影响重型乙型脑炎病人预后的因素分析

对446例重型流行性乙型脑炎病人的临床资料进行分析表明,影响预后的因素主要是：①年龄：儿童及老年病人出现后遗症比率达47.7%,而其它年龄组为20.7%,P〈0.001;②潜伏期：潜伏期越短,后遗症出现率越高,潜伏期〈7天的病人,后遗症率为53.9%,而〉7天者为8.6%,P〈0.001;③极期持续时间：极期越长,后遗症率及死亡率越高。极期〉3天者,后遗症率高达74.4%,死亡率为11.9%,而极期〈3天者,后遗症率为20.6%,死亡率为2.9%,P〈0.001。其他的原因还有病人免疫功能低下,营养不良,并发其它感染,治疗不当等。     

我国八个大中城市院前急救流行病学调查分析

Objective To investigate the epidemiological information of patients in pre-hospital medical care for our large and medium-sized cities and probe the patients' characteristic. Method The data in 2008 were exported from the computer databases of 8 large and medium-sized cities' emergency medical centers in our country.The thorough records of data were conducted to statistical analysis. Results ( 1 ) The scheduling time, running time, rescue time, returning time, total time and service radius in the pre-hospital medical care group were 2.16± 1.10(min), 14.01 ±6.82(min), 12.12±5.96(min), 14.08± 6.85(min), 42.34± 20.21(min)and 8.50±4.18(km), and the above parameter in the non-death group were 2.19 ± 1.13(min), 14.15 ± 7.14(min),11.60±6.72(min), 14.92 ±6.89(min), 41.86± 19.53(minutes) and 8.63±4.31(Km), and the above parameter in the death group were 2.10± 1.08(min), 13.68 ± 7.14(min), 25.25 ± 12.34(min), 13.75±6.48(min), 54.74 ± 25.47(min) and 7.86± 3.91(Km), and the above parameter in the non-sudden cardiac death group were2.09± 1.03(min), 13.58±6.78(min), 25.53± 12.34(min), 13.60± 6.54(min), 53.79±23.77(min) and 7.67 ± 3.86(Km), and the above parameter in the sudden cardiac death group were 2.12 ±1.02(min), 14.10±7.05(min), 24.79± 12.08(min), 13.79±6.61(min), 54. 80 ± 25. 36( min) and 7.90±3.92(Km) respectively. The scheduling time, running time, returning time and service radius in the death group were less than those of the non-death group, but the rescue time and total time of the former were more than those of the latter respectively ( P ＜ 0.05 or P ＜ 0. 001 ). The scheduling time and returning time didn' t have significant difference between the sudden cardiac death group and the non-sudden cardiac death group respectively ( P ＞ 0.05), but the running time, total time and service radius of the sudden cardiac death group were more than those of the non-sudden cardiac death group, and the rescue time of the former was less than that of the latter respectively ( P ＜ 0.05 or P ＜ 0.001 ). (2)The patients' amount in pre-hospital medical care group, the non-death group, the death group, the non-sudden cardiac death group and the sudden cardiac death group were at most in first quarter, and the least time slice of patients' amount were 4:00～ 6:00, 4:00～6:00, 4:00～ 6:00, 22:00～ 24:00, 2:00～4:00 respectively, and the most time slice of patients' amount were 20:00～ 22:00, 20:00～22:00, 8:00～ 10:00, 2:00 ～ 4:00, 8:00 ～ 10:00 respectively. (3)In 241 876 cases of pre-hospital medical care group, the patients' amount of trauma was at most, whose age grades was by far among21 ～50, and the others in sequence were nervous system, circulatory system, other group, digestive system, respiratory system and poisoning group respectively, whose age grades in nervous system, circulatory system and respiratory system was by far above 51, especially above 70. The patients' age grades in other group and digestive system had two climax age groups, which the one was 21 ～ 30, and the other was above 70. The patients' age grades in poisoning group was by far among 21 ～ 50, which the patients' amount of acute alcoholism was at the most. (4) In 12 568 cases of death group, the death amount of circulatory system, other group, respiratory system, nervous system and digestive system ranked at the lst,2nd,4th,5th 8th respectively, whose age grades was by far above 51, especially above 70,and the patients' amount of sudden cardiac death was at the most in the death amount of circulatory system. The death amount of trauma and poisoning group ranked at the 3rd, 6th respectively, whose age grades was by far among 21 ～ 50. (5)The total amount, the death amount and the sudden cardiac death amount of male patients were more than those of female patients. (6)The percentage of the death group to the pre-hospital medical care group was 5.20%, and the percentage of the sudden cardiac death group to the pre-hospital medical care group was 1.29%,and the percentage of the sudden cardiac death group to the death group was 24.87 %, and the percentage of the sudden cardiac death group to the circulatory system group was 67.33 %. Conclusions ( 1 )The trauma and the sudden cardiac death are the overriding reason of disease and the overriding reason of death in our large and medium-sized cities respectively. (2) It is very important to cut the death rate of the middle-old age patients by strengthening prevention and cure of cardiovascular and cerebrovascular diseases, discerning the critical illness early and improving the level of pre-hospital medical care. (3)It is a strong method to decrease the total amount and the death amount of the trauma, especially in traffic accident, by strengthening safety in production, observing traffic regulation and enhancing the legal awareness.     

我国大中城市院前心脏性猝死流行病学调查分析

目的调查我国大中城市院前心脏性猝死患者流行病学情况,探讨院前心脏性猝死病例特点。方法从我国8个大中城市急救中心系统数据库中导出2008年度全部死亡数据,就其有完整记录的资料进行统计分析。结果①院前心脏性猝死的调度时间、到达时间、现场时间、返回时间、总时间、急救半径分别为（2．12±1．02）min、（14．10±7．05）min、（24．79±12．08）min、（13．79±6．61）min、（54．80±25．36）min、7．90±3．92（km）;②院前心脏性猝死的病例数以第一季度为最多,且最多时间段是8：00～10：00,最少时间段是2：00～4：00;③男性院前心脏性猝死明显多于女性,但年龄明显小于女性;④院前心脏性猝死目击者CPR为4．48％,医护人员现场CPR成功率2．26％。结论①心脏性猝死已成为我国大中城市最常见的院前死亡原因;②加强心血管病防治,提高中老年患者的常见急危重症早期识别与院前急救水平以及普及公众CPR对降低死亡有重要意义。     

应用抗狂犬病血清并狂犬病疫苗接种犬咬伤患者的抗体水平研究

实验证明,头面部、颈胸部、多部位或重度犬咬伤患者,应用抗狂犬病血清按0.5～10ml/kg 注射后,1次/d,连续接种10支狂犬病疫苗,可以刺激机体免疫系统迅速生成足量抗体,对延长头颈部等严重咬伤总者的潜伏期,控制发病具有重要意义。     

FQ-PCR、ELISA检测生殖器疱疹患者HSV-2相关指标结果分析

目前生殖器疱疹（GH）主要由HSV-2感染引起。其诊断主要靠典型的临床表现。某些缺乏特征表现的患者常容易被漏诊。2007年2月-2008年11月,我们采用FQ-PCR法和ELISA法对115例GH患者HSV-2的相关指标进行检测。现对比分析如下。     

不同评分系统对严重外伤患者预后的评估价值对比

目的：对比不同评分系统对严重外伤患者预后的评估价值。方法对海南医学院附属医院于2012年9月至2013年9月收治的400例严重外伤患者分别进行急性生理和慢性健康状况评分Ⅱ（APACHEⅡ评分）、改良早期预警评分（MEWS）及简单临床评分（SCS）,对比三种评分系统对患者预后的评估效果。结果随着病死率的上升,三种评分亦随之逐渐升高。APACHEⅡ评分的误差值最小（0.026）,MEWS评分的误差值最大（0.034）;APACHE评Ⅱ分的ROC曲线下面积最大（0.866）,MEWS评分的曲线下面积最小（0.749）。结论 MEWS评分、APACHEⅡ评分及SCS评分均可以有效地对严重外伤患者的预后进行评估,但APACHEⅡ评分的评估准确度最高,MEWS评分准确度最低。而SCS评分系统操作方便、快速、准确度较好,更有利于早期对严重外伤患者预后的评估。     

骨化三醇联合糠酸莫米松乳膏外用治疗稳定期寻常型银屑病35例

银屑病是一种常见的慢性、复发性、炎症性皮肤病,其中稳定期寻常型银屑病主要以外用药物治疗为主,但疗效均不确切。2006—2008年,我们采用骨化三醇软膏联合糠酸莫米松乳膏外用治疗寻常型银屑病患者35例,疗效较好。现报告如下。     

海口市社区精神分裂症患者干预治疗效果分析

目的 探讨在社区治疗的精神分裂症患者进行康复干预的有效的、可行的措施.方法 抽取海口市某门诊免费药物治疗的120名精神分裂症患者,其中干预组60名,对照组60名,对照组在给予门诊免费药物治疗,根据患者的病情变化调整药物的剂量和常规处理药物副反应之外,无特别的指导.干预组除了对照组的处理外,还进行了由家属、经过培训的社区医师和本单位专科医生、居委会人员组成的管理小组,给予患者个案管理,包括定期随访、危险评估、用药指导,康复计划指导的综合干预,干预时间为1年.使用SDSS社会功能缺陷量表评定和包括用药、复诊、复发情况、住院情况、公众对精神疾病的看法等等在内的个案管理表,危险行为的评估并进行效果分析.结果 实施干预1年后,与入组时比较,SDSS量表总分与对照组比较,均有显著的差异（P＜0.01）,两组的患者在维持用药、复发住院、良好生活习惯等上均有明显差异(P＜0.01),具有危险行为倾向的患者减少(P＜0.01),减轻了家属和社会的压力.结论治疗中及时和恰当的社区综合干预,可以促进精神分裂症患者的社会功能的康复,预防复发,是一种可行的、有效的科学治疗方法.     

我国大中城市院前死亡患者流行病学调查分析——附12568例分析

目的：调查中国大中城市院前死亡患者流行病学情况,探讨院前死亡病例特点.方法：从中国8个大中城市急救中心系统数据库中导出2008年度全部死亡数据,对有完整记录的资料进行统计分析.结果：①12 568例院前死亡者调度时间、到达时间、现场时间、返回时间、总时间、急救半径分别为（2.10±1.08） min、（13.68±7.14） min、（25.25±12.34） min、（13.75±6.48） min、（54.74±25.47） min、（7.86±3.91） km;院前非心脏性猝死组分别为（2.09±1.03） min、（13.58±6.78） min、（25.53±12.34） min、（13.60±6.54） min、（53.79±23.77） min、（7.67±3.86） km,院前心脏性猝死组分别为（2.12±1.02） min、（14.10±7.05） min、（24.79±12.08） min、（13.79±6.61） min、（54.80±25.36） min、（7.90±3.92） km.院前非心脏性猝死组与院前心脏性猝死组到达时间、现场时间、出车总时间、急救半径比较差异均有统计学意义 （P〈0.05或0.01）.②院前死亡总体、院前非心脏性猝死组、院前心脏性猝死组的病例数月份及季节分布以2月份、第一季度为最多,日时间段分布以8：00～10：00为最多.③院前死亡患者中循环系统、其他、呼吸系统、神经系统、消化系统类的死亡数分别位居第一、二、四、五、八,均以51岁（尤其是70岁）以上的中老年阶段最多,其中循环系统类中心脏性猝死死亡最多;创伤、中毒类的死亡分别位居第三、六,均以21～50岁青壮年阶段最多.④男性院前死亡数及院前心脏性猝死数均明显多于女性.⑤院前心脏性猝死占循环系统类死亡的绝大部分（67.33%）,目击者现场心肺复苏（CPR）为4.46%,医护人员现场CPR成功率2.21%.结论：①心脏性猝死是中国大中城市最常见的院前死亡原因.②加强心脑血管疾病和呼吸系统疾病防治,提高中老年患者的常见急危重症早期识别与院前急救水平以及普及公众CPR对降低死亡有重要意义.③创伤致死是中国大中城市又一常见院前死因,加强安全生产、遵守交通法规、强化法制意识将是降低创伤,尤其是交通意外伤发生及其死亡的有力手段.     

试论艾滋病健康教育效果评价方法

艾滋病全名为获得性免疫缺陷综合征(AIDS),是由人类免疫缺陷病毒(HIV)感染引起的一种传染病.1981年美国首先报道了5例艾滋病病例,而后艾滋病以惊人的速度在世界各地传播,病死率几乎是100%,被称为全球第4大杀手,严重影响人类健康,阻碍社会发展.因此,艾滋病防治已成为各国政府十分关注的社会问题.