目的:构建脑卒中吞咽障碍患者居家护理模式并评价其效果.方法:选取脑卒中吞咽障碍患者78例为研究对象.采用计算机产生随机序列法将患者随机分为观察组和对照组,每组各39例.对照组给予常规健康教育,观察组在常规健康教育基础上给予居家护理服务计划和干预措施,干预12周后,评价并比较2组患者干预前后的吞咽障碍情况、神经功能缺损程度、营养风险、自理能力、日常活动能力、心理状态及康复依从性.结果:干预12周后,2组吞咽障碍功能较治疗前明显提高(P＜0.05),且观察组更优于对照组(P＜0.05).干预后,观察组患者神经功能缺损、营养风险、抑郁评分明显低于干预前及对照组(均P＜0.05),观察组患者自理能力、日常活动能力、依从性得分均高于干预前及对照组(均P＜0.05);对照组各项指标干预前后比较除营养风险和抑郁评分外,其余各项指标差异有统计学意义(均P＜0.05).结论:脑卒中吞咽障碍患者居家护理模式有较高的实用价值,对改善脑卒中吞咽障碍患者吞咽情况,提高患者生活质量,促进患者康复,实现医院-社区-家庭的无中断长期护理服务有重要作用.

目的 研究糜烂性胃炎幽门螺杆菌(H.pylori阳性患者益生菌联合四联疗法治疗后的胃肠道微生态变化.方法 将我院88例糜烂性胃炎H.pylori阳性患者以随机数表法分为观察组与对照组,每组44例.对照组以四联疗法进行治疗,观察组在对照组基础上加用双歧杆菌三联活菌片.比较两组临床疗效及治疗后3、6个月H.pylori转阴率,比较两组治疗前后肠道菌落及血清胃泌素(GAS)、胃动素(MTL)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)检查结果,最后对用药安全性进行分析.结果 观察组总有效率为90.91％,显著高于对照组的72.73％ (P ＜0.05).观察组治疗后3、6个月H.pylori转阴率显著高于对照组(P＜0.05).与对照组相比,观察组治疗后双歧杆菌、乳酸杆菌水平显著提高,肠球菌、大肠杆菌水平显著降低(P＜0.05).观察组治疗后GAS、MTL、TNF-α、IL-6水平分别显著低于治疗前及对照组治疗后(P＜0.05).观察组用药后不良反应总发生率为11.36％,与对照组的9.09％相比差异无统计学意义(P＞0.05).结论 四联疗法治疗糜烂性胃炎H.pylori阳性时加用双歧杆菌三联活菌片可提高临床疗效及H.pylori转阴率,且用药安全.

Objective:To observe the efficacy of minocycline Hydrochloride Capsules Combined with Supra-molecular Salicylic Acid on moderate to severe acne.Methods:66 cases of moderate to severe acne patients were ran-domly divided into experimental group(n=33)and control group(n=33).The experimental group was treated with oral minocycline combined with 2% super-molecular salicylic acid nourishing facial mask,and the control group was given oral minocycline hydrochloride for 8 weeks.After 2 weeks,4 weeks and 8 weeks,the digital camera and Visia skin detector were used to record the regression and adverse reactions of acne lesions(acne,inflammatory papules and cysts)before and after treatment.Results:The total effective rate in the experimental group was higher than that in the control group(P<0.05).Both groups after the 2,4 and 8 weeks treatment have fewer number of lesions and the average value of lesion lesion were lower than those before treatment,while the experimental group the number of skin lesions and lesion mean value were lower than the control group,the difference was statistically significant(P<0.05).Conclusion:Minocycline hydrochloride combined with supramolecular salicylic acid is effective in the treat-ment of moderate and severe acne,less adverse reactions,which is worthy of clinical promotion.

目的:比较早期肠内营养对脑卒中患者的影响.方法:将150例患者随机分为观察组和对照组,观察组采用早期肠内营养,营养液中额外增加乳清蛋白制剂,对照组采用家属自制流质饮食,观察并比较两组患者入院2w后的营养状况血清指标、营养状况评分(MNA)、神经功能评分(NIHSS评分)及并发症情况.结果:观察组患者入院2w后的血清白蛋白、血清总蛋白、血红蛋白、MNA评分显著高于对照组,差异具有统计学意义(P＜0.05);两组患者的三酰甘油、血糖水平差异没有统计学意义(P＞0.05);观察组患者入院2w后的NIHSS评分显著低于对照组,差异具有统计学意义(P＜0.05);观察组患者消化道出血、肺部感染、褥疮发生率显著低于对照组,差异具有统计学意义(P＜0.05);两组患者的尿路感染发生率差异没有统计学意义(P＞0.05).结论:早期肠内营养有利于改善脑卒中患者早期营养状态,有利于脑卒中患者神经功能恢复,有利于减少脑卒中患者并发症的发生.