ObjectiveTo investigate the clinical characteristics of leprosy-related neuritis with bullous pemphigoid after treatment of paucibacillary leprosy.MethodsThe treatment of leprosy reaction combined with bullous pemphigoid of a cured case of leprosy was analysed.ResultsFive years after standard treatment for leprosy， erythema and vesicles appeared in the limbs without obvious inducement， and the disease became more and more severe. With clinical diagnosis and pathological examination， pemphigoid was confirmed， and the patients were given hormone treatment for leprosy reaction and anti-immunotherapy， as well as symptomatic supportive treatment.ConclusionLeprosy reaction and pemphigoid are both related to immunity， but the occurrence of both at the same time is relatively rare， so in the clinical process we should attach great importance to early detection， early diagnosis and prompt treatment to prevent further harm to the patient.

[目的]了解综合性康复干预对麻风治愈患者畸残情况的影响.[方法]选取浙江省5家麻风村中的省级麻风村作为观察组,其他4家麻风村列为对照组,两组间年龄相差≤5岁,残疾指数(眼手足平均残疾)无差异.通过自行设计的问卷调查表对麻风治愈住村患者进行调查,并采用综合性康复干预方法对观察组进行干预,2年后对观察组和对照组的后遗症进行比较.[结果]麻风治愈留院者残疾比重较高.综合性康复干预后,与基线后遗残疾比较,观察组的后遗残疾损害中的红眼、手部皮肤皲裂、足部皮肤皲裂、足溃疡等较基线的下降率分别为61.54％、71.96％、60.41％、52.86％;对照组的后遗残疾损害红眼、手部皮肤皲裂、足部皮肤皲裂、足溃疡较基线分别下降37.5％、58.74％、45.64％、21.43％.两组红眼下降率相比P>0.05,无明显统计学差异;手、足皲裂以及足部溃疡相比P<0.05,差异有统计学意义.[结论]麻风治愈留院患者残疾率高,生存质量普遍较差,应加强综合性干预,以提高生存质量、减少后遗残疾的发生.

目的 了解浙江省现存麻风病住院患者的婚姻状况、畸残情况、基本状况、劳动生活能力、经济状况以及医疗保障等.方法 采用调查表由麻风病防治人员对浙江省住院154例现存麻风病患者进行系统的调查.结果 154例麻风病住院患者中,病期在两年内的畸残较两年以上的发生低且随时间延长畸残率越高,麻风病村的患者生活自理能力普遍差,且文化程度与婚姻状况较差;住院患者的医疗状况基本由所在村的医疗机构承担,无后顾之忧.结论 麻风病治愈留院患者畸残率高,但在生活和医疗保障方面情况较好,尤其对于一些孤寡无依和严重畸残而丧失劳动和生活能力的患者,集中收治到麻风病村,以保证他们安度晚年.

对麻风残疾的护理是预防麻风残疾加重和恶化的重要措施,虽然目前麻风眼手足残疾护理的相关报告较多[1-2],但是不少国家的干预实践表明,麻风眼手足残疾的护理受到许多主客观因素的影响,在现场的实施仍然是一项挑战[3-4],在麻风病防治一体化的新形势下,其可及性、干预质量以及获得的最佳效果都有待进一步研究评估[5-6].近年来,在麻风病残疾护理方面取得了不少新的进展[7-10],用麻风残疾护理的一些新模式、方法、理念来改进提高麻风残疾护理工作的质量显得十分必要.

总结2例麻风病患者服用氨苯砜治疗后发生氨苯砜综合征的护理经验,认为此类患者护理的重点是加强发热护理,在容易发热的时段增加巡视观察,配合医生做好物理降温和降温药物效果观察;鼓励患者进食高蛋白、富含铁和钙的饮食,纠正贫血和肝功能损害;加强皮肤的护理,防止皮疹向剥脱性皮炎转化;注意观察糖皮质激素的不良反应,及时通知医生用药干预;做好心理护理,安抚患者情绪,使其配合治疗护理。本组2例患者经治疗护理均好转出院。

近年来,卫生服务费用不断上涨,居民的经济负担加重,严重制约卫生服务的利用.1因此,如何早期发现麻风病人对于降低患者的经济负担显得尤其重要.本文通过对我省近年来新发病人且完成联合化疗疗程的麻风病人经济负担进行研究,为我省防治工作提供有利依据,也为国家对这方面的卫生资源投入提供理论基础.

近10余年来,浙江省麻风病整体处于低流行状态,对于广大麻风受累者的相关防治服务,已经实现了由垂直性麻风防治系统直接提供向基层综合性卫生服务体系具体承担的转变,麻风病防治相关专业机构目前仅承担规划、督导、培训、技术支持、转诊服务等较宏观性任务.

Objective To understand financial burden of leprosy hospital patients with plantar ulcer in Zhejiang province and provide a theoretical basis for preventing leprosy's plantar ulcer.Methods The three leprosy villages were selected as the survey respondents by using self-made questionnaire for economic burden of leprosy plantar ulcer by trained personnel on prevention and treatment of leprosy plantar ulcer patients.Results There were eighty three leprosy patients with plantar ulcers in the villages,including 70 of the patients with complicated plantar ulcer and 11 of the patients with simple foot ulcers.The direct economic burden by foot ulcers in the past year including: dressing fee is 400-7300 yuan,a total of 250 003.80 yuan,an average of 3 378.43 yuan;treatment fee is 100-3 800 yuan(including six cases of amputation ulcer patients),a total of them is 31 530.70 yuan,with average of 389.27 yuan;medicine fee is 90-3 000 per month,a total of 30 377.40 yuan,an average of 506.29 yuan;inspection fee is 4 072.50 yuan,an average of 50.28 yuan.Indirect economic burden: nutrition fee is 20 076 yuan,an average of 247.85 yuan;protective footwear expenditure is 50-150 yuan,a total of 5,605.7 yuan,an average of 69.21 yuan.Conclusion Foot ulcers are a common complication of leprosy with relatively heavy economic burden.The state should increase investment in this area of health resources to reduce the leprosy burden in hospital patients.

Objective To understand the cognition to leprosy and health education demands among floating population.Methods A qualitative study was made in a construction site,which is located in Deqing,Zhejiang.The investigation was semi-structure open dialogue.Results 42 cases were investigated,in which nearly a half of workers never heard of leprosy and nearly a half of the others knew leprosy was an infectious disease.The majority of 42 cases did not know the exact symptoms of leprosy and only a small portion of objectives considered that leprosy was curable.Among the cases who have heard of leprosy,a considerable of cases felt that leprosy was a terrible disease.The majority of 42 cases like to accept leprosy health education when they were free.The favorable propaganda media were TV,propaganda sheet or picture board.The most interested contents were how to protect themselves against leprosy.Conclusion The leprosy cognition were very low among floating population.It is proposed that the health education strategy of TV combined with propaganda sheet and board should be carried out among these non-native population.

了解浙江省麻风病留院者伤害流行状况及相关影响因素,为采取相应的伤害干预措施提供科学依据.采用整群抽样方法,调查浙江省8所麻风病院225例留院者1年内(2008年1～12月)伤害发生情况,并使用Logistic回归分析方法来确定其影响因素.麻风病留院者伤害发生率为40.4%(91/225),伤害事件发生率为61.8%(139/225),发生率居前3位的依次是烧烫伤46.8%(65/139)、跌落伤25.2%(35/139)、行走新溃疡伤15.8%(22/139);伤害地点主要是病房36%(50/139)、个人厨房30.2%(42/139)、道路24.5%(34/139);烹调与辅助支具使用是伤害发生的影响因素.麻风病留院者伤害发生率较高,有自身的伤害流行特征,应加强麻风病院的伤害预防控制工作.

麻风患者及治愈者为弱势群体,他们要治疗麻风的并发症及其它疾病,加之社会上还不同程度存在着对麻风患者的社会歧视,且麻风患者家庭多数为低收入家庭,因此,相应的医疗保障如城镇职工、居民医疗保险与新型农村合作医疗保险等就显得十分必要,特别是对社会上一些重度残疾和离群化的麻风病人,研究其医疗保障状况及医疗服务利用更具有特别的意义.在荷兰麻风救济会的支持下,我们对我省社会上的部分麻风患者及治愈者的医疗保障及医疗服务利用情况进行了专题调查,现将结果报道如下.

为了了解麻风留院者心电图情况,于2004年6～7月对我院127例麻风治愈留院患者进行了心电图检查,为麻风患者老年性疾病的预防和临床诊治提供依据,现将结果报道如下.

近年来心血管疾病的发生率和死亡率明显增高,其诊断仪器也日新月异,但心电图仍是最为经济、简便和实用且不可缺少的检查方法.有关老年人心电图已有大量报道[1],也有对福利院老年人的心电图调查[2],但未见对麻风患者心电图的探讨.

多杀巴斯德菌为一种动物致病菌,其导致麻风溃疡感染尚未见报告,我们在对我所麻风住院部病人溃疡局部换药与自我护理过程中见到1例,现报告如下: