论著

基于护理目标执行理念的护理方式在支气管哮喘患儿治疗中的应用效果研究

The value of nursing goals execution concept intervention in the treatment of children with asthma

:1078-1083
 
目的 探讨护理目标执行理念护理在哮喘患儿治疗中的价值。方法 前瞻性选取泉州市妇幼保健院于2021年8月—2023年8月收治的100例支气管哮喘患儿,应用随机数字表法将其分为两组,每组均为50例。对照组采取常规护理,观察组在常规护理基础上给予护理目标执行理念护理。3个月后,对比两组家属对患儿的疾病管理能力、哮喘控制状况、生活质量。结果 护理后两组患儿家属相关家庭管理测量量表(FaMM)评分均升高,且观察组高于对照组(P<0.05);观察组患儿哮喘控制率高于对照组(P<0.05);护理后两组患儿情感、活动、症状相关标准儿童哮喘生活质量评分表(PAQLQ)评分均升高,且观察组高于对照组(P<0.05)。结论 护理目标执行理念护理可改善哮喘患儿家属对患儿疾病的管理能力,改善哮喘控制效果,提升患儿生活质量。
Objective To explore the value of nursing goal execution concept intervention in the treatment of children with asthma.Methods From August 2021 to August 2023,100 children with bronchial asthma admitted to Quanzhou Maternal and Child Health Hospital were Prospective selected.They were randomly divided into observation group and control group,with 50 cases in each group.The control group of children received routine care,while the observation group of children received intervention based on the nursing goals execution concept in addition to routine care.After 3 months of intervention,The disease management ability,compliance,asthma control and quality of life of the two groups were compared.Results Family-related FaMM scores were increased in all two groups after the intervention,and the observation group was higher than the control group(P<0.05).The asthma control rate of the children in the observation group was higher than that in the control group(P<0.05);after nursing,the PAQLQ score increased,and the observation group was higher than the control group(P<0.05).Conclusions Intervention based on the nursing goals execution concept can improve the management ability of family members of asthma patients towards their diseases,and enhance their quality of life,which is worthy of clinical application and promotion.
论著

接触苯及苯系化合物作业人员血常规检查结果分析

Observation of blood routine examination results of workers exposed to benzene and its derivatives

:1072-1077
 
目的 接触苯及苯系化合物作业人员血常规检查结果的分析。方法 收集2022年1月—2022年12月726名接触苯系物作业人员健康监护资料,均行血常规检测,并对其进行分析。结果 男性苯及苯系物接触作业人员的红细胞计数(RBC)(t=16.253)、血红蛋白(Hb)(t=25.345)、淋巴细胞绝对值(t=4.420)高于女性,血小板计数(PLT)(t=-5.523)低于女性,差异有统计学意义(P<0.001);30~39岁和≥50岁作业人员、40~49岁和≥50岁作业人员的Hb比较差异有统计学意义(F=6.581,P=0.001),<30岁和≥50岁作业人员、30~39岁和≥50岁作业人员、40~49岁和≥50岁作业人员的PLT比较差异有统计学意义(F=7.082,P=0.001)。结论 苯及苯系化合物的接触对劳动者血常规的结果有一定的影响,其中女性、高龄更为明显,应加强相应的职业健康防护措施,应改善作业环境,完善防护设备,防止职业疾病的发生。
Objective Analysis of blood routine test results for workers exposed to benzene and its derivatives.Methods Collect health monitoring data from 726 workers exposed to benzene derivatives from January 2022 to December 2022,all of whom underwent blood routine tests and were analyzed.Results The absolute values of RBC(t=16.253),Hb(t=25.345),and lymphocytes(t=4.420)in male workers exposed to benzene and its derivatives were higher than those in females,while PLT(t=-5.523)was lower than that in females,with statistical significance(P<0.001);There was a significant difference in Hb between workers aged 30-39 and≥50,and between workers aged 40-49 and≥50(F=6.581,P=0.006,P<0.001).There was a significant difference in PLT between workers aged 30-39 and≥50,between workers aged 30-39 and≥50,and between workers aged 40-49 and≥50(F=7.082,P=0.005,P=0.001,P<0.001).Conclusions The exposure to benzene and its derivatives has a certain impact on the blood routine results of workers,with females and elderly being more prominent.Corresponding occupational health protection measures should be strengthened,the working environment should be improved,protective equipment should be perfected,and occupational diseases should be prevented.
论著

血流感染患者血小板参数动态变化及其预后价值

:1066-1071
 
目的 分析血流感染(BSI)患者血小板参数的动态变化及其在患者预后中的价值。方法 回顾性分析南通市中西医结合医院检验科明确BSI的66例患者,分为生存组(55例)和死亡组(11例)。比较不同组间病原菌分布及1周内血小板参数动态变化情况,并通过Logistic回归分析评估血小板参数动态变化的在治疗预后评估中的价值。结果 (1)BSI患者病原菌分为革兰氏阳性菌(G+)25株、革兰氏阴性菌(G-)39株、真菌2株;G+病原菌中前三位为金黄色葡萄球菌(10.61%)、表皮葡萄球菌(7.58%)、头状葡萄球菌(4.55%);G-病原菌中前三位为大肠埃希菌(24.24%)、肺炎克雷伯菌肺炎亚种(15.15%)、肠炎沙门菌血清型(3.03%);真菌为新生隐球酵母(1.52%)、光滑假丝酵母(1.52%)。(2)生存组序贯性器官功能衰竭评分(SOFA)评分为(3.24±0.53)分,低于死亡组的(6.02±1.17)分(t=12.535,P<0.001);生存组BSI病程为(20.50±2.17)d,低于死亡组的(25.71±4.81)d(t=3.352,P<0.001);生存组肺部原发感染灶30.91%,高于死亡组的63.64%(χ2=4.243,P=0.039);生存组最大平均血小板体积(MPV)为(10.96±1.58)fL,低于死亡组的(11.99±1.42)fL(t=2.004,P=0.049);生存组入院血小板计数(PLT)为(144.33±23.18)109/L,低于死亡组的(166.91±20.29)109/L(t=3.005,P=0.004);生存组最低PLT为(113.48±30.76)109/L,高于死亡组的(80.16±38.24)109/L(t=3.148,P=0.002)。(3)两组入院及BSI时、BSI后4 d内的指标比较差异均无统计学意义(P>0.05),在BSI后的5~7 d,生存组PLT为(210.83±102.37)109/L,高于死亡组的(112.75±116.84)109/L(t=2.835,P=0.006);生存组MPV为(10.12±1.58)fL,低于死亡组的(11.27±1.85)fL(t=2.142,P=0.036);生存组MPV/PLT 比值(MPR)为(5.69±2.89),低于死亡组的(11.64±8.23)(t=4.290,P<0.001)。(4)多因素Logistic回归分析发现,入院SOFA(OR=5.461,95%CI:1.544~19.319,P=0.008)、BSI病程(OR=0.773,95%CI:0.622~0.960,P=0.020)、5~7 d MPR(OR=18.976,95%CI:1.776~202.709,P=0.015)是BSI的预测因素。结论 BSI患者血小板参数动态变化较为明显,而入院SOFA、BSI病程、5~7 d MPR对于预测患者死亡风险有重要意义。
论著

福辛普利钠联合多沙唑嗪治疗对肾性高血压患者血压控制及相关生物活性因子的影响

Effects of fosinopril sodium combined with doxazosin on blood pressure control and related bioactive factors in patients with renal hypertension

:1060-1065
 
目的 探讨福辛普利钠与多沙唑嗪联合对肾性高血压的治疗效果,并分析治疗后患者血压控制情况及相关活性因子变化。方法 前瞻性选取天津市北辰区北辰医院2020年10月—2023年10月收治的98例肾性高血压患者,以随机数字表法作为分组方式,分为观察组(n=49)与对照组(n=49)。对照组患者采取福辛普利钠治疗,观察组在对照组基础上增加多沙唑嗪治疗。对比两组的血压控制效果,治疗前后一氧化氮(NO)、内皮素(ET)、血管紧张素Ⅱ(AngⅡ)相关生物活性因子水平变化,肾功能变化,不良反应发生情况。结果 观察组总有效率89.79%,高于对照组的73.47%(χ2=4.356,P=0.037);治疗后两组AngⅡ、ET水平均降低,且观察组[(13.62±2.24)ng/mL、(68.62±6.66)ng/L]低于对照组[(16.25±4.32)ng/mL、(74.26±9.35)ng/L],对比差异有统计学意义(t1=3.783,t2=3.439,P<0.001);NO水平升高,观察组[(54.26±3.42)μmol/L]高于对照组[(50.51±2.37)μmol/L],对比差异有统计学意义(t=6.309,P<0.001);治疗后两组血肌酐(Scr)、尿素氮(BUN)、胱抑素C(CysC)水平均降低,且观察组[(404.36±92.12)μmoI/ L、(13.34±4.31)mmol / L、(2.19±0.24)mg / L]低于对照组[(443.49±80.19)μmoI / L、(15.07±4.23)mmol / L、(2.87±0.38)mg / L],对比有统计学意义(t1=2.243,P1=0.027;t2=2.005,P2=0.048;t3=10.591,P3<0.001);两组不良反应发生率对比差异无统计学意义(10.20% vs 8.16%,P>0.05)。结论 对肾性高血压患者,采取福辛普利钠与多沙唑嗪联合治疗可提升其血压控制效果,改善血管内皮功能,降低血管紧张素Ⅱ表达水平,改善肾功能,且不增加不良反应。
Objective To explore the therapeutic effect of the combination of fosinopril sodium and doxazosin on renal hypertension,and to analyze the blood pressure control and changes in related active factors in patients after treatment.Methods A prospective study was conducted on 98 patients with renal hypertension admitted to Beichen Hospital from October 2020 to October 2023.Random number table method was used as the grouping method,and they were divided into an observation group(n=49)and a control group(n=49).The control group patients were treated with fosinopril sodium,while the observation group was treated with doxazosin additionally.The blood pressure control effect,changes in levels of NO,ET,Ang II related bioactive factors,renal function changes before and after treatment,and their adverse reactions were compared.Results The total response rate in the observation group was 89.79%,which was higher than 73.47% in the control group(χ2=4.356,P=0.037).Ang Ⅱ and ET levels in both groups decreased after treatment,the observation group[(13.62±2.24)ng/mL,(68.62±6.66)ng/L] was lower than the control group[(16.25±4.32)ng/mL,(74.26±9.35)ng/L],the difference was statistically significant(t1=3.783,t2=3.439,P<0.001).Elevated NO levels in the observation group[(54.26±3.42)μmol/L] was higher than the control group[(50.51±2.37)μmol/L],the difference was statistically significant(t=6.309,P<0.001).Blood Scr,BUN,and CysC levels were decreased in both treatment groups,and those in observation group[(404.36±92.12)μmoI/L,(13.34±4.31)mmol/L,(2.19±0.24)mg/L] were lower than the control group[(443.49±80.19)μmoI/L,(15.07±4.23)mmol/L,(2.87±0.38)mg/L],the differences were statistically significant(t1=2.243,P1=0.027;t2=2.005,P2=0.048;t3=10.591,P3<0.001;P<0.05).There was no difference in the incidence of adverse effects between the two groups(10.20% vs 8.16%,P>0.05).Conclusions The combination treatment of fosinopril sodium and doxazosin can improve the blood pressure control effect,improve endothelial function,reduce the expression level of angiotensin II,and improve renal function in patients with renal hypertension,with high safety.
论著

早产儿语言-社会行为发育差异的回顾性研究

A retrospective study of language-social behavior developmental differences in preterm infants

:1054-1059
 
目的 探讨早产儿语言-社会行为情况及其影响因素,研究语言-社会行为发育与智能发育之间的关系,为早产儿保健提供指导。方法 采用自制的一般情况问卷对125例早产儿开展随访、追踪,直至2岁时,采用盖泽尔发展量表(GDS)进行语言-社会行为及智能发育评估。结果 早产儿语言发育正常43例(34.4%),社会行为发育正常40例(32%)。早产儿语言发育商平均为(67.99±25.75),社会行为发育商平均为(67.75±23.98),处于发育低下水平。性别、脑出血病史、定期随访史、康复干预史、家庭干预史在语言、社会行为方面比较差异均无统计学意义(P>0.05)。不同胎儿期安胎史、胎龄、出生体质量在语言、社会行为方面比较差异有统计学意义(P<0.05);且胎儿期反复安胎,胎龄小,出生体质量低,语言及社会行为发育较差。与出生时无中-重度窒息史的患儿相比,出生时有中-重度窒息的患儿存在更多的语言发育异常,比较差异有统计学意义(P<0.05);但在社会行为发育方面比较差异无统计学意义(P>0.05)。语言-社交行为发育落后的同时,早产儿的大运动、精细动作、适应性行为也存在落后,五大能区比较差异并均有统计学意义(P<0.05)。结论 多数早产儿存在语言-社会行为发育落后,其同时可能伴有更多的运动和适应行为发育问题;语言-社交行为发育落后的患儿在胎儿期存在反复安胎且胎龄较小、出生体质量更低或有中-重度窒息史。对早产儿的语言-社会行为要及时给予关注,早期发现并早期干预,改善预后。
Objective To explore the language-social behavior of preterm infants and its influencing factors,to study the relationship between language-social behavior development and intellectual development,and to provide guidance for preterm infants' health care.Methods A self-administered general questionnaire was used to follow up 125 preterm infants until the age of 2 years,and Gesell development scale(GDS)was used to assess their language-social behavior and intellectual development.Results Preterm infants had normal language development in 43 cases(34.4%)and normal social behavioral development in 40 cases(32%).The mean language development quotient of preterm infants was(67.99±25.75)and the mean social behavioral development quotient was(67.75±23.98),which was at the low developmental level.There were no significant differences in gender,history of cerebral hemorrhage,regular follow-up,rehabilitation intervention,family intervention and language or social behavior(P>0.05).Infants with different fetal age history,gestational age,and birth weight varied significantly in language and social behavior(P<0.05);and with repeated miscarriage,small gestational age,low birth weight,showed poor language and social behavior development.Compared the children with and without moderate to severe asphyxia at birth,there was statistically significant differences in language development(P<0.05),but in social behavior there was no significant difference(P>0.05).The backward development of language-social behavior was accompanied by backwardness in gross motor,fine motor,and adaptive behavior in preterm infants,and the differences in the five major domains were all present and statistically significant(P<0.05).Conclusions A major of preterm infants have poor language-social behavior development,which may be accompanied by more motor and adaptive behavior development problems;children with poor language-social behavior development have repeated miscarriage prevention at younger gestational ages,lower birth weights,or a history of moderate-to-severe asphyxia during the fetal period.It is important to give timely attention to language-social behavior in preterm infants for early detection and early intervention to improve prognosis.
论著

LC + ERCP / EST治疗胆囊结石合并肝外胆管结石患者疗效研究

Clinical efficacy of LC combined with ERCP/EST in treating gallbladder stones complicated by extrahepatic bile duct stones

:1049-1053
 
目的 探讨胆囊结石并发肝外胆管结石经腹腔镜胆囊切除术(LC)联合内窥镜逆行胰胆管造影术(ERCP)/内窥镜下括约肌切开术(EST)治疗的临床效果。方法 选取2020年1月—2023年6间就诊于南平市第一医院的86例胆囊结石合并肝外胆管结石患者,根据治疗方案不同分为对照组(n=40)和观察组(n=46)。对照组给予LC联合经腹腔镜胆总管切开取石术(LCBDE)治疗,观察组给予LC联合ERCP、EST在治疗,观察两组手术相关指标情况、血管紧张素水平、肝功能以及并发症发生情况。结果 观察组患者术中出血量少于对照组的(t=12.440,P<0.001),观察组手术用时、肛门排气时间以及住院时间均短于对照组(均P<0.001);观察组血管紧张素1-7(Ang1-7)、血管紧张素Ⅰ(AngⅠ)、血管紧张素Ⅱ(AngⅡ)水平低于对照组,组间比较差异均无统计学意义(均P>0.05);观察组总胆红素(TBIL)、谷氨酸转氨酶(ALT)水平低于对照组水平,组间比较差异无统计学意义(均P>0.05);观察组无患者发生胆漏、结石残留,对照组胆漏、结石残留发生率分别为5.00%、2.50 %,组间对比差异均无统计学意义(均P>0.05),观察组出血、胆道感染生率分别为4.35 %、2.17 %低于对照组10.00%、5.00 %,组间对比差异均无统计学意义(均P>0.05。结论 LC联合ERCP/EST治疗胆囊结石合并肝外胆管结石可以减少术中出血,缩短手术用时和住院时间。
Objective This study aims to investigate the clinical efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic retrograde cholangiopancreatography(ERCP)or endoscopic sphincterotomy(EST)in the treatment of gallbladder stones complicated by extrahepatic bile duct stones.Methods A total of 86 patients with gallbladder stones and extrahepatic bile duct stones treated at the First Hospital of Nanping from January 2020 to June 2023 were selected.According to different treatment regimens,they were divided into a control group(n=40)and an observation group(n=46).The control group received LC combined with laparoscopic common bile duct exploration(LCBDE),while the observation group received LC combined with ERCP and EST.Surgical-related indicators,angiotensin levels,liver function,and complications were observed in both groups.Results The observation group had less intraoperative bleeding than the control group(t=12.440,P<0.001).The observation group had a shorter operation time,postoperative anal exhaust time,and hospital stay than the control group(all P<0.001).The levels of angiotensin 1-7(Ang1-7),angiotensin I(AngⅠ),and angiotensin II(AngⅡ)in the observation group were lower than those in the control group,with no statistically significant differences between the groups(all P>0.05).Total bilirubin(TBIL)and alanine aminotransferase(ALT)levels in the observation group were comparable to those in the control group(all P>0.05).No patients in the observation group experienced bile leakage or residual stones,while the incidence rates in the control group were 5.00% and 2.50%,respectively,with no statistically significant differences between the groups(all P>0.05).The observation group had lower rates of bleeding and biliary tract infection at 4.35% and 2.17%,respectively,compared to the control group at 10.00% and 5.00%,with no statistically significant differences between the groups(all P>0.05).Conclusions LC combined with ERCP/EST in the treatment of gallbladder stones complicated by extrahepatic bile duct stones can reduce intraoperative bleeding,shorten operation time,and decrease hospital stay.
论著

右美托咪定联合丙泊酚或依托咪酯对颅内动脉瘤介入术患者围插管期血流动力学的影响

Effect of dexmedetomidine combined with propofol or etomidate on periintubation hemodynamics in cerebral aneurysm patients

:1043-1048
 
目的 探讨右美托咪定(Dex)分别联合丙泊酚或依托咪酯在颅内动脉瘤介入术中的镇静效果及对患者血流动力学的影响。方法 将60例颅内动脉瘤介入术患者按照随机数表法分为A组(Dex+丙泊酚,n=30)、B组(Dex+依托咪酯,n=30)。记录两组不同时间点的平均动脉压(MAP)、心率(HR),比较苏醒期的镇静效果、呛咳程度、拔管时间、苏醒时间、清醒时间及术后不良反应。结果 A组患者T1MAP、HR为(84.56±5.13)mmHg、(65.87±5.14)次/分和T2(83.29±5.47)mmHg、(65.87±5.14)次/分均低于B组T1(87.89±3.88)mmHg、(70.22±5.67)次/分和T2(86.71±3.75)mmHg、(69.97±5.87)次/分(t分别为2.836、2.825、3.113、3.391,均P<0.001)。两组苏醒期各项指标和躁动(10.00% vs 0%,P=0.757)、呼吸抑制发生率(3.33% vs 0%,P=0.313)比较差异均无统计学意义(均P>0.05),A组恶心、呕吐发生率(3.33%)较B组(20.00%)更低(χ2=4.043,P=0.044)。结论 Dex联合丙泊酚、依托咪酯麻醉在颅内动脉瘤介入术中均可发挥良好安全的麻醉作用,降低患者术后躁动和呼吸抑制的发生率,使用Dex联合依托咪酯在患者围插管期的血流动力学的稳定性效果更好,但在降低患者术后恶心呕吐的风险方面效果较差。
Objective To evaluate the sedative effect of dexmedetomidine(Dex)combined with propofol or etomidate during cerebral aneurysm intervention and its effect on patient hemodynamics.Methods A total of 60 cerebral aneurysm patients were randomly divided into two groups:Group A(Dex + propofol,n=30)and Group B(Dex + etomidate,n=30).Mean arterial pressure(MAP)and heart rate(HR)were recorded at different time points in the two groups,and the sedation effect,choking degree,extubation time,waking up time,waking time and postoperative side effects were compared.Results T1 MAP,HR of(84.56±5.13)mmHg,(65.87±5.14)times / min and T2(83.29±5.47)mmHg,(65.87±5.14)times / min in group A were lower than those in group B T1(87.89±3.88)mmHg,(70.22±5.67)times / min and T2(86.71±3.75)mmHg,(69.97±5.87)times / min(t=2.836,2.825,3.113,3.391,all P<0.001).There was no significant difference in the incidence of emergence agitation(10.00 % vs 0.00 %,P=0.757)and respiratory depression(3.33 % vs 0.00 %,P=0.313)between the two groups(P>0.05).The incidence of nausea and vomiting in group A(3.33 %)was lower than that in group B(20.00 %)(χ2=4.043,P=0.044).Conclusions Dex combined with propofol and etomidate anesthesia can have a good and safe anesthesia effect in intracranial aneurysm intervention,and reduce the incidence of postoperative agitation and respiratory depression in patients.Hemodynamic stabilization during the tube phase is more effective,but less effective in reducing the risk of postoperative nausea and vomiting in patients.
论著

早产儿经胃管喂养后采用空气冲管的应用评价

Evaluation of flushing gastric tube by air after feeding in premature infants

:1038-1042
 
目的 评价早产儿经胃管喂养后采用空气冲管的应用效果。方法 选择2021年1月–2021年12月广州市第一人民医院收治的经胃管喂养后采用温水冲管的60例早产儿为对照组,选择2022年1月–2022年12月收治的经胃管喂养后采用空气冲管的57例早产儿为研究组。喂养1周后,比较两组患儿体质量增加量、血清白蛋白浓度增加量、大便量、喂养不耐受发生率、胃管堵塞率等指标的差异。结果 无患儿发生胃管堵塞。研究组的血清白蛋白浓度增加量[(2.86±5.61)g/L]高于对照组[(0.84±5.27)g/L](P<0.05),而两组患儿在体质量增加量、大便量、喂养不耐受发生率等方面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空气冲管为血清白蛋白浓度增加量的影响因素(P<0.05)。结论 采用空气进行胃管冲管的方法可改善早产儿的营养状态。
Objective To evaluate the effects of flushing gastric tube by air after feeding in premature infants.Methods A total of 60 premature infants admitted to Guangzhou First People's Hospital from January 2021 to December 2021 whose gastric tube were flushed with water after feeding were selected as the control group,while 57 admitted from January 2022 to December 2022 whose gastric tube were flushed with air after feeding were selected as the study group.After 1 week of feeding,the differences of weight increase,serum albumin concentration increase,stool volume,feeding intolerance incidence and gastric tube blockage rate were compared between the 2 groups.Results No gastric tube blockage occurred.The increase of serum albumin concentration in the study group[(2.86±5.61)g/L] was significantly higher than that in the control group[(0.84±5.27)g/L](P<0.05),but there were no significant differences in weight increase,stool volume and feeding intolerance incidence between the 2 groups.Multiple linear regression analysis showed that the flushing gastric tube with air was an independent influencing factor for the increase of serum albumin(P<0.05).Conclusions Flushing gastric tube with air can improve the nutritional status of premature infants,which is worthy of clinical application.
论著

时机理论的护理干预在三叉神经痛微血管减压术中的应用效果评估

Evaluation of the application effect of timing theory nursing intervention in microvascular decompression surgery for trigeminal neuralgia

:1033-1037
 
目的 探讨时机理论的护理干预在三叉神经痛微血管减压术中的应用效果。方法 选取2020年7月—2023年6月厦门大学附属第一医院神经外科三叉神经痛患者85例,均实施微血管减压术治疗,通过奇偶数抽签的方式分组,即对照组(n=43,予以常规护理)与观察组(n=42,实施常规护理基础上给予基于时机理论的护理干预),通过专业调查表对两组患者疼痛、负面情绪及生活质量进行全面评估。结果 观察组出院时数字分级评分表(NRS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)评分分别为(2.13±0.57)(42.45±3.17)(42.45±3.17)分,低于对照组的(3.23±0.78)(52.34±4.45)(48.23±3.23)分(P<0.05);观察组术后1个月简明健康状况调查表(SF-36)生理功能、生理职能、躯体功能、活力、社会功能、情感职能、心理健康及总体健康状态等维度评分分别为(38.12±8.27)(42.22±9.12)(52.34±8.23)(64.11±8.92)(70.12±9.03)(34.46±6.18)(71.34±8.17)(75.24±8.46)分,高于对照组的(35.23±8.13)(38.56±9.23)(45.03±8.11)(60.57±8.23)(65.23±8.78)(30.14±6.13)(66.23±8.08)(72.12±8.35)分(P<0.05)。结论 三叉神经痛患者实施微血管减压术治疗的同时,采取基于时机理论的护理干预不仅可减轻其疼痛程度,改善其负面情绪,还可全面提高其生活品质。
Objective To explore the application effect of timing theory nursing intervention in microvascular decompression surgery for trigeminal neuralgia.Methods The research period was from July 2020 to June 2023.The study subjects were 85 patients with trigeminal neuralgia selected from the Neurosurgery Department of the First Affiliated Hospital of Xiamen University,all of whom underwent microvascular decompression surgery.They were divided into a control group(n=43,receiving routine care)and an observation group(n=42,receiving timing based nursing intervention on the basis of routine care)through odd and even number drawing.A preliminary assessment of pain,negative emotions,and quality of life for two groups of patients were conducted through a professional questionnaire.Results The scores of NRS,SDS and SAS in the observation group at discharge were(2.13±0.57),(42.45±3.17)and(42.45±3.17)respectively,which were significantly lower than those in the control group(3.23±0.78), (52.34±4.45)and(48.23±3.23).The scores of physiological function,physiological function,physical function,vitality,social function,emotional function,mental health and general health status in the observation group one month after operation were(38.12±8.27),(42.22±9.12),(52.34±8.23), (64.11±8.92), (70.12±9.03), (34.46±6.18), (71.34±8.17) and(75.24±8.46), which were significantly higher than those of the control group(35.23±8.13), (38.56±9.23), (45.03±8.11), (60.57±8.23), (65.23±8.78), (30.14±6.13), (66.23±8.08)and(72.12±8.35)(P<0.05).Conclusions While implementing microvascular decompression surgery for patients with trigeminal neuralgia,nursing interventions based on timing theory can not only alleviate their pain,improve their negative emotions,but also comprehensively improve their quality of life.
论著

儿童嗜酸细胞性胃肠炎的临床诊治分析

Clinical diagnosis and treatment of eosinophilic gastroenteritis in children

:1027-1032
 
目的 总结儿童嗜酸细胞性胃肠炎(EG)的临床表现、内镜检查和病理学特点、治疗和预后。方法 回顾性分析2019年1月—2022年12月滨州医学院附属医院儿科确诊的48例EG患儿临床资料,包括临床症状、实验室检查、影像学检查、内镜和病理学检查、治疗和随访情况。结果 48例患儿中,男26例(54.17%),女22例(45.83%),中位年龄7.8岁,20例(41.67%)患儿有过敏史或家族史,临床症状主要有腹痛(34例,70.83%)、腹泻(18例,37.5%)和腹胀(12例,25%)。外周血嗜酸性粒细胞(EOS)升高36例(75%),血清总IgE升高14例(29.17%)。48例行胃镜检查,最常见的表现是黏膜充血水肿(32例,66.67%)、点状红斑(28例,58.33%)和糜烂(22例,45.83%),28例行结肠镜检查,表现为黏膜充血水肿(18例,64.29%)、点状红斑(15例,53.57%)和结节样隆起(12例,42.86%)。黏膜组织病理表现为大量EOS浸润,主要累及十二指肠降部、胃窦和回肠末端。所有患儿均采用饮食干预的治疗,6例(12.5%)单纯饮食干预治疗后好转,16例(33.33%)孟鲁司特钠、酮替芬、奥美拉唑治疗后好转,26例(54.17%)联合泼尼松治疗后好转,随访10个月~3年,8例(16.67%)停药后复发,再次治疗后好转。结论 儿童EG临床症状和内镜表现多样化、缺乏特异性,内镜下黏膜组织病理检查有助于确诊。大多数患儿外周血EOS升高,饮食干预和糖皮质激素治疗效果显著,但存在复发的可能,需长期维持治疗和随访。
Objective To summarize the clinical manifestations,endoscopic and pathological features,treatment and prognosis of eosinophilic gastroenteritis(EG)in children.Methods A retrospective analysis was carried out on clinical data of 48 patients with EG diagnosed at the Department of Pediatrics of Binzhou Medical University Hospital from January 2019 to December 2022,including clinical symptoms,laboratory examination,imaging examination,endoscopic and pathological examination,treatment and follow-up.Results A total of 48 patients were included in the analysis,including 26 males(54.17%)and 22 females(45.83%),with the median age of 7.8 years(7 months to 13 years).Twenty patients(41.67%)had a history or family history of allergy.The most clinical symptoms were abdominal pain(34 cases,70.83%),diarrhea(18 cases,37.5%)and abdominal distension(12 cases,25%).Peripheral blood eosinophils(EOS)increased in 36 cases(75%),and the serum total IgE increased in 14 cases(29.17%).48 cases underwent gastroscopy,the most common manifestations were mucosal hyperemia and edema(32 cases,66.67%),punctate erythema(28 cases,58.33%)and erosion(22 cases,45.83%).Twenty-eight cases underwent colonoscopy,the manifestations were mucosal hyperemia and edema(18 cases,64.29%),spotted erythema(15 cases,53.57%)and nodular eminence(12 cases,42.86%).Mucosal histopathology showed a large number of EOS infiltration,mainly involving the descending duodenum,gastric antrum and terminal ileum.All children were treated with dietary intervention,6 cases(12.5%)were improved after simple diet intervention,16 cases(33.33%)were improved after treatment with montelukast,ketotifen,omeprazole,26 cases(54.17%)were improved after combined treatment with prednisone acetate.Followed up for 10 months to 3 years,8 cases(16.67%)relapsed after drug withdrawal and improved after retreatment.Conclusions The clinical symptoms and endoscopic manifestations of EG in children are diverse and lack of specificity,endoscopic mucosal histopathological examination is helpful for diagnosis.The EOS in peripheral blood of most children increased,diet intervention and glucocorticoid therapy are effective,but there is a possibility of recurrence,which need long-term maintenance treatment and follow-up.
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