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find Author "洪军" 2 results
  • 临床肺部感染评分评估呼吸机相关性肺炎预后的研究

    目的 探讨临床肺部感染评分( CPIS) 对呼吸机相关性肺炎( VAP) 患者早期病情演变及预后评估的价值。方法 将42 例符合纳入标准的VAP 患者根据其预后分为存活组和死亡组, 采用方差分析及独立t 检验, 对两组患者的一般情况, VAP 起病前、起病后1 d 及5 d 的CPIS 分值进行分析比较。结果 42 例患者中, 存活18 例, 死亡24 例, 死亡率57. 14% 。存活组平均年龄明显低于死亡组[ ( 43. 0 ±14. 58) 岁比( 64. 75 ±14. 19) 岁, P lt; 0. 001] 。两组患者的平均机械通气时间均gt;10 d。存活组CPIS 分值在VAP 起病后1 d 较起病前明显升高[ ( 5. 78 ±0. 94) 分比( 3. 0 ±1. 81) 分,P lt;0. 001] , 起病后5 d 则明显下降[ ( 3. 72 ±1. 36) 分, P lt; 0. 001] ; 死亡组CPIS 分值在VAP 起病后1 d较起病前也有明显升高[ ( 6. 41 ±1. 21) 分比( 3. 75 ±1. 67) 分, P lt;0. 001] , 但起病后5 d 仍维持于较高水平[ ( 7. 08 ±1. 10) 分] 。结论 CPIS 评分在评估VAP患者病情及预后上有一定临床价值。

    Release date:2016-09-13 04:07 Export PDF Favorites Scan
  • PSYCHOLOGY DURING THE PROCESS OF HUMAN HAND ALLOGRAFT

    OBJECTIVE: To study the psychology and its management during the process of hand allograft. METHODS: One psychologist participated through the whole process of the present hand allograft. 12 potential candidates of hand transplant were interviewed during the selection of patients to evaluate the state of psychiatry and their abilities to manage stressors like cooperation with medical workers and medical interventions, waiting for donors, adaptation to a new hand and post operation depression. The psychological state of 11 patients were believed to be able to receive hand transplant, and they are further prepared psychologically by the psychologist while waiting for a donor. Two lucky candidates were decided by tissue typing and received hand allograft simultaneously. After the operation, the two patients psychotherapy assisted with effective analgesia, supporting from family and environmental improvement. RESULTS: One out of 12 patients was found not suitable for the transplantation because of psychiatric problem. One week postoperation, the 2 patients were anxious, lack of patience, and horrified at seeing the long-expected grafted hand. After 1 week of treatments and adapation the patients managed to settle with the new hand, and accepted the hand as a whole 1 month postoperation. With the recovery of the hand sensation and motion 4 to 5 months postoperation, the patients held the hand as his own. CONCLUSION: Psychologists are required in the hand transplantation team during the pre-transplant selection of patients and post-transplant rehabilitation.

    Release date:2016-09-01 10:21 Export PDF Favorites Scan
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