目的 为老年股骨颈骨折的患者制定合理的循证护理方案。 方法 在充分了解老年股骨颈患者病情的基础上，根据PICO原则，提出临床问题并转化为易于检索的形式，于2012年5月检索了Cochrane系统评价数据库（CDSR）、Cochrane对照试验注册中心（CCTR）、效果评论摘要数据库（DARE）、Medline、国家指南网（NGC）、PubMed 网站、中国生物医学文献数据库（CBM）以及复旦大学JBI循证护理中心，获取并评价相关的系统评价、随机对照试验以及临床指南。 结果 共检索到3篇系统评价、2篇临床随机对照试验和1篇临床实践指南。根据检索的结果，与患者及家属沟通后，选用Braden量表对患者进行压疮评估；指导患者每2小时翻身；进行腰背肌的锻炼，2～4 h/次，第1天5遍/次，之后逐渐递增为10～20遍/次；指导摄入高能量、高蛋白食物。1周后，患者机体状况良好，顺利接受手术治疗。 结论 采取循证护理的方法可以为患者提供科学、个性化的护理。
Objective To explore the burden situation among caregivers of stroke survivors, and analyze the association between burden and the quality of life among caregivers. Method In this cross-sectional study, a total of 230 stroke survivor-caregivers were investigated with basic demographic information, Zarit Burden Interview (ZBI) and the World Health Organization Quality of Life Instrument-Short Form (WHOQOL-BREF) from May 2015 to November 2015. Results The mean age of the caregivers of stroke survivors was (66.7±11.7) years, and the caregiver burden was in the mild level with the mean ZBI score of 21.11±6.96. The multiple linear regression analysis showed that the influencing factors of caregiver burden were the complications, self-care ability, residence of stroke survivors, and the self-rating health status of caregivers (P<0.05). And the total ZBI score was negatively correlated with the total WHOQOL-BREF scores (P<0.01), physiological dimensional scores (P<0.01), social dimensional scores (P<0.01), and environmental dimensional scores of caregivers (P<0.01). Conclusions The caregivers of stroke survivors suffer from general caregiver burden, and the heavier caregiver burden is, the poorer the quality of life of the caregivers is. According to the different conditions between urban and rural areas of China, it is reasonable to formulate a targeted program with the consideration of requirements referring to stroke survivors and their caregivers. It should involve physiological, psychological, social, environmental factors and so on to improve the caregivers’ quality of life finally.
目的 探讨结肠癌患者术后3年生存情况的影响因素。方法 回顾2006年1月至2007年12月期间笔者所在科室收治的确诊为结肠癌且随访资料完整的169例患者临床资料，从术前CEA水平、肿瘤病理分型、分化程度和体质指数（BMI）方面分析影响结肠癌预后的因素。结果 术前CEA水平、肿瘤分化程度及BMI对术后3年生存期的差异有统计学意义（P＜0.05），术前CEA水平对术后3年生存率的差异均有统计学意义（P＜0.05）；术前CEA水平、病理分型、分化程度对术后发生转移的差异有统计学意义（P＜0.05）。结论 术前CEA水平是结肠癌预后的高危因素。
ObjectiveTo analyze the risk factors of acute wound infection in orthopedic patients. MethodsA retrospective analysis was made on the clinical data of 576 orthopedic patients in accordance with the inclusion criteria between July and October 2012. There were 345 males and 231 females, aged 18-95 years (mean, 44 years). Single factor analysis was used for related factors, and logistic regression analysis of multi-factors for risk factors of acute wound infection. ResultsWound infection occurred in 73 of 576 patients (12.7%). Single factor analysis showed that the influence factors were gender, education, smoking history, nutritional status (hemoglobin, red blood cell count, serum albumin, and total serum protein), blood glucose level, shock history, wound situation (characteristics, multiple injuries, and cleaning), type of injuries, the time of trauma handling, antibiotic use, whether to stay in ICU, wound pain score, drug analgesia, patient controlled analgesia, and dressings and cleaning solution choice. The logistic regression analysis showed that the gender, time of trauma handling, blood glucose level, wound pain score, dressing choice, and wound characteristics were the risk factors of acute wound infection (P<0.05). ConclusionTo achieve the best results in clinical prevention of infection, these risk factors (gender, the time of trauma handling, blood glucose level, wound pain score, dressing choice, and wound characteristics) should be considered well.