干扰素治疗小儿呼吸道感染的研究

目的观察干扰素治疗小儿呼吸道感染的疗效。方法将90例呼吸道感染的小儿随机分成3组,在对症治疗基础上,A组静脉点滴利巴韦林10mg/(kg·d),B组肌注干扰素10μg,1次/d,C组空气压缩泵雾化吸入干扰素10μg,1次/d,观察3组的病情变化。结果C组咳嗽、发热、喘憋及肺部体征好转时间均较A组明显缩短(P<0.01),B组与C组疗效无显著性差异。结论干扰素治疗小儿呼吸道感染疗效确切,值得推广。     

黄连解毒汤对高胆固醇兔血液流变学和动脉粥样硬化干预作用

目的:观察黄连解毒汤对肺炎衣原体(Cpn)感染后高胆固醇饮食兔血液流变学和动脉粥样硬化的影响.方法:造模前60只新西兰兔经采血检测Cpn IgG均为阴性.随机选取8只兔作正常组,其余52只以含2.5 g·kg~(-1)胆固醇的饲料喂养并接种Cpn.经检测血清Cpn IgG阳性者随机分为4组:黄连解毒汤高、低剂量(3.34,1.67 g·kg~(-1)·d~(-1))组、阳性药阿奇霉素(20 mg·kg~(-1)·d~(-1))组和模型组(生理盐水),每组11只,灌胃给药6周;Cpn IgG阴性者作高胆固醇组,不予药物干预.治疗结束后采血测定高、中、低全血黏度、血浆黏度和红细胞压积,并计算RBC聚集指数、变形指数和刚性指数;取主动脉弓近左颈总动脉分叉处血管,测定和计算最大血管内膜厚度(MIT)、动脉粥样硬化病变占管周百分比(P_(LCI))、动脉粥样硬化斑块面积指数(Ⅰ_(PA)).结果:高胆固醇组和模型组血液流变学均显著紊乱,主动脉均有典型的动脉粥样硬化病理变化,后者最大MIT(23.65±8.19 vs 12.76±4.06)μm、动脉粥样硬化病变P_(LCI)(41.08±12.51 vs 22.43±9.45)%、动脉粥样硬化斑块Ⅰ_(PA)(9.57±1.82 vs 2.84±0.25)%显著较前者高(均P＜0.01);黄连解毒汤高、低剂量组、阿奇霉素组血液流变学紊乱和动脉粥样硬化病理变化与模型组比较显著改善,其中黄连汤高剂量组MIT(6.45±1.27 vs 23.65±8.19),(P＜0.01),P_(LCI),(22.39±6.74 vs41.08±12.51),(P＜0.05);Ⅰ_(PA)(1.44±0.33 vs 9.57±1.82),(P＜0.01)显著降低.结论:Cpn感染加重高胆固醇饮食兔血液流变学紊乱和动脉粥样硬化损害,黄连解毒汤可减轻Cpn感染所致高胆固醇饮食兔的血液流变学紊乱和动脉粥样硬化损害.     

封闭式负压引流治疗软组织感染

目的探讨封闭式负压引流治疗软组织感染的疗效。方法应用封闭式负压引流治疗开放性骨折发生软组织感染18例。结果18例均获随访,时间6个月-1年6个月。软组织感染均愈合,骨折正常愈合12例,延迟愈合6例,无慢性骨感染发生。结论封闭式负压引流治疗软组织感染,可短期控制感染,为进一步治疗创造条件,尤其适用于深部软组织感染患者。手术简单,疗效可靠,适合基层医院应用。     

左氧氟沙星序贯治疗下呼吸道感染的临床评价

目的评价左氧氟沙星序贯治疗下呼吸道感染(LRTIs)的有效性和安全性。方法采用开放试验,应用左氧氟沙星注射液0.3g治疗30例LRTIs患者,1～2次/d,静脉滴注,4～6d,序贯以0.2g,2次/d,口服,5～9d。结果痊愈率、有效率、细菌清除率分别为63.33%,86.67%,89.29%,不良反应轻微。结论左氧氟沙星序贯治疗下呼吸道感染疗效肯定,安全、经济、方便。     

Effectiveness of a hospital-wide selective screening programme for methicillin-resistant Staphylococcus aureus (MRSA) carriers at hospital admission to prevent hospital-acquired MRSA infections

Screening of potential MRSA-positive patients at hospital admission is recommended in German and international guidelines. This policy has been shown to be effective in reducing the frequency of nosocomial MRSA transmissions in the event of an outbreak, but the influence of screening on reducing hospital-acquired MRSA infections in a hospital setting where MRSA is endemic is not yet well-documented. This study describes the effect of hospital-wide screening of defined risk groups in a 700-bed acute care hospital during a period of 19 months. In a cohort study with a 19-month control period, the frequencies of hospital-acquired MRSA infections were compared with and without screening. In the control period, there were 119 MRSA-positive patients, of whom 48 had a hospital-acquired MRSA infection. On the basis of this frequency, a predicted total of 73.2 hospital-acquired MRSA infections was calculated for the screening period, but only 52% of the expected number (38 hospital-acquired MRSA infections) were observed, i.e., 48% of the predicted number of hospital-acquired MRSA infections were prevented by the screening programme. The screening programme was performed with minimal effort and can therefore be recommended as an effective measure to help prevent hospital-acquired MRSA infections.     

鱼腥草注射液佐治下呼吸道感染的疗效观察

目的观察鱼腥草注射液佐治下呼吸道感染的疗效及安全性.方法将76例急性下呼吸道感染患者随机分为治疗组和对照组,两组均予内科常规治疗,治疗组则另予鱼腥草注射液治疗.结果治疗组的总有效率为94.7%,显著优于对照组的73.7%(x2=6.33,P＜0.05),且未见明显副作用.结论鱼腥草注射液佐治急性下呼吸道感染安全、有效,值得推广.     

Situation analysis of quality of abortion care in the main maternity hospital in Hai Phòng, Viet Nam

Six months after a Comprehensive Abortion Care project was implemented in Phu-San Hospital, the main maternity hospital in Hai Phòng, northern Viet Nam, a study of quality of abortion services was carried out. The study explored the interaction between providers and women seeking abortion and how cultural values influenced quality of care. A quantitative and qualitative approach was employed: a three-part structured survey with 748 women before and after they had an abortion, 20 in-depth interviews with women just after abortion, seven informal interviews with health care staff and 100 participant observations. Both the women and the staff equated quality of care mainly with improved technical performance of abortion. Insufficient knowledge and skills had a negative impact on provision of information and good quality counselling in relation to understanding and uptake of contraception, treating reproductive tract infection and preventing post-abortion infection. To further improve abortion care in hospitals such as Phu-San, training programmes are needed that integrate counselling and clinical skills and address the cultural factors that hinder health staff and women from interacting in an equitable manner. A supportive supervisory system that holds health staff accountable for conducting high quality information and counselling sessions should also be established.     

慢性肝病合并细菌感染临床特点分析

目的 :分析慢性肝病合并细菌感染的特点。方法 :对 1997～ 2 0 0 2年住院的慢性重度、重症肝类及肝硬化合并细菌感染患者 52例进行回顾性分析。结果 :其中医院内感染占 2 9 8%。感染的部位 :腹腔感染 40 4% ,血液感染17 3 % ,呼吸道感染 18 1% ,肠道感染 9 6% ,胆道感染 7 7% ,口腔感染占 6 3 % ,其他感染占 3 3 % ,重型肝炎的感染率最高 ,其次为肝硬化和慢性重度肝炎。结论 :肝病患者免疫力低下 ,易于合并细菌感染 ,感染使病情加重 ,影响肝病的愈后 ;提高患者免疫力 ,增强控制医院感染的措施 ,重视潜伏感染状态病灶的处理 ,早期诊治感染可提高肝病患者的生存率     

3261例老年患者医院感染分析及对策

目的　探讨老年人医院感染状况 ,以采取有效措施降低医院感染率。方法　对我院 3 2 61例老年住院患者进行回顾性调查分析。结果　 3 2 61例中 2 1 2例发生医院感染 ,感染率为 6 .5 % ,以下呼吸道感染为多 ,占 49.5 % ;其次为泌尿道感染 ,占 2 2 .0 % ;胃肠道感染占 1 6 .5 % ;皮肤感染占 6 .6 % ;其他感染占 5 .2 %。结论　老年患者抵抗力低下 ,不合理使用抗生素以及住院时间延长 ,是造成医院感染的主要因素 ,因此应加强老年患者的护理 ,提高其自身防御能力 ,严格加强感染管理制度及医院感染监测 ,合理使用抗生素 ,以有效地降低医院感染的发生。