专家述评

血小板药物递送系统的研究进展

Advances in platelet as drug delivery systems

:577-584
 
药物递送系统对于各类疾病意义非凡,但传统药物载体面临细胞毒性强、组织相容性低、半衰期短和靶向性弱等诸多挑战。血小板及其相关衍生物作为新型药物载体具有更为显著的优势。由于血小板自身的生理特点,以及在肿瘤、心血管疾病、血栓性疾病、感染等多种疾病中发挥的病理生理作用,血小板能够弥补传统药物载体的缺陷,具有极大的临床转化意义。该文总结了血小板相关药物递送系统目前的研究进展,以期为新型药物载体研究提供参考。
Drug delivery systems are important for various diseases,but conventional therapeutic drug have many shortcomings,such as high cytotoxicity,low histocompatibility,short half-life and weak targeting.Platelets and their derivatives have more significant advantages as novel drug carriers.Platelets play an important role in the pathophysiology of a wide range of diseases including oncology,cardiovascular diseases,thrombosis and infection.In this paper,we summarized the current research progress of platelet-related drug delivery systems to provide a reference for the research of novel drug delivery systems.
医院管理

价值医疗下公立医院运营管理部门组织架构设计

Research on Organization Structure Design of Operation Management Departments in Public Hospitals from the Perspective of Value-Based Healthcare

:815-819
 
价值医疗下公立医院需转变运营管理模式,建设专门运营管理部门对满足外部政策要求和改善内部运营管理十分必要。通过梳理公立医院开展运营管理的主要任务,确定公立医院专门运营管理部门的职责,设计与承担职责相适应的组织架构,保证专门运营管理部门的职能充分发挥。
Public hospitals need to change the operation management mode under value-based healthcare.It is necessary to build a special operation management department to meet the requirements of external policies and improve internal operation management.By sorting out the operation and management tasks of public hospitals,the responsibilities of the operation management department are determined,and the organizational structure suitable for the responsibilities is designed,so that the construction of specialized operation management department can be effectively implemented.
论著

俯卧位通气在脓毒症合并急性肺损伤患儿的应用效果

The application effect of prone position ventilation in children with sepsis combined with acute lung injury

:796-800
 
目的 探讨俯卧位通气在脓毒症合并急性肺损伤患儿的应用效果。方法 选取泉州市儿童医院2020年9月—2023年9月收治的72例脓毒症合并急性肺损伤患儿,应用抽签法将其分为观察组与对照组,均为36例。对照组患儿实施常规仰卧位机械通气与对应护理,观察组患儿在常规护理基础上增加俯卧位通气与对应护理。对比两组患儿机械通气时间,干预前和干预3 d后气道平台压和心率水平,动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2),并计算动脉血氧分压与吸入气中的氧浓度分数比值(PaO2/FiO2),评价两组患儿预后及不良事件发生情况。结果 观察组机械通气时间明显低于对照组(P<0.05),干预后两组患儿气道平台压、心率均降低,且观察组低于对照组(P<0.05);干预后两组患儿PaO2/FiO2、PaO2水平升高,观察组高于对照组,PaCO2降低,观察组低于对照组(P<0.05);干预后两组患儿全身性感染相关性器官功能衰竭评分(SOFA)、急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)评分均降低,观察组低于对照组(P<0.05);两组患儿呼吸机管路折管、管路滑脱、压力性损伤等不良事件发生率对比差异无统计学意义(P>0.05)。结论 俯卧位通气在脓毒症合并急性肺损伤患儿的应用效果显著,可降低患儿气道平台压及心率,缩短机械通气时间,改善患儿通气功能,有助提升预后水平。
Objective To explore the application effect of prone position ventilation in children with sepsis complicated with acute lung injury.Methods From September 2020 to September 2023,72 children with sepsis and acute lung injury admitted to Quanzhou Children's Hospital were selected and divided into observation group and control group by drawing lots,both with 36 cases.The children in the control group received routine supine mechanical ventilation and corresponding nursing,and the children in the observation group added prone ventilation and corresponding nursing on the basis of routine nursing.By comparing the duration of mechanical ventilation,airway plateau pressure and heart rate level,PaCO2,PaO2,PaO2/FiO2,the prognosis and occurrence of adverse events in the two groups were evaluated.Results The mechanical ventilation time in the observation group was significantly shorter than that in the control group(P<0.05).After intervention,the airway plateau pressure and heart rate levels of the two groups of children decreased,and the observation group was lower than the control group(P<0.05).After the intervention,the levels of PaO2/FiO2 and PaO2 in the two groups of children increased,with the observation group higher than the control group,while the level of PaCO2 was lower,with the observation group lower than the control group(P<0.05).After the intervention,the SOFA and APACHE II scores of the two groups of children decreased,and the observation group was lower than the control group(P<0.05).There was no difference in the incidence of adverse events such as ventilator tube folding,tube slip and pressure injury between the two groups(P>0.05).Conclusions The application of prone position ventilation in children with sepsis combined with acute lung injury has a significant effect,which can reduce airway plateau pressure,lower heart rate,shorten mechanical ventilation time,improve ventilation function,and assist in improving prognosis.
论著

个体化肠内营养支持在胃肠术后早期应用的临床观察

Personalized enteral nutrition support in early-stage postoperative gastrointestinal surgery:A clinical observation

:786-790
 
目的 探讨个体化肠内营养支持在胃肠术后早期应用的可行性及安全性。方法 选取2022年1月—12月安徽省亳州市中医院普通外科收治的胃肠手术患者100例。使用随机数字表法将患者随机为观察组和对照组,每组各50例。观察组在常规治疗基础上实施个体化肠内营养,持续7 d。对照组则接受术后常规处理。术后第7天测定实验室指标,并比较两组胃肠功能的恢复情况。结果 观察组术后肛门首次排气时间短于对照组[(55.41±19.63)h vs (81.46±19.39) h],前白蛋白水平高于对照组[(241.14±65.73)g/L vs(217.35±51.63)g/L],组间比较差异有统计学意义(P<0.05)。血清总蛋白水平[(70.55±18.89)g/L vs (68.16±20.05)g/L]、血清白蛋白水平[(53.22±17.76)g/L vs(50.76±18.54)g/L]、淋巴细胞计数[(1.60±0.54)×109/L vs (1.56±0.55)×109/L]以及肛门排便时间[(89.67±22.31)h vs (97.77±21.27)h ]在组间比较差异无统计学意义(P>0.05)。结论 根据个体情况在胃肠术后早期实施个体化的肠内营养支持是安全可行的,能够促进胃肠功能的快速恢复,从而改善患者的营养状况。
Objective To investigate the feasibility and safety of personalized enteral nutrition support during the early postoperative period of gastrointestinal surgery.Methods A total of 100 patients who underwent gastrointestinal surgery at the Department of General Surgery,Bozhou Hospital of Traditional Chinese Medicine,who were enrolled in this study during January 2022 to December 2022.Patients were randomly allocated into either the observational or control group,with 50 patients in each group.The randomization was performed using a random number table.The observational group received personalized enteral nutrition support in addition to routine treatment for 7 days.The control group received standard postoperative care.Laboratory indicators were measured on the 7th postoperative day to compare recovery of gastrointestinal function between the two groups.Results The observational group exhibited a significantly shorter time to the first passage of flatus from the anus compared to the control group(55.41±19.63 h vs 81.46±19.39 h,P<0.05),as well as higher prealbumin levels(241.14±65.73 g/L vs 217.35±51.63 g/L,P<0.05).However,there were no significant differences between the two groups in terms of serum total protein levels(70.55±18.89 g/L vs 68.16±20.05 g/L),serum albumin levels(53.22±17.76 g/L vs 50.76±18.54 g/L),lymphocyte counts[(1.60±0.54)×109/L vs (1.56±0.55)×109/L],and time to the first defecation from the anus(89.67±22.31 h vs 97.77±21.27 h)(all P>0.05).Conclusions Personalized enteral nutrition support based on individual conditions is safe and feasible in the early postoperative period of gastrointestinal surgery.It can promote the rapid recovery of gastrointestinal function and improve patients' nutritional status.
论著

快速康复理念联合腹腔镜手术治疗对小儿腹股沟疝疗效观察

Observation on the therapeutic effect of rapid rehabilitation concept combined with laparoscopic surgery for inguinal hernia in children

:781-785
 
目的 探讨快速康复理念联合腹腔镜手术治疗对小儿腹股沟疝疗效观察。方法 选取焦作市妇幼保健院2021年1月—2023年1月收治的86例腹股沟疝患儿进行分析与研究,应用随机数字表法将其分为观察组与对照组,各组均为43例。所有患儿均采取腹腔镜手术治疗,对照组采取常规护理,观察组采取快速康复理念护理。对比两组围术期恢复情况,术后4、12、24、48 h疼痛程度,并发症及护理满意度情况。结果 观察组首次下床时间、首次肛门排气时间、进食时间、住院时间短于对照组(P<0.05);两组患儿术后4、12、24、48 h视觉模拟量表(VAS)评分逐渐降低,观察组低于对照组(P<0.05);两组恶心呕吐、尿潴留、腹胀腹痛、感染并发症发生率对比差异无统计学意义(P>0.05);观察组患儿及家长健康教育、住院环境、专科护理、检查指导、病情观察相关护理满意度评分高于对照组(P<0.05)。结论 快速康复理念联合腹腔镜手术治疗小儿腹股沟疝效果显著,可进一步促进患儿早日康复,缩短住院时间,术后疼痛水平低,同时可提升患儿及家长护理满意度。
Objective To explore the therapeutic effect of rapid rehabilitation concept combined with laparoscopic surgery on pediatric inguinal hernia.Methods A total of 86 children with inguinal hernia admitted to Jiaozuo Maternal and Child Health Care Hospital from January 2021 to January 2023 were selected for analysis and study,and divided into observation group and control group by random number table method,with 43 cases in each group.All patients were treated with laparoscopic surgery,while the control group received routine care,while the observation group received rapid recovery concept care.The perioperative recovery,pain level,complications,and nursing satisfaction at 4,12,24,and 48 hours after surgery were compared.Results The first discharge time,first anal exhaust time,feeding time,and hospitalization time were shorter than the control group(P<0.05).The VAS scores decreased after 4 h,12 h,24 h and 48 h,and the observation group was lower than the control group(P<0.05).The incidences of nausea and vomiting,urinary retention,abdominal distension,abdominal pain and infectious complications between the two groups were significantly insignificant(P>0.05).The health education,inpatient environment,specialized care,nursing examination guidance and condition observation were significantly higher than that of the observation group(P<0.05).Conclusions The combination of rapid recovery concept and laparoscopic surgery for the treatment of inguinal hernia in children has a significant effect,which can further promote early recovery,shorten hospital stay,lower postoperative pain levels.At the same time,it can improve the nursing satisfaction of children and parents.
论著

分析不同高血压分级血压变异性与空腹甘油三酯血糖指数及内皮功能的相关性

Analysis of the correlation between blood pressure variability in different hypertension grades and fasting triglyceride blood glucose index and endothelial function

:770-775
 
目的 探讨不同高血压分级血压变异性与空腹甘油三酯血糖指数及内皮功能的相关性。方法 选取天津市第一医院2020年10月—2023年10月收治的150例高血压患者作为研究对象,将患者分为:1级组(n=50),即140~159 mmHg和(或)舒张压90~99 mmHg,2级组(n=60),即收缩压160~179 mmHg和(或)舒张压100~109 mmHg,3级组(n=40),即收缩压≥180 mmHg和(或)舒张压≥110 mmHg。测量所有患者收缩压加权标准差(SBPwSD)和舒张压加权标准差(DBPwSD)评价血压变异性,检测空腹血糖、空腹甘油三酯水平,计算空腹甘油三酯血糖指数(TyG),以及记录丙二醛(MDA)、一氧化氮(NO)、内皮素-1(ET-1)、超氧化物歧化酶(SOD)水平对内皮功能进行评价。采用Spearman相关分析法分析血压变异性与空腹TyG及内皮功能的相关性。结果 1级组DBPwSD、SBPwSD低于2级组和3级组(P<0.05);1级组空腹血糖、空腹甘油三酯、TyG低于2级组和3级组(P<0.05);1级组MDA、ET-1低于2级组和3级组,NO、SOD高于2级组和3级组(P<0.05); DBPwSD、SBPwSD与空腹血糖、空腹甘油三酯无关(P>0.05),DBPwSD、SBPwSD与NO、SOD水平呈负相关,与TyG、MDA、ET-1呈正相关(P<0.05)。结论 不同血压分级的高血压患者血压变异性、TyG及血管内皮功能具有明显差异,且高血压患者血压变异性与TyG和血管内皮功能具有明显相关性。
Objective To explore the correlation between blood pressure variability and fasting triglyceride blood glucose index and endothelial function in different hypertension grades.Methods A total of 150 hypertensive patients admitted to our hospital from October 2020 to October 2023 were selected as study participants.Patients were classified into group level 1 (n=50),with systolic blood pressure 140~159 mmHg and/or diastolic blood pressure 90~99 mmHg,group level 2(n=60),with systolic blood pressure 160~179 mmHg and/or diastolic blood pressure 100~109 mmHg,and group level 3(n=40),with systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg.SBPwSD and DBPwSD of all patients were measured to assess their blood pressure variability.Fasting blood glucose and fasting triglyceride levels were measured to calculate TyG.MDA,NO,ET-1 and SOD were used to evaluate endothelial function.The correlation between blood pressure variability and glycemic index and endothelial function was analysed using Spearman correlation analysis.Results The DBPwSD and SBPwSD of the group level 1 were significantly lower than those of the groups level 2 and 3(P<0.05).The fasting blood glucose,fasting triglycerides and TyG in the group level 1 were significantly lower than those in the groups level 2 and 3(P<0.05).MDA and ET-1 values in the group level 1 were significantly lower than in the groups level 2 and 3,while NO and SOD values in the group level 1 were significantly higher than those in the other two groups(P<0.05).DBPwSD and SBPwSD did not correlate significantly with fasting blood glucose and fasting triglycerides(P>0.05),while DBPwSD and SBPwSD correlated negatively with NO and SOD values and correlated positively with TyG,MDA and ET-1(P<0.05).Conclusions There are significant differences in blood pressure variability,TyG,and endothelial function among hypertensive patients with different grades,and there is a significant correlation between blood pressure variability and TyG and endothelial function in hypertensive patients.
论著

常见炎性指标与进展性脑梗死病灶损害程度的关联及对预后的预测效能分析

Analysis of the correlation between common inflammatory indicators and the degree of damage to progressive cerebral infarction lesions and their predictive efficacy for prognosis

:764-769
 
目的 分析常规炎性指标与进展性脑梗死(PCI)患者病灶损害程度的关联,及其对预后水平的预测效能。方法 采用回顾性研究,纳入2021年6月—2023年2月平顶山市第二人民医院收治的100例PCI患者,根据入院时神经功能缺损评分(NIHSS)结果,将NIHSS评分≥21分的30例患者列为重度组,将NIHSS评分15~20分的35例患者列为中度组,将NIHSS评分<15分的35例患者列为轻度组,比较三组患者的神经功能血清学指标及炎症指标,经Pearson相关性分析炎症指标与神经功能血清学指标的相关性;根据是否发生不良预后将入组患者分为预后良好组和预后不良组,比较两组患者各炎症指标及改良Rakin量表(mRS)评分间的差异,并通过绘制受试者操作特征(ROC)曲线、曲线下面积(AUC)评估炎症指标对PCI患者预后水平的预测效能。结果 重度组患者的C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)分别为(26.44±5.18)mg/L、(95.28±10.46)ng/L、(45.24±10.31)pg/mL,均高于中度组[(23.12±5.46)mg/L、(90.44±10.17)ng/L、(40.25±10.18)pg/mL],轻度组[(20.28±5.33)mg/L、(84.33±10.27)ng/L、(35.62±8.45)pg/mL],差异具有统计学意义(P<0.05)。重度组的神经元特异性烯醇化酶(NSE)、S100钙结合蛋白β(S100β)分别为(25.45±5.69)μg/L、(60.45±10.31)ng/mL,均高于中度组[(22.18±5.36)μg/L、(55.27±10.46)ng/mL],轻度组[(19.44±5.37)μg/L、(50.49±10.25)ng/mL],差异具有统计学意义(P<0.05)。经Pearson相关性分析,PCI患者的CRP、IL-6、TNF-α等常见炎性指标水平与NSE、S100β等神经功能血清学指标水平正相关(P<0.05)。经检测,预后不良组的CRP、IL-6、TNF-α、mRS分别为(26.62±5.31)mg/L、(96.77±10.24)ng/L、(47.25±10.33)pg/mL、(4.24±1.33)分,均高于预后良好组[(23.75±5.44)mg/L、(91.25±10.37)ng/L、(41.12±10.44)pg/mL,(3.36±0.27)分],差异具有统计学意义(P<0.05)。经ROC曲线验证,CRP、IL-6、TNF-α等常见炎性指标水平越高,PCI患者的mRS评分越高(AUC均>0.85)。结论 CRP、IL-6、TNF-α等常见炎性指标会随PCI患者脑神经功能损伤程度加剧而不断升高,与病灶损害程度正相关;通过检测上述炎性指标能实现对患者不良预后的早期预测。
Objective To analyze the correlation between routine inflammatory indicators and the degree of lesion damage in progressive cerebral infarction(PCI) patients,as well as predictive efficacy of indicators on prognosis levels.Methods This is a retrospective study,with case enrollment from June 2021 to February 2023.The study subjects were 100 PCI patients.Based on the NIHSS score at admission,30 patients with a NIHSS score ≥ 21 were classified as the severe group,35 patients with a NIHSS score of 15~20 were classified as the moderate group,and 35 patients with a NIHSS score <15 were classified as the mild group.The neurological function serological and inflammatory indicators of the three groups of patients were compared.The correlation between inflammatory indicators and neurological serological indicators was verified by Pearson correlation coefficient.According to the occurrence of adverse prognosis,enrolled patients were divided into good prognosis group and poor prognosis group.The differences in inflammatory indicators and mRS scores between the two groups were compared,and the predictive power of inflammatory indicators on the prognosis level of PCI patients was evaluated by plotting ROC and observing AUC.Results After testing,the levels of CRP,IL-6 and TNF in the severe group were(26.44±5.18)mg/L,(95.28±10.46)ng/L and(45.24±10.31)pg/mL,respectively,higher than those in the moderate group[(23.12±5.46)mg/L,(90.44±10.17)ng/L and(40.25±10.18)pg/mL]and the mild group[(20.28±5.33)mg/L,(84.33±10.27)ng/L and(35.62±8.45)pg/mL](P<0.05).NSE and S100β in the severe group were(25.45±5.69)μg/L and(60.45±10.31)ng/mL,all higher than those in the moderate group[(22.18±5.36)μg/L,(55.27±10.46)ng/mL]and mild group[(19.44±5.37)μg/L,(50.49±10.25)ng/mL](P<0.05).According to Pearson correlation coefficient test,CRP,IL-6,TNF-α and mRS in PCI patients positively correlated with NSE,S100β(P<0.05).After testing,CRP,IL-6,TNF-α and mRS in the group with poor prognosis were(26.62±5.31)mg/L,(96.77±10.24)ng/L,(47.25±10.33)pg/mL and(4.24±1.33)scores,respectively,which were higher than those in the group with good prognosis[(23.75±5.44)mg/L,(91.25±10.37)ng/L,(41.12±10.44)pg/mL and(3.36±0.27)scores](P<0.05).Verified by ROC curve,the higher the levels of CRP,IL-6 and TNF- α,the higher the mRS scores of PCI patients(AUC>0.85).Conclusions Common inflammatory indicators such as CRP,IL-6 and TNF- α of PCI will continue to increase with the severity of brain nerve function damage in patients,and are positively correlated with the degree of lesions damage.By detecting the aforementioned inflammatory indicators,early prediction of poor prognosis can be achieved for patients.
论著

输尿管硬镜与输尿管软镜钬激光碎石术治疗输尿管上段不同部位结石的比较

Comparison of ureteral rigid versus ureteral flexible holmium laser lithotripsy for the treatment of stones in different parts of the upper ureter

:752-758
 
目的 对比输尿管硬镜、输尿管软镜钬激光碎石术在输尿管上段结石治疗中的应用价值。方法 分析于我院接受住院手术治疗的80例输尿管上段结石患者基本资料,按照入院顺序对患者进行分组治疗,对照组实施输尿管硬镜钬激光碎石术治疗,研究组实施输尿管软镜钬激光碎石术治疗,对比两组治疗相关数据及并发症发生率。结果 术后研究组患者PCT、CRP、IL-6、IL-10指标均较对照组理想(P<0.05);术后研究组患者生活质量评分高于对照组(P<0.05);研究组高热发生率低于对照组(P<0.05),其他并发症发生率无明显差异(P>0.05)。结论 相比输尿管硬镜,对输尿管上段结石患者实施输尿管软镜钬激光碎石术治疗能够显著改善手术指标和炎性因子指标,有利于提升患者术后生活质量,且安全性良好。
Objective To explore the value of ureteral rigid and ureteral flexible holmium laser lithotripsy in the treatment of upper ureteral stones.Methods The basic data of 80 patients with upper ureteral stones who underwent inpatient surgical treatment in our hospital were analysed,and the patients were divided into equal groups according to the order of admission.The control group was treated with holmium laser lithotripsy by rigid ureteroscopy,and the study group was treated with holmium laser lithotripsy by ureteroscopy,and the treatment-related data and the incidence of complications were compared between the two groups.Results PCT,CRP,IL-6,and IL-10 indices were closer to the standard range in patients in the study group after surgery(P<0.05);postoperative quality of life scores of the patients in the study group were higher compared with those in the control group(P<0.05);the incidence of hyperthermia was lower in the study group than in the control group(P<0.05),and there was no significant difference in the incidence of other complications(P>0.05).Conclusions Holmium laser lithotripsy with flexible ureteroscopy for patients with upper ureteral stones can significantly improve surgical indexes and inflammatory factor indexes,and is conducive to the improvement of postoperative quality of life and safety,and has the value of popularization.
论著

氟哌噻吨美利曲辛联合帕罗西汀对重度抑郁障碍患者躯体化症状、睡眠和认知功能的影响分析

Analysis of the effect of haloperitoxine melitrexine in combination with paroxetine on somatic symptoms,sleep and cognitive function in patients with major depressive disorder

:747-751
 
目的 探讨氟哌噻吨美利曲辛联合帕罗西汀对重度抑郁障碍(MDD)患者躯体化症状、睡眠和认知功能的影响分析以及临床应用效果。方法 回顾性分析2020年8月—2023年2月在南昌市某医院接受治疗的120例MDD患者相关资料,按照其治疗方案不同分为帕罗西汀治疗组(常规组,n=55)和氟哌噻吨美利曲辛联合帕罗西汀治疗组(联合组,n=65)。两组患者治疗周期均为4周,比较两组患者治疗前和治疗第2、4周的汉密尔顿抑郁量表(HAMD-17)评分、躯体化症状自评量表(SSS)评分、睡眠质量评分(PSQI)、神经心理状态评定量表(RBANS);且治疗后对患者进行1个月的随访比较两组患者治疗后总体疗效及不良反应发生情况。结果 经治疗第2、4周联合组RBANS评分高于常规组(P<0.05),而PSQI评分、SSS评分、HAMD-17评分均低于常规组(P<0.05)。治疗后1个月随访资料显示,两组患者不良反应总发生率比较,差异无统计学意义(P>0.05),且总有效率高于常规组(P<0.05)。结论 氟哌噻吨美利曲辛联合帕罗西汀对MDD患者临床应用疗效确切,还可以帮助患者减轻躯体化症状,改善患者睡眠质量,并且提高患者认知功能。
Objective To investigate the effect of haloperitoxine melitraxine combined with paroxetine on somatic symptoms,sleep and cognitive function in patients with major depressive disorder(MDD)and its clinical application effects.Methods A retrospective analysis was performed on the relevant data of 120 patients with MDD who received treatment in our hospital from August 2020 to February 2023,and divided into conventional group(treated with paroxetine,55 cases)and combined group(haloperitoxetex melitraxine combined with paroxetine,65 cases)according to their different treatment regimens.The treatment duration of the two groups was 4 weeks,and the Hamilton Rating Scale for Depression(HAMD-17)score,Somatized Symptom Self-rating Scale(SSS)score,Sleep Quality Score(PSQI) and Neuropsychological State Rating Scale(RBANS)scores were compared before treatment and at the 2nd and 4th week of treatment.After treatment,the patients were followed up for 1 month,and the total efficacy and adverse reactions of the two groups of patients after treatment were compared.Results After 2 and 4 weeks of treatment,the combined group showed significantly higher RBANS scores compared to the control group(P<0.05),while PSQI scores,SSS scores and HAMD-17 scores were significantly lower in the combined group compared to the control group(P<0.05).One month after treatment,follow-up data showed that there was no statistically significant difference in the overall incidence of adverse reactions between the two groups(P>0.05).Additionally,the total effective rate was significantly higher in the combined group compared to the control group(P<0.05).Conclusions Haloperitoxine melitrexine combined with paroxetine has a definite clinical effect in patients with MDD,and can also help patients reduce somatization symptoms,improve patients' sleep quality,and improve patients' cognitive function.
论著

早期积极心理干预对DTC患者负性情绪和癌因性疲乏的影响

The effect of early positive psychological intervention on negative emotions and cancer-related fatigue in patients with differentiated thyroid cancer

:741-746
 
目的 探讨在分化型甲状腺癌(DTC)患者的治疗中,采用早期积极心理进行干预,对患者负性情绪和癌因性疲乏的影响。方法 抽取2021年6月—2023年1月平煤神马医疗集团总医院收治的160例DTC癌患者,随机分为对照组(常规护理)和研究组(常规护理+早期积极心理干预),每组各80例,评估患者干预前后的心理状态、癌因性疲乏、生活质量、护理工作满意度。结果 护理干预1~4周后,两组患者汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分均降低,并且研究组患者评分更低(P<0.05);干预后,两组患者的癌因性疲乏评分均升高,但是研究组患者的以上指标升高幅度小于对照组(P<0.05);此外,两组患者的护士观察量表(NOSIE)评分均明显改善,并且研究组变化幅度大于对照组(P<0.05);研究组患者的护理满意度高于对照组(95.00% vs 82.50%,P<0.05)。结论 对DTC患者开展早期积极心理干预,能够帮助患者改善负性情绪,减轻癌因性疲乏,提高患者的生活质量和护理满意度。
Objective To investigate the effect of early positive psychological intervention on negative emotions and cancer-related fatigue in the treatment of differentiated thyroid cancer(DTC) patients.Methods From June 2021 to January 2023,160 patients with DTC admitted to General Hospital of Pingmei Shenma Group were randomly divided into the control group(routine nursing)and the research group(routine nursing + early positive psychological intervention),with 80 patients in each group.The psychological state,cancer-related fatigue,quality of life and nursing satisfaction of patients before and after intervention were evaluated.Results After 1~4 weeks of intervention,the scores of Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)were decreased in both groups,and the scores of research group were lower(P<0.05).After intervention,the cancer-related fatigue scores of both groups were increased,but the increase of research group were less than that of control group(P<0.05).Moreover,NOSIE scores of both groups were significantly improved,and the change range of research group was greater than that of control group(P<0.05).The nursing satisfaction of research group was higher than that of control group(95.00% vs 82.50%,P<0.05).Conclusions Early positive psychological intervention for patients with DTC can effectively improve negative emotions,reduce cancer-related fatigue,and improve nursing satisfaction of patients.
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