ABSTRACT
Objective To evaluate management stratagy for patients with traumatic splenic rupture.Methods The clinical data of 124 patients with traumatic splenic rupture admitted to the 422 Hospital of PLA from April 2008 to June 2016 were retrospectively analyzed.38 patients were treated conservatively,while 86 patients underwent surgery.To investigate impact factors of management strategy in patients with traumatic splenic rupture,clinical characteristics and CT features between the two groups were compared.Results Univariate analysis results showed that injury causes,blood pressure,at admission,pulse,CT grade and abdominocentesis were closely related with therapeutic scheme.And multivariate Logistic regression analysis results showed that pulse (OR =4.264,95％ CI 1.206-15.073),CT grade (OR =2.086,95％ CI 1.019-4.271) and abdominocentesis (OR =3.428,95％ CI 1.024-11.479) were the significant determining factors of therapeutic scheme in patients with traumatic splenic rupture.Surgical intervention was carried out in 86 patients accounting for 69.4％ of all patients.The rate of surgical intervention was 58.1％ in the patients with CT grade of 1 and 2,that was 94.7％ in patients with CT grade of 3 and 4.Conclusions Operative management is needed for most traumatic splenic rupture,patients those with hemodynamic stability and CT grade of 1 or 2 may be qualified for watchful non-operative management.
ABSTRACT
Objective:To explore influence of psychological intervention on mental state in patients With rheumatic heart dis-ease (RHD)after valve replacement surgery.Methods:A total of 60 RHD patients after valve replacement surgery Were randomly and equally divided into routine nursing group and psychological intervention group according to number table,the latter received additional psychological intervention besides routine nursing intervention.Symptom checklist 90 (SCL-90) Was used to assess mental state of tWo groups 1 d before and one Week after surgery.Results:There Were no significant difference in SCL-90 scores betWeen tWo groups before psychological intervention (P>0.05).Compared With routine nursing group one Week after operation,there Were significant reduction in SCL-90 scores of somatization [(1.31±0.47) scores vs.(0.55±0.68)scores],obsessive-compulsive symptom [(2.11±0.35)scores vs.(0.78±0.35)scores],inter-personal relationship sensitivity [(1.57±0.53)scores vs.(1.22±0.46)scores],depression [(1.63±0.29)scores vs. (1.00±0.41)scores],anxiety [(0.98±0.17)scores vs.(0.76±0.13)scores],hostility [(1.11±0.31)scores vs.(0.80 ±0.37)scores]and phobia anxiety [(1.39±0.26)scores vs.(0.53±0.19)scores]in psychological intervention group,P<0.01 or P<0.05. Conclusion:Psychological intervention can alleviate the adverse psychological state and improve quali-ty of life in patients With rheumatic heart disease.