综合疗法对头面部瘢痕的治疗分析

目的:探究综合疗法对头面部瘢痕的治疗效果。方法:选取在我院进行治疗的头面部瘢痕的患者48例,采取手术切除、术中切缘注射糖皮质激素、术后加压、局灶放疗等综合治疗,经过术后随访,观者患者的恢复情况。结果:经过术后的随访,患者术后效果比较好,治愈35例,占72.92%,显效11例,占22.92%,总有效率为95.83%,仅有2例无效,占4.17%,无患者治疗后随访中复发,患者对于治疗比较满意。结论:对于头面部瘢痕的患者来说,采取手术切除、术中切缘注射糖皮质激素、术后加压、局灶放疗等综合治疗,能够取得良好的临床效果,而且患者术后复发率比较低,情况比较满意,值得在临床推广。     

预构皮瓣的研究与应用进展

Prefabricated flap is so named as the skin flap is prepared by prefabricating a circulation-rich skin flap by implanting a named blood vessel or a portion of fascia which is incorporated with rich bloo...     

管床护士与护工捆绑管理的老年护理服务模式探索

目的通过管床护士与护工捆绑管理在老年护理服务中的实践,探索老年慢性病护理服务模式改革新路。方法建立管床护士护工捆绑护理管理领导小组,制定护士与护工工作职责,组织护工进行培训,由管床护士与护工分组定位管理患者,强化“以患者为中心”的整体责任制护理,为患者提供满意服务。结果实施捆绑管理后,患者及家属对护工工作态度、病房舒适整洁、病区生活服务质量的评价显著提高,与实施前比较,差异有统计学意义（均P〈0．01）。结论管床护士护工捆绑管理,调动了管床护士的积极性,由管床护士直接指导护工覆盖面宽、效果好,能够为住院患者提供全程、全面、专业、人性化的护理服务,促进优质护理服务健康、持续发展。     

Self-reported difficulty in climbing up or down stairs in nondisabled elderly

Verghese J, Wang C, Xue X, Holtzer R. Self-reported difficulty in climbing up or down stairs in nondisabled elderly.

Objective

To examine clinical and functional correlates of self-reported difficulty in climbing up or climbing down stairs in older adults.

Design

Cross-sectional survey.

Setting

Community sample.

Participants

Older adults (N=310; mean age, 79.7y; 62% women), without disability or dementia.

Interventions

Not applicable.

Main Outcome Measures

Clinical and functional status as well as activity limitations (able to perform activities of daily living [ADLs] with some difficulty).

Results

Of the 310 subjects, 140 reported difficulties in climbing up and 83 in climbing down stairs (59 both). Self-reported difficulty in climbing up stairs was associated with hypertension, arthritis, and depressive symptoms. Difficulty in climbing up stairs was also associated with poor balance and grip strength as well as neurologic gait abnormalities. Subjects with difficulty climbing down stairs had more falls. Both activities were associated with leg claudication, fear of falling, non-neurologic gait abnormalities, and slow gait. Examined individually, self-reported difficulty climbing down stairs captured a wider spectrum of ADL limitations than climbing up stairs. However, combined difficulty in both phases of stair climbing had a stronger association with activity limitations (vs no difficulty; odds ratio, 6.58; 95% confidence interval, 3.35−12.91) than difficulty in any one phase alone.

Conclusions

Self-reported difficulty in climbing up and down stairs revealed commonalities as well as differences in related clinical correlates. Difficulty in both climbing up and down stairs should be separately assessed to better capture clinical and functional status in older adults.     

基层医院门诊传染病病人管理的实践与效果

我院是一所县级综合性二级甲等医院，门诊量每日约200人次，流动性强，病种复杂，且大部分病人来自农村，就医环境陌生。医院虽设有感染科门诊，但由于位置不醒目等原因，其中，相当数量的传染病人仍分布在内科、儿科等门诊科室，不利于传染性疾病的控制。因此，采取积极有效的预防措施，是门诊科室预防和控制医院感染的重要任务。现将其介绍如下。     

郭志强教授运用"提壶揭盖"法治疗多囊卵巢综合征的经验

多囊卵巢综合征(polycystic ovary syndrome,PCOS)为临床上常见的生殖内分泌代谢性疾病,根据其临床表现,中医常将其归为闭经、月经后期、月经过少、不孕症等范畴.目前中医治疗PCOS思路多从肝、脾、肾的调理入手.郭志强教授根据多年临床经验提出应用"提壶揭盖"法从肺论治PCOS."提壶揭盖"法主要适用于PCOS中的两种实证:肺失宣降,痰湿内蕴;肺气闭郁,气滞血瘀."提壶揭盖"多为宣肺之法,临床多用辛味、发散之药,并常佐以健脾、养血之品顾护气血.     

喉癌患者的健康教育需求调查分析

目的 了解喉癌患者对健康教育的需求并分析其原因.方法 采用自行设计的调查表对105例喉癌患者入院时、围手术期、出院前健康教育需求情况进行调查.结果 喉癌患者在入院时最希望了解自己目前病情及其治疗方案;围手术期时患者最关心的是:由自己决定是否手术,在术后能及时咨询和得到医护人员的指导;出院前费用情况及各项收费标准;患者出院后日常护理的健康需求具有多样性.结论 现有的健康教育模式需要不断改进,才能满足不同患者的健康需要.     

直肠癌保肛术后肠道功能障碍研究进展

直肠癌手术理念和技术的进步,使得低位直肠癌保肛率明显提高,而肠道功能障碍是困扰保肛术后患者的主要问题。目前研究从解剖、生理及动力学角度分析排粪功能改变的机制,认为肠道功能障碍与术后解剖改变、神经损伤以及括约肌功能受损等密切相关。本文总结了直肠癌术后肠道功能障碍的流行病学和发生机制,并阐述术后肠道功能障碍发生机制对预防和治疗术后肠道功能障碍的重要意义。