目的 探讨心肌梗死再发的危险因素.方法 2008年7月1日-2013年12月31日,将某集团有限公司在岗和离、退休职工初发心肌梗死的患者纳入观察队列,以初发心肌梗死住院为随访起点,进行追踪随访,每年随访一次,随访其是否再发心肌梗死,并收集临床资料进行比较分析,包括血压、心率、生化指标、痰病的诊断和治疗情况等.以患者再发心肌梗死住院为随访终点.将初发心肌梗死的职工在随访期间再发心肌梗死者作为病例组,无再发者为对照组,对影响心肌梗死再发的因素进行分析.结果 ①观察队列中初发心肌梗死者有1 008例,其中有135例再次发生心肌梗死,在135例患者中,符合入选标准为113例.根据纳入排除标准,按照1∶2选择对照组226例,由339例观察对象组成观察队列.病例组年龄(62.2±11.5)岁,对照组年龄(62.5±11.7)岁.病例组中男86例(76.1％),对照组中男172例(76.1％).②分析结果:吸烟史、高血压病史、糖尿病史、高脂血症病史、冠心病家族史、Ⅲ度房室传导阻滞、服用抗血小板药物与心肌梗死再发有关,差异有统计学意义(P＜0.05).结论 吸烟、高血压、糖尿病、高血脂症、冠心病家族史、Ⅲ度房室传导阻滞、以及是否服用抗血小板药物是心肌梗死再发的危险因素.

Objective To probe into the influencing factors such as the ADL (Activities of Daily Living) and the chronic disease situation of quality of life of elderly people in pension institutions.Methods A stratified cluster random sampling method was selected.Eight pension institutions were selected in Tangs-han city from Nov.2012 to Apr.2013.Totally 401 elderly people met with the inclusion criteria were inves-tigated with the demographic data questionnaire,the quality of life questionnaire and the ADL question-naire.Results 96.3% of the 401 elderly people in pension institutions were 70 years old or above.The sin-gle factor analysis results showed that the gender,age,ADL and the frequency of children visiting their par-ents were related to the quality of life.Multiple linear stepwise regression analysis results showed that the gender,ADL and cerebrovascular disease were the main factors affecting the quality of life of elderly people in pension institutions.Conclusion The main factors affecting the quality of life of elderly people in pen-sion institutions are the ADL and the chronic disease situation.

Objective To evaluate the effect of health education by follow -up with telephone for diabetes patients .Methods Four hundred and six discharged diabetes patients were randomly divided into control group and intervention group .Patients in control group received traditional health education .Except for traditional health education ,patients in intervention group received health education on follow -up by doc-tors with telephone .The questionnaire survey was carried out in all patients on their return visit after half year .The common sense ,compliance of treatment on diabetes mellitus ,and satisfaction of hospital service were evaluated in the survey .Results Patients'common sense on diabetes mellitus in intervention group was higher than control group ,and the defference of awareness rate was statistically significant between the two groups(P<0 .05) .The compliance of drug ,controlling diet ,keeping sports ,quit smoking ,and limit alcohol in intervention group were higher than them in control group (P<0 .05) .There was no significant difference on that keeping calm could reduce blood sugar in two groups (P>0 .05) .The satisfaction rate on hospital service in intervention group was significantly higher than that in control group .Conclusion Health education by follow -up with telephone improves patients'common sense ,compliance of treatment on diabetes mellitus ,and satisfaction of hospital service .

肝囊肿是一种良性病变,以单纯性居多.一般来说5cm以上的囊肿是需要处理的,以往多采用手术切除治疗,手术创伤较大,医疗费用高.近年来,随着微创技术的应用,彩超引导下穿刺肝囊肿无水酒精硬化治疗是一种操作简便、安全,疗效显著的治疗方法,采用在彩超引导下将穿刺针、导管、药物或操作器械等正确放置到所要到达的病灶、囊腔、体腔,达到定性诊断和治疗目的[1].我院对确诊为为肝囊肿的63例患者行彩超引导下肝囊肿穿刺硬化治疗,护理体会报告如下.

<正>我国肝脏疾病的发病率较高,肝脏病理组织学检查对肝脏疾病的诊断、治疗及预后判断中有重要的地位[1]。经皮穿刺活检术是获取肝脏病变标本的重要途径,影像引导下的穿刺活检较盲穿法活检更安全、准确[2]。临床护理路径(clinical nursing path,CNP)是由临床医生、护士及功能技术人员共同制定的、针对某种手术提供最适当的、最合理的的临床护理服务计划,达