目的：了解青年高血压患者高血压并发症的知信行状态，以期对青年高血压患者高血压相关并发症的预防管理提供依据。方法：采用自拟高血压并发症知信行量表对本院心内科收治的320例青年高血压患者进行调查，了解其高血压并发症的知信行状态及其影响因素。结果：被调查者高血压并发症的知信行评分均处于中等偏低水平，尤其是其高血压并发症行为更是处于低等水平。患者文化水平、婚姻状态、家庭人均月收入、医疗费用支付方式、是否均有并发症均是其高血压并发症知信行状态的影响因素（P＜0.05）。结论：青年高血压患者高血压并发症知晓率处于较低水平。临床应针对影响青年高血压患者高血压并发症知信行的相关因素，采取有效干预措施，以提高患者对相关并发症的防治水平。

目的:探讨大柴胡汤加黄芪桂枝五物汤对痰湿型非酒精性脂肪性肝炎(Non-alcoholic Steatohepatitis,NASH)的临床疗效.方法:采用前瞻性研究方法,将符合要求的58例NASH病患分为观察组(30例)和对照组(28例).对照组患者提供非诺贝特与复方甘草酸苷药物进行治疗;观察组患者在对照组的治疗方案基础上加用大柴胡汤和黄芪桂枝五物汤,两组疗程均为12周.记录两组患者治疗前后丙氨酸氨基移换酶(Alanine Aminotransferase,ALT)和γ-谷氨酰转肽酶(γ-glutamyl Transpeptidase,GGT)、血清炎性因子、转化生长因子-β1(Transforming Growth Factor-β1,TGF-β1)水平、血脂水平和肝脏瞬时弹性纤维检测中的脂肪受控衰减参数(Controlled Attenuation Parameter,CAP),作出疗效评价.结果:观察组治疗的总有效率明显高于对照组,差异具有统计学该意义(P<0.05).两组ALT、GGT、血清炎性因子、TGF-β1水平、血脂水平和CAP水平在治疗后均较治疗前显著降低(P<0.05);治疗后观察组ALT、GGT、血清炎性因子、TGF-β1水平、血脂水平均优于对照组(P均<0.05),而治疗12周后两组间CAP值的差异没有统计学意义(P>0.05).按照非酒精性脂肪性肝病(Non-alcoholic Fatty Liver Disease,NAFLD)轻重程度分级,观察组有2例转为正常,对照组有1例转为正常;观察组有2例由重度转为中度,4例由中度转为轻度;而对照组中有2例由重度转为中度.结论:大柴胡汤加黄芪桂枝五物汤治疗能够改善NASH患者的肝功能,降低血清炎性因子、TGF-β1水平和血脂水平,效果优于对照组.

目的 对采取替比夫定联合"肝炎方"合升降散治疗慢性乙肝的临床有效性进行深入研究,方法 以收治的64例慢性乙肝患者为研究对象,随机分成对照组及观察组进行治疗,对照组应用替比夫定治疗,观察组在对照组基础上联用"肝炎方"合升降散,对两组患者的临床疗效进行评价及比较分析.结果 经统计学分析,观察组肝功能中的ALT及AST指标与对照组有显著差异(P＜0.05),HBeAg转阴率与对照组有显著差异(P＜0.05),免疫细胞CD4+/CD8+比值显著上升(P＜0.05).结论 "肝炎方"合升降散可以有效调节慢性乙肝患者的免疫力,加强对乙肝病毒复制的抑制,与替比夫定联合使用,可以增加替比夫定的治疗效果.

目的 对比分析在非酒精性脂肪性肝病(NAFLD)患者中应用基于王氏养生三法进行中医体质调节的临床效果.方法 选择2020年1月—12月于医院接受治疗的100例NAFLD患者为研究对象,将其按照随机数字表法区分为对照组、普通减重组、养生1组、养生2组和养生3组(每组各20例),对照组未进行养生,亦不参加有氧运动;普通减重组每日坚持中等量有氧运动30 min,每周5次,或每天高强度有氧运动2 min,每周3次,同时做8～10组阻抗训练,每周2次;干预1组每周养生2次;干预2组每周养生2～5次;干预3组每周养生>5次;5组患者观测时间为24周,8周检测1次,评估5组患者干预中中医体质、BMI、WHR、FBG、TG、TC、LSM、CAP变化情况.结果 评估显示干预前、干预8周、干预16周和干预24周过程中,对照组、普通减重组、干预1组的中医体质无明显变化(P>0.05);干预2组和干预3组在干预8周、干预16周以及干预24周时同干预前比较,平和质变化明显(P<0.05),干预2组和干预3组平和质占比在干预过程中无明显变化(P>0.05);干预前5组患者BMI、WHR、FBG、TG、TC、LSM及CAP组间差异无统计学意义,干预后干预2组和3组显著优于其他组别(均P<0.05).结论 在NAFLD患者中开展基于王氏养生三法的中医体质调节可明显提高其平和质者比例,改善肝脏LSM、CAP水平和相关代谢指标.

目的 分析在上消化道出血急救患者护理中应用优质护理理念的临床价值.方法 选取2018年2月～2019年2月消化科收治上消化道出血患者82例为试验对象,采用数字列表法分成实验组(常规+优质护理理念)和对照组(常规护理),每组41例,对比两组患者临床效果.结果 实验组患者生活质量改善幅度以及治疗有效率、护理满意率等均明显的优于对照组,同时,实验组患者所用止血时间较少,出血量较少,组间结果差异较大.结论 在上消化道出血急救患者护理中应用优质护理理念能够提高护理效果和治疗有效率,能够被患者所接受.

目的:观察小剂量阿司匹林预防妊娠期高血压疾病(H D P)效果.方法:选取H D P高危孕妇160例,随机分为对照组及观察组,每组80例.对照组行常规预防,观察组在对照组基础上联合小剂量阿司匹林干预.观察患者血压指标(SBP、DBP、MAP)变化,比较两组HDP发生情况、剖宫产情况及不良妊娠结局.结果:干预后观察组SBP、DBP、MAP水平低于对照组(P<0.05);观察组HDP发生率、剖宫产率不良妊娠结局发生率低于对照组(P<0.05).结论:小剂量阿司匹林预防HDP效果良好,可有效控制孕妇血压,改善妊娠结局.

目的:探讨分析健康教育对功能性子宫出血患者心理状态及治疗依从性的影响.方法:选取86例功能失调性子宫出血患者为研究对象,采用随机数字表方法分为观察组(43例)和对照组(43例),对照组予以常规护理,观察组在对照组的基础上实施健康教育,两组均护理至出院.采用自拟健康知识调查量表、自拟依从性量表评估两组护理前后健康知识掌握情况及治疗依从性.结果:观察组的用药知识、合理饮食及卫生指导评分均显著高于对照组(P<0.05);观察组在按时服药、按疗程治疗及按时就诊方面的依从性均显著高于对照组(P<0.05).结论:针对功能性子宫出血患者实施健康教育能够改善其心理状态,提高健康知识水平及治疗依从性.

目的:观察中西医结合急救对有机磷农药中毒患者的急救效率及预后的影响.方法:90例有机磷农药中毒患者随机分为观察组和对照组,每组45例.对照组实施常规急救,观察组在对照组基础上实施中医急救.比较两组治愈率、中毒症状消失时间及反跳现象出现情况.结果:观察组治愈率高于对照组,差异有统计学意义(P＜0.05);观察组中毒症状消失时间短于对照组,差异有统计学意义(P＜0.05);观察组反跳现象出现率低于对照组,差异有统计学意义(P＜0.05).结论:对有机磷农药中毒患者进行中西医结合急救,能够提高急救效率,改善预后,值得深入研究并在临床推广应用.

目的 观察腹腔镜辅助下全子宫切除术与腹腔镜下全子宫切除术的临床疗效.方法 选择2016年1月至2018年12月在德兴市人民医院治疗的子宫良性病变患者75例为研究对象,应用随机数字表法分为对照组(n=37)、观察组(n=38).对照组接受腹腔镜下全子宫切除术,观察组接受腹腔镜下阴式全子宫切除术.观察两组患者围术期指标、疼痛程度及切除子宫体积.结果 观察组术中出血量、手术时间、排气时间、住院时间较对照组低,差异有统计学意义(P<0.05);观察组视觉模拟评分法(VAS)评分较对照组低,切除子宫体积较对照组高,差异有统计学意义(P<0.05);两组患者下床时间、并发症发生率相比,差异无统计学意义.结论 子宫良性病变患者接受腹腔镜下阴式全子宫切除术治疗是安全、可行的,在减少手术损伤、缓解疼痛、切除子宫体积等方面优势明显.

目的 分析产前心理护理干预对初产妇分娩方式及分娩后抑郁的影响价值.方法 选取于2015年3月至2017年7月在我院接受治疗的100例初产妇作为研究对象,随机将其分为对照组和观察组(各50例).对照组采用常规护理,观察组采用产前心理护理干预,对比两组初产妇分娩方式及分娩后抑郁情况.结果 观察组初产妇自然分娩率明显高于对照组(x2 =6.828,P＜0.05),剖宫产率明显低于对照组(x2=4.332,P＜0.05);对照组和观察组SDS评分较护理前均明显降低,且观察组初产妇SDS评分显著低于对照组(t=7.948;P＜0.001).结论 对初产妇采用产前心理护理干预,能明显改善分娩后抑郁情绪,提高初产妇自然分娩率,值得临床进一步推广使用.

目的 探讨个案护理在眼科临床护理教学中的应用效果.方法 随机选取2016年3～10月在眼科实习的20名护生为对照组,20名护生为观察组.对照组用传统教学方法,观察组在传统教学方法的基础上完成一份个案护理.比较两组护生的理论、操作成绩和教师评分以及教学质量的满意度.结果 观察组的理论、操作成绩、教师评分以及满意度均高于对照组,差异有统计学意义(P<0.05).结论 个案护理在眼科临床护理教学中可提高护生成绩,提高护生对教学质量的满意度,值得应用推广.

Objective:To study the nursing care of lacrimal duct obstruction treated with laser forming combined with retrograde implantation of lacrimal duct.Methods:90 cases of lacrimal duct obstruction from March 15,2016 to January 10,2017 treated in our department were classified according to different medical record number for the observation group and control group.Two groups of patients were treated with laser dacryocystoplasty combined with retrograde intubation treatment.The observation group was given entire nursing treatment,and the control group was given routine nursing treatment.The related nursing score and postoperative adverse reaction rate and the satisfaction of patients to nursing were analyzed after treatment.The observation time was 10 months.Results:The two groups of lacrimal obstruction patients on the score of nursing care,the control group (69.45 ± 77.56) was less than the observation group (76.54 ± 82.23),there were significant differences,with statistical significance(P ＜ 0.05).In the incidence of adverse reactions,the control group was greater than the observation group,there were significant differences,with statistical significance (P ＜ 0.05).In the nursing satisfaction,the control group was less than the observation group,there were significant differences,with statistical significance (P ＜ 0.05).Conclusion:For laser dacryocystoplasty combined retrograde tube grafting treatment of lacrimal duct obstruction patients,nursing effect on patients after surgical nursing is satisfying;trauma,postoperative appearance,postoperative adverse reaction are improved significantly,worthy of clinical expansion.

目的 探讨止痛化症胶囊联合米非司酮治疗子宫腺肌症的临床应用价值.方法 选取我院2015年8月～2016年8月76例子宫腺肌症患者为试验对象,采取随机抽签法将患者平分为观察组、对照组各38例,对照组服用米非司酮治疗,观察组加用止痛化症胶囊治疗,对比两组患者的痛经改善情况、血清CA125变化程度.结果 观察组的无痛经率为94.70％较对照组的50.00％较高(P＜0.05),且该组停药3个月后的血清CA125指标远低于对照组(P＜0.05).结论 子宫腺肌症患者经止痛化症胶囊联合米非司酮治疗较米非司酮治疗的效果有较大改观,且减轻患者痛经程度,该治疗方案具有可行性.

目的 探究血府逐瘀汤联合米非司酮治疗子宫肌瘤的有效和安全性.方法 将我院妇科自2015年4月～2016年7月收治的90例子宫肌瘤患者按照入院先后随机的分为观察组及对照组两组,每组各45例,其中对照组给予米非司酮治疗,观察组则在对照组基础上给予血府逐瘀汤内服,治疗结束后分析两组患者的临床效果及不良反应情况.结果 治疗结束后,观察组临床有效率为91.10％,明显优于对照组(75.60％),差异具有统计学意义;不良反应方面,观察组不良反应发生率为11.10％(5例),对照组不良反应发生率为15.60％,两者无明显差异性.结论 血府逐瘀汤联合米非司酮治疗子宫肌瘤的临床疗效确切,且不增加药物毒性,安全性高,值得推广.

OBJECTIVE:To evaluate the effect of annular electrode lacrimal duct reconstruction in improving the safety and efficacy of nasolacrimal duct stent implantation for treatment of nasolacrimal duct obstruction.METHODS:This randomized clinical trial was performed to compare the efficacy, success rate of intubation, time used for stent implantation, intraoperative pain, and extubation-assciated complications between nasolacrimal stent implantation with and without annular electrode lacrimal duct reconstruction.RESULTS:A total of 119 eligible patients were enrolled in this trial. The total curative rate at 6 months of follow up after extubation was 70.9% (83/117) in these patients, and was significnatly higher in pateinets with lacrimal duct reconstruction than in those without [80.6% (54/67) vs 58.0% (29/50); χ(2)=7.093, P<0.05]. The total success rate of stent implantation was 98.3% (117/119) in all the patients initially enrolled, and two patients experienced failure of stent implantation and were excluded; the success rate was signfiicantly higher in patients initially enrolled in the lacrimal duct reconstruction group (χ(2)=6.282, P<0.05). The median time required for intubation was shorter in lacrimal duct reconstruction group (12 s vs 33 s; Z=-36.722, P<0.05). The intendity of intraoperative pain was comparable between the two groups (t=0.833, P=0.405). The total rate of puncta injury was 43.6% (51/117) in these patients and similar between the two groups (χ(2)=1.459, P=0.227). The total rate of extubation difficulty was 9.4% (11/117) in all the patients, and was lower in lacrimal duct reconstruction group [4.5% (3/67) vs 16% (8/50); χ(2)=4.463, P<0.05]. Stent breakage in extubation occurred in 4.3% (11/117) of the patients with similar rates between the two groups (χ(2)=2.964, P=0.085). Spearman bivariate correlation analysis showed that the time required for intubation was inversely correlated with the treatment efficacy (r=-0.584, P<0.05) and positively with the occurrence of extubation difficulty (r=0.491, P<0.05); extubation difficulty was inversely correlated with the curative effect (r=-0.511, P<0.05).CONCLUSION:Annular electrode nasolacrimal duct reconstruction can increase the safety and efficacy of nasolacrimal duct stent implantation for treatment of nasolacrimal duct obstruction.

目的：探讨鼻泪管阻塞模型理想的制作方法，以及动物模型鼻泪管阻塞的判断方法等。方法10只新西兰大白兔随机分成3组，金葡组4只8眼行鼻泪管损伤后接种金黄色葡萄球菌，结扎组4只8眼行鼻泪管损伤后缝线结扎，另一组2只4眼作为对照组，行鼻泪管损伤后不做进一步处理。观察损伤后3、7、14 d的临床表现及14 d时的泪道冲洗结果，泪囊造影情况，比较这些制作鼻泪管阻塞模型方法的成功率、临床表现等。结果结扎组鼻泪管阻塞成功率为100％（8／8），金葡组成功率为25％（2／8），对照组为0（0／4）。金葡组与结扎组、金葡组与对照组、结扎组与对照组比较，成功率的差异均有统计学意义（ P＜0.05）。泪道阻塞眼均有溢泪，泪道冲洗不通，泪囊造影示泪囊显影，鼻泪管不显影，但分泌物较少，金葡组早期分泌物较多。结论兔可作为鼻泪管阻塞模型较理想的实验动物，结扎法是制作兔鼻泪管阻塞模型的较理想的方法。

目的：探究甲基强的松龙对外伤性视神经病变视网膜厚度和视网膜神经节细胞的影响。方法从2012年1月到2014年8月在我们两院进行治疗的外伤性视神经病变患者中随机选择60例作为研究对象，按照入院的先后顺序平均分为治疗组和对照组。治疗组患者采用大剂量甲基强的松龙进行冲击治疗，同时配合高渗剂、神经营养药及血管扩张剂等进行治疗。对照组则应用常规剂量地塞米松进行治疗，辅助治疗同治疗组。在治疗前及治疗后第七、十四、二十一天分别检测两组患者的闪光及图形视觉诱发电位（ VEP）、视乳头周围视网膜神经纤维层（ pRN－FL）平均厚度和黄斑区视网膜神经节细胞复合体（ mGCC）整体平均厚度，并对两组数据的变化情况进行观察和比较。结果在治疗期间对两组患者的各项指标进行检测后发现，随着时间的变化，每组患者治疗前后的VEP波幅值、pRNFL厚度、mGCC 平均厚度出现一定程度的变化，差异有统计学意义（P＜0．05）。但治疗组与对照组比较，各项指标差异没有统计学意义（P＞0．05）。结论使用甲基强的松龙对外伤性视神经病变进行冲击治疗，没有得到优于对照组的治疗效果。因此在实际治疗过程中，不建议将大剂量甲基强的松龙冲击治疗作为 TON 的标准治疗方法。

Objective To analyze the ultrasonic characteristics of elderly type 2 diabetes mellitus (T2DM) patients with lower extremity vascular disease. Methods Sixty-two elderly patients with T2DM were chosen as the observation group, and 62 healthy volunteers were selected as the control group, which all underwent bilateral lower limbs by color Doppler ultrasonography. The ultrasonic characteristics of lower extremity vascular diseases of the el-derly patients with T2DM were observed. The incidence of mixed plaques and fibrous plaque, lower extremity vascu-lar intimal thickness (IMT), and blood flow parameters of two groups were compared. Results The incidence of mixed plaque, fibrous plaque and plaque in the observation group were 29.0%, 41.9%and 70.9%, significantly higher than those in the control group (P<0.05). The femoral artery and popliteal artery IMT in observation group were (0.87± 0.25) mm and (0.78 ± 0.18) mm, significantly thicker than those in the control group, but the peak systolic velocity (PSV), accelerated speed (Acc) of femoral artery and popliteal artery in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Elderly patients with type 2 diabetes mellitus have significant-ly higher incidence of peripheral arterial disease, and there are significant differences in Doppler spectrum parameters between T2DM patients with lower extremity vascular diseases and health volunteers.

Objective To explore the cause for elevated intraocular pressure ( IOP) of non-surgical eye of patients in prone posi-tion after operation, and summarize the clinical nursing countermeasures. Methods One hundred cases of patients, admitted in Oph-thalmology Department of our hospital from March 2013 to December 2014, were divided into control group and observation group, ac-cording to such standards as the IOP, anterior chamber angle, anterior chamber depth, refractive conditions, eye axial diameter and corneal diameter. By observing both groups continually for 7 days, we recorded the IOP of the non-surgical eyes, and analyzed the in-cidence of high IOP. Results Before the operation, the differences in IOP of non-surgical eye of the two groups were not statistically significant (P>0. 05). Data within a week after operation showed that the IOP of non-surgical eye of the observation group was signifi-cantly higher than that of the control group, with statistical significant difference (P<0. 01). The incidence rate of high IOP of non-surgical eyes of the observation group was significantly higher than that of the control group, with statistical significant difference ( P<0. 05). Conclusion Patients with vitreous retinal are apt to have high IOP if in prone position after operation. So the early postopera-tive observation and clinical nursing are of great significance in preventing elevated intraocular pressure.

Objective To evaluate effect and safety of ultrasound guided puncture and washing with sterile normal saline in treating breast abscess .Methods From Jan 2012 to Oct 2013 ,79 patients with breast abscess were divided into two groups ,39 cases were received puncture guided with ultrasound treatment and washing with sterile normal saline ,while 40 patients were received the traditional abscess incision drainage .Swelling subsiding time ,the healing time ,local scar and other efficacy variables of the two groups were compared .Results All patients of the two groups were cured completely .There was no difference between the two groups in swelling subsiding time ,the heal‐ing time ,galactorrhea ,nipple sensory disturbance and reoccurrence rate (P>0 .05) .Frequency of refreshing bandage of ultrasound guided puncture group (1 .33 ± 0 .73)was lower than that of the traditional abscess incision drainage group(12 .23 ± 2 .46)(P<0 .01) .The degree of pain of ultrasound guided puncture group was lower than that of the traditional abscess incision drainage group (P<0 .01) .After treatment ,the percentage of breastfeeding again of the ultrasound guided puncture group(74 .36% ) was higher than that of the traditional abscess incision drainage group (15 .00% ) ,while less local scars were found in ultrasound guided puncture group (0 .00% )than in abscess incision drainage group(77 .50% )(P<0 .01) .Conclusion Puncture guided with ultrasound for breast abscess is safe ,conven‐ient and reliable for small trauma ,faster recovery and free of scars .