目的:探討膠囊內鏡在老年患者消化道疾病診斷中的應用。方法:對129例行OMOM膠囊內鏡檢查的患者資料行回顧性分析。結果:129例患者中完成膠囊內鏡檢查118例,發現異常103例,陽性檢出率873%。發現食管、胃、小腸、結腸病變分別為3例、38例、92例、7例,占陽性發現率分別為29%、369%、893%、68%。完成膠囊內鏡檢查的91例消化道出血患者和25例腹痛、腹瀉患者分別發現小腸病變75例(824%)和17例(68%)。其中黏膜下隆起及新生物、炎癥病變和血管病變最為常見。檢查過程中患者無任何不適。結論:OMOM膠囊內鏡檢查方法安全性好,對老年患者消化道疾病有較高的診斷價值。建議檢查前對患者身體進行適當的評估,采取相應措施提高檢查質量。
In the management of diabetic nephropathy patients with hemodialysis, diabetes link nurse (DLN) can realize the continuity of nursing management, simplify the communication between multiple disciplines, and play multiple roles such as relieving patients’ psychology, participating in scientific research and clinical management. In this paper, by introducing the origin and development status of DLN in foreign countries, and summarizing the function and clinical contribution of DLN in the management of diabetic nephropathy hemodialysis patients. This article combines the current development status of DLN in China, to arouse the attention of clinical nursing colleagues, and provide some reference for the management of diabetic nephropathy patients with hemodialysis and the training of DLN in China.
【摘要】 目的 了解腫瘤復發患者希望水平及其影響因素。 方法 2010年10-12月采用Herth希望量表和自制的一般情況調查表,對302例腫瘤復發患者進行問卷調查,并對相關影響因素進行分析。 結果 腫瘤復發患者希望總體均分為（31.14±5.56）分,7.95%（24例）的患者希望評分為低等水平,74.50%（225例）的患者希望評分為中等水平,17.55%（53例）的患者希望評分為高等水平。腫瘤復發患者希望水平得分的主要影響因素有:婚姻狀況、工作狀況、醫療費用支付情況、腫瘤類型以及無瘤生存時間。其中,與未婚患者相比,離異患者希望水平較低；與在職患者相比,退休患者希望水平較高；在醫療費用的支付方式上,自費所占的比例越大,患者希望水平越低；與其他腫瘤類型相比,以乳腺癌患者希望水平最低；此外,患者無瘤生存時間越長,其希望水平就越低。 結論 盡管腫瘤復發患者希望水平受多種因素的影響,但多數患者仍對現狀和未來充滿希望,其希望仍維持在較高水平。【Abstract】 Objective To explore the level of hope and the influential factors of hope in patient with tumor recurrence. Methods A total of 302 patients with tumor recurrence were enrolled. The patients were investigated by Herth Hope Scale and self-designed questionnaire. Results The average level of hope in patients with tumor recurrence was 31.14±5.56; of the total patients，7.95% (24 patients) had low level, 74.50% (225 patients) had media level and 17.55% (53 patients) had high level of hope. Parts of demographic characteristics had significant influences on level of hope and specifically: patient devoiced had lower level of hope than patients married (F=-1.868，Plt;0.05); patients retired had higher level of hope than patients on job (F=2.004，Plt;0.005); patients with greater own proportion of medical expense had lower level of hope than patients with smaller own proportion of medical expense (F=-0.937，Plt;0.05); patients with breast cancer had lower level of hope than patients with other type of cancer (F=-10.824，Plt;0.001); and finally, patients with longer free survival time had lower level of hope than patients with shorter free survival time (F=-1.930，Plt;0.001). Conclusion Parts of demographic characteristics have significant influences on level of hope in patients with tumor recurrence, but most patients still have high level of hope.
目的 了解婦幼保健院住院患者抗菌藥物應用情況。 方法 采用橫斷面調查法，對2012年2月份患者的抗菌藥物使用情況進行調查。 結果 抗菌藥物橫斷面使用率為71.14%，其中單用率為79.27%，二聯使用率為20.73%；住院患者使用頻率排行前10位的抗菌藥物中應用最多的是頭孢硫脒；兒科抗菌藥物使用率最高為93.27%；產科抗菌藥物使用頻率強度最高為77.37，婦科為67.19；所有患者臨床微生物檢驗樣本送檢率僅為39.3%。 結論 抗菌藥物使用率及抗菌藥物使用強度不符合相關規定，需要加強其抗菌藥物臨床應用的管理。
Objective Methods of evidence-based medicine were used to make an individulized treatment plan concerning newly diagnosed type 2 diabetes mellitus in elderly patients. Method After clinical problems were put forward, evidence was collected from third issue, 2003, Cochrane Library, Medline (PubMed 1990.1-2003.2) and http:// sumsearch.uthscsa.edu/ searchform4.htm according to the search strategy. Subject words were: diabetes mellitus non-insulin-dependent; self-monitor of blood glucose; micro-and macro-vascular complications; sulphonylureas; insulin ; aspirin; metformin; acarbose; self-monitor of blood glucose; older patient; hypertension management; Lipid management; RCT; human; meta-analysis；systmatic review. Results A total of 112 RCTs, and 24 systematic reviews were identified. A rational treatment plan was made upon a serious evaluation of the data. After one year follow-up, the plan was proved optimal. Conclusions The treatment efficacy in newly diagnosed type 2 diabetes mellitus in the elderly has been improved by determining an individulized treatment plan according to evidence-based methods.