锁骨钩板固定术治疗肩锁关节脱位48例疗效分析

目的:探讨锁骨钩板固定术在肩锁关节脱位治疗中的临床效果。方法:选取收治的肩锁关节脱位患者共48例,随机分为研究组25例和对照组23例,对照组实施克氏针固定术治疗、研究组实施锁骨钩板固定术治疗。比较两组优良率及并发症。结果:对照组与研究组优良率分别为73.9%和92.0%,研究组高于对照组,差异有统计学意义(P<0.05);研究组并发症显著少于对照组(P<0.05)。结论:对于临床中肩锁关节脱位患者实施锁骨钩板固定术治疗,恢复良好,并发症少,值得推广。     

高渗氯化钠羟乙基淀粉40注射液高容量血液稀释对大鼠肝脏缺血再灌注损伤的影响

Objective To investigate the effects of hypervolemic hemodilution (HH) with hypertonic saline plus hetastarch solution 40 injectio on hepatic ischemia-reperfusion (I/R) injury in rats. Methods Thirty male Wistar rats weighing 300-350 g were randomly divided into 3 groups ( n = 10 each): group I sham operation (group S); group II I/R and group Ⅲ HH. Partial liver ischemia was produced by clamping hepatic portal vein and left arteria hepatica for 30 min with atraumatic mini-clamp, followed by 2 h of reperfusion in I/R group and HH group. In HH group the animals were infused hypertonic saline plus hetastarch solution 40 injectio 10 ml/kg through vena caudalis over 30 min and then hepatic I/R was performed IS min after the infusion.The animals were killed at 2 h of reperfusion. The left liver was removed and blood sample was taken from inferior caval vein for determination of (1) serum alanine amino transferase (ALT) and aspartate amino transferase (AST) activities; (2) superoxide dismutase ( SOD) activity and malondialdehyde ( MDA) content in the liver; ( 3 ) microscopic examination. Results The serum ALT and AST activities and MDA content in the liver were significantly higher, SOD activity in the liver significantly lower after hepatic I/R and pathological changes in the liver severer in group I/R and HH than in group S. The serum ALT and AST activities and MDA content in the liver were significantly lower, SOD activity in the liver significantly higher after hepatic I/R and pathological changes in the liver milder in group HH than in group I/R. Conclusion Hypervolemic hemodilution with hypertonic saline plus hetastarch solution 40 injectio can ameliorate hepatic I/R injury by decreasing oxygen free radical production in rats.     

桡骨远端骨折手术与非手术治疗63例的临床分析

目的：探讨桡骨远端骨折治疗方法及临床效果。方法：我院自2002年1月至2004年1月共收治63例桡骨远端骨折，按AO原则分类，根据不同类型骨折，治疗方法：手术组17例，骨折内固定分别选用T型钢板螺钉内固定，克氏针内固定，外固定支架固定。非手术组46例，治疗方法单纯手法复位，石膏夹板外固定。结果：63例全部随访3～18个月，手术组功能满意14N(82％)，一般2例(12％)，不满意1例(6％)。非手术组功能满意32例(70％)，一般10例(22％)，不满意4例(8％)。结论：桡骨远端骨折合理选择治疗方法，治疗后骨折复位满意，配合功能锻炼，能使腕关节功能达到最大恢复。减少骨折并发症。     

55例早期梅毒临床资料分析

我科室2005年度门诊诊治的早期梅毒临床资料总结分析如下:1临床资料1.1一般资料共55例,男27例,年龄22~62岁,平均28.89岁,其中20~30岁14例,31~40岁5例,>40岁8例。女性28例,包括孕妇3例,年龄20~67岁,平均30.78岁,其中20~30岁17例,31~40岁6例,>40岁5例。未婚者15例。商业服务14例,驾驶员8例,待业16例,民工2例,干部2例,农民6例,学生2例,工人5例。传染来源,非婚性接触传染48例,夫妻间传染4例,不明原因3例。1.2临床表现一期梅毒共16例,男14例,女2例。13例为单发损害,3例为多发损害。皮损为圆形、类圆形糜烂性硬结,肉红色,触之较硬似软骨,3例伴有疼…     

浅谈医院图书馆的图书采访工作

图书采访工作是图书馆最基本的工作,有目的、有计划地采购图书,对于提高馆藏质量,满足读者需要是十分重要的,只有高质量的图书才能更好地为科研和医疗服务。现阶段,各图书馆的购书经费都比较紧张,在信息量大、资料多、内容重复交叉、书价暴涨、经费有限的情况下如何将有限的资金投入到高质量的采购中呢?我院图书馆根据科研、医疗、读者的需要“,多渠道,全方位、有针对性”地购进了一部分有用的图书,具体措施如下:1提高采访工作人员素质图书馆能否形成重点突出、系统完整、具有本专业特色的藏书体系,取决于多方面的因素,其中采访人员素质起着…     

6%羟乙基淀粉130/0.4对患者硬膜外复合全麻诱导期肺循环的影响

Objective To observe the effect of pulmonary circulation by 6% hydroxyethyl starch 130/0.4 during induction period from epidural block combined with general anesthesia. Methods Twenty-six hepatobiliary surgical patients with ASA Ⅰ-Ⅱ, aged 32 y-59 y, weighing 54 kg-73 kg, were randomized into 2 groups(n=13): hydroxyethyl starch 130/0.4 group(HS)and complex acetic acid Ringer's solution (RL). Above-mentioned solutions were infused 7 ml/kg respectively before induction. The pulmonary circulation hemodynamic parameters such as pulmonary arterial systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), mean pulmonary artery pressure(MPAP), pulmonary artery wedge pressure(PAWP), pulmonary vascular resistance(PVR) and right ventricular stroke work(RVSW) were recorded at base value(T0), 10 min after infusion(T1), 5 min after induction(T2), 5 rain after intubation(T3), 10 rain after intubation(T4)and 20 min after intubation(T5). Results PASP、PADP、MPAP、PAWP and CVP were significantly higher in group HS at T, than the values at T0 (P<0.05); PVR in group HS was obviously lower from T1 to T5 than the value at To (P<0.05 or P<0.01); RVSW was significantly higher in two groups at T1 than base value (P<0.05), but that in group HS was lower than base value (P<0.05 or P<0.01); HR obviously decreased in two groups from T2 to T5 as compared with the value at T0 (P<0.05); MAP was lower from T3 to T5 than the value at To (P<0.05 or P<0.01). PVR was obviously lower in group HS from T1 to T5 than that in group RL (P<0.05 or P<0.01); MAP obviously increased from T2 to T5 in group HS as compared with the value in group RL(P<0.05 or P<0.01). Conclusion 6% hydroxyethyl starch 130/0.4 can obviously reduce PVR during induction pe-riod from epidural block combined with general anesthesia. In all, there is no effect on pulmonary circulation by 6% hydroxyethyl starch 130/0.4.     

变应性亚败血症继发中性粒细胞缺乏一例

患儿男,2岁,因发热、皮疹十余天,关节疼痛5天入院。体检:体温39.4℃,心率180次/分,热病容,精神尚可,前额、腹部及四肢可见散在风团状皮疹,颈部及腹股沟可触及数枚黄豆大小淋巴结,活动、无压痛,心肺听诊正常,肝肋下1.5cm,剑下3cm,质软,脾未及。各关节无红肿。化验:血色素115g/L,白细胞总数23×10~9/L,中性0.73,淋巴     

7例SARS患者治疗的临床研究

目的　进行严重急性呼吸综合征 (SARS)的临床研究。方法　对 2 0 0 4年 4月 2 2日在地坛医院收治的 7例确诊SARS患者进行回顾性分析。结果　 7例确诊SARS患者 ,男性 2例、女性 5例 ,年龄 2 0～ 4 9岁 ,平均年龄为 (35 3± 11 3)岁。临床症状主要表现为发热、咳嗽、不同程度的呼吸困难、全身不适、恶心、呕吐等 ,肺部可闻及湿音 ,可伴有肺外损伤。临床治疗中采用综合治疗原则 ,包括氧疗 ;小剂量、短期应用甲泼尼龙 ,剂量为每天 1～ 2mg kg;及时应用呼吸机 ;必要的心理干预及支持治疗等 ,患者均好转。结论　合理应用糖皮质激素 ,及时使用呼吸机是SARS治疗的关键。     

脊柱健康操对成都市脊柱发育异常小学生的矫治效果

  目的  观察脊柱健康操对成都市脊柱发育异常小学生的矫治效果,为改善脊柱倾斜角度和脊柱后凸角度异常提供参考。  方法  在2020年9月至2021年6月,选取成都市武侯区4所小学中高年级331名小学生,筛查出脊柱弯曲异常者94名,随机分为对照组和观察组各47例。对照组实施为期12周的常规体育活动,观察组在对照组基础上,实施12周线上线下相结合的脊柱健康操训练。采用SpineScan手持式电子脊柱测量仪测试2组对象实施前后的脊柱活动度(颈椎、胸椎的侧屈角度、前屈后伸角度以及旋转角度)、脊柱倾斜角度、脊柱后凸角度、身体平衡度(肩水平线、骶髂后棘水平线),并采用手持式肺活量计测试两组实验前后的肺活量。  结果  实施12周干预后,观察组和对照组在颈椎侧屈角度(78.36±3.72,72.39±3.17)°、颈椎前屈后伸角度(112.37±5.17,107.41±4.40)°、颈椎旋转角度(119.37±4.22,112.49±5.78)°、腰椎侧屈角度(49.37±4.12,41.85±3.37)°、腰椎前屈后伸角度(106.47±4.90,98.09±3.84)°、腰椎旋转角度(54.37±5.12,50.30±4.17)°,差异均有统计学意义(t值分别为5.24,2.82,4.02,4.96,4.36,5.75,P值均＜0.05);两组的脊柱倾斜角度(4.14±0.36,6.02±0.48)°、脊柱后凸角度(30.17±1.82、37.48±2.14)°、肩水平线不平衡度(0.96±0.18,2.30±0.37)°、骶髂后棘水平线不平衡度(0.77±0.15,1.40±0.21)°差异均有统计学意义(t值分别为-5.95,-6.74,-7.52,-6.58,P值均＜0.01);两组肺活量[(2 119.55±115.40)(2 042.47±104.35)mL]差异有统计学意义(t=4.81,P＜0.01)。  结论  脊柱健康操能提高脊柱弯曲异常小学生的脊柱关节活动度,改善脊柱倾斜角度和脊柱后凸角度异常,提高身体平衡度和肺活量。     

小儿肝移植无肝期丙泊酚的药代动力学特点

目的：研究小儿肝移植无肝期丙泊酚的药代动力学特征。方法：5例同种异体原位肝移植患,分别于麻醉诱导及无肝期开始时静脉注射丙泊酚2mg/kg,采用反相高效液相色谱法测定血浆中丙泊酚浓度,对比两之间的药代动力学差异。结果：丙泊酚的药-时曲线符合开放性三室模型,具有分布广,清除率高等特性。结论：无肝期与诱导期丙泊酚代谢无明显差异,推测该药可能存在明显的肝外代谢。