目的 對燒傷層流病房多重耐藥菌感染的相關因素進行分析，通過護理干預來預防和減少燒傷病房多重耐藥菌感染的發生。 方法 回顧性分析2011年1月－12月收治的629例燒傷患者，其中發生多重耐藥菌感染74例，感染率為11.8%。 結果 感染部位：創面分泌物培養感染占70.2%，痰液標本培養感染占9.4%，血液標本培養感染占16.2%，其他占4.2%。感染病原菌：以金黃色葡萄球菌為主，占77.0%；鮑曼不動桿菌占4.2%，銅綠假單胞菌占10.8%，肺炎克雷伯菌占6.7%，真菌感染占1.3%。 結論 對發生醫院內多重耐藥菌感染的原因進行分析并及時采取相應的護理干預措施，及可行的醫院感染管理控制措施，對燒傷患者預后有重要的意義，可有效降低院內感染率的發生。
【摘要】 目的 探討肢體深度燒傷后，影響功能康復的相關因素。 方法 采用美國日常生活自理量表和功能性日常生活量表，對2009年4月-2010年7月來門診復診的101例肢體深度燒傷患者的功能康復情況進行問卷調查和統計學分析。 結果 接受專業康復的患者得分明顯低于自我康復患者得分，差異有統計學意義（Plt;0.01）；不同性別、不同文化程度之間的比較差異有統計學意義（Plt;0.001）；年齡14～50歲的患者對是否接受專業康復的比較，差異有統計學意義（Plt;0.001）；年齡lt;14歲、gt;50歲及婚姻狀況，在是否接受專業康復的比較差異無統計學意義（Pgt;0.01）。 結論 肢體深度燒傷后患者在專業醫師的指導下進行專業功能康復比自我康復的患者效果更好，使得燒傷患者社會期日常生活自理能力得到提高。【Abstract】 Objective to explore the related factors affecting the function recovery of deeply burned limps. Methods Adopting ADL body independent living scale and functional daily life scale, the questionnaire survey of the function recovery situation and statistical analysis were performed on the patients from the 101 outpatient appointment patients whose limbs were deeply burned from April 2009 to July 2010. Results The score of patients who accepted professional rehabilitation was significantly lower than that of the self healing patients, and the difference was significant (Plt;0.01); the difference of sex and the comparison between different literate degree were statistically significant (Plt;0.001); the difference in whether to accept the comparison of the professional rehabilitation among the patients with age oflt;14 years old, gt;50 years old and different marital status was not statistically significant (Pgt;0.01). Conclusion patients with deeply burned limbs recover better under the professional function recovery direction of professional doctor than the patients who have self recovery.
【摘要】 目的 通過對老年人燒傷的原因進行調查與分析，為預防老年人燒傷提供有效的依據。 方法 調查分析2000年1月-2009年6月收治的270例60歲以上老年燒傷住院患者的致傷因子、好發年齡、燒傷月份、燒傷程度、燒傷地點、家庭及居住情況。 結果 270例老年燒傷中，致傷因子以火焰燒傷最多占147例（54.44%），與其他的致傷因子比較有統計學意義（Plt;0.05）；好發年齡以60～69歲年齡段發生率最高占153例（56.67%），與其他年齡段比較有統計學意義（Plt;0.05）；老年燒傷一年四季均可發生，但以寒冷的冬季12月-次年2月居多，占158例（58.52%），與其他季節比較有統計學意義（Plt;0.05）；燒傷程度以輕度為主共142例（52.59%）；燒傷地點大多發生在家中共213例（78.89%），且為獨居占191例（70.74%）；老年燒傷家庭以農村家庭居多共208例（77.04%）。 結論 隨著老年人群逐步增加，燒傷發生率也增高，在日常生活中應采取有效防范措施，防止和減少老年燒傷的發生。【Abstract】Objective To provide the effective evidence for preventing burn injury of aged people by investigating and analyzing the reasons of burn injury. Methods The injury factors, age, month, degree, place, family and habitation of 270 aged people over 60 years old were analyzed between January, 2000 to June, 2009 in this department. Results In 270 aged patients, there were 147 patients whose injury factors were flame (54.44%) , and there was statistical difference compared with other injury factors (Plt;0.05) . The injury age of the highest incidence rate was 60 to 69 (153 patients, 56.67%) , and there was statistical difference compared with other injury age (Plt;0.05) .The aged burn injury may happen in all seasons, but the highest incidence rate appeared in winter (from December to next February) and there was statistical difference compared with other seasons (Plt;0.05) (158, 58.52%). There were 142 minor injury degree patients mainly (52.59%). The most injury places were at home (213 patients, 78.89%) and 191 patients (70.74%) were living alone.Two hundred and eight patients (77.04%) came from countryside. Conclusion With the aged people increasing, the incidence rate of burn injury is also raised.So effective methods should be adopted to prevent and decrease the incidence of age burn injury.
Objective To investigate the present status of anxiety and depression in patients through video electroencephalogram examination and analyze the influencing factors, providing a basis for clinical intervention. Methods A questionnaire survey was conducted on 177 patients at the Second Affiliated Hospital of Guangzhou Medical University using the general information and disease-related data questionnaire, the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS). Results The SAS and SDS scores of the patients in this study were significantly higher than the domestic norms (P<0.01). The detection rates of anxiety and depressive moods were 18.08% and 32.77%, respectively. Logistic regression analysis showed that the risk factors for anxiety in these patients included disease duration, head discomfort, and the psychological burden of inducing experiments. The risk factors for depression included disease duration, head discomfort, and occupational factors. ConclusionPatients in this study generally exhibited anxiety and depressive moods. Their anxiety and depression are influenced by various factors. Targeted psychological interventions should be implemented to improve their mental health.
ObjectiveTo summarize clinical features, imaging findings, and pathological characteristics of pancreas intraductal papillary mucinous neoplasm (IPMN) and to improve effect of clinical diagnosis and treatment of pancreas IPMN.MethodThe clinical data of 45 patients with pancreas IPMN who underwent surgical resection from February 2014 to February 2019 in the First Affiliated Hospital of Soochow University were retrospectively analyzed.ResultsOf the 45 patients with pancreas IPMN, 28 patients were male and 17 patients were female, aged from 44 to 81 years old with (65±21) years old. There were 35 patients with age > 60 years old. The most common clinical manifestation was the upper abdominal discomfort (26 patients) and the lesions mainly occurred in the head of pancreas (20 patients). Twenty-four (58.5%, 24/41) patients and 17 (81.0%, 17/21) patients were definitely diagnosed by the CT and MRI, respectively. Twenty-five patients underwent the pancreaticoduodenectomy, 5 patients underwent the partial pancreatectomy, 2 patient underwent the pancreatic tumor resection, 12 patients underwent the pancreatic body and tail resection, 1 patient underwent the total pancreatectomy. The pathological findings showed that 15 cases were mild dysplasia, 5 cases were moderate dysplasia, 3 cases were severe dysplasia. Six cases invaded the pancreas and its surrounding adipose tissue, 5 cases invaded the tissue outside the pancreas. After the discharge, 28/32 patients were followed up for 3 to 24 months. Among all the followed-up patients, the 1-year survival rate was 100% (28/28) and the 2-year survival rate was 96.4% (27/28). The patients underwent the CT examination on the 3rd, 6th, 12th,18th, and 24th month, no lymph node metastasis was found.ConclusionsPancreas IPMN is more common in the elderly, mainly manifests as gastrointestinal symptoms, such as upper abdominal discomfort, etc. Surgery is its main treatment mean. Preoperative diagnosis mainly depends on CT examination and MRI examination, but positive rate of MRI examination is higher. Postoperative pathological section shows different degree of dysplasia.
ObjectiveTo explore the psychological process and needs of the second victims of medical adverse events after the occurrence of adverse events, so as to provide reference for the psychological intervention strategies of medical institutions for the second victims of medical adverse events.MethodsThe second victims of medical adverse events in the First People’s Hospital of Ziyang were selected from April to July 2019. Qualitative research method was used to conduct semi-structured in-depth interviews with the second victims. Colaizzi method was used to analyze the transcripts through reading and rereading, coding, and thematizing. ResultsA total of 22 second victims of medical adverse events were interviewed. The second victims of medical adverse events experienced negative emotional experience, and the desire to seek emotional support was urgent. The psychological process of the second victims of medical adverse events mainly involved five stages: fear, anxiety, depression, guilt and recovery. Emotional support hada positive effect on regression. Conversely, negative or lack of emotional support had a negative effect on regression. ConclusionsThe emotional experience of the second victims of medical adverse events is relatively staged, and the recovery and regression are greatly affected by internal and external factors. Hospital administrators should take active measures and establish an emotional support mechanism for adverse events in order to reduce psychosomatic injuries and improve medical quality and efficiency.