支气管哮喘发病率具有显著的上升趋势,反复支气管哮喘发作可导致患者肺功能的损伤,增加患者心肺系统并发症的发生率[1].特别是在具有慢性支气管炎或者自身免疫性疾病的吸烟人群中,支气管哮喘的发生风险可平均上升5％以上[2].临床治疗上主要是对症处理,缓解支气管痉挛和降低气管的高敏感性,必要时联合糖皮质激素抑制气管的炎症反应等,最终达到控制咳喘等症状和减少发作的效果;但长期的研究揭示,单纯糖皮质激素或者沙丁胺醇类药物治疗支气管哮喘后,患者短期内的临床症状改善并不明显,治疗后哮喘患者的喘息症状及肺部哮鸣音情况仍然较为明显[2～3].穴位贴敷含有多种有效中药活性成分,能够发挥“散寒逐饮、消肿散结、消痰平喘”等功效,辅助改善患者的肺部临床症状[4-5].为了指导临床上支气管哮喘的诊疗,本次研究选取我院社康中心治疗的100例支气管哮喘患者,证实了穴位贴敷联合沙丁胺醇等西药治疗支气管哮喘的临床效果,及治疗后患者肺部症状的改善情况.

目的 为患有糖尿病的老年患者实施中医优质护理与传统保健运动八段锦联合护理的效果进行分析,并观察对患者的情志状态和血糖、血脂的代谢情况的影响.方法 2018年5月—2019年5月在社康中心接受糖尿病治疗的老年患者120例,按照奇偶法将样本均分为探究组和常例组,两组患者均接受中医优质护理,探究组在此基础上实施传统运动八段锦进行运动训练,比较两组患者的情志状态和血糖、血脂的代谢情况.结果 实施护理后探究组患者的焦虑情绪评分(38.34±4.33)分与抑郁情绪评分(35.44±5.15)分明显低于常例组,差异有统计学意义(t=12.894,17.340,P<0.05);探究组患者的空腹血糖值、餐后2 h血糖值、胆固醇含量和血清甘油三酯明显低于常例组,差异有统计学意义(P<0.05).结论 为患有糖尿病的老年患者实施中医优质护理和传统运动八段锦联合护理的效果较为显著,患者的情绪状态更好,出现焦虑和抑郁的情绪状态更少,患者的血糖值和血脂含量也会有明显的改善,使患者的临床治疗效果得以提升,相比单一护理干预,将中医优质护理与传统运动八段锦联合护理方式更适合应用于老年糖尿病患者的临床护理工作中.

目的:探讨延续护理模式结合中医健康教育对高血压病患者慢性疾病管理自我效能的影响.方法:选择2017年5月-2018年8月来深圳市龙岗区人民医院进行治疗的128例高血压患者作为此次研究对象并随机将其分成对照组与观察组.对照组64例患者全部采用常规中医健康教育方式,观察组64例患者全部给予护理模式结合中医健康教育,比较两组患者慢性疾病管理自我效能.结果:①干预前,观察组患者症状管理评分与对照组比较无明显差异(P>0.05),干预后,观察组患者症状管理评分(34.88±4.19)分显著高于对照组患者(27.12±4.54)分,两组间比较具有统计学意义(P<0.05);干预前,观察组患者疾病共性管理评分与对照组比较无明显差异(P>0.05),干预后,观察组患者疾病共性管理评分(16.74±2.47)分显著高于对照组患者(13.79±2.81)分,两组间比较具有统计学意义(P<0.05).②观察组患者收缩压下降数值(11.87±13.56)mm Hg(1 mm Hg≈0.133 kPa)显著高于对照组患者(3.79±12.04)mm Hg,两组间比较具有统计学意义(P<0.05);观察组患者舒张压下数降值(6.31±13.47)mm Hg显著高于对照组患者(3.67±10.06)mm Hg,两组间比较具有统计学意义(P<0.05).结论:延续护理模式结合中医健康教育对高血压病患者慢性疾病管理自我效能效果显著,能够有效改善患者症状管理评分、疾病共性管理评分,并降低患者血压,值得临床推广应用.

目的:分析研讨中医"治未病"在社区公共服务中的作用效果.方法:随机从2017年9月1日-2018年12月30日在笔者所在社区卫生服务站社区居民中抽取800例进行讨论.用随机数字法将其分组,其中400例接受常规服务(对照组),另400例接受中医"治未病"服务(研究组).观察比较干预效果,如患者心理状态、满意度、疾病知识知晓状况等.结果:研究组患病率(8.75％)低于对照组(19.00％),差异有统计学意义(P<0.05).研究组满意度评分、疾病知识知晓评分均高于对照组,差异均有统计学意义(P<0.05).研究组敌对率(8.00％)、急躁率(6.25％)、焦虑率(5.25％)均低于对照组(17.00％、18.50％、19.00％),差异均有统计学意义(P<0.05).结论:将中医"治未病"用于社区卫生服务中,可显著降低疾病发病率,提升服务满意度和居民疾病知识率,值得推广.

目的 随着人民生活水平的提高,糖尿病患病率也不断升高,健康教育可以转变受教育者的健康观念和健康行为,改善患者心理健康状况和生活质量.本研究通过观察健康教育对糖尿病患者血糖指标、自我管理能力及生活质量的影响,为糖尿病患者的社区管理提供指导.方法 选择2017-03-01-2017-09-30在龙岗区人民医院中央悦城社区健康服务中心就诊的100例糖尿病患者作为研究对象,按照配比的方法分为观察组和参照组.参照组实施常规干预指导,观察组实施健康教育指导.比较两组干预前后血糖指标、自我管理能力情况和生活质量评分.结果 干预后,观察组空腹血糖水平为(7.63±1.24) mmol/L,低于参照组的(8.45±1.57)mmol/L,t=2.898,P=0.005;餐后2h血糖为(9.52±2.14) mmol/L,低于参照组的(10.85±2.63) mmol/L,t=2.773,P=0.006;糖化血红蛋白水平为(7.04±1.17)％,低于对照组的(7.79±1.32)％,t=3.001,P=0.003.干预后,观察组饮食评分为(24.56±3.22)分,高于参照组的(20.44±2.87)分,t=6.754,P＜0.001;运动评分为(11.25±2.23)分,高于参照组的(9.52±2.07)分,t=4.020,P＜0.001;血糖监测评分为(11.51±2.44)分,高于参照组的(10.25±2.32)分,t=2.646,P=0.007;足部护理评分为(11.48±2.32)分,高于参照组的(9.41±2.15)分,t=4.628,P＜0.001;用药行为评分为(5.21±1.54)分,高于参照组的(4.47±1.42)分,t=2.497,P=0.018.干预后,观察组社会功能评分为(79.52±23.96)分,高于参照组的(63.57±21.53)分,t=3.501,P＜0.001;心理健康评分为(73.52±19.11)分,高于参照组的(60.37±15.67)分,t=3.762,P＜0.001;总体健康评分为(78.62±15.93)分,高于对照组的(45.38±14.52)分,t=10.904,P＜0.001.结论 健康教育能够更有效帮助患者控制血糖水平,并显著提高糖尿病患者自我管理能力和生活质量,效果显著,具有较高的临床应用价值.

目的:研究社区健康教育对糖尿病患者的心理与社会功能所产生的影响.方法:将2016年7月1日-2018年3月30日笔者所在社区400例糖尿病患者作为此次研究对象,根据随机法对其进行分组,一组为对照组采取常规健康教育,一组为研究组采取社区健康教育,对其干预效果进行分析.结果:干预前两组患者SDS及SAS评分比较差异无统计学意义(P>0.05);干预后研究组患者SDS及SAS评分均优于对照组患者,差异均有统计学意义(P<0.05).干预后研究组患者SF-36评分优于对照组患者,差异有统计学意义(P<0.05).结论:社区健康教育对糖尿病患者的心理与社会功能有着重要的影响,有效缓解了患者焦虑、抑郁的症状,提高了糖尿病患者的社会功能,有着广阔的应用前景.

目的 分析家庭医生服务模式下高龄孕妇的妊娠结局.方法 选取我院收治的高龄孕妇226例,依据管理方式分为对照组和研究组各113例.对照组接受常规门诊随诊保健,研究组接受家庭医生服务模式下责任管理方式,观察比较两组妊娠结局和合并症.结果 研究组围生期并发症总发生率(5.31％)显著低于对照组(15.93％),差异明显(P<0.05).研究组新生儿不良结局总发生率(6.19％)低于对照组(16.81％),差异明显(P<0.05).研究组妊娠不良结局总发生率(8.85％)高于对照组(18.58％),差异明显(P<0.05).结论 建议将高龄孕妇纳入家庭医生服务模式管理,有利于改善妊娠结局,应用推广价值较大.

目的 了解入学新生视力状况及体重指数(BMI)对视力的影响,为高校新生健康管理提供参考依据.方法 采用标准对数视力表,对深圳市某大学2014年新招收的5 820名学生进行裸眼视力检查,分析BMI值对视力的影响.结果 达到入学视力要求的学生占38.22％,男性视力不良率高于女性,不同性别的新生视力检查结果差异有统计学意义(P＜0.05);不同性别体质量过低的学生之间、体质量正常的学生之间视力比较差异有统计学意义(P＜0.05).结论 BMI异常与新生不良视力存在相关性,高校新生视力低下现状令人堪忧,营养不良比例较高,学校管理者应重视学生的健康教育.

目的 探讨家庭医生签约服务模式在社区慢性病高危人群中的干预效果.方法 选取2015年2月-2017年2月在我院社区健康服务中心确诊患有慢性病的200例患者为研究对象,采用随机分组的方法分为观察组和对照组,每组各100例.对照组给予常规社区卫生健康护理,观察组采取家庭医生签约服务模式,对两组的健康知识问卷平均得分、危险因素存在率和干预效果进行比较研究.结果 观察组健康知识问卷平均得分、干预效果总有效率显著高于对照组,危险因素存在率显著低于对照组,差异有统计学意义 (P＜0.05).结论 家庭签约服务模式可以有效控制危险因素,提高社区慢性病高危人群的干预效果,值得推广.

Objective:The dyslipidemia management of the aged based on the family doctor service mode, a comprehensive community management mode that is suitable for the aged and high risk groups with dyslipidemia is explored. Methods: A community health service center in Longgang District, Shenzhen was selected. 200 respondents were chosen to participate in the study. Moreover, the aged above 60 years old with dyslipidemia were considered as research objects and were divided into two groups: The management group implemented comprehensive management of the family doctor service mode. The control group was only given general follow-up visit. Through 6-month differentiated management, differences of serum cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-L) and triglyceride (TG), differences of patients’ awareness rate, ways of life behaviors, family members’ awareness rate of patients were compared. Results: In the management group, the blood lipid level, the awareness rate of the patients, the awareness rate of the main family members, the improvement of life behavior, blood pressure, blood sugar control and physical index decreased significantly compared with the control group. Conclusion: The lipid management based on the family doctor service mode has an obvious intervention effect on the community aged with dyslipidemia, thus it is deserved to be further promoted.

目的 针对小儿腹泻发病特点和流行病学特征,探讨控制和减少小儿感染性腹泻的措施及预防对策.方法 选择2010年1月至2012年12月在深圳市龙岗区人民医院就诊,每日排便≥3次的小儿,作为研究对象,在患儿未使用抗菌药物之前进行大便细菌病原学检验并进行描述性统计分析.结果 539例小儿感染性腹泻病例中男女比例为1.44∶1,共检出101株病原菌,总分离率18.73％ (101/539).居前三位的是致病性大肠埃希菌(EPEC) 37.62％(38/101)、产毒性大肠埃希菌(ETEC) 27.72％ (28/101)、沙门菌17.82％(18/101).3岁以下小儿检出病原菌最多占85.15％(86/101);以秋季腹泻最多占52.48％ (53/101).结论 龙岗区小儿感染性腹泻以EPEC和ETEC感染为主.

Objective:Raising awareness of maternal HIV prevention,to reduce the rates of mother-to-child of HIV.Method:From January 2012 to December 2012 in The People’s Hospital in Longgang District of Shenzhen City,we randomly selected 400 cases for the study,taking the questionnaire and maternal and neonatal pathogen detection.Result:400 cases studied there for HIV mastery of knowledge were not very satisfactory,there were 25.00%of the people do not understand,grasp a basic understanding of the main stage crowd at 190 cases(47.50%).4 cases were HIV-positive pregnant women,pregnant women testing positive rate was 1.28%,newborn testing HIV positive two cases,mother-to-child HIV transmission rate was 50.00%.Conclusion:Strengthen prevention and control of maternal awareness can effectively control the rate of mother-to-child of HIV,the control of HIV incidence and prevalence has a very important significance.

Objective:Analysis the infant bone alkaline phosphatase (BANP) detection significance,its relationship with the incidence of rickets in children.Methods:Whole blood dry chemical and immunological enrichment technology methods, 1776 cases of infant bone alkaline phosphatase detection, the analysis blood NBAP rickets incidence of early.Results: Difference between men and women of all age groups was not statistically significant (P>0.05),among the age group difference was statistically significant (P <0.05).When paties younger,bone alkaline phosphatase is of the higher positive rate.Conclusion: Determination of bone alkaline phosphatase is early diagnosis of infantile rickets high sensitivity,specificity indicators.

[Objective]By understanding the epidemiological characteristic of acute infectious diarrhea in Longgang District of Shenzhen City from 2009-2011,to promptly carry out the measures for preventing outbreaks of infectious diseases.[Methods]Patients having defecation more than 3 times a day were collected for the study,the examination of pathogenic bacteria was performed in the fecal specimens before antimicrobial therapy,and the results were analyzed with descriptive statistics.[Results]Among 1 807 specimens,500 strains of pathogenic bacteria were isolated with the positive rate of 27.67%,and most of the patients were young and middle-aged people.The top three pathogenic bacteria were Enterotoxigenic Escherichia coli,Pathogenic Escherichia coli and Vibrio parahaemolyticus,which were isolated from 172 strains(34.4%),143 strains(28.6%) and 68 strains(13.6%),respectively.One cases of O157∶ H7 pathogen has been detected.359 strains of pathogenic bacteria were isolated in autumn and winter,which were more than 141 strains(28.2%) in the spring and summer.[Conclusion]It is necessary not only to carry out prevention and control measures according to the differences in the detection rate of pathogen during different seasons,but also to monitor the specific pathogenic bacteria based on the geographical characteristics.

目的掌握深圳市龙岗区流行性感冒(流感)流行动态和病原学特征,为制定流感防控策略提供参考依据。方法收集2008—2010年深圳市龙岗区人民医院监测的流感样病例(ILI)资料,采用描述性流行病学方法进行分析。采集ILI鼻咽拭子或咽漱液样本进行流感病毒分离;从2009年8月开始采用PCR方法检测甲型H1N1流感病毒。结果 3年监测医院门急诊就诊总人数为480 473人次,其中ILI 16 233例,ILI比例为3.38%。ILI主要集中在0～4及5～14岁年龄组,分别为8 602例(占52.99%)和4 169例(占25.68%)。全年均有病例发生,每年均呈双峰型流行趋势,2008年ILI主要集中在2—3及6—7月,2009年集中在4—7及11—12月,2010年集中在3—5及7—9月。2008—2010年从1 671份样本中分离出季节性流感病毒株142株,其中A型62株、B型80株;2009—2010年从679份样本中检出新甲型H1N1流感病毒核酸阳性204份,其中2009年阳性检出率为60.80%(183/301),2010年阳性检出率为5.56%(21/378)。结论深圳市龙岗区2008—2010年季节性流感发病相对平稳,2009年甲型H1N1流感较为活跃。

目的:通过对新生儿进行听力障碍发病率筛查,了解该疾病的发生率,并进行早期干预.方法:采用美国GSI(格雷森-斯塔德勒公司)生产的GSI 70 自动耳声发射听力筛查仪,诱发畸变耳声发射法,通过初筛、复筛对新生儿听力障碍进行早发现、早诊断、早干预.结果:初筛率90%,初筛未通过率5.8%,复筛率90.1%,复筛未通过率40.5%,最终确诊率3‰.结论:对新生儿进行听力筛查工作,可早期发现听力障碍儿,早期采取干预治疗和康复措施.

<正>老年性便秘是老年人最常见的胃肠道疾患,主要表现为大便量少而硬、排便困难、排不尽感、腹胀、神倦乏力及头昏脑胀等症状。长期便秘不仅影响患者的工作和生活,甚至会诱发或加重冠心病、原发性高血压及脑出血、心肌梗死等疾病。2008-01—2011-01,我们应用苁蓉通便汤结合腹部按摩治疗老年性便秘100例,并与麻仁软胶囊

Objective To know the trend of HIV infection and behavior change among drug users in Longgang district of Shenzhen, and provide basis for prevention of AIDS. Methods SPSS17.0 was adopted to analyze the HIV sentinel surveillance data from 2009 to 2011 in Longgang district of Shenzhen. Results There were 1 214 drug users surveyed from 2009 to 2011, with an average annual HIV infection rate of 2.31%, and the rate of heroin user declined year by year (declined from 64.75% to 36.66%). The rate of the 2 new drugs users showed a rising trend year by year (rose from 17.50% to 39.65%). The annual AIDS awareness rate was 53.13%, showing a rising trend year by year. The rate of the needle sharing among drug-injection users was 45.49%. The rate of never using condoms in commercial sexual promiscuity showed a rising trend year by year (rose from 25.64% to 57.14%). Conclusion More attention should be paid on the use of the 2 new drugs in Longgang district of Shenzhen although the HIV infection rate of drug users remains on a low level.

Objective To investigate the efficacy and cost of levofloxacin and cefoperazone/sulbactam in the treatment of community-acquired lower respiratory tract bacterial infections.Method A total of 180 cases with community-acquired lower respiratory tract bacterial infections were studied.A prospective randomized controlled clinical trial was conducted,and 0.3g levofloxacin or 4.0g cefoperazone/sulbactam as control were given by intravenous drip once a day for 7 to 14 days.Result The clinical efficacy rate of levofloxacin and cefoperazone/sulbactam were 92.2% and 93.3%;cure rate were 74.4% and 78.9%,and bacterial clearance were 89.7% and 90.0%,respectively.The courses of treatment were(8.7±2.1)d in patients receiving levofloxacin,while(8.2±2.3)d of control group.There was no statistical difference between two groups.The cost(RMB) of levofloxacin was significantly lower than that of cefoperazone/sulbactam(387.2±93.5 vs 615±172.5,P<0.05).Conclusion Levofloxacin therapy was as effective as cefoperazone/sulbactam in the treatment of community-acquired lower respiratory tract bacterial infections,but the cost(RMB) of levofloxacin was lower than that of cefoperazone/sulbactam.

目的了解C-反应蛋白(CRP)和白细胞介素-6(IL-6)在社区获得性下呼吸道感染中的临床价值.方法选择我院2003年1月～2004年12月就诊的社区获得性下呼吸道感染患102例,采用免疫比浊法测定治疗前后CRP水平,同时采用ELISA双抗体夹心法检测IL-6水平,并与白细胞计数、体温作比较.结果社区获得性下呼吸道感染患者CRP水平显著升高(94.52mg/L±63.01 mg/L),其阳性率远高于白细胞计数升高、发热等常规指标.而抗菌治疗1周后又迅速降至接近正常水平(8.12mg/L±3.28mg/L);IL-6含量治疗前后无显著性差异(75.87mg/L±6.32mg/L vs 77.25mg/L±7.14 mg/L,P＞0.05).结论 C-反应蛋白水平测定能够对社区获得性下呼吸道感染的性质做出判断,也是考核抗生素治疗是否有效的一个有用指标.