【摘要】 目的 分析臨床實習對護理本科生專業認同的影響，探討提高專業認同的措施。 方法 2010年6—10月，對某綜合性大學60名2007級普通全日制護理本科生進行抽樣調查，評價其實習前1個月和實習后3個月的專業認同情況，比較實習前、后的變化并分析影響因素。 結果 實習后專業認同的專業價值觀得分[（3.13±0.85）分]高于實習前[（2.78±1.00）分]，實驗專業期望得分[（12.09±2.13）分]低于實習前[（13.13±1.30）分]，差異有統計學意義（P=0.045，0.002）；而專業認識、情感、意志、技能和專業認同總分方面，實習前、后差異無統計學意義（Pgt;0.05）；其影響因素由強到弱依次為:帶教老師（37.04%）、實際的護理工作（33.33%）、實習科室（22.22%）、他人態度（7.41%）。 結論 臨床實習可提高護理本科生的專業價值觀，帶教老師及實際護理工作對專業認同影響較大。【Abstract】 Objective To analyze the effect of clinical practice on student nurses’ professional identity and explore measures to develop their professional identity. Methods Convenience sampling was used to select 60 general full-time student nurses who entered a comprehensive university in 2007. Then we assessed their professional identity at the time of one month before, and three months after clinical practice, compared the two results, and analyzed the related factors. Results The score of professional value dimension after clinical practice was higher than before (3.13±0.85 vs. 2.78±1.00, P=0.045), while the professional expectation dimension was lower than before (12.09±2.13 vs. 13.13±1.30, P=0.002), and the differences in above-mentioned indexes were statistically significant. There was no statistical difference before and after clinical practice in professional knowledge, professional affection, professional volition, professional skill dimensions, and total score of professional identity (Pgt;0.05). The related factors in a order from b to weak were clinical teacher (37.04%), practice work (33.33%), training department (22.22%), and others’ attitudes (7.41%). Conclusion Clinical practice may improve professional values but impair professional expectations of the student nurses, and clinical teacher and practice work have a great effect on student nurses’ professional identity.
Objective To explore the influencing factors for early complications after laparoscopic sleeve gastrectomy (LSG). Methods A retrospective analysis was conducted for the clinical data of 306 obese patients undergoing LSG at the Weight Reduction and Metabolism Center of Xuzhou Medical University Affiliated Hospital of Lianyungang from January 2020 to September 2022. Early postoperative complications (≤30 d) of LSG were classified according to the Clavien-Dindo classification, and the influencing factors of early postoperative complications were explored. Results There were 27 cases (8.8%) suffered from early complications, including 8 cases of grade Ⅰ (2.6%), 15 cases of grade Ⅱ (4.9%), 4 cases of grade Ⅲ (1.3%), there were no grade Ⅳ and grade Ⅴ complications. The multivariate results showed that BMI≥45 kg/m2 [OR=3.63, 95%CI (1.10, 11.92)], high cholesterol [OR=7.12, 95%CI (2.42, 20.95)], and preoperative GERD [OR=3.69, 95%CI (1.11, 12.23)] were influencing factors for early complications. Conclusions LSG is a safe diagnostic and therapeutic method for treating obesity. Attention should be paid to the impact of BMI, high cholesterol, and preoperative GERD on the occurrence of complications after LSG.
【摘要】 目的 探討淋巴結轉移數目對行手術治療的結腸癌患者預后的影響。 方法 回顧性分析2005年1月-2007年12月符合篩選標準的148例行手術治療的結腸癌患者的臨床和隨訪資料，按照淋巴結轉移數目進行分組：N0組（0枚）91例、N1組（1～3枚）41例、N2組（≥4枚）16例，采用Kaplan-Meier法進行生存分析，用Log-rank比較3組術后3年生存率，等級資料采用秩和檢驗，用χ2檢驗進行兩兩比較術后3年局部復發率、遠處轉移率和死亡率情況。 結果 N0、N1、N2 3組的術后3年生存率分別為88.1%、71.4%、61.1%，3組生存率差異有統計學意義（P=0.003）；N0、N1、N2 3組的總體局部復發率、遠處轉移率和死亡率的差異有統計學意義（P=0.006，0.001，0.005）。 結論 淋巴結轉移數目是結腸癌患者術后3年生存情況的危險因素，無淋巴結轉移的患者術后3年生存情況明顯比有淋巴結轉移者好。【Abstract】 Objective To discuss the impact of the number of lymph node metastasis on the prognosis of patients with colon cancer after surgical operation. Methods The clinical data of 148 patients with colon cancer who underwent surgical operation between January 2005 and December 2007 were analyzed retrospectively. According to the number of lymph node metastasis, the patients were divided into three groups, group N0(the number of lymph metastasis equals to 0), group N1(the number of lymph node metastasis ranges from 1 to 3) and group N2 (the number of lymph node metastasis was equal or greater than 4). And we chose Kaplan-Meier to analyze patients′ survival and Log-rank test was used to compare the 3-year survival index; rank sum test was used to analyze the level data, and then chi-square test was chosen to compare local recurrence rate, metastasis rate and mortality among the three groups. Results The indexes of the 3-year survival in group N0 (91 cases), group N1 (41 cases) and group N2(16 cases) wre 88.1%, 1.4%, and 61.1%, respectively. The differences were significant (P=0.003). Besides, the differences between group N0 and N1, N0 and N2 were both significant (P=0.012,0.002); the differences between group N1 and N2 was not significant (P=0.344). The differences among three groups in local recurrence rate, metastasis rate and mortality were all significant(P=0.006, 0.001, 0.005); the differences between group N0 and N1 in local recurrence rate, metastasis rate and mortality were significant (P=0.008, 0.000, 0.012); the differences between group N0 and N2 in local recurrence rate, metastasis rate and mortality were significant (P=0.021, 0.047, 0.010), while the differences between group N1 and N2 in local recurrence rate, metastasis rate and mortality were not significant (P=1.000,0.585,0.523). Conclusion The number of lymph node metastasis is a dangerous factor to the 3-year survival in patients with colon cancer after operation, and the prongnosis of the 3-year survival in patients without lymph node metastasis is better than that in patients′ with lymph node metastasis.