目的 探究外用益生菌乳膏缓解卡培他滨所致手足综合征的临床疗效.方法 将210例卡培他滨化疗的晚期肿瘤患者随机分为益生菌组、凡士林对照组及空白对照组各70例;完成研究分别为63、67、59例.益生菌组化疗期间手足外用含双歧杆菌及乳酸菌的益生菌乳膏1周;凡士林组只应用凡士林乳膏,方式同益生菌组;空白对照组采取一般护理措施.结果 益生菌组手足皮肤双歧杆菌及乳酸杆菌阳性率显著高于另外两组,且金黄色葡萄球菌、棒状杆菌阳性率显著低于另外两组(均P＜0.0125),化疗期间益生菌组手足综合征发生率及严重程度也显著低于另外两组(P＜0.05,P＜0.0125).结论 外用益生菌乳膏有利于抑制卡培他滨化疗患者的皮肤致病菌,降低卡培他滨所致手足综合征的发生率及严重程度.

[目的]探讨临床护士绩效考核制度。[方法]选取2个大城市教学医院从事临床工作的42名护士，采用描述性的定性方法、框架分析方法来分析数据。[结果]归纳为情境问题和绩效考核结构相关问题。[结论]绩效考核对提高员工几乎没有影响动机，最重要的原因是缺乏公平的、客观的、适当的反馈和缺少员工参与绩效考核，说明评价系统是主观的、不专业的，绩效考核系统是需要完善的。

Objective To assess the relationship between the psychological state and the coping style of patients with nodular goiter. Methods A total of 169 nodular goiter patients, who came from general surgical department, the First Affiliated Hospital of Harbin Medical University, were asked to complete general information, symptom checklist scale (SCL-90), simplified coping style questionnaire (SCSQ) and self-composed general questionnaire. Results Nodular goiter patients′self-rating scale points showed somatization, interpersonal sensitivity, anxiety and horror scores were (1. 59 ± 0. 56), (1. 37 ± 0. 46), (1. 50 ± 0. 56), (1. 34 ± 0. 48) significantly higher than the norm (1. 37 ± 0. 48), (1. 65 ± 0. 51), (1. 39 ± 0. 43), (1. 23 ± 0. 41) score (t=5. 747, 8. 022, 2. 806, 3. 362,respectively;P<0. 01); the negative coping scores of patients with mental disorder was (1.04 ±0.50) higher than (0.79 ±0.60) of patients with mental health (t= -2.36,P<0.05). Conclusions Patients with nodular goiter had poor mental health and negative coping style, which is related with social support and psychological health of nodular goiter patients.

Objective To assess the relationship between the psychological state and the im-pulsive characteristics of nodular goiter .Methods One hundred and sixty-nine nodular goiter patients were asked to complete Life Events Scale (LES), Symptom Checklist Scale(SCL-90), Barratt Impulsive Scale (BIS), Simplified Coping Style Questionnaire (SCSQ) and self-com-posed general questionnaire .All data were statistically analyzed by t-test,χ2 test and stepwise multiple regression .Results The scores of somatization , interpersonal sensitivity , anxiety and phobia were obviously higher in patients with nodular goiter than those in norms .The total scores of planned impulse , the scores of somatic impulse , cognitive behavioral impulse , and the scores of negative coping were significantly higher in patients with psycho-problems than those with psychological health .Correlation analysis showed that planned impulse was positive related to hostility , psychosis , annexation and the total scores of SCL; while somatic impulse was positive related to compelling , interpersonal sensitivity , depression , anxiety , hostility , phobia , psychosis , annexation and the total scores of SCL .Cognitive behavioral impulse was not related to any factors .Conclusion The overall mental health condition of nodular goiter patients is poor;and personality traits of planned impulse and somatic impulse are closely relat-ed to the mental health of nodular goiter patients .

目的 评估甲状腺功能亢进患者心理健康状况及其与冲动性、攻击性人格特征的关系.方法 采用症状自评量表、Baratt冲动性人格量表、攻击性人格量表对169例甲状腺功能亢进患者进行问卷调查.结果 甲状腺功能亢进患者躯体化、人际关系敏感、焦虑、恐怖得分高于常模(P＜0.01);存在心理问题的患者言语攻击、愤怒攻击、敌意攻击、自我攻击得分高于心理健康患者(P＜0.01或P＜0.05);行动性冲动与强迫症状、人际关系敏感等呈正相关,言语攻击与SCL总分呈正相关,敌意攻击与强迫症状、人际关系敏感等呈正相关,自我攻击与精神病性呈正相关(P＜0.01或P＜0.05).结论 甲状腺功能亢进患者心理健康状况较差;冲动性、攻击性人格特征与甲状腺功能亢进患者心理健康密切相关.建议帮助甲状腺功能亢进患者正视自己的心理问题和人格弱点,调整应对方式,促进其心理健康.

Objective To explore the application value of five row of emotional nursing program in the patients suffering from gastrointestinal operation.Methods Totals of 228 patients suffering from gastrointestinal operation were randomly divided into the observation group and the control group, with 114 cases in each group. The observation group received five rows of emotional nursing program according to the three kinds of negative emotions, and the control group was implemented the general emotional nursing care.The symptom checklist was used to assess patients’ symptoms, the St.Mary’ s Hospital Sleep Questionnaire ( SMH) was used to evaluate the sleep quality of patients.Patients’ symptoms and sleep quality were compared at the second day after admission and the first day after intervention.Results The scores of symptom checklist and SMH were not significant (P>0.05).After the intervention, the total scores of somatization and SMH were (1.36 ±0.20) and (18.09 ±3.58) in the observation group.Those scores of the control group were (1.42 ±0.33) and (17.69 ±2.48).There were no significant differences between the two groups ( t =0.368, 0.985, respectively;P>0.05).Other aspects of the observation group were significantly better than those in the control group (t=2.896-4.023,P<0.05).The self-assessment lists and SMH of the observation group before and after the intervention had significant differences (t=3.012-7.362,P<0.05).After the intervention, the total scores of somatization and SMH of the control group were significantly improved ( t =3.026, -4.331, respectively;P<0.05).The rest of the aspects had no significant differences (t=0.639-0.942,P>0.05). Based on the five row emotional care programme, 112 patients in the observation group were satisfied and 2 patients were not satisfied.Those numbers of the control group were 91 and 23.There was a significant difference between the two groups (χ2 =19.726,P<0.01).Conclusions The five row emotional nursing program for patients suffering from gastrointestinal operation have a certain effect on negative emotional, and can improve the sleep quality and treatment satisfaction of the patients.

Objective: Through the status investigation of Ankang Hospital,the Compulsory treatment medical institutions in Heilongjiang Province,the study wants to know the quantity and the quality of human resources in the hospital,to know the status of employee training and stuff mobility and working conditions,to find out the problems exist in the human resources management and propos the improvement strategies.Methods:In this study,literature review was used to know the human resources status in drug addiction treatment center at home and abroad.Questionnaire and in-depth personal interview were used to know the human resources status of the target hospital.Brainstorming was used to propose the improvement strategies.Results: There are 100 employees in target hospital,the ratio of doctor and nurse is 1:0.85,ratio of doctor nurse and bed is 1:0.85:2.78.The stuff access way is Civil Service Examinations.In the past five years,the doctors have been transferred in the hospital for about 2.4 in average,and the nurses are 1.4 in average.43.3 % nurses work over 15 hours per day,and over 22 days per month.The workers are dissatisfied with the employee training.The most needed training for the employees include: medication knowledge,psychotherapy,psychiatric knowledge,the latest nursing techniques and information,psychological care,equipment operation and simple troubleshooting.The employees are under pressure and the sources include working environment,busy work,the patient,interpersonal relationships and career development,the lack of occupational protection.80 % doctors and 93.3 % nurses are generally satisfied with their work,but only 50 % doctors and 44 % nurses are satisfied with their own salary.Conclusions: The stuff of target hospital is stable.The number of doctor basically meets the needs of work,but the hospital needs more nurse,for the nurse is under great workload and pressure.The employee training does not fit for the actual work.With less occupational protection,the work satisfaction is quite low.

Objective To assess the level of mental health and impulsive personality among hyperthyroidism patients and to explore the role of mental health and impulsive personality in the pathogenesis of hyperthyroidism.Methods Symptom Checklist-90(SCL-90) and impulsive personality scale were used to measure 217 patients with hyperthyroidism.Results The self-rating score of somatization(1.59±0.56),interpersonal sensitivity(1.37±0.46),anxiety(1.50±0.56),and horror(1.34±0.48) of the hyperthroiclism patients were significantly higher than those of the norm,with significant differences(P0.01 for all).Somatic impulse was positively correlated with coercion,interpersonal sensitivity,depression,anxiety,hostility,horror,paranoid,and psychosis(P0.01 or P0.05).Cognitive behavior impulse was positively correlated with coercion,depression,hostility,paranoid,psychosis,somatization,anxiety,and horror(P0.01 or P0.05)and was not correlated with interpersonal sensitivity.Planned impulse had no correlation with somatization,coercion,interpersonal sensitivity,depression,anxiety,hostility,horror,paranoid,and psychosis.Conclusion Hyperthyroidism patients had poor mental health and impulsive personality characteristics was related to the incidence of hyperthyroidism.

抚触是一种具有悠久历史的医疗技术,通过对婴儿皮肤感官温和的刺激,有益于婴儿的健康发育[1],更能增进家人与婴儿的亲情传递。对婴儿施行抚触,通过操作性条件反射原理,实现对内脏器官和骨骼肌活动的改造,对负性情绪进行疏导,改变人格特征,以达到心身良性成长的目的。

现代医学模式强调人不仅是生物的有机体,而且是生物、心理、社会的综合体,人在受到外界不良刺激时,会表现出很多负面情绪,如果这些负面情绪得不到及时调整,就很有可能导致某些心理疾患或者直接影响到病情的发生、发展和转归.

经尿道汽化术是利用电切镜,高频电刀发声器,安装特别的电极圈进行电切的技术,电极在接触组织表面后立即汽化深约2～3mm,创面凝固坏死,其下面有1～3mm凝固层.术中基本无出血,灌洗液吸收很少,不会发生经尿道切除(TUR)综合征.本院从1997-12迄今治疗下尿路梗阻10例,收到了与TUR手术同样效果.认为本法术中出血明显减少,缩短术后留置尿管时间,且有操作简单,对病人侵袭小等优点.现将术中配合与护理体会,报告如下.