增进积极体验为目标的健康干预对抑郁症病人抑郁情绪及生活质量的影响

目的:探讨增进积极体验为目标的健康干预对抑郁症病人抑郁情绪及生活质量的影响。方法:选择2019年9月—2021年3月在医院就诊的68例抑郁症病人为研究对象,按照随机数字表法分为观察组与对照组,每组34例。对照组予以常规护理,观察组在常规护理基础上予以增进积极体验为目标的健康干预。干预前后分别采用汉密尔顿抑郁量表(HAMD)、世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评估病人的抑郁情绪和生活质量,同时对两组病人的护理满意度进行比较。结果:干预后观察组病人抑郁评分低于对照组(P<0.05);两组病人的生理功能、心理功能、社会功能及环境功能指标均较干预前有明显改善,且观察组评分均高于对照组(P<0.05);观察组病人对护理干预的总满意度为97.06%,高于对照组的61.76%(P<0.05)。结论:增进积极体验为目标的健康干预可明显缓解抑郁症病人的抑郁情绪,提高病人的生活质量。     

一体化管理的老年综合评估护理模式对前列腺癌患者心理因素和生活质量的影响

目的探讨对前列腺癌患者采用一体化管理老年综合评估(CGA)护理模式对其心理因素和生活质量的影响。方法选取2020年3月至2021年3月在南京市第一医院就诊,确诊为前列腺癌,且首次行腹腔镜下前列腺癌根治术的患者96例,随机分为对照组、观察1组、观察2组,各32例。对照组为住院后采用常规护理模式进行护理,观察1组为入院后行CGA干预组,观察2组为一体化管理的CGA干预组。三组患者分别在干预前、出院时,进行焦虑自评量表(SAS)、抑郁自评量表(SDS)测评;在干预前、术后30 d,进行生活质量核心量表QLQ-C30(V3.0)和前列腺癌特异性补充量表QLQ-PR25测评。结果出院时,观察2组SAS、SDS评分显著优于对照组及观察1组(P<0.05);术后30 d,观察2组生活质量QLQ-C30、QLQ-PR25评分显著优于对照组及观察1组(P<0.05)。结论一体化管理CGA护理模式可有效改善前列腺癌患者的心理状态,提高其术后生活质量。     

重复经颅磁刺激治疗青少年抑郁症认知功能损害的研究进展

青少年抑郁症不仅存在情绪调节障碍,还存在认知功能的改变,影响患者的生活质量和社会功能。传统的治疗方法,如药物治疗和心理治疗,改善认知功能的周期长、效果差。重复经颅磁刺激(repetitive transcranial magnetic stimulation, rTMS)作为一种新兴的非侵入治疗方法,已被广泛运用于青少年认知功能损害的治疗中。本文就rTMS治疗青少年抑郁症认知功能损害的研究进展进行综述,旨在为临床提供依据。     

血管内介入与单纯药物治疗老年重度颅内前循环动脉狭窄的疗效观察

目的 研究血管内介入与单纯药物运用于老年重度颅内前循环动脉狭窄中的价值。方法 选取我院收治的老年重度颅内前循环动脉狭窄76例，随机分为研究组和对照组，各38例。研究组实施血管内介入治疗，对照组使用单纯药物，测定两组治疗前后的血浆黏度、纤维蛋白、全血高切黏度、全血低切黏度、血细胞比容指标，评价两组治疗前后的神经行为认知(NCSE)、神经功能缺损(NIHSS)、日常生活能力(ADL)评分，统计两组并发症发生情况，比较两组治疗结果。结果 两组治疗前的血流动力学指标比较无差异(P>0.05),治疗后，研究组血浆黏度、纤维蛋白、全血高切黏度、全血低切黏度、血细胞比容均高出对照组(P<0.05);治疗后，研究组NCSE评分、ADL评分高出对照组，但NIHSS评分低于对照组(P<0.05);研究组并发症发生率低于对照组(P<0.05)。结论 血管内介入在老年重度颅内前循环动脉狭窄中效果显著，可促进血流动力学指标改善，改善神经功能与认知能力，并提升日常生活能力，并发症少，安全性高。     

居家个性化护理,助脑梗死患者早日康复

脑梗死也叫作缺血性脑卒中,是中老年人群中常见的一种脑血管疾病,死亡率、致残率均较高。脑梗死急性期须治疗1~2周,出院后也须长期服药预防复发,从康复角度来讲,也须进行3~6个月的康复治疗。许多老年患者在治疗的过程中会产生恐惧、焦虑等情绪,对治疗配合度、治疗效果均有着一定的影响。因此,脑梗死护理在治疗过程中起着非常重要的作用,患者需要接受个性化的身心护理来配合治疗。     

经鼻高流量氧气湿化治疗老年慢性阻塞性肺疾病急性加重合并呼吸衰竭的可行性研究

ObjectiveTo investigate the feasibility of transnasal heated humidified high flow nasal cannula oxygen therapy (HFNC) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure in elderly patients. MethodsA total of 176 elderly patients with AECOPD complicated with respiratory failure who were hospitalized at Peking University Shougang Hospital from December 2016 to January 2022 were enrolled, including 82 patients in an HFNC group and 94 patients in an NPPV group. After treatment, pulse oxygen saturation (SPO₂), arterial partial pressure of carbon dioxide (PaCO₂), oxygenation index (OI), respiratory rate (RR), heart rate (HR), mean arterial pressure (MAP), comfort score, discharge rate, rate of endotracheal intubation, rate of transfer to intensive care unit (ICU), and mortality were compared between the two groups. The independent sample t-test was used for comparison between the two groups. Statistical data are expressed in percentage or number of cases and the χ² test was used for their comparisons. ResultsThe SPO₂ values at 30 min, 1 h, and 6 h were significantly higher in the HFNC group than in the NPPV group (t=-2.049,-2.618, and -3.314, P=0.043, 0.010, and 0.001, respectively). SPO₂ before discharge was significantly lower than that of the NPPV group (t=2.162, P=0.033), but OI at each time point and before discharge had no statistical significance (P＞0.05). MAP at 6 h was significantly higher in the HFNC group than in the NPPV group (t=-2.209, P=0.029), but within the normal range. HRs at 2 h and 3 h in the HFNC group were significantly higher than those of the NPPV group (t=-2.199 and -2.336, P=0.030 and 0.021, respectively). There were no significant differences in RR, HR, or MAP between the two groups at other time points and before discharge (P＞0.05). There was no significant difference in PaCO2 between the two groups (P＞0.05). Comfort score in the HFNC group was significantly higher than that of the NPPV group (t=-46.807, P＜0.001). There were no significant differences in discharge rate, ICU transfer rate, endotracheal intubation rate, and mortality between the two groups (P＞0.05). ConclusionHFNC is as effective as NPPV in treating elderly patients with AECOPD complicated with type Ⅰ or mild type Ⅱ respiratory failure, and HFNC is more comfortable than NPPV.