静脉留置针的护理

使用静脉留置针进行点滴过程中很少发生药物外泄,并且可随血管形状弯曲,不易脱出血管,便于肢体活动。3天的留置时间也减少反复穿刺的痛苦和对静脉带来的伤害,同时保证合理用药时间。对我科138例使用静脉留置针的患者进行临床观察护理,现总结如下。     

小细胞肺癌的影像学分析

本文收集了19例小细胞肺癌，经胸部正侧位平片，螺旋CT检查，分析其影像学表现。患者均经X线电视或CT导向穿刺活检、病理证实。结果表明，小细胞肺癌中央型较多，主要表现为肺内肿块影和肺门、纵隔淋巴结肿大，恶性程度高，转移旱，预后差。     

中西医结合治疗冠心病的体会

冠心病．又称缺血性心脏病，是一种常见的心血管疾病，属中医“胸痹心痛”．“怔忡”等范畴。随着人民生活水平的提高，冠心病（CAD）发病率也逐年上升．并成为危害人类健康的主要疾病。1979年WHO将冠心病（CAD）分为五型：无症状性心肌缺血，心绞痛．心肌梗死。缺血性心肌病，猝死。近年提出为急性冠脉综合征（acute conoary syndrome，ACS），     

胰岛素强化治疗对严重创伤患者炎性反应及预后的影响

Objective To investigate the effects of intensive insulin therapy on inflammatory re-sponse and prognosis of patients with severe trauma. Methods Eighty severely injured patients were di-vided into intensive insulin therapy group (n = 40, IT) and routine therapy group (n = 40, RT) in random pair. At the time of admission, a continuous infusion of insulin (2 -4 U/h) was pumped into the patients of IT group to maintain blood glucose level at 6 -8 mmol/L. Patients in RT group were given routine treatment without administration of insulin. Fever, organ injury, and mortality of patients in 2 groups were recorded. Venous blood was drawn from patients of 2 groups on the morning of post treatment day (PTD) 1, 3, 5, and 7. Values of TNF-α, C-reactive protein (CRP), IL-2, and IL-10 in plasma were assayed. Results High fever appeared in 9 patients in IT group, and WBC exceeded 10.0×109 for more than 3 days in 17 patients in this group, versus 20 and 29 patients respectively in RT group. Dysfunction of 1 organ appeared in 31 pa-tients in IT group and 30 patients in RT group. Dysfunction of 3 organs appeared in 10 patients in IT group and 19 patients in RT group. Dysfunction of 4 organs appeared in 7 patients in IT group and 12 patients in RT group. In IT group, 4 patients died within 3 post-injury day (PID), and 1 patient died after PID 3 (total case fatality: 12.5% ). In RT group, 5 patients died within 3 PID, and 4 patient died after PID 3 (total case fatality: 22.5%). Plasma levels of TNF-α and CRP of patients in IT group were significantly lower than those of patients in RT group on PID 3 - 7 ( P<0.05 or P<0.01 ), while levels of IL-2 and IL-10 of patients in IT group were significantly higher than those of patients in RT group ( P<0.05 or P<0.01 ). Plasma levels of TNF-α ( 1.3±0.6 μg/L) and CRP (55±16 mg/L) of patients in IT group on PTD 7 were lowered to the trough level, and they were significantly lower than those of patients in RT group (3.0±0.8μg/L, 89±20 mg/L, respectively, P <0.01 ). Conclusions Intensive insulin therapy can mitigate systemic inflammatory response and improve prognosis of patients with severe trauma.     

浅谈局域网故障诊断

对于小型局域网来说经常会出现网络故障,针对这一问题,进行分析和探讨.     

针刀配合膝关节间断主动活动治疗膝关节强直

膝关节强直是膝关节及关节周围创伤、关节炎晚期及手术后的严重并发症,同时伴有髌骨活动度严重减少甚至消失.病理多为髌上囊及两侧沟的广泛粘连,部分患者伴有关节外结构的挛缩.物理治疗几乎无效、开放性手术切开松解及关节镜下松解创伤大,出血多,存在再粘连的可能性,手术并发症多,一次手术失败,没有再次松解的机会.我院自1997年8月-2002年3月,应用针刀闭合松解加关节间断主动活动治疗严重膝关节粘连52例疗效满意.……     

糖尿病患者血浆内皮素测定40例分析

内皮素 (Ｅｎｄｏｔｈｅｌｉｎ ,ＥＴ)是一种由血管内皮细胞及平滑肌细胞分泌的生物活性多肽 ,近年来发现是一种效应最强、持续时间最久的血管收缩物质 ,尤其在缺血、缺氧、高凝状态、肾上腺素等因素的作用下其血浆浓度明显升高。初步发现可能是一种内源性致病因素。我们对 4 0例糖尿病患者作血浆内皮素测定 ,观察其与糖尿病脑、眼、心、肾微血管病变的关系。1　临床资料1.1　一般资料　观察对象糖尿病组 4 0例 ,男 16例 ,女 2 4例 ,年龄 30～ 78岁 ,平均年龄 (6 1.75± 10 .2 5 )岁 ,病程 1月～ 2 4年。本组病人均为住院患者 ,其诊断均符合…     

内外固定相结合治疗桡骨远端粉碎骨折

我院从 1997年至今采用单侧多功能外固定支架加有限内固定治疗桡骨远端粉碎性骨折 18例 ,疗效满意 ,现报告如下。1　临床资料本组 18例 ,男 13例 ,女 5例 ;年龄 19～ 5 2岁 ;病程 2ｈ～1周。闭合骨折 14例 ,开放骨折 4例。按Ｍｅｌｏｎｅ桡骨远端骨折分型 :Ⅲ型 (干骺端粉碎骨折、桡骨干蝶形骨折 ) 4例 ,Ⅳ型(关节面劈裂伴旋转 ) 5例 ,Ⅴ型 (暴裂骨折 ) 9例。2　手术方法2 1　手术指征　①Ｍｅｌｏｎｅ骨折Ⅲ、Ⅳ、Ⅴ型 ;②开放性骨折。2 2　手术方法　在臂丛麻醉下常规消毒铺巾 ,开放骨折严格清创。首先在第 2掌骨中间和基底部穿 2枚外固…     

小儿有机磷杀虫剂中毒的神经系统远期随访

随着有机磷杀虫剂在农业上日益广泛地应用，中毒病例相应增加。小儿（尤其婴幼儿）中毒原因与成人不同，神经系统远期症状（或后遗症）的表现形式也与成人患者有明显的差异，为了探索其中的规律，对30例小儿有机磷杀虫剂中毒临床近期痊愈病例进行了远期随访，现报道如下：     

罗格列酮联用胰岛素发生水肿一例

患者,男,70岁,因患糖尿病、高血压病14年,全身浮肿4天于2002年1月6日内分泌科就诊.1987年患糖尿病、高血压病,用各种降糖药、降压药效果不满意.