Objective:Recently, platelet≥110×10 9/L was taken as the indication of renal needle biopsy in our unit. To identify the risk factors for bleeding complication after percutaneous renal biopsy in patients with normal platelet count and built predictive models. Methods:We conducted a retrospective study in adult patients undergoing percutaneous renal biopsy in Guangdong provincial people's hospital from June 13, 2017 to December 27, 2018. Those requiring clinical intervention was defined as apparent bleeding, while red blood cell infusion, interventional therapy, kidney surgery, or death was defined as major bleeding.Results:Total 1036 patients were enrolled. Among them, 3.76% patients had apparent bleeding and major bleeding occurred in 1.54% patients. Multiple logistic regression mode demonstrated that estimated glomerular filtration rate<60 mL·(min 1.73 m 2) -1, hematocrit<0.4, and kidney length/height<0.066 were risk factors for apparent bleeding, with an odds ratios ( ORs) of 2.16 (95% CI: 1.08-4.34), 4.04 (95% CI: 1.39-11.76) and 2.65 (95% CI: 1.08-6.50), respectively. Hemoglobin <100 g/L and kidney length/height<0.066 were independently associated with major bleeding, with ORs of 10.29 (95% CI: 3.65-28.95) and 7.87 (95% CI: 1.02-60.43). Predictive bleeding models from the logistic analysis were further visualized using nomogram. These models showed good clinical performances, which were evaluated by the receiver operating characteristic curve. The areas under the curve were 0.713 (95% CI: 0.682-0.742) for the apparent bleeding and 0.802 (95% CI: 0.774-0.827) for the major bleeding, respectively. Conclusions:For patients with normal platelets, baseline renal function, anemia, and relative kidney size are independent risk factors for bleeding complication after percutaneous renal biopsy.

报道1例腹膜透析行胃肠镜检查后肠壁出血继发腹膜炎病例，经积极治疗和护理，患者无肠壁再出血，腹膜炎治愈出院。我们认为仔细评估内镜诊治风险、重视预防性使用抗生素、注重个体化管理是主动性预防内镜相关性并发症和腹膜炎发生的关键。

目的 分析全程教育和常规护理在糖尿病护理管理中的应用效果.方法 随机选取2015年1月～2016年1月100例符合本研究相关标准的糖尿病患者为研究对象,根据随机数字表法分为观察组与对照组,每组50例.观察组采用全程教育模式,对照组采用常规护理模式.观察两组患者护理前后的血糖控制率,采用本院特制问卷调查表观察两组患者护理前后对糖尿病知识的掌握情况,应用生活质量问卷调查表观察两组患者的生活质量变化情况,最后通过本院护理服务评量表观察两组患者对护理服务的满意度.结果 两组患者护理前的血糖控制率比较差异无统计学意义(P＞0.05),观察组(68.0％)护理后的血糖控制率显著高于对照组(40.0％)(P＜0.01);两组护理前的糖尿病知识掌握情况以及生活质量评分比较差异无统计学意义(P＞0.05),观察组护理后的糖尿病知识掌握情况以及生活质量评分[(86.9±15.2)、(81.6±14.6)分]显著优于对照组[(71.6±12.6)、(73.5±12.5)分](P＜0.01);观察组与对照组的护理满意率分别为94.0％、80.0％,两组比较差异有统计学意义(P＜0.05).结论 全程教育在糖尿病护理管理中具有较好的应用效果,能够有效提高患者对糖尿病相关知识的认知能力、改善生活质量和提高护理满意度.