镇痛泵持续硬膜外滴注术后镇痛疗效观察

病人术后镇痛方法很多,要达到镇痛完全、病人舒适、镇痛药量最小、安全且副作用最少,则是需要探讨的课题。我们对雅倍镇痛泵持续硬膜外滴注,与术毕一次性硬膜外注入镇痛药物两种方法作对比观察,结果报道如下。     

老年COPD患者并发肺部真菌感染的相关因素分析及控制对策

目的探讨老年COPD患者并发肺部真菌感染的相关诱因，为有效控制老年COPD患者肺部真菌感染提供依据。方法对本院住院61例老年COPD患者并发肺部真菌感染病例进行分析。结果免疫功能低下、广谱抗生素的使用、侵入性操作及住院时间过长等是老年COPD患者并发肺部真菌感染的主要诱因。结论应加强对相关诱因的控制，从而有效减少老年COPD患者并发肺部真菌感染的发生。     

烟曲霉引起肺部感染1例

近年来随着皮质激素、免疫抑制荆、各种广谱抗生素等在临床的大量应用以及临床各种侵入性检查和治疗技术的不断开展,使烟曲霉感染呈上升趋势。2006年8月,我们从1例支气管哮喘患者痰液中两次分离出烟曲霉,现报道如下。1病例简介患者女性,54岁。因反复咳嗽、咳痰、喘息40年并加重     

新生儿硬肿症的保温护理和治疗

新生儿硬肿症是新生儿时期常见病之一。一般在出生一周内发生，是新生儿特别是早产儿因受寒、饥饿、感染、缺氧、窒息等影响，引起皮下脂肪硬化与水肿的一种疾病。特别是重症硬肿症恶化迅速并发症多，严重可导致心、肺、肾多脏器损害，甚至出现DIC，死亡率高。在对病儿护理中以复温为主，加以一般护理。治疗选用综合治疗，同时加用东莨菪碱、多巴胺和潘生丁。     

髓过氧化物酶和过氧化氢酶基因多态性及其酶活力与燃煤污染型地方性砷中毒关系的探讨

Objective To detect genetic polymorphism of myeloperoxidase (MPO) gene and catalase (CAT) gene and their activities, and to analyze their relationship with arsenic poisoning caused by coal-burning. Methods One hundred and thirty arsenic poisoning patients were chosen as case group in Jiaole Village, Xingren County, Guizhou Province(an endemic area). One hundred and forty healthy residents living in 13 km away were chosen as control group. Their blood was collected. Polymerase chain reaction-restriction fragment length polymorphism technique(PCR-RFLP) was used to detect polymorphism of MPO-463G/A and CAT-262C/T. Ultraviolet spectmphotometer method was used to detect myeloperoxidase activity. Chromatometry method was used to detect catalase activity. Results The genotype frequency of MPO-463G/A at GG, GA, AA site was 47.24%(60/127), 44.09%(56/127),8.67% (11/127) in case group and 42.34% (58/137),48.17% (66/137)1,9.49% (13/137) in control group, respectively. The difference between the two groups was not significant(χ2 = 0.642, P > 0.05). The genotype frequency of CAT-262C/T, at CC, CT, TT site was 65.60%(82/125),28.80%(36/125),5.60%(7/125) in case group and 76.51%(101/132), 18.94% (25/132) ,4.55% (6/132) in control group, respectively, without significant difference (χ2 =3.845, P>0.05). The relationship between polymorphism of MPO-463G/A and CAT-262C/T and the risk of arsenic poisoning was not found in this study(ORadj= 1.36, 95%CI: 0.74-2.50 for MPO; ORadj=1.35, 95%CI: 0.69-2.63 for CAT). The activities of MPO and CAT were (25.30±8.70)U/L and (2.80± 1.09)×103 U/L in case group, while (22.76±7.59)U/L and (3.90±1.01)×103U/L in control group with a significant difference(F=0.760 for MPO, F=0.855 for CAT, all P < 0.05). The genotype of MPO-463G/A and CAT-262C/T was not found to have relationship with the activities of MPO, CAT(F=1.312,2.822 for MPO; F= 0.151,0.036 for CAT, P>0.05). Conclusions Genetic polymorphism of MPO-463G/A and CAT-262C/T is not found to have relationship with arsenic poisoning. Arsenic can lead to the change of MPO and CAT activity, which, however, may not be affected by MPO-463G/A and CAT-262C/T polymorphism.     

儿童急性再障误诊为特发性血小板减少性紫癜1例分析

对儿童急性再障误诊为特发性血小板减少性紫癜1例分析如下。 1 病历要 女，10岁。因鼻衄15d，面色苍白伴全身皮肤紫癜1周，发热3d入院。患15d前无明显诱因出现鼻衄现象，3次／d，每次出血量较多，无发热、腹痛等不适。在当地诊所对症治疗（用、药不详）后有明显好转，但未进一步诊治。     

加强护理安全管理强化护士法律意识

针对当前护理安全面临的挑战，强化护士法律意识已非常必要，要求护理人员认真学法、懂法、守法，工作中用法律来保护自己。同时充分认识到护理行为与病人生命的密切关系，并在工作中以规章制度、法律法规来约束自己，以不断提高自身素质和护理质量，加强护理安全管理，对不安全因素提出相应的防范措施和对策，减少或杜绝医疗差错和事故的发生，以维护医患双方的合法权益。     

不同程度的溶血对ELISA一步法检测HBsAb的影响

目的探讨不同程度溶血标本对ELISA一步法检测HBsAb结果的影响。方法分别用已知HBsAb和HBsAb阳性的血标本．人为造成不同程度的溶血，同时用ELISA一步法进行HBsAb检测，用酶标仪检测标本OD值，通过对检验结果的观察，分析溶血标本对ELISA一步法检测的干扰程度。结果以标本的OD：cut off≥1为阳性进行结果判读。结果当样本中游离血红蛋白≥8g／L时，对ELISA一步法检测有明显的影响，可造成结果假阳性。结论用ELISA一步法进行HBsAb检测时，如样本游离血红蛋白≥8g／L时，要重新取样进行复查。     

乳腺分泌物中检出产色葡萄球菌1例

凝固酶阴性葡萄球菌是人体体表及腔道的正常菌群,当机体抵抗力低下时可引起机体的各种感染。2006年11月,我们从1例患者乳腺分泌物中分离出产色葡萄球菌(Staphylococcuschromogenes),现报道如下。1病例介绍1·1一般资料患者女性,31岁,因双侧乳房注射隆乳术后4年,右侧乳房肿痛3天