目的 探讨阿莫西林克拉维酸钾干混悬剂(7:1)联合胸腺肽治疗支气管哮喘合并肺部感染患儿的临床疗效。方法 选取我院支气管哮喘合并肺部感染患儿102例,依照治疗方案不同分为研究组(n=51)、常规组(n=51)。常规组采用M胆碱受体阻断剂联合阿莫西林克拉维酸钾干混悬剂(7:1)治疗,研究组于常规组基础上采用胸腺肽治疗,统计比较两组临床疗效、随访3个月复发率及治疗前后血清炎性因子[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、肺功能指标[第1 s用力呼气容积(FEV₁)、第1 s用力呼气容积/用力肺活量(FEV₁/FVC)]。结果 研究组治疗总有效率94.12%高于常规组80.39%(P＜0.05);治疗2周后研究组FEV₁、FEV₁/FVC水平高于常规组,血清IL-6、TNF-α水平低于常规组(P＜0.05);研究组复发率3.70%(1/27)与常规组11.11%(2/18)比较,差异无统计学意义(P＞0.05)。结论 阿莫西林克拉维酸钾干混悬剂(7:1)联合胸腺肽治疗支气管哮喘合并肺部感染患儿疗效显著,可降低患儿炎症反应、改善肺功能。

目的 探讨观察静吸复合麻醉与全凭静脉麻醉对中老年妇科腹腔镜手术的作用。方法 以2016年8月—2018年8月为时间段,选择我院收治的86例中老年妇科腹腔镜手术患者,将其随机分成对照组、实验组,各组43例患者。对照组采取静吸复合麻醉方式,实验组采取全凭静脉麻醉方式。对比观察两组患者的麻醉效果,比较手术中的血流动力学指标,另外统计不良反应及术后认知功能障碍。结果 实验组麻醉起效时间、睁眼时间及拔管时间比对照组短,不良反应发生率及认知功能障碍发生率低于对照组,二组比较差异有统计学意义(P<0.05);手术中心率、氧饱和度、收缩压与舒张压比较,组间差异无统计学意义(P>0.05)。结论 和静吸复合麻醉比较,全凭静脉麻醉在中老年妇科腹腔镜手术中的应用价值更高,建议推广。

目的 探讨硝普钠联合多巴胺治疗心肌梗死后左心衰竭的疗效。方法 选取2018年11月—2019年11月我院收治的心肌梗死后左心衰竭患者148例,应用随机数字法分为两组,对照组应用多巴胺治疗,研究组应用硝普钠联合多巴胺治疗。比较2组治疗效果,心率、呼吸、收缩压及舒张压等心功能指标,头痛、视力模糊、肌肉颤搐等不良反应。结果 经过治疗后,比较2组治疗效果,经研究可知,研究组有效率为97.2%,对照组为87.8%,研究组疗效高于对照组,差异有统计学意义(P＜0.05);治疗后,2组患者心脏功能指标均优于治疗前,且研究组心脏功能指标优于对照组,差异有统计学意义((P＜0.05);经过治疗后,比较2组治疗效果,经研究可知,研究组不良反应为2.8%,对照组为10.8%,研究组不良反应低于对照组,差异有统计学意义(P＜0.05)。结论 在治疗心肌梗死左心衰竭患者,通过使用硝普钠联合多巴胺治疗,治疗效果显著,能够有效改善患者的心率、呼吸等心功能指标,而且患者在用药后出现的不良反应少,提高了患者的生活质量,有助于早日康复出院,值得临床上大力推广应用。

目的 探讨建立适合我妇女儿童医院检验科血常规检查的复检规则,帮助检验人员快速准确地审核检验结果,同时为下一步仪器自动执行3R复检和智能审核功能提供基础数据。方法 随机收集本院就诊患者,成人457例,儿童869例,用Sysmex XN-2000全自动血液分析仪检测血常规,改进中间传输软件Laboman的复检规则,以人工镜检为标准,计算复检规则判断结果的真阳性率、假阳性率、真阴性率和假阴性率。结果 所建立改进的复检规则判断结果,真阳性率为15.38%,假阳性率为5.13%,真阴性率为75.64%,假阴性率为3.85%,假阴性率<5%,符合复检要求。结论 通过Laboman复检规则判断功能,保证了低漏检率,又减少了假阳性标本的复检,有效提高工作效率,可以作为自动复检和智能审核的实验依据。

目的 了解从化地区儿童人冠状病毒((human coronavirus,HCoV)流行情况和临床特点,观察人冠状病毒分型OC43(HCoV-OC43)基因分布特点,探讨从化地区小儿呼吸道感染HCoV-OC43分离株与国内的HCoV-OC43分离株的同源性与基因分型,探讨HCoV-OC43与小儿呼吸道感染疾病的关系,为预防和控制呼吸道疾病提供依据。方法 本研究从化地区2017年1月—2019年6月门诊就诊的6个月~14岁的儿童610例,采集鼻咽拭子标本,病毒检测阳性的患者,这些标本取自患有急性上呼吸道感染或下呼吸道感染疾病的患者,表现出呼吸道感染的症状,例如发热(体温> 37.5℃)、咽痛、流涕、鼻塞、咳嗽和咳痰等。采用荧光定量PCR方法,对HCoV-OC43病毒核酸进行分析和测序。采用直接免疫荧光法检测其他7种常见呼吸道病毒;包括:流感病毒 A、B型(influenza virus,IVA、B)、副流感病毒Ⅰ、Ⅱ、Ⅲ 型 (parainfluenza virus, PIVⅠ、Ⅱ和Ⅲ)、呼吸道合胞病毒(respiratory syncytial virus, RSV)、腺病毒(ad enovirus, ADV)共七种常见呼吸道病毒进行检测,通过HCoV-OC43和常见呼吸道病毒的病毒监测,找出从化地区呼吸道感染患儿HCoV-OC43的N蛋白编码基因的特征。结果 从化地区6月~14岁的呼吸道感染儿童610例,采集鼻咽拭子标本,病毒检测阳性的患者,分析了8种呼吸道病毒,重点分析HCoV-OC43的临床特点。从发病时间月份分布可以看出,人HCoV-OC43主要是在春季流行, HCoV-OC43全年均可检出,春季4月份和5月份检出率较高,冬季较低,但不同月份的检出率无差异。各种常见病毒的发病率,流感病毒A(IVA)111例(18.20%)、流感病毒B(IVB)61例(10.00%)、副流感病毒Ⅰ(PIVⅠ)42例(6.89%)、副流感病毒Ⅱ(PIVⅡ)34例(5.57%)、副流感病毒Ⅲ(PIVⅢ)77例(12.62%)、呼吸道合胞病毒(RSV)135例(22.14%)、腺病毒(ADV) 82例(13.45%),冠状病毒(HCoV-OC43)68例(11.14%)。呼吸道感染多为流感病毒(A+B)和副流感病毒(Ⅰ,Ⅱ,Ⅲ)共325例(53.28%),其次是合胞病毒感染135例(22.14%),腺病毒(ADV) 82例(13.45%),冠状病毒感染最低68例(11.14%)。建立荧光定量PCR方法检测HCoV-OC43 病毒分离及基因分型测序,阳性PCR 产物测序,与HCoV-OC43中N 蛋白基因序列进行比较分析,该地区冠状病毒具有临床多样性,与国内已发表的菌株HCoV-OC43相比具有很高的同源性。结论 人冠状病毒OC43的检出率与以前的报道相符,未发现新的传染性冠状病毒,冠状病毒HCoV-OC43的流行趋势稳定,所有呼吸道感染者均表现出正常的呼吸道感染症状。常见呼吸道病毒检测, 对临床早期诊断和合理用药具有重要意义。

目的 结合临床现状分析影响护士护患沟通能力的相关因素,并根据影响因素制定相关应对方案。方法 采用《护士临床沟通能力量表》对广州市某三甲医院的941名护士进行调查。结果 护士沟通能力得分为(4.19±0.43)(评分范围为1～5分),其中情感支持能力维度得分最低(4.05±0.37),护士性别、婚姻状况、职称、职务和培训次数不同,其护患沟通能力得分有差异(P<0.05))。结论 护士的情感支持能力有待提高,性别、婚姻状况、职称、职务和接受培训的次数是护患沟通能力的影响因素,管理者应根据护士特征应加强对护士的培训,以提高其护患沟通能力。

Objective Combined with the clinical situation, this paper analyzes the relevant factors that affect the nurse-patient communication ability, and makes relevant countermeasures according to the influencing factors. Methods 941 nurses in a tertiary hospital in Guangzhou were surveyed using the Nurse Clinical Communication Competence Scale. Results The communication competence score of nurses in the hospital was (4.19±0.43) (the score was ranged from 1 to 5), among which nursing staffs' emotional support competence were scored in lowest (4.05±0.37). There was statistically significant in communication competence between nurses with different gender, marital status, job title, position and training times. (P<0.05). Conclusion The emotional support competence of nurses needs to be improved. The gender, marital status, professional title, position and number of trainings are the influencing factors of nurse-patient communication ability. Nursing managers could improve nurses' communication competence by increasing the training of nurses according to their charateristics.

目的 探讨腰椎间盘手术护理路径对经皮椎管成型下腰椎间盘摘除手术患者腰腿功能康复效果。方法 选择2018年1月—2019年11月住院进行经皮椎管成型下腰椎间盘摘除手术患者60例,按住院时间先后分为对照组和实验组各30例,对照组患者术后按椎间盘摘除手术给患者进行病情观察、腰腿功能康复锻炼、腰围配戴和康复护理知识宣教等护理;实验组患者在实施对照组护理措施基础上按腰椎间盘手术护理路径对患者进行有计划的康复护理知识宣教,按制定的康复护理路径对患者进行个性化康复活动训练指导。术后1周和出院时分别对患者掌握康复护理训练知识、腰椎功能障碍指数(ODI)、服务满意度进行评价。结果 实验组患者在术后首次进行康复训练时间早于对照组,差异有统计学意义(P=0.000 4);掌握康复护理知识得分实验组高于对照组,差异有统计学意义(P=0.002 3);掌握康复训练活动实验组高于对照组,差异有统计学意义(P<0.05);腰椎功能障碍指数(ODI)实验组低于对照组,差异有统计学意义(P<0.05);护理服务满意度实验组高于对照组,结果差异有统计学意义(P<0.05)。结论 椎间盘手术护理路径能促进患者早期进行康复训练,提高患者对腰椎间盘术后康复护理知识和康复训练技能的掌握,降低患者腰椎功能障碍指数,促进术后患者机体功能的康复。

Objective To explore the effect of nursing path of lumbar disc operation on the rehabilitation of lumbar and leg function in patients undergoing percutaneous laminoplasty. Methods From January 2018 to November 2019, 60 patients who were hospitalized for percutaneous laminoplasty were divided into the control group and the experimental group with 30 patients in each group according to the length of stay. The patients in the control group were given nursing care including condition observation, waist and leg function rehabilitation exercise, waist circumference wearing and rehabilitation nursing knowledge propaganda and education after the operation. On the basis of the nursing measures of the control group, patients in the experimental group received the planned rehabilitation nursing knowledge education according to the nursing path of lumbar disc operation, and individualized rehabilitation activity training guidance according to the established rehabilitation nursing path. One week after the operation and at the time of discharge, the patients' mastery of rehabilitation nursing training knowledge, lumbar dysfunction index (ODI) and service satisfaction were evaluated. Results The first time of rehabilitation training in the experimental group was earlier than that in the control group, the results were statistically significant (P=0.000 4); the score of mastering rehabilitation nursing knowledge in the experimental group was higher than that in the control group, the results were statistically significant (P=0.002 3); the experimental group of mastering rehabilitation training activities was higher than that in the control group, the results were statistically significant (P<0.05); lumbar dysfunction index ODI in the experimental group was lower than that in the control group, the results were statistically significant (P<0.05); the satisfaction of nursing service in the experimental group was higher than that in the control group, the results were statistically significant (P<0.05). Conclusion The nursing path of lumbar disc surgery can promote the early rehabilitation training of patients, improve the mastery of postoperative rehabilitation nursing knowledge and rehabilitation training skills of patients, reduce the lumbar dysfunction index of patients, and promote the rehabilitation of patients' body function.

目的 探究甲状腺癌患者对健康知识了解详情和需求,同时提出合理健康教育方案。方法 随机抽取本院2017年11月—2019年5月期间收治的122例甲状腺癌患者为研究对象,通过本院自制的调查问卷对其进行调查,分析和掌握患者对健康知识了解详情和具体需求,同时根据其特点提出合理的健康宣教方式。结果 患者对疾病和生活习惯的联系、定期入院复诊的重要性、临床治疗对疾病的控制详情、具体治疗方案和疗效、疾病临床特征以及疾病详细信息等甲状腺癌相关知识不了解率分别为50.00%、51.64%、72.95%、74.59%、77.87%、8.19%;健康教育内容需求评分较高,需求占比全部高于40%;患者对不同的健康教育形式有着不同的需求,其中需求最高的为护患会议交流,占比98.36%,其次为微信科普知识,占比96.72%,之后依次为播放视频和音频(94.26%)、创建专题讲座(93.44%)、个体指导(91.80%)、电话随访(83.60%)、相同疾病患者经验介绍(80.32%)、宣传栏和宣传册(63.90%)。结论 甲状腺癌患者对健康知识了解较少且需求较大,因此可对患者采取多元化健康知识教育方案,满足不同患者的需求,进而增加患者对疾病的重视程度,有利于患者树立治疗信心、提升其生活质量。

Objective To explore the health knowledge of thyroid cancer patients to understand the details and needs, and put forward a reasonable health education program. Methods 122 patients with thyroid cancer admitted to our hospital from November 2017 to May 2019 were randomly selected as the research objects. Through the questionnaire made by our hospital, we investigated the patients, analyzed and mastered the patients' understanding details and specific needs of health knowledge, and proposed reasonable health education methods according to their characteristics. Results The rates of patients' ignorance about thyroid cancer related knowledge, such as the relationship between disease and lifestyle, the importance of regular admission to hospital, the control details of the disease in clinical treatment, the specific treatment plan and effect, the clinical characteristics of the disease and the detailed information of the disease, were 50.00%, 51.64%, 72.95%, 74.59%, 77.87% and 8.19%, respectively. The score of demand for health education content was high, accounting for more than 40% of the total demand.Patients with different forms of health education had different needs, one of the highest requirements for meeting communication, nurses and patients accounted for 98.36%, followed by WeChat popular science knowledge, accounted for 96.72%, followed by after playing video and audio (94.26%), creating a seminar (93.44%), individual guidance (91.80%), telephone follow-up (83.60%), experience introduction (80.32%),patients with the same disease, publicity column and brochure (63.90%). Conclusion Patients with thyroid cancer have less knowledge of health knowledge and need more health knowledge. Therefore, we may take diversified health knowledge education programs to meet the needs of different patients, and then increase the attention of patients to the disease, which is conducive to the patients to establish treatment confidence and improve their quality of life.

目的 回顾分析我医院近9年产妇行剖宫产术治疗的患者的住院病历资料,探索术后出现切口脂肪液化的危险因素。方法 选取我医院2011年1月—2019年8月期间行剖宫产术治疗的产妇患者1 018例,分成术后切口脂肪液化组和甲级愈合组,比较2组间的差异,分析其相关危险因素。结果 1 018例产妇患者中出现切口脂肪液化的为34例,发生率为3.34%(34/1 018);单因素分析结果显示,糖尿病、体质指数超重、7 cm以上切口长度是术后出现切口脂肪液化的相关因素,差异有统计学意义;多因素Logistic回归分析结果显示,糖尿病、体质指数超重、7 cm以上切口长度是术后出现切口脂肪液化的独立危险因素。结论 产妇患者行剖宫产术治疗出现切口脂肪液化率较高;围手术期控制患者血糖,以及孕期控制体质指数、缩小剖宫产手术切口长度可能有效地减少切口脂肪液化发生率。

Objective To retrospectively analyze the medical records of patients undergoing cesarean section in our hospital in recent 9 years, and explore the risk factors of incision fat liquefaction after operation. Methods 1 018 patients undergoing cesarean section in our hospital from January 2011 to August 2019 were divided into two groups: incision fat liquefaction group and grade A healing group. The differences between the two groups were compared and the risk factors were analyzed. Results Among 1 018 parturients, 34 had incision fat liquefaction, and the incidence was 3.34% (34/1018). Univariate analysis showed that diabetes mellitus, overweight body mass index and incision length of more than 7 cm were risk factors for incision fat liquefaction after operation, and the difference was statistically significant. Multivariate logistic regression analysis showed that diabetes mellitus, overweight body mass index and incision length over 7 cm were independent risk factors for incision fat liquefaction. Conclusion The incision fat liquefaction rate is higher in patients undergoing cesarean section. Controlling blood sugar level, body mass index during pregnancy and shortening the length of incision during perioperative period may effectively reduce the incidence of incision fat liquefaction.

目的 探讨近期大咯血对支气管镜诊疗操作相关出血的影响。方法 回顾性分析2015年12月—2019年12月我院支气管镜操作导致出血超过30 mL患者的临床资料,根据近1周是否发生大咯血,分为观察组(大咯血组)和对照组(无大咯血组),比较2组间的出血量以及大出血、血凝块、窒息的发生率。结果 观察组的出血量以及大出血的发生率高于对照组,2组间差异有统计学意义,血凝块、窒息的发生率两组间差异无统计学意义。结论 近期大咯血的患者支气管镜操作发生大出血的风险高。

Objective To explore the effect of short-term massive hemoptysis on the procedure-related bleeding of bronchoscopy. Methods The clinical data of patients with more than 30 mL bleeding caused by bronchoscopy operation in Guangzhou Chest Hospital from December 2015 to December 2019 were analyzed retrospectively. According to whether massive hemoptysis occurred in the past week, the patients were divided into observation group (massive hemoptysis group) and control group (no massive hemoptysis group). The bleeding volume, the incidence of massive hemorrhage, blood clot and asphyxia were compared between the two groups. Results The amount of bleeding and the incidence of massive hemorrhage in the observation group were higher than those in the control group, that there was a statistical significance between the two groups. There was no statistical significance between the two groups in the incidence of blood clots and asphyxia. Conclusion Patients with recent massive hemoptysis have a higher risk of massive haemorrhage due to bronchoscopy.