癌症患者医院感染病原菌菌谱及耐药性分析

目的 探讨癌症患者医院感染病原菌的分布及其耐药状况.方法 回顾分析癌症患者医院感染1451例病例,采用WHONET-5软件进行统计处理.结果 1451株病原菌中革兰阴性(G-)杆菌492株,占33.9%,革兰阳性(G+)球菌411株,占28.3%,真菌548株,占37.8%;痰标本955株中G-杆菌为25.5%,G+球菌为31.2%,真菌为43.3%;大便标本284株中检出G-杆菌为64.4%,G+球菌为10.2%,真菌为25.5%;血液72株中检出G-杆菌为62.5%,G+球菌为30.5%,真菌为7.0%;咽拭子140株中检出G-杆菌为15.0%,G+球菌为43.0%,真菌为42.0%;药敏试验结果提示,G-杆菌对亚胺培南高度敏感对一代、二代头孢菌素、氨苄西林、哌拉西林等有较高耐药性,G+球菌对万古霉素高度敏感,对苯唑西林、青霉素、红霉素等耐药率很高,真菌对唑类抗菌药呈明显耐药.结论 由于产超广谱β-内酰胺酶菌(ESBLs)和耐甲氧西林葡萄球菌(MRS)检出率较高,临床用药应依据药敏试验结果选择和合理使用抗菌药物,控制病原菌的耐药性.     

慈溪市登革热媒介白纹伊蚊综合防治措施的研究

目的评价2004—2005年慈溪市登革热媒介综合性防治的效果。方法综合防治清除蚊虫孳生地,灭蚊以白纹伊蚊密度指数考核灭效。结果2004年疫区的白纹伊蚊幼虫房屋指数、容器指数和布雷图指数分别下降了96．6％、92．5％和99．0％,疫情得到了控制。2005年疫区白纹伊蚊幼虫房屋指数、容器指数和布雷图指数分别为4．1、5．2和4．5,全年无新发病例。结论采取清除蚊虫孳生地为主的综合性防治措施,可迅速有效地遏制登革热的发生或流行。     

提高股骨干骨折合并同侧股骨颈骨折早期诊断率的前瞻性研究

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.     

肌成纤维细胞与医源性胆管狭窄的相关性研究

目的探讨肌成纤维细胞（MFB）在医源性胆管狭窄形成过程中的作用及医源性胆管狭窄的形成机制。方法通过建立家兔肝外胆管损伤修复模型,分别于术后1周、3周、3个月、6个月取材行光镜、电镜观察,并免疫组织化学染色观察d平滑肌肌动蛋白（α-SMA）。结果MFB功能活跃,持续存在于整个胆道愈合过程;α-SMA表达于肌成纤维细胞胞浆,术后1周-6个月表达均较强,与正常对照比较差异有统计学意义（P〈0．01）,术后各期表达差异无统计学意义（P〉0．05）。结论MFB功能活跃,持续存在,是导致胆道瘢痕性挛缩和管腔狭窄的主要原因。     

米非司酮配伍米索前列醇终止孕8～16周妊娠100例效果观察

自 1 997年 9月～ 1 999年 9月 ,我院采用米非司酮配伍米索前列醇用于终止孕 8～ 1 6周妊娠 1 0 0例 ,效果满意 ,现对其有效性及安全性分析如下。1　资料与方法1 .1　对象 :1 0 0例孕 8～ 1 6周要求终止妊娠的健康妇女 ,无急、慢性病史 ,无肝炎、血液病史 ,无心脏病史 ,无药物过敏史。经妇科及 B超检查确诊宫内妊娠 ,常规化验白带 ,如有阴道炎 ,先治疗。1 .2　孕产史 :经产妇 75例 (包括剖宫产 5例 ) ,占75%。未产妇 2 5例 ,占 2 5% ,其中有人流史 1 5例。1 .3　给药及观察方法 :患者勿需住院。第 1天上午7时空腹顿服米非司酮 2 5mg× 6片 …     

糖尿病并发脑血管病66例临床分析

目的：探讨脑血管病患者常见的危险因素。方法：对66例老年糖尿病并发脑血管病患者与同期60例未合并糖尿病的脑血管病患者的临床表现及CT、血脂、血流变学等改变进行对比分析。结果：DM、血脂水平、血液高凝状态、高血压均是CVD病常见的危险因素。结论：对DM患者,不但要控制血糖,还要同时进行控制血压、降低血脂、控制血液高凝状态的综合治疗,才能降低CVD的发生。     

提高股骨干骨折合并同侧股骨颈骨折早期诊断率的前瞻性研究

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.     

对癌症患者告知真情的伦理举措

通过分别论述不告知癌症患者真情的理由和告知真情的理由，探讨解决的策略，提出了患者情况评估积分法，并论述其依据和临床应用的方法，旨在为临床医生提供帮助。     

正位可控N形回肠膀胱术后排尿功能训练31例护理体会

2000年12月～2005年12月，我们对31例行正位可控N形回肠膀胱术的男性患者进行术后排尿功能训练，效果满意。现将护理体会报告如下。