儿童糖尿病患者治疗依从性调查分析及干预对策

目的:分析影响儿童糖尿病患者治疗依从性的原因,探讨其干预对策。方法:选取32例儿童糖尿病患者进行调查、分析其影响治疗依从性的原因,将其随机分为两组各16例,对照组采用常规护理,观察组针对问题采取相关干预措施,比较干预后的效果。结果:影响儿童糖尿病患者治疗依从性的主要原因有:儿童心理行为、对疾病和药物的了解、家长的配合力度、社会的支持力度、对治疗的信心。通过采取干预措施后,观察组的治疗依从性明显高于对照组,差异有统计学意义(P<0.05)。结论:影响儿童糖尿病患者治疗依从性的因素比较多,在治疗过程中应采取积极的干预措施,以提高治疗效果。     

健康教育对社区绝经期妇女骨质疏松症知信行的影响

目的:探讨健康教育对社区绝经期妇女骨质疏松症知信行的影响.方法:选取218例围绝经期的妇女,随机分为对照组及观察组:观察组108例,进行健康教育干预,干预一年后通过调查问卷分析干预效果;对照组110例,不采取干预措施.结果:两组研究对象干预前在骨质疏松知识,健康信念及预防保健差异不具统计学意义(t =1.87,t=0.24 ,t=1.56;P均>0.05).干预后与对照组相比,观察组骨质疏松知识,健康信念及预防保健的分值更高且差异具有统计学意义(t =8.46,t=6.02 ,t=22.79;P均<0.01).结论:健康教育可纠正社区围绝经期妇女对骨质疏松的错误认知,树立健康理念,改善预防保健行为,可预防骨质疏松症的发生.     

围绝经期妇女的心血管疾病管理方法与评价

目的:探讨激素替代疗法和参龙宁心胶囊联合综合护理干预措施对围绝经期妇女心血管疾病管理的效果及其临床应用价值。方法:将80例伴有心血管疾病的围绝经期妇女随机分为对照组和干预组各40例,对照组进行小剂量激素替代治疗,干预组在对照组的基础上采取参龙宁心胶囊联合综合护理的干预措施。检测治疗前后两组患者的生化指标,并观察其不良反应。结果:两组患者治疗后,血脂指标TG、TC、LDL-C和Lp(a)较治疗前均明显下降,APOA1和HDL-C较治疗前明显升高,差异均有统计学意义(P<0.05)。干预组与对照组相比,各项指标的变化更为显著,两组差异有统计学意义(P<0.05)。结论:激素替代疗法和参龙宁心胶囊联合综合护理干预措施能够明显改善围绝经期妇女的血脂水平,预防血脂紊乱,发挥保护心血管系统的作用,值得在临床推广应用。     

人性化护理在糖尿病患者中的应用效果

目的:研究人性化护理在糖尿病患者中的应用效果。方法:选取我院2014年5月至2017年5月期间入院治疗的糖尿病患者104例,将其按照不同护理方式进行分组后,对照组48例,采取常规护理干预措施,观察组56例,采取人性化护理干预措施,对比两组患者在相同治疗措施下,其临床症状缓解情况,并对两组患者的临床满意度进行对比分析。结果:对照组患者血糖恢复率低于观察组患者血糖恢复率,对照组患者服药期间依从性低于观察组患者,对照组患者的临床满意度低于观察组患者,经比较,P均0.05,表明具有显著差异。结论:在针对糖尿病患者的临床治疗中,采取人性化护理干预措施,相比较传统护理干预措施,能够更好提高患者的服药依从性,并提高患者血糖控制率,同时也可以更好提高患者的护理满意度,在临床中值得进行进一步推广。     

研究社区护理干预对老年妇女骨质疏松症的影响

目的探析社区护理干预对老年妇女骨质疏松症的效果。方法选择2015年2月-2016年2月期间深圳市宝安区人民医院集团第二人民医院园美社康中心收治的108例老年妇女骨质疏松症患者为研究对象,按照随机数字表法将其分为观察组和对照组各54例,其中对照组给予常规护理干预,观察组在对照组护理的基础上,再行社区干预,对比分析两组护理干预后骨密度、治疗总有效率、并发症发生率。结果两组骨密度干预前比较差异无统计学意义(P0.05);干预后,观察组的骨密度值明显比对照组增加,差异有统计学意义(P0.05)。观察组治疗总有效率为96.30%,高于对照组的77.78%,差异有统计学意义(P0.05)。结论临床上给予老年妇女骨质疏松症患者社区护理干预,能够使并发症减少,骨密度增加,提高治疗效果。     

急性脑梗死患者氧疗依从性差的原因分析及干预措施

目的探讨急性脑梗死患者氧疗依从性差的原因,并针对其原因采取相应干预措施。方法将200例急性脑梗死患者随机分为实验组和对照组,对照组患者接受常规方法氧疗,实验组病人接受采取干预措施后氧疗方法。比较两组患者依从性效果。结果实验组依从性差0级患者增至75例;依从性差2级,自行间断吸氧患者减为0例。明显优于对照组(P﹤0.01)。结论对急性脑梗死氧疗患者采取一系列增进舒适措施,有利于提高氧疗患者依从性,积极配合治疗。     

PDCA循环用于癌痛患者规范化治疗的护理干预效果观察

目的探讨PDCA循环对于癌痛患者规范化治疗的护理干预的效果。方法将60例伴有疼痛的癌症患者按随机数字表法分为观察组和对照组。两组均按照癌痛示范病房要求采取相应的护理干预措施,观察组在此基础上采用PDCA循环模式对影响有效控制疼痛的原因实施护理干预。干预2周后分别对两组规范化治疗的依从性、疼痛控制效果进行评价。结果观察组对规范化治疗的依从性明显高于对照组,差异有统计学意义(P0.05),观察组的NRS评分明显低于对照组,差异有统计学意义(P0.05)。结论对癌痛患者实行PDCA循环护理干预,可明显提高其治疗依从性,保证癌痛规范化治疗的顺利进行,降低癌症患者NRS疼痛评分,提高其治疗效果。     

中医综合疗法治疗绝经期妇女骨质疏松症56例疗效观察

目的绝经期妇女骨质疏松症的治疗疗效。方法将56例病人随分为治疗组与对照组分别于治疗后对两组病人进行比较。结果治疗组疗效明确(p<0.05)。结论绝经期妇女骨质疏松症的治疗采用综合治疗效果好。     

护理干预对绝经期后冠心病患者服药依从性的影响

[目的]探讨综合护理干预对绝经期后冠心病患者服药治疗依从性的影响.[方法]选择2008年5月～2009年8月入住我院心血管内科的绝经期后冠心病患者240例,随机将患者分为干预组和对照组各120例.对照组给予常规的专科护理以及一般的健康教育,而干预组在常规护理措施和一般的健康教育外,给予了综合性的护理干预.采用问卷调查法,比较两组患者服药依从性以及疾病复发率的差异.[结果]两组在服药依从性以及疾病复发率比较,差异有统计学意义(P<0.05).[结论]综合性护理干预可提高患者的健康知识水平,改善认知态度及不良行为,提高了患者服药治疗的依从性,有效控制了疾病的复发率,提高了患者的生活质量水平.     

膝关节镜手术的护理配合及效果评价

目的:评价护理配合膝关节镜手术的效果.方法:将本院在2015年1月～2017年6月所收治的膝关节镜手术62例患者随机分成对照组(31例)、观察组(31例).采取常规护理措施护理对照组患者,而采取综合护理的措施干预观察组,对比与观察其临床疗效.结果:观察组的生活质量评分(疼痛评分、情感评分、躯体活动评分)均低于对照组,而依从性评分却高于对照组,差异显著(P<0.05).结论:综合护理干预膝关节镜手术临床患者,获取了较好的效果,大大提升了患者的治疗和康复训练的依从性,并显著改善了其生活质量.     

Awareness of risk of osteoporosis may cause uncertainty and worry in menopausal women

AIMS: A study was undertaken to explore how menopausal women are affected by awareness of potential risk of osteoporosis. METHODS: A qualitative interview study, including analysis of in-depth interviews with 17 women who independently gave views on risk, out of 24 women interviewed about their menopausal symptoms. The women were selected on the basis of a survey including 1261 women chosen at random, to cover a broad spectrum of Danish women, their menopausal experiences, and contact with the healthcare system. The study was part of a larger project targeting menopause. RESULTS: Awareness of osteoporosis risk caused a feeling of uncertainty and worry in some women. Only women reacting in this way seemed to act in order to prevent future fractures. The affected women were puzzled to realize that risk-reducing medication could introduce new hazards. Most of the women had heard about osteoporosis related to menopause as culturally embedded knowledge. CONCLUSIONS: Making individual women uncertain and worried must be considered a potentially serious side effect of health promotion. The findings raise the question of whether introducing healthy people to the threat of future diseases is ethically justifiable. As hormonal treatment is no longer recommended for long-term use, it is suggested that the strong link between osteoporosis and menopause should be toned down when counselling menopausal women.     

148例围绝经期妇女双能X线骨密度结果分析

目的:探讨围绝经期妇女年龄、月经情况、身高、体重与骨密度(BMD)的关系,筛选绝经后骨质疏松症的高危人群。方法:随机选取148例2004年9～11月青岛市部分金融系统女职员健康查体中的围绝经期(40～60岁)妇女,加查双能X线BMD(已筛除影响骨代谢性疾病如糖尿病、甲亢等及药物因素,如性激素补充),将BMD测定结果与其年龄、月经情况、体重、身高进行相关分析。结果:148例围绝经期妇女平均腰椎低骨量发生率为26.35%。50～60岁妇女腰椎低骨量发生率为48.44%,明显高于40～50岁妇女(9.52%);绝经者腰椎低骨量发生率为61.70%,明显高于未绝经者(9.90%);体重低于60kg者腰椎低骨量发生率为36.92%,高于体重在60kg以上者(18.07%);身高在160cm以下者腰椎低骨量发生率为44.12%,高于身高在160cm以上者(21.05%),其差异均有统计学意义;年龄、绝经与否、身高、体重与左髋部BMDt值无相关性。结论:围绝经期妇女腰椎低骨量发生率与绝经、年龄及其身高体重有关,绝经、年龄50岁以上、体重60kg以下、身高160cm以下的妇女是发生绝经后骨质疏松症的高危人群。     

Benefits and risks of menopausal estrogen and/or progestin hormone use

Current evidence is reviewed here on risks and benefits of estrogen and progestin use by peri- and postmenopausal women in relation to the following conditions: endometrial cancer, breast cancer, osteoporosis, and coronary artery disease (CAD). On balance, estrogen therapy appears to be beneficial for menopausal women, as it probably reduces the risks of CAD and osteoporosis, two of the major causes of mortality and morbidity. Although unopposed estrogen therapy increases the risk of endometrial cancer, that cancer is relatively rare and is not fatal in the vast majority of cases associated with estrogen use. Definitive conclusions about the relation of menopausal estrogens to breast cancer cannot be drawn due to inconsistent evidence to date. Although evidence from randomized controlled trials is lacking, biochemical and clinical evidence suggest that progestin supplementation is associated with a reduction in endometrial cancer risk in women taking menopausal estrogens. Progestin supplementation also may augment the beneficial effects of estrogens in providing protection against osteoporosis, although this effect is not yet well established. There is little direct evidence bearing on the relation of menopausal progestins to breast cancer. Although studies of CAD per se are lacking at present, progestins probably unfavorably alter lipoprotein profiles, thereby increasing a user's risk of CAD. Given the relatively high incidence and mortality of CAD in postmenopausal women, any negative effects on CAD risk could potentially counterbalance beneficial effects on other causes. We conclude that estrogen replacement therapy is of potential benefit to postmenopausal women, but that the question of progestin supplementation requires further study, particularly for CAD risk.     

Tratamiento de la osteoporosis con bifosfonatos: aproximaciones a nuestra realidad asistencial

ObjectiveOsteoporosis predominantly affects menopausal women and has a significant morbidity expressed as fractures. The study aimed to describe the types of bisphosphonates used to treat osteoporosis in post-menopausal women and to establish how treatment non-compliance affects the fracture rate.DesignRetrospective cohort study of women on active treatment with bisphosphonates for the past five years.LocationUtebo Health Centre (Zaragoza) (16,000 inhabitants) with a general medical quota of 1,890 patients).ParticipantsA total of 129 women who were on active treatment with bisphosphonates for five years were included.Main measuresThe distribution by drug was analysed, as well as the percentage of women who did not comply with the treatment correctly and any identified fractures.ResultsA total of 129 women on treatment were identified (13.0% of all women patients): alendronic acid (45.7%), ibandronic acid (21.7%), risedronic acid (19.4%) and alendronic acid plus cholecalciferol (13,2%). 19.4% of women stopped their treatment after at least 3 months. Thirteen hip fractures were identified.ConclusionsThe overall treatment compliance was 80.6%, Depending on the type of bisphosphonate: alendronic acid plus cholecalciferol (88.2%), risedronic acid (88.0%), alendronic acid (78.0%), ibandronic acid (75.0%). The incidence of hip fractures was similar incidence to that observed with respect to non-compliance to treatent. Lack of therapeutic compliance is common in menopausal women, and measures should be promoted to increase effectiveness as well as to make patients aware of the importance of continuing treatment.     

农村绝经后妇女骨密度影响因素分析

目的：了解绝经后妇女骨密度的影响因素,以便及时采取措施预防骨质疏松。方法：对224名农村已绝经妇女用SD－1000型单光子骨矿物仪测量由松质骨组成的前壁远端桡骨骨密度值,同时进行相关的问卷调查,对所获得的资料进行相关分析、t检验、方差分析及多元逐步回归分析。结果：年龄、绝经年限,体重低是引起骨密度（BMD）降低的3个重要因素,多食水产品、少食脂肪含量高的有肥肉可提高BMD的值。结论：绝经后高龄低体重的妇女是骨质疏松的高危人群,建议对绝经后妇女使用雌激素治疗将有助于预防骨质疏松。     

Why do women doctors in the UK take hormone replacement therapy?

STUDY OBJECTIVES: To ascertain the determinants and experiences of hormone replacement therapy (HRT) use by menopausal women doctors. DESIGN: Postal questionnaire. SETTING: UK. PATIENTS: A randomized stratified sample of women doctors who obtained full registration between 1952 and 1976, taken from the current Principal List of the UK Medical Register. MAIN OUTCOME MEASURES: Current and previous use of HRT; reasons for and against HRT use; menopausal status; hormonal contraceptive use; lifestyle patterns; family and personal history of disease. MAIN RESULTS: While 73.2% of 471 users had started HRT for symptom relief, 60.9% cited prevention of osteoporosis and 32.7 prevention of cardiovascular disease. Altogether 18.7% had started for preventive purposes alone. Significant predisposing factors to starting HRT were the presence and severity of menopausal symptoms, surgical menopause, past use of hormonal contraception, and a family history of osteoporosis. HRT users were also more likely to use skimmed rather than full fat milk, to try to increase their intake of fruit, vegetables, and fibre, and to undertake vigorous physical activity at least once a week. They were less likely to have had breast cancer. Long duration users were more likely than short duration users to be past users of hormonal contraception and to be using HRT for prevention of osteoporosis as well as symptom relief; they were less likely to have experienced side effects. CONCLUSIONS: The high usage of HRT by women doctors reflects the fact that many started HRT on their own initiative and with long term prevention in mind. The results may become generalisable to the wider population as information on the potential benefits of HRT is disseminated and understood. However, HRT users may differ slightly from non-users in health-related behaviour and a substantial minority may never take up HRT, at least until the benefit-risk ratio is more clearly established.     

嘉峪关市绝经前后妇女骨质疏松影响因素研究

目的了解嘉峪关市绝经前后妇女骨质疏松症发生的可能影响因素,为有效预防妇女骨质疏松、增进其骨健康水平提供依据。方法对189名≥45岁的绝经前后妇女采用问卷调查,并通过骨密度(BMD)测定、X线摄片、骨代谢指标、激素水平测定及数量不平衡传递试验方法(QTDT)进行横断面研究。结果对象的年龄、教育程度、经济收入、饮食习惯等与骨质疏松的发生有关。在相关基因领域中等位基因(TA)21与BMD显著相关,雌激素受体α基因与BMD无显著相关。低密度受体相关蛋白5(LRP5)多态性位点显示,ERB基因位点1730G/A多态性与股BMD显著相关,ERB的CA的重复多态性与股骨颈BMD相关。等位基因G显示与股BMD负相关。结论本地区绝经前后妇女对骨质疏松症相关知识及危害性认知水平偏低,骨健康状况及相关影响因素应引起足够的重视并对其风险进行干预。     

朝鲜族更年期妇女焦虑、抑郁状况及影响因素

目的:了解社区朝鲜族更年期妇女焦虑、抑郁状况及影响因素。方法:采用自编量表、焦虑自评量表、流调中心用抑郁量表按整群抽样法对延吉市北山街道8个居委会的304例朝鲜族更年期妇女进行调查。结果:肯定有抑郁症状者32例(10.53%);有焦虑症状者114例(37.50%),经Logistic回归分析,受婚姻、收入、就业、性格影响。结论:朝鲜族更年期妇女有一定比例的抑郁和焦虑症状,应加强这类人群的社区精神卫生服务。     

The prevalence of osteoporosis risk factors and physician intervention

To determine the prevalence of osteoporosis risk factors and the probability of physician risk recognition and intervention, the medical records of a cohort of 243 women aged 40 to 65 years were reviewed retrospectively. A historical cohort design was used. Risk factors present before the start of the study were identified. Osteoporosis risk recognition (discussion, problem list), osteoporosis specific intervention (counseling about risk, or estrogen or calcium supplementation), or nonspecific intervention (dietary, exercise, smoking, or alcohol counseling) were recorded over a 3-year follow-up period. Seventy-four percent of the women had two or more risk factors. The most common were perimenopausal or postmenopausal status (73%) and absence of estrogen supplementation (ever) (65%). During the period of the study, 46 women (19%) had received an osteoporosis-specific intervention. One hundred eleven women (46%) had received one of the above or a less specific intervention. The medical records of only 25 women (10%) documented an assessment of osteoporosis risk. Only menopausal status predicted osteoporosis intervention, and the probability of intervention decreased as the total number of risk factors increased. The data identify three groups of women who could benefit from increased risk-reduction strategies: premenopausal women, perimenopausal or postmenopausal women who have never previously taken supplemental estrogens, and women with multiple risk factors.     

绝经前合理应用维生素D和钙剂与绝经后妇女骨密度的关系

目的:调查绝经前后妇女的体成分与绝经年龄、身高及应用维生素D和钙剂后骨密度的关系。方法:采用1∶1配对设计方法,将196例妇女分为绝经期前未用维生素D和钙剂者和用维生素D和钙剂者两组,采用米尺和磅秤测量两组妇女的身高和体重,采用双能X线骨密度仪检测两组妇女的骨质疏松值,采用超声骨密度仪检测两组妇女的左侧跟骨的超声速度、骨硬度指数和低骨量。观察两族妇女体内骨密度指标。结果:绝经前后不同年龄组妇女体质指数、超声速度、骨硬度指数、低骨量及骨质疏松值比较差异有统计学意义(P<0.05)。应用维生素D和钙剂的妇女骨密度较未应用维生素D和钙剂的妇女同年龄组相比,骨质疏松值有所下降。结论:绝经前后妇女合理应用维生素D和钙剂安全、有效,可早期预防骨质疏松,值得推荐,特别适用于绝经后妇女。