红霉素联合莫沙必利治疗糖尿病胃轻瘫的临床观察

目的:探讨红霉素与莫沙必利联合治疗糖尿病胃轻瘫的临床价值.方法:64例确诊为糖尿病胃轻瘫患者随机分为3组,给予红霉素治疗20例、莫沙必利治疗20例、红霉素与莫沙必利联合治疗24例,观察其疗效并进行比较.结果:红霉素联合莫沙必利治疗糖尿病胃轻瘫疗效优于红霉素或莫沙必利单药治疗,具有统计学意义.结论:红霉素与莫沙必利联合治疗糖尿病胃轻瘫是理想的治疗方法.     

阿奇霉素和红霉素治疗小儿支原体肺炎的优劣分析

目的观察阿奇霉素和红霉素治疗小儿支原体肺炎的疗效。方法选取2012年1月~2014年8月我院收治的220例小儿支原体肺炎患儿作为研究对象,采用随机数字表法将所选患儿分为阿奇霉素组和红霉素组各110例,阿奇霉素组进行阿奇霉素静脉滴注治疗,红霉素组进行红霉素静脉滴注治疗。综合比较两组患儿治疗总有效率和不良反应发生率差异。结果阿奇霉素组治疗总有效率为94.5%,高于红霉素组的81.8%(P<0.05);阿奇霉素组不良反应发生率为9.1%,低于红霉素组的23.6%(P<0.05)。结论阿奇霉素静脉滴注治疗小儿支原体肺炎疗效好,不良反应少,优于红霉素。     

阿奇霉素序贯疗法治疗儿童支原体肺炎疗效观察

目的观察阿奇霉素序贯疗法治疗儿童支原体肺炎的效果。方法应用阿奇霉素序贯疗法对46例儿童支原体肺炎的治疗效果及不良反应,与同期对照组40例应用红霉素治疗作比较。结果应用阿奇霉素序贯疗法治疗效果与红霉素比较,P=0.097,差异无统计学意义;但胃肠道反应发生率明显低于红霉素,2χ=41.71,P=0.000,观察组发生率明显少于对照组。结论阿奇霉素序贯疗法治疗支原体肺炎疗效优于红霉素,不良反应较红霉素少。     

对比分析注射用阿奇霉素与红霉素治疗小儿肺支原体肺炎的临床疗效

目的:对比分析注射用阿奇霉素与红霉素治疗小儿肺炎支原体肺炎的临床疗效。方法:选取2012年4月~2014年4月我院收治的120例小儿肺炎支原体感染患者,随机分为阿奇霉素组(应用阿奇霉素治疗)60例与红霉素组(应用红霉素治疗)60例,分析比较两组患儿临床治疗效果。结果:阿奇霉素组临床总有效率96.67%明显高于红霉素组76.67%,差异对比有统计学意义(P0.05);阿奇霉素组临床症状消退时间明显短于红霉素组,差异有统计学意义(P0.05);阿奇霉素组不良反应发生率明显低于红霉素组,差异有统计学意义(P0.05)。结论:阿奇霉素对于小儿肺炎支原体患者治疗效果明显优于红霉素,临床应用价值更高。     

红霉素胸膜固定术治疗难治性气胸的探讨

目的评价红霉素作为胸膜硬化剂治疗难治性气胸的价值。方法复发性自发性气胸患者48例,红霉素1 g溶于50 mL生理盐水中注入患侧胸膜腔内进行胸膜粘连。结果红霉素治疗总有效率为81.3%,其中一次注药有效率为52.7%,两次有效率为75.4%,复发率为10.4%。不良反应主要为胸痛,发生率为49.3%。结论红霉素可作为一种有效的胸膜硬化剂治疗难治性气胸。     

红霉素联合甲氧氯普胺治疗ICU患者肠内喂养失败的效果

目的:在ICU患者肠内喂养失败的情况下,研究红霉素或甲氧氯普胺治疗胃排空障碍的效果,以及红霉素联合甲氧氯普胺补救治疗单药治疗失败病例的效果。寻找一种更适合ICU患者胃排空障碍的治疗方案。方法:收集2007年1月至2010年12月共117例肠内喂养失败患者(6h胃液潴留量≥250mL),肠内喂养失败后第1天8:00进行肠内营养。试验随机分为2组:红霉素组(200mg,静脉滴注,每12小时一次);甲氧氯普胺组(10mg,静注,每6小时一次),共6d。各组第1次给药均在第1天8:00,给药24h后,记录每日10:00,16:00,22:00和次日4:00胃液潴留量以及患者基本情况和治疗前24h的胃液潴留量。比较每日胃液潴留量及肠内喂养成功率。对于单药治疗失败者(给药1d后仍存在6h胃液潴留量≥250mL),则直接纳入联合治疗组(红霉素200mg,静脉滴注,每12小时一次+甲氧氯普胺10mg,静注,每6小时一次),联合治疗6d,治疗24h后,记录联合治疗组每日胃液潴留量及肠内喂养成功率。结果:(1)在ICU患者肠内营养失败的情况下,红霉素组的促进胃排空效果较佳,红霉素组的每日平均胃液潴留量较甲氧氯普胺(甲氧氯普胺)少;红霉素组的喂养成功率较甲氧氯普胺组高(P<0.05)。(2)在单药治疗失败后,红霉素联合甲氧氯普胺补救治疗效果更佳,在第5天的成功率仍高达65%,明显高于单药治疗组(红霉素组37.5%,甲氧氯普胺组14.9%)。结论:在ICU患者肠内营养失败的情况下,应用小剂量红霉素与甲氧氯普胺相比,效果更佳;在单药治疗失败后,红霉素联合甲氧氯普胺补救治疗效果更佳。     

红霉素治疗糖尿病胃轻瘫33例临床报告

目的:探讨红霉素治疗糖尿病胃轻瘫的疗效.方法:选择33例糖尿病合并胃轻瘫,在常规降糖、改善微循环治疗基础上,予红霉素0.5 g加入5%葡萄糖中静脉滴注治疗5～7天,症状好转后改用红霉素0.25 g每日3次口服维持,共14天.结果:用药后患者症状改善总有效率84.84%,其中显效21例,有效7例.结论:红霉素治疗糖尿病胃轻瘫效果确切,可作为糖尿病胃轻瘫患者的一种有效治疗方法.     

红霉素和甲硝唑调入儿童护肤乳液外用治疗痤疮的效果评价

目的总结66例面部痤疮患者采用红霉素和甲硝唑联合外用治疗效果。方法实验组采用红霉素和甲硝唑片剂捣碎混于儿童乳液中外擦,对照组口服甲硝唑加外擦市面销售祛痘护肤产品。结果2组治疗效果有显著性差异。结论红霉素和甲硝唑片剂溶于儿童乳液中外擦治疗难治性痤疮,取得满意疗效,值得推广。     

红霉素可致听力减退

红霉素可致听力减退早在１９８４年澳大利亚药物副作用咨询委员会（ＡＤＲＡＣ）曾发表过一篇与红霉素具有耳毒性有关的文章。截到１９９０年８月为止，该委员会收到３８例与应用红霉素治疗有关的听力减退，其中２０例单用红霉素治疗。听力减退出现于治疗开始后的１～２１...     

西沙比利及红霉素治疗新生儿胃食管返流疗效观察与护理

目的 :观察西沙比利与红霉素治疗新生儿胃食管返流的疗效。方法 :随机将喂养困难的新生儿 96例分为 3组 ,每组各 32例 ,西沙比利组 (治疗组 1)用西沙比利以 0 1～ 0 2mg/kg口服 ;红霉素组 (治疗组 2 )用红霉素以3～ 5mg/kg加入 5 %葡萄糖 2 0ml中缓慢静脉滴入 ,每日 1次 ;对照组常规治疗 ;观察各组疗效。结果 :治疗组有效率明显高于对照组 ,差异有显著性 (P <0 0 1) ,治疗组中两组疗效无明显差异 (P >0 0 5 )。结论 :西沙比利及红霉素对新生儿胃食管返流疗效肯定。西沙比利与红霉素之间则无明显差异     

Influence of hepatic reserve and cause of esophageal varices on survival and rebleeding before and after the introduction of sclerotherapy: a retrospective analysis

Esophageal variceal sclerotherapy has been enthusiastically accepted as the procedure of choice for patients with variceal hemorrhage. Because the relationships among liver function, different causes of varices, survival, and rebleeding rates have not been well established in sclerotherapy trials, this enthusiasm may be unjustified. We studied these relationships in 80 patients with bleeding esophageal varices who were admitted to hospitals affiliated with our clinic between 1978 and 1980 and who did not receive sclerotherapy and in 162 patients admitted between 1980 and 1982 who received sclerotherapy with ethanolamine oleate. In both groups of patients, survival and bleeding-free intervals were significantly related (P less than 0.005 and P less than 0.01, respectively) to hepatic reserve (Child's class). In addition, patients with nonalcohol-related liver disease and poor hepatic reserve (Child's class C) had reduced survival and bleeding-free intervals compared with patients in class C with alcohol-related liver disease. Similar probabilities of survival and bleeding-free intervals were noted for Child's class subgroups and etiologic subgroups in the sclerotherapy and nonsclerotherapy groups, although a formal comparison was not made because of the retrospective nature of this study. Indications that sclerotherapy increases survival and reduces rebleeding may be due to different distributions of Child's classes and causes of varices within sclerotherapy and nonsclerotherapy groups in published control trials.     

超声引导下经皮穿刺硬化治疗肾囊肿

目的探讨超声引导下经皮穿刺硬化治疗肾囊肿的效果及其并发症的预防。方法在超声引导下经皮穿刺注射无水乙醇硬化治疗肾囊肿81例。结果术后经半年以上随访,治愈率为85．2％,有效率为95．1％。结论超声引导下经皮穿刺注射无水乙醇硬化治疗肾囊肿,方法简便易行,疗效肯定,并发症少。     

An evaluation of emergency sclerotherapy of varices in randomized trials: looking the needle in the eye

BACKGROUND: The role of sclerotherapy for acute variceal bleeding is challenged by vasoactive drugs and by ligation. AIM: A meta-analysis was performed to evaluate whether sclerotherapy remains a gold standard in acute variceal bleeding. METHODS: Sclerotherapy was evaluated across four randomized trial groups: (a) combined with vasoconstrictors vs. vasoconstrictors alone (five trials, with 400 patients); (b) vs. vasoconstrictors alone (15 trials, with 1296 patients); (c) vs. combination of vasoconstrictors and sclerotherapy (eight trials, with 1026 patients); (d) vs. ligation (12 trials, with 1309 patients). We used the risk difference (absolute risk reduction) as our main effect measure. RESULTS: The efficacy of acute sclerotherapy was highest vs. ligation at 95 %, with a small advantage for ligation (an overtube was used in eight trials) of 2.5 % (95 % CI 0.4 % to 4.6 %) ( P = 0.018), but no survival difference. Efficacy of sclerotherapy combined with vasoconstrictors vs. vasoconstrictors alone was 86 %, whereas it was 83 % for sclerotherapy vs. vasoconstrictors alone. In both these groups sclerotherapy was superior for control of bleeding at, respectively, 16.3 % (95 % CI 8.7 % to 23.9 % ( P = 0.0001) and 5.9 % (95 % CI, 1.5 % to 10.3 %) ( P = 0.008), with increased survival in the latter. In the combination group of sclerotherapy with vasoconstrictors, the efficacy of sclerotherapy alone was 69 %, with the combination superior in controlling bleeding, at 13.2 % (95 % CI, 8.4 % to 18.1 %) ( P < 0.0001) but with no survival difference. CONCLUSION: This comparison of sclerotherapy across trials demonstrates a problem in defining its real efficacy. The conclusive evidence for substituting banding ligation or the combination of vasoconstrictors with sclerotherapy as better therapeutic approaches has not been provided in randomized trials. Sclerotherapy can remain a gold standard in variceal bleeding but there is scope for further studies of ligation and vasoactive drugs.     

Physicians' negative perception of sclerotherapy for venous disorders: review of a 7-year experience with modern sclerotherapy.

Sclerotherapy is the injection of a sclerosing substance directly into a varicosity or telangiectasia to cause damage, fibrosis, and eventual obliteration of the vessel. Although sclerotherapy has been shown to be effective with a low incidence of side effects, many physicians in the United States are unaware of the technique or view it in a negative way. To better define the extent of physician unfamiliarity or prejudice toward sclerotherapy, we surveyed a local medical community of gynecologists by anonymous written questionnaire. The results indicated that 82% of the responding physicians believed that their knowledge of sclerotherapy was insufficient to advise their patients, leaving patients to learn about sclerotherapy from mass media sources. Sclerotherapy was perceived as only slightly effective therapy for varicose veins and was thought to have a relatively high incidence of side effects. With recent improvements in the technique, our collaborative experience with 3000 patients receiving 50,000 injections over the past 5 years has shown that sclerotherapy is a safe procedure achieving outstanding cosmetic results with concomitant symptomatic relief of painful varicosities and telangiectases. Sclerotherapy, as practiced today, offers an effective, simple, and less costly alternative to surgical stripping for most varicose and telangiectatic veins. The survey data demonstrate the need to educate the American medical community about the technique and merits of modern sclerotherapy so that patients may be properly guided by their physicians to the best sources of care for their aching and unsightly leg veins.     

微波固化术治疗肝脏巨大血管瘤的临床分析

目的探讨肝脏巨大血管瘤患者在超声引导下进行微波固化治疗的方法及临床分析。方法应用超声引导经皮肝穿刺微波固化治疗患者15例,共15个瘤体。术后监测局部病灶大小变化。结果术后5d瘤体逐渐缩小,经介入相应肝动脉栓塞后,瘤体内基本无血液充盈。结论肝血管瘤经一次微波固化治疗后,瘤体虽然未完全消失,但瘤体内血管窦组织已较大程度的纤维化。配合介入治疗行血管瘤相应动脉栓塞术,尤其是巨大血管瘤,效果更加显著。     

A new approach to esophageal varices: endoscopic variceal ligation

Bleeding from esophageal varices is a devastating complication of portal hypertension and is associated with a high mortality rate. The management goals for this group of patients are to achieve hemostasis in the acute phase, reduce variceal size, reduce the potential of rebleeding and eliminate varices with a follow-up program. For the past two decades, the gold standard of treatment has been endoscopic sclerotherapy but at the expense of many complications, which often cause serious morbidity. Endoscopic variceal ligation was developed as an alternative to endoscopic sclerotherapy. The experience to date shows that the goals of therapy can be achieved with fewer complications than those associated with sclerotherapy.     

Laser disintegration of cyanoacrylate clot with successful endoscopic removal of sclerotherapy needle from gastric varix

Intravariceal cyanoacrylate injection is a highly effective and safe procedure for the treatment of bleeding gastric varices. Nevertheless, some cases of severe cyanoacrylate-specific complications due to embolization have been described. Technical difficulties, including risk of sclerotherapy needle clogging, and cyanoacrylate sticking to the tip and the accessory channel of the endoscope, have been mentioned in other reports. We report a case in which a sclerotherapy needle that remained stuck in gastric valves after bucrylate injection was successfully removed by laser disintegration of the cyanoacrylate clot.     

体表血管瘤和脉管畸形的综合治疗临床观察

目的 观察综合治疗体表血管瘤及脉管畸形的临床疗效.方法 2008年1月-2010年9月,收治体表血管瘤和脉管畸形患者共205例.手术治疗156例,其中单纯手术治疗103例,合并介入治疗9例,硬化剂治疗44例;非于术治疗49例,其中介入治疗1例,硬化剂治疗38例,介入合并硬化剂治疗10例.术后随访6个月～3年.结果 15...     

经皮穿刺硬化和腹腔镜去顶术治疗单纯性肾囊肿的对比研究

目的探讨经皮穿刺硬化和腹腔镜去顶术在单纯性肾囊肿治疗中的价值。方法对90例单纯性肾囊肿患者，48例采用经皮穿刺硬化治疗，42例采用腹腔镜去顶术治疗，并对其临床疗效、术后恢复及费用进行对比研究。结果经皮穿刺硬化和腹腔镜去顶减压术两组疗效比较差异无统计学意义（P〉0．05）。穿刺硬化组无术后并发症，腹腔镜组术后并发症发生率为7．1％（3／42）。穿刺硬化组平均住院10d，术后住院3d；腹腔镜组为16d和10d，两组总住院和术后住院时间比较差异均有统计学意义（P〈0．01）。同年两组的住院及手术费用比较，穿刺硬化组各项费用明显降低，差异有统计学意义（P〈0．01）。结论采用经皮穿刺硬化和腹腔镜去顶术治疗单纯性肾囊肿疗效相似，但前者创伤小、痛苦小、恢复快、并发症少、费用低，可以门诊施治，应作为单纯性肾囊肿的首选治疗方法。     

短期内反复内镜治疗难治性食管静脉曲张破裂大出血

目的：探讨食管静脉曲张破裂大出血急诊硬化治疗术后仍持续出血的再次内镜下处理。方法：52例食管静脉曲张破裂大出血首次硬化术后仍出血不止或于1周内再次大出血患者,插入二腔一囊管后牵拉,再次进行硬化或（和）组织黏合剂黏堵治疗。结果：再次硬化治疗41例,黏堵加硬化治疗11例,无效转外科手术1例,死亡2例。急诊止血率为94.2%。发生较重并发症7例。结论：内镜下反复硬化或（和）黏堵治疗是控制难治性食管静脉曲张破裂大出血的首选抢救措施。