异位妊娠药物保守治疗的疗效分析

目的探讨异位妊娠药物保守治疗的临床疗效。方法回顾性研究2005年8月至2010年2月期间确诊为异位妊娠并在我院住院进行药物保守治疗的114例患者,随机分为两组:A组66例用甲氨蝶呤(MTX)进行治疗,B组48例应用MTX联合米非司酮进行治疗,两组均辅以中药治疗,对比观察其临床疗效及不良反应。结果 A组总治愈率为71.2%,B组为81.3%,两组比较差异无统计学意义(P0.05)。A组第1个疗程治愈率为59.1%,B组为77.1%,两组比较差异有统计学意义(P0.05)。两组的不良反应发生率分别是25.8%及29.2%,两组比较差异无统计学意义(P0.05)。结论 MTX联合米非司酮治疗异位妊娠效果确切、剂量小、疗程短,是一种较理想的治疗方法。     

Ultrasonographic appearance of gastric lymphosarcoma.

The ultrasonographic appearance of a diffusely infiltrating gastric lymphosarcoma is presented. The stomach appeared as a large mass with sonolucent periphery and central sonodensity. This appearance should suggest a lesion arising from the gastrointestinal tract.     

恶性胸膜间皮瘤两种化疗方案治疗效果比较

目的探讨恶性胸膜间皮瘤两种内科保守治疗方案培美曲塞联合顺铂与培美曲塞联合卡铂的治疗生存率是否存在差异。方法我院2005—2009年经病理学确诊为恶性胸膜间皮瘤患者17例,临床分期达到Butehart标准Ⅲ期及以上者,分别采用培美曲塞联合顺铂（10例）与培美曲塞联合卡铂（7例）两种方案化疗,对患者的生存率进行统计,了解是否存在差异。结果培美曲塞联合顺铂组患者,早期生存率（1—3个月）略高于培美曲塞联合卡铂组患者,但其差异并无统计学意义（x^2值分别为0、1．52、1．52,P均〉0．05）。中期（4～9个月）生存率培美曲塞联合顺铂组高于培美曲塞联合卡铂组,差异有统计学意义（X2值分别为5．21、4．41、4．41、4．50、4．50、4．55,P均〈0．05）。中远期生存率（10～12个月）,培美曲塞联合顺铂组与培美曲塞联合卡铂组生存曲线趋向一致,差异并无统诈学意义（x^2值分别为1．31、0．09、0．09,P均〉0．05）。结论为增加中期生存率,应尽力采用培美曲塞联合顺铂方案。对于部分副反应较大,采用维生素B12及叶酸等辅助药物能够缓解的患者亦应选择此方案。但对于采用了上述方式后仍不能降低副作用者选择培美曲塞联合卡铂的方法也是适当的,尤其是身体虚弱者。     

Efficacy of prostanoids in the treatment of gastric ulcer

Prostanoids decrease gastric acid secretion and exert cytoprotective properties. The effect of several synthetic prostanoids on gastric ulcer healing was evaluated. The first trials were performed on a small number of patients with PGE2 analogs and their results were inconclusive. Two huge multicenter trials tested the efficacy of misoprostol, a synthetic PGE1 analog, in comparison to placebo and cimetidine. In the placebo-controlled trial, following 8 weeks of therapy, misoprostol 100 micrograms q.i.d was significantly better than placebo. In the cimetidine controlled trial, 2 doses of misoprostol were tested, 50 micrograms and 200 micrograms q.i.d. Ulcer healing rates following 4 weeks were 39%, 51%, and 58% in the misoprostol 50 micrograms, 200 micrograms, and cimetidine treatment groups, respectively. There was no statistically significant difference in the healing rates at 4 weeks between the misoprostol 200 micrograms and cimetidine 300 mg q.i.d groups (P = 0.16). The healing rate with the misoprostol 200 micrograms dose was significantly better than with the 50 micrograms dose (P = 0.008). Cimetidine 300 mg relieved global pain significantly better than misoprostol 200 micrograms at 2 weeks (P = 0.047) but not at 4 weeks. The 200 micrograms dose of misoprostol relieved pain significantly better than the 50 micrograms dose at 4 weeks (P = 0.019), but not at 2 weeks. All 3 treatments were well tolerated. Severe adverse events were rare. The efficacy of enprostil, another PGE2 analog, on gastric ulcer healing was also found to be better than placebo and not significantly different from ranitidine. The synthetic prostanoids, misoprostol and enprostil, appear to be safe and effective in the treatment of gastric ulcer.     

中青年急性非结石性胆囊炎48例保守治疗效果分析

目的探讨中青年急性非结石性胆囊炎保守治疗方法及效果。方法回顾性分析48例非结石性胆囊炎中青年患者的临床资料。结果经保守治疗治愈32例,有效15例,死亡1例,治疗有效率为97．9％。结论中青年急性非结石性胆囊炎保守治疗效果确切。     

宫角妊娠的保守治疗

目的:探讨一种保守治疗宫角妊娠的方法。方法:对阴道B超及血β-HCG放射免疫测定确定为宫角妊娠的患者给予米非司酮配伍米索前列醇口服。结果:18例宫角妊娠的患者给予口服米非司酮配伍米索前列醇,成功17人,成功率达94.4.%。结论:米非司酮配伍米索前列醇用于宫角妊娠治疗,不受孕周限制,较传统吸宫、开腹手术安全、可靠、简单、时间短、患者痛苦小,值得在临床推广。     

Results of the treatment of lymphosarcoma of the large intestine

Comparative study of the efficacy of the different therapeutic measures for colonic lymphosarcoma indicates that in locally disseminated colonic lymphosarcoma (primary injury) radical surgery appears to be the most efficacious. Application of the drug therapy is helpful for disseminated primary colonic lymphosarcoma and metastatic injuries. The performance of the palliative surgery noticeably deteriorates the disease prognosis.     

无碘油稀释氰基丙烯酸酯在预防性治疗胃静脉曲张中的应用

目的评价无碘油稀释氰基丙烯酸酯(NBCM)在内镜预防治疗胃静脉曲张的有效性与安全性。方法收集2012年1月-2012年10月该院20例门静脉高压症胃静脉曲张(GV)患者伴或不伴食管静脉曲张(EV),釆用无碘油组织粘合剂NBCM治疗处理。采用生理盐水、α-氰基丙烯酸酯和生理盐水夹心法治疗。内镜证实出血停止,治疗0.5 d后患者无呕血及便血等现象,生命体征平稳。记录患者术中、术后并发症。所有患者术后接受随访,记录出血复发及其他不良事件。结果 20例门静脉高压伴胃底静脉曲张患者接受NBCM内镜预防性治疗。18例(90%)患者曾采用内镜套扎(EBL)术治疗EV,其余患者无EV。13例(65%)患者在第1疗程(1期)治疗中GV闭塞,7例(35%)患者在第2疗程(2期)治疗中GV闭塞,平均NBVM用量为(1.37±0.48)ml。6个月随访中,仅1例(5%)患者GV复发,1例患者在第35个月随访中经内镜超声确认GV复发。总体而言,在6~40个月,中数31个月的随访中,GV复发率为10%,出血率为5%。该组病例未发现死亡案例,3例患者(15%)报告存在轻度胃痛,其与患者未发现严重不良事件(全身性栓塞、败血症或胃肠道出血)。结论无碘油NBCM内镜注射是胃静脉曲张性出血的一种安全有效的初始预防性治疗方式。     

洗胃对兔口服百草枯急性中毒的治疗作用

目的:探讨洗胃对兔口服百草枯急性中毒的治疗作用。方法:对随机分组的日本大耳白兔灌胃高剂量或低剂量百草枯,分别在灌胃后不同时间启动洗胃。比较各组兔血百草枯浓度、肺病理改变、兔生存情况。结果:对兔灌胃百草枯10min后启动洗胃能够降低高剂量中毒组的血百草枯浓度,但不能减轻肺损伤及改善预后。对低剂量中毒组,10min后启动洗胃能减轻肺损伤并改善预后;将启动洗胃时间推迟到灌胃百草枯后30min,没有发现洗胃治疗有效。结论:对于较低剂量范围的口服百草枯急性中毒,尽早洗胃可能会改善预后。