纳洛酮治疗COPD慢性呼吸衰竭60例的I临床疗效

目的观察纳洛酮在COPD呼吸衰竭患者出现呼吸抑制的临床疗效。方法120例入选者随机分为对照组和治疗组（在对照组治疗的基础上加用纳洛酮），对比观察抢救成功率和死亡率及治疗前后血气变化。结果治疗组抢救成功率达85％，死亡率15％，与对照组相比有显著差异（P〈0．01）。讨论纳洛酮抢救慢性呼衰患者的呼吸抑制不失为一种安全有效的方法，值得临床推广应用。     

无创辅助通气联合纳洛酮治疗COPD合并呼吸衰竭疗效

目的探讨无创双水平正压通气(BiPAP)联合纳洛酮(NLX)治疗COPD并发呼吸衰竭的治疗效果。方法将2010年2月到2011年12月住院治疗的96例COPD并发呼吸衰竭患者随机为对照组与观察组,两组患者均给予无创双水平正压通气治疗,观察组同时应用纳洛酮(NLX)。治疗48 h后比较两组的疗效、死亡率、治疗前后呼吸次数、心率、以及血气分析指标的变化。结果观察组治疗有效率高于对照组(85.41%VS 66.67%,P0.05);观察组与对照组住院期间死亡率无显著差别;治疗后48 h观察组呼吸次数和心率下降,血气分析指标PH及PaO2升高,PaCO2下降,效果优于对照组,差别有统计学意义(P0.05)。结论与对照组相比,观察组应用无创呼吸机联合纳洛酮治疗COPD并发呼吸衰竭可显著改善血气分析指标,提高临床疗效。     

无创呼吸机联合纳洛酮治疗老年COPD并发呼吸衰竭的临床疗效分析

目的探讨无创呼吸机联合纳洛酮治疗老年COPD并发呼吸衰竭的临床疗效。方法将本院住院治疗的128例老年COPD并发呼吸衰竭患者随机分入对照组与观察组,两组患者均给予常规治疗及无创呼吸机应用,观察组患者同时接受纳洛酮静滴。比较两组患者临床疗效、住院期间死亡率及治疗前后血气分析指标的变化。结果观察组治疗总有效率显著高于对照组(92.4%vs 82.3%,P<0.05);观察组与对照组住院期间死亡率无显著差别;治疗后72 h观察组血气分析指标PaCO2、PH及PaO2值显著优于对照组,差别具有统计学意义(P<0.05)。结论与常规治疗方法相比,无创呼吸机联合纳洛酮治疗老年COPD并发呼吸衰竭可显著提高临床疗效,改善血气分析指标。     

纳洛酮加用葛根素治疗急性乙醇中毒的疗效观察

目的 观察纳洛酮与葛根素注射液联用治疗急性乙醇中毒的临床疗效。方法 将56例急性乙醇中毒患者随机分为治疗组和对照组。治疗组30例用纳洛酮与葛根素注射联合治疗；对照组26例单用纳洛酮治疗。观察两组患者症状消失和重症患者清醒时间。结果 治疗组症状消失时间、重症清醒时间均明显短于对照组。结论 纳洛酮与葛根素注射液联用是治疗急性乙醇中毒的有效药物，使用方便，作用迅速，疗效可靠，能提高抢救成功率，降低病死率。     

纳洛酮治疗重度有机磷中毒呼吸抑制的疗效观察

纳洛酮自应用于临床后,其治疗范围在不断地拓展,在危重急症患者的抢救中,已显示出广泛的用途和独特的疗效。本文就我院1998年以来,应用纳洛酮抢救重度有机磷农药中毒所致呼吸抑制,收到了明显疗效,报告如下。临床资料一般资料　符合诊断标准[1]的口服有机磷农药中毒58例,分为两组:对照组28例,为1996年6月至1997年12月的住院病例;治疗组30例,为1998年1月至1999年6月的住院病例。两组患者在年龄、性别、毒物种类、中毒量、中毒时间均基本相似,具有可比性。治疗方法　对照组在常规解毒剂治疗的基础上,对28例呼吸抑制的患者给予可拉明、洛贝林交…     

纳洛酮在37例心肺脑复苏中的应用疗效

目的探讨纳洛酮在37例心肺脑复苏中的应用疗效。方法 2012年2月到2014年3月我院收治突发心跳骤停患者共73例,并随机分为对照组（n=36例）和观察组（n=37例）。两组均给予常规心肺复苏措施,在此基础上给予观察组纳洛酮治疗。对比两组的复苏情况、复苏成功率以及48h生存率。结果观察组在自主循环恢复率、自主呼吸恢复率均高于对照组（χ2自主循环恢复率=7.439,P=0.006;χ2自主呼吸恢复率=7.820,P=0.005）,意识恢复时间低于对照组（t意识恢复时间=6.250,P=0.000）。观察组的复苏成功率、48h生存率分别为51.4%、45.9%,对照组分别为22.2%、16.7%,观察组均显著高于对照组（χ2复苏成功率=6.643,P=0.010;χ2生存率=7.249,P=0.007）。结论在心肺脑复苏过程中,应用纳洛酮能够改善患者的呼吸循环,提高复苏成功率和生存率,应大力推广。     

纳洛酮治疗早产儿原发性呼吸暂停疗效观察

目的观察纳洛酮治疗早产儿原发性呼吸暂停的临床疗效。方法将诊断为原发性呼吸暂的78例早产儿随机分为两组,对照组38例给予常规治疗,治疗组40例在常规治疗基础上用纳洛酮,比较两组患者的疗效。结果治疗组和观察组间差异有统计学意义(P<0.05)。结论纳洛酮治疗早产儿原发性呼吸暂停疗效显著。     

纳洛酮与无创呼吸机联合在COPD并发呼吸衰竭治疗中的应用分析

目的研究纳洛酮与无创呼吸机联合治疗老年慢性阻塞性肺疾病(COPD)的疗效。方法老年COPD伴呼吸衰竭患者60例,随机分为观察组与对照组,对照组予以常规治疗,观察组在对照组治疗基础上加用纳洛酮与无创呼吸机联合治疗。结果观察治疗总有效率为93.33%,对照组为66.67%。观察组患者治疗后pH值、氧分压明显高于对照组,二氧化碳分压明显低于对照组;呼吸频率、心率明显低于对照组。结论纳洛酮与无创呼吸机联合,可显著提高老年COPD伴发呼吸衰竭治疗总有效率,明显改善患者血气情况,降低其呼吸频率及心率。     

不同院前急救模式对急性冠脉综合征疗效的影响

目的探讨急性冠脉综合征患者分别应用不同院前急救模式的临床意义。方法纳入我院急诊接收的282例急性冠脉综合征患者作为研究对象,所有患者均接受院前急救,按随机数字表法进行分组,对照组141例(应用常规院前急救模式),观察组141例(在对照组基础上应用院前急救创伤评分模式),观察两组现场救治、转运和延续抢救情况,比较两组死亡情况。结果对照组现场明确急救诊断率、急救成功率以及急诊科延续抢救成功率低于观察组(P0.05),两组转运成功率对比无意义(P0.05);对照组现场急救死亡率较对照组更高(P0.05);两组急诊科延续抢救死亡率、转运死亡率以及进ICU/专科病房2h内死亡率对比差异无意义(P0.05)。结论常规院前急救模式能有效抢救患者生命,为后续治疗争夺宝贵时间,院前急救创伤评分模式效果更佳,患者抢救成功率更高,死亡率显著降低。     

纳洛酮与无创呼吸机联合治疗老年慢性阻塞性肺疾病并发呼吸衰竭的疗效

目的研究纳洛酮与无创呼吸机联合在老年慢性阻塞性肺疾病(COPD)并发呼吸衰竭中的临床疗效。方法选取2012年3月至2013年3月于该院ICU和呼吸内科住院治疗的老年COPD伴发呼吸衰竭的患者60例,随机分为观察组与对照组,对照组予以常规治疗,观察组在对照组治疗的基础上加用纳洛酮与无创呼吸机联合治疗。比较两组患者治疗总有效率、动脉血气、呼吸频率及心率。结果观察组治疗总有效率(93.33%)明显高于对照组(66.67%)(P<0.05)。两组患者治疗后pH值、氧分压均明显高于治疗前,二氧化碳分压均明显低于治疗前(P<0.05)。观察组患者治疗后pH值、氧分压明显高于对照组,二氧化碳分压明显低于对照组(P<0.05)。两组患者治疗后呼吸频率、心率明显低于治疗前(P<0.05)。观察组患者治疗后呼吸频率、心率明显低于对照组(P<0.05)。结论纳洛酮与无创呼吸机联合用于治疗老年COPD伴发呼吸衰竭时,可显著提高治疗总有效率,明显改善患者血气情况,降低其呼吸频率及心率。     

Pathology of chronic hepatitis B and chronic hepatitis C

Histologic evaluation of the liver is a major component in the medical management and treatment algorithm of patients with chronic hepatitis B (HBV) and chronic hepatitis C (HCV). Liver biopsy in these patients remains the gold standard, and decisions on treatment are often predicated on the degree of damage and stage of fibrosis. This article outlines the clinical course and serologic diagnosis of HBV and HCV for the clinician and the pathologist, who together have a close working relationship in managing patients with acute and chronic liver disease. The salient histologic features are elucidated in an attempt to provide the clinician with an understanding of the basic histopathology underlying chronic HCV and HBV.     

Sweet's syndrome during the chronic phase of chronic myeloid leukaemia

We report the case of a 52 year-old male in the chronic phase of chronic myeloid leukaemia, with Philadelphia chromosome due to t(9;22) in the karyotype. He was treated with courses of busulfan and hydroxyurea. Fourteen months after initial presentation, the patient developed fever, non-productive cough, maculonodular violaceous painful skin lesions and bilateral pulmonary infiltrates visible on a chest roentgenogram. Laboratory data, repeated bone marrow aspiration and biopsy and karyotype analysis showed findings similar to those of the initial diagnosis. A biopsy taken from one of the trunk lesions was consistent with Sweet's syndrome. Oral methylprednisolone therapy was initiated at doses of 64 mg daily, and the skin lesions and fever were rapidly resolved. When we reduced the steroid dose, skin lesions and fever recurred. Two further courses of steroid therapy were given with similar results. Finally we treated him with naproxen (750 mg daily for 1 month) with a rapid and stable response. This drug should be considered as an alternative treatment for patients with Sweet's syndrome not responding to corticosteroids or for immunocompromised hosts.     

Epidemiology of chronic bronchitis and acute infective exacerbations of chronic bronchitis

Acute exacerbations of chronic bronchitis (AECBs) are one of the major causes of morbidity and mortality in the United States, resulting in significant cost to the health care system. Epidemiological information on chronic bronchitis is abundant and has been collected in most industrialized countries. The epidemiology of AECB, however, is less forthcoming. The causes of AECB are multifactorial and include environmental pollutants, allergic responses, and viral and bacterial infections. The role of bacterial infection in AECB is controversial but is believed to account for half of AECB. Because the medical and economic implications of treatment failure in these patients are substantial, an aggressive approach to stratify and treat these patients is necessary. Epidemiological data on chronic bronchitis and acute infective exacerbations of chronic bronchitis will allow us to more precisely define the role of bacterial infection in AECB, and this information may help guide antimicrobial therapy.     

Etiologic theories of chronic prostatitis/chronic pelvic pain syndrome

The etiology of chronic prostatitis/chronic pelvic pain syndrome is unknown. Whereas infection causes category I and II prostatitis, the evidence for an ongoing infection in category III patients is lacking. Immunologic, neurologic, and psychologic factors likely play a role in the development and maintenance of symptoms in these men. The traditional concept of pain as a simple response to a noxious stimulus has some merit, but modern research indicates that the response is much more complex, and we must look at a patient’s physiology and psychology to be able to interpret each individual’s pain response. It is some advance in the field to realize that we probably need to look beyond the prostate and address the entire biopsychosocial problem to be able to offer successful treatment to these men.     

Diagnosis and treatment of chronic gastroparesis and chronic intestinal pseudo-obstruction

Chronic gastroparesis and CIP are debilitating disorders that are difficult to treat with currently available therapies. Failure of proper migration and differentiation of enteric neurons or ICC can result from specific genetic mutations and lead to phenotypes of CIP with or without concomitant gastroparesis. Intestinal dysfunction in diabetes may reflect a depletion of NO production (and perhaps other neurotransmitters or modulators), which is manifest as a syndrome of gastroparesis, diarrhea, or constipation in individual patients. As the key molecular changes underlying these disorders are defined, clinicians will begin to understand their precise etiology and rational medical therapy may become possible. In the future, testable hypotheses regarding the etiology of other functional bowel disorders (e.g., functional dyspepsia, irritable bowel syndrome, and so forth) may be developed.