先进急诊医学最新文献

{"title":"糖尿病足病的治疗与预防","authors":"宋 立卓","doi":"10.18686/xjjz.v1i1.1098","DOIUrl":"https://doi.org/10.18686/xjjz.v1i1.1098","url":null,"abstract":"<div>研究影响糖尿病患者足病发生</div><div>、</div><div>愈合及复发的风险因素</div><div>。</div><div>方法 我院内分泌科住院治疗且</div><div>资料完整的糖尿病足</div><div>(DF)</div><div>患者</div><div>95</div><div>例为</div><div>DF</div><div>组</div><div>,</div><div>以同期住院的无足病糖尿病</div><div>(NDF)</div><div>患者</div><div>98</div><div>例为对照</div><div>(NDF 组</div><div>),</div><div>比较分析两组的临床特征</div><div>,</div><div>多因素</div><div>Logistic</div><div>回归分析糖尿病足病的风险因素</div><div>。</div><div>结果</div><div>DF</div><div>组年龄</div><div>、</div><div>收</div><div>缩压</div><div>、</div><div>白细胞计数</div><div>、</div><div>血小板计数</div><div>、</div><div>尿</div><div>ALB/</div><div>肌酐比值</div><div>(ALB/Cr)、24h</div><div>尿白蛋白定量显著高于</div><div>NDF</div><div>组</div><div>(P</div><div>均</div><div><</div><div>0.05),</div><div>而体重指数</div><div>(BMI)、</div><div>血红蛋白</div><div>、</div><div>血清白蛋白</div><div>(ALB)、</div><div>总胆固醇</div><div>、</div><div>三酰甘油</div><div>、</div><div>高密度脂蛋白胆固醇</div><div>、</div><div>低密</div><div>度脂蛋白胆固醇</div><div>、</div><div>踝肱指数</div><div>(ABI)</div><div>明显低于</div><div>NDF</div><div>组</div><div>(P</div><div>均</div><div><0.05)。DF</div><div>组的糖尿病视网膜病变</div><div>、</div><div>糖尿病肾</div><div>病</div><div>、</div><div>糖尿病下肢血管病变</div><div>、</div><div>糖尿病周围神经病变发生率明显高于</div><div>NDF</div><div>组</div><div>(P</div><div>均</div><div><0.05),NDF</div><div>组高脂血症发</div><div>生率显著高于</div><div>DF</div><div>组</div><div>(P<0.05)。</div><div>多因素</div><div>Logistic</div><div>回归分析</div><div>,</div><div>收缩压</div><div>、</div><div>血小板计数</div><div>、</div><div>血清白蛋白为糖尿病足</div><div>的独立危险因素</div><div>(P</div><div>均</div><div><0.05)。</div><div>根据预后</div><div>,</div><div>愈合组和未愈组收缩压</div><div>、C</div><div>肽</div><div>、</div><div>尿</div><div>ALB/Cr、24h</div><div>尿蛋白定量</div><div>、</div><div>ABI</div><div>有统计学差异</div><div>(P<0.05),</div><div>愈合组和复发组在空腹胰岛素</div><div>、</div><div>尿</div><div>ALB/Cr、</div><div>溃疡时间有统计学差异</div><div>(P<</div><div>0.05)。</div><div>足部分泌物细菌学检查</div><div>,</div><div>最常见的病原菌为金色葡萄球菌</div><div>,</div><div>占</div><div>14.0%(7/50)。</div><div>结论</div><div>:</div><div>老年糖尿病合</div><div>并收缩压高</div><div>、</div><div>血小板计数增高</div><div>、ALB</div><div>低发生糖尿病足的风险增高</div><div>。</div><div>临床应在糖尿病足病的不同病期</div><div>,</div><div>针对</div><div>不同的风险因素</div><div>,</div><div>进行积极的处理</div><div>,</div><div>以预防和延缓糖尿病足的发生</div><div>、</div><div>发展</div><div>。</div>","PeriodicalId":69898,"journal":{"name":"先进急诊医学","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85836818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"预防性护理对降低心血管内科住院患者坠床跌倒的应用","authors":"信 千千","doi":"10.18686/xjjz.v1i1.1094","DOIUrl":"https://doi.org/10.18686/xjjz.v1i1.1094","url":null,"abstract":"<div>探讨心血管内科住院患者采取预防性护理对其降低坠床跌倒发生的应用效果</div><div>。</div><div>方法 选择</div><div>2017</div><div>年</div><div>1</div><div>月至</div><div>2019</div><div>年</div><div>1</div><div>月至我院诊疗的</div><div>100</div><div>例心血管内科住院患者当做研究对象</div><div>,</div><div>并以抽签法将其均等</div><div>划分为两组</div><div>,</div><div>即观察组和对照组</div><div>,</div><div>对照组以常规护理干预施护</div><div>,</div><div>观察组以此为基础实施预防性护理</div><div>,</div><div>对两组</div><div>患者坠床跌倒事件发生情况</div><div>、</div><div>健康教育知识掌握度评分以及满意度加以对比</div><div>。</div><div>结果 观察组的坠床跌倒</div><div>事件发生率低于对照组</div><div>,</div><div>且健康教育知识掌握度评分以及总体满意率均高于对照组</div><div>,</div><div>差异显著</div><div>,</div><div>有统计学</div><div>意义</div><div>,P<0.05。</div><div>结论 心血管内科住院患者采取预防性护理能够使患者掌握疾病治护相关知识</div><div>,</div><div>使坠床</div><div>跌倒事件的发生减少</div><div>,</div><div>从而提升患者满意度</div><div>,</div><div>值得推广</div>","PeriodicalId":69898,"journal":{"name":"先进急诊医学","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73277684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"舒适性护理干预对初产妇母乳喂养与新生儿皮肤护理 认知水平的影响","authors":"曹 慧蓉","doi":"10.18686/xjjz.v1i1.1090","DOIUrl":"https://doi.org/10.18686/xjjz.v1i1.1090","url":null,"abstract":"<div>实验研究行舒适性护理干预措施对初产妇母乳喂养与新生儿皮肤护理认知水平的影响</div><div>。 方法 将本医院</div><div>2017</div><div>年</div><div>8</div><div>月到</div><div>2019</div><div>年</div><div>3</div><div>月收治的初产妇</div><div>72</div><div>例</div><div>,</div><div>作为研究的样本</div><div>,</div><div>根据护理方式的不同将</div><div>研究的样本分为两组</div><div>,</div><div>实验组和对照组</div><div>,</div><div>实验组实施舒适性护理干预措施</div><div>,</div><div>对照组实施基础的干预措施</div><div>。 分析两组产妇对于新生儿喂养以及皮肤护理知识的了解情况</div><div>。</div><div>结果 利用评分法对两组产妇的母乳喂养</div><div>认知水平以及新生儿皮肤护理认知水平进行评分</div><div>,</div><div>根据评分结果显示</div><div>,</div><div>实验组产妇的评分要显著高于对照</div><div>组</div><div>,</div><div>与对照组差异明显</div><div>P<0.05,</div><div>存在统计学意义</div><div>。</div><div>结论 对初产妇实施舒适性护理干预措施</div><div>,</div><div>可以提高</div><div>其母乳喂养的水平</div><div>,</div><div>强化产妇对新生儿皮肤护理的认知水平</div><div>,</div><div>减少了新生儿患病的概率</div><div>,</div><div>促使新生儿更加</div><div>健康的成长</div><div>,</div><div>具有临床护理应用的价值</div><div>。</div>","PeriodicalId":69898,"journal":{"name":"先进急诊医学","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90661662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"心血管内科临床用药问题及用药研究","authors":"周 洋","doi":"10.18686/xjjz.v1i1.1096","DOIUrl":"https://doi.org/10.18686/xjjz.v1i1.1096","url":null,"abstract":"<div>统计分析心血管内科疾病患者治疗中存在的用药安全问题</div><div>,</div><div>以及管理整改措施</div><div>。</div><div>方法 随</div><div>机抽取我院</div><div>2018</div><div>年</div><div>2</div><div>月</div><div>-2019</div><div>年</div><div>2</div><div>月心血管内科收治的</div><div>300</div><div>例患者</div><div>,</div><div>调查患者用药情况</div><div>,</div><div>分析主要用药</div><div>问题以及处理方式</div><div>。</div><div>结果</div><div>300</div><div>例患者中不合理用药总例数为</div><div>34,</div><div>其中不合理用药类型主要为抗菌药物</div><div>使用不合理</div><div>,</div><div>其次为配伍不合理</div><div>、</div><div>用法用量不合理</div><div>、</div><div>疾病诊断与用药不相符以及用药禁忌症忽视</div><div>。</div><div>结论 提</div><div>升心血管内科临床治疗用药的安全性对于治疗效果的提升有非常重要的作用</div><div>,</div><div>相关管理人员需要结合患</div><div>者的基本情况以及治疗方案为患者选择相应的药物进行治疗</div><div>,</div><div>确保治疗效果以及用药安全型的提升</div>","PeriodicalId":69898,"journal":{"name":"先进急诊医学","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88083991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"西药药剂头孢哌酮钠舒巴坦钠在临床当中应用的几点体会","authors":"蔡 子凤","doi":"10.18686/xjjz.v1i1.1089","DOIUrl":"https://doi.org/10.18686/xjjz.v1i1.1089","url":null,"abstract":"浅析在临床当中西药药剂头孢哌酮钠舒巴坦钠的应用体会。方法 此次82例研究对象都是2017年4月至2018年12月之间我院收治的用西药头孢类药物治疗的患者,用双盲法均分为两组,研究组患者使用头孢哌酮钠舒巴坦钠,参照组患者使用头孢他啶,对比两组疗效。结果 研究组临床总有效率为97.56%,明显高于参照组的85.37%,组间差异有统计学意义(P<0.05)。不良反应发生率研究组为19.51%,参照组为14.63%,组间差异无统计学意义(P>0.05)。结论 在临床当中西药药剂头孢哌酮钠舒巴坦钠有着较好的抗感染效果,但是不合理用药会诱发不良反应,所以为了保证用药的安全性和有效性要规范、合理使用。","PeriodicalId":69898,"journal":{"name":"先进急诊医学","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82978648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"陆军军医大学第一附属医院皮肤科 重庆","authors":"李 垚莹","doi":"10.18686/xjjz.v1i1.1308","DOIUrl":"https://doi.org/10.18686/xjjz.v1i1.1308","url":null,"abstract":"<div>目的 探究重症患者大便失禁肛周皮肤护理干预的新技术及其临床应用效果。方法 以 2018 年 1 月至 2019 年</div><div>3 月为研究时间段，将该时间段在我院治疗的大便失禁重症患者 80 例作为研究对象，根据临床前瞻性研究原则，采用</div><div>随机数字表法，将之分为两组，各 40 例，在重症患者大便失禁肛周皮肤护理干预中，对照组采用传统技术，观察组采</div><div>用新技术，对比两组干预效果。结果 观察组肛周皮肤损伤发生率为 2.50%，低于对照组的 32.00%，且观察组均为Ⅰ期</div><div>损伤，两组数据对比差异显著（P＜0.05），有统计学意义。结论 重症患者大便失禁肛周皮肤护理干预新技术效果显</div><div>著，能够有效改善肛周皮肤损伤问题，降低损伤率及损伤程度，值得采纳应用。</div>","PeriodicalId":69898,"journal":{"name":"先进急诊医学","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77379118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"产科优质护理新模式对自然分娩的促进作用","authors":"李 春梅","doi":"10.18686/xjjz.v1i1.1099","DOIUrl":"https://doi.org/10.18686/xjjz.v1i1.1099","url":null,"abstract":"<div>探讨产科优质护理新模式对自然分娩所发挥的促进作用</div><div>。</div><div>方法 选择</div><div>2017</div><div>年</div><div>1</div><div>月至</div><div>2019 年</div><div>1</div><div>月至我院分娩的</div><div>100</div><div>例产妇当做研究对象</div><div>,</div><div>并以抽签法将入选对象随机均等划分为观察组及对照组</div><div>, 各</div><div>50</div><div>例</div><div>,</div><div>对照组采用常规模式施护</div><div>,</div><div>观察组在此基础上采用产科优质护理新模式施护</div><div>,</div><div>对两组自然分娩</div><div>率</div><div>、</div><div>产后</div><div>2h</div><div>出血量</div><div>、</div><div>汉密尔顿</div><div>(HAMD)</div><div>评分</div><div>、</div><div>下床活动时间以及满意度加以对比</div><div>。</div><div>结果 观察组的自然分</div><div>娩率以及总体满意率均比对照组高</div><div>,</div><div>差异显著</div><div>,</div><div>有统计学意义</div><div>,P<0.05;</div><div>观察组的产后</div><div>2h</div><div>出血量</div><div>、HAMD 评分以及下床活动时间均比对照组低</div><div>,</div><div>差异显著</div><div>,</div><div>有统计学意义</div><div>,P<0.05。</div><div>结论 产科优质护理新模式的</div><div>应用能够提升产妇自然分娩的概率</div><div>,</div><div>减少产后出血量</div><div>,</div><div>并且还能够使产后出现的负性心理得以减弱</div><div>,</div><div>使产</div><div>妇早日实现恢复</div><div>,</div><div>使产妇的满意度得到提升</div><div>,</div><div>值得推广</div><div>。</div>","PeriodicalId":69898,"journal":{"name":"先进急诊医学","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81384983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"分析急性心肌梗死(AMI)患者经皮冠状动脉介入治疗 (PCI)术后进行心脏康复训练的有效性","authors":"冠军 周","doi":"10.18686/xjjz.v1i1.1095","DOIUrl":"https://doi.org/10.18686/xjjz.v1i1.1095","url":null,"abstract":"<div>研究急性心肌梗死</div><div>(AMI)</div><div>患者经皮冠状动脉介入治疗</div><div>(PCI)</div><div>术后进行心脏康复训练的有效</div><div>性</div><div>。</div><div>方法 选取本院</div><div>2018</div><div>年</div><div>2</div><div>月</div><div>-2019</div><div>年</div><div>2</div><div>月收治的</div><div>76</div><div>例急性心肌梗死</div><div>(AMI)</div><div>行</div><div>PCI</div><div>患者作为研究对</div><div>象</div><div>,</div><div>随机分为观察组</div><div>(38</div><div>例</div><div>)</div><div>和对照组</div><div>(38</div><div>例</div><div>)。</div><div>对照组采用常规术后护理</div><div>,</div><div>观察组在此基础上进行心脏康</div><div>复训练</div><div>。</div><div>观察两组干预效果</div><div>。</div><div>结果 心脏康复训练</div><div>7</div><div>天后</div><div>,</div><div>观察组患者的生活能力评分</div><div>、</div><div>左心室射血分数</div><div>都比对照组高</div><div>,</div><div>住院时间比对照组短</div><div>,</div><div>差异有统计学意义</div><div>(P<0.05)。</div><div>术后</div><div>6</div><div>个月</div><div>,</div><div>观察组患者在生理领</div><div>域</div><div>、</div><div>心理领域</div><div>、</div><div>社会关系领域和环境领域的生活质量评分都比对照组高</div><div>,</div><div>差异有统计学意义</div><div>(P<0.05)。</div><div>结</div><div>论</div><div>AMI</div><div>患者经</div><div>PCI</div><div>手术后</div><div>,</div><div>进行心脏康复训练</div><div>,</div><div>可以提高预后效果</div><div>,</div><div>改善患者生活质量</div><div>。</div>","PeriodicalId":69898,"journal":{"name":"先进急诊医学","volume":"66 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72565676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}