目的 对烧伤层流病房多重耐药菌感染的相关因素进行分析，通过护理干预来预防和减少烧伤病房多重耐药菌感染的发生。 方法 回顾性分析2011年1月－12月收治的629例烧伤患者，其中发生多重耐药菌感染74例，感染率为11.8%。 结果 感染部位：创面分泌物培养感染占70.2%，痰液标本培养感染占9.4%，血液标本培养感染占16.2%，其他占4.2%。感染病原菌：以金黄色葡萄球菌为主，占77.0%；鲍曼不动杆菌占4.2%，铜绿假单胞菌占10.8%，肺炎克雷伯菌占6.7%，真菌感染占1.3%。 结论 对发生医院内多重耐药菌感染的原因进行分析并及时采取相应的护理干预措施，及可行的医院感染管理控制措施，对烧伤患者预后有重要的意义，可有效降低院内感染率的发生。
【摘要】 目的 探讨肢体深度烧伤后，影响功能康复的相关因素。 方法 采用美国日常生活自理量表和功能性日常生活量表，对2009年4月-2010年7月来门诊复诊的101例肢体深度烧伤患者的功能康复情况进行问卷调查和统计学分析。 结果 接受专业康复的患者得分明显低于自我康复患者得分，差异有统计学意义（Plt;0.01）；不同性别、不同文化程度之间的比较差异有统计学意义（Plt;0.001）；年龄14～50岁的患者对是否接受专业康复的比较，差异有统计学意义（Plt;0.001）；年龄lt;14岁、gt;50岁及婚姻状况，在是否接受专业康复的比较差异无统计学意义（Pgt;0.01）。 结论 肢体深度烧伤后患者在专业医师的指导下进行专业功能康复比自我康复的患者效果更好，使得烧伤患者社会期日常生活自理能力得到提高。【Abstract】 Objective to explore the related factors affecting the function recovery of deeply burned limps. Methods Adopting ADL body independent living scale and functional daily life scale, the questionnaire survey of the function recovery situation and statistical analysis were performed on the patients from the 101 outpatient appointment patients whose limbs were deeply burned from April 2009 to July 2010. Results The score of patients who accepted professional rehabilitation was significantly lower than that of the self healing patients, and the difference was significant (Plt;0.01); the difference of sex and the comparison between different literate degree were statistically significant (Plt;0.001); the difference in whether to accept the comparison of the professional rehabilitation among the patients with age oflt;14 years old, gt;50 years old and different marital status was not statistically significant (Pgt;0.01). Conclusion patients with deeply burned limbs recover better under the professional function recovery direction of professional doctor than the patients who have self recovery.
【摘要】 目的 通过对老年人烧伤的原因进行调查与分析，为预防老年人烧伤提供有效的依据。 方法 调查分析2000年1月-2009年6月收治的270例60岁以上老年烧伤住院患者的致伤因子、好发年龄、烧伤月份、烧伤程度、烧伤地点、家庭及居住情况。 结果 270例老年烧伤中，致伤因子以火焰烧伤最多占147例（54.44%），与其他的致伤因子比较有统计学意义（Plt;0.05）；好发年龄以60～69岁年龄段发生率最高占153例（56.67%），与其他年龄段比较有统计学意义（Plt;0.05）；老年烧伤一年四季均可发生，但以寒冷的冬季12月-次年2月居多，占158例（58.52%），与其他季节比较有统计学意义（Plt;0.05）；烧伤程度以轻度为主共142例（52.59%）；烧伤地点大多发生在家中共213例（78.89%），且为独居占191例（70.74%）；老年烧伤家庭以农村家庭居多共208例（77.04%）。 结论 随着老年人群逐步增加，烧伤发生率也增高，在日常生活中应采取有效防范措施，防止和减少老年烧伤的发生。【Abstract】Objective To provide the effective evidence for preventing burn injury of aged people by investigating and analyzing the reasons of burn injury. Methods The injury factors, age, month, degree, place, family and habitation of 270 aged people over 60 years old were analyzed between January, 2000 to June, 2009 in this department. Results In 270 aged patients, there were 147 patients whose injury factors were flame (54.44%) , and there was statistical difference compared with other injury factors (Plt;0.05) . The injury age of the highest incidence rate was 60 to 69 (153 patients, 56.67%) , and there was statistical difference compared with other injury age (Plt;0.05) .The aged burn injury may happen in all seasons, but the highest incidence rate appeared in winter (from December to next February) and there was statistical difference compared with other seasons (Plt;0.05) (158, 58.52%). There were 142 minor injury degree patients mainly (52.59%). The most injury places were at home (213 patients, 78.89%) and 191 patients (70.74%) were living alone.Two hundred and eight patients (77.04%) came from countryside. Conclusion With the aged people increasing, the incidence rate of burn injury is also raised.So effective methods should be adopted to prevent and decrease the incidence of age burn injury.
ObjectiveTo summarize clinical features, imaging findings, and pathological characteristics of pancreas intraductal papillary mucinous neoplasm (IPMN) and to improve effect of clinical diagnosis and treatment of pancreas IPMN.MethodThe clinical data of 45 patients with pancreas IPMN who underwent surgical resection from February 2014 to February 2019 in the First Affiliated Hospital of Soochow University were retrospectively analyzed.ResultsOf the 45 patients with pancreas IPMN, 28 patients were male and 17 patients were female, aged from 44 to 81 years old with (65±21) years old. There were 35 patients with age > 60 years old. The most common clinical manifestation was the upper abdominal discomfort (26 patients) and the lesions mainly occurred in the head of pancreas (20 patients). Twenty-four (58.5%, 24/41) patients and 17 (81.0%, 17/21) patients were definitely diagnosed by the CT and MRI, respectively. Twenty-five patients underwent the pancreaticoduodenectomy, 5 patients underwent the partial pancreatectomy, 2 patient underwent the pancreatic tumor resection, 12 patients underwent the pancreatic body and tail resection, 1 patient underwent the total pancreatectomy. The pathological findings showed that 15 cases were mild dysplasia, 5 cases were moderate dysplasia, 3 cases were severe dysplasia. Six cases invaded the pancreas and its surrounding adipose tissue, 5 cases invaded the tissue outside the pancreas. After the discharge, 28/32 patients were followed up for 3 to 24 months. Among all the followed-up patients, the 1-year survival rate was 100% (28/28) and the 2-year survival rate was 96.4% (27/28). The patients underwent the CT examination on the 3rd, 6th, 12th,18th, and 24th month, no lymph node metastasis was found.ConclusionsPancreas IPMN is more common in the elderly, mainly manifests as gastrointestinal symptoms, such as upper abdominal discomfort, etc. Surgery is its main treatment mean. Preoperative diagnosis mainly depends on CT examination and MRI examination, but positive rate of MRI examination is higher. Postoperative pathological section shows different degree of dysplasia.
ObjectiveTo explore the psychological process and needs of the second victims of medical adverse events after the occurrence of adverse events, so as to provide reference for the psychological intervention strategies of medical institutions for the second victims of medical adverse events.MethodsThe second victims of medical adverse events in the First People’s Hospital of Ziyang were selected from April to July 2019. Qualitative research method was used to conduct semi-structured in-depth interviews with the second victims. Colaizzi method was used to analyze the transcripts through reading and rereading, coding, and thematizing. ResultsA total of 22 second victims of medical adverse events were interviewed. The second victims of medical adverse events experienced negative emotional experience, and the desire to seek emotional support was urgent. The psychological process of the second victims of medical adverse events mainly involved five stages: fear, anxiety, depression, guilt and recovery. Emotional support hada positive effect on regression. Conversely, negative or lack of emotional support had a negative effect on regression. ConclusionsThe emotional experience of the second victims of medical adverse events is relatively staged, and the recovery and regression are greatly affected by internal and external factors. Hospital administrators should take active measures and establish an emotional support mechanism for adverse events in order to reduce psychosomatic injuries and improve medical quality and efficiency.