目的:探讨加强护理人员手卫生干预在控制医院感染中的应用价值.方法:选取2015年10月～2016年10月120名相关临床科室护理人员为对照组,2016年11月开始加强手卫生护理干预,并选取2016年12月～2017年12月120名相关临床科室护理人员为观察组,比较两组手卫生依从性、洗手行为及医院感染发生情况.结果:对照组培养出细菌70株,观察组11株;观察组接触患者前后、护理操作前后手卫生依从率均高于对照组(P<0.05);观察组医院感染发生率明显低于对照组(P<0.05),手卫生合格率明显高于对照组(P<0.05).结论:加强手卫生护理干预可有效提高护理人员手卫生依从性,强化洗手行为,进而降低医院感染的发生.

目的 通过对社区产妇产后健康知识需求进行调查,进一步了解社区产妇的健康需求,改进健康教育方法,提高产后保健服务.方法 选取2015年1月~2016年6月广东省英德市人民医院城南社区卫生服务中心(以下简称本中心)进行居家访视的755例产妇为调查对象,采用单项选择法和多项选择法的问卷调查方式,对健康知识需求情况及缺乏相关健康知识的原因进行调查,另外对获得有关健康知识的方法和途径需求也进行调查.结果 社区产后妇女普遍欠缺健康预防保健知识,对健康知识指导需求高,其中婴儿早期教育占75.6%,婴儿抚触、按摩的方法占73.5%,产妇保健操的锻炼占56.1%,新生儿喂养和辅食添加的注意事项及产妇腰痛的预防占49.1%,婴儿国家免疫规划疫苗的预防接种及新生儿异常情况的应急处理占47.5%,婴儿常见疾病(如尿布疹、鹅口疮、脓疱疮等)的预防及护理占46.7%,新生儿日常护理的注意事项占41.9%,及早开乳和母乳喂养的好处占40.4%,产妇会阴伤口、恶露、子宫复旧等占29.8%,产妇乳腺炎的预防占20.2%.社区产妇健康知识普遍缺乏,需求多,存在的原因也是多种多样的,都希望得到科学具体的针对性康复指导,教育方法和途径以医护人员讲解演示和上门家访得到最多的支持.结论 通过对社区产后妇女健康知识需求的调查,从而了解产后妇女对健康知识需求的差异,并采取各种方法和途径提供相应妇女保健知识,有助于调整、改进产后妇女的健康知识水平,显著提高健康教育的效果和产后保健服务的质量.

目的:探讨面对面指导干预对社区产后妇女进行母乳喂养的影响.方法:抽取英德市城西社区卫生服务中心辖区内的581例社区产后妇女为观察组,观察组所有产妇于生产后1周、2周进行居家面对面访视,宣传健康知识,指导正确母乳喂养,6周对产妇进行体检时继续加强宣教;再随机抽取非本辖区内的550例社区产后妇女为对照组,对照组产妇实施电话干预指导.记录并比较两组产妇母乳喂养的状况及引起母乳喂养不良的存在因素.结果:观察组母乳喂养不良因素发生率明显低于对照组,母乳喂养率明显高于对照组,混合喂养率和人工喂养率明显低于对照组,两组比较,差异具有统计学意义(P＜0.01).结论:对社区产后妇女实施面对面指导干预,能够提高母乳喂养率,降低混合喂养率和人工喂养率,并能减少母乳喂养不良因素的发生率.

目的：探讨五常法在无菌物品管理中的应用价值。方法选取2014年1月至2015年12月广东省英德市中医院外科的185例无菌物品，按随机数字表法将其分为对照组（90例）与试验组（95例），常规组实施常规管理方法，试验组则实施五常法管理。比较两组无菌物品的定位存放正确率、过期率、用后补充率。结果试验组无菌物品定位存放正确率明显高于对照组，差异有统计学意义（P＜0.05）；试验组无菌物品未过期失效率、过期失效率均明显低于对照组，差异均有统计学意义（均P＜0.05）；试验组无菌物品用后补充率明显高于对照组，差异有统计学意义（P＜0.05）。结论应用五常法可使无菌物品管理更加规范有序，可提高无菌物品定位存放正确率及用后补充率，避免物品过期失效造成浪费。

Objective To explore the application effect of multi-sectoral joint intervention model in hospital infection prevention and control of multiple drug-resistant organisms. Methods A total of 70 cases of patients in our hospital from January 2015 to February 2016 were selected and randomly divided into two groups, with 35 cases in each group. The control group received routine intervention model, while the observation group received multi-sectoral joint intervention model. The intervention effects were compared between two groups. Results The observation group was superior to the control group in the qualified rate rate of knowledge of disease of medical staff, standard-reaching rate of medical environmental disinfection, qualified rate of hand hygiene of medical staff, and incidence of multi-drug resistant infections (P<0.05);Also, the observation group was superior to the control group in the situations of 1 united, 2 united, and 3 united and above antibiotic medication (P<0.05). Conclusions Multi-sectoral joint intervention model in hospital infection prevention and control of multiple drug-resistant organisms can significantly reduce the infection of multi-drug resistant in hospital, improve the knowledge level of disease of medical staff, and improve the situation of qualified medical environmental disinfection.

目的：评估空腹血糖（FPG)和糖化血清白蛋白（GA)在筛查糖调节受损（IGR)中的应用价值。方法选取2013年4月—2014年4月在该院体检中心行健康体检的20岁以上成年人869例作为研究对象，男633名，女236名，平均42.95±12.3岁，受检者空腹10 h测定空腹血糖及糖化血清白蛋白。 FPG≥6.1且<7.0 mmol/l或GA>18.5%行口服葡萄糖耐量试验（OGTT)进行确诊。结果按照1999年WHO的DM诊断标准，该研究人群DM、IGR和正常糖调节者（NGR)分别为35例、19例、815例。通过绘制ROC曲线，FPG与诊断为IGR相关的临界点为6.31 mmol/L，敏感性和特异性分别为68.2%和99.3%，曲线下面积0.294（95%CI0.087~0.501)，阳性似然比96.3，阴性似然比0.32；GA与诊断为IGR相关的临界点为11.9%，敏感性和特异性分别为73.1%和38.9%，曲线下面积为0.737（95%CI0.469~1.0)，阳性似然比1.196，阴性似然比0.692。当筛查IGR时，AUC的结果为GA=11.9(0.737)>FPG=6.31(0.294)，提示GA的筛查准确度较高。联合试验可以提高筛查效率，系列试验即FPG≥6.31且GA大于11.9%同时符合为阳性，得出灵敏度为94.1%，比单纯采用FPG≥6.31 mmol/L筛查糖调节受损提高筛查效率38%，而特异度无明显差异。结论空腹血糖联合糖化血清白蛋白筛查糖调节受损有较高的灵敏度、特异度，6.31 mmol/L<FPG<7.0 mmol/L且GA>11.9%时应进一步行OGTT了解2hPG，以明确有无IGR。

Objective To investigate the validity of using fasting blood glucose(FBG)and glycosylated serum albumin(GA) for the screening of diabetes. Methods 869 subjects(633 men, 236 women) over the age of 20 in our hospital physical examination center line underwent health check-up for screening diabetes between April 2013 and April 2014. Their average age was(42.95 ± 12.3)years. FBG and GA were examined at the same time on an empty stomach for 10 h. When FBG 7.0 mmol/L and ≥ 6.1 mmol/L or GA ≥ 18.5 %, OGTT was necessary to verify the diagnosis of diabetes. Results According to 1999 WHO criteria, 834 patients were normal, while 35 patients had diabetes. Using a receiver operating characteristic curve(ROC), the optim al cut-point of FBG related to diabetes diagnosed by OGTT was 6.2mmol/L that was associated with a sensitivity and specifi city of 97.1 % and 96.0 % respectively. Area under the curve(AUC) was 0.988(95 % CI 0.980 ~ 0.996), a positive likelihood ratio(LR)was 24.55, and a negative LR was 0.03. The optimal cut-point of GA related to diabetes diagnosed by OGTT was 14.55 %, which was associated with a sensitivity and specifi city of 82.8 % and 90.2 % respectively. Area under the curve(AUC) was 0.923(95 % CI 0.870 ~ 0.975), a positive LR was 8.43, and a negative LR was 0.19. When screening for DM, the result of the AUC for the FBG=6.2(0.988) GA=0.988(0.923), indicating higher FBG screening accuracy. Joint test can improve the effi ciency of screening, series of experiments that FBG ≥ 6.2 and GA was more than 14.55 % in accord with positive criteria at the same time, so it was concluded that the sensitivity was 96.7 %, than just used the FBG ≥ 7.0 mmol/L screening diabetes screening effi ciency by 35.4 %, and no obvious difference was found between specifi c degrees. Conclusion The joint test can improve the screening effi ciency. When FBG 7.0 mmol/L and ≥ 6.2 mmol/L and GA ≥ 14.55 %, OGTT is necessary adopted as a screening test to verify the diagnosis of diabetes.

Objective To mobilize the work activeness and initiative of nurses.Methods Carry out a humanized management to nurses,make nurses felt warm and fragrant,to build the environment atmosphere promoting the physical and mental health of nurses,to help them carry out the ego value.Results The work activeness of the nurse had a bigger exaltation,the work of the allotment could be finished in conformity with the specify quality,quantity and time,the work loophole reduced,patient's satisfaction had an exaltation from original foundation.Conclusion To practice the emotion management can receive half effort and double results to the nurse.

Objective To study the efficacy and safety of budesonide distal colon topical administration in treating ulcerative colitis.Methods The patients that were final diagnosed were randomly divided into therapy group and control group.The patients in the control group were regularly given semi liquid diet and correct the water-electrolyte disturbances,associated with taking orally Sulfasalazine 1.0 g qid and complex glutamine grains 1 packet tid for 4 weeks.The therapy group,on the basis of conventional treatment,the budesonide were given in enema by budesonide supplement(budesonide 2 mg was added into 100 ml normal saline solution) twice everyday(morning and afternoon) for 2 weeks,and were only given an enema 30 minutes before evening sleep 2 weeks later.The efficacy was evaluated according to improving after medication and the change of colonofiberscope.To evaluate safety through observing the blood routine test and liver-renal function before and after therapy.Results The total effective rate of therapy group and control group were 92.6% and 64.3%.There was significant difference between two groups(p0.05).Conclusion To supply budesonide distal colon topical administration on the basis of conventional treatment can quickly control pathogenetic condition,without evidence of adverse effect.It is a better project in treating ulcerative colitis.

目的探讨一次性抽液器应用于液气胸病人排气排液的效果.方法通过对传统胸穿包与一次性抽液器行胸穿排气、排液的应用对比,分析一次性抽液器的优越性.结果一次性抽液器在简化操作程序、防止交叉感染、提高工作效益方面明显优于胸穿包,两者比较,有显著差异.结论一次性抽液器应用于液气胸病人排气、排液,操作简单、经济实惠、减少了医源性感染的机会.