社区健康教育对高血压患者的影响

目的探讨社区健康教育对高血压患者的影响。方法选择2011年1—12月收治的160例高血压患者,随机分成对照组和观察组各80例,对照组给予常规药物治疗,观察组在对照组基础上给予针对性健康教育,比较两组1年内血压控制情况和心脑血管并发症出现情况。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果对照组收缩压(145.0±7.5)mm Hg(1 mm Hg=0.133 kPa),舒张压(85.0±7.0)mm Hg。观察组收缩压(125.0±7.8)mm Hg,舒张压(75.0±7.5)mm Hg。两组比较差异均有统计学意义(均P<0.05)。对照组因心脑血管并发症住院42例,占52.50%;观察组因心脑血管并发症住院14例,占17.50%。两组比较差异有统计学意义(P<0.05)。结论社区健康教育有助于高血压患者的血压控制,延缓和减少并发症发生,改善生活质量。     

家庭医生签约模式下社区护士在高血压患者管理中地位

目的家庭医生通过签约方式对居民健康进行全方位维护,为慢性病防治提供专业化综合干预方案,可有效提高居民生活质量。本研究探讨家庭医生签约模式下社区护士对原发性高血压患者血压水平和自我管理水平控制效果。方法采用分层抽样法选取2017-01德州市6个社区188例签署《家庭医生式服务协议书》的原发性高血压患者为研究对象,根据不同护理方式分为对照组和干预组,各94例。对照组进行常规血压控制及电话随访,干预组采用家庭医生签约模式下社区护理干预措施,比较两组血压控制效果和自我管理水平。结果干预后6和12个月,干预组收缩压分别为(132.18±4.42)mm Hg和(120.31±2.62)mm Hg,低于对照组的(138.75±6.83)mm Hg和(130.25±4.59)mm Hg,差异有统计学意义,F=20.328,P0.001;干预组舒张压分别为(100.33±7.24)mm Hg和(84.32±2.68)mm Hg,低于对照组的(105.36±7.89)mm Hg和(90.21±4.59)mm Hg,差异有统计学意义,F=12.730,P=0.001;干预组自我管理水平分别为(14.029±2.244)分和(23.463±1.383)分,高于对照组的(8.623±2.210)分和(18.115±1.294)分,差异有统计学意义,F=435.212,P0.001。结论家庭医生签约模式下社区护士对原发性高血压患者进行护理干预,可以更好地改善其血压及自我管理水平。     

内镜逆行胰胆管造影术治疗急性胆源性胰腺炎合并血压增高临床观察

目的急性胆源性胰腺炎(acute biliary pancreatitis,ABP)病情危急,合并血压增高患者治疗更为棘手。本研究探讨ABP合并血压增高患者应用内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)治疗疗效,以期为临床诊治提供参考。方法选取2017-01-01-2018-09-01鹤壁市人民医院收治的ABP合并血压增高患者为研究对象,在患者知情同意前提下,采用性别、年龄、血压水平及病情程度组间均衡的原则,选择观察组与对照组。对照组43例给予常规抗感染、补液治疗,观察组44例联合ERCP治疗,对比两组患者治疗后症状体征改善时间、血压及血清炎症因子水平变化。结果观察组黄疸消退时间为(8.16±1.19)d,低于对照组的(11.71±1.49)d,t=12.294,P<0.001;腹痛缓解时间为(68.77±15.25)h,低于对照组的(89.02±20.05)h,t=5.310,P<0.001;肝功能正常时间为(6.35±0.88)d,低于对照组的(8.91±1.19)d,t=11.427,P<0.001;体温恢复时间为(65.15±13.02)h,低于对照组的(101.16±21.25)h,t=9.505,P<0.001;肛门排气时间为(65.53±13.22)h,低于对照组的(91.16±18.03)h,t=7.547,P<0.001;CRP水平为(20.19±6.60)mg/L,低于对照组的(52.29±13.55)mg/L,t=13.997,P<0.001;TNF-α水平为(62.11±9.66)ng/L,低于对照组的(133.65±25.01)ng/L,t=17.523,P<0.001;IL-8水平为(4.99±0.89)ng/L,低于对照组的(7.30±1.62)ng/L,t=8.268,P<0.001;收缩压为(130.08±2.51)mm Hg,低于对照组的(140.21±3.66)mm Hg,t=15.023,P<0.001;舒张压为(82.31±2.93)mm Hg,低于对照组的(89.93±4.31)mm Hg,t=9.664,P<0.001。结论内镜ERCP术能够有效抑制炎症反应,快速改善胆总管压力,对血压影响轻微,治疗ABP伴血压增高效果显著,快速改善患者症状体征。     

氨氯地平阿托伐他汀钙片治疗老年原发性高血压效果观察

目的观察氨氯地平阿托伐他汀钙片治疗老年原发性高血压的临床效果。方法选择2011年10月-2012年10月收治的老年原发性高血压患者82例,随机分为治疗组42例和对照组40例,治疗组给予氨氯地平阿托伐他汀钙片5 mg口服,1次/d,对照组给予苯磺酸氨氯地平片5 mg口服,1次/d,8周后比较两组血压变化及药物不良反应情况。计量资料采用t检验,P<0.05为差异有统计学意义。结果治疗8周后治疗组收缩压(126.3±10.8)mm Hg(1 mm Hg=0.133 kPa),舒张压(68.8±5.6)mm Hg;对照组收缩压(131.5±11.7)mm Hg,舒张压(84.6±4.7)mm Hg。与治疗前比较差异均有统计学意义(均P<0.05)。两组比较差异均有统计学意义(均P<0.05)。治疗组轻度腹胀1例,颜面部潮红1例;对照组踝部轻度水肿2例,头痛1例。结论氨氯地平阿托伐他汀钙片治疗原发性高血压血压降幅明显,尤其适用于高血压合并多个危险因素的老年患者。     

高血压合并OSAHS患者睡眠期间收缩压水平变化临床意义

目的阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)与高血压之间存在密切相关性,但目前针对OSAHS患者血压波动尤其是收缩压变化与高血压相关性的研究较少。本研究探讨高血压合并OSAHS患者睡眠期间收缩压变化的临床意义。方法选择2018-03-31-2019-04-30濮阳市油田总医院收治的初治高血压患者80例作为研究对象,其中合并OSAHS患者40例为病例组,单纯高血压患者40例为对照组。统计整个睡眠过程中两组出现的自发性血压升高、呼吸相关性血压升高、睡眠期血压升高及觉醒期血压升高比例,并分析睡眠前30min、快动眼睡眠时期、慢动眼睡眠时期、苏醒前30min,两组收缩压变化情况,计算两组呼吸暂停指数及阻塞性指数。结果病例组出现自发性血压升高(χ~2=19.835,P<0.001)、呼吸相关性血压升高(χ~2=36.565,P<0.001)、睡眠期血压升高(χ~2=25.128,P<0.001)及觉醒期血压升高(χ~2=30.336,P<0.001)比例均大于对照组,差异有统计学意义。病例组快动眼睡眠时期、慢动眼睡眠时期和苏醒前30min收缩压水平分别为(133.8±2.3)、(128.6±2.1)和(135.5±3.2)mm Hg,均高于对照组的(143.3±2.5)、(142.3±1.8)和(149.2±3.4)mm Hg,t值分别为17.687,31.327和18.558,均P<0.001。病例组呼吸暂停指数和阻塞性指数分别为(43.2±2.6)和(15.2±1.6)mm Hg,均高于对照组的(13.5±1.2)和(8.6±0.8)mm Hg,t值分别为65.596和23.335,均P<0.001。结论高血压合并OSAHS患者,睡眠过程中收缩压升高明显,且血压增高水平与OSAHS病情严重程度存在一定关联。     

原发性高血压合并脑梗死患者24小时动态血压变化特点的研究

目的 分析原发性高血压合并脑梗死患者24 h动态血压变化特点,探讨血压异常与脑梗死的关系.方法 对38例原发性高血压患者(单纯高血压组)和94例原发性高血压合并脑梗死患者(高血压合并脑梗死组)进行24 h动态血压监测,并对两组患者的24h、日间、夜间血压平均值,血压负荷值,血压变异性和血压昼夜节律性进行统计分析.结果 高血压合并脑梗死组患者24h、日间、夜间收缩压(SBP)和舒张压(DBP)及sBP和DBP负荷值均明显高于单纯高血压组患者,差异有统计学意义(P<0.01或<0.05).高血压合并脑梗死组日间SBP变异性高于单纯高血压组[(15.84±4.56)mm Hg(1 mm Hg=0.133 kPa)比(14.21±4.29)mm Hg],SBP和DBP夜间下降率低于单纯高血压组[(5±8)%比(9±11)%,(7±6)%比(11±10)%],差异有统计学意义(P<0.05或<0.01).结论 血压平均值和血压负荷值增高及血压昼夜节律性消失与脑梗死相关.     

个体化护理在控制老年高血压患者血压及并发症中的效果观察

目的探讨个体化护理在控制老年高血压患者并发症和血压中的应用效果。方法选取我院2016年1月至2018年1月收治的180例老年高血压患者,随机分为观察组(91例)和对照组(89例)。对照组行常规护理,观察组在对照组基础上给予个体化护理。观察两组患者护理前后的收缩压、舒张压以及并发症发生率。结果护理前,两组的收缩压、舒张压比较差异均无统计学意义(P>0.05)。护理后,观察组的收缩压为(121.35±4.18) mm Hg,明显低于对照组的(141.36±5.98) mm Hg,差异有统计学意义(P <0.05);观察组的舒张压为(89.41±3.27) mm Hg,明显低于对照组的(110.18±5.68) mm Hg,差异有统计学意义(P <0.05)。护理后,观察组的并发症发生率为3.30%,明显低于对照组的14.61%(P <0.05)。结论对老年高血压患者采用个体化护理,效果明显,能够帮助其合理控制血压,减少并发症发生,值得应用推广。     

非洛地平缓释片治疗社区高血压临床观察

目的探讨非洛地平缓释片治疗社区高血压临床效果。方法选取2015年1月—2016年1月受诊的45例高血压患者作为研究对象,随机分为观察组23例和对照组22例,观察组口服非洛地平缓释片,对照组服用硝苯地平缓释片,两组疗程同为6个月,比较两组血压变化状况、治疗依从性,对数据进行统计分析,P0.05为差异有统计学意义。结果观察组总有效率高于对照组,两组比较差异有统计学意义(χ~2=4.625,P0.05);观察组治疗依从性为80.65%,对照组为64.87%,两组比较差异有统计学意义(χ~2=3.146,P0.05);观察组收缩压(122±11)mm Hg,舒张压(81±10)mm Hg,对照组收缩压(139±8)mm Hg,舒张压(92±11)mm Hg,两组比较差异均有统计学意义(t=5.994、3.549,均P0.05)。结论非洛地平缓释片在治疗社区高血压患者中更具优势。     

缬沙坦联合氨氯地平治疗社区老年原发高血压合并糖尿病疗效观察

目的观察缬沙坦联合氨氯地平治疗社区老年原发高血压合并糖尿病疗效。方法选择2016年4月—2017年1月期间在我院接受治疗的社区老年原发高血压合并糖尿病患者56例作为研究对象,随机划入观察组和对照组,其中观察组28例,对照组28例,分别接受缬沙坦联合氨氯地平治疗和氨氯地平单用治疗,比较两组患者的血糖和血压水平。结果观察组患者空腹血糖(5.2±0.6)mmol/L,餐后2 h血糖水平(8.2±0.9)mmol/L,收缩压(117.3±5.2)mm Hg,舒张压(86.5±5.9)mm Hg;对照组患者空腹血糖(7.3±0.8)mmol/L,餐后2 h血糖水平(10.8±0.7)mmol/L,收缩压(138.4±5.6)mm Hg,舒张压(97.3±6.3)mm Hg;组间差异有统计学意义(P0.05)。结论缬沙坦联合氨氯地平治疗社区老年原发高血压合并糖尿病疗效优于氨氯地平单用,值得临床应用与推广。     

山东农村中老年高血压患者健康干预效果评价

目的评价山东省农村中老年高血压患者健康干预效果,为制定高血压预防策略提供参考依据。方法随机抽取2009年10月山东大学研究基地(平阴县、梁山县和莒南县)健康体检时检出的8个村548例和4个村285例55~75岁中老年高血压患者分别作为干预组和对照组,于2013年7月—2014年7月对干预村村医进行5次培训,提升村医高血压药物治疗水平及健康宣教技能。按照国家基本公共卫生服务要求,村医对干预组与对照组患者进行4次随访,比较2组高血压患者干预前后血压的变化情况。结果与干预前比较,干预后2组高血压患者收缩压和舒张压均低于干预前(均P0.05),干预组患者收缩压和舒张压分别下降(11.79±21.85)和(7.24±11.40)mm Hg,均高于对照组的(10.72±25.39)和(6.44±12.36)mm Hg(均P0.05);干预后干预组男性高血压患者收缩压和舒张压分别下降(13.06±22.88)和(8.64±11.70)mm Hg,均高于女性的(10.66±20.85)和(5.99±10.99)mm Hg(均P0.05);干预后对照组男性高血压患者收缩压和舒张压分别下降(9.61±24.78)和(6.16±13.32)mm Hg,均低于女性的(11.81±26.00)和(6.71±11.37)mm Hg(均P0.05);干预后干预组和对照组≤65岁高血压患者的收缩压分别下降(10.84±19.58)和(8.70±23.39)mm Hg,均低于65岁的(12.49±23.78)和(12.03±26.92)mm Hg,舒张压分别下降(7.10±11.11)和(5.84±12.85)mm Hg,均低于65岁的(7.41±11.56)和(6.88±12.13)mm Hg(均P0.05)。结论以加强村医抗高血压药物治疗水平及健康宣教技能为主的健康干预可有效降低山东省农村中老年高血压患者的收缩压和舒张压。     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.