119例传染病住院患者防治知识知晓情况调查分析

目的:通过调查分析传染病患者对传染病感染途径及预防知识知晓情况,为传染病患者制订健康教育措施提供依据。方法:利用传染病患者住院治疗期间通过面对面交流进行传染病防治知识问卷调查方式,对先后在感染病区住院的119例传染病患者进行调查。结果:119例传染病患者对消化道传染病和呼吸道传染病知晓率普遍较高,对经血液、接触传播的传染病了解较低;119例传染病患者防治知识获取途径主要是就诊时医务人员告知,其次为电脑网络查询。结论:119例传染病患者对感染途径及预防知识有一定了解,但普遍存在误区,在今后的工作中医务工作人员应根据传染病患者的需要,在治疗的同时采取有效的方式进行健康教育。

分层护理模式对乳腺科住院患者护理质量的影响

目的:研究针对乳腺科住院病患使用分层护理模式的实际影响。方法:选择从2019年1月到2019年5月期间本院接收的共计100名乳腺科的住院患者,并按照随机抽签的方式将其均分为两组,观测小组以及对照小组。每一组中各有50人。针对对照小组只是单纯的使用常规形式的护理模式,观测小组从入院第二天开始就开始对其使用分层护理模式。结果:观测小组在使用分层护理模式之后在SAS以及SDS方面的评分是要显著的低于对照小组中的病患,数据自身具备统计学意义(P<0.05)。并且在有关护理质量的评价中,分数也均要高于对照小组,数据也具备统计学意义(P<0.05)。结论:针对乳腺科的住院病患实施相应的分层护理模式,可以十分有效的帮助病患环节焦虑等等不良情绪,同时也能够显著的提升护理工作的质量。

加强药事管理对住院患者抗菌药物使用情况的影响分析

探究加强药事管理对住院病患抗菌药物使用情况的影响。方法:选取本院2018年1月份~2019年12月份收治的住院病患600例为本次研究对象,根据时间段及药事管理模式分为参照组、研究组,2018年1月份~2018年12月份300例开展常规药事管理的住院病患为常规组,2019年1月份~2019年12份300例加强药事管理的住院病患为研究组[1]。对比两组住院病患抗菌药物使用情况及不合理用药情况。结果:研究组住院病患抗菌药物使用不合理率1.67%低于参照组7.00%,抗菌药物合理使用认知优良率97.33%低于参照组91.00%,差异有统计学意义(P<0.05)。结论:加强药事管理对减少住院病患抗菌药物不合理使用情况、提升医护人员对抗菌药物合理使用意识以及提高病患对抗菌药物合理使用认知程度有积极意义。

重庆某三甲医院住院患者营养风险发生率现状调查

目的了解重庆市某三甲医院住院患者营养风险发生率及营养不良状况。方法采用定点连续抽样方法收集2017年12月到2018年4月住院患者进行营养风险筛查评分(NRS2002),并对NRS2002≥3分的住院患者以体重指数为标准评价其营养状况。结果抽样的新入院患者3924例,其中3712例(94.6%)完成数据收集,营养风险发生率为11.7%(435/3715);抽样的住院患者27544例,其中25986例(94.3%)完成数据收集,营养风险发生率为43.0%(11169/25986)。新入院患者营养风险发生率明显低于已住院患者,差异有统计学意义(P<0.05)。11169例住院有营养风险患者营养不良率为48.4%(5409/11169)。结论已住院患者营养风险发生率明显高于新入院者,且营养不良比例较高。及时对已入院患者进行营养风险复筛有助于了解患者的营养状况,及时制定营养干预方案。

妇科患者术后疼痛的护理探究

讨论为妇科腹腔镜手术患者开展优质护理的作用效果。方法:2020年4月-2021年5月,将126例妇科腹腔镜手术患者分两组,各63例,参照组常规护理,研究组优质护理,测算对比两组的护理满意度测算项目,以及接受护理前后的SDS测算项目、SAS测算项目、VAS测算项目、生活质量测算项目和睡眠质量测算项目。结果:研究组的护理满意度测算项目高于参照组(P<0.05)。护理前,研究组的SDS测算项目、SAS测算项目、VAS测算项目、生活质量测算项目和睡眠质量测算项目均与参照组大致相当(P>0.05)。护理后,研究组的SDS测算项目、SAS测算项目、VAS测算项目、生活质量测算项目和睡眠质量测算项目均优于参照组(P<0.05)。结论:指向妇科腹腔镜手术患者优质护理,效果良好,值得推广。

Risk factors analysis of rosiglitazone in patients with diabetes mellitus

According to the drug-related risk factors indicated in the latest product monograph, we made this research to analyze and discuss the risk factors associated with rosiglitazone in clinical application in China-Japan Friendship Hospital. We collected and reviewed all cases involving inpatients who had used rosiglitazone in the hospital over the past two years. The focus of our study is on the identification and discussion of the incidence of adverse reactions, contraindications and drug induced problems associ- ated with monotherapy or combined therapy of rosiglitazone. Three hundred and ninety eight cases were reviewed in the study including 3 patients with type 1 DM （0.75%） and 395 patients with type 2 diabetes mellitus （99.25%）. Peripheral edema developed in 9 patients （2.26%） in the course of rosiglitazone therapy; one patient （0.25%） was found to have macula edema before rosiglitazone therapy; Cardiac abnormalities were identified in 6 patients （1.51%） in the course of treatment, of which 2 patients were NYHA class 1, 3 patients were NYHA class Ⅱ and 1 patient was NYHA class IV. Abnormal hepatic function （elevated ALT） was found in 79 patients （19.85%） during their stay in hospital. In these patients, ALT levels of 1 - 2.5 times, 2.5 - 3 times over the upper limit were identified in 70 patients, 3 patients and 6 patients, respectively. Of the 398 patients on rosiglitazone, 123 patients （30.90%）, 165 patients （41.46%）, 104 patients （26.13%）, 3 patients （0.75%） and 1 patient （0.25%） were found to use concurrently insulin, metformin, organic nitrate, gemfibrozil and rifampin, respectively. We analyzed the risk factors associated with the clinical use of rosiglitazone, and identified the potential risks, and put forward suggestions to improve the effectiveness and safety of rosiglitazone therapy.

慢性心力衰竭病患实施老年综合评估干预的效果及预后探讨

研究老年综合评价在慢性心衰住院病人治疗中的作用。方法 本研究拟选取80例70岁及以上的 CHF病人,随机分成40例,对比组采用对症处理,研究组采用 CGA评价及干预。对两组病患入院及出院后一个月进行 CGA评分,并进行对比分析。研究组在3个月的随访中,其各项指标均有所改善。术后1年内再住院率及病死率。结果 术后1个月,研究组的各项机能指标均较对比组有显著提高(P<0.05);在随访三个月之后,研究组病患的心力衰竭知识掌握率、低盐饮食占比、体育锻炼占比以及体重控制占比、生活质量各项评分比对比组更高(P<0.05)结论 对于高龄 CHF病人,早期改善 CGA,及时采取有效的干预措施,对于提高病人的生存质量和预后具有十分重要的作用。

The association between frailty of older stroke patients during hospitalization and one-year all-cause mortality:A multicenter survey in China

Objective:Frailty is a common geriatric syndrome defined as multiple deficits,impairing the capacity to figure out insult.Previous studies have reported a significant association between frailty and mortality in stroke patients.This study aimed to explore the association between frailty and mortality among older Chinese stroke patients.Methods:This study was a secondary analysis of a multicenter prospective cohort study conducted in older Chinese inpatients from October 2018 to February 2020,and patients with a primary diagnosis of stroke including hemorrhage and ischemia,were included in our study.Frailty of older inpatients with stroke from six hospitals was measured by the FRAIL scale,and a one-year follow-up was performed by well-trained nurses of these hospitals via telephone.Multivariable logistic regression was used to detect the association between frailty and one-year mortality.Results:A total of 530 stroke patients with an average age of 72.94(SD¼5.79)years were included in the present study.There were 37(7.0%)hemorrhagic strokes and 493(93.0%)ischemic strokes,with 228(43.0%)females in this population.The prevalence of frailty was 22.5%.In the logistic regression model with adjustment for age,sex,instrumental activities of daily living(IADL),basic activities of daily living(ADL),education,history of falls,BMI,smoking,alcohol consumption,low handgrip strength,type of stroke and polypharmacy,stroke patients with frailty had an increased risk of one-year mortality compared to those without frailty(OR¼3.38,95%CI:1.22e9.37,P¼0.019).Conclusion:Our study indicated that frailty was an independent risk factor for one-year all-cause mor-tality among older stroke patients in China.Frailty may be an essential factor for clinicians to consider before making a comprehensive treatment,and corresponding mixed interventions,including exercise training and nutritional programs,need to be conducted among older stroke patients.

Association of swallowing problems with frailty in Chinese hospitalized older patients

Objective:To estimate the prevalence of dysphagia and frailty among hospitalized older patients and to analyze the relationship between dysphagia and frailty in these people.Methods:Data were collected on 386 participants aged 65 and older in a general hospital from April to December 2017.Patients were asked to complete a self-designed demographic questionnaire.Frailty and swallowing function assessments were performed using the Fried frailty phenotype and the 30-ml water swallowing test,respectively.Multiple stepwise logistic regression analyses were used to identify the association between frailty and dysphagia.Results:Dysphagia developed in 31.1%of older people,and 24.4%developed frailty.Frailty was statistically significantly related with dysphagia.Dysphagia was more prevalent in frail and pre-frail patients(48.9%and 32.4%,respectively)than those who were non-frail(13.6%).In multivariate analyses,frail(OR,5.420;95%CI,2.684±10.944;P<0.001)and history of choking/coughing while drinking(OR,2.954;95%CI,1.844±4.733;P<0.001)were associated with dysphagia.result.Conclusions:Frailty is associated with dysphagia.More attention should be paid to frailty and dysphagia of the elderly and further studies are needed to evaluate the correlated mechanism and develop targeted nursing interventions.

Health personnel-targeted education interventions on inpatient suicide prevention in general hospitals:A scoping review

Background:Inpatient suicide is an important part of patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by health personnel mastering inpatient suicide prevention strategy.To enhance health personnel’s inpatient suicide prevention strategy,education intervention is a common method.Educational interventions in the researches varied in contents,duration and outcome measurements.However,there has been not synthesis of education interventions targeting health personnel on inpatient suicide prevention.Objective:Prevention of inpatient suicide is a critical priority in patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by effective strategies mastered by health personnel through education interventions.Educational interventions in researches varied in contents,duration and outcome measurements.We aimed to review education interventions targeting health personnel on inpatient suicide prevention.Methods:A scoping review was used to analyze existing researches on education interventions targeting health personnel focusing on inpatient suicide prevention in general hospitals.Cochrane Library,PubMed,Embase,CINAHL,China National Knowledge Infrastructure,WanFang,and Chinese Scientific Journal Database were searched in Oct 2019.According to the inclusion and exclusion criteria,the searched studies were screened by two reviewers.And then,two researchers conducted the data extraction independently by using a table format,including the first author,year of publication,study design,participants,education intervention,etc.Results:Twelve studies were included in this scoping review.The contents of education interventions on inpatient suicide prevention included three aspects:suicide knowledge,suicide assessment,and skills for coping with suicide.The duration of education interventions ranged from 1.5-h to 32.0-h.The effects of education interventions were mainly focused on participants’knowledge,attitudes and skills of suicide prevention.Conclusion:The evidence showed that education interventions on inpatient suicide prevention had positive impact on health personnel’s knowledge,attitude and skills about inpatient suicide prevention in general hospitals.However,the best health personnel-targeted education intervention on inpatient suicide prevention in general hospitals was yet to be determined.In the future,it is necessary to combine evidence in this review and the actual condition in clinical practice.

Effect of Vacuum Sealed Drainage on Recovery of Gastrointestinal Function in Gastric Cancer Patients after Radical Gastrectomy

Objective This study aims to explore the effect of vacuum sealed drainage on the recovery of gastrointestinal function in gastric patients after radical gastrectomy. Methods One hundred and twenty patients who received radical gastrectomy for gastric cancer were randomly divided into two groups.Patients in the control group received continuous gastrointestinal decompression to drain the gastric juices after radical gastrectomy,whereas patients in the treatment group received vacuum sealed drainage.The postoperative variables between the two groups were compared,including time of bowel sound reoccurrence,time of the first flatus,indwelling time of gastric tube,days of hospitalization,and complications,such as anastomotic leakage,intestinal obstruction,wound infection,pulmonary infection,fever, and pharyngitis.SPSS 13.0 was used to analyze the data. Results Significant differences in the following variables were observed in patients between the two groups:time of bowel sound reoccurrence,time of the first flatus,indwelling time of gastric tube,and length of hospitalization of the patients.The value of each of these variables was much smaller in the treatment group than in the control group(P<0.05).No significant difference was found in the incidence of anastomotic leakage,intestinal obstruction,and wound infection among patients between the two groups(P>0.05). However,a significant differences were observed in the incidence of pulmonary infection,fever,and pharyngitis among the patients between the two groups(P<0.05),with much lower incidence of the variables in the treatment group than in the control group. Conclusions Vacuum sealed drainage used in gastric cancer patients after radical gastrectomy can accelerate the recovery of gastrointestinal function and reduce postoperative complications.Moreover,it shortens the indwelling time of the gastric tube, thereby making the patients feel comfortable without the disturbance from the gastric tube.

多环节质量改进在降低中心静脉导管相关血流感染中的应用研究

了解多项质量改善措施对中心静脉留置针所致血流感染的效果。方法采取前后对照研究方法,将2019年9月1日-2019年12月31日的109例住院病患作为对照组,将2021年6月1日-2021年9月30日的136例住院病患作为实验组,对照组实施常规护理,实验组进行中心静脉导管多环节质量改进,将中心静脉导管相关血流感染发生率、中心静脉导管留置时长、医护人员手卫生合格率。结果 实验组中心静脉导管相关血流感染发生率、医护人员手卫生执行率与对照组相比有统计学差异(P<0.05),两组病患中心静脉导管留置时长比较不具有统计学差异(P>0.05)。结论 制度管理、人员培训、置管及维护等环节质量改进有助于降低住院病患中心静脉留置导管相关性血流感染发生率。

An investigation of vitamin B12 deficiency in elderly inpatients in neurology department

Objective To investigate the status of vitamin B 12 deficiency in elderly inpatients in the department of neurology. Methods A total number of 827 patients in the department of neurology of Shanghai Punan hospital, from March 2007 to July 2008, were employed in the present study. They were 60 years or older, and the average age was 77.1±7.5 years old. All the patients were diagnosed with no severe hepatic or renal dysfunction, without any usage of vitamin B 12 during the previous 3 months before the detection. The levels of serum vitamin B 12, folate and homocysteine （Hcy） were evaluated. The patients with vitamin B 12 deficiency were screened. The resulting symptoms, positive signs of neurological examination, and the neuroelectricphysiological results were compared between patients with or without vitamin B 12 deficiency. Results Vitamin B 12 deficiency was found in 163 patients （19.71% of the total patients）, and was more prevalent in female than in male patients, also with increased incidences with aging. Patients with low levels of serum vitamin B 12 exhibited higher rate of gastrointestinal diseases, while only 9.82% of the vitamin B 12 deficient patients had megaloblastic anemia. Symptoms of vitamin B 12 deficiency included unsteadily walking in the darkness and hypopallesthesia, and some chronic diseases such as cerebral ischemia, hypertension, Parkinson＇s disease （Parkinsonism）, diabetes mellitus and coronary heart disease. Most of the vitamin B 12 deficient patients had neuroelectricphysiological abnormalities. Conclusion Vitamin B 12 deficiency is remarkably common in elderly patients in neurology department, with various and atypical clinical manifestations, and the neurological symptoms are more common than megaloblastic anemia symptoms.

Why are we performing fewer cholecystectomies for mild acute biliary pancreatitis?Trends and predictors of cholecystectomy from the National Readmissions Database(2010–2014)

Background:Current guidelines recommend cholecystectomy for patients with mild acute biliary pancreatitis(MABP)during the index admission because it is associated with better outcomes.In this study,we aimed to assess national trends in cholecystectomy during index admissions for MABP and to identify factors associated with cholecystectomy completion and 30-day readmission.Methods:Using diagnostic codes and the National Readmissions Database,we identified patients admitted with MABP between 2010 and 2014.Differences in cholecystectomy rates were computed on the basis of various characteristics.We conducted a multivariable analysis to identify factors associated with 30-day readmission and cholecystectomy during the same admission.Results:We identified 255,695 unique index MABP cases(41.3%male)and the 30-day readmission rate was 12.6%.Overall,43.8%underwent cholecystectomy and 25%underwent endoscopic retrograde cholangiopancreatography(ERCP)with sphincterotomy.We observed a decreasing trend in both procedures during the study period(P<0.001).In multivariate analysis,odds of 30-day readmission were reduced for patients undergoing ERCP with sphincterotomy(odds ratio,0.78;95%confidence interval,0.74–0.84)or cholecystectomy(odds ratio,0.37;95%confidence interval,0.35–0.39).Conclusions:For patients with MABP,cholecystectomy or ERCP with sphincterotomy during the index admission decreased the risk of 30-day readmission.Despite this benefit and national guidelines recommending cholecystectomy during the index MABP admission,the rate of cholecystectomies performed nationally decreased during the study period.Further research is needed to understand the implications and reasons underlying this deviation from guidelines.