脑梗塞恢复期病人的心理分型及护理

目的：通过对病例的治疗与护理,探讨脑梗塞恢复期的护理体会,总结护理经验。方法：根据病人各期的不同心理分型,采取相应的护理措施。结果：通过分类指导临床效果显著,比较对照组有显著性差异。结论：脑梗塞患者常伴有明显恐惧、焦虑、抑郁心理,心理护理能缓解患者的心理障碍、促进康复。     

飞行员注意力分配测试研究

随着新型战斗机自动化和智能化水平的不断提高,飞机座舱内动态信息越来越多,使飞行员的主要任务由原有的飞行操纵向信息监控处理方面转移,飞行员的心理负荷逐渐加大。     

长期住院病人心理护理现状调查

目的 通过对长期住院病人心理护理现状的调查、分析,探讨心理护理效果不佳的原因,为日后建立有效且针对性强的心理护理细则打下基础.方法 通过对我院长期住院病人200人进行问卷调查和简短交谈的方式,了解长期住院病人在住院期间的心理状态、医患关系和是否接受过心理服务及具体内容和次数.结果 83％的病人心理健康状况一般,或多或少的出现人格特征变化;医患关系满意度较低,满意以上的仅为36％;接受过一定的心理服务的病人为23％,其中4.5％接受过专业的心理服务,服务内容以入院心理健康宣教为主,占接受心理服务总人数的87.0％,接受专业的个体咨询患者占接受心理服务总人数的19.6％;服务频次累计:1次者占接受心理服务总人数的93.5％,2次者占接受心理服务总人数的6.5％.结论 在医院范围内对长期住院病人心理护理的实施效果不佳.主要原因分析有:①工作模式的局限;②实施者的局限;③专业机构的局限;④环境的影响.     

不同麻醉方法对老年患者非心脏手术后认知功能障碍的影响

目的 比较两种不同的麻醉方法 对老年患者非心脏手术后早期认知功能的影响.方法 87例拟行择期开腹手术的老年患者,随机接受全身麻醉或连续硬膜外麻醉.分别在术前1天和术后1天、7天对患者进行简易精神状态量表(MMSE),术后MMSE评分与术前MMSE评分比较下降≥2分即诊断为POCD.结果 80例完成了术前及术后MMSE测试,术后第1天、第7天认知功能障碍发生率全麻组2/42,连硬组为1/38,两组间差异无统计学意义.结论 两种麻醉方法 对患者术后认知功能障碍的影响差异无统计学意义.     

70例手足口病病原检测和临床分析

Objective To analyze the etiology and clinical manifestations of 70 patients with hand-foot-mouth disease (HFMD). Methods The viral RNA from the pharynx swab samples were extracted and collected from 70 HFMD patients (of which,60 cases were under 5 years old) to detect the 5'-UTR gene of EV,the Vp3-Vp1 genes of EV71 and Cox-A16 by utilizing the technique of RT-PCR. Results Of 70 HFMD patients,30 cases (42.8%, 30/70) were positive in enterovirus nucleic acid, including EV71 and Cox-A16,pharynx swab sample testing. While, of the enteroviral pathogen RNA-positive 30 cases, EV71 accounted for 66. 7% (20/30). The proportion of etiological positive of 39 samples collected within 4 days after onset was 66.7% (26/39), but the probability of 31 samples collected after more than 5 days after onset was 12.9%(4/31),the difference was significantly(χ2=20.4,P<0. 01). Conclusion HFMD patients were mainly infants and young children between 0-5 years old, but adults could also be attacked. The enterovirus detected was mainly EV71,and the pharynx swab samples should be collected within 4 days after onset to increase the related viral nucleic acid positive detection probability.     

局麻药骨骼肌毒性作用的研究与临床意义

最新研究证实,局麻药(locae anesthetic,LA)可导致骨骼肌损伤,甚至引起肌肉坏死,临床上使用的LA均存在骨骼肌毒性,因此将其对骨骼肌的损害视为局麻药的潜在并发症,但在临床上相关病例却很少见.现将近来国外对LA骨骼肌毒性的研究进展综述如下.     

不同年龄人群感染甲型H1N1流感病毒临床特征分析

Objective To describe the feature of different age patients with A-H1N1.Methods Cross-sectional study was performed in 95 patients who were confirmed to be infected with A-H1N1 from May,2009 to July,2009,in according to their age.Results The average age of patients with A-H1N1 infection was 23.44±14.73.Accumulative prevalence in children and young adult reached 74.7% of total patients.There was a trend that the subclinical infection rate raised gradually from 0-15 years group to over 45 years group.The percent of lymphocyte in 0-15 years group was significantly higher than other age groups,P=0.039.The average time of virus shedding were 6.5±2.10 days (from 2 days to 12 days),and there were no significant difference in diverse age groups,P=0.272.13 out of 95(13.7%)patients presented complications related with A-H1N1 infection,and 4 of 6 patients complicated with pneumonia were in the 0-15 years group.Conclusion The distribution of age in A-H1N1 infection is markedly different from seasonal influenza,with more cases in school children and young adults and fewer cases in older adults. Flu-like symptoms in children were apparent and pneumonia was the major complication in children.     

重症急性胰腺炎并发急性肺损伤16例

通过对16例重症急性胰腺炎（SAP）并发急性肺损伤（ALI）患者的救治分析，得出救治SAP特别是在高原地区，应早期采取综合性防治措施，积极预防并发ALI。     

不同年龄人群感染甲型H1N1流感病毒临床特征分析

Objective To describe the feature of different age patients with A-H1N1.Methods Cross-sectional study was performed in 95 patients who were confirmed to be infected with A-H1N1 from May,2009 to July,2009,in according to their age.Results The average age of patients with A-H1N1 infection was 23.44±14.73.Accumulative prevalence in children and young adult reached 74.7% of total patients.There was a trend that the subclinical infection rate raised gradually from 0-15 years group to over 45 years group.The percent of lymphocyte in 0-15 years group was significantly higher than other age groups,P=0.039.The average time of virus shedding were 6.5±2.10 days (from 2 days to 12 days),and there were no significant difference in diverse age groups,P=0.272.13 out of 95(13.7%)patients presented complications related with A-H1N1 infection,and 4 of 6 patients complicated with pneumonia were in the 0-15 years group.Conclusion The distribution of age in A-H1N1 infection is markedly different from seasonal influenza,with more cases in school children and young adults and fewer cases in older adults. Flu-like symptoms in children were apparent and pneumonia was the major complication in children.     

自身免疫性肝炎Ⅰ、Ⅱ、Ⅲ型的临床特点比较

目的 分析比较自身免疫性肝炎（AIH）Ⅰ、Ⅱ、Ⅲ型的临床特征、血清学和病理学特点。方法 回顾分析65例AIH患者的临床资料、血清学特征和病理学特点,其中Ⅰ型53例,Ⅱ型3例,Ⅲ型9倒。结果 AIH以中年女性多见,AIHⅡ型较Ⅰ、Ⅲ型年龄轻,临床表现及体征Ⅰ、Ⅱ、Ⅲ型比较差异无统计学意义;AIHⅠ、Ⅱ、Ⅲ型中血清丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）均增加,以Ⅱ型增加最明显,IgG均增高,以Ⅲ型增加最显著,碱性磷酸酶（ALP）、γ-谷氨酰转肽酶（GGT）轻度增加,IgA和IgM变化不明显;Ⅰ型抗核抗体（ANA）阳性率92．5％,抗平滑肌抗体（SMA）阳性率37．7％,抗肌动蛋白（actin）阳性率13．2％;Ⅱ型抗肝肾微粒体抗体-1（LKM-1）阳性率100％,未检出抗胞质抗体-1（LC-1）;Ⅲ型抗可溶性肝抗原／肝胰抗原（SLA／LP）阳性率100％,7例伴ANA阳性;共有21例肝活检标本,主要表现为界面炎（85．7％）,明显的小叶内炎（51．7％）,浆细胞浸润（52．4％）,伴有桥接坏死（19．0％）,以及玫瑰花结（19．0％）等改变;Ⅰ、Ⅲ型病理学特征比较差异无统计学意义。结论 AIHⅠ、Ⅱ、Ⅲ型在试验室检查和自身抗体等方面各有特点,血清抗体检测有助于3种类型的诊断和鉴别诊断;Ⅰ型与Ⅲ型在临床特征、实验室检查、病理学方面差异无统计学意义,可归为Ⅰ型。