RESUMEN
Objective: This study aimed to investigate the effect of nursing intervention based on the G-Caprini scale on the incidence of venous thromboembolism (VTE) after gynecological surgery and patients' satisfaction rate for nursing care. Methods: Ninety-eight patients who attended Taizhou People's Hospital and underwent gynecological surgery between January 2021 and December 2021 were selected as subjects and divided into two groups according to a random number table, with 49 cases in each group. The control group was given conventional nursing care, and the experimental group received nursing intervention based on the G-Caprini scale. The rate of postoperative lower-limb deep-vein thrombosis in the two groups was compared, and the incidence of VTE and the level of nursing satisfaction in the two groups were statistically analyzed. Results: The incidence of postoperative VTE in each risk class of the G-Caprini scale was lower in the experimental group than in the control group, and the difference was statistically significant (P < 0.01). In the experimental group, 47 patients were very satisfied with the nursing care, 1 was satisfied, and 1 was dissatisfied, which meant the nursing satisfaction rate in the experimental group was 97.96 (48/49). In the control group, 40 patients were very satisfied with the nursing care, 2 were satisfied, 1 was basically satisfied, and 6 were dissatisfied; thus, the satisfaction rate for nursing care in the control group was 87.75%. The difference between the two groups was statistically significant (χ 2 = 19.657, p < 0.05). Conclusion: Nursing interventions based on the G-Caprini rating scale were significantly effective in preventing VTE in patients after gynecological surgery and resulted in higher levels of patient satisfaction in terms of nursing care.
RESUMEN
OBJECTIVE: To investigate the epidemiologic features of disseminated histoplasmosis (PDH) in Hubei province. METHODS: Bone marrow smears of 12 patients diagnosed as Kala-azer in Hubei province including 4 patients in Jingsan, 2 patients in Shashi and each 1 in Yichang, Jinmen, Zhongxiang, Luotian, Xianning and Guanghua respectively were re-examed under microscope. Peripheral blood and bone marrow smears of several patients were detected. After inoculated the bone marrow, peripheral blood, liver and spleen tissue of patients in MLI, the single colony was trans-inoculated in BHIB, SDA and CMA and incubated at 25 degrees C and 35 degrees C. Bone marrow, peripheral blood and bacterial fluid of yeast-phase Histoplasma capsulatum (H.cap) were injected into the abdominal cavity of Kunming mice and nude mice. When symptoms and signs developed, the spleen tissue was separated, then observed under microscope and cultured. Mycelium-phase and Yeast-phase H.cap were inoculated in urase and gelatin medium, then incubated at 25 degrees C and 35 degrees C. Histoplasmin was injected subcutaneously into patients, and then followed for 48 - 72 hours. Amphotericin B was selected to treat the PDH patients. RESULTS: Moriform cell cluster and sausage-shaped cell were not observed in mononuclear-macrophages in the bone marrow smears from 12 patients. Leishman-Donovan body was found only in one patient. There wasn't kinetoplast in the cellular plasm of spores in 11 patients and no transeptae was found. The reaction of H.cap to urease was positive and H.cap did not liquefy the gelatin. It appeared to be mycelium-phase at 25 degrees C but no penicillus and catenulate conidia was found. The characteristic denticle macroconidia was observed but produced red coloring matter. It also appeared to be yeast-phase at 35 degrees C. Yeast-phase spores were observed under microscope. No sausage-shaped spore and transeptae were identified. H.cap could be acquired in the spleen tissue in Kunming mice and nude mice. Bacterium forms, characteristics under microscope and biochemical reaction of mycelium-phase and yeast-phase H.cap were different from some other kinds of dimorphic fungi such as Penicillium marneffei and Histoplasm duboisii etc. CONCLUSION: There were scattered epidemics of PDH in Hubei province. The detection rate of PDH was higher in the southeast area then in the northwest area. The golden standards of clinic diagnosis were mycological culture and inoculation to animals. Amphotericin B was necommended as the first choice for treatment.