纵隔镜腹腔镜经颈-腹二切口治疗早期颈段食管癌患者的护理

对8例早期食管癌患者采用纵隔镜腹腔镜辅助经颈-腹二切口手术治疗。术后平均住院8.0d,均顺利出院,未发生严重并发症。提出术前加强心理护理、呼吸道准备;术后密切观察病情变化及颈部吻合口情况,做好呼吸道护理、胃管护理及营养护理,可使患者顺利渡过手术期,促进康复。     

急性白血病病人鞘内注射化疗药物的护理干预

[目的]探讨责任护士全程陪同的护理干预对急性白血病病人鞘内注射化疗药不良反应的影响。[方法]初次行腰椎穿刺鞘内注射三联药（地塞米松、甲氨蝶呤、阿糖胞苷）的住院病人64例为研究对象,随机分为对照组、干预组各32例。对照组采用常规护理,干预组除常规护理外责任护士全程陪同进行综合护理干预,观察两组紧张、恐惧程度及不良反应发生情况;观察两组病人好转等程度及不良反应情况。[结果]两组病人的紧张、恐惧程度,头痛、头晕、恶心、呕吐不良反应比较差异有统计学意义（P〈0.05）。[结论]主管医生与责任护士密切配合,在鞘内注射全程中进行综合护理干预可减少病人紧张、恐惧的程度,减少不良反应发生率,有利于操作顺利完成。     

湖南省第二次血吸虫病抽样调查报告

为了解全省血吸虫病流行现状及不同类型流行区流行特征，评价血防“八五”规划防制策略效果，1995年9－11月，采取分型、分层整群随机抽取样本村52个。未控制流行村43个，粪检阳性率7.84％，病人EPG、G分别为63．27、17.63；人群EPG、G分别为4．96、0．26；晚期血吸虫病患病率为0．27％；粪检阴、阳性人群症状体征出现率存在明显差异（P＜0.05）；耕牛粪检阳性率9．63％。控制流行区9个村，IHA阳性率为0．09％；粪检未发现病人。推算全省尚有病人228498人；晚期血吸虫病病人9151人；病牛12314头。与1989年抽样调查结果比较，居民粪检阳性率下降了45．44％；耕牛粪检阳性率下降了45．19％。     

血液净化对血透患者血清瘦素水平的影响

目的:研究慢性肾功能衰竭患者血液透析(HD)及血液透析滤过(HDF)前、后血清瘦素(Leptin)水平的变化。方法:采用放射免疫测定(RIA)方法,测定55例HD患者和36例HDF患者HD及HDF前、后血清Leptin水平。结果:HD前、后血清Leptin水平分别为:HD前男(5.02±2.65)μg/L ,女(7.03±4.89)μg/L和HD后男(5.12±3.47)μg/L,女(7.93±3.65)μg/L,两组同性别间无明显差异。(P>0.05);HDF前血清Leptin水平为:男(542±3.14)μg/L,女(7.88±338)μg/L,明显高于HDF后:男(3.32±2.71)μg/L,女(5.66±3.21)μg/L(P<0.05)。结论:HD不能有效地清除血清Leptin水平,而HDF可以部分清除血清Leptin。     

再生障碍性贫血患者细胞酶学研究

采用图像分析技术,对30例再生障碍性贫血(AA)患者治疗前、后骨髓细胞内细胞色素氧化酶(CCo),琥珀酸脱氢酶(SDH),中性粒细胞碱性磷酸酶(NAP),脱氧核糖核酸(DNA),核仁区嗜银蛋白(AgNORs)进行定量测试,并与正常进行比较.结果治疗前AA患者的CCO,SDH,DNA,AgNORs含量明显低于正常对照;NAP含量则显著高于对照组,差异有非常显著性(P<0.01).病情稳定缓解后,其含量分别接近正常人(P>0.05).提示生物氧化酶,DNA,NAP,AgNORs代谢紊乱在AA发病中有着重要作用.     

肉苁蓉对小鼠睾丸和附睾形态学及组织化学的影响

目的　观察肉苁蓉对小鼠睾丸和附睾的形态学及组织化学的影响。方法　选昆明系雄性小鼠 30只 ,随机分为用药Ⅰ、Ⅱ组与对照组。用肉苁蓉水煎液 (4g·kg-1·d-1和 8g·kg-1·d-1)灌胃 ,对照组用生理盐水灌胃 ,三周后处死小鼠 ,测定精液中精子数量、活率、运行速度等形态学指标 ,以及精浆中果糖含量。组织化学观察睾丸和附睾琥珀酸脱氢酶和非特异性脂酶反应。结果　给药组上述指标均高于对照组。结论　提示肉苁蓉确有壮阳补肾之功效。     

老年病人胸部手术后便秘原因分析与护理进展

介绍了老年病人胸部手术后便秘的原因、危害和护理进展.强调根据不同病人的情况采取针对性护理措施,同时加强健康教育,养成良好的生活习惯,降低便秘发生率.     

肺部单纯磨玻璃样结节术前CT引导下钡剂悬液定位的临床研究

目的 探讨肺部单纯磨玻璃样结节（pGGO）术前CT引导下钡剂悬液定位的应用价值.方法 选择27例pGGO患者（共29个）,行CT引导下穿刺硫酸钡悬液定位,后行全胸腔镜下肺部楔形切除术,若术中快速病理为恶性结节则行完全胸腔镜肺叶切除加淋巴结清扫术.观察并统计定位成功率、定位时间、定位并发症、中转开胸率及肺楔形切除时间等.结果 27例患者的29个pGGO在CT引导下钡剂悬液定位成功率为100％（29/29）,定位时间（23.25±8.12） min.定位完成后2～24h（平均14.2 h）患者无明显疼痛不适;少量气胸3例,无需外科处理;少量咯血1例;胸膜反应2例,无血胸或血气胸,无空气栓塞.术中病灶手指均能探查,且X线透视均能显示定位,病灶行全胸腔镜下楔形切除,无中转开胸探查,标本切缘距病灶距离＞ 10mm.电视胸腔镜手术肺楔形切除时间（15.45±7.32） min,术中失血量（46.11±8.91） ml,住院时间（7.20±3.12）d.所有患者均明确诊断.结论 pGGO全胸腔镜术前CT引导下钡剂悬液定位准确、安全、经济、方便.     

Alterative application of five anticonvulsants according to the half life for the treatment of status epilepticus in children with severe viral encephalitis

BACKGROUND: Traditional subhibernation therapy may easily cause complications, such as respiratory depression and hyportension because of application of chlorpromazine hydrochloride and promethazine in a large dosage. OBJECTIVE: To observe therapeutic effect of modified subhibernation therapy (alterative application of five anticonvulsants according to the half life) on status epilepticus in children with severe viral encephalitis (VE). DESIGN: Contrast observation. SETTING: Department of Pediatrics, the First Hospital of Jilin University. PARTICIPANTS: The participants in present study were 96 patients with severe viral encephalitis including 52 boys and 44 girls who received treatment in the Department of Pediatrics, the First Hospital of Jilin University from February 2000 to March 2006. All children met the diagnostic criteria of Zhufutong Practice Pediatrics (the seventh edition). Two weeks ago, they ever got upper respiratory infection or enteronitis and so on before the onset, spirit abnormal, behavior disorder, limbs act disorder, vomit, headache, convulsion, nervous system masculine signs such as limbs act disord, autonomic nerve damage manifestation, brain nerve palsy, dysreflexia, meningeal irritation sign, cerebrospinal fluid and electroencephalography (EEG) abnormity. All parents provided the confirmed consent. The patients were randomly divided into control group (n =40) and experimental group (n =56). METHODS: Patients in the control group received anticonvulsion, ice compress and routine treatment. The convulsion was treated with five drugs: 0.5 mg/kg wintermin and phenergan, respectively, 100 g/L chlorpromazine hydrochloride (0.5 mL/kg), 5 mg/kg luminal, 0.3 mg/kg ansiolin. When convulsion attacked, those five drugs were given alternatively; however, those were not given if the convulsion did not attack. Children in the experimental group were treated with improved subhibernation therapy based on routine treatment. The dosages of anticonvulsants were as the same as those in the control group. Based on the half life, every drug was alternated every 4–6 hours. In addition, anticonvulsants administrated for 2 successive days whether tic attacked or not. Then the hypnotic was removed gradually. MAIN OUTCOME MEASURES: Therapeutic efficacy, time of disappeared clinical symptoms and physical sign, and security of administration. RESULTS: All the 96 patients were involved in the final analysis. ① Total effective rate and reliability: Total effective rate was higher in the treatment groups than the control group (χ2=5.871 7, P < 0.05). All patients did not have respiratory depression and side effects. ② Time of disappeared clinical symptoms and physical sign: Recovery time of convulsion, fever, headache and vomit was shorter in the treatment group than that in the control group, and there was significant difference (t =17.612 1–34.330 7, P < 0.05); in addition, symptoms of status epilepticus were relieved obviously. Meanwhile, recovery time of paralysis, coma and anepia was shorter in the treatment group than that in the control group, and there was significant difference (t =10.660 8–24.700 8, P < 0.05). CONCLUSION: Therapeutic effect of improved subhibernation therapy on status epilepticus induced by severe viral encephalitis is positively and safer.     

实时超声显像对肝脏和脾脏闭合性损伤的诊断价值探讨

本文通过对114例闭合性肝、脾损伤的实时超声显像研究,根据超声声像图特征与病理改变相结合,将肝、脾的损伤程度分为四型:Ⅰ挫伤型、Ⅱ包膜下裂伤型、Ⅲ包膜裂伤型、Ⅳ、严重损伤型。重点分析了不同程度损伤所致四型的临床处理结果,认为超声显像对于肝、脾损伤程度的判定具有准确性高、能动态观察出血是否继续、判断病情的发展,同时结合血液动力学(血压、脉搏、血色素)和腹部体征的改变,为临床提供手术或非手术治疗的指征,具有较高的实用价值。