地奥司明治疗下肢慢性静脉瓣膜功能不全21例

目的 观察地奥司明治疗下肢慢性静脉瓣膜功能不全（CVT）的疗效. 方法 CVT患者21例,给予地奥司明片,每次1 000 mg,bid,po. 在治疗后7,15,30,45和60 d进行小腿周径测定,观察患者症状、体征改善情况. 结果 治愈6例,好转15例,21例患者全部有效. 下肢沉重、酸胀、乏力及疼痛症状、浅静脉曲张程度、小腿周径均有明显改善. 结论 地奥司明片治疗CVI有效、安全,且无明显不良反应.     

术后并发静脉栓塞的原因分析与护理对策

下肢静脉栓塞是外科手术后一种常见并发症，尤其以小腿静脉丛血栓最常见。症状轻者有小腿部疼痛、压痛、肿胀，重者造成下肢功能不全，影响日常生活及工作，甚至可发展为肺栓塞。因此术后细心观察、良好的护理可预防下肢静脉栓塞的发生，减轻病人的痛苦。     

下肢深静脉瓣膜功能不全的外科治疗

目的探讨原发性下肢深静脉瓣膜功能不全的手术治疗方法及效果。方法对原发性下肢深静脉瓣膜功能不全50例患者56条肢体施行股浅静脉瓣膜包窄术,并同时行浅静脉手术。结果患者浅静脉曲张,下肢沉重感及肿胀均消失,足靴区溃疡愈合,1例继发血栓形成。结论本手术操作简便,合理选择手术适应证,是取得理想效果的关键。     

下肢静脉性溃疡的治疗

下肢静脉性溃疡是下肢各种静脉疾病所导致的慢性静脉功能不全，是最严重的并发症。其多由慢性下肢静脉瓣膜功能不全、静脉性高压所致。l999年3月至2004年3月我科共收治70例，疗效满意。现报告如下。     

老年人全髋关节置换术后并发下肢静脉栓塞的原因分析与护理

下肢深静脉栓塞是全髋关节置换术后常见的一种并发症，尤其是小腿静脉丛血栓最常见。症状轻者有小腿部疼痛、压痛、肿胀，重者可造成下肢功能不全，而影响日常生活，甚至可发展成肺栓塞，因此术后细心的观察，良好的护理，可预防下肢静脉栓塞的发生，减轻患者的痛苦。     

下肢浅静脉曲张患者小腿交通静脉的彩色多普勒超声研究

<正>下肢慢性静脉功能不全(chronic venous insufficiency,CVI)是血管外科的常见病和多发病。人群患病率高达27%[1],已有大量的研究证明浅静脉和深静脉功能不全的程度和临床症状表现的程度有关[2]。近年来人们逐渐认识到交通静脉(perforating veins,PVs)扩张或功能不全与下肢静脉功能不全患者的临床表现的关系。     

下肢静脉性溃疡的激光治疗

<正>下肢静脉性溃疡是下肢各种静脉疾病所导致的慢性静脉功能不全最终、也是最严重的并发症。其多由慢性下肢静脉瓣膜功能不全、静脉性高压所致。自2006年5月至2008年6月我科共收治静脉性溃疡患者106例,采用半导体激光(英国DIOMED810nm)处理,疗效满意,现报告如下。     

彩超在下肢交通支静脉功能不全诊断中的应用

下肢慢性静脉病主要包括单纯性下肢浅静脉曲张和原发性下肢深静脉瓣膜功能不全。临床表现为一系列症状,最典型的是下肢浅静脉曲张和静脉性溃疡,下肢慢性静脉疾病是严重影响患者的生活质量的常见病和多发病,其中大部分是由于静脉瓣膜功能不全引起的倒流性疾病,静脉倒流导致的下肢静脉压升高引起慢性静脉疾病症状发生和发展的主要原因之一。     

曲克芦丁颗粒剂的特性及临床效果

目的:研究曲克芦丁颗粒剂的特性,观察其对慢性静脉功能不全症的疗效.方法:考察曲克芦丁颗粒剂的流动性、溶出度和其中三羟乙基芦丁的比例以及对患者踝周径及其小腿最肿处周径的改善.结果:曲克芦丁颗粒剂具有良好的流动性和溶出度,其含三羟乙基芦丁的比例大于80%,服用3.5g·d-1曲克芦丁1个月能明显缩小患肢踝周径及其小腿最肿处周径.结论:曲克芦丁颗粒剂对治疗慢性静脉功能不全症有效.     

腔镜深筋膜下交通支静脉结扎术的临床应用

目的:讨论经腔镜深筋膜下交通支静脉结扎术治疗下肢慢性静脉功能不全的疗效。方法:对34例下肢慢性静脉功能不全病人施行经腔镜深筋膜下交通支静脉结扎术的临床资料进行回顾性分析。结果:手术效果明显,所有病人色素沉着、皮肤瘙痒明显改善,溃疡于8～40天愈合,无严重并发症发生。结论:经腔镜深筋膜下交通支静脉结扎术操作简便,是治疗下肢慢性静脉功能不全的重要组成部分。     

Therapeutic effects of hidrosmin on chronic venous insufficiency of the lower limbs.

A double-blind, placebo-controlled trial was carried out to assess the effectiveness of a new synthetic bioflavonoid, hidrosmin, in patients with chronic venous insufficiency of the lower limbs. Fifty-seven patients, showing varicose veins and ankle swelling and suffering from local pain and heaviness of the legs, were allocated at random to receive treatment for 45 days with 1 capsule 3-times daily of either 200 mg hidrosmin (30 patients) or placebo (27 patients). Pain and heavy legs were assessed using rating scales; swelling was assessed by a photographic method. The results showed that hidrosmin produced a significant clinical improvement in all of the parameters evaluated; compared with placebo, there was a marked reduction in the main subjective symptoms accompanied by a 10% reduction in swelling. Apart from 1 patient who complained of epigastric pain, there were no reports of adverse events during the study period.     

Therapeutic effects of hidrosmin on chronic venous insufficiency of the lower limbs

Summary

A double-blind, placebo-controlled trial was carried out to assess the effectiveness of a new synthetic bioflavonoid, hidrosmin, in patients with chronic venous insufficiency of the lower limbs. Fifty-seven patients, showing varicose veins and ankle swelling and suffering from local pain and heaviness of the legs, were allocated at random to receive treatment for 45 days with 1 capsule 3-times daily of either 200?mg hidrosmin (30 patients) or placebo (27 patients). Pain and heavy legs were assessed using rating scales; swelling was assessed by a photographic method. The results showed that hidrosmin produced a significant clinical improvement in all of the parameters evaluated; compared with placebo, there was a marked reduction in the main subjective symptoms accompanied by a 10% reduction in swelling. Apart from 1 patient who complained of epigastric pain, there were no reports of adverse events during the study period.     

硫酸吗啡控释片直肠给药治疗中晚期癌性疼痛临床疗效观察

目的:评价中晚期癌性疼痛患者应用硫酸吗啡控释片直肠给药的治疗效果和安全性。方法:100例患者随机分为试验组(n=50)与对照组(n=50),试验组先直肠给予硫酸吗啡控释片30mg,12h1次,连用14d,再口服30mg,12h1次,连用14d;对照组先口服给予硫酸吗啡控释片30mg,12h1次,连用14d,再直肠给予30mg,12h1次,连用14d。结果:试验组与对照组组间、组内疼痛缓解率、生活质量改善情况、不良反应发生率比较差异无统计学意义(P>0.05),但直肠给药的镇痛起效时间快于口服给药(P<0.05)。结论:硫酸吗啡控释片直肠给药临床效果确切,不良反应少于口服给药,适用于不能口服或口服不良反应较多的患者。     

重症感染肿瘤患者使用万古霉素致相关肾功能不全的危险因素分析

目的:统计分析肿瘤患者使用万古霉素治疗重症感染致肾功能不全的发生率及相关危险因素。方法:回顾我院24个月共87例入住重症监护病房的重症感染肿瘤患者使用万古霉素的病历,采集包括合并慢性疾病情况、合并肾毒性药物情况、用药前肿瘤治疗情况(是否手术、放疗、化疗)及急性生理与慢性健康评分(APACHE-Ⅱ评分)等数据,详细记录万古霉素的剂量、疗程及用药前后血肌酐水平等。使用SPSS 21.0统计学软件,进行单变量及多变量分析(χ²检验, P<0.05定义为差异有统计学意义)。结果:纳入病例中57例(65.5%)患者APACHE-Ⅱ评分在15分以上,24例(27.6%)患者合并慢性疾病(高血压、糖尿病、慢性阻塞性肺疾病等),34例(39.1%)患者万古霉素使用疗程在7 d以上,50例(57.5%)患者用药前30 d内行手术治疗,13例(14.9%)患者用药前30 d内行放射治疗,23例(26.4%)患者用药前30 d内行肿瘤化疗。18例(20.7%)患者在使用万古霉素后至停药14 d内出现不同程度的肾功能不全。单变量分析显示年龄、性别、合并慢性疾病情况、药物使用疗程、用药前手术、放疗、用药前血肌酐水平及合用潜在肾毒性药物情况对用药后肾功能不全的发生无显著影响。APACHE-Ⅱ评分、用药前30 d内行肿瘤化疗对用药后肾功能不全发生率有显著影响(P=0.034、P=0.011)。结论:APACHE-Ⅱ评分较高及用药前30 d曾行化疗的肿瘤患者在发生重症感染使用万古霉素时发生肾功能不全的风险增加,应特别注意。     

Edema in a patient receiving methadone for chronic low back pain.

PURPOSE: The case of a patient who developed edema after receiving methadone for chronic low back pain is reported. SUMMARY: A 45-year-old white woman developed edema in her lower extremities one week after starting methadone, etodolac, and gabapentin as part of her treatment for chronic low back pain. She was taking methadone as part of her treatment regimen to manage her pain in addition to other agents, including etodolac and gabapentin. After several days on this therapy, she developed edema and stated that she was "feeling drunk." At that time the etodolac and gabapentin were stopped, and the methadone dosage was increased. Several days later, the patient returned to the pain clinic, complaining of continued swelling. The methadone dosage was then decreased, and a diuretic was added to treat the edema; however, her edema did not resolve with the lower dosage of methadone. Methadone was then discontinued, and a fentanyl patch was prescribed. Prednisone was also prescribed, and the dosage of the diuretic was increased. The patient's symptoms resolved, and prednisone was ultimately tapered. The likelihood that the administration of methadone was related to the development of edema in this patient was determined to be probable. There have been a few cases reported in the literature regarding the development of edema with methadone use. In the cases reported, the edema developed after three to six months of methadone therapy. CONCLUSION: A patient with chronic low back pain developed edema one week after receiving methadone as part of her pain management regimen.     

Tramadol/paracetamol

The orally administered fixed combination tablet of tramadol (centrally-acting opiate) plus paracetamol (acetaminophen; nonopiate, nonsalicylate analgesic) [37.5/325 mg] provides effective analgesia in patients with moderate to severe acute pain and those with chronic painful conditions characterised by intermittent exacerbations of pain. Two tramadol/paracetamol 37.5/325 mg tablets provided greater relief of dental pain over an 8-hour period than either agent alone, with a faster onset of action than tramadol alone and a longer duration of action than either agent as monotherapy. In patients with postoperative dental pain, two tramadol/paracetamol tablets (37.5/325 mg) provided similar analgesia to hydrocodone/paracetamol 10/650 mg over an 8-hour period. The addition of one or two tramadol/paracetamol 37.5/32 5mg tablets (up to four times daily) for 5 days to existing NSAID or cyclo-oxygenase-2 inhibitor analgesic therapy provided effective pain relief in patients with osteoarthritis flare pain. Tramadol/paracetamol 37.5/325 mg provided similar efficacy to that of codeine/paracetamol 30/300 mg in patients with chronic back pain in a 4-week, randomised, double-blind trial (a maximum of 10 tablets or capsules per day of the active drug).     

迈之灵合并地奥司明治疗下肢静脉功能不全的疗效观察

目的：观察迈之灵合并地奥司明治疗下肢静脉功能不全的临床疗效。方法：随机抽取2012年4月～2013年6月在我院住院的患者50例（患有下肢静脉功能不全）。采用双盲随机分组法分为两组,其中25例单用地奥司明片,每日午餐、晚餐时各服1次,1片/次。联合治疗组25例,服用地奥司明片,每日午餐、晚餐时各服1次,1片/次;同时服用迈之灵片,每日早晚各服1次,2片/次,疗程为20d。结果：合并治疗组治疗前后小腿周径的变化有显著差异,联合治疗组治愈率及总有效率分别为40%、92%,单用地奥司明治疗组治愈率及总有效率分别为24%、68%。结论：迈之灵合并地奥司明治疗下肢静脉功能不全的疗效确切、可靠,值得推广。     

复方甘草酸苷注射液引起假性醛固酮增多症

1例38岁女性患者,因服用酮康唑导致药物性肝损害入院。入院后给予复方甘草酸苷注射液100ml（含甘草酸苷200mg）加入5%葡萄糖注射液250ml静脉滴注,共2周。随后,患者出现全身水肿,双下肢明显,血压波动在136～140/90～100mmHg,血钾2.56mmol/L。停用该药,给予螺内酯片及氯化钾控释片治疗,7d后症状好转。入院26d痊愈出院,随访2周无不适。     

福多司坦片治疗慢性呼吸道疾病的祛痰作用观察

目的 评价福多司坦片祛痰作用的安全性与疗效。方法 以盐酸氨溴索片为对照药，采用随机双盲、平行对照的试验方法，将30例有慢性呼吸道疾病的患者随机分为两组，即福多斯坦组16例和盐酸氨溴索组14例。福多司坦组给予福多司坦片，每次400 mg，tid，饭后服用；盐酸氨溴索组给予盐酸氨溴索片，每次60 mg，tid，饭后服用。均连续用药7 d。结果 福多司坦组临床有效率93.75%，盐酸氨溴索组92.86%，两组比较差异无显著性（P＞0.05）；盐酸氨溴索组中有1例出现胃酸增多，数小时后消失。结论 福多司坦片是一种安全有效的祛痰药物。     

地奥司明片减轻肛门直肠手术后水肿、疼痛和促进创面愈合的临床观察

目的：观察地奥司明片减轻肛门直肠手术后水肿、疼痛和促进创面愈合的临床效果。方法：将我院2011年3—9月260例行肛门直肠手术患者随机分为治疗组（136例）和对照组（124例）。治疗组术后第l天开始服用地奥司明片,每次2片（每片0．45g）,每日2次,连服7d;对照组术后不口服地奥司明片及其他止痛、消炎药物。对2组患者术后创面局部水肿和疼痛情况及创面愈合时间进行比较。并观察不良反应。结果：治疗组术后48、72h和7d的水肿和疼痛评分及总评分较对照组显著改善（P〈0．01）;治疗组术后平均创面愈合时间显著短于对照组（P〈0．01）。2组患者均未见不良反应发生。结论：地奥司明片能有效减轻患者肛门直肠手术后水肿和疼痛症状,促进创面愈合,且安全性较好。