手机移动教育对PICC带管出院患者导管相关性血栓预防知信行的影响

目的 探讨手机移动教育对PICC带管出院患者导管相关性血栓预防知信行的影响,为制定PICC带管出院患者健康教育提供参考依据.方法 选取PICC带管出院患者100例,根据出院时间分组,2016年5—6月PICC带管出院患者的50例患者为对照组,2016年7—8月PICC带管出院患者的50例为观察组.对照组给予常规健康宣教,观察组在对照组基础上采用手机移动教育进行出院后健康宣教.观察比较2组患者导管相关性血栓预防知信行得分水平的差异.结果 干预1个月时,观察组在导管相关性血栓预防的知识、信念、行为方面得分均高于对照组,差异具有统计学意义(均P<0.05).结论 采用手机移动教育,能提高患者导管相关性血栓预防知识水平,改善其导管相关性血栓预防信念,促进其导管相关性血栓预防行为,为治疗顺利进行提供保障,同时移动教育完善了延续性护理,便于更好更高效地服务于患者.     

EPOCH方案治疗老年人外周T细胞淋巴瘤的临床研究

Objective To evaluate the clinical efficacy and toxicity of EPOCH regimen in the treatment of elderly patients with peripheral T-cell lymphoma. Methods Twenty-eight elderly patients with pathologically diagnosed peripheral T-cell lymphoma were treated with EPOCH regimen, including 96-hour continuous infusion of etoposide 50 mg/m2, epirubincin 12 mg/m2 and vincristin 0.4 mg/m2 on daysl through 4,cyclophosphamide 750 mg/m2 given as intravenous bolus on day 5 and prednisone 60 mg/m2 administered orally on daysl through 5. The EPOCH regimen was repeated very 21 days. Clinical efficacy and safety profiles of EPOCH regimen was systemically reviewed and analysed. Results All the 28 patients received a total of 85 cycles of EPOCH regimen. The median cycles was two courses. Fifteen patients achieved complete response, while five cases obtaining partial response. The overall response rate was 71.4 %. The median survival time was 20 months. In newly diagnosed patients, complete response rate (CR) as well as partial response (PR) and overall response rate (OR) reached 64.7 %, 23.5 % and 88.2 %, respectively, which was significantly higher than that in refractory cases, whose CR, PR and OR were 36.4 %, 9.1% and 45.5 %(λ 2 = 5.99, P ＜0.05). In addition, the median survivalduration of newly diagnosed patients was longer than that of refractory cases, whose median survival time was 24 and 13 months, respectively. The major adverse events was myelosuppression with grade 3-4 neutropenia and thrombocytopenia in 53.6 % and 50.0 % cases.Non-hematologic toxicities were moderate and uncommon. The frequency of adverse effects in de novo patients showed little difference in comparison with that in refractory ones (P＞0.05). Conclusion EPOCH regimen was an effective and well tolerated therapeutic schedule for elderly patients with peripheral T-cell lymphoma.     

EPOCH方案治疗老年人外周T细胞淋巴瘤的临床研究

Objective To evaluate the clinical efficacy and toxicity of EPOCH regimen in the treatment of elderly patients with peripheral T-cell lymphoma. Methods Twenty-eight elderly patients with pathologically diagnosed peripheral T-cell lymphoma were treated with EPOCH regimen, including 96-hour continuous infusion of etoposide 50 mg/m2, epirubincin 12 mg/m2 and vincristin 0.4 mg/m2 on daysl through 4,cyclophosphamide 750 mg/m2 given as intravenous bolus on day 5 and prednisone 60 mg/m2 administered orally on daysl through 5. The EPOCH regimen was repeated very 21 days. Clinical efficacy and safety profiles of EPOCH regimen was systemically reviewed and analysed. Results All the 28 patients received a total of 85 cycles of EPOCH regimen. The median cycles was two courses. Fifteen patients achieved complete response, while five cases obtaining partial response. The overall response rate was 71.4 %. The median survival time was 20 months. In newly diagnosed patients, complete response rate (CR) as well as partial response (PR) and overall response rate (OR) reached 64.7 %, 23.5 % and 88.2 %, respectively, which was significantly higher than that in refractory cases, whose CR, PR and OR were 36.4 %, 9.1% and 45.5 %(λ 2 = 5.99, P ＜0.05). In addition, the median survivalduration of newly diagnosed patients was longer than that of refractory cases, whose median survival time was 24 and 13 months, respectively. The major adverse events was myelosuppression with grade 3-4 neutropenia and thrombocytopenia in 53.6 % and 50.0 % cases.Non-hematologic toxicities were moderate and uncommon. The frequency of adverse effects in de novo patients showed little difference in comparison with that in refractory ones (P＞0.05). Conclusion EPOCH regimen was an effective and well tolerated therapeutic schedule for elderly patients with peripheral T-cell lymphoma.     

两种麻醉法在纤支镜检查中的效果评价及护理

纤维支气管镜（Fibor bronchoscopy，FB，简称纤支镜）检查应用广泛，不但可以用于诊断，而且可以用于进行多种治疗。在检查中，术前麻醉的效果直接关系到整个检查过程能否顺利进行，笔对采用喷雾法结合环甲膜穿刺麻醉的患进行了仔细的观察统计，并与单纯喷雾法对照观察，结果表明，喷雾法结合环甲膜穿刺麻醉有利于纤支镜检查的顺利进行。[第一段]     

血小板活化在下肢深静脉血栓形成中的临床意义

作者对30例下肢深静脉血栓（LDVT）患者和30例健康人的血小板数量（BPC）、血小板表面α颗粒膜蛋白（GMP140）分子数、血小板聚集率（PAgT）、血浆血栓素B2（TXB2）和6-酮前列腺素F1a（6-酮-PGF1a）进行了测定，以观察这些指标与下肢深静脉血栓发病的相关性。结果显示LDVT患者的血小板表面GMP－140、TXB2、PAgT明显升高，与正常对照组相比有显著性差异（P＜0．05）；BPC、6-酮-PGF1a与正常对照组相比无明显差异（P＜0．05）。提示血小板活化是参与下肢深静脉血栓形成的重要因素之一，并对防治深静脉血栓的形成有一定临床意义。     

T淋巴细胞亚群和体液免疫测定对COPD临床意义的探讨

慢性阻塞性肺疾病(chronicobstructivepulmonary disease,COPD)是一种气流受阻特征的疾病。其患病人数多,病死率高,社会经济负担重,已成为一个重要的公共卫生问题。其反复发作将导致机体免疫系统的功能变化[1]。本文以COPD患者为研究对象,检测了60例COPD患者外周血T淋巴细胞亚群和体液免疫球蛋白,探讨COPD患者免疫功能的变化,为临床诊疗提供科学依据。1资料与方法1.1一般资料60例均为住院COPD患者,男32例,女28例,年龄36～82岁,平均65岁。所有病例检测前均未用过激素和免疫抑制剂,分别取血标本。对照组60例来自健康检查者,男34例,女…     

含异环磷酰胺的联合化疗在治疗非霍奇金淋巴瘤中的疗效观察

我院自1998年4月—2002年2月期间用江苏连云港制药厂生产的异环磷酰胺(IFO)联合化疗加用美安(MesNa)治疗非霍奇金淋巴瘤(NHL)共32例，取得了比较满意的近期疗效。现报道如下。 1 材料与方法 1．1 临床资料 NHL32例，病例人选……     

血浆血栓前体蛋白在DIC检测中的临床意义

目的观察血浆前体蛋白（TpP）在弥散性血管内凝血（DIC）病人实验室诊断中的临床意义。方法分别对27例DIC病人、45例Pie—DIC患者和30例健康志愿者进行BPC、PT等DIC常规检测，以及包括TpP在内的血小板活化、凝血纤溶激活和内皮细胞受损的分子标志物检测。并对其进行敏感度和特异性的比较。结果DIC患者组的各项指标与正常对照组相比差异有显著性（P〈0．001或P〈0．001或P〈0．05）。Pre—DIC患者组的分子标志物检测与正常对照组相比有统计学差异（P〈0．05或P〈0．01）。TpP在DIC早期诊断中的敏感度为80％，而特异性为96％。结论TpP可作为DIC实验室诊断的一个既敏感又特异，且对DIC的早期诊断和抗凝治疗具有临床指导意义的指标。     

恶性肿瘤患者化疗前后血小板和血小板平均体积的变化及临床意义

目的探讨恶性肿瘤患者化疗前后血小板和血小板平均体积的变化及临床意义。方法使用XE-2100全自动血细胞分析仪,检测我院血液肿瘤科收治的120名恶性肿瘤患者化疗前后静脉血的白细胞数(WBC)、血小板(PLT)数和血小板平均体积(MPV)。结果肿瘤患者化疗后骨髓抑制最明显的时候,MPV却是最大;肿瘤患者化疗后WBC2.0×109/L及2.0-3.0×109/L之间时,PLT数和MPV与化疗前(WBC≥4.0×109/L)比较差异有显著性(P0.01);化疗后WBC在3.0-4.0×109/L之间时,PLT数与化疗前比较差异无显著性(P0.05),但MPV与化疗前比较差异有显著性(P0.05)。结论 MPV在评价肿瘤患者化疗后骨髓造血恢复时,是一个非常有用的指标;结合观察血小板和白细胞计数的变化能更好地了解化疗后患者的骨髓抑制情况,有利于指导化疗后造血生长因子的应用和下一步治疗方案的选择。     

冠状动脉介入手术导管室护理中实施风险管理对手术成功率的影响

目的探讨冠状动脉介入手术导管室护理中实施风险管理对手术成功率的影响。方法于2017年1月至2019年1月,选择心血管介入导管室120例冠状动脉介入手术患者,随机分组,对照组实施常规护理,观察组实施风险管理,比较护理质量、护理差错事件、手术成功率、焦虑抑郁评分、护理满意度。结果与对照组相比,观察组护理质量评分更高,护理差错事件发生率降低,手术成功率增高(P<0.05)。护理后,SAS与SDS评分在观察组、对照组中比较,观察组更低(P<0.05)。护理总满意率观察组95.00%高于对照组80.00%(P<0.05)。结论风险管理用于心血管介入导管室可提高护理质量,减少护理差错事件,有利于提高冠脉介入手术成功率。