利伯曼理论联合特质正念与控制点在急性期精神分裂症中的应用及对患者不良情绪的影响

[目的]探讨利伯曼理论联合特质正念与控制点在急性期精神分裂症中的应用及对患者不良情绪的影响。[方法]选取2018年3月至2020年3月本院收治的114例急性期精神分裂症患者,根据入院顺序分为观察组(2019年7月至2020年3月)和对照组(2018年3月至2019年6月),各57例。对照组给予常规干预.观察组在对照组的基础上给予利伯曼理论联合特质正念与控制点,连续干预8周。比较两组患者干预前、干预4周及8周后不良情绪(PANAS)、正念水平(MAAS).控制水平(LOCS)。[结果]干预4周、8周后,两组患者正性情绪评分高于千预前,负性情绪评分低于干预前,且观察组与对照组比较差异均有统计学意义(P<0.05);两组患者觉知行动、对内在经验的非反应性、对内在经验的非评判性评分均高于干预前,且观察组均高于对照组,差异有统计学意义(P<0.05);两组患者内在控制感、外在控制感LOCS评分均高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组护理满意度为94.74%(54/57).高于对照组的73.68%(42/57).差异有统计学意义(χ^(2)=9.50,P=0.002<0.05)。[结论]利伯曼理论联合特质正念与控制点通过生活技能、社会独立技能及正念干预措施能缓解急性期精神分裂症患者不良情绪,提高正念水平,增强自我控制能力。

Low Calf Circumference Predicts Nutritional Risks in Hospitalized Patients Aged More Than 80 Years

Objective The aim of this study was to determine whether low calf circumference(CC) could predict nutritional risk and the cutoff values of CC for predicting nutritional risk in hospitalized patients aged ≥ 80 years.Methods A total of 1,234 consecutive patients aged ≥ 80 years were enrolled in this study.On admission, demographic data, CC, and laboratory parameters were obtained.Patients with Nutritional Risk Screening 2002(NRS-2002) total score ≥ 3 were considered as having nutritional risk.Results CC values were significantly lower in patients with nutritional risk compared to those in patients without nutritional risk [27.00(24.50-31.00) vs.31.00(29.00-33.50], P < 0.001].CC was negatively correlated with age and nutritional risk scores.Logistic regression analysis of nutritional risk revealed that body mass index, albumin level, hemoglobin level, cerebral infarction, neoplasms, and CC(OR, 0.897;95% confidence interval, 0.856-0.941;P < 0.001) were independent impact factors of nutritional risk.Nutritional risk scores increased with a decrease in CC.In men, the best CC cutoff value for predicting nutritional risk according to the NRS-2002 was 29.75 cm.In women, the cutoff value was 28.25 cm.Conclusion CC is a simple, noninvasive, and valid anthropometric measure to predict nutritional risk for hospitalized patients aged ≥ 80 years.

糖皮质激素治疗急性中重度1,2-二氯乙烷中毒预后影响因素分析

目的分析糖皮质激素(GC)治疗急性中重度1,2-二氯乙烷(1,2-DCE)中毒的影响因素,提出治疗建议。方法对2005-2015年广东省职业病防治院收治的27例急性中重度病例进行回顾性研究,统计其预后和后遗症情况,选用秩和检验、 Fishers卡方检验等方法,单因素分析其影响因素。结果根据《职业性急性1,2-二氯乙烷中毒诊断标准》(GBZ39-2002) 27例诊断为重度中毒而应用GC治疗,多见前期滴注甲泼尼龙,后期口服地塞米松;现根据《职业性急性1,2-二氯乙烷中毒诊断标准》(GBZ39-2016)进行27例病历回顾,重新分为中度、重度中毒,发现女性、非O型血、初诊不正确、感染、发生GC不良反应会降低治愈率,以抽搐震颤为典型表现、重度中毒、初诊不正确会增加神经系统后遗症的发生,重度中毒、无抽搐震颤表现、女性、年龄≥31岁、 GC使用较迟(距发病≥5d)、感染、有GC不良反应是引起病例死亡的危险因素。结论建议尽早(<5 d)治疗;中度、重度分级治疗,重度病例使用冲击疗法(甲泼尼龙500 mg qd, 5 d),中度病例用药适当保守(首剂≤160 mg qd, 3 d);长时间密切观察,尤其是重度、以非抽搐震颤为典型表现、非O型血、女性、年龄≥31岁的病例。