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1.
目的分析护理风险安全管理防御机制在手术室护理管理中的应用效果。方法将于2018年4月-2019年5月在该院接受手术治疗的50例患者作为该次实验的研究对象,将其分为对照组和观察组,每组随机分配25例患者,并给予对照组患者常规手术室护理管理方式,观察组与之不同,采用护理安全风险管理防御机制,对比两组患者在护理过程中的风险发生情况及护理人员对风险管理的认知程度评分。结果据该次实验来看,采用护理风险安全管理防御机制的观察组,出现1例记录差错,风险发生率为(4%),护理人员的风险管理认知评分为(25.39±0.48)分,风险意识评分(23.99±1.02)分,风险管理行为(24.17±1.26)分,风险管理态度(22.92±0.73)分;而采用常规手术室护理管理的对照组,出现2例记录差错,1例切口感染,1例投诉纠纷,风险发生率为(16%),护理人员的风险管理认知、风险意识、风险管理行为、风险管理态度评分分别为(16.85±0.28)分、(17.03±0.84)分、(16.52±0.74)分、(15.92±1.14)分。组间差异有统计学意义(P<0.05)。结论对需要接受手术治疗的患者采用护理风险安全管理防御机制可以有效提高护理安全性,降低风险发生率。  相似文献   
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BackgroundEnd-stage hemophilic arthropathy is the result of recurrent joint hemarthrosis. Although total hip arthroplasty (THA) and total knee arthroplasty (TKA) can reduce severe joint pain and improve functional activity, controversy remains regarding outcomes after THA and TKA among patients with hemophilia. This study evaluated the risk of adverse outcomes of hemophilia patients who underwent THA and TKA.MethodsThis retrospective cohort study was conducted using data from the National Health Insurance Research Database. Patients who had hemophilia and underwent THA and TKA between 2000 and 2015 were identified. A total of 121 patients with hemophilia and 194,026 patients without hemophilia were included. Through propensity score matching, patients with hemophilia were matched at a 1:4 ratio to patients without hemophilia. Multivariable regression analysis was used to control for confounding variables and compare the risk of postoperative complications and mortality, differences in length of stay, and cost of care for the hospital.ResultsAfter propensity score matching and multivariate regression analysis, the adjusted hazard ratio of postoperative transfusion for hemophilia patients was 5.262 (95% confidence interval [CI] = 3.044-26.565, P < .001) in THA group and 6.279 (95% CI = 3.246-28.903, P < .001) in TKA group, when compared with the control group. Patients with hemophilia had longer length of hospital stay (THA group: 95% CI, 1.541-2.669, P < .001; TKA group: 95% CI, 1.568-2.786; P < .001) and higher total hospital charges (THA group: 95% CI, 3.518-8.293, P < .001; TKA group: 95% CI, 3.584-8.842; P < .001) compared to patients without hemophilia. Hemophiliacs had a higher yet nonsignificant 1-year infection rate (8.11% vs 3.38%, P = .206) in the THA group. There were no differences between the rates of 30-day and 90-day complications, 1-year infection, reoperation and mortality between the hemophilia and nonhemophilia groups.ConclusionHemophilia patients have higher rates of postoperative transfusion, hospital costs, and increased length of stay. There is an appreciable clinical difference in 1-year infection rates following THA but our analysis was limited by the small sample size. Other postoperative complications and mortality rates were comparable. Patients with hemophilia should be counseled that infection rate maybe as high as 8% following THA. Further investigation is needed to develop prophylactic and effective methods to decrease the rates of transfusions and associated adverse outcomes in hemophilia patients undergoing THA and TKA.  相似文献   
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White mold and stem rot is a common disease of Phaseolus vulgaris caused by Sclerotinia sclerotiorum. Biological control is a promising alternative for the control of this disease. In the present study, two Trichoderma spp., T. erinaceum and T. viride, and the consortium of both were evaluated as biocontrol agents against sclerotinia stem rot disease. The results revealed that T. erinaceum (NAIMCC-F-02171) and T. viride (NAIMCC-F-02500) when applied alone, significantly suppressed the infection rate of S. sclerotiorum and increased the rate of survival of plants by 74.5%. On the contrary, the combination of both the Trichoderma spp. was found to be more effective in reducing stem rot by 57.2% and increasing the survival of plants by 87.5% when compared to the individual Trichoderma applications. Further, the exogenous supplementation of Trichoderma activated antioxidative machineries, such as peroxidase, polyphenol oxidase, superoxide dismutase, catalase, and ascorbic acid in the plant. Besides, hydrogen peroxide and superoxide-free radical accumulation were also found to be reduced when T. erinaceum and T. viride were used either individually or in combination under the pathogen-challenged condition. Additionally, the photopigments in the bioprimed plants were markedly increased. Moreover, the combined inoculation of the two isolates yielded the highest records of growth parameters (root weight, shoot length, and leaf weight) compared with individual inoculation. Therefore, based on the above results, it was concluded that the combination of T. erinaceum and T. viride can be effectively used as an alternative to control white mold and stem rot caused by S. sclerotiorum.  相似文献   
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ObjectiveChronic pain has a great prevalence in the society of adults, which causes important problems for health and quality of life. The present study aims to investigate a hypothetical model of pain perception in patients with chronic pain, considering the role of unconscious, emotional, behavioral and meta-cognitive factors.MethodsA total of 391 patients (155 males, 236 females) who referred to the pain centers in Tehran suffering from chronic musculoskeletal pain, participated in the study. Participants were asked to complete the Defense Style Questionnaire (DSQ-40), Toronto Alexithymia Scale (TAS-20), The Inhibition/Activation System Scale (BIS/BAS), Meta-Cognitions Questionnaire (MCQ-30), and Numeric Rating Scale (NRS).ResultsThe results revealed that the model could anticipate the intensity of pain in patients with chronic pain. Immature defence style, behavioral inhibition system, alexithymia, and meta-cognitive beliefs predicted the intensity of pain in patients with chronic pain.ConclusionEvaluation of results indicated that the perception of the intensity of pain in patients with chronic pain is affected by unconscious, emotional, behavioral and meta-cognitive factors.  相似文献   
7.
IntroductionPrevious studies have indicated that the ratio of pulmonary artery (PA) to ascending aorta (Ao) diameter as measured by computed tomography (PA/Ao) is strongly associated with pulmonary artery pressure. However, the clinical significance of PA/Ao in heart failure (HF) has not been fully characterized. We sought to investigate the prognostic impact of PA/Ao in HF.MethodsBased on the prospective registry of patients admitted to our institution due to acute decompensated HF (ADHF), the records of the consecutive 761 patients admitted between 2011 and 2016 were reviewed. Thoracic computed tomography data during the hospital stays were obtained from 447 patients (median 78 (70–84) years of age; male, 62.2%). The diameters of PA and Ao were measured at the level of PA bifurcation. The subjects were divided into the H group (PA/Ao ≥ 1.0) and the L group (PA/Ao < 1.0) according to the PA/Ao values. The cutoff value was derived from receiver operating curve analysis.ResultsThere were no significant differences in age, sex or body mass index between the H and L groups. The H group was associated with significantly larger left atrial dimension (LAD), higher tricuspid regurgitation peak gradient (TRPG) and E/e’ (LAD, H, 48 (42–55) mm vs L, 45 (39–50) mm, P < 0.001; TRPG, H, 34 (26–48) mm Hg vs L, 28 (22–38) mm Hg, P < 0.001; E/e′, H, 23.3 (42–55) vs L, 18.4 (13.9–25), P < 0.001). Length of hospital stay was significantly longer in the H group than in the L group (H, 19 (14–32) days vs L, 16 (12–23) days, P < 0.001). In-hospital mortality was significantly higher in the H group compared with the L group (H, 5.4% vs L, 1.2%, P = 0.02). Age, sex, LAD and TRPG were independently associated with PA/Ao. The primary endpoint, defined as the composite of all-cause death and ADHF rehospitalization during a median of 479 days after discharge, was significantly more common in the H group (P < 0.001, log-rank test). PA/Ao was independently associated with the primary endpoint, even after adjusting for the other confounding factors (P = 0.002).ConclusionsPA/Ao is a reliable marker for the prediction of the outcome of patients with ADHF.  相似文献   
8.
目的:探讨焦虑症患者的防御方式以及与A型行为的关系。方法采用防御方式问卷( DSQ)及A型行为问卷( TABP)对60例焦虑症患者进行问卷调查,并与60例对照者加以比较。结果①观察组不成熟和中间型防御机制因子评分均显著高于对照组( P<0.05或P<0.01),而成熟防御机制因子评分则显著低于对照组( P<0.05);②观察组A型行为者为61.7%,显著高于对照组的40.0%( P<0.05);其TH、CH及TH+CH评分亦均显著高于对照组( P<0.05或P<0.01);③焦虑症患者的不成熟和中间型防御机制因子评分与TH、CH及TH+CH评分均呈显著性正相关( P<0.01),成熟防御机制因子评分与TH、CH及TH+CH评分则呈显著性负相关( P<0.05)。结论焦虑症患者的防御方式较差,与A型行为有关。  相似文献   
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目的 评价心理动力性心理治疗对强迫症患者疗效及防御机制的影响.方法 将符合入组标准的强迫症患者随机分成研究组和对照组,研究组42例,对照组45例.研究组接受心理动力性心理治疗联合帕罗西汀治疗,对照组单用帕罗西汀治疗,分别于治疗前、治疗第4周末、第8周末和第12周末评定Y-BOCS,在治疗前后评定防御方式问卷.结果 研究组有效率为73.8%,对照组有效率为53.3%,差异具有统计学意义(x2=3.92,P<0.05);自治疗第8周末开始,研究组在Y-BOCS强迫思维因子分[(8.25±4.29)分]及总分[(16.42±5.78)分]均低于对照组[(11.44±5.54)分,(21.74±4.88)分],在第12周末时Y-BOCS强迫行为因子分[(5.55±3.81)分]也低于对照组[(8.24±3.27)分],差异均有统计学意义(t=2.99,4.65,3.54,P<0.05);研究组不成熟防御机制的评分在治疗后[(4.24±1.27)分]较治疗前[(5.74±1.28)分]降低,而成熟防御机制的评分在治疗后[(5.56±1.74)分]较治疗前[(4.01±1.45)分]升高,差异均有统计学意义(t=5.39,4.44,P<0.05).结论 心理动力性心理治疗对强迫症患者有较好疗效且能改善患者的心理防御机制.  相似文献   
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