groups.Results The median quartiles of EOS% for the control group and experimental group were 0.5(0.10.9)% and 5.15(2.60,10.05)%,respectively.There was a statistically significant difference between the EOS% of two groups(P<0.05).The median quartiles of IL-5 levels for the control group and experimental group were 0.98(0.56,1.78)ng/L and 3.6(1.73,6.77)ng/L,respectively.There was also a statistically significant difference in IL-5 levels between the two groups(P<0.05).For the control group,the median quartiles of FEV1,FVC,and FEV1/FVC were 1.32(1.18,1.58),2.07(1.92,2.62)and 0.62(0.57,0.67),respectively.For the experimental group,they were 1.24(1.00,1.52),2.22(1.94,2.56)and 0.58(0.47,0.67)respectively.There was no statistically significant difference between the two groups in FEV1,FVC and FEV1/FVC levels(P<0.05).Spearman rank correlation analysis showed a positive correlation between EOS% and IL-5 level (rs=0.870,P<0.001).Stratified by group,both the control and experimental groups showed a positive correlation between EOS% and IL-5 level (rs=0.820,P<0.001;rs=0.938,P<0.001).There was a negative correlation between EOS%,IL-5 level,and FEV1,FEV1/FVC(P<0.05),but no correlation with FVC(P>0.05).In the control group,there was no correlation between EOS%,IL-5 level,and FEV1,FEV1/FVC,or FVC(P>0.05).In the experimental group,there was a negative correlation between EOS%,IL-5 level,and FEV1,FEV1/FVC(P<0.05),but no correlation with FVC(P>0.05).Conclusions During AECOPD,blood EOS% is positivelycorrelated with serum IL-5 levels.When peripheral blood eosinophils are ≥2%,blood EOS%,serum IL-5,and FEV1,FEV1/FVC are negatively correlated,while there is no correlation with FVC.
目的 调查深圳地区综合性医院门诊幽门螺杆菌(Hp)对8种常见抗菌药物的耐药情况。方法 采集13C呼气试验阳性的患者胃黏膜标本313例,进行Hp分离培养及抗菌药物敏感性试验。结果 313例患者分离培养得到247例Hp菌株,培养阳性率78.91%,不同性别、不同年龄患者Hp分离培养阳性率比较差异无统计学意义(P>0.05)。Hp对甲硝唑、克拉霉素、左氧氟沙星、利福平、阿莫西林、四环素、呋喃唑酮、庆大霉素耐药率依次为88.66%(219/247)、38.46%(95/247)、38.06%(94/247)、4.05%(10/247)、1.21%(3/247)、0.40%(1/247)、0.40%(1/247)、0(0/247)。双重耐药率为38.46%(95/247),其中Hp对克拉霉素+甲硝唑组合耐药率最高(18.62%,46/247),对甲硝唑+左氧氟沙星耐药率居其次(17.00%,42/247)。多重耐药率为19.84%(49/247)。不同年龄、性别患者双重耐药率、多重耐药率比较差异均无统计学意义(P>0.05)。结论 深圳地区分离的Hp菌株对甲硝唑、克拉霉素、左氧氟沙星耐药率相对更高,且双重耐药、多重耐药情况严重。
Objective To investigate the antibiotic resistance of Helicobacter pylori(Hp)to eight commonly used antibiotics in outpatients of general hospitals in Shenzhen.Methods Gastric mucosal samples were collected from 313 patients who tested positive for the 13C breath test,and Hp strains were isolated and cultured.Antibiotic susceptibility testing was performed on the isolated Hp strains.Results Of the 313 patients,247 Hp strains were isolated,with a culture-positive rate of 78.91%.There was no significant difference in culture-positive rates between different genders and age groups(P>0.05).The resistance rates to metronidazole,clarithromycin,levofloxacin,rifampicin,amoxicillin,tetracycline,furazolidone,and gentamicin were 88.66%(219/247),38.46%(95/247),38.06%(94/247),4.05%(10/247),1.21%(3/247),0.40%(1/247),0.40%(1/247),0(0/247),respectively.The dual resistance rate was 38.46%(95/247),with the highest combination resistance observed in clarithromycin + metronidazole(18.62%,46/247),followed by metronidazole + levofloxacin(17.00%,42/247).The multi-drug resistance rate was 19.84%(49/247).There were no significant differences in dual resistance rates(P>0.05)or multiple resistance rates(P>0.05)between different age groups and genders.Conclusions The Hp strains isolated in Shenzhen exhibited relatively higher resistance rates to metronidazole,clarithromycin,and levofloxacin,with substantial dual and multi-drug resistance.
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.
目的 探讨基于手术风险模型(RoSCo)评分系统的早期下床活动时机在肾肿瘤患者术后的应用效果。方法 选取2021年6月—2024年6月天津市人民医院收治的80例肾肿瘤患者,应用随机数字表法将其分为观察组与对照组,各40例。80例患者均实施腹腔镜肾部分切除术,对照组实施常规干预与术后早期下床活动干预,观察组实施常规干预与基于RoSCo评分系统的早期下床活动时机干预。对比两组术后康复水平,疼痛程度与睡眠质量,并发症发生率及生活质量。结果 观察组首次下床活动(19.30±4.17)h、排气(22.03±4.15)h、排便时间(29.93±5.58)h及术后住院时间(5.35±1.33)h短于对照组[(25.08±5.11)、(29.38±5.75)(34.20±5.98)(7.35±2.38)]h,对比差异有统计学意义(t=-5.540、-6.557、-3.308、-4.637,P<0.05);手术后,观察组视觉模拟量表(VAS)评分(3.93±0.92)分、PSQI评分(9.13±1.64)分高于对照组[(5.38±1.25)、(12.23±2.40)]分,对比差异有统计学意义(t=-5.902、-6.747,P<0.05);观察组并发症发生率7.50%低于对照组27.50%(χ 2 =5.541,P=0.019);手术后观察组SF-36评分相关维度[生理职能(84.45±9.74)、总体健康(60.75±10.65)、躯体疼痛(65.65±8.60)、生理功能(72.98±9.22)、活力(71.95±6.93)、社会功能(75.38±8.33)、精神健康(75.63±8.02)、情感职能(65.43±9.70)]分值高于对照组[生理职能(69.98±10.09)、总体健康(53.58±7.96)、躯体疼痛(58.83±9.35)、生理功能(65.68±7.58)、活力(62.83±12.80)、社会功能(68.98±10.99)、精神健康(71.58±9.69)、情感职能(57.90±6.86)]分值,对比差异有统计学意义(t=6.530、3.414、3.398、3.870、3.966、2.936、2.037、4.004,P<0.05)。结论 针对肾肿瘤患者术后应用基于RoSCo评分系统的早期下床活动时机干预可促进其术后康复,辅助减轻术后疼痛程度,提升睡眠质量,降低并发症发生率,进一步提升患者生活质量。
Objective To explore the application effect of early mobilization timing based on the Risk of Surgical Complication(RoSCo)scoring system in renal tumor patients after surgery.Methods From June 2021 to June 2024,80 patients with renal tumors admitted to the hospital were selected as the research subjects.They were randomly divided into an observation group and a control group using a random number table method,with 40 patients in each group.All patients underwent laparoscopic partial nephrectomy.The control group received routine care and early postoperative mobilization intervention,while the observation group received routine care and early mobilization intervention based on the RoSCo scoring system.The postoperative rehabilitation level,pain level and sleep quality,incidence of complications,and quality of life between two groups were compared.Results The first time getting out of bed,exhaust,defecation and postoperative hospitalization time in observation group([19.30±4.17]h,[22.03±4.15]h,[29.93±5.58]h,[5.35±1.33]h) were shorter than those in control group([25.08±5.11]h,[29.38±5.75]h,[34.20±5.98]h,[7.35±2.38]h),the differences were statistically significant(t=-5.540,-6.557,-3.308,-4.637,all P<0.05).After operation,VAS score(3.93±0.92)and PSQI score(9.13±1.64)in the observation group were higher than those in the control group([5.38±1.25]and[12.23±2.40]),and the differences were statistically significant(t=-5.902,-6.747,both P<0.05).The complication rate of the observation group (7.50%) was lower than that of the control group(χ 2 =5.541,P=0.019).After operation,SF-36 scores in the observation group were physiological function(84.45±9.74),general health(60.75±10.65),physical pain(65.65±8.60),physiological function(72.98±9.22),vitality(71.95±6.93),social function(75.38±8.33),spiritual health(75.63±8.02)and emotional function(65.43±9.70),which were higher than those of the control group(physiological function[69.98±10.09],general health[53.58±7.96],physical pain[58.83±9.35],physiological function[65.68±7.58]and vitality[62.83±12.80],social function[68.98±10.99],mental health[71.58±9.69],emotional function[57.90±6.86]),and the differences were statistically significant(t=6.530,3.414,3.398,3.870,3.966,2.936,2.037,4.004,all P<0.05).Conclusions Early mobilization intervention based on the RoSCo scoring system can promote postoperative recovery,assist in reducing postoperative pain,improve sleep quality,reduce the incidence of complications,and further enhance the quality of life of patients with renal tumors.