血液灌流治疗急性百草枯中毒临床分析

目的观察血液灌流治疗急性百草枯中毒的临床疗效。方法42例急性百草枯中毒患者按收治时间分为灌流组（22例）和对照组（20例）,对照组给予洗胃、补液、利尿、激素等常规治疗;灌流组在此基础上给予血液灌流治疗,比较2组疗效。结果灌流组死亡15例,死亡率68.18%;对照组死亡18例,死亡率90.00%,2组比较差异有显著性（P〈0.05）。灌流组中存活病例服毒剂量低于死亡患者（P〈0.01）,首次灌流治疗时间也早于死亡患者（P〈0.01）。结论血液灌流治疗急性百草枯中毒可提高治愈率,降低病死率。     

百草枯中毒行血液灌流疗效观察与护理

目的:探讨百草枯中毒行血液灌流的疗效及护理方法。方法:对25例百草枯中毒患者在常规治疗的基础上行血液灌流综合治疗,并给予精心护理。结果:本组存活17例,存活率为68%,血液灌流2 h后血浆百草枯浓度由血液灌流前的(11.51±2.56)μg/ml降至(2.76±1.02)μg/ml。结论:对百草枯中毒患者行血液灌流治疗与护理,可显著降低患者的病死率。     

综合性碱化疗法治疗急性百草枯中毒的疗效观察

[目的]探讨碳酸氢钠溶液洗胃和后继的胃肠道碱化以及血液内环境碱化治疗急性百草枯中毒的疗效.[方法]选取本院47例百草枯中毒患者,依据其就诊时间分为两组.对照组16例应用常规清水洗胃,碱化组31例应用综合性碱化疗法.两组均给予血液灌流、肾上腺皮质激素等基础治疗.观察比较两组患者口腔溃疡、纵隔气肿的发生率和24 h、48 h、72 h,5d,7d,10 d,14 d的肝功能、肾功能、动脉血气、病死率的变化.[结果]碱化组口腔溃疡、纵隔气肿发生率低于对照组(P＜0.05);在不同时间段的血肌酐、血清总胆红素水平明显低于对照组(P＜0.05).碱化组患者的动脉血氧分压的下降水平和速度较对照组平缓.碱化组患者各个时间段病死率和总病死率较对照组低.[结论]在百草枯中毒早期使用综合性碱化疗法可以促进患者胃肠道以及血液内环境中残余百草枯的分解,减轻百草枯对器官功能的损害,降低其病死率.     

应用碳酸氢钠溶液洗胃治疗百草枯中毒疗效观察

目的观察质量分数5%碳酸氢钠溶液洗胃治疗百草枯中毒的治疗效果。方法 142例百草枯中毒患者依据就诊时间分为2组,对照组49例应用常规清水洗胃,治疗组93例应用质量分数5%碳酸氢钠溶液洗胃并漱口,2组均给予谷胱甘肽、肾上腺皮质激素、环磷酰胺、血必净及血液灌流等综合治疗。比较2组治疗后口腔黏膜、肝脏、肾脏、肺损伤发生率,白细胞升高概率及病死率。结果对照组治疗后口腔溃疡、肝脏、肾脏、肺损伤发生率,白细胞升高概率及病死率均高于治疗组,差异有统计学意义(P<0.05)。结论百草枯中毒早期应用质量分数5%碳酸氢钠溶液洗胃效果优于清水洗胃。     

血液灌流联合血液滤过治疗35例百草枯中毒的疗效

目的探讨血液灌流联合血液滤过治疗百草枯中毒患者的临床疗效。方法对2011年4月至2012年6月收治的35例百草枯中毒患者采用血液灌流联合血液滤过技术治疗的临床资料进行回顾性分析,并对同期收治27例采用常规治疗的百草枯中毒患者进行比较分析。结果观察组患者在治愈率、有效率均显著优于对照组,死亡率明显低于对照组,差异均具有统计学意义(P<0.05);观察组患者急性呼吸窘迫综合征、多器官功能障碍发生率明显低于对照组(P<0.05);观察组患者死亡病例存活天数均较对照组时间长,差异均有统计学意义(P<0.01)。结论血液灌流联合血液滤过治疗百草枯中毒能有效提高患者的抢救成功率,降低病死率,可作为抢救百草枯中毒患者的首先治疗方法。     

Depmas双重血液净化治疗急性百草枯中毒的疗效观察

目的探讨Depmas双重血液净化治疗急性百草枯中毒的临床疗效。方法回顾性研究我科2011年3月至2013年11月急性百草枯中毒患者,将其分为四组:常规治疗组未行血液净化治疗,只采用药物治疗;血液灌流组除了采用药物治疗外,还行HA230/330血液灌流治疗,血液灌流联合血浆置换组除了采用药物治疗,还行HA230/330血液灌流及血浆置换联合治疗;Depmas组除采用药物治疗外,通过血浆分离器,对分离的血浆再串联HA230/330及BS330血液灌流治疗。观察四组患者的存活率、平均存活时间,血液中百草枯浓度、胆红素及炎性介质的变化。结果血液灌流组、血液灌流联合血浆置换组及Depmas组较常规治疗组存活率提高,平均存活时间延长,周围血液中的百草枯、胆红素及炎症介质浓度明显降低,差异具有统计学意义(P<0.01);血液灌流联合血浆置换组及Depmas组较血液灌流组存活率提高,平均存活时间延长,周围血液中的百草枯、胆红素及炎症介质浓度降低,差异具有统计学意义(P<0.05);血液灌流联合血浆置换组与Depmas组存活率、平均存活时间、周围血液中的百草枯、胆红素及炎症介质浓度未见明显异常,差异不具有统计学意义(P>0.05)。结论 Depmas双重血液净化治疗急性百草枯中毒有显著疗效。     

血液灌流联合血液滤过治疗百草枯中毒的临床观察

目的:探讨血液灌流与连续性静-静脉血液滤过对百草枯中毒的疗效.方法:百草枯中毒49例,其中27例行血液灌流与连续性静-静脉血液滤过(治疗组),22例仅行常规治疗(对照组),观察2组患者痊愈率、有效率、病死率,2组急性呼吸窘迫综合征、多器官功能障碍发生率及死亡病例存活天数.结果:2纽患者痊愈率、有效率、病死率差异有统计学意义(P<0.01),2组急性呼吸窘迫综合征、多器官功能障碍发生率及死亡病例存活天数比较差异有统计学意义(P<0.01).结论:血液灌流联合血液滤过治疗百草枯中毒能有效 提高抢救成功率,降低病死率.降低急性呼吸窘迫综合征,多器官功能障碍发生率,增加死亡病例存活天数,为临床救治百草枯中毒提供新的治疗方法.     

高强度血液灌流联合血液滤过对百草枯中毒生存状况影响的研究

目的:探讨分析血液灌流联合血液滤过强度对百草枯中毒生存状况影响。方法:选取本院收治的百草枯中毒患者50例,随机法分为观察组和对照组,每组各25例,两组均给予血液灌流联合血液滤过治疗,观察组洗胃后进行7次血液灌流,每天1次,每天1次血液滤过,而对照组仅给予1次血液灌流,每天1次血液滤过,对两组患者不同时间段血清百草枯水平进行比较,观察对比两组死亡率。结果:两组在血液灌流前、后即刻血清百草枯水平无明显差异(P0.05),而血液灌流后24 h、48 h的百草枯水平两组较灌流前均有明显改善,但观察组患者改善程度更高(P0.05),治疗48 h后观察组血液乳酸、肌酐改善程度优于对照组,观察组的总体死亡率稍低于对照组(P0.05),且死亡患者生存时间延长。结论:对百草枯中毒患者增加高强度血液灌流联合血液滤过治疗能够改善病情,提高血清百草枯的清除效果,对预后有着明显的改善作用。     

血液灌流治疗百草枯中毒疗效观察

目的 探讨血液灌流治疗百草枯中毒的疗效。方法 40例百草枯中毒患者分为2组：对照组21例给予常规治疗；血液灌流组19例给予血液灌流联合常规治疗，对2组疗效进行观察。结果 与对照组比较，血液灌流组痊愈率、总有效率均高于对照组（P均〈0．05）；而其病死率、急性呼吸窘迫综合征、多器官功能衰竭发生率均明显降低于对照组（P均〈0．05）。2组存活患者地塞米松用量及住院时间比较差异有显著性（P〈0．01或0．05）。结论 血液灌流治疗百草枯中毒效果显著。     

急性百草枯中毒23例分析

目的：总结分析急性百草枯（PQ）中毒的临床特点及治疗效果。方法：对23例百草枯中毒患者临床资料进行回顾性分析。结果：23例中毒者存活8例，死亡15例，其中口服剂量小于10mL、10～30mL、大于30mL患者病死率分别为0、57．2％和91．6％；在服毒6h内和6h后经洗胃的患者，病死率分别为60％和100％；服毒12h内血液灌流治疗8例，死亡6例，病死率75％。结论：百草枯中毒预后与中毒剂量的大小、初始洗胃时间关系密切；早期血液净化治疗效果仍有争议。     

超声评分对膝骨性关节炎患者病变特点的评估价值

目的 探讨超声评分对膝骨性关节炎患者病情严重度的诊断价值。方法 回顾性收集我院收治的膝骨性关节炎患者52例,同期收集50例健康成人,分析超声评分与膝骨性关节炎患者病情严重度的相关性。结果 膝骨性关节炎患者超声评分显著高于健康成人(6.93±1.76 vs. 1.73±0.56,P=0.000)。膝骨性关节炎患者超声评分与髌上囊液体深度、髌下囊液体深度、关节腔液体深度、滑膜厚度显著正相关(r=0.265、0.216、0.310和0.255,P=0.004、0.035、0.000和0.012),与Lyshsolm显著负相关(r=-0.381,P=0.000)。与增生滑膜内血管阴性的患者相比,增生滑膜内血管阳性的患者超声评分显著增加(7.43±1.61 vs. 5.58±1.42, P=0.000)。结论 超声评分与膝骨性关节炎患者病情严重度相关。     

Use of the Role Checklist with the patient with multiple personality disorder

A paucity of occupational therapy evaluation tools exists for use with patients with multiple personality disorder. The Model of Human Occupation (Kielhofner & Burke, 1980), particularly the volition and habituation subsystems within this model, proved useful for the identification of the many facets of patients with multiple personality disorder on a short-term treatment unit. The Role Checklist (Oakley, Kielhofner, Barris, & Richler, 1986), a tool derived from the Model of Human Occupation, was adapted for use with this population and was found to be beneficial in the identification of common goals held by most of the personalities of each patient with multiple personality disorder. The use of the Role Checklist is illustrated with a case example.     

Living with a woman with fibromyalgia from the perspective of the husband

BACKGROUND: Fibromyalgia (FM) is a chronic pain syndrome, which affects mostly middle-aged women. The syndrome is poorly understood and treatment is mainly palliative. The diagnosis is established from diagnostic criteria. Living with FM means living a life greatly influenced by the illness in various ways for people affected. Aim of the study. The aim of this study was to describe the experiences of living with a woman with FM from the husbands' perspective. METHODS: Five men married to women with FM were interviewed using a narrative approach. The interviews were analysed using qualitative thematic content analysis. FINDINGS: The analysis resulted in the following seven themes: increasing responsibility and work in the home; being an advocate for and supporting the wife; learning to see the woman's changing needs; changing relationship between spouses; changing relationship with friends and relatives; deepening relationship with the children and lacking information and knowledge about FM. The findings show that the women's illness had a great impact on husbands' lives, and that husbands lacked information about the woman's illness. CONCLUSION: This study shows that it is not only the women with FM who experience a changed life; the whole family life is influenced and limited by FM. The husband's role in the family changes, first and foremost concerning responsibility and workload within the family. This must be taken into consideration in care planning. This study also highlighted the need of information and knowledge about FM expressed by the participants, information that health care personnel have a great responsibility to give.     

Experience with the use of plasmapheresis in the combined treatment of children with the crush syndrome

Plasmapheresis (PP) was applied to the treatment of 5 children aged 6-14 years with the crush syndrome. The multimodality treatment using antibiotics, erythrocytic mass, rheologically active preparations, hemodialysis and blood rheologically active preparations, hemodialysis and hemoperfusion carried out for 6-7 days before PP did not bring about any appreciable improvement of the patients' status. The patients failed to get rid of anuria and manifested the signs of increasing intoxication. The treatment with PP consisted of 1 to 6 procedures, in the course of which 70 to 85 of the design volume of the circulating plasma was removed. The use of PP resulted in the disappearance of myoglobin from the patients' blood and urine, in the normalization of the coagulogram, a considerable decrease of the content of medium molecules, and in the appearance of the first urine towards the end of the procedure. Thus, the introduction of PP into multimodality treatment of the crush syndrome made it possible to eliminate anuria, disseminated intravascular coagulation, and to noticeably reduce intoxication and to clear the blood off myoglobin.