卫辉市消除麻疹措施的效果评价

目的 研究消除麻疹措施的有效性,为逐步减少麻疹传播提供依据。方法 应用分析性流行病学方法,分析含麻疹成分疫苗常规免疫接种率、强化免疫接种率、查漏补种接种率、麻疹监测与麻疹发病率及发病年龄变化等特点。 结果 卫辉市1966年开始接种麻疹疫苗、1978年开始实行计划免疫、2002年开始麻疹监测,各阶段麻疹年均发病率分别为249.33/10万、12.12/10万、8.74/10万,其中2002年、2012—2013年、2017—2020年麻疹发病均为0。2002—2020年卫辉市共确诊麻疹219例,8月龄以下及20岁以上人群麻疹发病增多,其中8月龄以下76例,占34.70%,20岁以上42例,占19.18%。2012年对1～15岁儿童开展麻疹抗体水平检测,共检测1952人,麻疹抗体阳性率96.93%。结论 通过实施消除麻疹措施,麻疹发病率明显下降,但是麻疹发病年龄已发生明显变化。     

恶性肿瘤患者癌因性疲乏的相关因素分析及护理干预

目的：恶性肿瘤患者癌因性疲乏发生的原因以及护理干预对于癌因性疲乏的影响。方法选择恶性肿瘤患者，并将癌因性疲乏患者随机分为给予护理干预的观察组和给予常规护理的对照组，观察患者的活动状态和生活质量。结果化疗例数、放疗例数以及VAS评分、HAMD评分、HAMA评分均表现为无疲乏组＜轻度疲乏组＜中度疲乏组＜重度疲乏组；护理后，观察组KPS评分、躯体功能、心理功能、社会功能、认知功能和总体生活质量评分明显高于对照组。结论放化疗、疼痛以及焦虑、抑郁情绪是肿瘤患者出现癌因性疲乏的重要原因，针对性的给予护理干预有助于治疗癌因性疲乏。     

胃镜下合金钛夹治疗十二指肠球部溃疡大出血

我院自2000年11月至今，在胃镜下应用合金钛夹治疗十二指肠球部溃疡大出血7例，均取得了满意的止血效果，并且有效地防止了再出血，使患者免除了手术之苦。     

内镜下注射肉毒毒素治疗贲门失弛缓症不会引起胃食管反流

肉毒毒素治疗肌肉痉挛性疾病在临床上已应用多年并取得了较满意的效果，但使用不当或剂量不妥往往会矫枉过正，造成肌肉瘫痪。在生理状态下，贲门根据机体的需要而适时地开闭，贲门失弛缓症是由于下食管括约肌(LES)的持续收缩而引起的临床症候群。肉毒毒素的局部注射使贲门松弛，可改善咽下困难等症状，但贲门的持续松弛，有可能     

EFFECT OF FUNDUS PIGMENT ON RESPONSE OF RABBIT RETINA TO TRANSPUPILLARY THERMOTHERAPY

Objective To study the effect of fundus pigment on the response of the retina to transpupillary thermotherapy （TTT）. Methods The retina were irradiated with 810 nm diode laser in 16 eyes of 8 pigmented rabbits and 12 eyes of 6 albino rabbits. The spot size was 1.2 mm; the duration was 60 s; and powers were 50, 80, 150 and 300 mW for pigmented rabbits and 800, 1 200 and 1 500mW for albino rabbits. All of the eyes were followed up with ophthalmolscope. The fundus was photographed and examined histologically with optic microscope immediately and 1 month after TTT respectively. Results The changes of the fundus and the histological examination were not significant immediately and 1 month after TTT in 50 mW group of pigmented rabbit and 800 mW of albino rabbit. Grey spot on the retina was observed on the fundus in 80 mW group of pigmented rabbit and 1 200 mW of albino rabbit immediately after TTT. The structure of the retina remained intact and subretinal fluid was observed histologically. Grey spot was still visible on the fundus, though the fluid was absorbed after 1 month. As the power of diode laser was increased to 150 mW for pigmented rabbits and 1500 mW for albino rabbit, fundus white spots were observed and the outer retina was destroyed while photoreceptors existed immediately after TTT. Pigmentation was found in white lesions and the fibrous proliferation was found in choroid 1 month after TTT. Prominent white spot was seen on the fundus immediately after laser irradiation of 300 mW in pigmented rabbits and the structure of the retina was obscured. One month after TTT, dense pigmentation appeared at laser lesions. The retina was thinner. There was prominent fibrous proliferation in the choroid. Conclusion The fundus pigment seems to play an important role in the response of the retina to TTT. The reaction of the retina is in proportion to the intensity of laser.     

椎管造影术后两种不同卧位的比较

椎管造影亦称脊髓造影(Myelography),是通过蛛网膜下腔注入造影剂使蛛网膜下腔显影的检查方法,它是诊断椎管内外、脊髓内外病变的有效方法之一[1],尤其对诊断腰椎间盘髓核突出具有重要的意义.椎管造影术后发生的与体位有关的问题一直存在,术后通常要求去枕平卧位,我们则采用将头、胸抬高20°,并在腰部垫一3～5 cm厚的软枕,取得了较为理想的效果.     

微创经皮肾镜治疗肾结石的护理

目的探讨微创经皮肾镜治疗肾结石术后并发症的观察及护理。方法总结50例患者术后易出现并发症及相应的护理对策。结果 50例击碎结石成功,经积极治疗和护理均痊愈出院。结论经皮肾镜治疗肾结石具有创伤小、术中出血少、没有严重的并发症发生,对术后患者进行有针对性的观察和护理。     

2.30 内镜下注射A型肉毒毒素治疗贲门失弛缓症

目的介绍内镜下注射A型肉毒毒素(BTXA)治疗贲门失弛缓症(Achalasia,AC) 的方法,探讨其近期疗效.方法原发性AC患者13例,于治疗前和治疗后1周做症状计分和食管造影(测量贲门开口、5min食管存留造影剂的高度和平均宽度).内镜下于贲门齿状线上0.5cm分4点各注射BTXA 20U至下食管括约肌(LES).结果治疗次日症状即明显缓解,咽下困难频度、咽下困难程度、反食频度、胸骨后疼痛频度计分分别由治疗前的2.6±0.5、3.9±1.2、2.5±1.0和2.2±0.8 ,降至治疗1周后的0.5±0.7、0.9±1.1、0.4±0.5和0,P＜0.0005;贲门开口由治疗前的1.5±1.8mm增大至4.4±2.4mm,P＜0.001;5 min食管碘柱高度和平均宽度分别由治疗前的89.5±37.4mm和31.9±11.3mm降至治疗后的14.4±22.0mm和8.4 ±9.4mm,P＜0.0005或0.001.结论内镜下注射BTXA治疗AC安全、经济、简便易行,近期效果良好.     

急性胰腺炎发生SIRS与肝脏损害的临床分析

胆系疾病等多种病因可引起急性胰腺炎(AP), 而AP病程中因免疫网络紊乱、多种细胞因子的过度释放和内毒素血症等因素可进一步发生全身炎症反应综合征(SIRS), 造成肝脏等重要组织器官损害.本文回顾性分析本院自2003～2006年3年间收治113例AP,以观察AP发生SIRS与肝脏损害的情况,现报告如下.……