ABSTRACT
Objective:To analyze the application effect of the home care model based on the Omaha system for elderly maintenance hemodialysis patients.Methods:A total of 73 elderly patients undergoing maintenance hemodialysis in the First People's Hospital of Longquanyi District, Chengdu city from December 2018 to December 2019 were enrolled.According to the randomization and double-blind principle, they were divided into the control group receiving the clinical routine care mode(n=32)and the intervention group undergoing the home care mode based on Omaha system(n=41). The Quality of Life Score, care satisfaction and awareness rate of health knowledge of patients were compared between the two groups before and after the care intervention.Results:Compared with before intervention, the quality of life scores was increased after caring in both two groups.And the scores in all dimensions were better in the intervention group than in the control group( t=3.173, 3.833, 3.514 and 4.593, P=0.001, 0.000, 0.000 and 0.000). The awareness rates of nutrition knowledge, water-intaking knowledge, iron supplementation knowledge, potassium and phosphorus limitation and dialysis mode were better in the intervention group than in the control group( χ2=7.592, 5.423, 8.494, 6.161 and 6.962, P=0.011, 0.011, 0.000, 0.010 and 0.011). The total satisfaction rate was 97.6%(40/41)in the intervention group, which was superior to that in the control group(75.0% or 24/32)( χ2 =8.460, P=0.000). Conclusions:The extended home care model based on the Omaha system can effectively improve patients' awareness of health knowledge, improve patients' quality of life and improve the satisfaction with care in elderly maintenance hemodialysis patients with a low education level, and it is worthy of clinical promotion.
ABSTRACT
Objective: To explore the advantages and evaluate feasibility of sentinel lymph node (SLN) biopsy and axillary lymph node dissection under mastoscopy for patients with early stage breast cancer in clinical diagnosis and treatment. Methods: 200 patients with breast cancer stage I and II diagnosed by breast surgery were divided into observation group (100 cases) and control group (100 cases) as different surgery method. The patients of observation group were treated by SLN biopsy and axillary lymph node dissection under mastoscopy, while those of control group were treated by traditional open surgery. To analyze the detection rate and accuracy rate, and compare the bleeding volume during operation, the operation time and hospitalization time between the two groups. And series of indexes, such as incidence of post-operative complication, recurrence rate and good appearance rate of breast were compared between the two groups. Results: The difference of accuracy rate between the two groups was no significant. The incidence of complication, good appearance rate of breast and recurrence rate of observation group were, respectively, 4%, 92% and 4%. And the differences between those results of observation group and those of control group were significant (x2=25.25, x2=16.61, x2=170.40; P<0.05). Other some indexes, such as the bleeding volume during operation, the operation time and hospitalization time, the differences between observation group and control group also were significant (t=9.73, t=13.86, t=11.66; P<0.05). Conclusion:Sentinel lymph node (SLN) biopsy and axillary lymph node dissection under mastoscopy are feasibility in clinical practice based on its series advantages, such as better detection rate, lower incidence of complication, better protection for breast appearance and so on.