前瞻性护理干预对新生血管性青光眼手术治疗患者临床疗效影响

目的:探讨前瞻性护理干预对新生血管性青光眼(NVG)手术治疗患者的疗效影响观察。方法:选取本院接受手术治疗的40例NVG患者,根据数字随机分配法均分为观察者和对照组各20例。对照组给予常规眼科护理,观察者在对照组基础上实施科学、系统的围手术期前瞻性护理干预。对比两组患者平均住院时间、术后出院时间,术后眼压控制、疼痛等级以及术后并发症发生率。结果:两组术后眼压控制水平及矫正视力比较无明显差异(P>0.05);观察组平均住院和术后出院时间明显短于对照组;观察组术后疼痛程度为轻痛、中痛者明显低于对照组;观察组术后并发症发生率明显低于对照组,以上差异均有统计学意义(P<0.05)。结论:对接受手术治疗的NVG患者实施科学、系统的围手术期前瞻性护理干预,能显著缩短患者平均住院治疗时间,减轻术后疼痛,降低术后并发症发生率,保证手术效果,加快床位周转。     

改良腭咽成形术治疗阻塞性睡眠呼吸暂停综合征患者的护理

阻塞性睡眠呼吸暂停综合征(OSAS)是一种睡眠障碍性疾病,主要临床表现为睡眠时鼾声响亮,呼吸困难,醒后头痛、头昏、嗜睡、精神不振。目前,外科手术治疗主要有悬雍垂腭咽成形术、气管切开术,上颌/下颌前移术和激光等治疗手段[1]。江苏省苏州市第一人民医院五官科自2004年以来采用改良腭咽成形术治疗OSAS患者15例,效果理想,未出现术后并发症,现将护理体会报告如下。1临床资料15例患者中男14例,女1例,年龄35~62岁,其中5例采用全身麻醉,10例采用局部麻醉。手术方法:在软腭游离缘上方约1.5 cm处作切口,向两侧延长至腭舌弓边缘下极处,切除软腭…     

巨噬细胞移动抑制因子在输卵管妊娠植入部位的表达及其临床意义

目的:通过检测巨噬细胞移动抑制因子(MIF)在输卵管妊娠的植入、非植入部位及正常分泌中期壶腹部输卵管组织中的表达,分析其在输卵管妊娠发生发展中的作用。方法:收集输卵管妊娠患侧输卵管标本30例,分别从植入及非植入部位取材,选择分泌中期正常壶腹部输卵管标本20例,采用链霉菌抗生物素蛋白-过氧化物酶连结(即SP法)免疫组织化学方法结合病理图象半定量分析检测各组标本中MIF的表达。结果:输卵管妊娠植入部位输卵管黏膜组织中MIF表达显著高于非植入部位及正常分泌中期组,差异有统计学意义(P<0.0125);非植入部位组与正常分泌期组MIF表达差异无统计学意义(P>0.0125)。结论:MIF在输卵管妊娠种植部位黏膜上皮中的表达增强,提示MIF可能在输卵管妊娠的发生发展中起重要作用。     

系统健康教育对青光眼患者疾病知晓度的影响

目的:探讨系统健康教育对青光眼患者疾病知晓度的影响。方法:将我院收治的152例青光眼患者随机分为对照组和干预组各76例,对照组接受青光眼患者常规健康教育,干预组接受健康教育集体讲座、参与青光眼俱乐部与个体化健康教育相结合的系统健康教育。比较健康教育前后及出院随访半年两组患者疾病知晓度及用药的依从性。结果:干预组在进行系统健康教育后疾病知晓度及用药依从性均明显高于对照组。结论:实施系统健康教育,能提高青光眼患者的疾病知晓度。     

252例完全性前置胎盘临床分析

目的 评估完全性前置胎盘的临床治疗策略对妊娠结局的影响.方法 回顾性研究2011年1月至2013年6月年间于内蒙古妇幼保健院分娩的252例完全性前置胎盘病例的临床资料,分析初次出血孕周、胎盘位置、术中处理与妊娠结局的关系.结果 手术时机和子宫切口的选择、孕妇出血孕周、胎盘位置及是否合并胎盘植入等因素均会影响术中出血量;孕妇初次出血孕周对新生儿体重、1 min Apgar评分、新生儿贫血的发生率及新生儿死亡率均有影响;手术选择的时机、术中止血策略及是否并发胎盘植入均可增加子宫切除率,其中胎盘植入为主要因素.结论 增加临床期待治疗时间,能改善新生儿的结局;充分延长产妇分娩的孕周,可减少急症剖宫产率,可改善妊娠预后;适当选择手术时机,个体化选择手术方案,可有效降低围产期子宫切除率.     

薄层扫描法测定不同季节采集羊踯躅根中八厘麻毒素的含量

羊踯躅根中含有八厘麻毒素。本文采用薄层扫描法测定羊踯躅根中八厘麻毒素的含量，用氯仿：丙酮：甲醇（８２：１：５）作展开剂、上行展开，用薄层扫描仪于波长６３０ｎｍ扫描定量，本法简便、灵敏、准确。测定了不同季节采集的羊踯躅根中八厘麻毒素的含量。     

小儿急性胰腺炎病情严重度评分的临床应用

目的 探讨小儿急性胰腺炎评分系统在病情严重度判定中的临床应用价值.方法 回顾分析2002年1月～2006年8月间本院收治的49例小儿急性胰腺炎(AP)病例,分析比较Ranson、APACHEⅡ及小儿急性胰腺炎评分(John评分)系统对小儿急性胰腺炎病情严重度评判的灵敏度、特异度、似然比及接收者工作特征(ROC)曲线下面积(AUC)等指标,检验各评分系统对小儿AP病情严重度评判的价值.结果 49例中,发生胰腺坏死/假性囊肿/脓肿,脏器功能障碍等严重并发症的小儿SAP重症急性胰腺炎(SAP)7例,轻症急性胰腺炎(MAP)42例.SAP组与MAP组间,3种评分系统的分值分别为(1.12±0.29)与(0.93±0.22),(3.39±0.73)与(2.85±0.68),(3.07±0.45)与(1.12±0.27),仅John评分分值的组间差异有统计学意义(t=15.1974,P=0.0000).3种评分系统对小儿SAP评判的灵敏度分别为28.57%、42.86%、85.71%,John评分高于前二者,特异度分别为88.10%、85.71%、83.33%.3种评分系统评判小儿SAP的AUC值分别为0.54、0.59及0.90,John评分的AUC值明显高于前二者,差异有显著性意义(P=0.0083、0.0112).结论 与Ranson及A-PACHEⅡ评分比较,John评分对小儿AP病情严重度和预后的评判价值较大.     

Effect of Antisense Oligodeoxynucleotide of Vascular Endothelial Growth Factor C on Lymphangiogenesis and Angiogenesis of Pancreatic Cancer

In order to investigate the effect of antisense oligonucleotide (ASODN) of vascular en-dothelial growth factor C (VEGF-C) on lymphangiogenesis and angiogenesis of pancreatic cancer, antisense and scamble-sense oligonucleotide of VEGF-C were constructed, and the model of nude mice with orthotopically xenografted human pancreatic cancer cells (Panc-1) was established. Thirty nude mice were randomly divided into 3 groups: PBS control group (group A), scramble-sense con-trol group (group B) and antisense group (group C). All nude mice were treated once every 2 days as 3 times per week, for 3 weeks (oligonucleotide 10 mg/kg every time). After treatments were com-pleted, ELISA method was used to examine the concentration of VEGF-C in plasma and immunohis-tochemical method to examine microvessel density (MVD), lymphtic vessel density (LVD) of pan-creatic cancer. The results showed that the expression of VEGF-C was inhibited significantly in group C. The concentrations were 237.5±41.5, 221.5±52.3 and 108.6±14.9 pg/mL in groups A, B and C re-spectively (P<0.01). LVD in groups A, B and C was 13.8±2.1, 12.4±1.9 and 4.2±1.6 respectively (P<0.01). MVD in groups A, B and C was 27.5±8.7, 25.9±4.2 and 19.4±5.6 respectively with no sig-nificant difference among the groups (P>0.05). It was suggested that VEGF-C ASODN decreased the expression levels of VEGF-C in nude mice with orthotopically xenografted human pancreatic cancer, and it could inhibit lymphangiogenesis, but had no significant effect on angiogenesis.     

Effect of HIF-1α on VEGF-C Induced Lymphangiogenesis and Lymph Nodes Metastases of Pancreatic Cancer

The effect of hypoxia inducible factor-1α(HIF-1α) on vascular endothelial growth factor C (VEGF-C) and the correlation between HIF-1αand lymphangiogenesis and lymph nodes metasta-ses (LNM) in pancreatic cancer were investigated. Immunohistochemical SP method was used to detect the protein expression of HIF-1αand VEGF-C, and Lymphatic vessel density (LVD) was determined by stain of VEGFR-3, collagen type IV in 75 pancreatic head cancers from regional pancre-atectomy (RP) during Dec. 2001 to Dec. 2003. The relationship between HIF-1αand VEGF-C, lymphangiogenesis, LNM was analyzed statistically. The results showed that the positive expression rate of HIF-1αand VEGF-C in pancreatic cancer tissues was 48.00 % (36/75) and 65.33 % (49/75) respectively. In positive group of HIF-1α, the positive rate of VEGF-C and LVD, and LVD rate was 80.56 % (29/36), 13.22±3.76 and 88.89 % (32/36) respectively, and in negative group of HEF-1α, positive rate of VEGF-C and LVD was 51.28 % (20/39), 5.98±2.17 and 66.67 % (26/39) respectively (P<0.01 or P<0.05). It was suggested that HIF-1αcould promote the expression of VEGF-C, lymphangiogenesis and LNM in pancreatic cancer.     

溶血尿毒综合征临床特征及影响预后因素

目的探讨溶血尿毒综合征(HUS)的临床特征、实验室检查、治疗方法及影响预后的相关因素。方法回顾性分析1998-2010年本院32例HUS住院患儿临床资料,组间比较采用t检验、Wilcoxon符号秩检验、Fisher’s精确概率法。对HUS患儿预后进行多因素非条件Logistic回归分析。结果 1.HUS患儿32例分为2组。腹泻后HUS(D+HUS)占同期收治HUS的53.13%(17/32例),7例透析治疗,病死率11.76%。无腹泻HUS(D-HUS)占46.87%(15/32例),9例透析治疗,病死率6.67%。2组平均病死率9.38%。2.平均少尿及无尿持续时间D-HUS组明显长于D+HUS组(P<0.05)。3.平均接受透析时间D-HUS组明显长于D+HUS组(P<0.05)。患儿平均住院时间>15 d者D-HUS组多于D+HUS组(P=2.67×10-6)。4.少尿持续时间长、PLT低水平、BUN高水平、Scr高水平、pH值低水平与预后明显相关(Pa<0.05)。透析治疗介入较晚、LDH高水平与预后显著相关(Pa<0.01)。结论儿童D-HUS较之D+HUS病情重,病程长。少尿持续时间长、LDH高水平者病死率高。早期诊断、早期透析治疗是降低病死率的关键。