乙状结肠造口术并发症73例分析

（目的）探讨乙状结肠造口术并发症的防治。（方法）1985年至1995年间进行了202例乙状结肠造口术。（结果）与造口有关的并发症73例，包括造口周围炎35例、造口狭窄21例、造口结肠旁疝6例、造口出血4例、造口肠管回缩3例、造口肠管脱垂2例、造口肠管坏死2例。73例并发症病人经治疗均痊愈出院。（结论）重视手术操作能降低并发症的发生率，术后加强观察和护理，早期发现和处理是提高治疗成功率的关键。     

Saline irrigation and wound infection in abdominal gynecologic surgery.

OBJECTIVE: To evaluate whether saline wound irrigation decreases the incidence of wound infection following abdominal gynecologic surgery. METHOD: In this prospective randomized study, 104 patients underwent wound irrigation before wound closure following abdominal gynecologic surgery and 102 patients did not. RESULTS: There were no significant differences between the 2 groups in patient characteristics or in factors influencing the incidence of wound infection after abdominal gynecologic surgery. The incidence of wound infection was 10.6% among women who underwent wound irrigation and 9.8% among those who did not, and the difference was not statistically significant. CONCLUSION: Saline wound irrigation before abdominal wall closure is not helpful in decreasing the incidence of wound infection after abdominal gynecologic surgery.     

硫酸镁对普鲁帕酮致心律失常的干预作用

目的探讨静脉滴注硫酸镁对普鲁帕酮致心律失常作用的干预效果。方法将92例心律失常患者随机分为对照组和干预组,每组46例。两组均口服普鲁帕酮,干预组同时静脉滴注硫酸镁,于治疗1周后常规心电图观察心律失常变化及致心律失常作用。结果心律失常消失率对照组为43.4%(20/46)、干预组为82.6%(39/46),致心律失常率对照组为19.6%、干预组为4.4%,两组比较有统计学意义(P<0.01)。结论普鲁帕酮抗心律失常同时有致心律失常作用,使用硫酸镁干预可降低致心律失常发生率。     

中小工厂防尘中适用除尘器的选型

目的探讨依据不同生产工序粉尘粒度分级组成和除尘器粒度分级效率测定结果进行适用除尘器选型的可行性。方法使用WY-1型冲击式尘粒分级仪测定粉尘的粒径分级组成和除尘器的粒径分级除尘效率。结果（1）①大理石和玉石雕刻、陶瓷、建材、耐火、砖瓦、石粉厂的轮碾、筛分，②陶瓷修坯，③玻璃配料工序的粉尘〉5岬的分别为90．4％～74％、66％、46％；（2）旋风、冲击水浴、冲击喷雾、滤袋、高压静电除尘器对粒径为5μm粉尘的分级除尘效率分别为73．0％、92．1％-98．4％、99．2％、〉99．0％、〉99．0％；计算得出上述除尘器对不同工序总除尘效率。根据有效、适用、经济要求，进行了不同粉尘作业适用除尘器的选型。结论根据现场调查测定结果可进行不同粉尘作业工序适用除尘器的选型，此为防尘设计提供依据。     

水枕在预防偏瘫患者压疮中的应用

目的：探讨水枕在偏瘫患者压疮预防中的效果。方法将2013年5～10月入科的偏瘫患者随机分为观察组和对照组各30例,对照组患者皮肤受压处使用普通软枕,观察组患者用水枕替代普通软枕,两组患者均使用气垫床,并定时协助翻身。观察两组患者受压处皮肤受损情况及受压后皮肤能否完全恢复。结果观察组患者仅有I期压疮2例,对照组患者发生I期压疮25例,Ⅱ期压疮2例。观察组患者皮肤受损程度明显低于对照组（ P＜0.01）。结论水枕在预防偏瘫压疮中起到了积极的作用,效果明显,是一种值得推广的好方法。     

Prevention of Mental and Substance Use and Abuse Disorders and Comorbidity in African Americans

Regrettably for African Americans, research has rarely addressed issues that affect their health and well-being. This lack of attention manifests itself in the dearth of literature available while doing literature reviews on prevention of comorbid mental illness and substance abuse (MISA) and substance use and abuse disorders in African Americans. However, there are a few studies on the prevention of substance use and abuse disorders alone and the prevention of relapse in African Americans with MISA problems. These articles form the basis of our proposal to prevent co-morbidity of mental and substance use and abuse disorders in African Americans.     

急诊护理中的暴力风险因素分析及预防对策分析

目的探讨急诊护理中导致暴力事件的风险因素,并针对因素研究相关对策。方法将急诊科56名护理人员纳入研究范围,在研究开始初期对其工作调查,了解其工作情况和所遇暴力事件类型,并对暴力风险进行预测,以了解导致暴力风险的因素,对调查中所涉及暴力风险因素进行评估,针对有价值因素提出干预方法用以研究预防措施,最终对预防结果进行评价。结果护理人员的综合能力、职业道德、工作经验、法律意识、抢救水平、器械熟悉度以及患者就诊环境、缺少系统支持等问题都是导致暴力发生的因素,在进行了急诊科室护理人员系统教育后的第二次调查中,由上述问题导致的暴力发生明显减少,其他难以人为单方面改善的因素仍可导致暴力事件发生,对此采取了加大安保力度、增加安保人员等方式来保证急诊科医护人员的安全。结论急诊科护理人员在工作中遭受暴力危害较多,应及时发现导致暴力的因素,积极寻找应对措施能有效降低暴力发生率,改善护患关系,保障护理人员的安全。     

Factors associated with Pap smear screening among French women visiting a general practitioner in the Rhône-Alpes region

BackgroundTo help prevent cervical cancer, three yearly opportunistic Pap smear screening is recommended in France for women aged 25–65 years. Pap smear screening coverage varies with age and socioeconomic level. The aim of this cross-sectional study was to identify factors associated with a low uptake of Pap smear screening among women with no limited access to healthcare.MethodsWe analyzed data from women aged 25–65 living in the Rhône-Alpes region who completed a self-administered questionnaire given to them by general practitioners between June and August 2008. The questionnaire covered knowledge about cervical cancer and its prevention as well as the women's history of Pap smear screening and other health-related behaviors. The relationship between low uptake of Pap smear screening – defined as not having had the test within the past 3 years – and a range of possible contributing factors was investigated using logistic regression.ResultsOf 1186 women with an intact uterus who completed the questionnaire, 89.1% said they had had a Pap smear within the past 3 years. On multivariate analysis, the 10.9% who had not were significantly more likely to live alone (1.76 [1.13–2.74]), to have no children (2.17 [1.31–3.62]), to have never used contraception (5.35 [2.98–9.62]), to have less knowledge about Pap smear screening (3.40 [1.55–7.49]), and to be unvaccinated against hepatitis B (0.55 [0.35–0.87]).ConclusionDespite high overall compliance with Pap smear screening recommendations among women who consulted general practitioners, several factors were significantly associated with a low uptake of the service. Considering these factors may help to refine messages aimed at cervical cancer prevention.     

A Confidential Inquiry Estimating the Number of Patients Affected with Sickle Cell Disease and Thalassemia Major Confirms the Need for a Prevention Strategy in The Netherlands

We have conducted a broad confidential inquiry among 401 hospital departments trying to estimate the number of patients affected with severe forms of hemoglobinopathies living in The Netherlands. With less than 30% response we have registered 559 patients in all age categories of whom 77.0% are affected with sickle cell disease and 17.5% with β‐thalassemia (thal) major. We estimate that the real figure could be around 800 patients, a figure more than six times higher than the number published in 1995 on which the reluctance to offer prevention was based. The actual figures and the incidence estimation of approximately 60 patients a year underline the urgent need for the official implementation of a prevention strategy in The Netherlands. During the last 5 years we have been working towards the implementation of a multi‐intervention strategy for primary prevention using the existing structures of public health. The obstacles we have encountered to endorse such a strategy are discussed as a possible guide for other immigration countries.