BiPAP治疗急性心源性肺水肿的临床观察

目的观察无创鼻/面罩BiPAP正压通气治疗急性心源性肺水肿的临床疗效。方法将78例急性心源性肺水肿患者随机分为治疗组40例,对照组38例,均常规抗心力衰竭治疗,但治疗组同时予以鼻/面罩正压通气治疗,观察两组治疗前后血pH值、PaO2、SaO2、PaCO2,观察血压、心率、呼吸及临床症状,并进行临床分析,(同时与38例常规药物治疗组相对照)。结果BiPAP组所有患者临床症状明显改善,总有效率95%,心率、呼吸频率、与治疗前比较显著降低(P<0.05);PaO2、SaO2、与治疗前比较显著增高,对照组总有效率为73.68%。结论无创性BiPAP呼吸机正压通气治疗急性心源性肺水肿是有效的,值得临床推广。     

BiPAP治疗重症肺炎致急性呼吸衰竭疗效观察

目的评价无创双水平气道正压通气(BiPAP)对重症肺炎所致急性呼吸衰竭(ARF)的治疗效果。方法采用BiPAP呼吸机治疗重症肺炎所致急性呼吸衰竭(ARF)患者25例,观察治疗效果。结果治疗前后PaO2和PaO2/FiO2比较差异有显著性(P<0.05)。结论用BiPAP正压通气治疗重症肺炎所致急性呼吸衰竭疗效肯定。     

无创双水平气道正压通气治疗心源性肺水肿所致的急性呼吸衰竭

目的观察无创双水平气道正压通气(B iPAP)对心源性肺水肿(CPE)所致的急性呼吸衰竭(ARF)的疗效,评估B iPAP在CPE治疗中的作用。方法采用B iPAP呼吸机经面罩气道正压通气治疗CPE所致ARF患者50例。结果CPE患者治疗前后PaO2和SaO2得到明显改善(P<0.01),且CPE治疗后临床症状和呼吸动力学得到明显改善。结论B iPAP对CPE所致ARF是一种有效、无创的治疗方法。     

无创机械通气治疗慢性阻塞性肺疾病并呼吸衰竭79例临床分析

目的：探讨面罩双水平气道正压无创通气（BiPAP）治疗慢性阻塞性肺疾病（COPD）并急性呼吸衰竭的临床应用价值。方法：对COPD并Ⅱ型呼衰患者79例采用BiPAP呼吸机经口鼻面罩正压通气，记录通气治疗前及通气治疗后2h，24h的pH，PaO2，PaCO2，SaO2变化。结果：72例患者经无创通气后PaO2，SaO2均明显升高，PaCO2明显降低，pH明显改善，差异有显著性（P〈0．01）。结论：BiPAP呼吸机经口鼻面罩无创通气治疗COPD并Ⅱ型呼吸衰竭，提高PaO2，SaO2，降低PaCO2，纠正pH，疗效满意，简单实用，值得推广。     

应用BiPAP无创机械通气治疗急性心源性肺水肿的疗效观察

目的 评价BiPAP无创机械通气治疗急性心源性肺水肿的疗效.方法 对我院收治的急性心源性肺水肿随机分为两组,治疗组25例急性心源性肺水肿患者在传统常规治疗同时加用BiPAP呼吸机经鼻(面)罩双水平气道正压通气治疗,时照组23例在传统常规治疗上加用鼻导管给氧治疗.结果 BiPAP组通气治疗后,23例患者临床症状明显改善,血气分析中pH、PaO2、PaCO2、SaO2等参数比较有显著性差异(P<0.05),总有效率为92.0%,避免了气管插管机械通气.对照组总有效率为73.9%.结论 BiPAP无创机械通气治疗急性心源性肺水肿能迅速纠正缺氧、改善心功能,可作为抢救急性心源性肺水肿的一种安全有效的方法.     

BiPAP呼吸机治疗急性呼吸衰竭的疗效观察

目的 :探讨 (鼻 )面罩双水平气道正压通气 (BiPAP)对急性呼吸衰竭的治疗作用。方法 :18例急性呼吸衰竭患者应用BiPAP呼吸辅助通气治疗 ,记录通气前及通气治疗 12h后呼吸空气条件下患者的血气分析结果。结果 :治疗前PaCO2 [(6 6± 15 )mmHg]、PaO2 [(45± 15 )mmHg],治疗后PaCO2 [(45± 10 )mmHg]、PaO2 [(80± 15 )mmHg],治疗前后比较有显著差异 (P <0 .0 5 )。 结论 :应用BiPAP呼吸机辅助通气治疗急性呼吸衰竭 ,可提高PaO2 ,为呼吸衰竭的病因治疗赢得时间。     

COPD合并Ⅱ型呼吸衰竭应用无创正压通气呼吸机的护理

目的:探讨面罩无创双水平气道正压通气(BiPAP)用于治疗COPD合并Ⅱ型呼吸衰竭的临床疗效及护理。方法:42例患者常规治疗外,均使用BiPAP呼吸机辅助通气,治疗前、后血气分析比较。结果:治疗后血气分析PaO2、SaO2较治疗前明显上升;患者症状不同程度改善。结论:BiPAP呼吸机对治疗COPD合并Ⅱ型呼吸衰竭临床疗效明显,值得进一步推广。     

BiPAP治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭疗效观察

目的:探讨无创通气治疗慢性阻塞性肺疾病(COPD)并Ⅱ型呼吸衰竭的临床应用价值。方法:对38例COPD并Ⅱ型呼吸衰竭患者采用BiPAP呼吸机经口鼻面罩正压通气,观察治疗前后血气分析之PH、PaO2、PaCO2、SaO2、HR指标变化。结果:通气后PaO2明显升高,PaCO2明显降低,PH明显改善,差异均有显著性(P<0.05)。结论:BiPAP呼吸机经口鼻面罩无创正压通气治疗COPD并Ⅱ型呼吸衰竭疗效满意,无明显并发症,值得临床推广应用。     

无创双水平气道正压通气治疗不同病因致急性呼吸衰竭的疗效观察

目的研究无创双水平正压通气(BiPAP)对慢性阻塞性肺病、急性心源性肺水肿和重症社区获得性肺炎所致呼吸衰竭的治疗效果。方法48例急性呼吸衰竭患者分为慢性阻塞性肺病组(30例)、心源性肺水肿组(7例)和重症肺炎组(11例),均应用BiPAP进行治疗,观察三组的治疗效果。结果三组患者应用BiPAP治疗后早期氧合均得到明显改善;心源性肺水肿组在BiPAP治疗时间方面均明显低于慢性阻塞性肺病组、重症肺炎组。结论无创正压通气在早期可以纠正慢性阻塞性肺病、心源性肺水肿和重症肺炎合并呼吸衰竭患者的氧合,但最终的预后因呼吸衰竭的病因不同有较大区别。     

无创正压通气治疗COPO并Ⅱ型呼吸衰竭30例体会

目的：探讨无创正压通气治疗慢性阻塞性肺疾病（COPD）并Ⅱ型呼吸衰竭的疗效。方法：对30例慢性阻塞性肺疾病（COPD）并Ⅱ型呼吸衰竭采用BiPAP呼吸机经口鼻面罩正压通气。观察：治疗前后血气分析的pH、PaO2、PaCO2、SaO2、指标变化。结果：无创正压通气后PaO2、SaO2均明显升高,PaCO2明显降低,pH明显改善,差异均有显著性（P〈0.01）。结论：BiPAP呼吸机经口鼻面罩无创正压通气治疗慢性阻塞性肺疾病（COPD）并Ⅱ型呼吸衰竭疗效满意,无并发症,值得临床推广应用。     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.