我院眼科1969例住院病人流行病学分析

目的探讨该院2001-2005年眼科疾病的流行特征。方法对眼科住院各类疾病按性别、年龄和病种进行统计和分析。结果发病人数为前五位的病种依次是：白内障、青光眼、视网膜疾病、角膜疾病和眼外伤，共占我院眼科四年来所有住院病人的65．16％；白内障发病人数最高，且多发于60～80岁，共353例，男：女=1．14：1，主要为老年性白内障；青光眼多发于60～80岁，男：女=1．58：1，急性闭角型青光眼男女比例为1：2．58，其他均为男性发病人数较多；视网膜疾病各年龄段发病构成比比较均匀，治愈率较低；角膜疾病主要病种为角膜炎；眼外伤20岁组发病人数最多，男女比例为7．52：1。结论反映了我院眼科疾病的构成和分布特色，为眼科疾病的流行病学研究提供了资料。     

人工富氧环境改善急进高原人员睡眠效果的研究

目的 通过研究高原人工富氧环境(简称富氧室)对急进高原人员睡眠的作用,探讨富氧室的抗缺氧效果及其与高原习服的关系. 方法 利用分子筛制氧机在海拔3500 m高原建立富氧室.将18名世居平原人员随机分为富氧组、缺氧组和平原组,每组各6人.平原组不进入高原,富氧组和缺氧组人员乘飞机到达高原后,在未供氧情况下记录2组受试人员的心率和血氧饱和度(arterial oxygen saturation,SaO2).当晚22:00两组人员分别进入富氧室和普通房间,休息至次日上午9:00通过睡眠呼吸记录分析系统,对受试人员进行监测,在同一时间对平原组也进行监测.数据采集完毕后利用系统自带分析软件进行分析. 结果 ①富氧组供氧后SaO2为92.3%.±1.0%,高于供氧前的82.9%±4.2%和缺氧组的79.3%±5.9%(P<0.01),但低于平原组的97.3%±0.8%(P<0.05),且差异均有统计学意义.心率值在富氧组供氧前后及与缺氧组间差异无统计学意义,但均高于平原组,且差异有统计学意义(P<0.01).②睡眠结构富氧组与缺氧组差异无统计学意义,与平原组比较浅睡眠偏多,深睡眠偏少,且差异有统计学意义(P<0.01).低通气次数和呼吸紊乱指数平原组低于缺氧组和富氧组(P<0.01);富氧组呼吸紊乱指数低于缺氧组,两组分别为28.1±11.9和53.2±23.4,且差异有统计学意义(P<0.05).③睡眠期间,富氧组和缺氧组的归一化低频功率和低频与高频的比值分别为89.3±2.9、9.4±2.8和90.2±1.8、9.9±1.9,组间差异无统计学意义,但均高于平原组的85.8±2.9和6.4±1.4,且差异有统计学意义(P<0.05);平原组的归一化高频功率则高于富氧组和缺氧组,且差异有统计学意义(P<0.05). 结论 高原富氧室可以有效改善急进高原人员睡眠情况,但对睡眠期间心率变异性未见显著影响,且与高原习服的关系尚待深入研究. Abstract： Objective To study the effects of the artificial oxygen-enriched environment (is called "oxygen-enriched room" in short) on sleep efficiency of the people who participate in the mission on plateau with hurry-up entry,and to investigate the anti-hypoxia effect of oxygen-enriched room to plateau acclimatization. Methods Eighteen subjects were randomly and averagety allocated into plain group,oxygen-enriched group and hypoxia group.Only the later two groups were dispatched to plateau by air.Molecular sieve oxygenerator was used to supply the room with oxygen on 3500 m plateau.The oxygen-enriched group and hypoxia group got into the oxygen-enriched rooms and normal rooms respectively at 22 o' clock and took rest till to 9 o' clock next morning.The changes of heart rate (HR) and the saturation of blood oxygen (SaO2) of three groups were recorded and compared between the states of with and without oxygen enrichment.The subjects were monitored by sleep respiration recording and analysis system. Results ①The SaO2 of the oxygen-enriched group was 92.3%±1.0%,and it was significant higher than the state before oxygen enrichment (82.9%±4.2%) and than that of hypoxia group (79.3%±5.9%,P<0.01),but lower than that of plain group (97.3%±0.8%,P<0.05).②There were less deep sleep and more slight sleep in hypoxia group and oxygen-enriched group than in plain group.The hypopnea and apnea hypopnea index (AHI) of plain group was significant lower than that of hypoxia group and oxygen-enriched group (P<0.05).The AHI of the oxygen-enriched group was 28.1±11.9,and it was significant lower than that of hypoxia group (53.2±23.4)(P<0.05).③The normalized low-frequency (Ln) and the ratio of low-frequency to high-frequency (LF/HF) measured in sleep was respectively 89.3±2.9 and 6.4±1.4 in oxygen-enriched group comparing to 90.2±1.8 and 9.9±1.9 in hypoxia group but without statistical difference.The corresponding Ln and LF/HF of plain group was 85.8±2.9 and 6.4±1.4 respectively,significantly higher than those of other two groups (P<0.05).Plain group also showed higher normalized high-frequency than others(P<0.05). Conclusions Oxygen-enriched environment can effectively improve the sleep quality but significantly change heart rate variation (HRV) of the people who participate in the mission with hurry-up entry to plateau.Further studies are still needed to reveal the quantitative effectiveness of oxygen-enriched room to plateau acclimatization.     

人工富氧环境改善急进高原人员睡眠效果的研究

Objective To study the effects of the artificial oxygen-enriched environment (is called "oxygen-enriched room" in short) on sleep efficiency of the people who participate in the mission on plateau with hurry-up entry,and to investigate the anti-hypoxia effect of oxygen-enriched room to plateau acclimatization. Methods Eighteen subjects were randomly and averagety allocated into plain group,oxygen-enriched group and hypoxia group.Only the later two groups were dispatched to plateau by air.Molecular sieve oxygenerator was used to supply the room with oxygen on 3500 m plateau.The oxygen-enriched group and hypoxia group got into the oxygen-enriched rooms and normal rooms respectively at 22 o' clock and took rest till to 9 o' clock next morning.The changes of heart rate (HR) and the saturation of blood oxygen (SaO2) of three groups were recorded and compared between the states of with and without oxygen enrichment.The subjects were monitored by sleep respiration recording and analysis system. Results ①The SaO2 of the oxygen-enriched group was 92.3%±1.0%,and it was significant higher than the state before oxygen enrichment (82.9%±4.2%) and than that of hypoxia group (79.3%±5.9%,P<0.01),but lower than that of plain group (97.3%±0.8%,P<0.05).②There were less deep sleep and more slight sleep in hypoxia group and oxygen-enriched group than in plain group.The hypopnea and apnea hypopnea index (AHI) of plain group was significant lower than that of hypoxia group and oxygen-enriched group (P<0.05).The AHI of the oxygen-enriched group was 28.1±11.9,and it was significant lower than that of hypoxia group (53.2±23.4)(P<0.05).③The normalized low-frequency (Ln) and the ratio of low-frequency to high-frequency (LF/HF) measured in sleep was respectively 89.3±2.9 and 6.4±1.4 in oxygen-enriched group comparing to 90.2±1.8 and 9.9±1.9 in hypoxia group but without statistical difference.The corresponding Ln and LF/HF of plain group was 85.8±2.9 and 6.4±1.4 respectively,significantly higher than those of other two groups (P<0.05).Plain group also showed higher normalized high-frequency than others(P<0.05). Conclusions Oxygen-enriched environment can effectively improve the sleep quality but significantly change heart rate variation (HRV) of the people who participate in the mission with hurry-up entry to plateau.Further studies are still needed to reveal the quantitative effectiveness of oxygen-enriched room to plateau acclimatization.     

膳食补充剂对雷达兵血清T-AOC、SOD活性及MDA含量的影响

目的观察服用膳食补充剂后雷达兵血清总抗氧化能力(T-AOC)、超氧化物歧化酶(SOD)活性及脂质过氧化物丙二醛(MDA)含量的变化,为评价膳食补充剂抗氧化的有效性提供科学依据。方法根据装备雷达型号不同选取2个雷达站的官兵,分为警戒组(n=40)和导航组(n=24),采用场强仪测定2个雷达站微波辐射强度并计算累积剂量及平均功率密度。膳食补充剂主要成分为7种维生素、2种微量元素及红景天甙和原花青素。分别在服用膳食补充剂前及服用30 d后抽取空腹静脉血,测定血清SOD活性、MDA含量及T-AOC活性。结果警戒组工作区微波辐射的累积剂量和生活区平均功率密度分别为37.4μW·h/cm2和6.1μW/cm2,而导航组工作区微波辐射累积剂量和生活区平均功率密度分别为6.5μW·h/cm2和4.5μW/cm2。导航组服用膳食补充剂后,T-AOC为(6.36±0.92)U/ml,明显高于服用前(5.00±0.94)U/ml,差异有显著性(P0.01);2组雷达兵血清SOD活性均显著降低(P0.01);MDA含量虽然略有增加,但各组之间差异无显著性(P0.05)。结论膳食补充剂可提高受试者体内抗氧化能力,调节抗氧化酶活性。     

加强干休所医疗保健工作精细化管理的几点思考

干休所是军队医疗保健机构的重要组成部分．实施精细化管理,提高工作效益,是适应新形势下军队建设的必由之路。“。现结合工作实际,就如何加强干休所医疗保健工作精细化管理谈几点思考。1将建标立制作为精细化管理的前提实施精细化管理,必须要有一整套完善规范的标准和制度体系,使工作具体化、流程化。1．1转变传统保障理念干休所的保障对象具有年龄大、疾病多、人员固定等特点,相对应的医疗保健工作也与部队其他卫生机构有着明显不同。因此,在制定标准中要突出医务人员慢性疾病治疗、功能康复、临终关怀等能力素质的建设,     

航空生理训练与气压损伤性航空病（摘要）

目的研究提出低压舱模拟低压差、低高度暴露、低空加压供氧生理训练方案。方法（1）降低传统迅速减压模拟训练的初高度及终高度,起爆高度2500m,迅速减压终高度5500m;（2）迅速减压压差由3．0kg／cm。缩小到O．25kg／cm2,迅速减压峰值小于500mmH2O;（3）改进加压供氧调节器,调整真空膜盒元件,实现低空4000±200m接通加压供氧,     

48名飞行员睡眠监测结果分析

阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)是常见的睡眠障碍,以反复发作的睡眠呼吸暂停和低氧血症为主要临床特征,可引起白天嗜睡、注意力不集中以及记忆力减退等症状,甚至可出现高血压、冠心病及脑卒中等心脑血管并发症.流行病学研究结果显示OSAHS患者冠心病的患病率为20％～30 ％,呼吸暂停低通气指数(apnea-hypopnea index,AHI)是预测冠心病死亡的独立危险指标[1].我国军事飞行人员OSAHS患病率在0.8％～1.9％之间[2],是航空医学研究的重点,特别是睡眠障碍对军事战斗力的影响及其干预方面的研究.军事飞行人员患OSAHS易出现飞行疲劳,生理、心理功能下降,尤其是中、重度患者,可能影响其认知和操作能力,出现飞行安全隐患[3],甚至引发飞行事故,特别是中年飞行骨干OSAHS发生率较高,及时进行诊断和治疗十分重要.     

安静和运动条件下富氧气体排氮效果的观察

目的探讨人体呼吸不同富氧气体的排氮规律,为促进吸氧排氮效果提供依据。方法7名男性青年采用自身对照,在静坐和运动状态下呼吸60％至纯氧的氧氮混合气。采用开放式排氮测量方法,用氧浓度计测量储气袋中氧气浓度,同步实时测量肺通气量和心输出量,功率脚踏车提供40w运动负荷。结果呼吸60％、70％、80％和90％富氧气体的排氮效果分别相当于呼吸纯氧排氮效果的59．31％、72．81％、76．45％和84．18％。运动对呼吸不同富氧气体排氮作用的影响不同。40w的运动负荷能使呼吸60％、70％富氧气体的排氮作用分别增加45％和12％;但呼吸80％和90％富氧气体时排氮作用增加的很少。结论体力活动所致的呼吸和循环功能增加能促进吸氧排氮的作用,吸氧浓度越低时,运动促进排氮的作用越明显。     

2009～2011年某部老干部死亡病因分析

目的 分析某部老干部死亡原因,为制订医疗保健对策提供依据,不断提高保健工作质量水平.方法 汇总某部各干休所2009～2011年老干部死亡的83例病例报告,按照ICD-10分类原则,进行统计分析.结果 死亡病例疾病构成前3位依次为恶性肿瘤、心血管系统疾病、呼吸系统疾病,占全部死亡例数的85.6％.结论 当前干部保健工作的成效比较明显,经费统筹使用的优势得到突出体现;强化预防保健工作的地位和作用、提高于休所医务人员急症救治能力是做好老干部保健工作的重点.