退休空勤人员糖尿病患病情况分析和研究

目的探讨退休空勤人员糖尿病患病情况分析和研究。方法选取2009年1月—2014年12月的退休空勤人员年度体检报告时发现了70例的糖尿病患者,将采用随机数学法将70例患者分为观察组和对照组。对照组患者将服用盐酸二甲双肌片,饭后服用;观察组患者口服阿卡波糖,饭后嚼服,同时给予观察组和对照组患者心理辅导和饮食调节及运动指导,患者持续的治疗3个月,然后比较观察组和对照组的血糖水平恢复情况和不良反应发生率,空腹血糖,饭后2 h血糖,高密度脂蛋白、胆固醇和尿酸变化情况。结果观察组和对照组治疗前空腹血糖,饭后2 h血糖,高密度脂蛋白、胆固醇和尿酸水平差异无统计学意义(P0.05)。治疗后的高密度脂蛋白胆固醇和尿酸水平对比治疗前没有明显的变化(P0.05),空腹血糖,饭后2 h血糖,对比治疗前明显降低,差异有统计学意义(P0.05)。观察组的空腹血糖,饭后2 h血糖,对比对照组没有明显变化,但是观察组的空腹血糖,饭后2 h血糖,更接近于正常人水平;观察组的血糖恢复正常率为71.4%,高于对照组的60.0%,差异无统计学意义(P0.05);两组都出现了1例腹胀和食欲不振的反应,都已自行缓解。结论服用阿卡波糖片并且进行心理辅导,饮食调节及运动指导能有效的控制空勤人员的糖尿病患者的血糖水平。     

重症监护病房铜绿假单胞菌医院感染病例对照研究

目的 探讨重症监护病房(ICU)铜绿假单胞菌医院感染的危险因素,为制定医院感染的防治策略、措施提供依据.方法 采用回顾性病例对照研究和非条件Logistic多元回归分析方法,分析2002年1月至2006年12月1 950例ICU患者铜绿假单胞菌医院感染危险因素.结果 64例患者发生铜绿假单胞菌医院感染(作为感染组),发生率为3.3%.同期与感染组同一科室的37例发生大肠埃希菌医院感染患者作为对照组.单因素分析结果:使用激素、昏迷或颅脑损伤、腹部手术、有胸腹引流管、机械通气、开放气道是铜绿假单胞菌医院感染的危险因素[使用激素:相对比值比(OR)=3.364,95%可信区间(95%CI)1.445～7.830;昏迷或颅脑损伤:OR=4.026,95%CI 1.545～10.490;腹部手术,OR=0.166,95%CI 0.068～0.403;有胸腹引流管:OR=0.350,95%CI 0.150～0.818;开放气道:OR=4.095,95%CI 1.638～10.740].多因素Logistic分析结果:铜绿假单胞菌医院感染的独立危险因素有使用激素、机械通气(使用激素:OR=3.143,95%CI 1.115～8.856;机械通气:OR=3.195,95%CI 1.607～6.353,P＜0.05和P＜0.01).结论 使用激素和机械通气是铜绿假单胞菌医院感染的独立危险因素,应针对危险因素采取措施以控制医院感染.

Abstract：

Objective To investigate the risk factors of nosocomial infection caused by Pseudomonas aeruginosa in intensive care unit (ICU), in order to provide reference for an effective measure of infection control. Methods A retrospective study of cases of Pseudomonas aeruginosa infection occurring in ICU was made with multivariable Logistic regression analysis. The clinical data of 1 950 cases admitted from January 2002 to December 2006 were found to have nosocomial infection caused by Pseudomonas aeruginosa were analyzed in order to identify its independent risk factors. Results Sixty-four out of 1 950 patients were found to suffer from nosocomial infection caused by Pseudomonas aeruginosa, the morbidity rate was 3.3%. At the same time, and in the same department, 37 patients suffering from infection caused by Escherichia coli, served as control group. Univariate analysis showed that the risk factors for nosocomial infection caused by Pseudomonas aeruginosa were the use of corticosteroid, unconsciousness or craniocerebral trauma, abdominal surgery, thorax/abdomen drainage tube, mechanical ventilation, and tracheostomy [the use of corticosteroid: odds ratio (OR)=3.364, 95% confidence interval (95%CI) 1.4457.830; unconsciousness or craniocerebral trauma: OR=4.026, 95%CI 1.54510.490; abdominal surgery: OR=0.166, 95%CI 0.0680.403; thorax/abdomen drainage tube: OR=0.350, 95%CI 0.1500.818;tracheostomy: OR=4.095, 95%CI 1.63810.740]. Multivariate analysis showed that the independent risk factors of nosocomial infection caused by Pseudomonas aeruginosa in ICU were: the use of corticosteroid and mechanical ventilation [the use of corticosteroid: OR=3.143, 95%CI 1.1158.856; mechanical ventilation: OR=3.195, 95%CI 1.6076.353, P<0.05 and P<0.01]. Conclusion The independent risk factors of nosocomial infection caused by Pseudomonas aeruginosa in ICU are the use of corticosteroid and mechanical ventilation. Measures should be taken to take care of the risk factors in order to prevent nosocomial infection caused by Pseudomonas aeruginosa in ICU.     

Kartagener氏综合征一例

患儿,男,11岁。因咳喘反复发作十年,心慌气促半年入院。近十年反复咳喘并头晕,曾咯血三次。半年前在某市医院诊断为“间质性肺炎,右位心”。曾间断不规则治疗。近半年出现心慌,气     

重症监护病房鲍曼不动杆菌医院感染病例对照研究

目的探讨上海长征医院ICU鲍曼不动杆菌医院感染的危险因素,为制订医院感染的防治策略和措施提供依据。方法用回顾性病例对照研究和非条件Logistic多元回归分析方法分析ICU患者鲍曼不动杆菌医院感染的危险因素。结果ICU患者鲍曼不动杆菌医院感染发生率为3．2％。与对照组相比,鲍曼不动杆菌致医院感染独立的危险因素是机械通气、肿瘤、应用激素。结论针对鲍曼不动杆菌致医院感染危险因素采取措施控制医院感染。