外科住院患者创伤后应激障碍相关因素及护理需求研究

目的 观察中药辨证分层换药治疗顽固性疮疡的临床疗效。方法 将接受换药治疗的141例疮疡患者随机分为三组。A组（47例,60处疮面）采用西药换药，B组（45例，60处疮面）采用中药常规换药。C组（49例,60处疮面）采用中药辨证分层换药。比较三组疮疡疮面的愈合过程，疮面面积的变化，疮面脓液中溶茼酶含量及疗效。结果 C组疮面愈合时间显著短于A、B组，疮面脓液中溶菌酶含量显著高于A、B组（均P〈0．05）。疮面治疗2～4周，C组疮面面积显著小于A、B组（均P〈0.05）。三组总有效率分别为81．67％、83．33％、95．00％，C组显著高于A、B组（均P〈0．05）。结论 中药辨证分层换药是根据疮疡疮面不同圈层面的阴阳变化选用不同的中药外敷。可以起到缩短治疗时间，增加治疗效果的作用。

The Family Functions and Family Burden in Surgical Patients

Objective To investigate related factors involved in post-traumatic stress disorder(PTSD) and nursing demand to provide information for the nursing intervention. Methods Ninety-three patients with PTSD was diagnosed in terms of PTSD on the basis of DSM-4. The SCL-90, Eysenck personality questionnaire (EPQ) and the self-designed questionnaire on demand for nursing care after traumatic events were used. Results PTSD was definitely diagnosed in 31 cases (33.33%). There were significant differences in sex, years of education and condition of trauma between PTSD patients and non-PTSD patients (n=62) (P< 0.05, P<0.01). The individual scores and total score of SCL-90 in PTSD patients were significantly higher than those of non-PTSD group (P<0.05, P<0.01). And the scores on the psychoticism (P), neuroticism (N), lie (L) scales were higher than those of non-PTSD patients but the score of introversion (E) was significantly lower than that of non-PTSD patients. The total scores of demands for psychological, mental and nursing care in PTSD patients were much higher than non-PTSD patients (P<0.05, P<0.01). Conclusion After traumatic events, the hospitalized patients are predisposed to PTSD and the PTSD patients tend to have higher demand for nursing care and nursing interventions should be taken as early as possible to meet the demand of the patients and to avoid PTSD.