链霉蛋白酶联合医用胃镜胶在无痛胃镜检查前胃腔准备中的应用效果观察

目的观察链霉蛋白酶联合医用胃镜胶在无痛胃镜检查前胃腔准备中的应用效果。方法选取行无痛胃镜检查的患者1890例,采用随机数字表法分为3组。3组患者检查前胃腔准备方法不同,链霉蛋白酶+医用胃镜胶组（648例）患者应用链霉蛋白酶+医用胃镜胶+复方盐酸利多卡因胶浆,医用胃镜胶组（630例）应用医用胃镜胶+复方盐酸利多卡因胶浆,对照组（612例）单用复方盐酸利多卡因胶浆。观察并比较3组患者胃镜视野清晰度与早期胃癌检出率。结果3组患者胃镜视野清晰度比较差异有统计学意义（P＜0.05）,组间两两比较差异亦均有统计学意义（均P＜0.05）。链霉蛋白酶+医用胃镜胶组、医用胃镜胶组和对照组患者胃镜视野优良率分别为86.6%、70.5%、27.3%,链霉蛋白酶＋医用胃镜胶组患者胃镜视野清晰度优于医用胃镜胶组,医用胃镜胶组患者胃镜视野清晰度优于对照组。链霉蛋白酶+医用胃镜胶组、医用胃镜胶组、对照组患者早期胃癌检出率分别为0.46%（3/648）、0.32%（2/630）、0.16%（1/612）,差异无统计学意义（P＞0.05）。结论患者无痛胃镜检查前服用链霉蛋白酶联合医用胃镜胶可明显提高胃镜视野清晰度,且对早期胃癌的检出率无不良影响,值得临床推广应用。     

无痛胃镜检查应用盐酸达克罗宁胶浆与二甲硅油乳剂的疗效研究

目的比较无痛胃镜检查应用盐酸达克罗宁胶浆与二甲硅油乳剂的效果。方法选取2018年9月至2019年5月鹤壁市人民医院收治的98例行无痛胃镜检查术患者,采用随机数字表法分为实验组50例和对照组48例。对照组术前口服二甲硅油乳剂;实验组术前口服盐酸达克罗宁胶浆。比较两组临床疗效、胃镜下不同部位黏膜视野清晰度和不良反应发生情况。结果实验组临床总有效率高于对照组(100.00%vs. 91.67%)(P<0.05)。实验组胃窦、胃角、胃体、胃底及食管黏膜视野清晰度评分高于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论无痛胃镜检查应用盐酸达克罗宁胶浆临床效果理想,其能够有效提高胃镜下不同部位的视野清晰度,且不增加患者的不良反应发生率。     

盐酸利多卡因胶浆加二甲硅油散在胃镜检查时局麻疗效观察

目的:观察盐酸利多卡因胶浆加二甲硅油散与盐酸利多卡因胶浆在胃镜检查时的疗效对比。方法:随机将96例患者分成观察组与对照组各48例,观察组检查前含服盐酸利多卡因胶浆加二甲硅油散,对照组检查前含服盐酸利多卡因胶浆行表面麻醉,比较两组患者胃镜检查时不适程度、胃镜检查视野清晰度。结果:两组胃镜检查时恶心程度接近,轻度(X~2=0.17,P=0.681)、中度(X~2=0.00,P=1.000)、重度(X~2=0.33,P=0.563),差异无统计学意义(P0.05);观察组胃镜检查视野清晰度1级例数显著高于对照组(X~2=9.50,P=0.002)。结论:盐酸利多卡因胶浆加二甲硅油散与盐酸利多卡因胶浆都能减轻患者胃镜检查时的恶心感,但盐酸利多卡因胶浆加二甲硅油散更能增加胃镜检查时的视野清晰度。     

链霉蛋白酶在微探头超声内镜检查中的作用

目的：探讨链霉蛋白酶颗粒对微探头超声内镜（MPS）图像清晰度的影响。方法：将40例行胃MPS检查患者分为两组：利多卡因组19例,检查前10 min服用利多卡因胶浆10 ml;联合组21例,在服用利多卡因胶浆基础上,检查前20 min加服链霉蛋白酶颗粒。观察两组患者内镜可见度、超声内镜图像清晰度及操作完成时间。结果：联合组内镜可见度评分及超声图像清晰度评分均明显高于利多卡因组（P〈0.01）,操作完成时间短于利多卡因组（P〈0.01）。结论：链霉蛋白酶可提高胃内清洁度,增加MPS图像的清晰度,减少检查操作时间,值得临床推广使用。     

链霉蛋白酶应用于胃镜检查的效果观察

目的探讨链霉蛋白酶在胃镜检查中的应用效果。方法将接受胃镜检查的270例患者按随机数字表法分为2组:试验组129例,检查前30min口服链霉蛋白酶和碳酸氢钠的混合液50mL,并于检查前10min口服盐酸利多卡因胶浆10mL;对照组141例,检查前10min口服盐酸利多卡因胶浆10mL。胃镜检查时分别对胃底、胃体上部、胃体下部、胃窦的黏膜清晰度进行评分,比较2组萎缩性胃炎及伴有肠上皮化生检出率。结果试验组胃底、胃体上部、胃体下部、胃窦黏膜以及总黏膜清晰度评分分别为(1.81±0.88)、(1.53±0.72)、(1.29±0.50)、(1.47±0.71)、(6.09±1.87)分,对照组分别为(2.48±0.67)、(2.37±0.80)、(2.31±0.78)、(2.12±0.83)、(9.23±2.39)分,试验组各部位及总胃黏膜评分均显著低于对照组,差异有统计学意义(P<0.001)。试验组对萎缩性胃炎及伴有肠上皮化生检出率显著高于对照组(17.8%比10.6%,P<0.05)。结论链霉蛋白酶能有效提高胃镜检查时胃黏膜清晰度,有利于胃黏膜微小病变的发现。 更多还原     

西甲硅油在胃镜检查中的祛泡作用

目的:探讨西甲硅油在胃镜检查中的祛泡作用。方法:将行胃镜检查的患者随机分为两组。检查前研究组予西甲硅油8ml 盐酸利多卡因胶浆10ml口服,对照组予盐酸利多卡因胶浆10ml口服。根据胃镜下视野清晰程度分成A、B、C、D 4级,记录每例患者检查时间。结果:服用西甲硅油组胃镜下视野清晰度明显高于对照组(P<0.05),检查时间显著少于对照组(P<0.01)。结论:应用西甲硅油能够明显提高视野清晰度,缩短检查时间,可作为胃镜检查前的常规辅助用药。     

链霉蛋白酶对上消化道内镜检查胃内清晰度的效果观察

目的:评价行胃镜检查的患者使用链霉蛋白酶后胃腔内的清晰度,探讨链霉蛋白酶协助胃镜检查的有效性。方法:收集胃镜检查的100例患者,分为试验组(给药链霉蛋白酶)和对照组(给药Na Cl溶液),分别比较其胃腔内的清晰度评分。结果:试验组使用链霉蛋白酶后胃内清晰度明显较对照组为高。结论:链霉蛋白酶能有效提高胃内清晰度,可作为检查前的辅助手段。     

链霉蛋白酶在无痛胃镜检查中的应用

目的:探讨链霉蛋白酶在无痛胃镜检查中的应用价值。方法:560例无痛胃镜检查者随机分为口服链霉蛋白酶组、对照组,观察两组患者检查过程中消化道气泡产生程度、视野清晰度。结果:口服链霉蛋白酶组气泡程度明显低于对照组,清晰度明显高于对照组,两组比较差异有统计学意义(P<0.05)。结论:链霉蛋白酶在胃镜检查中消泡效果明显。     

盐酸达克罗宁与利多卡因在胃镜检查前准备中应用比较

目的比较盐酸达克罗宁与利多卡因在胃镜检查前准备中应用效果。方法选取2016年5月至2017年4月于本院进行胃镜检查的患者74例,采取随机数字表法将其分为观察组(使用盐酸达克罗宁胶浆)和对照组(使用利多卡因),各37例。比较两组患者的麻醉效果、祛泡效果和不良反应发生率。结果对照组患者麻醉效果较观察组差,差异有统计学意义(P0.05);对照组患者祛泡效果较观察组差,差异有统计学意义(P0.05);两组患者均未发生严重不良反应。结论在患者行胃镜检查过程中使用盐酸达克罗宁可有效增加麻醉效果,减轻患者疼痛,同时可清除胃镜检查过程中产生的泡沫,增加胃镜检查的清晰度,提升诊断准确率。     

盐酸利多卡因胶浆在纤维支气管镜检查中的应用

目的 探讨纤维支气管镜检查中应用盐酸利多卡因胶浆的临床效果.方法 纤维支气管镜检查住ICU患者60例,分为对照组（30例）和实验组（30例）.对照组,采用常规纤维支气管镜检查法,实验组采用常规纤维支气管镜检查法,同时用盐酸利多卡因胶浆涂抹纤维支气管镜再行检查,观察血流动力学、不良反应、一次性置管顺利程度及在气管内停留时间.结果 操纵过程中实验组收缩压、舒张压及心率均显著低于对照组,差异均有统计学意义（ P＜0.05）.实验组恶心、喉和支气管痉挛及呛咳的发生率分别为23.3%、10%、6.7%,显著低于对照组（P＜0.05）;实验组纤支镜一次性检查顺利率（93.3%）显著高于对照组（56.7%）,P＜0.01;实验组纤支镜在气管内停留时间[（3.07±1.36）分]显著短于对照组[（5.00±1.31）,（P＜0.001）].结论 在纤支镜检查中使用盐酸利多卡因胶浆可使患者血流动力学稳定,减少操作中的不良反应,从而一次性置管顺利,缩短了操作时间.     

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.