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31.
目的 评价逐瘀止血汤加减对慢性子宫内膜炎(CE)气虚血瘀证患者妊娠结局的影响及对免疫炎症因子的调节作用。方法 将144例患者随机按数字表法分为观察组和对照组各72例。观察组脱落、失访4例,剔除2例,完成66例;对照组脱落、失访3例,剔除5例,完成65例。两组均给予抗感染治疗14 d。对照组口服妇科千金片,6片/次,3次/d。观察组内服逐瘀止血汤加减,1剂/d。两组疗程均为3个月,并随访6个月。记录治疗前后月经经量、经期和周期变化情况;进行治疗前后宫腔镜和阴道彩色多普勒超声检查,评价子宫内膜形态、子宫内膜容受性(CP)[子宫内膜厚度、阻力指数(RI),搏动指数(PI)和血流指数(FI)]等,并进行子宫内膜病理检查;进行治疗前后气虚血瘀证评分;检测治疗前后月经血白细胞介素-1β(IL-1β),IL-6和肿瘤坏死因子-α(TNF-α)水平和外周血测T淋巴亚群(CD3+,CD4+,CD8+)水平;随访记录妊娠情况和流产情况。进行安全性评价。结果 治疗后观察组经量、经期、周期和月经完全正常率均高于对照组(P<0.05);观察组子宫内膜厚度和FI均高于对照组(P<0.01),RI和PI均低于对照组(P<0.01);观察组月经血IL-1β,IL-6和TNF-α水平均低于对照组(P<0.01);观察组CD3+,CD4+水平和CD4+/ CD8+均高于对照组(P<0.01),CD8+水平低于对照组(P<0.01);在6个月随访期间,观察组妊娠率46.97%(31/66),高于对照组的27.69%(18/65)(χ2=5.197,P<0.05);观察组子宫内膜形态疗效总有效率为96.97%(64/66),高于对照组的86.15%(56/65)(χ2=4.981,P<0.05);观察组子宫内膜病理组织疗效总有效率为95.45%(63/66),高于对照组的84.62%(55/65)(χ2=4.304,P<0.05);观察组综合临床疗效总有效率为93.94%(62/66),高于对照组的81.54%(55/65)(χ2=4.696,P<0.05);两组治疗期间均未发现与中药相关不良反应。结论 逐瘀止血汤加减治疗CE气虚血瘀证患者,可调经月经、减轻临床症状,改善宫腔镜下内膜形态,调节全身和局部的免疫炎症反应,提高了CP,从而改善了妊娠结局,有着较好的综合疗效,且安全。 相似文献
32.
Yu Fan Xiaoling Liao Yuesong Pan Kehui Dong Yilong Wang Yongjun Wang 《Journal of stroke and cerebrovascular diseases》2019,28(1):220-226
Background
The intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) therapy is safe and efficient during the treatment of acute ischemic stroke. Nonetheless, the different outcomes among various stroke subgroups have limited data with regard to the safety and efficacy of cryptogenic stroke (CS). The present study compared the safety and efficacy when IVT with rt-PA was used for the treatment of CS and the other stroke subtypes.Methods
This study classified the IVT with rt-PA patients within 4.5 hours after stroke onset, based on the trial of ORG 10172 in acute stroke treatment criteria in terms of diagnostic evaluation. The data were obtained from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China database, a large multicenter prospective registry. A multivariable logistic regression model was employed to compare the differences between the subtypes in symptomatic intracerebral hemorrhage (sICH) within 7 days and studied the mortality and the outcome during 90 days.Results
In total, 1118 patients were recruited; of these, 131 (11.7%) suffered from CS and 987 (88.3%) with the other etiology. In the CS group, patients were younger than those in the other etiology groups (P < .001). Moreover, it had a lower prevalence of previous stroke (P?=?.0117), receiving antiplatelet drug in 24 hours prior to thrombolysis (P?=?.0017), and functional independence (mRS > 1 before stroke, P?=?.003). The CS group had lower blood pressure (systolic blood pressure P?=?.0001; diastolic blood pressure; P?=?.0212) before thrombolysis, atrial fibrillation (P < .001), and diabetes mellitus (P?=?.0005). Transient ischemic attack, hypertension, hyperlipidemia, blood glucose, receiving anticoagulants in 24 hours prior to thrombolysis, and standard dosage of rt-PA were equally distributed in both groups. After the adjustment of confounders between the CS and the other subgroups, no obvious differences were observed in sICH rate and mortality (P > .05) The CS patients exhibited excellent recovery (mRS, 0-1; 63.78%) and functional independence (mRS, 0-2; 74.8%) than the large artery atherosclerosis patients.Conclusions
IVT with rt-PA is a safe and effective method for the treatment of CS patients. 相似文献33.
34.
目的 探讨腰硬联合(CSEA)及患者自控镇痛(PCEA)对产程及分娩结局的影响。方法 随机选取2014年1~12月足月待产、无妊娠合并症和并发症初产妇996例,其中503例产妇于活跃期实施CSEA+PCEA镇痛(分娩镇痛组),493例未行分娩镇痛(对照组),分别记录并比较两组产妇各产程时间、子宫收缩、镇痛效果、运动神经阻滞程度、产程中缩宫素的使用率、产后出血率、羊水Ⅲ度污染率、新生儿Apgar评分、产钳助产和剖宫产率。结果 分娩镇痛组第一产程、第二产程较对照组有所延长,差异有统计学意义(P<0.05);第三产程无明显改变;子宫收缩力减弱;分娩镇痛组较对照组镇痛效果显著,差异有统计学意义(P<0.05);运动阻滞程度低;缩宫素使用率、产后出血率、羊水Ⅲ度污染率、及新生儿Apgar评分及产钳助产和剖宫产率两组比较,差异均无统计学意义(P>0.05)。结论 腰硬联合分娩镇痛可能会使第一产程、第二产程延长,对子宫收缩力有一定的影响,但并未增加缩宫素的使用率及产钳助产和剖宫产率,其镇痛效果显著,运动阻滞程度低,对分娩结局无不良影响。 相似文献
35.
Background Context
Long-term follow-up of patient-reported outcome measures (PROM) is essential in both modern spinal care and research. Lack of time and staff are commonly reported barriers to implementing long-term follow-up of PROM. Automated and digital follow-up systems for PROM collection are seeing widespread use, yet their validity and comparative effectiveness have never been evaluated.Purpose
The present study aimed to assess the validity of digital follow-up systems in comparison with the conventional paper-based follow-up (PB-FU).Study Design
This is a retrospective analysis of prospectively collected double follow-up data.Patient Sample
Patients who underwent lumbar spinal fusion for spondylolisthesis or degenerative disc disease between 2013 and 2016 were included in the study.Outcome Measures
The study determined the Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS) for back and leg pain severity at baseline, 6 weeks, 12 months, and 24 months.Materials and Methods
After lumbar spinal fusion surgery, a double follow-up of PROM was carried out by conventional PB-FU during clinical visits, while simultaneously completing an automatically dispatched digital follow-up questionnaire. As the primary end point, we assessed the intraindividual discrepancy in PROM between PB-FU and automated digital follow-up (AD-FU).Results
Forty patients completed all parts of the dual follow-up trajectory and were analyzed. We detected no discrepancy in ODI or NRS for back and leg pain severity at any of the baseline, 6-week, 12-month, or 24 month follow-ups (all p>.05). This was confirmed in a sensitivity analysis.Conclusions
In an analysis of dual paper-based and digital follow-up after lumbar fusion surgery, patients report highly similar values using either method of follow-up. It appears that AD-FU without incentives produces lower response rates. To reassess the validity of these systems for data collection in spinal patient care, a prospective validation with higher statistical power is warranted. 相似文献36.
Shinichiro Uchiyama Takao Hoshino Leila Sissani Monteiro Tavares Linsay Kenji Kamiyama Taizen Nakase Kazuo Kitagawa Kazuo Minematsu Kenichi Todo Yasushi Okada Jyoji Nakagawara Ken Nagata Hiroshi Yamagami Takenori Yamaguchi Pierre Amarenco 《Journal of stroke and cerebrovascular diseases》2019,28(8):2232-2241
BackgroundTIAregistry.org is an international cohort of patients with transient ischemic attack (TIA) or minor stroke within 7 days before enrollment in the registry. Main analyses of 1-year follow-up data have been reported.5 We conducted subanalysis on the baseline and 1-year follow-up data of Japanese patients.MethodsThe patients were classified into 2 groups based on Japanese ethnicity, Japanese (345) and non-Japanese (3238), and their baseline data and 1-year event rates were compared. We also determined risk factors and predictors of 1-year stroke.ResultsCurrent smoking, regular alcohol drinking, intracranial arterial stenosis, and small vessel occlusion; and hypertension, dyslipidemia, coronary artery disease, and extracranial arterial stenosis were more and less common among Japanese patients, respectively. Stroke risk was higher and TIA risk was lower at 1-year follow-up among Japanese patients. The baseline risk factors for recurrent stroke were diabetes, alcohol drinking, and large artery atherosclerosis. Independent predictors of 1-year stroke risk were prior congestive heart failure and alcohol consumption.ConclusionsThe two populations of patients featured differences in risk factors, stroke subtypes, and outcome events. Predictors of recurrent stroke among Japanese patients included congestive heart failure and regular alcohol drinking. Strategies to attenuate residual risk of stroke aside from adherence to current guidelines should take our Japanese-patient specific findings into account. 相似文献
37.
38.
Giada Lullini Eugenio Cammisa Stefania Setti Iacopo Sassoli Stefano Zaffagnini Giulio Maria Marcheggiani Muccioli 《World journal of orthopedics》2020,11(6):285-293
Although the rate of patients reporting satisfaction is generally high after joint replacement surgery, up to 23% after total hip replacement and 34% after total knee arthroplasty of treated subjects report discomfort or pain 1 year after surgery. Moreover, chronic or subacute inflammation is reported in some cases even a long time after surgery. Another open and debated issue in prosthetic surgery is implant survivorship, especially when related to good prosthesis bone ingrowth. Pulsed Electro Magnetic Fields(PEMFs) treatment, although initially recommended after total joint replacement to promote bone ingrowth and to reduce inflammation and pain, is not currently part of usual clinical practice. The purpose of this review was to analyze existing literature on PEMFs effects in joint replacement surgery and to report results of clinical studies and current indications. We selected all currently available prospective studies or RCT on the use of PEMFs in total joint replacement with the purpose of investigating effects of PEMFs on recovery, pain relief and patients' satisfaction following hip, knee or shoulder arthroplasty. All the studies analyzed reported no adverse effects, and good patient compliance to the treatment. The available literature shows that early control of joint inflammation process in the first days after surgery through the use of PEMFs should be considered an effective completion of the surgical procedure to improve the patient's functional recovery. 相似文献
39.
目的 探讨经皮电刺激联合导乐分娩镇痛对分娩结局的影响及安全性。方法 选择160例在我院住院待产的产妇作为研究对象,随机将其分为观察组与对照组,每组各80例;其中对照组予导乐分娩镇痛,观察组给予经皮电刺激联合导乐分娩镇痛。观察比较两组的VAS评分、产程时间、产后出血、剖宫产率、产妇满意度、新生儿情况、不良反应发生情况等。结果 与镇痛前比较,观察组镇痛后各时间段VAS评分降低,P<0.05;与对照组比较,观察组的产后2 h出血量、剖宫产率降低,产妇满意度提高,P<0.05。结论 经皮电刺激联合导乐镇痛可减轻产妇痛苦,降低剖宫产率,减少产后出血,提高产妇满意度,且无明显不良反应,值得在临床上推广应用。 相似文献