前置胎盘的观察及护理

目的：探讨前置胎盘对母婴的影响以及临床护理方法，为临床护理前置胎盘提供一定的指导。方法：选取2009年1月至2012年1月我院收治的前置胎盘产妇40例作为观察组，选择同期40例正常产妇作为对照组，观察两组对产妇和新生儿影响的不同。结果：观察组在产妇出血、产妇休克、胎盘植入等方面明显高于对照组，存在统计学意义（p ＜0.05）；观察组在新生儿窒息、低体重儿、新生儿死亡等方面明显高于对照组，存在统计学意义（p，0.05）。结论：前置胎盘严重影响着母婴的安全，要加强对前置胎盘产妇的预防和护理，以减少母婴的并发症发生率和死亡率。     

人类免疫缺陷病毒与分枝杆菌合并感染的临床探讨

目的:探讨人类免疫缺陷病毒与分枝杆菌合并感染的临床特点、诊断和治疗方法。方法:选取住院的28例人类免疫缺陷病毒与分枝杆菌合并感染患者,对其临床资料进行回顾性分析。结果:发热25例,咳嗽14例,咳痰11例,身体乏力23例,腹痛14例,腹泻4例,盗汗4例,胸痛4例。给予结核组患者临床治疗后,胸片病灶吸收好转10例,胸片显示病灶有吸收3例,死亡5例,给予非结核患者临床治疗后,结果显示在10例患者中,临床症状好转6例,胸片显示病灶有吸收3例,死亡1例。结论:人类免疫缺陷病毒与分枝杆菌合并感染率较高,对其临床诊断存在较大的难度,尤其对免疫力较差,同时合并多种并发症的患者,经过对患者进行抗病毒、抗结核治疗,多数患者临床疗效明显。     

泮托拉唑治疗消化性溃疡合并上消化道出血的临床分析

目的 探讨对于消化性溃疡合并上消化道出血应用半托拉唑治疗的临床效果.方法 随机选取1 00例由消化性溃疡引起的上消化道出血患者,采取随机分为试验组和对照组,各50例,其中试验组采用泮托拉唑注射,对照组采用奥美拉唑注射,进行一段时间的注射治疗后,观察2组的情况.结果 试验组中患者痊愈为28例,好转为20例,无效为2例,总有效率为96％;对照组痊愈23例,好转1 7例,无效为1 0例,总有效率为80％.试验组临床治疗总有效率明显优于对照组,数据差异有统计学意义(P＜0 05).结论 对于消化性溃疡合并上消化道出血患者,半托拉唑的临床效果更佳,不良反应少,使用方便,值得在临床推广使用.     

布地奈德合BiPAP治疗老年支气管哮喘并呼吸衰竭疗效观察

目的:探讨布地奈德联合双水平呼吸道正压通气(BiPAP)治疗老年支气管哮喘合并呼吸衰竭患者的疗效。方法:选取我院2016年10月～2018年9月收治的老年支气管哮喘合并呼吸衰竭患者74例,按照随机数字表法分为观察组和对照组,每组37例。对照组采用BiPAP治疗,观察组采用BiPAP+布地奈德治疗,观察比较两组临床疗效,治疗前后肺功能及血气分析各指标变化情况。结果:观察组治疗总有效率94.59%(35/37),高于对照组的75.68%(28/37)(P0.05);治疗后观察组最大呼吸峰值(PEF)、用力肺活量(FVC)、第1秒用力呼气容积率(FEV1%)水平高于对照组(P0.05);治疗后观察组动脉血二氧化碳分压(Pa CO2)低于对照组,动脉血氧分压(Pa O2)高于对照组(P0.05)。结论:布地奈德联合BiPAP治疗老年支气管哮喘合并呼吸衰竭患者可改善患者血气分析指标水平,促进患者肺功能恢复,效果显著。     

经鼻高流量氧气湿化治疗老年慢性阻塞性肺疾病急性加重合并呼吸衰竭的可行性研究

ObjectiveTo investigate the feasibility of transnasal heated humidified high flow nasal cannula oxygen therapy (HFNC) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure in elderly patients. MethodsA total of 176 elderly patients with AECOPD complicated with respiratory failure who were hospitalized at Peking University Shougang Hospital from December 2016 to January 2022 were enrolled, including 82 patients in an HFNC group and 94 patients in an NPPV group. After treatment, pulse oxygen saturation (SPO₂), arterial partial pressure of carbon dioxide (PaCO₂), oxygenation index (OI), respiratory rate (RR), heart rate (HR), mean arterial pressure (MAP), comfort score, discharge rate, rate of endotracheal intubation, rate of transfer to intensive care unit (ICU), and mortality were compared between the two groups. The independent sample t-test was used for comparison between the two groups. Statistical data are expressed in percentage or number of cases and the χ² test was used for their comparisons. ResultsThe SPO₂ values at 30 min, 1 h, and 6 h were significantly higher in the HFNC group than in the NPPV group (t=-2.049,-2.618, and -3.314, P=0.043, 0.010, and 0.001, respectively). SPO₂ before discharge was significantly lower than that of the NPPV group (t=2.162, P=0.033), but OI at each time point and before discharge had no statistical significance (P＞0.05). MAP at 6 h was significantly higher in the HFNC group than in the NPPV group (t=-2.209, P=0.029), but within the normal range. HRs at 2 h and 3 h in the HFNC group were significantly higher than those of the NPPV group (t=-2.199 and -2.336, P=0.030 and 0.021, respectively). There were no significant differences in RR, HR, or MAP between the two groups at other time points and before discharge (P＞0.05). There was no significant difference in PaCO2 between the two groups (P＞0.05). Comfort score in the HFNC group was significantly higher than that of the NPPV group (t=-46.807, P＜0.001). There were no significant differences in discharge rate, ICU transfer rate, endotracheal intubation rate, and mortality between the two groups (P＞0.05). ConclusionHFNC is as effective as NPPV in treating elderly patients with AECOPD complicated with type Ⅰ or mild type Ⅱ respiratory failure, and HFNC is more comfortable than NPPV.     

美托洛尔用于老年COPD合并冠心病史治疗的临床疗效观察

目的:探讨美托洛尔(β1受体阻滞剂)用于老年COPD合并冠心病史治疗的临床疗效。方法:选取2018年6月—2019年6月在我院接受治疗的60岁以上(包括60岁)COPD合并冠心病史老年患者,分为对照组与观察组。对照组给予接受布地奈德福莫特罗粉吸入剂治疗,观察组在使用布地奈德福莫特罗粉吸入剂治疗的基础上口服琥珀酸美托洛尔缓释片治疗,观察对比两组治疗效果。结果:观察组临床治疗效果优于对照组,观察组住院时长以及并发症的发生率低于对照组(P<0.05),差异具有统计学意义。结论:老年COPD合并冠心病史接受美托洛尔治疗,可有效缩短住院时长、用药效果明显、有效提升用药安全性,值得临床推广。     

联合手术治疗白内障合并青光眼的临床观察

目的:探讨联合手术治疗白内障合并青光眼的临床效果。方法:以我院收治的84例(90眼)白内障合并青光眼患者作为研究对象,观察组患者给予联合手术治疗,对照组患者给予联合手术治疗。结果:观察组患者的术后并发症发生率为6.67%,对照组为15.55%,观察组患者的术后并发症发生率要明显低于对照组,两组之间的差异具有统计学意义(P0.05)。结论:应用联合手术方法治疗白内障合并青光眼可以取得很好的治疗效果,能够有效的改善患者的临床症状,安全性较好。     

探讨替米沙坦对冠心病合并糖尿病肾病患者疗效的影响

目的:探究替米沙坦对冠心病合并糖尿病肾病患者疗效的影响情况。方法:56例探究目标对象均为某院接收的冠心病合并糖尿病肾病患者,挑选时间2018年6月~2019年6月。将"计算机表法"作为分组的参考,分配为参照组(n=28例)执行依那普利治疗,探究组(n=28例)执行替米沙坦治疗。结果:探究组的LVEF、LVEDd、肌酐、24h尿蛋白4项指标与参照组相比,差异有统计学意义(P<0.05);收缩压、舒张压、空腹血糖、餐后2h血糖4项指标与参照组相比,差异没有统计学意义(P>0.05)。结论:冠心病合并糖尿病肾病患者选择替米沙坦治疗后,心室功能的重构以及肾脏预后结局均得到改善,且临床效果比依那普利好,值得借鉴。