【摘要】 目的 了解老年慢性阻塞性肺疾病（chronic obstructive pulmonary diseases，COPD）患者的家庭功能与疾病应对方式情况。 方法 2009年12月-2010年2月对102例老年COPD患者采用医学应对方式问卷和家庭功能评估问卷调查。 结果 82.4%的患者家庭功能良好，老年COPD患者疾病应对方式评分分别为“面对”（19.14±2.67）分，“回避”（13.92±2.38）分，“屈服”（12.99±2.77）分；家庭功能良好的老年COPD患者更多采取“面对”的应对方式。 结论 本次调查的老年COPD患者家庭功能总体水平较高，不同的老年COPD患者采取的应对方式不同，应该给予相应的健康教育及护理干预。【Abstract】 Objective To explore the family function of the elder patients with chronic obstructive pulmonary disease (COPD) and their coping style. Methods From December 2009 to February 2010, 102 elder patients with COPD were investigated via a medical coping style questionnaire and a family function questionnaire. Results About 82.4% patients had good family function. The coping styles of the patients included "envisaging" (19.14±2.67), "eviting" (13.92±2.38), and "yielding" (12.99±2.77). Most of the patients with good family function had a coping style of "envisaging". Conclusion The general level of the family function of the elder patients with COPD is high; the patients have different coping style, who should accept relevant health education and nursing interference.
Objective To determine the influence and significance of combinative assessment of 64 multi-slice spiral computer tomography (MSCT) with serum amyloid A protein (SAA) or fibrinogen (FIB) on the selection of operative procedures of rectal cancer under the multidisciplinary team. Methods Prospectively enrolled 240 patients diagnosed definitely as rectal cancer at West China Hospital of Sichuan University from February to June 2009 were randomly assigned into two groups. In one group named MSCT+SAA group, both MSCT and SAA combinative assessment were made for the preoperative evaluation. In another group named MSCT+FIB group, both MSCT and FIB combinative assessment were made for preoperative evaluation. Furthermore, the preoperative staging and predicted operation procedures were compared with postoperative pathologic staging and practical operation procedures, respectively, and the relationship between the choice of operation procedures and clinicopathologic factors was analyzed. Results According to the criteria, 234 patients were actually included into MSCT+SAA group (n=118) and MSCT+FIB group (n=116). The baseline characteristics of two groups were statistically similar (Pgt;0.05). For MSCT+SAA group, the accuracies of preoperative staging T, N, M and TNM were 72.9%, 83.1%, 100% and 80.1%, respectively. For MSCT+FIB group, the accuracies of preoperative staging T, N, M and TNM were 68.1%, 75.0%, 100% and 74.1%, respectively, and there was not a statistically significant difference (Pgt;0.05). There was also not a statistically significant difference of the accuracy of prediction to operative procedures in two groups (99.6% vs. 96.6%, Pgt;0.05). The preoperative T staging (P＜0.001), N staging (P＜0.001), TNM staging (P＜0.001), serum level of SAA (P＜0.001), serum level of FIB (Plt;0.001) and distance of tumor to the dentate line (P＜0.05) were associated to the operative procedures. Conclusions Combinative assessment of MSCT and FIB could improve the accuracy of preoperative staging and operative procedures prediction, however, it may be not superior to MSCT plus SAA.