目的：通過經外周靜脈穿刺中心靜脈置管（PICC）或鎖骨下靜脈置管與前臂靜脈留置針在血液病患者并發深部真菌感染時應用兩性霉素B中的比較，探討如何減少患者靜脈炎及并發癥發生率和再次靜脈穿刺的發生率，從而提高患者生活質量。方法：80例血液病患者分為兩組，40例PICC置管或鎖骨下靜脈置管組為A組，40例前臂靜脈留置針為B組，記錄靜脈炎、疼痛發生情況、留置時間。結果：A組留置時間30～68天，B組留置時間1～5天；A組靜脈炎率5%，B組靜脈炎率45%；A組疼痛率5%，B組疼痛率35%；結論：在血液病患者并發深部真菌感染時應用兩性霉素B治療中，選用PICC置管或鎖骨下靜脈置管效果明顯優于前臂靜脈留置針，值得臨床推廣。
目的 調查造血干細胞移植出院患者的社會支持現狀，尋求相應的護理對策，幫助患者保持較高的社會支持水平。 方法 選擇2007年9月-2009年3月在層流病房進行造血干細胞移植的患者48例，采用肖水源的社會支持評定量表，進行住院期間和出院3個月后的問卷調查，并進行統計學分析。 結果 患者住院期間社會支持總分為(41.40±5.60)分，出院3個月后社會支持總分為(38.19±3.65)分，比較具有統計學意義(Plt;0.05)。 結論 造血干細胞移植患者出院后社會支持水平降低，護士應加強對造血干細胞移植患者出院后的指導，拓寬造血干細胞移植出院患者社會支持渠道，幫助患者保持較高的社會支持水平，從而促進患者的康復。
ObjectiveTo analyze the epidemic characteristics of the notifiable infectious diseases in West China Hospital of Sichuan University, so as to guide the prevention, control and treatment of notifiable infectious diseases in the hospital and other medical institutions. MethodsDescriptive analysis was used to make statistics and analysis on the data of notifiable infectious diseases in West China Hospital of Sichuan University from 2015 to 2020, and the reporting situation, disease classification and transmission route were summarized. ResultsA total of 21 382 cases of notifiable infectious diseases with 32 types were reported. There was no class A infectious disease reported. There were 16 305 cases (76.26%) of class B infectious diseases and 5 077 cases (23.74%) of class C infectious diseases. The top 5 infectious diseases were pulmonary tuberculosis, influenza, syphilis, acquired immunodeficiency syndrome (including human immunodeficiency virus infection), and viral hepatitis type B. From the trend of the infectious disease reporting, the number of notifiable infectious diseases showed an upward trend from 2015 to 2020. ConclusionsThe report of notifiable infectious diseases in West China Hospital of Sichuan University from 2015 to 2020 mainly focuses on class B infectious diseases and class C infectious diseases. In the future, the prevention and control of infectious diseases should focus on respiratory infectious diseases, blood borne and sexually transmitted infectious diseases.
【摘要】 目的 總結應用Hyper-CVAD/MA強力化療方案治療成人急性淋巴細胞白血病的護理措施，以提高護士對相關患者的護理水平。 方法 2004年6月-2009年2月，應用Hyper-CVAD/MA強力化療方案治療80例急性淋巴細胞白血病患者，在化療過程中，護士密切監護并觀察化療藥物的不良反應，積極給予護理措施。 結果 80例急性淋巴細胞白血病患者均順利完成化療并出院，未發生與護理相關的不良反應。 結論 應用Hyper-CVAD/MA強力方案治療成人急性淋巴細胞白血病，護理工作十分重要。嚴密觀察病情，強化化療護理，可以有效地預防和減輕毒副反應的發生。【Abstract】 Objective To summarize the nursing measures of patients with adult acute lymphocytic leukemia treated with hyper-CVAD/MA chemotherapy regimen, a dose-intensive regimen, and improve the level of nursing care. Methods Eighty patients with acute lymphocytic leukemia treated by hyper-CVAD/MA regimen in this hospital were included June 2004 to February 2009.The patients were closely monitored and given nursing interventions.The drug adverse reactions were observed. Results All patients completed scheduled regimen and discharged successfully without any adverse events associated with nursing care. Conclusion The nursing interventions are very important for the patients with adult acute lymphocytic leukemia treated with hyper-CVAD/MA regimen, and close observation on the patients and strengthening nursing care can effectively prevent and mitigate the occurrence of toxicity.
Objective To optimize the report procedure of infectious diseases, solve the problems during routine surveillance such as incomplete report and incorrect report, in order to improve the report quality of infectious diseases. Methods Common problems in the report cards which were systematically collected in the infectious disease report management system were analyzed. Then, through negotiation with engineers of the information center, procedures which might easily lead to errors were deleted, report procedures were optimized. Furthermore, clinicians were also trained on infectious disease report from time to time. The entire study was divided into three periods, including baseline period (from October 1, 2012 to December 31, 2013), intervention period (from January 1, 2014 to December 31, 2014) and enhanced intervention period (from January 1, 2015 to December 31, 2015). The incorrect report rate and incomplete report rate were automatically calculated and compared among the three periods to evaluate the report quality. Results Compared with the baseline period, the total incomplete rate in the enhanced intervention period decreased from 8.21% to 3.19% (χ2=103.143,P<0.001), the incorrect report rate of hepatitis B virus decreased from 32.84% to 21.63% (χ2=19.002,P<0.001), and the incorrect report rate of syphilis decreased from 24.93% to 6.86% (χ2=90.416,P<0.001). respectively. Conclusion The infectious disease report system plays a very important role in timely identification of errors and improvement of incomplete and incorrect report, and is of great significance in the management of infectious diseases.
Objective To analyze the report status of the pulmonary tuberculosis in the elderly people aged ≥ 65 years old. Methods The reported data of senile pulmonary tuberculosis and the whole population pulmonary tuberculosis at West China Hospital of Sichuan University between January 1, 2012 and December 31, 2022 were retrospective selection. Descriptive methods were used to analyze the different characteristics and etiology of senile pulmonary tuberculosis. Results A total of 2 182 senile pulmonary tuberculosis were reported. The report was mainly positive reports of etiology [1091 cases (50.00%)], and the component ratio increased year by year (χ2=49.986, P<0.001). The proportion of senile pulmonary tuberculosis in the whole population pulmonary tuberculosis increased from 17.62% in 2012 to 29.04% in 2022, and the difference between different years was statistically significant (χ2=40.261, P<0.001). In the reported patients, the male to female ratio was 2.30∶1. There were 7 cases of rifampicin resistant, 1 091 cases of etiology positivity, 674 cases of etiology negativity, and 410 cases of no etiology results. The number of reported cases in the age group of 65-74 was higher than that in the age group of 75 and above. The seasonal distribution was not obvious (concentration<0.3). The patients were mainly from other cities of the province [919 cases (42.12%)], and the Department of Pulmonary and Critical Care Medicine (including the Tuberculosis Ward) was reported the most [1439 cases (65.95%)]. The majority of occupations were retired individuals [952 cases (43.63%)]. Conclusions From 2012 to 2022, the prevention and treatment of senile pulmonary tuberculosis has achieved some results, but the overall burden is still very heavy. The detection of senile pulmonary tuberculosis should be strengthened.