慢性肾功能衰竭血液透析治疗患者皮肤瘙痒的原因及护理对策

目的分析慢性肾功能衰竭血液透析治疗患者皮肤瘙痒的原因,同时提出有效的护理对策;方法选择我院2012年1月至2015年1月收治的慢性肾功能衰竭血液透析治疗并发皮肤瘙痒的患者30例,分析发生皮肤瘙痒的原因,同时根据具体原因提出有针对性的治疗护理对策;结果全部30例患者中,因为电解质代谢障碍发生的皮肤瘙痒患者18例(60.0%),因为氮质代谢产物刺激皮肤引起瘙痒的患者9例(30.0%),因为过敏反应引起皮肤瘙痒的患者3例(10.0%);全部患者经过有针对性的治疗护理后,瘙痒症状好转20例,完全缓解7例,无效3例,总有效率为90.0%(27/30)。结论分析慢性肾功能衰竭血液透析治疗患者皮肤瘙痒的原因,同时提出有效的护理干预,能有效缓解患者的瘙痒症状,提高患者的生活质量。     

血液透析联合血液灌流治疗维持性血液透析患者顽固性皮肤瘙痒症

随着血液净化技术的日臻完善,维持性血液透析患者存活时间不断延长,透析相关长期并发症不断出现,皮肤瘙痒是慢性肾功能衰竭患者常见的皮肤症状之一,单纯性血液透析治疗可增加瘙痒的发生率约60%～90%,我们采用血液透析联合血液灌流对皮肤瘙痒患者治疗42例,取得满意疗效.     

血液透析联合血液灌流治疗尿毒症皮肤瘙痒的观察及护理

目的 为提高慢性肾功能衰竭长期血液透析患者的生活质量,探讨血液灌流(HP)联合血液透析(HD)治疗尿毒症顽固性皮肤瘙痒的疗效.方法 灌流器串联于透析器前端,联合治疗2小时结束灌流,取下灌流器后再继续透析2小时,HD+HP1次/2周.结果 血液灌流与血液透析联合治疗尿毒症皮肤瘙痒效果明显.     

间歇性血液灌流配合血液透析治疗尿毒症顽固性皮肤瘙痒的护理体会

目的:观察间歇性血液灌流配合血液透析治疗终末期尿毒症患者伴有顽固性皮肤瘙痒的疗效及护理方法。方法:将148例终末期尿毒症患者顽固性皮肤瘙痒随机分为治疗组74例和对照组74例,治疗前后采用Dirk R Kuypers的评分方法进行瘙痒程度评分,重度皮肤瘙痒56例,中度皮肤瘙痒92例。其中治疗组重度皮肤瘙痒34例,中度皮肤瘙痒40例。对照组重度皮肤瘙痒22例,中度皮肤瘙痒52例。对中度及重度皮肤瘙痒采取血液灌流配合血液透析。治疗组每周按2次血液透析,1次间歇性血液灌流配合血液透析,对照组每周3次全部进行血液透析,连续治疗8周,比较治疗前后瘙痒改善程度。结果:治疗组治疗前后皮肤瘙痒评分下降96%,有明显效果,对照组治疗前后皮肤瘙痒评分下降25%,治疗组与对照组间比较差异有统计学意义(P<0.01)。结论:间歇性血液灌流配合血液透析治疗终末期尿毒症患者伴有皮肤瘙痒,效果显著。     

血液透析联合血液灌流治疗尿毒症合并慢性乙型肝炎患者皮肤瘙痒的疗效及护理体会

目的:探讨如何减轻尿毒症合并慢性乙型肝炎患者皮肤瘙痒的症状,提高其生活质量。方法:对20例尿毒症合并慢性乙型肝炎的皮肤瘙痒患者,进行血液透析联合血液灌流治疗,治疗2次后,对患者的皮肤瘙痒症状进行评价。结果:治疗后患者瘙痒评分为(12.9±4.4)分,较治疗前(27.5±6.1)分明显好转。结论:血液透析联合血液灌流治疗能有效减轻患者的瘙痒症状,改善患者生活质量。     

血液灌流联合血液透析治疗急慢性肾功能衰竭的护理

目的 分析探讨急慢性肾功能衰竭应用血液灌流联合血液透析(HP+HD)治疗的护理措施.方法 回顾性分析本科收治的40例急、慢性肾衰竭患者的临床资料,所有患者均接受(HP+HD)、护肝、营养心肌等治疗,治疗期给予系统化的护理,总结护理方法.结果 40例患者均顺利完成每次的治疗,无死亡病例,无灌流器凝血现象,患者无出血倾向;40例患者经HP+HD治疗后,皮肤瘙痒、睡眠障碍、心功能等症状有所改善.结论 加强血液灌流联合血液透析治疗期的护理,可以有效缓解急慢性肾功能衰竭患者的临床症状,系统化护理工作具有重要的临床意义.     

血液灌流联合透析在治疗慢性肾功能衰竭中的研究

目的:研究血液灌流联合透析在治疗慢性肾功能衰竭中的临床疗效。方法:采用等距随机抽样法将100例慢性肾功能衰竭患者分为对照组(血液透析治疗)及观察组(血液灌流联合血液透析治疗)各50例,对两组临床疗效进行比较。结果:治疗后,观察组患者炎症指标、血液指标、钙磷代谢指标优于对照组,差异有统计学意义(P<0.05);两组患者治疗后生活质量相比较,观察组各维度评分均高于对照组,差异有统计学意义(P<0.05)。结论:在慢性肾功能衰竭治疗中血液灌流联合透析取得的疗效更佳,且能够明显改善患者预后,可作为优选治疗方案推广使用。     

慢性肾功能衰竭患者顽固性皮肤瘙痒的病因及治疗

目前,随着临床血液净化学的不断发展,特别是血液滤过和血液灌流方法在临床上的应用,慢性肾功能衰竭的患者并发顽固性皮肤瘙痒的发生率较前有所减少,有些甚至治愈.我院肾脏内科血液净化室对慢性肾功能衰竭患者并发顽固性皮肤瘙痒的病人采取血液滤过和血液灌流方法治疗,取得了一定疗效.现报告如下:     

血液透析联合血液灌流治疗维持性血液透析患者皮肤瘙痒的临床效果

目的 探讨血液透析联合血液灌流治疗维持性血液透析患者皮肤瘙痒的临床效果。方法 选取湖南省怀化市第三人民医院收治的42例长期血液透析并伴有皮肤瘙痒的患者,随机均分为对照组和实验组（n=21）。对照组单纯进行血液透析治疗,实验组进行血液透析联合血液灌流治疗。比较2组患者治疗前后皮肤瘙痒评分与皮肤瘙痒改善情况的差异。结果 治疗后实验组瘙痒评分为（15.6±4.9）分,显著低于对照组（P〈0.05）。实验组患者治疗显效率（57.1%）和总有效率（95.2%）均显著高于对照组（P〈0.05）。结论 血液透析联合血液灌流治疗维持性血液透析患者皮肤瘙痒症疗效确切,可有效提高患者生活质量。     

浅析血液透析联合血液灌流与联合血液透析滤过治疗维持性血液透析患者皮肤瘙痒的疗效

目的：研究分析维持性血液透析皮肤瘙痒症状使用血液透析联合血液灌流与联合血液透析滤过治疗的临床效果。方法：根据2013年6月至2014年6月该院的48例接受维持性血液透析治疗皮肤瘙痒患者来进行研究分析,分成对照组和观察组,均有24例。对照使用血液透析滤过联合血液透析的治疗方式,观察组使用血液灌流联合血液透析的治疗方式。比较两组的临床治疗效果。结果：观察组临床症状缓解率是87.5%,对照组是50%,结果存在统计学差异（P <0.05）。结论：尿毒症皮肤瘙痒症状使用血液透析联合血液灌流治疗的效果比血液透析联合血液透析滤过治疗优秀,临床中推介使用。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.