横开口法经口内镜下肌切开术治疗贲门失弛缓症的临床观察

目的对横开口法经口内镜下肌切开术(T-POEM)治疗贲门失弛缓症的疗效和安全性进行分析与探讨。方法选取自2011年1月~2013年10月在我院接受治疗的15例贲门失弛缓症的患者,予横开口法经口内镜下肌切开术(T-POEM)的方法治疗,并对患者手术前后食管的动力学指标的变化及治疗前后的Eckardt评分进行分析与探究。结果手术后,食管下端括约肌的静息压(13.84±6.46)mm Hg明显低于手术前食管下端括约肌的静息压(27.91±14.67)mm Hg;手术后食管下端括约肌4 s完全松弛压(12.91±3.82)mm Hg明显低于手术前食管下端括约肌4 s完全松弛压(23.79±19.91)mm Hg;贲门失弛缓症患者治疗前的Eckardt评分(7.71±0.89)分明显高于治疗后患者的Eckardt评分(0.81±0.58)分,统计学上有意义(p<0.05)。结论针对贲门失弛缓症的患者采用横开口法经口内镜下肌切开术(T-POEM)进行治疗,疗效更优,并发症少,值得在临床中推广应用。     

间歇洗胃法救治急性有机磷中毒患者效果观察及护理

目的探讨间歇洗胃方法救治急性有机磷中毒(acute organophosphorus pesticide poisoning,AOPP)患者效果及总结护理要点。方法将66例本院收治的AOPP患者随机分为实验组及对照组各33例。对照组采用传统洗胃方法(即温开水一次性洗胃至洗出胃液无味为止),实验组采用生理盐水间歇洗胃法。比较两组患者阿托品用量、反跳发生率及住院天数。结果两组患者阿托品用量、反跳发生率及住院天数比较,均P<0.05,差异具有统计学意义,实验组优于对照组。结论间歇洗胃方法在AOPP患者救治中能减少阿托品用量,降低患者反跳发生率,缩短患者住院天数。     

序贯疗法治疗幽门螺杆菌阳性消化性溃疡的疗效分析

目的评估序贯疗法治疗幽门螺杆菌(Helicobacter pylori,Hp)阳性消化性溃疡的疗效。方法选取我院消化内科2011年1月～2011年12月经快速尿素酶试验(RUT)和14C-尿素呼气试验(UBT)证实感染幽门螺杆菌的消化性溃疡患者126例随机分为治疗组(64例)和对照组(62例),治疗组接受10 d序贯疗法,对照组接受10 d标准三联疗法。结果与对照组比较,治疗组溃疡愈合情况、症状缓解程度无显著性差异(p>0.05);治疗组幽门螺杆菌根除率为96.5%,对照组为75.3%,两组比较差异有统计学意义(p<0.05);两组不良反应发生率均较低,差异无统计学意义(p>0.05)。结论序贯疗法治疗Hp阳性消化性溃疡可有效促进溃疡愈合,缓解症状,Hp根除率高,而且不良反应少,值得临床推广应用。     

关于"便血"的诊断思考

龚飞跃(珠海市人民医院消化科,广东珠海519000)本例患者的临床特点为:(1)年轻男性,反复便血;(2)无肝病史,未见肝病体征及实验室检查异常,无门脉高压表现及依据;(3)结肠镜显示全结肠黏膜充血,血管充盈,升结肠及直肠静脉曲张明显;(4)无肝静脉、肠系膜上、下静脉及脾静脉栓塞或阻塞表现,无心衰、胰腺病及结缔组织病变等依据。根据上述的临床特点,诊断:特发性结肠静脉曲张。结肠静脉曲张是一种较少见的病,3/4以上是由于门脉高压所致,其可继发于肝硬化、胆道闭塞、胆道硬化、充血性心衰、肠系膜上、下静脉栓塞等。而特发性结肠静脉曲张仅占极少数…     

4615例体检者幽门螺杆菌检测结果分析

目的 通过分析茂名地区4615例体检者的幽门螺杆菌（Hp）检测结果,了解Hp在茂名地区的感染情况及其与性别、年龄、生活区域及消化道症状等的相关性.方法 使用14C-尿素呼气试验（14C-UBT）对2011年1月至2012年12月到我院进行健康体检的茂名地区体检者共4615例进行Hp检测.结果 4615例体检者的Hp阳性率为58.5％.男性和女性Hp阳性率分别为60.3％和56.8％,差异无统计学意义（P＞0.05）.20～50岁组与51 ～ 60岁组Hp阳性率比较差异有统计学意义（P＜0.05）,＜ 20岁组与20～50岁组、51～60岁组比较差异均有统计学意义（P＜0.05）,51 ～ 60岁组与＞60岁组比较差异有统计学意义（P＜0.05）.农村人口和城镇人口的Hp阳性率分别为68.2％和51.4％,差异有统计学意义（P＜0.05）.有消化道症状者Hp阳性率为67.1％,无任何消化道症状者Hp阳性率为40.9％,差异有统计学意义（P＜0.05）.结论 茂名地区4615例体检者中Hp的感染率与年龄、生活区域和消化道症状有关,与性别无关.     

综合法治疗百草枯中毒82例体会

目的 评估综合法治疗百草枯中毒患者的疗效。方法 回顾性分析2008年1月～201 3年6月给予综合法治疗的百草枯中毒82例患者 的临床资料,总结疗效。结果82例患者中治愈49例,死亡1 8例,自动出院1 5例。结论早期进行综合法治疗百草枯中毒患者是行之有效的方法。     

综合康复干预对肠易激综合征患者心理状况的影响

Objective To study the incidence rate of anxiety and depression about the IBS, and the psychological effect of comprehensive rehabilitation intervention for IBS. Methods A questionnaire survey was conducted among 100 outpatients and 20 inpatients with IBS by using SAS and SDS. The incidence rate of anxiety and depression was studied, then the patients suffering from anxiety and depression were treated with comprehensive rehabilitation intervention for three months. The scores of SAS and SDS were recorded before and after treatment Results Of all the 120 IBS, the incidence rate of anxiety was 26.7%, and the incidence rate of depression was 25.0%. To the anxiety and depression ones, the SAS and SDS scores were reduced obviously (P＜0.05) . Conclusions Comprehensive rehabilitation intervention can enhance the quality of life by reducing the incidence rate of anxiety and depression of IBS.     

综合康复干预对肠易激综合征患者心理状况的影响

Objective To study the incidence rate of anxiety and depression about the IBS, and the psychological effect of comprehensive rehabilitation intervention for IBS. Methods A questionnaire survey was conducted among 100 outpatients and 20 inpatients with IBS by using SAS and SDS. The incidence rate of anxiety and depression was studied, then the patients suffering from anxiety and depression were treated with comprehensive rehabilitation intervention for three months. The scores of SAS and SDS were recorded before and after treatment Results Of all the 120 IBS, the incidence rate of anxiety was 26.7%, and the incidence rate of depression was 25.0%. To the anxiety and depression ones, the SAS and SDS scores were reduced obviously (P＜0.05) . Conclusions Comprehensive rehabilitation intervention can enhance the quality of life by reducing the incidence rate of anxiety and depression of IBS.     

综合康复干预对肠易激综合征患者心理状况的影响

目的 探讨肠易激综合征(IBS)患者焦虑、抑郁的发生率及综合康复干顶对IBS患者心理状况的影响.方法 采用Zung焦虑自评量表(SAS)及抑郁自评量表(SDS)对100例门诊及20例住院的肠易激综合征患者进行问卷调查,了解其焦虑、抑郁的发生率;并对存在焦虑、抑郁的患者进行综合康复护理干预3个月,并对干预前后焦虑、抑郁情况进行评价.结果 120例肠易激综合征患者焦虑发生率为26.7%、抑郁的发生率为25.0%;对存在焦虑、抑郁的患者,干预后与干预前比较,SAS及SDS评分明显降低(P＜0.05).结论 肠易激综合征患者焦虑、抑郁的发生率高,给予综合康复干预,可明显降低患者焦虑、抑郁症状,有利于肠易激综合征患者康复,提高其生活质量.

Abstract：

Objective To study the incidence rate of anxiety and depression about the IBS, and the psychological effect of comprehensive rehabilitation intervention for IBS. Methods A questionnaire survey was conducted among 100 outpatients and 20 inpatients with IBS by using SAS and SDS. The incidence rate of anxiety and depression was studied, then the patients suffering from anxiety and depression were treated with comprehensive rehabilitation intervention for three months. The scores of SAS and SDS were recorded before and after treatment Results Of all the 120 IBS, the incidence rate of anxiety was 26.7%, and the incidence rate of depression was 25.0%. To the anxiety and depression ones, the SAS and SDS scores were reduced obviously (P＜0.05) . Conclusions Comprehensive rehabilitation intervention can enhance the quality of life by reducing the incidence rate of anxiety and depression of IBS.     

改良胃肠减压对急性胰腺炎患者的影响

目的探讨2种不同的深度的胃管置入的胃肠减压对急性胰腺炎疗效的影响。方法将80例急性胰腺炎患者随机分为两组,两组均按急性胰腺炎临床路径进行治疗,常规予以禁食、胃肠减压。对照组用传统方法插入胃管45～55cm进行胃肠减压,观察组胃肠减压插入胃管长度比传统方法增加5～10cm,约50～65cm,并在置管第1～3天,每天2次予生理盐水行胃管冲洗。观察两组患者负压引流量、堵管例数和腹痛缓解时间,血淀粉酶恢复时间及住院天数。结果观察组患者负压引流量≥800ml例数比对照组多,堵管例数比对照组少;腹痛缓解时间,血淀粉酶恢复时间及住院天数均比对照组缩短,P〈0.05,差异有统计学意义。结论适当延长插入胃管长度,增加胃管冲洗,利于保持胃肠减压的有效性,促进急性胰腺炎的康复。