早孕试条法联合pH试纸法诊断胎膜早破的价值

目的　探讨早孕试条法联合pH试纸法 ,在胎膜早破诊断中的价值。方法　对 80例胎膜早破孕妇的宫颈阴道分泌物进行早孕试条法和pH试纸检测。结果　联合法诊断胎膜早破的准确率 88 3 0 %,敏感性 84 3 5 %,特异性 1 0 0 .0 0 %。结论　早孕试条法联合pH试纸法诊断胎膜早破 ,是一种特异性的诊断方祛 ,适用于临床难于确诊的胎膜早破的诊断     

高海拔地区笑气吸入性分娩镇痛的临床研究

目的 :研究高海拔地区笑气吸入性分娩镇痛的疗效和对母婴的影响 ;方法 :将2 50例产妇随机分为观察组和对照组 ,对照组除不给笑气吸入外 ,其它产科措施与观察组相同 ;观察比较两组的产痛程度、产程时间、分娩方式、新生儿Apgar评分、产时出血量和产后出血率等 ;结果 :观察组的阵痛强度明显低于对照组 (P <0 .0 1 ) ,观察组的活跃期和总产程时间短于对照组 (P值均 <0 .0 5) ,差异有显著性 ;结论 :高海拔地区产妇笑气吸入性分娩镇痛效果良好 ,产程时间短 ,对母婴均无不良影响 ,是一种理想的分娩镇痛方法 ,值得产科临床推广使用     

胆汁反流在大鼠急性颅脑损伤后应激性溃疡中的作用

目的　探讨胆汁反流在大鼠急性颅脑损伤后应激性溃疡中的作用。方法　采用改良的Allen法建立大鼠颅脑损伤模型 ,检测应激后 1、3、6、2 4h胃液、血胆汁酸含量 ,胃液pH值与溃疡指数 ,并与假手术组对照比较。结果　应激组与假手术组相应时段比较 ,胃液胆汁酸含量明显增高 (P <0 .0 5～0 .0 1 ) ,随着应激时间的延长 ,胃内胆汁酸的含量逐渐增加 (P <0 .0 5 ) ,胃黏膜的损伤亦逐渐加重 (P <0 .0 5 ) ,其 6、2 4h组与假手术组相应时段比较差异有统计学意义 (P <0 .0 1 ) ,且胃胆汁酸含量与溃疡指数呈正相关 (r =0 .5 5 ,P <0 .0 1 ) ,而应激组与假手术组血中胆汁酸含量及胃内pH值的变化则不大 (P >0 .0 5 ) ,它们与溃疡指数之间亦无相关性 (P >0 .0 5 )。结论　胆汁反流参与颅脑损伤应激性溃疡的发病 ;胆汁反流程度与胃黏膜损伤程度呈正相关     

负压封闭引流联合局部氧疗在骨科慢性难愈合创面治疗中的应用效果分析

【摘要】 目的 探讨负压封闭引流联合局部氧疗治疗骨科慢性难愈合创面的效果。 方法 选取 2017年1月至2020年6月铁岭市中心医院收治的180例骨科慢性难愈合创面患者作为研究对象,按照随机数表法将其随机分为观察组(90例)与对照组(90例), 观察组患者采用负压封闭引流联合局部氧疗治疗, 对照组患者单纯采用负压封闭引流治疗, 对比两组患者血浆促红细胞生成素(EPO)水平、创面细菌阳性率、创面温度、创面pH值、压疮愈合计分量表(PUSH)评分以及创面愈合时间。结果 治疗7、14 d时,观察组患者EPO水平均明显高于对照组(t=5.689、4.807,P均<0.05）。治疗14 d时, 观察组患者创面细菌阳性率明显低于对照组(χ2=10.062,P=0.002）,创面温度明显高于对照组(t = 6.040,P<0.001）,创面pH值、PUSH评分均明显低于对照组(t=4.079、3.783,P均<0.001）。观察组患者创面愈合时间明显短于对照组 (t = 5.038,P <0.05）。结论 负压封闭引流联合局部氧疗治疗骨科慢性难愈合创面,可明显提高血浆EPO水平,增强创面抑菌效果,改善创面pH值、温度等微环境,缩短创面愈合时间。     

复方普鲁卡因止痛合剂治疗放射性食管炎疗效观察

目的　探讨放射性食管炎的有效治疗方法。方法　选取 68例肿瘤放疗患者 ,病例随机分为观察组、对照组 ,应用常规分割量6 0 Co放疗。观察组在出现放疗反应后立即给予复方普鲁卡因止痛合剂 ,对照组服用思密达。观察两组病情转归情况。结果　观察组总有效率84.8% ,对照组总有效率 5 9.1% ,两组相比差异性显著 (P <0 .0 5 )。结论　复方普鲁卡因止痛合剂是治疗放射性食管炎的一种高效方法     

光量子血疗治疗神经症190例

目的　研究光量子血疗对神经症的治疗作用。方法　将 380例神经症随机分为对照组和观察组 ,每组 190例 ,观察组治疗方法除与对照组相同外 ,另加光量子血疗。结果　观察组有效率 94 7% ,治愈率 85 % ,比对照组有效率82 6 %、治愈率 74 6 %明显提高 ,P <0 .0 5 ,尤其是癔症观察组的治愈率达 10 0 %。结论　光量子血疗治疗神经症 ,尤其是癔症疗效高 ,安全简便。     

口服螨液免疫治疗过敏性哮喘

目的　观察舌下给药口服螨液免疫 (脱敏 )治疗过敏性哮喘的效果。方法　 42例患者随机分观察组 2 2例 ,对照组 2 0例。对照组按常规给予治疗 ,观察组在常规治疗基础上采用逐日递增法加服螨液 ,半年为 1疗程。疗程结束后进行症状评分、FEV1 %测定、血清螨sIgE检测。结果　症状评分 :观察组治疗后 ( 0 .8± 0 .4)分与对照组 ( 1 .8±0 .4)分对比有非常显著差异(P <0 0 1 )。FEV1 %观察组治疗后为 ( 86± 4%) ,对照组为 ( 65± 6%) ,两组对比差异很明显(P <0 0 1 )。血清螨sIgE :观察组转阴率为 83 %,对照组为 1 0 %,两者对比有非常显著差异(P <0 0 1 )。结论　螨液舌下给药口服脱敏对于控制患者临床症状 ,改善肺功能 ,促使螨slgE转阴 ,均有明显效果     

清开灵联合颅脑降温仪治疗大面积脑梗死高热的效果观察

目的　探讨清开灵联合颅脑降温仪 (HTI)治疗大面积脑梗死 (LCI)高热的效果。方法　 97例病人 ,随机分为两组 ,观察组 5 3例 ,在脱水、对症、支持等治疗的同时 ,清开灵注射液 3 0ml加入 0 .9%盐水 10 0ml中 ,静脉滴注 ,1次 /d ,连续 7d ;同时应用颅脑降温治疗仪进行头部低温治疗 ,当病人体温恢复到 3 7.5℃以下 2～ 3d为终止治疗时间。对照组 44例 ,除不加用清开灵及HTI外 ,其它治疗方法同观察组。结果　两组比较 ,3d体温恢复率观察组明显高于对照组 (P <0 .0 5 ) ;体温反复率及病死率显著低于对照组 (P <0 0 1,P <0 .0 5 ) ;生存者NDS ,ADL明显优于对照组 (P <0 0 5 ,P <0 .0 1)。结论　清开灵联合颅脑降温仪治疗LCI高热 ,可明显改善预后和降低病死率     

服用健脾增免中药对耐力运动员免疫机能及有氧运动能力的影响

目的:观察健脾增免中药对耐力运动员免疫机能、内分泌及有氧运动能力的影响。方法:33名优秀自行车、中长跑运动员随机分为2组,实验组运动员每天早晚空腹服健脾增免中药汤剂2 0 0ml。1个月后,分别采用3H -TdR掺入法、ELISA法、免疫扩散法、放射免疫法、2 90 0心肺功能测试观察两组运动员免疫机能、内分泌激素和有氧运动能力的变化。结果:实验组运动员服用健脾增免中药后,NK细胞活性、辅助性T细胞亚群比值(Th1/Th2 )、IgG、IgA较实验前显著升高(P <0 . 0 5 ,P <0 . 0 1)。实验组男子运动员服药后血睾(T)和血睾/皮质醇(T/C)较实验前显著升高(P <0 . 0 5 ,P <0 . 0 1) ,并与对照组相比有显著差异(P <0 . 0 5 ) ;实验组女子运动员服药后T/C与对照组相比有显著差异(P <0 .0 5 )。实验组男、女运动员VO2 max相对值较实验前显著提高(P <0 . 0 5 ) ,其中男运动员蹬踏最大功率显著提高(P <0 . 0 1)。实验组服药后血清sIL - 2R明显下降(P <0 . 0 5 )。结论:服用健脾增免中药能有效增强耐力运动员的免疫机能,良好地调节其内分泌激素水平,有助于有氧运动能力的提高。     

枪击噪音对大鼠胃肠传输液体食物的影响及其机制探讨

目的　研究枪击噪音对大鼠液体食物胃肠传输的影响 ,并通过测定大鼠血浆胃肠激素浓度的变化探讨枪击噪音致胃肠传输功能紊乱发生的机制。方法　 32只SD大鼠随机分组 ,以模拟 5 6式冲锋枪射击时产生的噪音为施加因素 ,分别给予不同强度的噪音刺激 ,采用炭粉推进法观察不同强度的声刺激对大鼠液体食物胃肠传输的影响 ,通过放射免疫法测定血浆胃肠激素浓度 ,包括血浆胃动素(MLT)、生长抑素 (SS)、P物质 (SP)、血管活性肠肽(VIP)。结果　当枪击噪音强度在 80dB以下时 ,大鼠胃肠传输液体食物速度为轻度抑制 ,与对照组比较差异无统计学意义 (P >0 0 5 ) ;噪音强度达 80dB时 ,血浆SS、SP、VIP浓度均较对照组升高 ,差异有统计学意义 (P <0 0 5或P <0 0 1) ;当枪击噪音达到 12 0dB时 ,大鼠胃肠传输液体食物速度较对照组明显加快 (P <0 0 5 ) ,同时血浆MLT、SS、SP的浓度也发生了明显的变化 (P <0 0 1)。结论　当枪击噪音在一定强度范围内时 ,大鼠血浆胃肠激素浓度已发生改变 ,但其胃肠对液体食物的传输功能仍保持在相对正常的范围 ;当枪击噪音超过一定强度时 ,大鼠血浆胃肠激素浓度发生了明显的变化 ,其胃肠对液体食物的传输功能发生紊乱。     

奥美拉唑对颅脑手术病人胃内pH的影响及对上消化道出血预防的临床研究

为观察奥美拉唑对颅脑手术病人胃内ｐＨ的影响,研究其对颅脑手术后上消化道出血的预防作用。作者将２０例颅脑手术病人随机分为两组,对照组１０ 例,术后予以常规治疗,奥美拉唑组１０ 例,术后除常规治疗外予以奥美拉唑４０ｍ ｇ 每日１ 次静脉推注。所有病人术前４ｈ 开始胃内７２ｈ ｐＨ监测,并记录有无呕血、黑便、输血及大便隐血试验阳性。发现颅脑手术病人术中胃内ｐＨ 明显升高（Ｐ＜ ０．０１）,但术后胃内ｐＨ 显著下降（Ｐ＜０．０５）。奥美拉唑可阻断术后胃内ｐＨ下降,使术后胃内ｐＨ 高于术前（Ｐ＜ ０．０１）,与对照组比,奥美拉唑组术后胃内ｐＨ明显升高（Ｐ＜ ０．０１）。术后对照组病人呕血２ 例、黑便１ 例、大便隐血阳性２ 例;奥美拉唑组仅１例出现大便隐血阳性。提示颅脑手术病人存在术后胃酸高分泌;奥美拉唑可抑制术后胃酸分泌,对上消化道出血有预防作用     

超声电导靶位透药对胃肠手术后胃肠功能恢复的研究

目的观察胃肠手术后患者应用超声电导靶位透药技术对胃肠功能恢复的影响。方法选取2010年1月～2012年6月间我院外科收治的胃肠手术患者40例随机分为治疗组和对照组。对照组术后给予常规补液、对症、营养支持等基础治疗和护理;治疗组术后在对照组治疗和护理的基础上给予超声电导靶位透药。比较两组胃肠功能恢复的情况。结果治疗组术后规律肠鸣音出现时间短于对照组（P〈0.01）;术后肛门排气时间及进食开始时间均早于对照组（P〈0.05）;术后腹胀发生率低于对照组（P〈0.01）,差异具有统计学意义。结论胃肠手术后患者采用超声电导靶位透药可加速术后胃肠功能恢复,且方法简单方便、无痛苦、安全实用,值得临床推广。     

外周介入术后观察表的设计及临床应用

目的 构建以时间点和观察项目为框架的外周介入术后患者观察表,应用于临床并评价其效果.方法 采用非同期病例对照研究,以便利抽样法选取2014年6月1日至2014年12月31日1 01例外周介入术后患者为对照组,进行常规护理及记录,2015年1月1日至2015年6月30日102例外周介入术后患者为干预组,采用常规护理并应用自行设计《外周介入术后观察表》进行观察,将两组观察结果进行统计学分析;实施后每月邀请10名患者、5名管床医师、5名责任护士进行一次护理质量满意度评价.结果 干预组主要术后并发症发生例数低于对照组,差异经X2检验均有统计学意义(P＜0.05);干预组患者平均住院时间、平均住院费用低于对照组患者,差异经t检验有统计学意义(P＜0.05);使用该表后,患者、管床医师对于护理质量满意度提高、责任护士对护理质量自评满意度提高,差异经t检验有统计学意义(P＜0.05).结论 干预组患者各项指标均优于对照组患者,表明该观察表设计合理且符合专科特点,突出了对外周介入术后患者病情的动态观察,强化了监测术后并发症的有效性,有利于外周介入术后病情观察的落实,值得推广使用.     

Gastroesophageal reflux: comparison of barium studies with 24-h pH monitoring

OBJECTIVE: To determine the correlation between massive gastroesophageal reflux (GER) on barium studies and pathologic acid reflux on 24-h pH monitoring. METHODS: A search of hospital records from January 1997 to January 2001 revealed 28 patients who underwent both barium studies and 24-h pH monitoring. The radiologic reports were reviewed to determine the presence and degree of GER. Patients with reflux to or above the thoracic inlet either spontaneously or with provocative maneuvers in the recumbent position were classified as having massive reflux, whereas the remaining patients with reflux below the thoracic inlet or no reflux comprised the control group. The pH monitoring reports were also reviewed to determine if pathologic acid reflux was present in the recumbent position. The findings on these studies were then compared to determine the frequency of pathologic acid reflux in the recumbent position on pH monitoring in patients with massive reflux on barium studies compared with the control group. RESULTS: Massive GER was observed on barium studies in 11 (39%) of the 28 patients and reflux below the thoracic inlet or no reflux in the remaining 17 patients (61%) who comprised the control group. All 11 patients (100%) with massive reflux on barium studies had pathologic acid reflux on pH monitoring in the recumbent position compared with six (35%) of 17 patients in the control group (P = 0.0009). The pH in the distal esophagus on pH monitoring was less than 4.0 for 13.1% of the recumbent period for patients with massive GER on barium studies compared with 6.2% of the recumbent period for the control group (P = 0.0076). CONCLUSION: Although 24-h pH monitoring remains the gold standard for the detection of GER, our experience suggests that patients with massive reflux on barium studies are so likely to have pathologic acid reflux in the recumbent position that these individuals can be further evaluated and treated for their gastroesophageal reflux disease (GERD) without need for pH monitoring.     

口服胃肠超声造影评价尿毒症患者胃肠动力及胃壁形态改变

目的 应用口服胃肠超声造影结合灰阶超声及彩色多普勒超声评估尿毒症患者胃十二指肠动力及胃壁形态的改变.资料与方法 35例经临床诊断为尿毒症但未接受透析治疗的患者作为尿毒症组,同时选取31名健康志愿者作为对照组,通过口服胃肠超声造影结合灰阶超声及彩色多普勒超声检测各项胃肠动力学的超声评估参数及胃壁形态.结果 尿毒症组胃窦收缩频率、胃窦动力指数(MI)及胃排空率(GER)低于对照组(P＜0.05),胃排空时间(ET)较对照组长(P＜0.05),十二指肠胃窦反流(DGR)率高于对照组(P＜0 05);尿毒症组胃窦胃壁厚度大于对照组(P＜0.05),其中19例胃壁层次模糊,其胃壁层次清晰性显著低于对照组(P＜0.05);餐后20min MI与ET呈负相关(r=-0.061,P＜0.05),GER与年龄、ET均无相关性(P＞0.05).结论 口服造影超声检查是一项简便、非侵入性、可重复进行的实时评估尿毒症患者胃动力改变及胃壁形态改变的方法,并可同时检测十二指肠胃窦反流的发生.     

美宝创疡贴在褥疮护理应用中的体会

目的 探讨一种有效、简便的褥疮治疗和护理方法.方法 将60例(68处)褥疮患者随机分为传统对照组和美宝创疡贴治疗组,观察并比较两组患者褥疮愈合情况和褥疮护理时间.结果 在相同观察时间内两组患者治愈率比较,创疡贴治疗组优于传统对照组;两组患者压疮护理时间比较(P＜0.05),创疡贴治疗组褥疮护理时间明显缩短.结论 美宝创疡贴是治疗褥疮理想的功能性敷料,值得临床广泛推广使用.     

CT-Guided Sclerotherapy for Simple Renal Cysts: Value of Ethanol Concentration Monitoring

Objective

The aim of our study was to evaluate the differences between sclerotherapy with and without ethanol concentration monitoring for the treatment of simple renal cysts.

Materials and Methods

Sixty-seven patients with 70 simple renal cysts were randomly assigned to two groups in a 12-month prospective controlled trial. One group (group A) was treated with computed tomography (CT)-guided sclerotherapy without ethanol concentration monitoring (33 patients with 35 cysts), whereas the other group (group B) had ethanol concentration monitoring (34 patients with 35 cysts) during the procedure. Treatment outcomes between the two groups were compared 12 months later with follow-up ultrasound examination.

Results

After the 12-month follow-up period, the overall success rate was 74.3% in group A and 94.3% in group B (p = 0.022). The mean cyst size before and after treatment was 8.6 ± 2.0 cm and 2.3 ± 2.9 cm, respectively, in group A, and 8.4 ± 1.7 cm and 0.8 ± 1.9 cm, respectively, in group B. The final size of the cysts in group B was significantly smaller than that in group A (p = 0.015). The likelihood of treatment with ethanol concentration monitoring being successful was approximately 16 times higher than without ethanol concentration monitoring (p = 0.026; odds ratio = 15.7; 95% confidence interval: 1.38-179.49). There were no major complications in either group.

Conclusion

Monitoring of Hounsfield units (HU) of ethanol by CT is an effective method in the treatment of simple renal cysts with ethanol sclerotherapy. The ethanol sclerotherapy procedure can be terminated at the point of clear fluid aspiration because the HU (-190) of CT scan corresponds to it.     

Gastroesophageal reflux disease: correlation of esophageal pH testing and radiographic findings.

In an attempt to ascertain radiologic efficacy in patients with evidence of gastroesophageal reflux disease (GERD) at pH testing, radiographic findings were correlated with pH values obtained with an esophageal monitor worn for a 24-hour period in 112 patients. Fifteen (30%) of 50 patients with abnormal pH test results had esophagitis diagnosed radiographically, compared with six (10%) of 62 with normal pH test results (P < .05). The severity of abnormal pH monitoring results was classified but did not correlate significantly with the prevalence of esophagitis diagnosed radiographically. Hiatal hernia was also more common (80% vs 60%) in patients with abnormal pH test results (40 of 50 patients) than in those with normal results (37 of 62 patients) (P < .05). Pharyngeal, laryngeal, and pulmonary symptoms were common indications for evaluation, and 14 of 27 (52%) patients with hoarseness had an abnormal pH tracing. Only a minority of patients with evidence of GERD as defined by abnormal pH test results had reflux esophagitis diagnosed radiographically.     

Detection of minimal residual disease in acute leukemia by Tc-99m MIBI femoral marrow imaging

To determine the potential of Tc-99m MIBI femoral marrow imaging for detecting minimal residual disease in acute leukemia, MIBI images of 68 patients with acute leukemia and 110 control patients were examined. MIBI accumulation was classified into three patterns: not detectable, mild accumulation, and clearly visualized accumulation. Clearly visualized accumulation was interpreted as abnormal. The mean uptake ratio of the femoral marrow to muscle was calculated. Forty-five patients who were in complete remission (CR) at the time of MIBI imaging had a follow-up study (mean interval, 23 months). Clearly visualized accumulation was demonstrated in 35 patients with acute leukemia: in 7 patients before starting induction chemotherapy, in 12 patients after relapse, and in 16 of the 49 patients in the CR group. Mild accumulation was demonstrated in 14 patients in the CR group and in 13 control group patients. No detectable accumulation was observed in 19 patients in the CR group and in 97 control patients. The marrow and muscle uptake ratio of patients before starting chemotherapy (2.29 +/- 0.26) was greater compared with that in patients after relapse (1.78 +/- 0.44, P < 0.02) and in patients with abnormal accumulation despite complete remission (1.84 +/- 0.36, P < 0.01). The uptake ratio in patients with abnormal accumulation despite CR was higher compared with patients with mild accumulation in CR (1.26 +/- 0.13, P < 0.001) and controls (1.23 +/- 0.10, P < 0.001) who had mild accumulation. Fifteen patients with abnormal accumulation despite CR had a markedly greater relapse rate (66.7% > 10.0%, P < 0.005), a higher mortality rate (46.7% > 6.7%, P < 0.01), and shorter remission time (8.7 +/- 10.2 months < 35.9 +/- 20.1 months, P < 0.001) compared with 30 patients without abnormal accumulation in CR. MIBI femoral marrow imaging may be a useful and simple method for monitoring levels of residual leukemic cells. Clearly visualized MIBI accumulation may be a marker for relapse.     

封闭负压引流技术治疗56例骨外露创面的临床疗效

目的观察封闭负压引流技术治疗骨外露创面的临床效果。方法取本院骨科于2010—2012年收治的骨外露创面患者56例作为研究对象,根据治疗方式不同分为使用负压封闭引流术的观察组与使用常规治疗方法的对照组,每组各28例。比较两组患者的治疗效果、日常生活活动能力和肢体功能、疼痛及负面情绪评分等差异。结果观察组患者的治疗效果明显优于对照组患者(P<0.05);观察组患者接受治疗后的日常生活活动能力和肢体功能评分均明显高于对照组患者(P<0.05);观察组患者接受治疗后的疼痛及负面情绪评分均明显低于对照组患者(P<0.05)。结论使用负压封闭引流技术治疗骨外露创面可以显著提高治疗效果,改善患者的生活能力及肢体功能,减轻患者的疼痛及负面情绪。