单纯手术与手术联合糖皮质激素治疗肿块型肉芽肿性乳腺炎的临床疗效

目的 对比分析单纯手术与手术联合糖皮质激素治疗肿块型肉芽肿性乳腺炎（GM）的临床疗效、复发情况及乳房外观评价。方法 本研究回顾性分析2017年1月至2022年1月就诊于宜昌市中心人民医院甲乳外科的106例肿块型GM患者。依据就诊期间治疗手段不同,分为A组（单纯手术治疗,n=67）和B组（手术联合糖皮质激素治疗,n=39）。观察比较两组患者的一般资料及临床资料,通过随访获得患者临床疗效、至临床治愈时长（TTCR）、1年内复发率及乳房外观评价情况。结果 经治疗后比较两组患者预后情况,手术联合糖皮质激素治疗组患者在临床治愈率、1年内复发率两方面均优于单纯手术组（P <0.05）,此外,手术联合激素治疗后患者乳房外观优良率（92.31%）明显高于单纯手术组（88.06%）,两组之间比较差异有统计学意义（P <0.05）。结论 手术联合糖皮质激素治疗肿块型GM能够有效提高患者总体临床治疗效果,降低短期复发率,同时在保证乳房外观完整性方面效果显著,且小剂量口服激素类药物不良反应少,安全性高。     

丹参化瘀汤治疗浆细胞性乳腺炎临床观察

目的:研究中药口服治疗浆细胞性乳腺炎(PCM)的临床疗效。方法:选取2017年5月—2018年5月的70例PCM患者,随机分为对照组和观察组,每组35例。对照组予以西医对症处理,观察组在对照组治疗的基础上加服中药汤剂丹参化瘀汤,治疗6个月后观察疗效。结果:对照组患者的有效率为80.0%,观察组为97.1%,2组临床疗效比较差异有统计学意义。2组患者在治疗后对生活质量的评分均有所升高,但两者之间的差异仍具有统计学意义。结论:丹参化瘀汤治疗浆细胞性乳腺炎疗效显著且能提高患者的生活质量。     

浆细胞乳腺炎60例临床分析

目的 探讨浆细胞乳腺炎的临床特点,提高对本病诊断的认识.方法 回顾性分析我院经手术病理证实的60例浆细胞乳腺炎的临床特点.结果 60例患者术前确诊26例,误诊率56.7%,均行手术治疗.结论 浆细胞乳腺炎多表现为乳腺肿块,乳头溢液,临床上易误诊为乳腺癌.针吸细胞学检查及溢液涂片细胞学检查是简单有效的诊断方法,可采用临床分期及病变范围来决定手术的方式.     

刮痧辅助治疗浆细胞乳腺炎的临床研究

目的:观察刮痧辅助治疗浆细胞性乳腺炎的临床疗效和安全性,探索浆细胞乳腺炎治疗的有效方案。方法:符合标准的63例患者随机分为观察组30例和对照组33例,2组患者均采用中药治疗,观察组加用刮痧治疗,比较2组在治疗前后的CRP、ESR、PRL及不良反应的变化。结果:2组患者在治疗后CRP、ESR及PRL均有下降,但观察组治疗后在CRP、PRL下降较对照组有明显差异(P<0.01),观察组治疗后ESR下降较对照组有差异(P<0.05),2组患者的不良反应无明显差异。结论:刮痧辅助治疗浆细胞性乳腺炎疗效明显,且安全有效,值得在临床上推广。     

浆细胞性乳腺炎98例诊治体会

目的探讨浆细胞性乳腺炎的临床特点、诊断及治疗方法。方法回顾性分析98例浆细胞性乳腺炎患者的临床资料。结果浆细胞性乳腺炎主要分肿块型、脓肿型和瘘管型,易误诊为乳腺良性肿瘤、乳腺癌、急性乳腺炎、乳房结核等。98例均手术治疗,经病理证实。有4例复发,再次手术后治愈。结论浆细胞性乳腺炎根据临床表现,结合多种辅助检查减少误诊率,及早手术切除病灶是治疗本病最彻底、最有效的方法。     

浆细胞性乳腺炎临床研究进展

浆细胞性乳腺炎属于非哺乳期乳腺炎,常好发于成年的青年女性患者,诊断主要靠临床表现及病理,治疗尚无统一指南,可分为保守及手术,但病程较长且复发率较高,甚至以切除患侧乳房为代价,给患者带来严重的身心健康伤害。目前浆细胞性乳腺炎发病机制不明,研究该病可能的发病机制具有重要的临床实践意义。      

浆细胞性乳腺炎32例诊治体会

浆细胞性乳腺炎是一种特殊类型的非感染性乳腺炎症.临床上不易诊断,保守治疗效果欠佳,容易复发,外科手术是治疗本病积极有效的方法.本次研究收治32例经手术及病理证实的浆细胞性乳腺炎,取得满意疗效,现报道如下.     

浆细胞性乳腺炎67例临床分析

目的探讨浆细胞性乳腺炎的临床表现及治疗方法与治疗效果。方法对石河子大学医学院第一附属医院2007年1月至2014年4月收治的67例浆细胞性乳腺炎患者的临床资料进行回顾性分析。结果 67例患者按其临床表现分为4型:隐匿型2例、肿块型52例、脓肿型9例、瘘管型4例。根据不同分型采用不同手术方式,包括乳管切除术、乳腺区段切除术、肿块局部切除术、脓肿切开引流术、乳腺瘘管切除术、单纯乳房切除术等,67例患者均治愈。结论浆细胞性乳腺炎临床表现复杂,依据临床分型治疗是有效的治疗方法。更多还原     

超声多参数评估浆细胞性乳腺炎疗效的临床研究

目的 通过常规超声、彩色多普勒及超声弹性等多参数评估浆细胞性乳腺炎(PCM)不同治疗方式的疗效。方法 回顾性选取经病理证实为PCM的患者114例为研究对象,随机分为中药组(65例)、西药组(49例),采用双盲法测量其病灶范围、血流速度、剪切波速度及杨氏模量等超声参数,对比两组患者经过不同治疗后各参数的变化。结果 中药组与西药组PCM患者超声参数比较,两组治疗后收缩期峰值流速(PSV)、舒张末期速度(EDV)均显著下降(P<0.05),Adler血流分级I级比例显著上升(P<0.05);中药组病灶范围的大小、E_mean、E_median、E_maximum、定性评分均显著高于西药组(P<0.05);两组疗效比较,中药组(89.2%)有效率高于西药组(73.5%),中药组的病程短于西药组,差异均有统计学意义(P<0.05)。结论 PCM患者病程迁延,临床上可采用中药、西药方法治疗,经超声多参数评估,中药治疗疗效优于西药治疗。     

骨水泥治疗胸腰椎压缩性骨折31例疗效分析

目的 探讨手术治疗胸腰椎压缩性骨折的疗效.方法 回顾性分析2010年10月至2012年10月收住洛宁县人民医院的63例胸腰椎压缩性骨折患者,依治疗方法不同分为手术组和保守组.手术组31例,采用骨水泥经皮椎体成形术治疗;保守组32例,采用传统手法整复、腰背肌锻炼等方法治疗.结果 手术组和保守组均取得了满意疗效,但两组疗效比较差异无统计学意义（P〉0.05）;对两组患者住院时间、椎体高度、Cobb角进行比较,手术组均优于保守组（P〉0.05）.结论 手术治疗科快速有效缓解患者痛苦、缩短住院时间,并可基本恢复损伤椎体的解剖形态,但费用高昂;保守治疗起效较慢,但临床效果肯定、治疗简便、费用低廉.故临床上应依据患者情况,采取适合的治疗方案.     

SOFA评分的临床意义及其在临床研究中的应用

多器官衰竭(Multiple Organ Failure,MOF)于70年代被提出后,随即得到医学界的重视。80年代,MOF进入评分化阶段,相继出现了如A-PACHE(Acute Physiologic and Chronic Health E-valuation)评分、MOF评分(Marshall法)等多种评分系统,其中APACHE-Ⅱ得到了广泛应用。医学界已逐渐认识到：器官功能衰竭是一个过程而并非仅是一个现象,不能简单的以“存在”或“不存在”来描述,在这两极之间还有严重的程度变化。     

Clinical evaluation of the ASPAN Pain and Comfort Clinical Guideline.

The ASPAN Pain and Comfort Clinical Guideline was created because of the urgent need for a standardized evidence-based approach to the management of patients' pain and comfort in all perianesthesia settings. The purpose of the research presented here was to test the content of the ASPAN Pain and Comfort Clinical Guideline, which included the domains of assessment, intervention, and outcomes. Each domain was rated on clarity, usability, and feasibility using a Likert scale, which ranged from 1 (strongly disagree) to 4 (strongly agree). A survey design was used with a convenience sample of 215 perianesthesia nurses. The results of the study demonstrated a mean score of clarity, usability, and feasibility in all perianesthesia settings ranging from 3.54 (SD) to 3.80 (SD). There were no differences in the clarity, usability, or feasibility of the guideline between perianesthesia settings. The results of this study support that the ASPAN Pain and Comfort Clinical Guideline has practical utility for perianesthesia nurses in all settings. Use of this guideline in perianesthesia settings will standardize pain and comfort management and has the potential to positively impact pain and comfort in perianesthesia patients.     

Toward Clinical Scholarship: Promoting Evidence-Based Practice in the Clinical Setting

Organizational interventions are being suggested to increase the rate of quality research dissemination and uptake. This article describes how one tertiary institution is using an evidence-based nursing (EBN) committee as an organizational strategy to shift its nursing culture toward clinical scholarship. A number of approaches and activities that have stimulated the movement toward evidence-based practice (EBP) are examined: organizational commitment to EBP, strategic positioning of the EBN committee within nursing's administrative structure, articulation of a mission, conceptualization of a model for EBN practice, learning on the job, selection and adoption of an evidence-based model for implementing change, marketing for a change in culture toward clinical scholarship, and other selected examples of projects undertaken by the committee. Action-oriented principles associated with committee experiences are related to the approaches and activities.     

Clinical Care Costing Method for the Clinical Care Classification System™

PURPOSE: To provide a means for calculating the cost of nursing care using the Clinical Care Classification System (CCCS). DATA SOURCES: Three CCCS indicators of care components, actions, and outcomes in conjunction with Clinical Care Pathways (CCPs). DATA SYNTHESIS: The cost of patient care is based on the type of action time multiplied by care components and nursing costs. CONCLUSIONS: The CCCM for the CCCS makes it possible to measure and cost out clinical practice. IMPLICATIONS FOR PRACTICE: The CCCM may be used with CCPs in the electronic patient medical record. The CCPs make it easy to track the clinical nursing care across time, settings, population groups, and geographical locations. Collected data may be used many times, allowing for improved documentation, analysis, and costing out of care.     

检验科与临床科互动式举措-回访制度的临床效果分析

目的 探索临床回访制度在检验科与临床科紧密结合、加强交流合作的互动式举措中的临床效果.方法 建立临床回访制度,每周固定某时段,各专业组技术骨干带领1～2名检验技师下临床科回访50次,回访临床主任、医生、护士等6 820人次,进行临床对话和了解情况,解决问题.结果 与回访前相比,临床纠纷降低(P<0.01),临床满意度明显提高(P< 0.01),每周检验报告单质量得到临床公正评判,解决许多实际问题,宣传了各专业技术和业务,消除了误会,提高了检验的可信度.结论 临床回访制度对增进"检验-临床"关系,提升检验服务质量和检验科的品牌具有积极的临床意义.     

Clinical evaluation of the shoulder

Shoulder pain is an exceptionally common problem in physiatric practice.Evaluation and management of patients with shoulder dysfunction can challenge even the most experienced practitioner. The complexity and inherent instability of the shoulder lead to functional overload of various bony and soft tissues within the joint complex and adjacent structures.Additionally, shoulder pain may be the initial manifestation of a potentially serious condition. Consequently, a detailed and systematic approach to the evaluation of a patient with shoulder pain is crucial in establishing a complete and accurate diagnosis. A skillfully performed history and physical examination allows identification of specific tissue pain generators and biomechanical dysfunction throughout the kinetic chain. Only after these elements have been defined clearly can an appropriate rehabilitation program be de-signed. A thorough clinical assessment also can aid in the detection of serious diseases that masquerade as shoulder pain. An effective clinical evaluation enhances the quality and cost-effectiveness of care and facilitates a successful outcome in most cases.