临床诊疗

癫痫患者疾病进展恐惧水平及其相关影响因素分析

:91-94
 
目的 探讨癫痫患者疾病进展恐惧水平的影响因素。方法 选取2021年1月—2022年8月本院收治的82例癫痫患者,评估所有患者的疾病进展恐惧水平,设计基线资料调查表,详细统计所有患者的基线资料,比较不同资料特征癫痫患者的恐惧疾病进展简化量表(FoP-Q-SF)评分,重点分析癫痫患者疾病进展恐惧水平的影响因素。结果 经评估,82例癫痫患者的FoP-Q-SF评分为(34.73±5.16)分;不同年龄、社会支持、希望水平、发作频率及受教育程度癫痫患者的FoP-Q-SF评分比较差异有统计学意义(均P<0.05),其他不同资料特征癫痫患者的FoP-Q-SF评分比较,差异无统计学意义(P>0.05);多元线性回归分析结果显示,低龄、发作频率高、低希望水平、社会支持低下及受教育程度低均为癫痫患者疾病进展恐惧水平的影响因素(P<0.05)。结论 癫痫患者疾病进展恐惧呈中高水平,低龄、发作频率高、低希望水平、社会支持低下及受教育程度低均为癫痫患者疾病进展恐惧水平的影响因素。
论著

老年髋部骨折患者围术期隐性失血的影响因素及护理措施分析

Analysis of influencing factors and nursing measures for perioperative hidden blood loss in elderly patients with geriatric hip fractures

:85-90
 
目的 探讨老年髋部骨折(GHF)患者围术期隐性失血的影响因素及护理措施。方法 回顾性分析2020年3月—2023年3月我院收治的86例老年GHF患者,所有患者均采取手术治疗,计算所有患者围术期失血量,并收集所有患者的一般资料及围术期相关治疗情况,分析不同一般资料患者围术期隐性失血情况,不同手术方式及麻醉方式围术期隐性失血情况,不同术后处理方式围术期隐性失血情况,随后采取Logistic回归分析老年GHF患者围术期隐性失血的影响因素,最后针对结果制定老年GHF隐性失血的护理措施。结果 不同性别和是否合并冠状动脉粥样硬化、高血压患者围术期隐性失血量比较差异无统计学意义(P>0.05),不同年龄、合并糖尿病、骨折类型患者围术期隐性失血量比较差异有统计学意义(P<0.05);不同手术方式、麻醉方式患者围术期隐性失血量比较差异有统计学意义(P<0.05);不同术后引流、使用肝素情况患者围术期隐性失血量比较差异有统计学意义(P<0.05);Logistic回归分析结果表明:年龄、合并糖尿病、手术方式、麻醉方式、术后引流、使用肝素都是造成GHF老年患者围术期隐性失血的影响因素(P<0.05)。患者经相关护理后,恢复较佳。结论 老年GHF患者围术期会存在大量隐性失血情况,同时年龄、合并糖尿病、手术方式、麻醉方式、术后引流、使用肝素与围术期隐性失血量密切相关,临床上可采取针对性措施减少GHF患者隐性失血。
Objective To explore the influencing factors and nursing measures of perioperative hidden blood loss in elderly patients with geriatric hip fractures(GHF).Methods From March 2020 to March 2023,86 elderly patients with GHF admitted to our hospital were selected as the study objects for retrospective analysis.All patients were treated with surgery.The perioperative blood loss of all patients was calculated,general information and perioperative treatment status of all patients were collected,the hidden blood loss of patients with different general information,different surgical and anesthesia methods and different postoperative treatment methods were analyzed.Logistic regression analysis was used to analyze the influencing factors of hidden blood loss of elderly GHF patients during the perioperative period.Nursing measures for hidden blood loss in elderly hip fractures were developed based on the results.Results There was no statistical difference in the amount of perioperative hidden blood loss among patients with different gender,complicated with coronary heart disease and hypertension or not(P>0.05),but there was statistical difference in the amount of perioperative hidden blood loss among patients with different ages,complicated with diabetes and fracture types(P<0.05).There was statistically significant difference in the amount of hidden blood loss during the perioperative period among patients with different surgical and anesthesia methods(P<0.05).There was statistically significant difference in the amount of hidden blood loss during the perioperative period among patients with different postoperative drainage and use of heparin(P<0.05).The results of Logistic regression analysis showed that age,complicated with diabetes,operation methods,anesthesia methods,postoperative drainage and heparin use were independent risk factors for perioperative hidden blood loss in elderly patients with GHF(P<0.05).Conclusions There will be a lot of hidden blood loss in the perioperative period of elderly patients with GHF.At the same time,age,complicated with diabetes,operation methods,anesthesia methods,postoperative drainage and heparin use are closely related to the amount of hidden blood loss in the perioperative period.Targeted measures can be taken clinically to reduce the hidden blood loss in patients with GHF.
论著

非重症监护室护士对住院卧床老年患者肺康复知信行的调查研究

A study of non-ICU nurses'knowledge,attitude and practice about pulmonary rehabilitation in hospitalized bedridden elderly patients

:79-84
 
目的 调查非重症监护室护士对住院卧床老年患者肺康复的知信行现状,探讨其影响因素。方法 采用自行设计的卧床老年患者肺康复知信行现状调查问卷,对广州市第一人民医院的555 名非重症监护室护理人员进行调查。结果 共回收有效问卷513份。调查对象肺康复知信行总分为(76.01±12.27)分,知识维度、态度维度、行为维度得分分别为(14.09±3.25)、(21.89±3.38)、(40.03±9.87)分。多元回归分析显示,主要影响护士对住院老年卧床患者实施肺康复知信行的因素为护龄、是否参加过肺康复相关培训及科室是否已开展肺康复(P<0.05)。结论 非重症监护室护士对卧床老年患者肺康复的态度积极,行为良好,但知识有待提升。建议开展卧床老年人相关肺康复培训,激励护士主动学习肺康复新理念的积极性和主动性,强化理论联系临床实践,从而提高临床护理质量。
Objective To investigate the knowledge,attitude and practice of non-intensive care unit(ICU)nurses about pulmonary rehabilitation of hospitalized bedridden elderly patients,and to explore the influencing factors.Methods A self-designed questionnaire on the status of knowledge,attitude and practice about pulmonary rehabilitation of bedridden elderly patients was used to investigate 555 non-ICU nurses in our hospital.Results A total of 513 valid questionnaires were collected.The total score of pulmonary rehabilitation was(76.01±12.27),and the scores of knowledge,attitude and practice were(14.09±3.25),(21.89±3.38)and(40.03±9.87),respectively.Multiple regression analysis showed that the main factors affecting nurses' knowledge,attitude and practice in implementing pulmonary rehabilitation for hospitalized elderly bedridden patients were nursing age,whether they had participated in training related to pulmonary rehabilitation and whether pulmonary rehabilitation had been carried out in the unit(P<0.05).Conclusions Non-ICU nurses have positive attitudes and good practice toward pulmonary rehabilitation for bedridden elderly patients,but their knowledge needs to be improved.It is recommended that training on pulmonary rehabilitation for the bedridden elderly be carried out to motivate nurses to learn new concepts of pulmonary rehabilitation,strengthen the link between theory and clinical practice,and improve the quality of clinical care.
论著

广州市越秀区助产机构医务人员对艾滋病母婴阻断知识及患者相关权益知识掌握情况调查

Investigation on the knowledge of AIDS prevention from mother to child and the knowledge of rights and interests of patients among medical staff in midwifery institutions in Yuexiu District of Guangzhou City

:74-78
 
目的 了解越秀区助产机构医务人员对艾滋病母婴阻断知识及患者相关权益知识掌握情况,为更好地贯彻落实消除艾滋病母婴传播工作提供下一步工作策略和措施依据。方法 于2022年7月—8月,对广州市越秀区5家助产机构妇产科、保健科和医务科的医务人员进行艾滋病母婴阻断知识政策及HIV感染孕产妇相关权益知识的问卷调查。结果 465名医务人员对个别艾滋病母婴阻断政策了解不足,包括“人类免疫缺陷病毒(HIV)感染孕产妇到定点医疗机构终止妊娠或住院分娩时可以获得一定的减免”(知晓率79.78%)、“HIV感染孕产妇的宝宝可以免费领取一定数量的奶粉”(知晓率66.88%);医务人员对HIV感染孕产妇的生育相关权益认识严重不足,对HIV感染孕产妇生育权益认识正确的仅有45.59%。临床护士群体对上述艾滋病母婴阻断政策及HIV感染孕产妇相关权益的知晓率低于临床医生及其他医务人员,组间比较差异有统计学意义(P<0.05)。结论 越秀区助产机构医务人员对艾滋病母婴阻断知识有一定的了解,但掌握不够完整、全面,对HIV感染患者的生育权认识严重不足,应进一步加强对助产机构医务人员、尤其是护士群体关于艾滋病母婴阻断政策知识及患者相关权益的培训,以更好地贯彻落实消除艾滋病母婴传播工作,保障HIV感染患者的权益。
Objective To understand the knowledge of medical staff of midwifery institutions in Yuexiu District about AIDS prevention of mother-to-children transmission(PMTCT)and patients' rights and interests,in order to provide the basis for the following work strategy and measures for better implementation of the elimination of mother-to-child transmission of HIV.Methods From July to August in 2022,a questionnaire survey about knowledge and policies of AIDS PMTCT and rights of HIV infected pregnant women was conducted among the medical staff of obstetrics and gynecology department,health care department and medical department in five midwifery institutions in Yuexiu District of Guangzhou City.Results A total of 465 medical workers had insufficient understanding of some policies on PMTCT of AIDS,including HIV-infected pregnant women can obtain certain fee waiver when they go to designated medical institutions to terminate pregnancy or hospitalized deliver(awareness rate of 79.78%),HIV-infected pregnant women's babies can receive a certain amount of free milk powder(awareness rate of 66.88%).There was a serious lack of awareness of reproductive rights of HIV-infected pregnant women among medical staff,and only 45.59% of them had correct understanding.The awareness rate of the PMTCT and the rights and interests of HIV-infected pregnant women among clinical nurses was significantly lower than that among clinicians and other medical staff.Conclusions The medical staff of midwifery institutions in Yuexiu District have some knowledge about the PMTCT of AIDS,but their knowledge is not complete and comprehensive,and their understanding of the reproductive rights of HIV-infected patients is seriously inadequate,so it is necessary to further strengthen the training of medical staff in midwifery institutions,especially nurses,on the policy knowledge of PMTCT of AIDS and the related rights and interests of patients,in order to better implement the elimination of mother-to-child transmission of AIDS and protect the rights and interests of infected patients.
论著

广州市社区居民对中医“治未病”认知的现状及影响因素分析

Analysis of current situation and influencing factors of community residents' cognition of traditional Chinese medicine pre-treatment in Guangzhou

:65-73
 
目的 了解广州市社区居民对中医“治未病”的认知现状,分析其影响因素,并为中医“治未病”的进一步发展提出可行建议。方法 采用多阶段整群抽样法,对广州市不同区域的652名居民进行问卷调查,通过描述性分析和χ2检验分别对基本认知情况与影响因素进行阐述。结果 广州市居民对“治未病”服务了解情况不太理想(67.80%),接受“治未病”服务的意愿情况较好(77.91%),对于中医“治未病”服务的认知还比较片面,主要通过手机、网络、社区等方式了解相关内容。影响居民接受意愿的因素主要是年龄、学历、户口、职业类型等。结论 目前广州市社区中医“治未病”服务具有一定群众基础和发展潜力,但是还存在居民认知不足、宣传力度不够、服务能力不足等问题,应当着重从这些方面进行改进。
Objective To understand the current cognitive status of community residents in Guangzhou regarding traditional Chinese medicine(TCM)pre-treatment,analyze its influencing factors,and provide feasible suggestions for the further development of TCM pre-treatment.Methods By multi-stage cluster sampling method,a questionnaire survey was conducted on 652 residents in different regions of Guangzhou.Descriptive analysis and chi-square test were used to elucidate the basic cognitive situation and influencing factors.Results The understanding of TCM pre-treatment services among residents in Guangzhou was not ideal(67.8%),and their willingness to receive TCM pre-treatment services was good(77.91%).Their understanding of TCM pre-treatment services was quite one-sided,mainly through mobile phones,internet,communities and other means.The main factors affecting residents' willingness to accept this service were age,education level,household registration and occupation.Conclusions At present,the TCM pre-treatment service in the community of Guangzhou has a certain mass basis and development potential.However,there are still problems such as insufficient residents' awareness,insufficient publicity,and insufficient service capabilities,which should be improved in the future.
论著

医用几丁糖治疗不可复性关节盘前移位患者临床疗效及生活质量分析

The efficacy of medical chitosan and its effect on the quality of life of patients with anterior disc displacement without reduction

:59-64
 
目的 分析医用几丁糖治疗不可复性关节盘前移位患者的临床疗效及其对患者生活质量、恐惧疾病进展的影响。方法 将200例确诊为不可复性关节盘前移位患者分为2组,实验组以颞下颌关节微创灌洗术联合几丁糖治疗,对照组采用单一颞下颌关节微创灌洗术治疗,分别于治疗前和治疗后1、3、6、12个月采用一般资料调查表、口腔健康影响程度量表(OHIP)-14中文版、恐惧疾病进展简化量表(FoP-Q-SF)、视觉疼痛模拟量表等进行问卷调查并进行统计学分析。结果 治疗后,2组患者最大张口度、疼痛评分、生活质量及恐惧疾病进展水平较治疗前明显改善(P>0.05),且2组间比较,颞下颌关节微创灌洗术联合医用几丁糖在临床效果、生活质量及恐惧疾病进展水平长期效果明显优于单一颞下颌关节微创灌洗术(P>0.05)。结论 颞下颌关节微创灌洗术单一应用或联合医用几丁糖均对不可复性关节盘前移位患者疗效良好,对提升患者生活质量和缓解恐惧心理方面也有着重要意义,其中不可复性关节盘前移位联合应用几丁糖的长期疗效优于其单一应用。
Objective To analyze the efficacy of medical chitosan and its effect on the quality of life and fear of disease progression of patients with anterior disc displacement without reduction.Methods A total of 200 patients with anterior disc displacement without reduction were selected and divided into two groups,the experimental group was treated with temporomandibular joint lavage and medical chitosan,the control group was treated with temporomandibular joint lavage only.Before and after treatment with 1 month,3 months,6 months and 12 months,general data questionnaire,OHIP-14 Chinese version,FoP-Q-SF and visual analogue scale were used to investigate and the data were analyzed statistically.Results After treatment,the maximum mouth opening degree,pain score,quality of life and fear of disease progression were significantly improved compared with those before treatment,the differences were statistically significant(P>0.05).The long-term curative effect of the temporomandibular joint lavage and medical chitosan was better than that of the temporomandibular joint lavage only in clinical outcome,quality of life and fear of disease progression(P>0.05).Conclusions Temporomandibular joint lavage combined with medical chitosan and temporomandibular joint lavage only are effective in the treating anterior disc displacement without reduction,and can improve the quality of life and fear of disease progression,while the combined treatment has better long-term effect.
论著

中老年人口腔健康相关生活质量评价及其影响因素分析

Evaluation of oral health related quality of life and its influencing factors in middle-aged and elderly people

:50-58
 
目的 通过关注追踪中老年人口腔健康问题对生活质量的影响,系统梳理中老年人口腔健康的相关影响因素及其关系,为此类人群的口腔健康及其相关生活质量的活动开展提供调研依据。方法 随机抽取2022年10月—2023年5月之间的266名中老年人参与调查,按照“病因链”收集该类人群的社会学特征、日常口腔保健行为、身体健康状况,分析评价中老年人口腔健康相关生活质量。结果 266名中老年人口腔健康常识和行为得分平均为(30.69±8.98)分,口腔健康评估平均为(8.59±3.68)分,口腔健康相关生活质量GOHAI总分为(25.65±8.10)分。单因素分析显示,人口学特征与一般身体健康状况、口腔健康常识和行为以及口腔健康情况与中老年人的口腔健康相关生活质量的GOHAI得分密切相关(P<0.05)。多因素分析显示,女性、年龄>45岁、患慢性病、日常生活习惯是影响中老年口腔健康和生活质量的独立危险因素(P<0.05或P<0.01)。结论 口腔健康作为全身健康的基础,其影响因素多种多样,通过控制干预主要影响因素来提高社区口腔健康和相关生活质量,以改善社区居民生活幸福值。
Objective By focusing on and tracking the impact of oral health problems of middle-aged and elderly people on the quality of life,the relevant influencing factors and relationships of oral health were systematically sorted out to provide a research basis for the development of oral health and related quality of life of such people.Methods A total of 266 middle-aged and elderly people were randomly selected from October 2022 to May 2023 to participate in the survey,and the sociological characteristics,daily oral health care behaviors and physical health status of this population were collected according to the “etiological chain”,so as to analyze and evaluate the quality of life related to the oral health of middle-aged and elderly people.Results The 266 middle-aged and elderly people had a mean score of(30.69±8.98)for general knowledge and behavioral scores of oral health,a mean score of(8.59±3.68)for oral health assessment,a total score of(25.65±8.10)for oral health-related quality of life GOHAI.The univariate analysis showed that demographic characteristics,general body health state,oral health cognition and behavior and oral health state were closely associated with the GOHAI score related to the oral health associated quality of life in the middle-aged and elderly people(P<0.05).The multivariate analysis indicated that female,age >45 years old,presence of chronic diseases and daily living habits were indepdent risk factors of the oral health and quality of life of the middle-aged and elderly(P<0.05).Conclusions Oral health,as the basis of systemic health,has various influencing factors,by controlling the main influencing factors can improve the community oral health and related quality of life,and improve the happiness of community residents.
论著

帕利哌酮在精神分裂症患者中剂量校正浓度影响因素分析

Analysis of the factors influencing the dose-corrected through concentration of paliperidone in schizophrenic patients

:46-49
 
目的 探究精神分裂症患者应用帕利哌酮后剂量校正浓度(C/D)的影响因素,旨在为精神分裂症患者的临床用药提供参考。方法 选择2021年9月–2022年5月在我院择期接受帕利哌酮治疗的122例精神分裂症患者作为研究对象,收集患者的年龄、性别、给药剂量、给药频次以及合并用药等状况。结果 不同性别间帕利哌酮C/D存在差异,其中女性的C/D明显比男性的C/D更高。在关于年龄、性别、给药剂量、给药频次以及合并用药对帕利哌酮C/D的影响分析中,合并用药阿立哌唑、性别对帕利哌酮C/D有影响。结论 帕利哌酮应用在精神分裂症患者治疗中,性别、合并应用阿立哌唑会对帕利哌酮C/D产生显著影响。
Objective To explore the influencing factors of dose-corrected through concentration(C / D)of paliperidone in patients with schizophrenia,in order to provide reference for clinical medication of patients with schizophrenia.Methods A total of 122 patients with schizophrenia treated with paliperidone in our hospital from September 2021 to May 2022 were selected as the research objects.The patient's age,gender,dosage,frequency of administration and combined medication were collected.Results There were differences in the C / D of paliperidone between different genders,and the C / D of women was significantly higher than that of men.In the analysis of the effects of age,gender,dosage,frequency of administration and combined medication on the C / D of paliperidone,the combined medication of aripiprazole and gender had effect on the C / D.Conclusions The application of paliperidone in the treatment of patients with schizophrenia,gender and combined application of aripiprazole can have significant impact on C / D.
论著

乳果糖联合莫沙必利治疗功能性消化不良的疗效及对肠道菌群的影响

Efficacy of lactulose combined with mosapride in treating functional dyspepsia and its effect on intestinal flora

:42-45
 
目的 探讨功能性消化不良(FD)患者应用乳果糖联合莫沙必利治疗的临床疗效及药物对肠道菌群的影响。方法 选取2019年1月—2021年12月来院诊治的180例FD患者作为研究对象,随机分为2组,每组90例,对照组口服莫沙必利片,观察组服用莫沙必利片+乳果糖口服液,4周后观察2组患者治疗后临床症状改善率及肠道菌群数量的情况。结果 治疗4周后,观察组的总有效率(86.67%)高于对照组(72.22%),P<0.05;观察组的乳杆菌菌群数多于对照组,肠球菌、肠杆菌菌群数少于对照组,P<0.05。结论 乳果糖联合莫沙必利用于FD患者临床治疗,总有效率高于单用莫沙必利,患者症状获得有效改善,明显改善FD患者肠道菌群水平。
Objective To explore the clinical efficacy and effect on intestinal flora of lactulose combined with mosapride in patients with functional dyspepsia(FD).Methods A total of 180 FD patients admitted to the hospital in January 2019 and December 2021 were selected as the study subjects and randomly divided into two groups,90 cases in each group.The control group took oxapride orally and the observation group took lactulose oral solution additionally.After 4 weeks,the improvement rate of clinical symptoms and the number of intestinal flora of patients were observed.Results After 4 weeks of treatment,the total effective rate of the observation group(86.67%)was obviously higher than that of the control group(76.67%),P<0.05;the number of Lactobacillus in the observation group was higher than that of the control group,and the numbers of Enterococcus and Enterobacteria were less than that of the control group,P<0.05.Conclusions The total effective rate of lactulose combined with mosalabin for FD patients is higher than that of mossalapride alone.The symptoms are effectively improved,and the intestinal flora level of FD patients is significantly improved.
论著

MLR联合FT3对HBV相关慢加急性肝衰竭患者生存状况的预测效果

The predictive effect of MLR combined with FT3 on the survival of patients with chronic hepatitis B virus associated acute-on-chronic liver failure

:36-41
 
目的 分析单核细胞-淋巴细胞比率(MLR)联合游离三碘甲腺原氨酸(FT3)对乙型肝炎病毒(HBV)相关慢加急性肝衰竭(ACLF)患者生存状况的预测效果。方法 纳入我院在2019年1月—2022年1月期间收治的HBV-ACLF患者共187例进行研究,随访患者90 d的生存状况,其中69例死亡患者设为死亡组,其余118存活患者设为存活组。对2组患者的各项资料进行单因素分析,对差异有统计学意义的因素行Logistic多因素分析,分析HBV-ACLF患者死亡的危险因素,并分析MLR联合FT3对HBV-ACLF死亡的预测效果。结果 死亡组患者的年龄、肝硬化发生率、原发性腹膜炎发生率、肝肾综合征发生率、电解质紊乱发生率、终末期肝病模型、MLR、中性粒细胞与淋巴细胞计数比值、国际标准化比值、肌酐、白细胞计数、总胆红素水平均高于B组,血钠、FT3、总血清胆固醇水平均低于存活组,差异有统计学意义(P<0.05)。MLR≥0.60、FT3≤2.50 pmol/L均为HBV-ACLF患者死亡的危险因素(P<0.05)。MLR、FT3、MLR+FT3对HBV-ACLF患者死亡均有一定的预测价值,但MLR+FT3的预测价值高于其他单项预测。结论 MLR≥0.60、FT3≤2.50 pmol/L均为HBV-ACLF患者死亡的危险因素(P<0.05),且二者联合应用对HBV-ACLF患者死亡有较佳的预测价值。
Objective To analyze the predictive effect of mononuclear-lymphocyte ratio(MLR)combined with free triiodothyronine(FT3)on the survival of patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods In the study,187 patients with HBV-ACLF from January 2019 to January 2022 in our hospital were included,and the survival status of the patients was followed up for 90 days.Among them,69 patients were included in the death group and the rest 118 patients were included in the survival group.The data of the two groups of patients were analyzed by univariate analysis,and the statistically significant factors were analyzed by Logistic multifactor analysis.The risk factors of death in patients with HBV-ACLF were analyzed,and the predictive effect of MLR combined with FT3 on the death of HBV-ACLF was analyzed.Results The age,incidence of cirrhosis,primary peritonitis,hepatorenal syndrome,electrolyte disturbance,ratio of neutrophil to lymphocyte count,international standardized ratio,model for end stage liver disease,MLR,creatinine,white blood cell count and total bilirubin of the patients in the death group were higher than those in survival group,and the levels of serum sodium,FT3 and total cholesterol were lower than those in survival group,the differences were significant(P<0.05).The results showed that MLR≥0.60,FT3≤2.50 pmol/L were risk factors for death of HBV-ACLF patients(P<0.05).MLR,FT3,MLR+FT3 had certain predictive value for the death of HBV-ACLF patients,but the predictive value of MLR+FT3 was higher than other single prediction.Conclusions MLR≥0.60 and FT3≤2.50 pmol/L are risk factors for death of patients with HBV-ACLF(P<0.05),and the combination of the two has a better predictive value for death of patients with HBV-ACLF.
出版者信息








《广州医药》公众号