护理人员311例接种甲型H1N1流感疫苗免疫效果分析

目的了解内蒙古大兴安岭地区医院中的护理人员接种甲型H1N1流感疫苗的免疫效果。方法选用随机采样的方法,对311名接种者的特异性抗体进行调查分析,采用酶联免疫吸附试验（ELISA）法半定量测定人血清中H1N1IgG含量。结果接种甲型H1N1流感疫苗后93d内的抗体的阳转率为86.17%。所产生的特异性抗体在各年龄段之间比较,差异没有统计学意义（P〉0.05）;免疫60d内的阳转率在92.98%以上,免疫80～93d的阳转率已经降至80%以下,差异有统计学意义（P〈0.01）。结论内蒙古大兴安岭地区医院中的护理人员接种甲型H1N1流感疫苗工作取得了非常好的免疫效果。     

纤维喉镜下微创治疗声带良性病变

目的探讨纤维喉镜下微创治疗声带良性病变的临床疗效。方法对2004年10月～2 0 1 0年1 0月诊治的1 0 2例声带良性病变患者表面麻醉下经纤维喉镜微创手术的临床资料进行回顾性分析。结果治愈率为96%,无手术并发症。所有患者术后随访3个月至1年,复发3例。结论纤维喉镜调整方向灵活,操作简单,可在门诊手术,费用少。适用于基底细单发声带息肉或不能耐受全麻及声门暴露困难者。但纤维喉钳钳取组织少,钳取质地较硬的声带息肉及小结容易滑脱,而基底宽的较大息肉难以一次切除。     

505名医务人员接种甲型H1N1流行性感冒疫苗3个月内的免疫效果分析

Objective To investigate the immunization effect of influenza A/H1N1 vaccine in health care workers (HCW) in Inner Mongolia Greater Khingan Mountains area. Methods Five hundred and five HCW who received A/H1N1 influenza vaccination (immunized group) and 129 staffs who didn't receive the vaccination (unimmunized group) were randomly sampled for semiquantitative testing of serum H1N1 antibody (IgG) levels by enzyme-linked immunosorbent assay (ELISA).Results were analyzed and stratified by age, sex, occupation and the time interval between the time of vaccination and serum sample collection. The antibody positive rates of the two groups were compared by x2test. Results There were 401 (79. 4%) HCW whose H1N1 antibody were positive and 50 (9.9%) whose antibody were weak positive among 505 immunized HCW. While among 129 unimmunized HCW, there were 59 (45.7%) whose antibody were positive and 15 (11.6%) whose antibody were weak positive. The seroconversion rates of specific antibody were not significantly different among the different age groups after receiving A/H1N1 influenza vaccine (P＞ 0.05).However, there were statistical differences of the seroconversion rates among different sex groups (men 95.7% vs women 87.4% in immunized group, x2=6.40, P＜0.05; and men 73.3% vs women 52.5% in unimmunized group, x2 =4.07, P＜0.05) and different occupation groups (doctor 86.0% vs nurse 94.5% in immunized group, x2 = 9. 16, P＜0.01; and doctor 43. 8% vs nurse 75.0% in unimmunized group, x2=12.61, P＜0.01 ). The seroconversion rate was 81.5% after 80 to 89 days of vaccination, which was significantly lower than those after 30 to 39, 50 to 59 days and 60 to 69 days of vaccination, which was 100.0%, 94.7% and 93.6%, respectively (x2 =3.96, P ＜0.05; x2=7.15, P ＜0. 01; x2 = 9. 98, P＜0. 01). Conclusions A/H1N1 influenza vaccination can induce effective immune response in HCW in Greater Khingan Mountains area of Inner Mongolia. However,the level of specific antibody significantly reduces after 80 to 89 days of vaccination.     

支撑喉镜下显微手术治疗声带良性病变的疗效分析

目的探讨应用支撑喉镜显微手术治疗声带良性病变的方法和疗效。方法回顾性分析诊治的158例声带良性病变患者进行支撑喉镜显微手术的临床资料。结果 158例声带良性病变患者,经支撑喉镜喉显微手术治疗,治愈136例,治愈率为86.1%;好转15例,占9.5%,总有效率96%。并发软腭擦伤及黏膜下淤血10例(6.33%)、舌体麻木13例(8.23%),均短期内恢复;上切牙松动5例(3.16%)。所有患者术后随访3个月至1年,无复发。结论支撑喉镜显微镜术能提供清晰声带图像,能分辨细小病变,切除病变彻底精细,适合于各种声带良性病变切除。但费用高,少数可出现软腭黏膜损伤、舌体麻木等并发症。     

MAPO指数在我国人工搬运患者护理人员WMSDs风险评估中的应用

目的评估我国医院病房人工搬运患者护理人员职业性肌肉骨骼疾患(WMSDs)发生风险,为预防WMSDs提供科学依据。方法采用现场访谈和观察与测量方式,选择MAPO评估方法,对11家医院226个病区的WMSDs发生风险进行评估。结果依据MAPO风险指数分级,11家医院226个病区风险等级为绿灯、黄灯、红灯的分别占4292%、 2965%、 2743%,超过半数以上的病区存在黄灯和红灯风险;各病区MAPO指数均值排在前三位的依次是神经外科、神经内科、老年病科,均为黄灯和红灯;MAPO各项目分值在不同病区比较中均具有统计学意义;各病区设施配置情况分析,轮椅缺乏的病区占总体病区的686%,病区中提举设备缺乏或不充足高达991%,辅助设施不充足占996%,仅有531%的病区护理人员参加过有关培训。结论建议医院及管理人员改善并补充相应设施,加强护理人员工作中的工效学培训,并在风险较高的重点病区增加护理人员。     

505名医务人员接种甲型H1N1流行性感冒疫苗3个月内的免疫效果分析

目的 了解内蒙古大兴安岭地区医务人员接种甲型H1N1流行性感冒(流感)疫苗的免疫效果.方法 采用单纯随机抽样方法,通过ELISA法对505名接种和129名未接种H1N1流感疫苗的健康医务人员半定量测定血清H1N1流感IgG.按年龄、性别、职业和从接种到不同采样时间检测结果进行分组分析.率的比较行x2检验.结果 505名医务人员接种甲型H1N1流感疫苗后,401人特异性抗体阳性,占79.4%;弱阳性50人,占9.9%.129名未接种组中特异性抗体阳性59人,占45.7%;弱阳性15人,占11.6%.两组各年龄分层比较差异无统计学意义(P＞0.05).接种组男性抗体阳转率为95.7%,女性为87.4%(x2=6.40,P＜0.05);未接种组男性抗体阳转率为73.3%,女性为52.5%(x2=4.07,P＜0.05).接种组护士和医生的阳转率分别为86.0%和94.5%(x2=9.16,P＜0.01),未接种组分别为43.8%和75.0%(x2=12.61,P＜0.01).从接种到不同采样时间特异性抗体检测结果比较,接种第80～89天阳转率为81.5%,与接种第30～39、50～59、60～69天的阳转率分别为100.0%、94.7%和93.6%比较,差异有统计学意义(x2=3.96,P＜0.05;x2=7.15,P＜0.01;x2=9.98,P＜0.01).结论 内蒙古大兴安岭地区医务人员甲型H1N1流感疫苗接种有良好免疫效果.免疫后第80～89天免疫水平较前有显著下降.

Abstract：

Objective To investigate the immunization effect of influenza A/H1N1 vaccine in health care workers (HCW) in Inner Mongolia Greater Khingan Mountains area. Methods Five hundred and five HCW who received A/H1N1 influenza vaccination (immunized group) and 129 staffs who didn't receive the vaccination (unimmunized group) were randomly sampled for semiquantitative testing of serum H1N1 antibody (IgG) levels by enzyme-linked immunosorbent assay (ELISA).Results were analyzed and stratified by age, sex, occupation and the time interval between the time of vaccination and serum sample collection. The antibody positive rates of the two groups were compared by x2test. Results There were 401 (79. 4%) HCW whose H1N1 antibody were positive and 50 (9.9%) whose antibody were weak positive among 505 immunized HCW. While among 129 unimmunized HCW, there were 59 (45.7%) whose antibody were positive and 15 (11.6%) whose antibody were weak positive. The seroconversion rates of specific antibody were not significantly different among the different age groups after receiving A/H1N1 influenza vaccine (P＞ 0.05).However, there were statistical differences of the seroconversion rates among different sex groups (men 95.7% vs women 87.4% in immunized group, x2=6.40, P＜0.05; and men 73.3% vs women 52.5% in unimmunized group, x2 =4.07, P＜0.05) and different occupation groups (doctor 86.0% vs nurse 94.5% in immunized group, x2 = 9. 16, P＜0.01; and doctor 43. 8% vs nurse 75.0% in unimmunized group, x2=12.61, P＜0.01 ). The seroconversion rate was 81.5% after 80 to 89 days of vaccination, which was significantly lower than those after 30 to 39, 50 to 59 days and 60 to 69 days of vaccination, which was 100.0%, 94.7% and 93.6%, respectively (x2 =3.96, P ＜0.05; x2=7.15, P ＜0. 01; x2 = 9. 98, P＜0. 01). Conclusions A/H1N1 influenza vaccination can induce effective immune response in HCW in Greater Khingan Mountains area of Inner Mongolia. However,the level of specific antibody significantly reduces after 80 to 89 days of vaccination.     

内蒙古大兴安岭地区人群接种甲型H1N1流感疫苗21～93天的免疫效果分析

目的了解内蒙古大兴安岭地区人群接种甲型H1N1流感疫苗免疫效果情况,为进一步开展甲型H1N1流感疫苗接种提供依据。方法选用随机采样的方法,对内蒙古大兴安岭地区17～68岁693名接种甲型H1N1流感疫苗的特异性抗体进行调查分析,并收集血液标本,应用人H1N1抗体（IgG）酶联免疫分析试剂盒,酶联免疫吸附试验（ELISA）法半定量测定人血清中H1N1IgG含量。结果内蒙古大兴安岭地区接种甲型H1N1流感疫苗的693人中特异性抗体阳转率为88.74%。接种该疫苗后所产生的特异性抗体,在年龄、性别上差异没有统计学意义（P〉0.05）,与接种甲型H1N1流感疫苗到采样的间隔时间有关,21～70天与71～93天之间比较,差异有统计学意义（P〈0.01）。结论内蒙古大兴安岭地区甲型H1N1流感疫苗接种工作取得了良好免疫效果,但随着时间的推移,接种疫苗70天后人体对甲型H1N1流感免疫水平有显著下降的趋势。     

老年前期与老年期人群听力残疾病因分析

目的通过对承德围场县自然村45周岁以上人口听力损失的调查及对可能的致使调查对象听力残疾的原因进行分析,为老年性耳聋的预防及治疗提供流行病学依据。方法选取承德围场县18个自然村作为调查点。对年龄≥45岁的2 018人进行问卷调查、纯音听阈测试及空腹血糖、血压、血脂的检查。结果 (1)在2 018例被调查的对象中,1 168例(57.88%)听力正常。214例(10.60%)存在听力残疾。(2)随年龄增长,听力残疾患病率逐渐增高,男性患病率高于女性,差异均有统计学意义(P0.05)。(3)对吸烟、饮酒、高血压、高血糖、高血脂与听力残疾的患病人数进行统计学分析,吸烟、饮酒、高血压、高血糖与听力残疾有关(P0.05),高血脂与听力残疾无关(P0.05)。(4)吸烟、饮酒、高血压、高血糖与调查对象是否患有听力残疾行非条件Logistic回归分析,有统计学意义。说明吸烟、饮酒、高血压、高血糖是听力残疾的危险因素。结论部分45周岁以上人口存在听力残疾。纠正吸烟饮酒等不良习惯,积极预防老年性疾病,有助于降低听力残疾的发病风险,改善老年人的听觉健康和生活质量。