尿路感染病人尿液中呋喃西林耐药性细菌的研究

泌尿系统感染是临床常见的医院感染之一，并常是混合感染。Baillie L（1987）建议对这种病人使用膀胱冲洗，而不主张全身使用抗生素进行治疗，因为抗生素治疗极少有疗效而且容易在病人正常菌群中选择出耐药菌株。国内多用价格较为低廉的呋喃西林溶液做为常规的膀胱冲洗消毒剂。本文对107株尿路感染病人尿液分离菌进行了呋喃西林耐药性的研究，以探讨长期以来临床常规使用该药作为膀胱冲洗消毒液的合理性。     

单流向持续负压引流加间断冲洗治疗切口感染

切口化脓感染是腹部外科中经常遇到的问题，对感染切口采用开放的方式换药是治疗腹部术后切口化脓性感染的传统方法，其不足是治疗时间长，住院时间久，换药频繁，加重了病人的痛苦和经济负担，也增加了医护人员的工作量。近年来有采用封闭引流技术治疗腹部术后切口化脓性感染的报道，上述情况有所改善，但仍不够理想。作者自2000-07月开始，采用单流向持续负压引流加间断冲洗技术治疗腹部术后切口化脓性感染，取得满意的治疗效果。     

中西医结合治疗手术后重度腹部感染——(附二例报道)

腹部感染是一种常见病和多发病,特别是肠破裂的病人,即使手术中腹腔冲洗彻底,术后也可能发生腹腔化脓性感染和切口感染。如果感染不能有效控制,酿成败血症可危及生命。笔者采用中西医结合治疗腹感染13例,其中2例严重感染取得了满意的疗效。特报告如下。     

留置两种不同气管切开切口感染率的对比分析

目的对比研究带囊可冲洗气管切开套管与带囊不可冲洗气管切开套管在气管切开切口感染率。方法抽取在我院ICU治疗需行气管切开的危重病人60例,随机分成两组,每组30例。实验组病人留置带囊可冲洗气管切开套管,行气管切开切口常规护理并定时囊上抽吸分泌物及囊上冲洗。对照组病人留置带囊不可冲洗气管切开套管,行气管切开切口常规护理。结果两组病人中对照组有5例发生切口感染,实验组30例应用可冲洗气管切开套管无1例发生切口感染,两组比较有统计学意义（P〈0．05）。结论带囊可冲洗气管切开套管可降低气管切开病人的切口感染率。     

纤维支气管镜在重型颅脑损伤患者气管切开治疗中的应用及护理

目的:探讨重型颅脑损伤重症肺部感染病人纤维支气管镜下吸痰加冲洗的治疗效果及护理.方法:采用经鼻插入纤维支气管镜,逐级观察总气管、主支气管以及叶、段、亚段支气管情况,行气管内分泌物吸引,并予35～37℃生理盐水10～20ml反复冲洗.结果:冲洗后临床症状、体征和各项指标明显改善.结论:良好的护理配合是提高纤维支气管镜下吸痰加冲洗治疗重型颅脑损伤肺部感染效果的关键.     

脑室穿刺引流尿激酶冲洗治疗脑室内出血

目的探讨脑室穿刺引流尿激酶冲洗治疗脑室内出血的效果。方法对32例病人进行回顾性研究,分析手术指征、方法、并发症和手术疗效。结果 32例术后恢复优良14例,病残12例,死亡6例。常见并发症依次为上消化道出血、中枢性高热和肺部感染。结论脑室穿刺引流尿激酶冲洗是一种治疗脑室内出血有效而安全的方法。     

气管内冲洗治疗术后急性阻塞性通气障碍(10例报告)

本文作者应用气管内冲洗法、治疗10例经一般治疗无效的术后急性阻塞性通气障碍的病人,10例中,包括急性阻塞性肺不张9例(其中酸性胃内容误吸2例)、术后急性支气管填塞1例,均取得了满意的效果。本文介绍了一种含抗生素和β-受体兴奋剂的气管内冲洗液,并详述了气管内冲洗浊的具体操作。使用该冲洗液进行气管内冲洗——吸引,能稀释呼吸道分泌物,浸泡软化固体     

自制塑性膜环形腹部切口保护器的临床应用

化脓性炎症病变的腹腔 ,在手术治疗的实际操作中 ,往往难以避免腹部切口的污染 ,尽管术中护皮、冲洗、或行腹腔引流 ,术后仍然避免不了切口的感染 ,给病人带来痛苦 ,延长住院时间 ,增加病人经济负担。为提高疗效 ,作者设计了塑性膜环形腹部切口保护器 (简称切口保护器 ) ,于 1990年 11月以来应用临床治疗化脓性阑尾炎、阑尾穿孔、阑尾周围脓肿共 2 0 0例。术后切口无 1例感染 ,解决了腹腔化脓性感染病变所致之术后切口感染的问题 ,现总结介绍如下。1　切口保护器的设计1.1　环形塑料圈　分大、中、小 3种型号 ,直径分别为 12ｃｍ、10ｃｍ、8…     

标准外伤大骨瓣减压并环池引流治疗重型颅脑损伤脑疝的效果

目的 探讨标准外伤大骨瓣减压并环池冲洗引流治疗重型颅脑损伤脑疝病人的效果.方法 回顾性分析比较重型颅脑损伤脑疝病人行标准外伤大骨瓣减压并环池冲洗引流术和单纯标准外伤大骨瓣减压术的疗效.两组术前、术后均进行脱水、预防感染、止血、脑保护等处理.结果 治疗组疗效明显优于对照组(u=5.6,P<0.05).结论 标准外伤大骨瓣减压并环池冲洗引流术可以有效提高重型颅脑损伤脑疝病人的疗效,改善预后.     

180例开放性损伤处理方法改进的体会

损伤是门诊外科的常见情形,开放性损伤其伤口清创缝合术后,一旦感染会给病人带来严重的后果和一定的经济损失.为此,作者2004年-2008年将传统交替使用肥皂水刷洗和盐水冲洗,0.1%新洁尔灭溶液冲洗,改为3%过氧化氢消毒液刷洗和盐水冲洗,经过观察180例伤口缝合后均获满意效果,现将自己的体会总结如下:     

大容量肺灌洗治疗尘肺病155例疗效观察

目的大容量肺灌洗治疗尘肺病短期疗效明显,而长期疗效相关报道较少。现选择我院2003—2005年进行大容量肺灌洗术治疗尘肺病155例资料完整的临床病例,随访5年,效果满意,目的在于推广临床应用。方法采用大容量肺灌洗术对155例尘肺病患者进行肺灌洗治疗,并对其灌洗前后和5年期进行临床症状学观察和肺功能的统计学分析。结果通过对155例尘肺患者的治疗观察,大容量肺灌洗可明显改善尘肺病患者胸闷、胸痛、气短等临床症状,灌洗后及5年期肺功能变化较灌洗前明显好转,差异有统计学意义(P<0.05,P<0.01),灌洗后与灌洗5年期随访,肺功能差异无统计学意义(P>0.05),肺功能改善具有远期疗效,与临床研究相符。结论大容量肺灌洗后可明显改善尘肺患者的临床症状和提高患者的生存质量,同时对患者的肺功能改善具有一定的长期疗效,值得临床推广应用。     

Hydrogen peroxide (H2O2): a review of its use in surgery

Wiener Medizinische Wochenschrift - Hydrogen peroxide has been used in medicine for more than 100 years. It is known in surgery as a highly useful irrigation solution by virtue of both its...     

The death of Sarah Lovell and the constrained feminism of Emily Stowe.

In 1879 a coroner's inquest was held on the body of Sarah Lovell, a young, unmarried woman who was thought to have died of an attempt at procuring an abortion. Suspicion fell on Emily Stowe, Toronto's first woman doctor. Stowe had graduated 12 years earlier from a US medical college but had not yet been granted a licence to practise in Ontario. She admitted to having seen and spoken to Lovell but denied any involvement in an abortion. Less than a year later she obtained the long-desired licence. The author has used newspapers, journals and other archival sources to explore the nature of Stowe's testimony and its relation to her acceptance by the profession.     

Gynecologic abscess: CT-guided percutaneous drainage

A 42-year-old woman with recurrent bilateral endometrial ovarian cystoma presented with fever and pelvic pain caused by a tubo-ovarian abscess (TOA), which was resistant to several varieties of intravenous and oral antibiotics for 2 weeks (Case 1). Computed tomography (CT)-guided diagnostic aspiration for a rapid enlarged right ovarian cystoma through a transabdominal route confirmed that it had developed into a TOA. Subsequent percutaneous abscess drainage (PAD) and irrigation for 3 days were successful. One-year follow-up revealed no recurrence of TOA. A 58-year-old woman with recurrent cervical cancer after external radiation therapy (RT) presented with fever, confusion and tremor caused by pyometra (Case 2). Since transvaginal drainage was impossible due to cervical os obstruction, the patient had undergone CT-guided transabdominal PAD and irrigation for a month. Thereafter, the clinical findings improved and a tracheloplasty was performed to prevent recurrence. CT-guided PAD may be a useful treatment option for gynecologic abscess as a diagnostic aspiration, a temporizing procedure until surgery, or an alternative surgery.     

青年女性大肠癌61例临床分析

本文报告经病理确诊的青年女性大肠癌61例。占同期大肠癌的17.8％。其中早期大肠癌7例。本组以14-20岁最少见(6例)。而26-30岁最多(37例)。提示患病率随年龄增长而增加。男女患病机率有显著差异。肿瘤分布以直肠和升结肠为多(共占82％)。临床表现直肠癌以血便和粘液血便(51.6％)为多;结肠癌以腹痛(46.7％)为多。病理分类恶性程度较高。     

脑脓肿51例临床分析

分析了５１例脑脓肿并结合文献讨论病因、诊断、脓液培养对药物选择的指导意义。分析了误诊及死亡原因，强调选用适当处理方法可增加其治愈率，并指出使用氨基糖甙类药物治疗脑脓肿的可能性，以及ＣＴ引进使穿刺冲洗术作为治疗脑脓肿的首选方法成为可能，本组共治疗７例，未发现明显并发症。     

导尿术中常见问题的临床观察与处理

目的探讨导尿术中常见问题的观察要点与处理方法。方法分别从导尿管的选择、导尿管插入受阻、导尿管的留置深度、气囊的灌注、膀胱冲洗、尿管拔出困难6个方面阐述常见问题的观察、原因分析与处理方法,孕妇导尿应注意的问题及择期手术导尿的时机。结果导尿过程的每个环节都很重要,特别是尿管插入受阻和膀胱冲洗中的问题更要正确处理。结论本文所述观点和方法经临床实践,能解决导尿术中的常见问题。     

Pulmonary metastases 12 years after a mastectomy for borderline phyllodes tumor

Phyllodes tumor is a rare breast tumor. A 45-year-old woman who underwent left mastectomy 12 years ago was found to have infiltrates in both lungs in a health examination. Combining histological examinations of the lung and breast samples, the diagnosis of borderline phyllodes tumor metastases to the lung was made. It is the longest interval to our knowledge that the metastases occurred 12 years after primary phyllodes tumor.

     

Schneiderian papilloma occasionally found in the lacrimal sac

Schneiderian papilloma is a kind of benign tumor that generally arises in the nasal and paranasal sinus mucosa.Here we present a case of Schneiderian papilloma found in the lacrimal sac.A 38-year-old woman with half-a-year history of right eye keratoleukoma applied to the clinic.Examinations found a central corneal ulcer,and penetrating keratoplasty was scheduled as a means of relieving vision problems in the right eye.However,penetrating keratoplasty was delayed because of a purulent discharge effusing from the right inferior punctum during irrigation of the lacrimal passages.     

Chronic falciparum malaria causing massive splenomegaly 9 years after leaving an endemic area

A 28-year-old woman from Sudan who had lived for 9 years in Victoria, Australia, was diagnosed with falciparum malaria 2 months after splenectomy for massive splenomegaly of unknown cause. Chronic falciparum malaria can occasionally present years after leaving endemic areas in partially immune patients. It should be considered in such patients with presentations possibly related to malaria, including splenomegaly, anaemia, or a long history of intermittent fevers and chills.