Objective To study the effect of modified Buyang Huanwu Decoction combined with acupuncture in the treatment of patients with posterior circulation ischemic vertigo. Methods 88 patients with posterior circulation ischemic vertigo in our hospital were selected March 2020 to October 2021,who were randomly divided into control group and observation group according to the random number table method, with 44 cases in each group.The patients of control group were treated with Betahistine Mesylate Tablets and Flunarizine Hydrochloride Capsules, the patients of observation group were treated with Buyang Huanwu Decoction combines with acupuncture based on the treatment of control group.The clinical efficacy, hemorheological indexes, oxidative stress indexes and adverse reactions of two groups were compared before and after treatment. Results The total effective rate of observation group was higher than that of control group, there was significant difference between two groups（P＜0.05）.After treatment, the whole blood viscosity, plasma viscosity and hematokrit of observation group were lower than those of control group, and the average blood flow velocity of vertebral artery and basilar artery were higher than those of control group, there was significant difference（P＜0.05）.After treatment, the levels of nitric oxide and superoxide dismutase in the observation group were higher than those in the control group, and malondialdehyde was lower than that in the control group, the difference between two groups was statistically significant（P＜0.05）.There was no significant difference in the total incidence of adverse reactions between two groups（P＞0.05）. Conclusion The modified Buyang Huanwu Decoction Combined with acupuncture in the treatment of posterior circulation ischemic vertigo can improve the blood flow and the degree of oxidative stress in patients with posterior circulation ischemic vertigo, and has high application safety, which is worthy of recommendation.
目的 探讨多学科综合治疗(MDT)模式下以病例为基础的学习(CBL)教学法对全科专业本科实习生在2 型糖尿病(T2DM)及并发症患者全科慢病管理教学中的效果.方法 选取2021 年1 月至2023 年1 月在我院全科实习的五年制临床专业实习生60 名,按教学方法的不同分为对照组(n =30)和实验组(n =30).对照组实习生采用常规实习带教方法,实验组实习生采用MDT结合CBL教学模式进行带教.采用理论知识考试和临床病例分析考核评估两组实习生的学习效果,采用问卷调查方式评估教学满意度(学习兴趣、临床思维能力、自学能力、合作能力、交流能力)情况.结果 实验组实习生的理论知识考试成绩及病例分析能力均显著高于对照组,差异均有统计学意义(t =-7.887、6.749,P =0.000、0.000).实验组实习生在提高学习兴趣(χ2 =4.929,P =0.026)、提高临床思维能力(χ2 =5.625,P =0.018)、提高自学能力(χ2 = 4.176,P =0.041)、提高与他人合作的能力(χ2 =4.565,P =0.033)、提高与他人交流的能力(χ2 =5.689,P =0.017)方面的满意度均显著高于对照组,差异均有统计学意义.结论 将MDT联合CBL教学方法应用于全科专业学生在T2DM及并发症患者全科慢病管理教学中的效果显著,能提高实习生的理论知识水平和各项能力,提高了实习生对教学的满意度.
目的 了解重庆某三甲综合性医院医务人员发生血源性职业暴露的现况,分析危险因素、探讨预防措施.方法 采用回顾性调查,收集分析2019 年1 月1 日至2021 年12 月31 日血源性职业暴露事件.结果 在362 名血源性职业暴露事件中,以护理人员(37.85%,137/362)、学生(32.87%,119/362)为主;工作年限在 5 年及以下的医务人员(76.25%,276/362)多见;职业暴露方式以锐器伤为主(75.69%,274/362),手术(缝合/切开)是最常见的暴露环节;锐器伤的暴露部位以手部为主,皮肤及黏膜接触的暴露部位以眼部、手部为主.本次调查最常见的暴露源病原体为乙型肝炎病毒(HBV).结论 加强职业安全培训、遵守操作规范、加强医疗废物管理、接种乙肝疫苗等可降低暴露风险.
目的 探讨多学科护理对沙利度胺治疗输血依赖型β地中海贫血患者自我护理能力及生活质量的影响.方法 选择2020 年7 月至2022 年6 月确诊输血依赖型β地中海贫血并接受沙利度胺治疗的患者60 例,按随机数字表法分为研究组和对照组,每组各30 例.对照组给予常规血液病护理,研究组在常规护理的基础上实施多学科团队合作(MDT)护理.观察比较两组患者护理前、护理6 个月及12 个月后的负面情绪、自我护理能力及WHO生存质量情况,并比较两组患者的临床效果.结果 护理前,两组患者的抑郁自评量表(SDS)、焦虑自评量表(SAS)评分比较,差异均无统计学意义(P>0.05);护理干预6、12 个月后,研究组的SDS、SAS评分均低于对照组,差异均有统计学意义(均P<0.05).护理前,两组患者的自我护理能力得分比较,差异无统计学意义(P>0.05);护理干预6、12 个月后,两组患者的自我护理能力得分比较,差异均有统计学意义(均P<0.05).护理前,两组患者的WHO生存质量比较,差异无统计学意义(P>005);护理干预6、12 个月后,研究组的WHO生存质量得分均高于对照组,差异均有统计学意义(均P<0.05).两组患者的临床效果比较,研究组明显优于对照组,差异有统计学意义(P<0.05).结论 多学科护理干预能提高沙利度胺药物治疗的输血依赖型β地中海贫血患者的治疗效果,改善了患者用药依从性,提高了患者自我护理能力和WHO生存质量.
