【摘要】 目的 分析临床实习对护理本科生专业认同的影响，探讨提高专业认同的措施。 方法 2010年6—10月，对某综合性大学60名2007级普通全日制护理本科生进行抽样调查，评价其实习前1个月和实习后3个月的专业认同情况，比较实习前、后的变化并分析影响因素。 结果 实习后专业认同的专业价值观得分[（3.13±0.85）分]高于实习前[（2.78±1.00）分]，实验专业期望得分[（12.09±2.13）分]低于实习前[（13.13±1.30）分]，差异有统计学意义（P=0.045，0.002）；而专业认识、情感、意志、技能和专业认同总分方面，实习前、后差异无统计学意义（Pgt;0.05）；其影响因素由强到弱依次为:带教老师（37.04%）、实际的护理工作（33.33%）、实习科室（22.22%）、他人态度（7.41%）。 结论 临床实习可提高护理本科生的专业价值观，带教老师及实际护理工作对专业认同影响较大。【Abstract】 Objective To analyze the effect of clinical practice on student nurses’ professional identity and explore measures to develop their professional identity. Methods Convenience sampling was used to select 60 general full-time student nurses who entered a comprehensive university in 2007. Then we assessed their professional identity at the time of one month before, and three months after clinical practice, compared the two results, and analyzed the related factors. Results The score of professional value dimension after clinical practice was higher than before (3.13±0.85 vs. 2.78±1.00, P=0.045), while the professional expectation dimension was lower than before (12.09±2.13 vs. 13.13±1.30, P=0.002), and the differences in above-mentioned indexes were statistically significant. There was no statistical difference before and after clinical practice in professional knowledge, professional affection, professional volition, professional skill dimensions, and total score of professional identity (Pgt;0.05). The related factors in a order from b to weak were clinical teacher (37.04%), practice work (33.33%), training department (22.22%), and others’ attitudes (7.41%). Conclusion Clinical practice may improve professional values but impair professional expectations of the student nurses, and clinical teacher and practice work have a great effect on student nurses’ professional identity.
【摘要】 目的 探讨淋巴结转移数目对行手术治疗的结肠癌患者预后的影响。 方法 回顾性分析2005年1月-2007年12月符合筛选标准的148例行手术治疗的结肠癌患者的临床和随访资料，按照淋巴结转移数目进行分组：N0组（0枚）91例、N1组（1～3枚）41例、N2组（≥4枚）16例，采用Kaplan-Meier法进行生存分析，用Log-rank比较3组术后3年生存率，等级资料采用秩和检验，用χ2检验进行两两比较术后3年局部复发率、远处转移率和死亡率情况。 结果 N0、N1、N2 3组的术后3年生存率分别为88.1%、71.4%、61.1%，3组生存率差异有统计学意义（P=0.003）；N0、N1、N2 3组的总体局部复发率、远处转移率和死亡率的差异有统计学意义（P=0.006，0.001，0.005）。 结论 淋巴结转移数目是结肠癌患者术后3年生存情况的危险因素，无淋巴结转移的患者术后3年生存情况明显比有淋巴结转移者好。【Abstract】 Objective To discuss the impact of the number of lymph node metastasis on the prognosis of patients with colon cancer after surgical operation. Methods The clinical data of 148 patients with colon cancer who underwent surgical operation between January 2005 and December 2007 were analyzed retrospectively. According to the number of lymph node metastasis, the patients were divided into three groups, group N0(the number of lymph metastasis equals to 0), group N1(the number of lymph node metastasis ranges from 1 to 3) and group N2 (the number of lymph node metastasis was equal or greater than 4). And we chose Kaplan-Meier to analyze patients′ survival and Log-rank test was used to compare the 3-year survival index; rank sum test was used to analyze the level data, and then chi-square test was chosen to compare local recurrence rate, metastasis rate and mortality among the three groups. Results The indexes of the 3-year survival in group N0 (91 cases), group N1 (41 cases) and group N2(16 cases) wre 88.1%, 1.4%, and 61.1%, respectively. The differences were significant (P=0.003). Besides, the differences between group N0 and N1, N0 and N2 were both significant (P=0.012,0.002); the differences between group N1 and N2 was not significant (P=0.344). The differences among three groups in local recurrence rate, metastasis rate and mortality were all significant(P=0.006, 0.001, 0.005); the differences between group N0 and N1 in local recurrence rate, metastasis rate and mortality were significant (P=0.008, 0.000, 0.012); the differences between group N0 and N2 in local recurrence rate, metastasis rate and mortality were significant (P=0.021, 0.047, 0.010), while the differences between group N1 and N2 in local recurrence rate, metastasis rate and mortality were not significant (P=1.000,0.585,0.523). Conclusion The number of lymph node metastasis is a dangerous factor to the 3-year survival in patients with colon cancer after operation, and the prongnosis of the 3-year survival in patients without lymph node metastasis is better than that in patients′ with lymph node metastasis.
Objective To explore the influencing factors for early complications after laparoscopic sleeve gastrectomy (LSG). Methods A retrospective analysis was conducted for the clinical data of 306 obese patients undergoing LSG at the Weight Reduction and Metabolism Center of Xuzhou Medical University Affiliated Hospital of Lianyungang from January 2020 to September 2022. Early postoperative complications (≤30 d) of LSG were classified according to the Clavien-Dindo classification, and the influencing factors of early postoperative complications were explored. Results There were 27 cases (8.8%) suffered from early complications, including 8 cases of grade Ⅰ (2.6%), 15 cases of grade Ⅱ (4.9%), 4 cases of grade Ⅲ (1.3%), there were no grade Ⅳ and grade Ⅴ complications. The multivariate results showed that BMI≥45 kg/m2 [OR=3.63, 95%CI (1.10, 11.92)], high cholesterol [OR=7.12, 95%CI (2.42, 20.95)], and preoperative GERD [OR=3.69, 95%CI (1.11, 12.23)] were influencing factors for early complications. Conclusions LSG is a safe diagnostic and therapeutic method for treating obesity. Attention should be paid to the impact of BMI, high cholesterol, and preoperative GERD on the occurrence of complications after LSG.