2006至2007年青海省支气管哮喘患病率调查

目的 调查2006至2007年青海省人群支气管哮喘(简称哮喘)的患病率.方法 根据青海省地理位置和海拔高度,以随机、分层、整群抽样方法,对青海省4个自治州、西宁市和海东行署内居住在海拔1920～4500 m的49个测试点27 851人进行了入户问卷调查,内容包括呼吸系统症状、个人史、过敏史和家族史,并进行体检,行胸部X线及肺功能检查(通气功能及支气管舒张试验),按照中华医学会呼吸病学分会哮喘学组制定的哮喘防治指南中的诊断标准确诊哮喘.结果 全省总人口患病率为0.38%(105/27 851).青海哮喘人群分布特点:女性为0.45%(61/13 433),男性为0.31%(44/14 418),女性高于男性(x2=4.11,P=0.04);儿童为0.85%(30/3510),成人为0.31%(75/24 341),儿童高于成人(x2=24.40,P＜0.01);农民为0.61%(46/7524),干部为0.23%(12/5252),半农半牧民为0.22%(4/1792),居民为0.20%(12/5865),工人为0.06%(1/1808),牧民为0%(0/2100),农民高于其他职业(x2=36.30,P＜0.01).不同地区和地理环境分布特点为:海拔1920～3000 m居住人群的患病率为0.45%(91/20 314),海拔3001～3500 m居住人群的患病率为0.29%(13/4462),海拔＞3500 m居住人群的患病率为0.03%(1/3075),低海拔地区的患病率高于高海拔地区(x2=12.98,P＜0.01);农村的患病率为0.64%(65/10 119),城市为0.27%(37/13 933),半农半牧区为0.15%(2/1310),牧区为0.04%(1/2489),农村最高、牧区最低(x2=32.85,P＜0.01).结论 青海地区哮喘患病率低于全国平均水平,高海拔地区患病率低于低海拔地区,牧民患病率低于其他职业人群.

Abstract：

Objective To study the prevalence of asthma in Qinghai Province between 2006 to 2007. Methods According to the geographical location and the altitude ( 1920 - 4500 m), stratifiedcluster-random sampling was use for this study. A total of 27 851 individuals were investigated by household survey at 49 locations in 4 autonomous prefectures, Xining Municipal City and Haidong Administrative District. The questionnaire included respiratory symptoms, personal history, allergic history, and family medical history. Chest X-ray and pulmonary function tests (ventilation function and bronchodilatation test) were performed. Diagnosis of bronchial asthma was made according to the criteria in the Guidelines for Asthma Management by Chinese Respiratory Society. Results The overall prevalence of asthma was 0. 38% ( 105/27 851 ). The prevalence of asthma in females was [0. 45% (61/13 433 ) ], which was higher than that in males [0. 31% (44/14 418) ]. The prevalence of asthma in children [0. 85% (30/3510) ] was higher than that in adults [0. 31% (75/24 341 )]. The prevalence of asthma in different occupational populations was as follows: farmers [0. 61% (46/7524)], government officials and employees [0. 23% (12/5252) ], half farmers and half herdsmen [0. 22% (4/1792) ], inhabitants [0. 20% ( 12/5865 ) ],factory workers [0. 06% (1/1808) ] and herdsmen [0% (0/2100) ]. The prevalence of asthma in farmers was higher than those in other occupations. The prevalence of asthma was also different in geographical Iocations and altitudes, 0. 45% (91/20 314) in population living at 1920 -3000 m above sea level, 0. 29%(13/4462) at 3001 -3500 m above sea level and 0. 03% at greater than 3500 m above sea level. The prevalence of asthma in rural, urban, half farming and half herding areas and the pastoral areas was 0. 64%(65/10 119), 0. 27% (37/13 933), 0. 15% (2/1310) and 0. 04% (1/2489) respectively; the highest in rural areas and the lowest in the pastoral areas. Conclusions The overall prevalence of asthma in Qinghai Province was lower than that in the nation as a whole. The prevalence of asthma in higher altitudes was lower than that in the lower altitudes, and was lower in herdsmen as compared to other occupational populations.     

卒中后抑郁与中医体质的相关因素分析

目的 研究卒中后抑郁(PSD)与中风病患者中医体质的相关性.方法 对353例卒中患者进行一般资料、中医体质、CCMD-3中国精神障碍分类与诊断标准等评分.把患者分为卒中后抑郁组与非卒中后抑郁组.对卒中后抑郁与中医体质进行Logistic回归分析.结果 PSD患者中,经非条件Logistic回归分析排除血瘀质、湿热质、痰湿质、阴虚质因素,气郁质,气虚质,阳虚质与PSD的发生有相关性.结论 中风病患者中气郁体质、气虚体质、阳虚体质更易伴发PSD的发生.     

腹针配合拔罐治疗过敏性鼻炎随机对照研究

目的评价腹针配合拔罐治疗过敏性鼻炎的有效性和安全性,并与氯雷他定治疗相比较。方法采用多中心、随机、对照、双盲的临床试验,将64例患者随机分为两组,每组32例。治疗组采用腹针配合拔罐治疗,每周治疗3次,治疗4周,共12次。对照组口服氯雷他定片,每次10 mg,每日1次,连续服用4周。疗效评价以鼻症状总积分表(total nasal symptom score, TNSS)为主要观察指标,以鼻炎伴随症状总分表(TNNSS)、鼻结膜炎生命质量调查问卷(RQLQ)作为次要观察指标,分别于治疗前、治疗1周、治疗2周、治疗4周进行量表评价。结果腹针配合拔罐治疗过敏性鼻炎与氯雷他定均安全有效,腹针配合拔罐治疗疗效优于氯雷他定治疗。结论腹针配合拔罐是治疗过敏性鼻炎的有效方法。     

卒中后抑郁与中医体质的相关因素分析

目的研究卒中后抑郁（PSD）与中风病患者中医体质的相关性。方法对353例卒中患者进行一般资料、中医体质、CCMD-3中国精神障碍分类与诊断标准等评分。把患者分为卒中后抑郁组与非卒中后抑郁组。对卒中后抑郁与中医体质进行Logistic回归分析。结果 PSD患者中,经非条件Logistic回归分析排除血瘀质、湿热质、痰湿质、阴虚质因素,气郁质,气虚质,阳虚质与PSD的发生有相关性。结论中风病患者中气郁体质、气虚体质、阳虚体质更易伴发PSD的发生。     

胸外科常见护理纠纷原因分析及防范措施

随着社会生活水平的发展，人们的健康观念也发生了改变，从减轻痛苦到追求健康，随之人们对医疗服务的质量要求也越来越高，维权意识越来越强。当医疗服务质量与患者健康追求的期望值存在偏差时，将会导致一些医疗纠纷。胸外科是医疗风险的高危科室，更是医疗纠纷的好发科室。本文就胸外科护理中常见纠纷产生的原因及防范措施进行了探讨，通过采取有效对应措施，避免护理纠纷的发生，提高患者的满意度和信任度。