参麦注射液联合低分子肝素钙治疗不稳定型心绞痛60例临床观察

目的观察参麦注射液联合低分子肝素钙治疗不稳定型心绞痛的临床疗效及安全性。方法120例不稳定型心绞痛患者在知情同意情况下按人院单双号随机分为观察组（60例）和对照组（60例）,对照组采用心绞痛常规治疗,观察组在对照组治疗的基础上给予参麦注射液联合低分子肝素钙治疗,观察比较两组治疗前后出血时间、凝血时间、凝血酶原时间、心电图变化及临床疗效。结果治疗2个疗程后,观察组有效52例、无效8例、有效率为86．7％,对照组分别为36例、24例、60．0％,两组有效率差异有统计学意义（X2=9．19,P〈0．05）;两组治疗后出血时间、凝血时间、凝血酶原时问等较治疗前差异均无统计学意义（均P〉0．05）;观察组心电图疗效：有效53例、无效7例、有效率88．3％,对照组分别为39例、2l例、65．0％,两组心电图疗效差异有统计学意义（x2=8．83,P〈0．05）。结论参麦注射液联合低分子肝素钙治疗不稳定型心绞痛疗效显著,安全可靠。     

胰腺癌患者氩氦刀冷冻治疗前后血清CA242和TSGF检测的临床意义

目的探讨胰腺癌患者氩氦刀冷冻消融治疗前后血清糖类抗原242(CA242)与恶性肿瘤特异性生长因子(TSGF)的水平变化及其临床意义。方法采用电化学发光和生化法对15例胰腺癌患者冷冻消融治疗前后血清CA242和TSGF水平进行测定,并与15例健康者作比较。结果胰腺癌患者在治疗前后血清CA242和TSGF的水平均显著高于健康者(P<0.01);患者治疗后血清CA242和TSGF水平均显著低于治疗前(P<0.05);患者治疗前后CA242的水平均与性别、临床分期及肝转移有关(P<0.05)。结论氩氦刀冷冻消融治疗后可降低胰腺癌患者血清CA242和TSGF水平,CA242和TSGF可作为胰腺癌诊断、疗效评估的重要指标,CA242对胰腺癌的预后观察有重要的临床意义。     

Combination of cryosurgery and Iodine-125 seeds brachytherapy for lung cancer

It has been proven that radioactive seeds such as Iodine-125 seeds implantation is a highly effective treatment for patients with localized cancer, such as lung cancer. It may increase the effectiveness of cryosurgery for lung cancer with the combination of Iodine-125 seed implantation into edge of the cryoablation zone. Percutaneous cryosurgery and Iodine-125 seed implantation are mutual complementation; both have been proved to be safe and effective modality for unresectable lung cancer, especially for centrally located lung cancer. Well-designed, randomized and control study both in the laboratory and in the clinical about this option are needed before the conclusive evidence submits.KEY WORDS : Lung cancer, cryosurgery, cryoablation, Iodine-125 seeds     

Cryosurgery for lung cancer

Cryosurgery is suited for patients with lung cancer who are not considered for lung resection because of the advanced stage of the disease or the patient's poor general condition or poor respiratory function and with tumor recurrence following radiotherapy, chemotherapy or lung resection, and those patients who have localized lung cancer but refuse to receive operative therapy. Procedures of cryosurgery for lung cancer can be performed through endobronchial, direct intrathoracic (at exploratory thoracotomy) or percutaneous routes depending upon location and size of tumor. Six hundred and twenty-five patients with Non-small cell lung cancer (NSCLC) received percutaneous cryoablation in Fuda Cancer Hospital Guangzhou, China. One hundred and fifty patients were followed-up for 12 to 38 months. Results showed that 1-, 2-, and 3-year survival rates were 64%, 45% and 32%, respectively. The adverse effects after cryosurgery of lung cancer include haemoptysis, pneumothorax, bloody thorax, pleural effusion and pulmonary infection which are generally mild, transient, and recovery with symptomatic management. In vitro studies have shown cryotherapy of lung cancer cells can improve the immune system to trigger the specific anti-tumor response. In the future, comparative studies between this modality and other therapies should be conducted for the treatment of lung cancer. In addition, more attention needs to be put on the immunomodulators that enhance the cryoimmunology.     

防范住院患者跌倒的护理安全管理

防范病人跌倒安全管理应从科学客观的评估开始,要重视对病人的健康教育,加强医院的综合治理,结合性开展工作,要在临床中善于不断的总结提高,全面落实防范跌倒的护理措施,可显著降低住院患者跌倒发生率,有利于提高护理队伍的整体素质。     

肿瘤患者跌倒常见因素中的病房设施缺陷与改进措施

目的前瞻性对造成住院肿瘤患者跌倒的常见设施配备缺陷进行改进,以降低跌倒发生率。方法统计分析病房设施缺陷致肿瘤住院患者跌倒的原因,提出科学的住院环境与基础设施改进方法。结果所有跌倒病例均与病房环境、设施缺陷有关联性。结论安全文化、综合治理,改进肿瘤病房存在的设施缺陷,能够有效减少肿瘤住院患者跌倒的几率。     

超声联合CT引导下经皮冷冻治疗胰腺癌85例

目的评估超声和CT引导经皮冷冻治疗胰腺癌的安全性及可行性。方法回顾性分析2008年11月至2010年5月在我院接受超声联合CT引导下经皮冷冻治疗的胰腺癌患者85例的临床资料,其中不可切除胰腺癌67例,拒绝手术治疗的可切除性胰腺癌患者18例,共计86个瘤灶接受121次经皮冷冻治疗。依据肿瘤的大小、形状及位置,分别选用1～8根探针。胰头癌采用经腹穿刺,胰体尾癌经腹或经背穿刺的方法。采用两个冷冻一复温循环,冷冻温度为（-160±10）℃,复温温度（25±5）℃,均持续5～10min。于冷冻前后检查CT,评估状态（kamofsky performance status,KPS）评分,观察冷冻治疗后并发症及术后住院时间。结果全组121例次经皮冷冻治疗均顺利完成,无一例死亡。出院时KPS较治疗前提高（P〈0．叭）。冷冻后1～3个月肿瘤平均直径明显缩小[（4．7±0．3）VS．（4．1±0．4）,P〈0．01],所有瘤灶冷冻区活性消失。平均住院时间为（8．0±0．6）d。结论超声联合CT引导经皮冷冻治疗胰腺癌安全可行,具有微创、准确、适形等特点,为临床胰腺癌治疗提供了新的技术手段。     

建立适应不同国籍肿瘤患者差异化需求的护理服务模式

总结不同国籍肿瘤患者差异化护理服务需求,引导全院护士正确树立护理服务理念,有效地建立把握科学护理知识技能的学习机制和满足不同国籍患者生活习俗的服务机制,提高患者满意度。     

肿瘤住院病人跌倒后的情况分析与诊疗护理

本文运用对比分析法,在对中美两国老年病人与我院肿瘤住院病人跌倒情况进行比较分析的基础上,紧密联系护理服务实践,提出了对肿瘤病人跌倒的有效诊疗护理方法,并对讨论内容进行了经验性的小结。     

胰腺癌患者氩氦刀冷冻消融治疗前后CA242、CA199、CA125、CEA、TSGF的变化及临床意义

目的：探讨胰腺癌患者氩氦刀冷冻消融治疗前后血清糖类抗原242（CA242）、糖类抗原199（CA199）、糖类抗原125（CA125）、癌胚抗原（CEA）及恶性肿瘤特异生长因子（TSGF）水平变化及临床意义。方法：测定30例胰腺癌患者氩氦刀冷冻消融治疗前后及15例正常对照的血清CA242、CA199、CA125、CEA及TSGF的水平,并分析其与临床病理参数的相关性。结果：胰腺癌患者冷冻前后所有标志物的血清水平及阳性率均明显高于对照组（P〈0.05）,冷冻后CA199、CA125及CEA血清水平均明显下降（P〈0.05）,冷冻后CA199,CEA及TSGF的阳性检出率均明显降低（P〈0.05）。CEA血清水平与患者性别相关（P〈0.05）,CA242水平与肿瘤大小及临床分期均相关（P〈0.05）,CA199、CA125、CEA水平与患者年龄、肿瘤大小、临床分期、分化程度、淋巴结转移及肝转移均相关（P〈0.05）,而血清TSGF水平与所有的病理参数均无关（P〉0.05）。结论：CA199、CA125、CEA血清水平可作为胰腺癌疗效评估的重要指标,CA242、CA199、CA125及CEA在胰腺癌的预后评估中发挥重要的作用。