介绍我院应对新型冠状病毒感染防控工作的护理管理措施,包括发热病区的组建,护理应急队伍的建设,工作流程指引的修订和完善,院感防护措施的严格落实,后勤保障的严密管理等,并进行护理质量控制与持续改进,为其他医院的防控工作提供借鉴。

It introduces nursing management measures of novel coronavirus infection prevention and control in our hospital, including the establishment of fever ward, the construction of nursing emergency team, the revision and improvement of working process guidelines, the strict implementation of hospital sensory protection measures, tight management of logistical support, and quality control and continuous improvement of nursing. It offers experiences for other hospitals.

目的 探讨产前超声联合磁共振诊断胎儿部分性胼胝体发育不全的价值。方法 收集产前超声联合磁共振诊断为部分性胼胝体发育不全的胎儿15例,对比出生或引产后的检查结果,分析产前超声特征。结果 产前超声直接征象:胼胝体正中矢状切面相应部位缺失12例(12/15,80.0%)。间接征象:透明隔腔形态异常(80.0%)、侧脑室扩张(73.3%)、大脑纵裂池分离(73.3%)、脑中线丘脑后方囊性包块(26.7%)、侧脑室“泪滴状改变”(26.7%)、胼周动脉走行异常(26.7%),合并颅内或其他系统畸形6例。对比出生或引产后随访结果,诊断准确率:产前超声80.0%,产前磁共振93.3%。结论 超声可以诊断胎儿部分性胼胝体发育不全,更精确的诊断建议结合产前胎儿头颅磁共振检查。

Objective To explore the value of prenatal ultrasound in diagnosis of fetal partial agenesis of corpus callosum. Methods 15 fetuses diagnosed as partial agenesis of corpus callosum by prenatal ultrasound combined with magnetic resonance imaging (MRI) were collected. Results of examination after birth or induction of labor were compared to analyze the characteristics of prenatal ultrasound. Results Direct signs were observed in the prenatal sonographic features: 12 cases (12/15, 80.0%) were missing corresponding parts in the midsagittal section of corpus callosum. Indirect signs: transparent partition morphological abnormalities (80.0%), lateral ventricle expansion (73.3%), separation of longitudinal crack on the brain pool(73.3%), posterior thalamic midline cystic mass (26.7%), “teardrop change” of the lateral ventricle (26.7%), abnormal course of pericallosal artery (26.7%), with intracranial and other system deformity in 6 cases, including multiple anomalies. Compared with the follow-up results after birth or induction of labor, the diagnostic accuracy was 80.0% of prenatal ultrasound and 93.3% of prenatal MRI. Conclusion Ultrasonography may diagnose fetal partial agenesis of corpus callosum properly, and more accurate diagnosis could be finished combining with prenatal fetal cranial MRI.

目的 探讨凯格尔(Kegel)锻炼法结合生物反馈电刺激对产后盆底康复管理效果的影响。方法 选取2018年5月—2019年4月在我院妇产科阴道分娩的足月产妇200例,采用随机数字法分为对照组和观察组,每组各100例,对照组单纯给予Kegel锻炼法,观察组给予Kegel锻炼法结合生物反馈电刺激。干预2～3个月,比较两组患者盆底肌肉功能相关指标改善情况,并比较两组患者生活质量的改变。结果 干预后,观察组患者盆底肌Ⅰ类肌纤维肌力恢复正常率为86.0%(86/100),高于对照组的56.0%(56/100),观察组盆底肌Ⅱ类肌纤维肌力恢复正常率为83.0%(83/100),高于对照组的54.0%(54/100),差异均有统计学意义(P<0.05)。且干预后,观察组下腹不适、尿失禁、排尿异常、排便异常及阴道分泌物异常患者低于对照组(P<0.05),性生活质量评分高于对照组(P<0.05)。结论 Kegel锻炼结合生物反馈电刺激可促进盆底肌力,改善尿失禁、盆腔器官脱垂等盆底异常症状,提高患者生性生活质量。

Objective To explore the effect of Kegel exercise combined with biofeedback electric stimulation on the management of postpartum pelvic floor rehabilitation. Methods A total of 200 full-term pregnant women who delivered vaginally in our hospital from May 2018 to April 2019 were randomly divided into two groups: the control group and the observation group, with 100 cases in each group. The control group was only given Kegel exercise method, and the experimental group was given Kegel exercise method combined with biofeedback electrical stimulation. After 2～3 months of intervention, the improvement of pelvic floor muscle function and quality of life of the two groups were compared. Results After intervention, the recovery rate of pelvic floor muscle type I muscle strength in the observation group was 86.0% (86/100), higher than that in the control group (56/100), and the recovery rate of pelvic floor muscle type II muscle strength in the observation group was 83.0% (83/100), higher than that in the control group (54/100). The difference was statistically significant (P<0.05). After the intervention, the patients situations in the experimental group were lower than those in the control group (P<0.05) including abdominal discomfort, urinary incontinence, abnormal urination, abnormal defecation and abnormal vaginal secretion, and the score of sexual quality of life was higher than that in the control group (P<0.05). Conclusion Kegel exercise combined with biofeedback electrical stimulation may promote pelvic floor muscle strength, improve the symptoms of urinary incontinence, pelvic organ prolapse and other pelvic floor abnormalities, and improve the quality of life of patients.

目的 探讨鼻咽癌个案管理模式,并评价临床中运用的效果。方法 回顾性将2017年8月—2018年4月93例新确诊的鼻咽癌患者作为对照组,按鼻咽癌患者的一般护理常规进行护理。2018年5月—2019年8月新确诊的鼻咽癌患者96例为实验组,实施个案管理比较两种方法的临床运用效果。结果 与对照组比,实验组诊断期完成检查时间和首次住院天数短、既定治疗计划完成率和治疗期间复诊依从性高,Ⅳ度骨髓抑制发生率低,差异均有统计学意义(P<0.05)。结论 鼻咽癌个案管理模式可为患者提供全程、连续性、高品质的护理,提高患者复诊依从性、提高治疗计划完成率,提高医疗护理质量,值得临床推广应用。

Objective To explore the case management mode of nasopharyngeal cancer (NPC) and evaluate the effect of clinical application. Methods 93 patients newly diagnosed NPC from August 2017 to April 2018 were used as the control group,and the general nursing routine was followed. 96 patients newly diagnosed NPC from May 2018 to August 2019 were taken as the experimental group,and accepted case management. Results Compared with the control group,the test time of the experimental group was shorter,the first hospital stay was shorter,the completion rate of treatment was higher,the patient's compliance of follow-up during treatment was better,incidence of grade Ⅳ myelosuppression was lower.The difference was statistically significant (P< 0.05). Conclusion The case management mode of NPC may provide seamless and high-quality nursing for NPC patients,improve the completion rate of treatment,improve the patient's compliance of follow-up and improve the quality of medical care,which is worthy of clinical application.

目的 了解血脂异常在青少年人群中的分布及影响因素。方法 以江门市棠下中学1 449名学生为研究对象,对其进行问卷调查、InBody人体成分仪检测和实验室检查。结果 血脂异常总检出率是8.3%,高胆固醇(TC)、高甘油三脂(TG)、高低密度脂蛋白胆固醇(LDL-C)和低高密度脂蛋白胆固醇(HDL-C)血症的检出率分别为8.3%、7.8%、10.6%和7.2%,女生血脂异常检出率(26.4%)高于男生(19.8%)(P<0.001);多因素分析显示性别(参照男性,OR=1.39,95%CI=1.08~1.80)和体脂百分比(参照正常组,超重、肥胖和重度肥胖组OR和95%CI分别OR = 1.62 / 2.89 / 4.45,95% CI = 1.13~2.32 / 1.85~4.51 / 2.48~7.96)与血脂异常间存在统计学关联(P<0.05)。结论 性别、体脂百分比是青少年血脂异常的影响因素。相对于青少年男生,青少年女生检出血脂异常的比例更高,体脂百分比高的青少年血脂异常的风险更高。

Objective To study the distribution and influencing factors of dyslipidemia among teenagers. Methods A questionnaire survey,InBody body composition test and laboratory examination were conducted on 1 449 students from the Tangxia Middle School in Jiangmen city as study objects. Results The total detection rate of dyslipidemia was 8.3% and the detection rates of high total cholesterol (TC),triglyceride (TG),high low-density-lipoprotein cholesterol (LDL-C) and low high-density-lipoprotein cholesterol (HDL-C) were 8.3%,7.8%,10.6% and 7.2%,respectively. The detection rate of dyslipidemia among teenage girls (26.4%) was higher than that among teenage boys (19.8%) (P<0.001). Multivariate analysis indicated that gender (with reference to male,OR=1.39,95%CI=1.08-1.80) and body fat percentage (with reference to normal group,for overweight,obesity and severe obesity groups,OR=1.62,2.89,4.45 and 95%CI=1.13-2.32,1.85-4.51,2.48-7.96,respectively) were statistically related to dyslipidemia (P<0.05). Conclusion Gender and body fat percentage are the influencing factors of dyslipidemia among teenagers. Compared with teenage boys,the teenage girls have a higher detection percentage of dyslipidemia. Teenagers with higher percentage of body fat show a higher risk of dyslipidemia.

目的 探究分析基于互联网平台的健康管理模式对2型糖尿病患者血糖管理的效果及其临床价值。方法 选择2018年3月—2019年3月期间到我院进行治疗的120例2型糖尿病患者作为研究对象,用电脑随机法分为对照组和实验组各60例,对照组患者对其进行常规的护理干预,实验组患者给予基于互联网平台的健康管理模式,测试他们接受护理管理前后的血糖情况,邀请所有患者填写焦虑、抑郁自评量表评分并比较两组患者的心理状态评分,比较两组患者的生活质量和护理满意度。分析它们的护理要点及其结果。结果 实验组患者的护理后的血糖低于对照组;实验组患者焦虑自评量表(SAS)、抑郁自评量(SDS)表得分分别为(45.2±4.3)分和(42.8±6.3)分,这两个表均低于对照组的(56.3±7.5)分、(58.1±3.9)分;实验组患者的生活质量高于对照组;护理满意度高于对照组,差异有统计学意义(P＜0.05)。结论 应用基于互联网平台的健康管理模式有利于提高糖尿病患者血糖控制效果,对改善患者负面情绪、提高其生活质量及维持良好的护患关系也具有积极意义。

Objective To explore the effect and clinical value of health management model based on internet platform on blood glucose management in patients with type 2 diabetes(T2DM). Methods 120 patients with T2DM who came to our hospital for treatment from March 2018 to March 2019 were selected and they were randomly divided into the control group and the experimental group with 60 cases each. The patients in the control group were given routine nursing intervention. The patients in the experimental group were given health management mode based on the internet platform to test their blood glucose before and after receiving nursing management. All patients were invited to filled in the self-rating anxiety scale (SAS) and self-rating depression scale (SDS).The blood glucose level, the psychological state, the self-rating scales and nursing points in the two groups were investigated and compared after intervention. Results The blood glucose of the experimental group was lower than that of the control group, the scores of SAS and SDS were (45.2 ± 4.3) (42.8 ± 6.3) respectively, both of which were lower than those of the control group (56.3 ± 7.5) and (58.1 ± 3.9); the quality of life of patients in the experimental group was higher than that in the control group; nursing satisfaction was higher than that in the control group, the difference was statistically significant (P<0.05). Conclusion The application of health management model based on internet platform is conducive to improving the effect of blood glucose control in diabetes patients, relieving their negative emotions, improving their quality of life and maintaining a good nurse-patient relationship.

目的 探讨品管圈(Quality Control Circle, QCC)活动对降低造影剂外渗的效果观察。方法 根据QCC的方法和步骤,成立QCC小组,通过比较和分析QCC活动实施前后外渗率的变化,找出导致CT增强扫描前接受高压静脉造影剂注射外渗的主要原因,提出针对性的改进措施并分析其效果。结果 QCC活动实施前外渗率达0.17%,而实施后外渗率为0.07%,差异有统计学意义(P<0.05)。结论 开展QCC活动可降低CT增强扫描前造影剂外渗发生率,值得临床推广应用。

Objective To investigate the effect of quality control circle (QCC)activity on reducing contrast agent extravasation. Methods According to the steps and methods of the quality control circle, a QCC group was set up to compare and analyze the data before and after the implementation of QCC activities to find out the main reason for the extravasation of high-pressure intravenous contrast agent injection before CT enhanced scanning, and put forward targeted improvement measures to analyze its effect. Results The extravasation rate before QCC activity was 0.17%, and the extravasation rate after implementation was 0.07%, the difference was statistically significant (P <0.05). Conclusion Carrying out QCC activities may reduce the incidence of contrast agent extravasation before CT enhanced scanning, which is worthy of clinical application.

新型冠状病毒肺炎是一种新发的急性呼吸道疾病,如何准确、完整、及时的记录好新冠肺炎患者的病历信息,为医学研究提供科学的依据是医院病案管理统计的工作重点。本文结合国家相关的规定和某新冠肺炎定点救治医院疫情防控工作经验,提出针对新冠肺炎病历的管理方案,包含病历的书写、编码、运行管理三方面,配合医院做好疫情防控工作的同时妥善记录好新冠肺炎患者病历信息。

Coronavirus disease 2019 is a new type of acute respiratory disease. Recording accurately, completely and timely the medical records of patients with COVID-19 and providing a scientific basis for medical research are the focus of the medical records management statistics. This paper proposes a management plan including writing, coding, and operation management for COVID-19 medical records, combining with the relevant national regulations and a COVID-19 designated hospital's experiences of epidemic prevention and control. This management plan cooperates with the hospital to do epidemic prevention and control work, and properly recordes the medical records of COVID-19 patients.

目的 探讨医院-社区-家庭一体化管理在精神分裂症患者中的应用效果。方法 选择我院2018年6月—2019年6月期间收治的精神分裂症患者86例,按随机数字表法分为两组,每组43例。对照组采取常规护理管理,研究组实施医院-社区-家庭一体化管理,观察6个月。比较两组精神症状、生活质量及肇事肇祸率。结果 两组管理前阳性与阴性症状量表(PANSS)评分、WHOQOL-100评分比较,差异无统计学意义(P＞0.05);两组管理后PANSS评分均低于管理前,生存质量测定量表简表(QOL-BREF)评分高于管理前,差异有统计学意义(P＜0.05);研究组管理后PANSS评分为(43.23±8.11)分,低于对照组的(49.48±8.26)分,WHOQOL-100评分为(83.69±8.87)分,高于对照组的(77.25±8.54)分,差异有统计学意义(P＜0.05);研究组肇事肇祸率为9.30%,低于对照组的25.58%,差异有统计学意义(P＜0.05)。结论 医院-社区-家庭一体化管理的实施能够减轻精神分裂症患者精神症状,提升生活质量,降低肇事肇祸率。

Objective To explore the applications of hospital community family integrated management on the quality of life and accident rate of schizophrenics. Methods 86 schizophrenics admitted to our hospital from June 2018 to June 2019 were divided into two groups according to the method of random number table, 43 cases in each group. Routine nursing management was adopted in the control group and hospital community family integrated management was implemented in the study group for 6 months. The mental symptoms, quality of life and accident rate were compared between the two groups. ResultsThere was no statistical significance in PANSS score and WHOQOL-100 score between the two groups before management (P>0.05); PANSS score of the two groups after management was lower than that before management, QOL-BREF score was higher than that before management, and the difference was statistically significant (P<0.05); PANSS score of the study group after management was (43.23±8.11), lower than that of the control group (49.48±8.26), WHOQOL-100 score was (83.69±8.87), higher than the control group (77.25±8.54), the difference was statistically significant (P<0.05); the study groupls accident rate was 9.30%, lower than that of the control group 25.58%, the difference was statistically significant (P<0.05). Conclusion The implementation of hospital community family integrated management reduces the mental symptoms of schizophrenics, improve the quality of life, and reduce the accident rate.

目的 分析应用蓝激光成像技术(BLI)联合内镜智能分光比色技术(FICE)诊断早期食管癌的临床意义。方法 收集本院及下级医院2016年1月—2018年6月在普通内镜下发现的108例食管可疑病变患者,分别给予白光、FICE和BLI不同模式进行观察诊断,再结合放大模式对病变部位的上皮乳头内毛细血管袢(IPCL)进行观察、分型、判断性质。最后取活检送病理学检查。内镜数据和病理数据采用Kappa一致性检验方法、Spearman相关性分析,统计每种内镜检查模式诊断的准确性,分析各方法下IPCL分型与病理诊断之间的相关性。结果 Kappa一致性检验显示,白光内镜、FICE、BLI以及FICE+BLI等模式诊断早期食管癌的准确度、敏感度、特异度、阳性预测、阴性预测及Kappa值呈逐步升高;Spearman相关性分析显示,FICE、BLI以及BLI与FICE联合诊断时,IPCL分型与早期食管癌的诊断均呈正相关,且BLI联合FICE的相关性强于BLI或FICE单独诊断。结论 BLI联合FICE可显著提高早期食管癌的诊断率,结合放大内镜下IPCL分型可判断早期食管癌病理分型。

Objective To analyze the clinical significance of blue laser imaging (BLI)technology combined with Fuji intelligent chromo endoscopy (FICE)in the diagnosis of early esophageal cancer. Methods 108 cases of patients with esophageal suspicious lesions admitted to our hospital from January 2016 to June 2018 were enrolled in the study. They were given different modes of white light, FICE and BLI for observation and diagnosis, and the magnifying endoscopy model was combined to observe the intraepithelial papillary capillary loop (IPCL)at lesions sites for IPCL typing. After complete endoscopic examinations, the lesions were taken for pathological examination. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa value of each method were tested by Kappa consistency test. Spearman correlation analysis was used to analyze the correlation between IPCL classification and pathological diagnosis under each method. Results Kappa consistency test showed that the accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa value of white light endoscopy, FICE, BLI and FICE+BLI were increased in the diagnosis of early esophageal cancer. IPCL classification under combined magnifying endoscopy showed that type IV was mainly early esophageal cancer, and types I-III were mainly precancerous lesions. Spearman correlation analysis showed that through FICE, BLI and BLI combined with FICE for diagnosis, IPCL classification was positively correlated with early esophageal cancer, and the correlation of BLI combined with FICE was stronger than that of BLI or FICE. Conclusions BLI combined with FICE can greatly improve the diagnosis rate of early esophageal cancer. Combined with magnifying endoscopy, IPCL classification can judge the pathological types of early esophageal cancer.