住院医师精神心理因素与变应性鼻炎的相关性研究

目的 研究精神心理因素对患有变应性鼻炎的住院医师生活质量的影响,焦虑、抑郁等精神心理因素与其生活质量是否相关。 方法 通过纤维鼻镜方法筛选住院医师中70例变应性鼻炎患者,通过焦虑、抑郁自评表与生活质量量表(SF-36量表)进行评分,并根据评分结果进行统计学分析,从而观察焦虑、抑郁等因素对罹患变应性鼻炎的住院医师生活质量的影响。 结果 罹患变应性鼻炎的住院医师的焦虑、抑郁等因素与其生活质量之间存在着统计学上的负相关。 结论 伴随焦虑及抑郁心理的加重,罹患变应性鼻炎的住院医师生活质量明显下降。     

老年非变应性鼻炎患者焦虑抑郁状态分析与生活质量评估

目的 研究老年非变应性鼻炎(non-allergic rhinitis,NAR)患者的焦虑抑郁状况及生活质量.方法 病例组为老年NAR患者82例,选择同期健康老年人75名为对照组.病例组在治疗前后以及对照组均采用焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rati...     

变应性鼻炎患者生活质量调查

目的:获取变应性鼻炎患者生活质量资料,评价汉化版生活质量量表(SF36)在变应性鼻炎患者生活质量评估中的应用。方法:2004年5～7月诊断为变应性鼻炎患者150例(鼻炎组),其中轻度68例(轻度鼻炎组),中重度82例(中重度鼻炎组),采用问卷调查方式,内容包括一般资料、症状问卷量表和SF36,将其所得分数与健康对照组进行比较。结果:①轻度鼻炎组生活质量与健康对照组比较,在总体健康、情感职能和生理职能3个维度积分出现下降(P<0.05)。②中重度鼻炎组的生活质量受到严重影响,各个维度积分均有显著下降(均P<0.05),在总体健康、情感职能和社会功能等维度生活质量下降最为明显。结论:变应性鼻炎严重影响患者的生活质量。中文版SF36可用于中国变应性鼻炎患者的生活质量评估。     

变应性鼻炎患者的心理健康状况分析

目的 分析变应性鼻炎患者的心理健康状况,探讨改进的办法.方法 对396例变应性鼻炎患者进行变应原检测,并对其中182例皮肤点刺试验阳性患者利用症状自评量表进行心理健康状况评测,对结果进行分析.结果 72.2％的患者变应原皮试反应阳性,阳性率最高的是屋尘螨(79.2％)和粉尘螨(77.5％).患者的心理健康状况较全国常模差,在躯体化、强迫症状、焦虑、敌对以及精神病性五个方面差异具有统计学意义.结论 应重视变应性鼻炎患者的心理状态和生活质量,通过心理干预进行指导、疏导,提高患者心理健康水平,改善其生活质量.     

鼻部症状对变应性鼻炎患者精神心理的影响

目的:探讨成人中重度持续性变应性鼻炎(AR)患者在鼻炎发作期的精神心理状态,以及鼻部症状对其精神心理状态的影响。方法:采用症状自评量表(symptom checklist 90,SCL-90)对539例中重度持续性AR患者的精神心理状况进行分析,SCL-90的各因子得分与中国成人正常值即全国常模比较,并统计分析鼻部症状对成人患者的精神心理状态的影响。结果:中重度持续性AR患者的SCL-90得分在躯体化、抑郁、焦虑和敌对4个症状的因子分都明显高于全国常模。男女患者和各年龄组之间各因子分无显著性差异。病程越长躯体化和强迫症状越明显。鼻塞对于躯体化、强迫、人际关系敏感、抑郁、精神病性5个症状具有显著影响;鼻痒对躯体化、抑郁、焦虑3个症状具有显著影响。结论:在鼻炎发作期,中重度持续性AR成人患者的精神心理状态明显比正常中国成人差。鼻塞、鼻痒等鼻部症状明显影响成人中重度持续性AR患者的精神心理状态。临床医生对患者精神心理问题的重视和妥善处理、适当干预将是AR治疗的新趋势。     

加味小青龙汤配合穴位埋线对变应性鼻炎患者生活质量的影响

目的:运用自制中医特色生活质量量表对变应性鼻炎患者的疗效及生活质量做出客观评价,观察加味小青龙汤配合穴位埋线治疗肺气虚寒型变应性鼻炎的临床疗效及对变应性鼻炎患者生活质量的影响,探讨用生活质量量表评价方式作为中医临床疗效评价方法的可行性,为以后研究打下基础。方法:采用自制中医特色生活质量量表并用非双盲研究进行研究。结果:加味小青龙汤配合穴位埋线在生活质量某些维度及总体生活质量方面优于氯雷他定和加味小青龙汤,且在改善生活质量的某些维度作用持久,优于氯雷他定和加味小青龙汤。变应性鼻炎生活质量量表在变应性鼻炎患者生活质量调查和临床疗效评价上有着一定的可信度、敏感性和可行性,能有效地反映变应性鼻炎患者生活质量状况和评价疗效,能够很好的体现中医药整体治疗的优势。结论:加味小青龙汤配合穴位埋线对肺气虚寒型变应性鼻炎疗效确切,在改善肺气虚寒型变应性鼻炎生活质量某些维度优于氯雷他定和加味小青龙汤,且作用更持久。中医药治疗的优势在于全身症状的改善。生活质量量表评价作为一种评价疗效的方法,能够很好的体现中医药整体治疗的优势。     

哮喘对变应性鼻炎患者精神心理的影响

目的　研究成人中重度持续性变应性鼻炎（AR）患者在鼻炎发作期的精神心理状态以及哮喘对其精神心理状态的影响。方法　采用症状自评量表（Symptom Checklist 90,SCL-90）对539例患有中重度持续性AR患者的精神心理状况进行分析,SCL-90各因子得分与中国成人正常值,即中国常模比较,并统计分析哮 喘对其精神心理状态的影响。结果　中重度持续性AR患者SCL-90得分在躯体化、抑郁、焦虑、敌对4个症状的因子分都明显高于中国常模。在9个症状因子得分上男女患者间、各年龄组间均无显著差异。躯体化、抑郁、焦虑、偏执4个症状的因子分,有、无哮喘史的患者之间存在着显著差异,伴有哮喘的患者这4个症状表现更明显。结论　在鼻炎发作期,中重度持续性AR成人患者的精神心理状态明显比正常中国成人差,哮喘明显影响患者的精神心理状态。临床医师对患者精神心理问题的重视和妥善干预将是AR治疗的新趋势。     

喉癌患者术后抑郁和焦虑的发病因素分析及其对喉癌患者预后和生活质量的影响

目的　探讨喉癌患者术后抑郁、焦虑发病的因素及其对喉癌患者预后和生活质量的影响。方法　对2010年1月1日～2012年10月31日在我院住院的84例喉癌患者于术后1个月进行问卷调查，包括一般资料问卷、Zung焦虑自评量表和抑郁自评量表，而生活质量EORTC QLQ-C30问卷分别在术后1个月、3年和5年进行问卷调查。应用SPSS 19.0统计学软件完成数据统计及分析。结果　78例喉癌患者完成随访，3年生存率为71.79%（56/78），5年生存率为57.69%（45/78）。术后1个月有52例（66.67%）患者抑郁阳性，43例（55.13%）患者焦虑阳性。低文化水平、低收入、长期吸烟、喉全切除及术后放疗的喉癌患者抑郁的发病率高，而经常 吸烟、喉全切除、发音功能及吞咽功能差的喉癌术后患者，焦虑的发病率高。抑郁组与对照组相比，术后5年的生存率差异有统计学意义，而术后3年生存率的差异无统计学意义；焦虑组和对照组相比，术后3年、5年生存率差异均无统计学意义。术后抑郁对患者的整体健康状况影响较大，但焦虑对生活质量的影响范围更广。抑郁和焦虑对患者术后失眠均有较大影响，且贯穿整个观察时间。结论　多重因素导致喉癌患者术后抑郁和焦虑。仅抑郁对患者术后5年生存率有影响；抑郁和焦虑均对患者术后生活质量造成影响，但影响方面不同。     

变应性鼻炎健康相关生活质量研究进展

变应性鼻炎作为一种临床常见慢性炎症性疾病,对患者生活质量的各方面均造成了显著的负面影响。除鼻部症状外,患者还会出现眼部甚至是全身症状,包括疲劳、睡眠障碍、抑郁、焦虑等情绪变化和工作、学习效率下降等。近年来,健康相关生活质量逐渐受到重视。就变应性鼻炎的临床症状及其对患者日常活动、情绪、睡眠、学习教育等方面具体影响的研究进展进行综述,指出临床上需关注患者自我感知的疾病负担,并加强公民对变应性鼻炎引起生活质量负担的意识,及早诊治。     

变应性鼻炎与精神心理紊乱

变应性鼻炎是目前最常见的呼吸道慢性炎症之一,严重影响患者的生活质量和身心健康.现已知变应性鼻炎与多种精神心理紊乱症状密切相关,如焦虑、抑郁、睡眠障碍及注意障碍等症状,甚至可能是自杀的危险因素之一.本文综述了变应性鼻炎与精神心理学相关的国内外研究进展.     

急性化脓性耳廓软骨膜炎手术疗效分析

目的 探讨能够缩短化脓性耳廓软骨膜炎疗程,降低耳廓畸形发生率且具个体化的局部治疗方法.方法 回顾分析1 989年4月～2010年2月我科诊治的25例化脓性耳廓软骨膜炎的临床资料.除进行抗生素治疗外,局部治疗方法包括清创术后重新行耳甲腔成行术;脓腔穿刺置静脉留置针进行持续负压引流;清创后创腔置管引流.结果 自定义疗效评定...     

耳廓开放性外伤的治疗方法探析

目的 探讨耳廓开放性外伤的治疗方法。方法 23耳耳廓开放性外伤经彻底清创，肝素生理盐水冲洗伤口后，对位缝合。术后用抗生素抗感染、丹参扩张血管、罂粟碱改善微循环。结果 23耳中2耳失访，18耳完全成活，1耳部分成活，2耳完全坏死。结论 耳廓撕裂伤、断伤、带有皮蒂的耳廓离断伤，由于断端双侧血管丰富，经对位缝合后容易成活。但耳廓完全离断伤由于缺乏血供，经对位缝合后不易成活，可采用去皮血管植入包埋法，带肌蒂皮瓣移植法或尝试显微外科技术施行血管吻合，以提高耳廓完全离断伤的成活率。     

诊治7例鼻腔嗅神经母细胞瘤的体会

目的：提高临床对鼻腔嗅神经母细胞瘤的认识及治疗效果。方法：７例患者按Ｋａｄｉｓｈ分期，Ｂ期２例，Ｃ期５例，单纯放疗３例，术前放疗４例，放射剂量为５０００￣７０００ｃＧｙ。均随访至１９９７年１２月，结果：存活５例，存活时间分别为２０，２２，２３，２９及７６个月；结论：放疗对该肿瘤有效；放疗与化疗结合的方法值得探讨，该瘤病理上可能存在不同的亚型。     

Scales of degree of facial paralysis: analysis of agreement

IntroductionIt has become common to use scales to measure the degree of involvement of facial paralysis in phonoaudiological clinics.ObjectiveTo analyze the inter- and intra-rater agreement of the scales of degree of facial paralysis and to elicit point of view of the appraisers regarding their use.MethodsCross-sectional observational clinical study of the Chevalier and House & Brackmann scales performed by five speech therapists with clinical experience, who analyzed the facial expression of 30 adult subjects with impaired facial movements two times, with a one week interval between evaluations. The kappa analysis was employed.ResultsThere was excellent inter-rater agreement for both scales (kappa > 0.80), and on the Chevalier scale a substantial intra-rater agreement in the first assessment (kappa = 0.792) and an excellent agreement in the second assessment (kappa = 0.928). The House & Brackmann scale showed excellent agreement at both assessments (kappa = 0.850 and 0.857). As for the appraisers’ point of view, one appraiser thought prior training is necessary for the Chevalier scale and, four appraisers felt that training is important for the House & Brackmann scale.ConclusionBoth scales have good inter- and intra-rater agreement and most of the appraisers agree on the ease and relevance of the application of these scales.     

术前使用布地奈德对声带息肉手术疗效的影响

目的 研究术前使用布地奈德雾化吸入治疗对手术疗效的影响。方法 按病程将3个月以内和1年以上患者随机分为两组,一组术前给予布地奈德雾化治疗,一组没有,术后两周复诊。分别于初诊、手术前和复诊时使用嗓音测试仪对病人进行测试并记录参数。结果 病程3个月以内患者术前给予雾化治疗后,其术后声学参数明显改善。结论 病程3个月以内患者术前给予雾化治疗能缩短术后恢复时间。     

Effects of time of contact and concentration of caustic agent on generation of injuries

OBJECTIVES: Solid caustic soda (CS) ingestion levels continue high in Brazil. The aggressiveness of a caustic agent depends, among other factors, on its concentration and time of contact with mucosa. However, the interdependence of these factors in the production of caustic lesion in the esophageal mucosa is not known, especially regarding CS as the strongest corrosive agent. We analyze the effects of concentration and time of contact on the aggressiveness of CS to the esophagus of live animals. STUDY DESIGN/METHODS: One milliliter of CS at concentrations between 1.83% and 73.33% was applied to rats. The solution was kept in contact with the mucosa for 10 to 120 minutes. Internal and external organ aspects were analyzed and the epithelium, submucosa, muscle layer, and adventitia were analyzed microscopically RESULTS: Epithelial necrosis was observed at all concentrations. Among the necrotic layers, the submucosa was observed starting at the 7.33% concentration, and the muscular layer and adventitia were observed at 14.66% concentration. Damage to the pulmonary parenchyma and trachea occurred at 33.66% after 10 minutes, and perforation of the esophagus was observed only after 120 minutes. After 10 minutes, important corrosive lesions installed in the esophageal layers, expanding in depth and superficial extension. The use of heparin had no effect on the production of lesions. CONCLUSIONS: Ten minutes were sufficient to provoke necrosis, and longer contact increased the area of necrosis. Solution concentration levels were more important in damage production: 1.83% was sufficient for epithelial necrosis, 7.33% caused submucosal necrosis, and 14.66% muscle and adventitia necrosis; 33.66% solutions caused lung and trachea damage after 10 minutes and esophageal perforation after 120 minutes.     

前壁切除法治疗耳廓假性囊肿的临床应用

我们采用前壁切除法治疗耳廓假性囊肿143例,取得了良好效果,现报告如下。1资料与方法1.1临床资料2001-2010年我科收治初次就诊的耳廓假性囊肿患者143例,男84例,女59例;年龄17～57岁,平均36.5岁;病程5d～9个月。囊肿最长径18～37mm,平均28mm。病变部位分别位于舟状     

Effect of the loss of auditory feedback on segmental parameters of vowels of postlingually deafened speakers

Objective: The most obvious and best documented changes in speech of postlingually deafened speakers are the rate, fundamental frequency, and volume (energy). These changes are due to the lack of auditory feedback. But auditory feedback affects not only the suprasegmental parameters of speech. The aim of this study was to determine the change at the segmental level of speech in terms of vowel formants. Methods: Twenty-three postlingually deafened and 18 normally hearing speakers were recorded reading a German text. The frequencies of the first and second formants and the vowel spaces of selected vowels in word-in-context condition were compared. Results: All first formant frequencies (F1) of the postlingually deafened speakers were significantly different from those of the normally hearing people. The values of F1 were higher for the vowels /e/ (418±61 Hz compared with 359±52 Hz, P=0.006) and /o/ (459±58 compared with 390±45 Hz, P=0.0003) and lower for /a/ (765±115 Hz compared with 851±146 Hz, P=0.038). The second formant frequency (F2) only showed a significant increase for the vowel/e/(2016±347 Hz compared with 2279±250 Hz, P=0.012). The postlingually deafened people were divided into two subgroups according to duration of deafness (shorter/longer than 10 years of deafness). There was no significant difference in formant changes between the two groups. Conclusion: Our report demonstrated an effect of auditory feedback also on segmental features of speech of postlingually deafened people.     

A national audit of sinus surgery. Results of the Royal College of Surgeons of England comparative audit of ENT surgery

The results of a national audit of sinus surgery are presented. Forty-six consultant ENT surgeons reported on over 2500 sinus procedures. There has been an exponential rise in the number of surgeons in England and Wales performing functional endoscopic sinus surgery (FESS) in recent years. Sixty-five per cent of surgeons in our study used the FESS technique and 81% had formal or other training. Outpatient sinus endoscopy and CT scans have become more routine pre-operative investigations, whilst the use of plain films has waned. There was a wide variation in the numbers of FESS procedures performed by individual surgeons in the 6-month period (between 5 and 85). The overall complication rate was 0.75% for conventional surgery and 1.41% for functional surgery but no major complications were recorded. The primary symptom of blockage was most successfully treated by both conventional and functional surgery (70% and 84% asymptomatic or improved at 6 months). Pain was relieved in 75% of functional procedures and 47% of conventional procedures and discharge relieved in 76% of FESS procedures and 47% of conventional procedures.