重症肝炎并发感染的危险因素分析及护理

目的 探讨重症肝炎并发感染的危险因素以及护理方法.方法 选择2014年4月-2015年4月期间我院收治的32例重症肝炎并发感染患者,分析重症肝炎患者并发感染的危险因素,并且提出具有针对性的护理措施.结果 患者的一般资料中性别、年龄与免疫功能均是造成患者重症肝炎并发感染的危险因素.多因素分析,男性、年龄超过60岁、免疫功能低下是独立诱导重症肝炎患者发生感染的危险因素.结论 重症肝炎并发感染的危险因素多种多样,通过对症治疗以及相应的护理干预能够有效降低患者并发感染的发生率,值得在临床推广应用.     

重症肝炎患者医院感染的临床特点和相关危险因素

目的探讨重症肝炎患者发生医院感染的临床特点及相关危险因素。方法选取我院2010年4月至2012年4月收治的564例重症肝炎患者,对其临床资料进行回顾性分析。结果重症肝炎患者医院感染发生率为44.86%,其中以腹腔和呼吸系统感染较为多见,且患者死亡率明显高于无感染病例(P<0.05);患者年龄大、住院时间长及侵袭性操作和治疗等患者的医院感染发生率明显增加(P<0.05)。结论重症肝炎患者医院感染发生率较高,且患者年龄、住院时间及侵袭性操作和检查等均是发生医院感染的危险因素,临床治疗应加强护理以减少医院感染的发生。     

重症肝炎并发感染的危险因素分析及护理

目的探析重症肝炎并发感染患者的相关危险因素以及临床护理干预措施。方法选择在我院医治的60例重症肝炎患者为观察对象,对其临床相关医治资料进行回顾性分析。结果男性感染率60.53%,高于女性31.82%;年龄60的感染率70.73%,高于年龄≤60的患者36.84%,对比存在统计学价值(P0.05)。结论积极的护理干预措施可有效控制重症肝炎患者的病情,对抑制感染的发生具有促进意义。     

老年重症肝炎患者医院感染分析和护理措施

目的了解老年重型肝炎患者医院感染的临床特点及分析探讨其危险因素,更好地指导临床护理。方法本院收治的重症肝炎患者266例,其中:老年患者76例。本文对发生医院感染的老年病例进行回顾性分析,并与中青年病例进行比较。结果 266例重型肝炎患者中,医院感染发生率老年组为52.6%(40/76),中青年组为36.3%(69/1.90),明显高于中青年组。老年组发生医院感染病例病死率为80.0%(32/40),明显高于无发生医院感染的老年患例(50.0%,18/36)和发生医院感染的中青年患者(47.8%,33/69)。住院时间越长,感染率越高,老年组发生医院感染的病例平均住院时间为49.4 d±48.9 d,无发生医院感染病例平均住院时间为27.6 d+30.3 d。重症肝炎患者医院感染常见部位是腹腔和肠道。结论预防医院感染是老年重症肝炎治疗成败的关键之一。而护理工作质量的好坏,是预防医院感染的重要因素。预见性护理是降低重症肝病医院感染、降低病死率的重要环节。     

重症脑卒中患者肺部感染的危险因素分析

目的探讨重症脑卒中患者肺部感染危险因素。方法对720例重症脑卒中患者临床资料回顾性分析,根据患者是否发生肺部感染将其分为研究组与对照组。结果重症脑卒中患者肺部感染危险因素有年龄高于60岁、有意识障碍、出血性脑卒中、合并慢性疾病是肺部感染的危险因素。结论重症肺部感染危险因素较多,临床应积极采取有效的预防措施,降低肺部感染发生率。     

青年重症肝炎危险因素调查研究

目的:探讨青年重症肝炎预后现状和影响因素。方法:采用重症肝炎患者预后可能影响因素自编问卷对2010年6月～2012年6月在我院传染科住院治疗的113例青年重症肝炎患者进行调查,收集患者的临床资料,根据患者预后将符合本研究纳入标准和排除标准的患者分为对照组和观察组,采用二分类Logistic回归分析找出青年重症肝炎预后现状和影响因素。结果:113例患者经过积极治疗存活44例,生存率为38.93%,治疗无效死亡69例,病死率为61.06%。多因素Logistic回归分析显示腹水、肝性脑病、上消化道出血、血清总胆红素升高是重症肝炎患者预后的危险因素,而白球比升高、血糖升高、胆固醇升高和AFP升高是重症肝炎患者预后的保护因素。结论:青年重症肝炎患者预后欠佳,且受多方面因素的影响,检测相关实验室指标综合评价患者的预后,采用针对性的治疗措施。     

106例重型肝炎并发医院感染的危险因素分析

目的探讨重型肝炎患者并发医院感染的危险因素。方法对重庆医科大学附属第一医院1998年12月～2003年12月发生医院感染的106例重型肝炎患者的危险因素进行1：1病例对照研究。结果重型肝炎患者的医院感染率为40．61％,重型肝炎患者发生医院感染的病死率为64．15％。感染部位以腹腔、下呼吸道和胃肠道为主。发生医院感染的危险因素为住院时间长、接受侵袭性操作、低蛋白血症、抗生素使用种类多、合并其他并发症。结论重型肝炎患者的医院感染率高,为医院感染的高危人群。     

慢性重症肝炎并发感染204例临床分析

目的:分析我院慢性重症肝炎并发感染的发生率及病死率,并探讨其相关因素及细菌感染种类。方法:采用回顾性病例分析方法分析我院慢性重症肝炎患者感染的相关因素。结果:我院慢性重症肝炎感染的发生率为81.5%,感染的发生与长期卧床,免疫功能差有关,多见于腹腔感染、肺部感染,与患者的肝功能状态呈正相关。结论:慢性重症肝炎并发感染的发生率高,细菌以革兰阴性杆菌,真菌为主。分析引起感染的原因有助于临床医师加强监控措施,积极治疗原发病,提高患者的免疫力,降低慢性重症肝炎患者并发感染的发生率。     

颅脑外伤重症监护患者合并肺感染的危险因素分析

目的针对颅脑外伤重症监护患者合并非感染的危险因素进行分析。方法随机选择2013年2月—2014年2月期间,该院重症监护科室收治的颅脑外伤重症监护患者80例,其中合并肺部感染患者40例,无肺部感染患者40例,作为该次研究的对象,合并肺部感染患者为观察组,无肺部感染患者为对照组,对两组患者的肺部感染危险因素进行分析比较。结果观察组与对照组患者的影响颅脑外伤重症监护患者合并非感染发生的危险因素中的年龄、昏迷、脱水剂使用、休克、意识障碍、激素应用、机械通气、开放性脑外伤、饮酒、吸烟、营养不良、肺部疾病、气管切开等,差异有统计学意义（P〈0.05）。结论颅脑外伤重症监护患者合并肺感染发生的危险因素有很多,有患者自身的因素、有药物因素、有诊疗因素等,重症监护室是感染发生的高危场所,需要采取有效的措施进行预防,降低颅脑外伤重症监护患者的合并肺感染发生率。     

慢性肝炎和肝硬化并发腹膜炎50例临床分析

目的探讨慢性重症肝炎和肝硬化患者并发自发性细菌性腹膜炎的临床特点、感染细菌的种类以及临床转归情况。方法对我院感染内科2005年1月—2009年12月住院的慢性重症肝炎和肝硬化并发自发性细菌性腹膜炎患者50例的临床资料进行回顾性总结、分析。结果本组50例患者中,大多数患者感染中毒症状不明显,腹膜炎体征不典型。以腹胀明显或加重,腹水短期增多,利尿治疗效果差为主要临床表现。治愈20例,好转16例,死亡14例,死亡原因主要为肝肾综合征,其次为上消化道出血及肝性脑病。结论慢性重症肝炎和肝硬化并自发性细菌性腹膜炎患者预后差,病死率高。积极治疗原发肝病及并发症,早确诊、早治疗自发性细菌性腹膜炎是降低相关危险因素,提高重症肝病及晚期肝病患者生存率的关键。     

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.     

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…     

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.     

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     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.