糖尿病合并肾病血液透析治疗临床效果观察

目的:探讨对糖尿病合并肾病患者利用血液透析方法进行治疗所取得的临床效果。方法:选择曾于我院进行治疗的54例糖尿病合并肾病患者,这些患者中,有27例患者为糖尿病终末期肾病患者,将其作为观察组,另外27例为非糖尿病终末期肾病患者,将其作为对照组,对这两组患者均进行血液透析治疗,完成治疗后对两组患者的临床治疗效果进行比较。结果:在完成治疗之后,比较两组患者的并发症发生率,观察组中患者高于对照组,比较两组患者1年以及3年死亡率,观察组中患者高于对照组,首次透析时,观察组中存活患者与死亡患者在肾功能方面比较,有显著差异存在。结论:利用血液透析方法对糖尿病合并肾病患者进行治疗,可取的较好临床效果,能够使患者生还率得到有效提高,但是在进行透析时,要掌握好透析最佳时机,并且要对心血管疾病进行较好预防以及控制,从而使治疗效果得以提高,提高患者的生存质量。     

终末期糖尿病肾病维持性血液透析患者并发结核感染11例临床分析

目的:分析终末期糖尿病肾病维持性血液透析患者并发结核菌感染的临床特点。方法:2007-2011年武汉市第三医院肾内科血液透析中心收治终末期糖尿病肾病维持性血液透析患者72例,其中并发结核感染11例,收集其临床资料、实验室检查,分析患者的临床表现、诊断及治疗转归情况。结果:11例(15.27%)终末期糖尿病肾病维持性血液透析合并结核菌感染患者中,有4例肺结核,3例胸膜结核,2例结核性腹膜炎,1例脊柱结核,1例部位不明。在给予抗结核治疗后,5例患者症状明显缓解,6例患者经治疗无效死亡。结论:终末期糖尿病肾病合并结核感染几率大,预后差,死亡率高。     

不同透析方式对非糖尿病终末期肾病患者胰岛素抵抗、冠状动脉钙化以及脂质代谢影响的对比分析

目的:探究不同透析方式对非糖尿病终末期肾病患者胰岛素抵抗、冠状动脉钙化以及脂质代谢影响。方法:选取2018年1—12月期间我院收治的60例非糖尿病终末期肾病患者,根据患者治疗方法分为研究组(血液透析治疗)与对照组(腹膜透析治疗),各30例,分别观察两组患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、CACS评分、胰岛素抵抗(IR)。结果:研究组TC、TG、LDL-C、CACS评分、IR均低于对照组,HDL-C水平则高于对照组(P<0.05)。结论:长期多次使用腹膜透析可导致非糖尿病终末期肾病患者胰岛素抵抗、脂质代谢出现障碍以及加重冠状动脉钙化情况,治疗过程中应首选血液透析治疗。     

糖尿病肾病血液透析患者发生肺炎的相关因素分析

目的：：对糖尿病肾病血液透析患者发生肺炎的相关因素进行探讨,为临床治疗和干预提供理论依据。方法：选取2010年6月至2015年6月期间于我院血液透析中心进行透析的300例患者作为研究对象。根据患者有无合并糖尿病肾病分为糖尿病肾病组和非糖尿病肾病组。对2组患者肺炎发生情况进行分析,探讨糖尿病肾病血液透析患者发生肺炎的相关因素。结果：1.糖尿病肾病组患者年龄大,高血压（76％）、脑卒中（32％）发病率明显高于非糖尿病肾病组（63.6％、2.8％）,差异具有统计学意义;2.糖尿病肾病组患者 BMI 更高,舒张压、平均动脉压、血清白蛋白较低,在 BMI、eGFR、舒张压、平均动脉压、血清白蛋白等指标方面与非糖尿病肾病组患者相比,差异具有统计学意义;3.共有20例（6.7％）患者发生肺炎,其中糖尿病肾病组有6例,非糖尿病肾病组14例,2组之间差异具有统计学意义。4.多因素 COX 回归分析高 BMI 及低血清白蛋白是糖尿病肾病组患者发生肺炎的独立危险因素。结论：高 BMI 及低血清白蛋白是糖尿病肾病组患者发生肺炎的独立危险因素,对于接受血液透析治疗的糖尿病肾病患者应注意控制体重,预防发生营养不良。     

终末期肾病维持性血液透析患者死亡原因及相关因素分析

目的探讨终末期肾病维持性血液透析患者的死亡原因及相关因素。方法回顾性分析该院2010年10月—2012年10月终末期肾病维持性血液透析患者53例的临床资料。结果 53例终末期肾病维持性血液透析患者中,死亡14例,其中心血管疾病6例(42.9%)、脑血管疾病5例(35.7%)、多脏器衰竭2例(14.3%)、消化道出血1例(7.1%)。死亡组血肌酐、总胆固醇、甘油三酯均显著高于存活组,死亡组血红蛋白、血浆白蛋白均显著低于存活组,差异有统计学意义(P<0.05)。死亡组甲状旁腺素高于对照组,差异无统计学意义(P>0.05)。血肌酐、血红蛋白、血浆白蛋白、总胆固醇、甘油三酯均是患者死亡的危险因素。结论终末期肾病维持性血液透析患者死亡原因多为心脑血管疾病,贫血、高胆固醇症、低蛋白血症均是独立危险因素。     

医学精细营养疗法对终末期肾病血液透析患者营养状况的影响

目的:探讨医学精细营养疗法应用于终末期肾病血液透析患者的效果。方法:选取在本院行血液透析的终末期肾病患者共95例根据入院时间分为两组,对照组47例予常规健康及饮食指导,研究组48例在对照组基础上增加医学精细营养疗法。对比干预后两组患者营养风险发生率、自身营养状况。结果:干预后研究组患者营养风险发生率显著低于对照组(P<0. 05);研究组的体重指数(BMI)、血清白蛋白(Alb)、血红蛋白(Hb)水平均高于对照组(P<0. 05)。结论:医学精细营养疗法可改善终末期肾病血液透析患者的营养状况,降低营养风险的发生。     

基于健康信念模式的护理干预对糖尿病肾病血液透析患者自我护理的应用效果

目的探讨基于健康信念模式的护理干预在糖尿病肾病行血液透析治疗患者中应用效果。方法选取2019年10月-2021年10月在我院接受血液透析治疗的66例糖尿病肾病患者,根据随机数字表达法将其分为研究组和对照组,每组各33例。对照组行常规健康宣教,研究组在常规护理基础上行基于健康信念模式的护理干预,观察两组患者干预前后自我护理能力和血液透析并发症发生情况。结果干预后,研究组患者自我护理能力量表(the exercise of self-care agency scale,ESCA)4维度评分高于对照组(P<0.05);干预后,研究组血液透析并发症发生率显著低于对照组(P<0.05)。结论基于健康信念模式的护理干预在糖尿病肾病行血液透析治疗中应用效果较好,可以有效提升患者自我护理能力,降低血液透析治疗中并发症发生的风险。     

终末期肾病给予腹膜透析联合血液透析治疗的临床研究

目的探析终末期肾病给予腹膜透析联合血液透析的治疗效果。方法选取2016年4月至2018年4月我院接诊的86例终末期肾病患者,采用随机数表法将其分为两组,各43例。研究组给予腹膜透析联合血液透析治疗,对照组仅给予腹膜透析治疗,比较治疗效果。结果研究组患者体重、血浆白蛋白、血红蛋白指数均高于对照组,24 h尿量、血小板计数均低于对照组,不良事件发生率低于对照组,差异显著(P0.05)。结论终末期肾病给予腹膜透析联合血液透析治疗安全可靠,值得推广应用。     

血液透析联合血液灌流对终末期糖尿病肾病患者胰岛素抵抗及营养状态的影响

目的 :对血液透析联合血液灌流对终末期糖尿病肾病患者胰岛素抵抗及营养状态的影响进行详细探究.方法 :随机选取2015年5月至2016年5月本院收治的40例终末期糖尿病肾病患者作为研究对象,对于观察组患者,采用血液透析联合血液灌流治疗法,对于对照组患者,采用血液透析联合血液透析滤过治疗法.对两组患者疗效进行比较.结果 :观察组患者FBG、FINS以及Homa-IR均明显低于对照组患者,观察组患者SAG、BMI以及TSF均明显高于对照组患者,组间差异具有统计学意义,P<0.05.结论 :对于终末期糖尿病肾病患者采用血液透析联合血液灌流治疗方法,有利于改善患者者胰岛素抵抗现象以及营养状态,值得推广和应用.     

探讨优质护理对终末期糖尿病肾病血液透析患者的效果

目的:探讨优质护理对终末期糖尿病肾病血液透析患者的效果.方法:选取该院2016年2月至2017年2月共130例终末期糖尿病肾病血液透析患者,以随机分配为原则,分为观察组和对照组各65例.对照组采用常规护理,观察组采用优质护理,对比两组患者的护理结果.结果:观察组患者身体舒适度高于对照组(P＜0.05);观察组患者并发症发生率、SAS评分、SDS评分均低于对照组患者(P＜0.05).结论:优质护理对终末期糖尿病肾病血液透析患者具有良好的效果,能有效降低患者并发症发生率,提高患者的身体舒适度,缓解患者的不良情绪,提高治疗依从度,值得在临床推广应用.     

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.