腺性膀胱炎电切术后卡介苗与碘伏膀胱灌注的疗效比较

目的比较腺性膀胱炎电切术后卡介苗与碘伏膀胱灌注的疗效。方法 63例病理证实的腺性膀胱炎患者随机分为两组,卡介苗(BCG)组33例行经尿道电切术后卡介苗膀胱内灌注,碘伏组30例行经尿道电切术后碘伏膀胱内灌注,两组患者均随访12个月,比较灌注后的疗效及复发率。结果 BCG组23例治愈,9例好转,1例无效,4例复发;碘伏组15例治愈,6例好转,9例无效,10例复发,BCG组疗效优于碘伏组,有统计学意义(uc=2.12,P<0.05),BCG组复发率低于碘伏组,差异有统计学意义(χ2=4.26,P<0.05)。结论腺性膀胱炎电切术后卡介苗灌注在促进治愈好转、预防复发方面优于术后碘伏灌注。     

脑出血昏迷患者采用纱布进行口腔护理的效果评价李艳华

目的 评价脑出血昏迷患者使用纱布进行口腔护理的效果,明确良好的口腔护理是否可以减少患者的并发症。方法 选择上海市浦南医院神经外科监护室脑出血昏迷患者60例,类实验性研究,对照组(30例)采用传统的口腔护理方法,实验组(30例)采用纱布进行口腔护理,观察并比较两组病人口腔护理的效果及十四天后患者肺部感染的发生率。结果 实验组患者口腔内细菌培养发生率、口腔清洁度、口腔溃疡的发生率、肺部感染情况均优于对照组(P<0.05)。结论 脑出血昏迷患者口腔护理采用纱布可减少口腔细菌的定植率,明显提高患者口腔的清洁度,同时对防治患者肺部并发症具有重要意义。     

The “strip” patch test: results of a multicentre study towards a standardization

Background The strip patch test (SPT) is a variant of patch testing which is used for substances with a poor percutaneous penetration. Penetration of the substances is enhanced by repeated applications of adhesive tape prior to their application to the skin. However, no guidelines exist for standardized performance of the SPT.Objectives The aim of this multicentre study was to obtain a first practical approach towards a standardized SPT procedure.Methods Intact noninflamed skin of the upper back of 83 healthy volunteers was tape-stripped. For sequential strips, a 25-mm diameter 3M Blenderm surgical tape was vertically applied and gently pressed downward using the fingertips for about 2 s. The tape was removed in one quick movement at an angle of 45° in the direction of adherence. Each strip was performed with a new piece of tape on exactly the same skin area.Results In each subject, we first determined the number of strips (A) until the skin surface started to glisten and calculated the median number of strips () in the sample (=26 strips). We then ascertained the median number of strips () in the sample that was necessary to achieve a statistically significant and twofold increase in TEWL (=11 strips), revealing a critical stratum corneum strip depth. The unknown number of strips (a) for each subject was finally calculated from the formula a/A=/, i.e. the individual number of strips (A) until the skin surface started to glisten was multiplied by a derived tape-specific correction factor (cf=/=11/26=0.4). The increase in percutaneous penetration in strip patch testing by performing a strips versus conventional patch testing was shown by scoring of clinical and subjective SLS irritant reactions.Conclusions The present multicentre study outlines an experimentally derived approach for a uniform SPT procedure, which does not require the use of complex technical equipment. This first approach now requires validation by a study involving the application of allergens to obtain evidence of enhancement in the sensitivity of patch testing.This work is presented on behalf of the German Contact Dermatitis Research Group (DKG).Parts of the work have been presented before in oral presentations at the 42nd Meeting of the German Dermatology Society (DDG) in Berlin, Germany, in May 2003, at the 7th Meeting of the Working Group on Occupational and Environmental Dermatology (ABD) of the DDG in Heidelberg, Germany, in September 2003, and at the 7th Congress of the European Society of Contact Dermatitis (ESCD) in Copenhagen, Denmark, in June 2004.We regret to report the recent death of Hans Joachim Schwanitz.     

可抽取性纱布填塞法在成人难治性心血管外科出血中的应用

目的探讨难治性心血管外科出血的应对策略。方法我院2008年1月—2011年5月成人心外科7652例体外循环手术中,对31例常规止血难以控制的病例采用可抽取性纱布填塞局部压迫的方法进行总结分析。结果 29例患者有效地控制了出血,缩短了手术时间,3例二次开胸,没有相关感染、心包填塞等并发症发生。围术期死亡2例。结论可抽取性纱布填塞法可减少手术时间、避免二次开胸的手术风险,是一种有效应对心外科难处理大出血的方法之一。     

三黄油纱条对鼻内镜术后鼻腔黏膜的改善作用

目的探讨三黄油纱条作为鼻腔填塞物的医学应用价值,为鼻科治疗提供一种新的、更有效的治疗手段。方法 76例慢性鼻窦炎鼻内镜手术后需要鼻部填塞的患者采用随机单盲对照设计方法分为两组进行临床试验。两组术后按照鼻窦炎术后护理。试验组鼻腔填塞三黄油纱条,术后24小时抽除纱条;对照组鼻腔置放普通凡士林油纱条,术后24小时抽除纱条。观察两组填塞前后鼻腔状况、术后基本情况、囊泡和肉芽等病变再生情况、上皮化完成的时间。结果两组疗效比较,差异有统计学意义（Z=-4.159,P〈0.01）;上皮化完成时间、出血量、出血次数差异无统计学意义（P〉0.05）,而鼻阻塞、头昏、头痛、黏膜情况、分泌物、息肉变化、囊泡情况评分试验组低于对照组,差异有统计学意义（P〈0.05）。结论三黄油纱作为鼻腔填塞物用于慢性鼻窦炎术后的鼻腔填塞效果优于对照组,有可能成为治疗慢性鼻窦炎术后新型鼻腔填塞物。     

碘伏液用于儿童白血病化疗后致黏膜炎的护理观察

目的：通过应用碘伏液和嘎木珠尔粉对黏膜炎护理的效果对比,总结出更有效的儿童白血病化疗后黏膜炎的护理方法。方法：对接受化疗的78例急性白血病患儿,进行碘伏液护理黏膜炎疗效观察,同时以传统方法蒙药-嘎木珠尔粉护理作为对照组。结果：碘伏液治疗组显效率和有效率分别为38.9%、52.8%;嘎木珠尔粉治疗组显效率和有效率分别为23.8%、43.9%;碘伏液治疗组的显效率和有效率与嘎木珠尔粉治疗组比较差异有统计学意义（P〈0.05）。结论：碘伏液对儿童白血病行化疗后黏膜炎的护理疗效肯定,方便见效快,明显优于嘎木珠尔粉治疗法。     

两种消毒方法对外固定架针孔的消毒效果

目的比较两种消毒方法对外固定架针孔消毒的效果,探讨高效、安全、经济、方便的外固定架消毒方法。方法将98例下肢骨折使用外固定架的患者,随机分为实验组和对照组,实验组用1%碘伏消毒针孔、生理盐水擦拭外固定架,2～3周后,针孔及架均用生理盐水消毒。对照组:用75%酒精消毒针孔及架,直到拆除外固定架。结果实验组消毒效果优于对照组,随访6个月实验组患肢功能优良率明显好于对照组(P<0.05)。结论实验组消毒方法应用于外固定架消毒有明显的优越性。     

两种消毒方法对外固定架针孔的消毒效果

目的比较两种消毒方法对外固定架针孔消毒的效果,探讨高效、安全、经济、方便的外固定架消毒方法。方法将98例下肢骨折使用外固定架的患者,随机分为实验组和对照组,实验组用1％碘伏消毒针孔、生理盐水擦拭外固定架,2～3周后,针孔及架均用生理盐水消毒。对照组：用75％酒精消毒针孔及架,直到拆除外固定架。结果实验组消毒效果优于对照组,随访6个月实验组患肢功能优良率明显好于对照组（P〈0．05）。结论实验组消毒方法应用于外固定架消毒有明显的优越性。     

甲状腺手术中可吸收性止血纱布的应用研究

目的:观察可吸收性止血纱布(商品名:泰绫)在甲状腺手术中的止血及术区不放置引流保证美容的治疗效果。方法:将120例接受甲状腺手术的患者随机分成三组,每组各40例。A组:应用可吸收性止血纱布置于甲状腺术后创面并放置颈前引流;B组:创面不放置任何止血材料放置颈前引流管;C组:应用可吸收性止血纱布置于甲状腺术后创面不放置颈前引流。A组、B组分别于术后12h以及24h观察引流管的引流量。C组进行3～5个月的随访。结果:A组术后颈部引流量较B组明显减少(P<0.05)。C组采取局部检查和彩超检查,均未发现有排斥反应、感染、血肿等情况。患者切口美观程度优于A、B组。结论:可吸收性止血纱布在甲状腺术中具有安全、有效的止血作用,尤其对甲状腺手术患者避免放置引流管起到积极的作用。     

宫腔纱布填塞术治疗产后出血

目的观察宫腔纱布填塞术治疗产后出血的临床疗效。方法选择56例因宫缩乏力导致产后出血病例,随机分成实验组和对照组,实验组采用宫腔纱布填塞术治疗,对照组用冰水囊宫腔填塞术治疗,比较两组的临床疗效。结果宫腔纱布填塞术治疗产后出血在止血时间、24h出血量上明显优于冰水囊宫腔填塞术法(P<0.01)。结论宫腔纱布填塞术治疗产后出血,具有对产妇损伤小,操作简便,对组织无损伤,止血效果快的优点,是治疗产后出血的较好方法。