The medical disability evaluation of patients with pulmonary hypertension and cor pulmonale]

The purpose of the study was to elaborate criteria for the assessment of the severity of pulmonary hypertension and cor pulmonale in patients with chronic bronchitis and to give rationale for expert medical evaluation of the working capacity of such patients. 94 patients (89 males and 5 females) aged 20 to 60 with chronic bronchitis were examined. Basing on the clinical, x-ray, ECG, VCG and echocardiography data, the gravity of cor pulmonale was assessed by the degree of right ventricular hypertrophy (absent, mild, marked, dramatically marked), changes in the right ventricular echo dimensions and the stage of heart failure, and by the lung vital capacity (in percent of the predicted value). The rationale for expert medical evaluation of patients with associated cor pulmonale and chronic bronchitis is described.     

健康俱乐部对原发性高血压患者病情进展的影响

目的探讨开展健康俱乐部对原发性高血压患者病情控制的作用。方法通过新闻媒体宣布成立原发性高血压俱乐部，采用自愿报名原则，对高危人群进行筛选、体检，检出原发性高血压患者152例，高危人群92例，组成健康俱乐部，对所有俱乐部会员实施综合护理干预措施，并对效果进行评价。结果通过每月健康教育及护理干预，高危人群血压控制效果较好。152例原发性高血压患者血压水平从原来的收缩压（158．0．±14．3）mmHg（1mmHg=0．133kPa），舒张压（96．4±8．9）mmHg降至收缩压（129．0±8．2）mmHg，舒张压（78．7±7．2）mmHg，体重、血脂、血糖等均控制良好，原有并发症未发生恶化。原发性高血压患者及高危人群懂得了遵医嘱服药、控制体重、合理的生活方式、保持良好的心理状态的重要性及自我照顾方法。结论凭借健康俱乐部实施综合护理干预措施可预防原发性高血压患者并发症，延缓原发性高血压病情进展。     

健康俱乐部对原发性高血压患者病情进展的影响

目的 探讨开展健康俱乐部对原发性高血压患者病情控制的作用.方法 通过新闻媒体宣布成立原发性高血压俱乐部,采用自愿报名原则,对高危人群进行筛选、体检,检出原发性高血压患者152例,高危人群92例,组成健康俱乐部,对所有俱乐部会员实施综合护理干预措施,并对效果进行评价.结果 通过每月健康教育及护理干预,高危人群血压控制效果较好.152例原发性高血压患者血压水平从原来的收缩压(158.0±14.3)mm Hg(1 mm Hg=0.133 kPa),舒张压(96.4±8.9)mm Hg降至收缩压(129.0±8.2)mm Hg,舒张压(78.7±7.2)mm Hg,体重、血脂、血糖等均控制良好,原有并发症未发生恶化.原发性高血压患者及高危人群懂得了遵医嘱服药、控制体重、合理的生活方式、保持良好的心理状态的重要性及自我照顾方法.结论 凭借健康俱乐部实施综合护理干预措施可预防原发性高血压患者并发症,延缓原发性高血压病情进展.     

乳腺癌术后患者伤残接受度的影响因素研究

目的调查乳腺癌术后患者伤残接受度水平,并探讨社会关系质量、心理一致感对伤残接受度的影响。方法采用一般资料调查表、伤残接受度量表、社会关系质量量表和心理一致感量表对343例乳腺癌术后患者进行问卷调查。结果乳腺癌术后患者伤残接受度得分为(79.56±8.53)分,呈中等接受水平;家庭月收入、医疗保险、社会关系质量各维度、心理一致感的可控制感维度是患者伤残接受度的主要影响因素。结论乳腺癌患者的伤残接受度有待进一步提高,临床护理人员可针对心理一致感和社会关系质量探索有效的干预方式,促进患者的身心健康。     

述情障碍对永久性结肠造口患者残障接受度的影响

目的 :了解永久性结肠造口患者残障接受度和述情障碍现状,探讨述情障碍对患者残障接受度的影响。方法 :采用残障接受度量表和述情障碍量表对222例永久性结肠造口患者进行问卷调查。结果 :残障接受度总分为(180.45±33.25)分,述情障碍总均分为(2.99±0.79)分。识别情感障碍、描述情感障碍、外向型思维及述情障碍总分均与残障接受度各维度及总分呈显著负相关(P0.05)。分层回归分析结果显示,识别情感障碍、描述情感障碍、外向型思维是永久性结肠造口患者残障接受度的影响因素(P0.05)。结论 :永久性结肠造口患者残障接受度处于中等水平,述情障碍为其影响因素,护士可从述情障碍入手对其进行护理干预来改善残障接受度。     

对哈萨克族原发性高血压患者实施社区健康教育的实践

目的：探讨对乌鲁木齐市南山牧区哈萨克族原发性高血压患者实施社区健康教育的方法。方法：采用类实验的单组时间序列设计,随机整群抽取乌鲁木齐市南山牧区252例哈萨克族原发性高血压患者作为研究对象,实施以社区健康教育为主要手段的连续10个月高血压病综合干预。结果：实施干预后,哈萨克族原发性高血压患者的健康调查量表总分及4个维度得分均比干预前明显提高,差异有统计学意义（P〈0.05）。哈萨克族原发性高血压患者的血压控制率由57.54%提高到了71.03%,差异有统计学意义（P〈0.05）。结论：社区健康教育有助于提高高血压患者的自我保健意识,对控制疾病发展、减少和推迟并发症、提高生存质量具有重要意义。     

健康教育对老年高血压病患者血压及高血压病相关危险因素的影响

目的探讨健康教育对老年高血压病（EH）患者血压及高血压相关危险因素的影响。方法360例EH按住院日单、双号编号,再用随机数字表分为健康教育组和非健康教育组,健康教育组药物治疗同时进行系统高血压健康教育,非健康教育组仅单纯药物治疗,观察两组的血压及高血压病相关危险因素情况。结果健康教育组血压及高血压病相关危险因素较非健康教育组明显降低（P〈0．05,P〈0．01）。结论全面系统的EH健康知识教育对老年EH患者的病情控制和提高生活质量具有重要作用。     

住院患者失禁性皮炎患病率和预防现状的调查研究

目的 ：了解住院患者失禁性皮炎的患病率及预防现状,对未来失禁性皮炎的培训及护理提供参考依据。方法 ：采用自行设计的失禁患者调查表,对293例失禁患者进行调查,对患有失禁性皮炎患者的医院分布、科室分布、分期、预防现状进行分析。结果 ：失禁患者中失禁性皮炎的患病率为14.0%,同时5.5%并发压疮、11.3%并发真菌性皮炎,失禁患者的预防措施较落后。结论 ：医院失禁性皮炎相关知识的培训和研究需要加强;建议建立失禁患者预警管理措施,定期调研和监控发生状况;加强护士培训,提高失禁性皮炎防范意识。     

The principles of the organization of individualized treatment for bronchial asthma patients]

The authors relate the principles according to which the individualized treatment of bronchial asthma patients may be organized: the permanent treating physician, active participation of the patient in the process of treatment, flexibility of the individualized complex of treatment measures under constant control of the treatment efficacy. Provide the experience gained with such organization of the treatment of 35 patients with grave bronchial asthma ("schools for bronchial asthma patients").     

The progression of disability among older adults in Mexico

Purpose: This paper seeks to document the progression of disability in a developing country and to examine gender differences in this process.

Methods: The data come from the Mexican Health and Aging Study (MHAS), a nationally representative sample of older adults. An ordinal logistic regression (n?=?3283) is used to measure the progression of disability that considers: (1) no disability, (2) mobility problems, (3) mobility problems with IADLs limitations, (4) mobility problems with ADLs limitations, (5) combinations of the latter three and (6) death.

Results: Approximately 43% of the sample remained in the same level of disability after 2 years. The patterns of progression with two disabilities differ for men and women.

Conclusions: Our model reflects the importance of separating ADLs and IADLs in the study of disability progression in Mexico. Varying risk profiles and cultural differences might influence the divergent disability paths followed by each gender.

• Implications for Rehabilitation

• The disablement process involving transitions from mobility impairments to IADL and ADL limitations seen in developed countries differs for older adults in Mexico.

• Cultural differences may influence the progression from non-disabled to becoming disabled in different ways for females in developing countries like Mexico.

• One-fifth of individuals showed greater function and independence over time, suggesting that the disablement process is reversible. This finding highlights the need to focus on improving mobility, ADL, and IADL skills to facilitate successful aging.

• Although disability is often conceptualised as a combination of ADL and IADL limitations, gender differences seen in Mexico indicate the need to separate ADL and IADL when developing approaches to prevent or ameliorate disability.

     

风险防范在冠状动脉造影术患者并发症预防中的应用

目的探讨风险防范在冠状动脉造影术(CAG)患者并发症预防中的应用效果。方法采用便利抽样法,选取2016年12月—2018年1月在北京同仁医院接受CAG的患者为研究对象。采用随机数字表将其分为对照组(n=50)和观察组(n=50)。对照组采用常规护理,观察组实施风险防范护理,比较两组患者并发症发生情况。结果观察组患者并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论风险防范护理可以有效降低CAG患者的并发症,值得推广应用。     

层流床在化疗病人预防感染中的作用

把化疗后病人分成二组，一组住层流床，一组住普通床，其它的保护性隔离措施相同。然后密切监测病人的体温，观察患者出现感染的症状、体征，及时采血、尿等标本送检，研究层流床在预防感染中的作用。结果：住层流床的病人发生感染率是２２．７％，住普通床的病人发生感染率是８６．４％。结论：住层流床病人感染率比住普通床的病人低。     

Pattern of disability among patients attending Taif Rehabilitation Center, Saudi Arabia

Purpose. Despite the growing awareness of the community about the economic, psychological and medical impact of disability, limited research has been carried out to determine the pattern of disabilities in Saudi Arabia.

Methods. This is a cross-sectional study of hospital records of patients who were admitted to Armed Forces Rehabilitation Center, Taif, Saudi Arabia, during the period from 1999 - 2005. A total of 850 patient records were reviewed. Data were collected on age, sex, nationality, data of admission and discharge and type of disability. Univariate and multivariate logistic regression analyses were performed to determine predictors of long stay at the hospital.

Results. Trauma as an etiology of disability was more common than non-traumatic incidents among male and middle age patients (16 - 45 years). Traumatic accidents mostly result in quadriplegia (72.8%). Male, single, less than 45 years old, patients with traumatic accidents and patients with paralytic types of disability were significantly more likely to stay longer at the hospital (≥6 months).

Conclusions. The home care program should be expanded to minimize duration of stay at the rehabilitation centers with lower cost as well as health education of the public would help in encouraging disabled patients to adapt to daily life activities.     

烧伤患者社交回避及苦恼与伤残接受度的相关性研究

目的 探讨烧伤患者社交回避及苦恼情况与伤残接受度水平的相关性.方法 运用自设一般情况调查表、社交回避及苦恼量表(SADS)、伤残接受度量表(AODS)对127例烧伤康复期患者进行问卷调查.结果 烧伤患者社交回避及苦恼量表得分为(21.38±6.75)分,患者的性别、婚姻状况、有无特殊部位烧伤、有无截肢对社交回避及苦恼影响显著,有统计学意义;相关分析显示,社交回避及苦恼总分及各维度与伤残接受度总分及各维度均呈负相关;回归分析显示,患者的伤残接受情况、有无头面颈部烧伤、性别对社交回避及苦恼有影响.结论 烧伤患者社交回避及苦恼程度与伤残接受度密切相关,护士应帮助患者尽早完成自我重建,建立主动参与社会交往的信心,提高社会适应性.     

老年高血压患者疾病防治知识和自我护理能力的相关性研究

目的 了解老年高血压患者疾病防治知识和自我护理能力,探讨两者之间的相关性.方法 以便利抽样的方法,采用高血压疾病防治知识量表和自我护理能力量袁,调查我院206例老年高血压患者.结果 本组患者疾病防治知识得分为(21.08±7.09)分;自我护理能力得分为(106.37±19.74)分.疾病防治知识和自我护理能力呈正相关(r=0.316,P＜0.001).结论 在制定护理措施时,应该重视高血压防治知识的宣教,提高患者自我护理技能、自护责任感、自我概念和健康知识水平,从而促进患者的自我护理能力.     

Pattern of disability among patients attending Taif rehabilitation center,Saudi Arabia

Purpose. Despite the growing awareness of the community about the economic, psychological and medical impact of disability, limited research has been carried out to determine the pattern of disabilities in Saudi Arabia.

Methods. This is a cross-sectional study of hospital records of patients who were admitted to Armed Forces Rehabilitation Center, Taif, Saudi Arabia, during the period from 1999 – 2005. A total of 850 patient records were reviewed. Data were collected on age, sex, nationality, data of admission and discharge and type of disability. Univariate and multivariate logistic regression analyses were performed to determine predictors of long stay at the hospital.

Results. Trauma as an etiology of disability was more common than non-traumatic incidents among male and middle age patients (16 – 45 years). Traumatic accidents mostly result in quadriplegia (72.8%). Male, single, less than 45 years old, patients with traumatic accidents and patients with paralytic types of disability were significantly more likely to stay longer at the hospital (≥6 months).

Conclusions. The home care program should be expanded to minimize duration of stay at the rehabilitation centers with lower cost as well as health education of the public would help in encouraging disabled patients to adapt to daily life activities.     

The morphofunctional parallels in arterial hypertension in patients with chronic glomerulonephritis]

The restructure of renal tissue in intravital nephric biopsy specimens, renin-angiotensin-aldosterone together with kallikrein synthetic functions were studied and compared in patients with mesangioproliferative and membranoproliferative glomerulonephritis (MsPGN and MPGN). The characteristics of the morphological changes were defined. In MsPGN with secondary hypertension (SH), nephronic wasting and hyalinosis of arteries were mostly detectable whereas MPGN with SH was primarily marked by the derangement of the tubulointerstitial structures. In MPGN, the levels of total and inactive renin (TR and IR) were significantly higher than in MsPGN. This can be regarded as risk factor of early development of SH. The content of TR and IR and in addition that of active renin (AR) in MRGN did not depend on the clinical form of chronic glomerulonephritis. As compared to MsPGN with an isolated urinary syndrome, in MsPGN with SH, AR was prevalent, while its level correlated well with systolic and the mean arterial pressure. AR may be implicated in the mechanism of SH in MsPGN. In MPGN with SH, kallikreinuria was found to be extremely low, which may be consequent to tubulointerstitial injuries. The discoordination of the renin-angiotensin and kallikrein system may be one of the causes of earlier formation and the grave course of SH in the morphological pattern under consideration.