肠套叠患儿的临床护理观察

一段肠管套入相邻的肠内称为肠套叠，是婴幼儿急腹症之一，也是最常见的急性肠梗阻疾患，4～10个月的小儿发病率最高。据统计，山东省肠套叠发病率在急腹症中占第3位。我科2001-2004年收治28例肠套叠患儿，均为10个月内的婴幼儿。经临床护理观察，采用非手术治疗的17例中14例空气灌肠整腹，3例钡剂灌肠整腹；手术复位的11例中8例行肠套叠手术松解，3例行肠管坏死切除。住院时间最长15d，最短1d。现将护理观察介绍如下。     

脊柱矫形术中唤醒试验的麻醉体会

<正>脊髓损伤是脊柱外科矫形手术中最严重的并发症,迄今为止仍未能完全避免,当患者手术结束完全清醒后发现脊髓损伤,虽然立即去除器械,采取各种措施,但脊髓功能仍不能完全恢复。     

超短波治疗输卵管不通的体会

输卵管不通其主要原因是由于各种感染因素所引起的输卵管炎症，如全身感染或人工流产，药物流产等其它原因引起的逆性型感染，炎症长期不愈，组织水肿及纤维组织大量增生，使输卵管不通，形成输卵管性不孕。如果堵塞不全，即输卵管通而不畅，易发生宫外孕。临床上经超短波治疗效果明显，将治疗体会介绍如下：     

Changes in T .lymphocyte subsets after severe traumatic brain inJury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.     

不同部位不同病原体感染引起感染综合征的异同--兼谈感染综合征的临床实践

感染综合征(sepsis或sepsis syndrome)的定义是感染 全身炎症反应综合征(SIRS)。它可视为一种基本的病理过程或独立的疾病诊断名,具有动态、复杂的病理生理过程,疾病轻重度的跨度大,临床表现多样、多变、个体差异大,诊断存在概率性(probability)[1]。由于缺乏“金标准”,诊断可分为确诊、临床诊断和可疑诊断。感染综合征这一整体疾病概念,打破了传统临床分科和以解剖器官、系统为专科基础的疾病分类概念,使许多疑难病得以早诊断、早治疗。但是仅仅停留在此诊断水平显然不够,应尽力找出其临床上已认识或可认识的临床综合征(尤其是感染性疾…     

电子束全身照射的实施和剂量学研究

自行设计了全身电子线照射(TSEI)的患者固定用标准体位架,以及可以人工360度旋转的特制旋转盘。分别应用剂量仪、仿真石蜡固体体模、固体水,柯达慢感光胶片,胶片分析仪等多种剂量测试工具,对开展该技术所需的临床剂量学参数进行系统的数据采集,并加以分析。总结出一套对临床行之有效的照射剂量参数,并已应用于临床,为逐步开展此项工作的临床机构提供参考。     

小儿全麻术后护理

小儿全麻在小儿外科中尤为常用。小儿由于大脑边缘系统尚未完全发育成熟，在使用全麻手术时，体内对麻醉剂的解毒能力较差，在临床上随时都有发生意外的可能，所以做好小儿全麻手术后的护理，是小儿外科护理工作中的一项重要内容。我科自1994年6月～2000年12月对小儿外科患者共施行了各种小儿全麻手术603例，无一例发生麻醉意外及术后并发症，现将护理体会介绍如下。     

治腮腺炎验方集萃

流行性腮腺炎是腮腺炎病毒所引起的急 性传染性呼吸道疾病,中医称“痄腮”此病多发于学龄前儿童,流行于冬春季节,发病急骤,恶寒发热,头痛,恶心,咽痛,全身不适,食欲不振。发病 1～2天内即出现腮腺肿大,肿胀部位以耳垂为中心漫肿,边缘不清,有弹性感,局部有些发硬,疼痛或压痛,张口咀嚼时疼痛加剧。两颊内腮腺管口可见红肿。治疗应及时,下列 21种验方治腮腺炎疗效卓著,可任意选用: 1 、赤小豆、青黛各 30g,大黄 15g。先将赤小豆、大黄研细末,再与青黛粉混匀分成五包,用鸡毛(翅羽)蘸药液涂两腮部。干后再涂,不拘次数,1～3 天能治愈。2 、川芦贝、…     

药物预防宫缩乏力性产后出血的临床观察

目的观察卡孕栓和催产素对宫缩乏力性出血的作用。方法正常分娩的产妇各150例,产后分别给与卡孕栓舌下含服及催产素静脉注射,观察2小时的出血量、出血发生率及用药副作用。结果卡孕栓组的产后出血量和出血率小于对照组,差异有显著性。结论卡孕栓预防产后出血的效果优于催产素,且无明显副作用。