风险管理在呼吸内科护理管理中的应用

目的分析风险管理在呼吸内科护理管理中的应用效果。方法现将我单位2017年1月至2019年1月收治的86例呼吸内科患者作为本次分析对象,按照不同护理管理方法进行分组,将给予常规护理管理的43例患者定为对照组,给予风险护理管理的43例患者定为观察组,对比两组患者护理效果。结果通过风险管理后,观察组护理水平及患者对护理满意度均明显提高,且患者风险事件发生率也较低,其数据结果同对照组患者数据相比均存在显著优势(P0.05)。结论对呼吸内科护理管理中采取风险管理,可有效提高护理水平,减少护理过程中风险事件的发生,使呼吸内科护理工作得到患者的认可及满意。     

苏州市1453 名女性血清一氧化氮与高血压关系的研究

目的 探讨苏州市女性人群中血清一氧化氮(NO)水平与高血压的关系.方法 以苏州市金阊区1453名女性常住居民为研究对象,测量血压、身高、体重和腰围,调查吸烟、饮酒、家族史等情况,检测血糖、血脂、血清NO水平,采用单因素和多因素分析方法,分析血清NO水平与高血压的关联性.结果 高血压组、血压正常组的血清NO水平依次为28.17(17.42～45.30)μmol/L、27.56(17.19～44.42)μmol/L,两组间差异无统计学意义(P＞0.05).多因素logistic回归模型分析,调整年龄、吸烟、饮酒、高血压家族史、超重、腹型肥胖、高血糖、血脂异常后,低NO和高血压不存在显著关联性(OR=0.979,95%CI:0.747～1.283).血清NO水平处于1、2、3和4分位者,其平均收缩压分别为130.1、128.5、129.8和129.1mm Hg(1 mm Hg=0.133 kPa),平均舒张压分别为83.3、82.7、83.2和83.3 mm Hg;患高血压的危险性并没有随NO水平的升高而变化,与最低分位者相比,调整多因素后,血清NO水平处于2、3和4分位者患高血压的危险性均无变化,分别为0.988(0.709～1.377)、1.001(0.720～1.390)和1.077(0.774～1.499).结论 女性人群中血清NO水平与高血压无显著性关联.

Abstract：

Objective To investigate the association between serum nitric oxide (NO) and hypertension among women in Suzhou. Methods Blood pressure, height, weight and waist circumference (WC) were measured and factors including smoking, alcohol intake, family history of hypertension were investigated and blood glucose, blood lipid, serum NO were tested among 1453 women aged ≥30 years who lived in Jinchang district of Suzhou. Association between serum NO and hypertension was analyzed by univariate and multivariate methods. Results The mean levels of serum NO in hypertensive and normotensive persons were 28.17 (17.42-45.30)μmol/L and 27.56(17.19-44.42) μ mol/L, respectively, with no significant difference between the two groups (P ＞ 0.05).Results from multivariable logistic regression analysis showed that low serum NO was not associated with hypertension, after adjustment for confounders (OR=0.979, 95% CI: 0.747-1.283).The mean levels of systolic blood pressure / diastolic blood pressure were 130.1/83.3,128.5/82.7,129.8/83.2 and 129.1/83.3 mm Hg for whose serum NO level were in the first, second, third and fourth quartile,respectively. The risk of hypertension did not change along with the elevated serum NO levels.Compared to the first quartile of serum NO, the risks of hypertension in the second, third and fourth quartile did not change after adjustment for confounders and OR were 0.988 (0.709-1.377), 1.001(0.720-1.390) and 1.077 (0.774-1.499), respectively. Conclusion The serum NO level was not associated with hypertension in women in Suzhou.     

术前中性粒细胞与淋巴细胞比值联合癌胚抗原检测对直肠癌患者预后的评估价值

目的探讨术前中性粒细胞与淋巴细胞比值(NLR)联合癌胚抗原(CEA)对直肠癌预后的评估价值。方法选取268例直肠癌患者,依据术后5年生存情况,分为生存组和死亡组,比较两组患者的临床特征,影响直肠癌患者预后的独立影响因素采用Cox回归分析,采用受试者工作特征(ROC)曲线和曲线下面积(AUC)评估NLR及CEA单独及联合检测对直肠癌预后的评估价值。结果随访结束,268例直肠癌患者中,生存156例,病死112例,直肠癌患者术后5年生存率为58.21%。将生存患者和病死患者分别作为生存组和死亡组,生存组和死亡组直肠癌患者性别、年龄比较,差异均无统计学意义(P﹥0.05);生存组和死亡组直肠癌患者TNM分期、分化程度、肿瘤直径、神经侵犯情况、浸润深度、远处转移情况、淋巴结转移情况、CEA水平及NLR比较,差异均有统计学意义(P﹤0.05)。Cox回归分析结果显示,TNM分期、肿瘤直径、远处转移、CEA水平和NLR是直肠癌患者预后不良的独立危险因素(P﹤0.05)。CEA、NLR及二者联合预测直肠癌预后的AUC分别为0.991、0.923、0.997,CEA和NLR联合检测对直肠癌患者的预后评估具有较高的准确性,二者联合检测的AUC高于单独预测的AUC(P﹤0.05)。结论术前NLR联合CEA检测对直肠癌预后具有较高的预估价值,二者联合能够为评估直肠患者预后提供重要的参考信息。