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1.
目的探讨子宫颈电环切术治疗宫颈糜烂的疗效。方法应用LEEP刀治疗宫颈糜烂100例,并与同期应用微波治疗的100例宫颈糜烂患者的疗效进行比较。结果观察组应用LEEP刀治疗的手术时间及术后出血量≥月经量方面比较,差异无统计学意义;术中出血量及阴道排液时间比较,微波组长于观察组,差异有统计学意义(P〈0.05)。观察组应用LEEP刀治疗8周后判断疗效显示,其治疗颗粒型和乳突型的疗效优于对照组,差异有统计学意义(P〈0.05)。观察组治疗中重度宫颈糜烂的疗效优于对照组,差异有统计学意义(P〈0.05)。结论 LEEP治疗宫颈糜烂疗效确切、操作简单、患者痛苦小、不良反应少,值得临床推广。  相似文献   

2.
目的研究伏立康唑联合小剂量高三尖杉酯碱和格列卫治疗慢性粒细胞白血病(CML)转变为急性白血病(急变期CML)合并肺曲霉菌感染(IPA)的疗效。方法选取CML急变期合并肺曲霉菌感染患者98例,随机分为观察组(49例)和对照组(49例),两组均给予小剂量高三尖杉酯碱(HHT)和格列卫治疗;对照组加用氟康唑,观察组加用伏立康唑。结果恶性血液病疗效方面,观察组患者有效率为95.92%,对照组有效率为91.84%,两组差异无统计学意义(χ^2=0.952,P〉0.05);IPA感染疗效方面,观察组患者有效率为81.63%,对照组有效率为65.31%,两组差异具有统计学意义(χ^2=5.137,P〈0.05);对照组和观察组患者的不良反应发生率分别为55.10%和57.14%,差异无统计学意义(χ^2=1.037,P〉0.05)。结论伏立康唑联合小剂量的HHT和格列卫可作为治疗急变期CML合并IPA感染者一线用药方案,高效且安全。  相似文献   

3.
目的对比激光、微波和宫颈炎康栓局部治疗宫颈糜烂的效果。方法随机将174例轻中度子宫糜烂患者分为对照组和研究A组、研究B组,各58例。对照组采用宫颈炎康栓局部治疗,研究A、B组分别采用激光、微波治疗。观察3组患者的临床疗效。结果研究A组及研究B组总有效率分别为94.83%、91.38%,明显高于对照组(81.03%),差异有统计学意义(P0.05)。研究A组总有效率与研究B组比较,差异无统计学意义(P0.05)。治疗期间各组患者均未发生明显不适及药物不良反应。结论激光、微波治疗轻中度子宫颈糜烂较传统宫颈炎康栓局部治疗疗效好,且不增加严重不适及不良反应发生率,操作简便,临床使用效果满意。  相似文献   

4.
目的:观察保妇康栓治疗老年性阴道眼的临床效果.方法:选取老年性阴道眼患者60例,随机分为两组,试验组30例,采用保妇康栓阴道给药,对照组30例采用甲硝唑阴道给药,比较两组疗效.结果:试验组治愈率90.%,对照组治愈率86.6%,两组相比差异无显著性(P<0.05).结论:保妇康栓治疗老年性阴道炎疗效显著,它可做为妇科常见病的首选药.  相似文献   

5.
目的观察包皮环切术联合光动力治疗尖锐湿疣的疗效。 方法选择2016年1月至2018年5月于首都医科大学附属北京安贞医院皮肤科门诊诊治的154例伴有包皮过长或包茎的尖锐湿疣患者,采用随机数字法分为两组,对照组77例患者给予光动力治疗,治疗组77例患者在对照组基础上联合包皮环切术治疗。 结果于患者治疗后第1周和第2周随访时,治疗组患者复发率(1.5%和1.3%)显著低于对照组(13.0%和13.0%),差异均有统计学意义(χ2 = 5.7840、P = 0.0162;χ2 = 7.8081、P = 0.0052)。治疗组患者总体有效率和复发率分别为99.0%和0.98%,对照组总体有效率和复发率分别为92.9%和7.14%,差异均具有统计学意义(P均< 0.001)。治疗组患者术后疼痛率(9.1%)较对照组(6.5%)低,但差异无统计学意义(χ2 = 0.3615、P = 0.5477);两组患者VAS评分经Kolmogorov-Smirnov Z检验,差异无统计学意义(Z =-1.0842,P = 0.2783)。两组患者术后各有1例出现创面感染。对照组和治疗组各有1例患者治疗后1周~6个月发生不良反应(均为治疗部位出现色素脱失),经Fisher精确检验差异无统计学意义(P > 0.9999)。 结论尖锐湿疣合并包皮过长或包茎者,在光动力术后行包皮环切联合治疗,可显著降低尖锐湿疣的复发率。  相似文献   

6.
目的:评价自体富血小板血浆注射对症状性宫颈内膜移位的治疗疗效。方法收集128例诊断为Ⅲ度症状性宫颈内膜移位患者,随机分为自体富血小板血浆(PRP)注射组(实验组)和微波组(对照组),阴道镜评估宫颈糜烂区愈合情况,应用Kirby-Baue抑菌圈试验评价PRP的抗菌性能,采用LIVE/DEAD BacLight死活菌试剂盒检测生物膜中细菌活力。结果 PRP体外具备良好的抗菌性能,临床随访表明PRP组和微波组6周后总有效率为96.8%(60/62)和80.0%(48/60),差异具有统计学意义(χ2=9.206,P<0.05),富血小板血浆组宫颈创面愈合速度(5.3&#177;2.1周)较微波组(7.9&#177;2.8周)显著加快(χ2=7.206,P<0.01);PRP组治疗相关的不良反应(阴道分泌物及出血等)显著低于微波组,提示PRP具有很好的耐受性和安全性。结论自体PRP对治疗症状性宫颈内膜移位具有良好的应用前景。  相似文献   

7.
目的分析乳腺癌患者高危型人乳头状瘤病毒(HPV)感染、p53蛋白表达和淋巴结转移率。 方法选取2016年5月至2018年5月于西北妇女儿童医院治疗的乳腺癌患者共90例作为观察组,选取同期于本院治疗乳腺增生患者90例作为对照组。对癌组织行HPV基因分型和p53蛋白检测,增生组织行HPV基因分型。观察入组患者高危型HPV感染率,分析乳腺癌患者肿瘤大小、TNM分期、淋巴结转移率与p53蛋白表达等。 结果观察组患者中共60例发生高危型HPV感染,对照组中共36例发生高危型HPV感染,观察组患者中HPV16、18基因型感染率分别为21.11%(19/90)和22.22%(20/90),均高于对照组[2.22%(2/90)和2.22%(2/90)],差异均有统计学意义(χ2 = 7.108、P = 0.001,χ2 = 8.063、P = 0.001)。观察组HPV阳性患者淋巴结转移率为93.33%(56/60),显著高于HPV阴性患者(21/30、70.00%),差异有统计学意义(χ2 = 4.072、P = 0.002)。观察组患者中p53蛋白阳性者39例(39/90、43.33%),其中肿瘤大小≤ 2 cm者27例(27/39、69.23%)、TNM分期Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期分别占15.38%(6/39)、30.77%(12/39)、35.90%(14/39)和17.95%(7/39),淋巴结转移率为82.05%(32/39);p53蛋白阴性患者51例(51/90,56.67%),肿瘤大小≤ 2 cm者35例(35/51、68.63%)、TNM分期Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期分别占7.84%(4/51)、19.61%(10/51)、49.02%(25/51)和23.53%(12/51),淋巴结转移率为86.27%(44/51),p53蛋白阴性组与p53蛋白阳性组患者肿瘤大小、TNM分期及淋巴结转移率差异均无统计学意义(χ2 = 0.682、P = 0.462,χ2 = 0.491、P = 0.507,χ2 = 0.572、P = 0.461)。 结论检测乳腺癌患者高危型人乳头状瘤病毒感染、p53蛋白表达及淋巴结转移率有助于对乳腺癌的诊疗;p53蛋白阳性率下降可能促进HPV感染相关肿瘤的发生和发展。  相似文献   

8.
目的探究气管切开不同时机对重型颅脑损伤(HCI)患者肺部感染的影响,为更有效地治疗重型颅脑损伤提供临床依据。 方法选取2016年1月至2018年12月遵义医科大学第五附属(珠海)医院收治的160例重型颅脑损伤患者为研究对象,按照气管切开的不同时机分为观察组(80例)和对照组(80例)。观察组和对照组患者分别于颅脑损伤24 h内(早期)和24 h后(晚期)实施气管切开救治方案,观察两组HCI合并肺部感染者的病原菌构成及感染控制的有效率,比较其疗效及手术前后的肺通气功能。 结果观察组患者不良反应如肺部感染(33.75%)、皮下气肿(8.75%)、低氧血症(3.75%)、出血(10.00%)、食管气管瘘(6.25%)、气胸(6.25%)等发生率均显著低于对照组(61.25%、20.00%、13.75%、25.00%、21.25%和16.25%),差异具有统计学意义(χ2 = 12.13、P < 0.001,χ2 = 4.11、P = 0.040,χ2 = 4.10、P = 0.040,χ2 = 6.23、P = 0.010,χ2 = 7.59、P = 0.010,χ2 = 6.01、P = 0.010)。重型颅脑损伤患者肺部感染病原体主要分为革兰阴性菌(60.00%、51/85),以铜绿假单胞菌(25.88%、22/85)为主;革兰阳性菌(34.12%、29/85)中以金黄色葡萄球菌(23.53%、20/85)为主;真菌(5.88%、5/85)感染中以白假丝酵母菌(4.71%、4/85)为主。观察组患者HCI合并肺部感染的治疗有效率(77.28%、21/27)显著优于对照组(32.66%、16/49)(χ2 = 14.18、P < 0.001),且其整体的生存率(88.89%、24/27)亦高于对照组(67.36%、33/49)(χ2 = 4.38、P = 0.04),差异均有统计学意义。观察组中HCI合并肺部感染者PO2[(128.22 ± 11.79)mmHg]和SaO2[(96.55 ± 1.41)%]均显著高于对照组[(101.35 ± 10.27)mmHg和(94.26 ± 1.64)%],差异有统计学意义(t = 15.37、9.47,P均< 0.001)。观察组中HCI合并肺部感染者PCO2[(35.79 ± 5.33)mmHg]低于对照组[(43.72 ± 6.06)mmHg],差异有统计学意义(t = 8.77、P < 0.001)。 结论重型颅脑损伤患者早期实施气管切开,能有效提高疗效,降低并发症发生率,改善患者预后。  相似文献   

9.
目的探讨采用α-2b干扰素联合LEEP刀治疗宫颈糜烂的临床疗效。方法回顾性分析笔者所在医院2009年2月~2010年12月门诊收治的宫颈糜烂Ⅰ~Ⅲ度140例患者资料。随机分为Α组和B组各70例。其中Α组行单纯LEEP刀治疗,B组患者行干扰素联合LEEP刀治疗,比较其疗效。结果 B组70例患者采用α-2b干扰素联合LEEP刀治疗宫颈糜烂,治愈率为98.4%。A组单纯采用LEEP刀治疗治愈率为96.2%,两组比较差异无统计学意义(P〉0.05);A组患者的出血时间明显缩短,阴道流液量明显减少,两组比较有统计学意义(P〈0.01);两组治疗3、6、9个月HPV转阴率分别为28.57%、52.86%、75.71%和68.57%、85.71%、92.86%,两组比较差异有统计学意义(P〈0.05)。结论α-2b干扰素联合LEEP刀治疗宫颈糜烂手术间短,术中具有止血效果好,术后出血少,创面修复宫颈无瘢痕,软。对未生育妇女尤其适用,不影响术后妊娠分娩时宫口扩张。  相似文献   

10.
吴洋  尚晴  马先俊  谌珩 《中国科学美容》2014,(5):181-182,194
目的探讨微通道与标准通道经皮肾镜治疗合并肾内感染的肾结石的临床效果。方法将本院2010年6月~2013年8月收治的90例合并感染的肾结石患者分为对照组和观察组,每组各45例,对照组患者采用标准通道经皮肾镜治疗,观察组患者采用微通道经皮肾镜治疗,比较两组患者的疗效。结果对照组患者的术中出血量、手术时间与观察组比较,差异无统计学意义(P〉0.05)。对照组患者一期碎石率高于观察组,差异有统计学意义(P〈0.05),两组结石残留率差异无统计学意义(P〉0.05)。对照组患者的感染率明显低于观察组,差异有统计学意义(P〈0.05)。结论对于合并肾内感染的直径〉2cm的肾结石,标准通道的疗效优于微通道。  相似文献   

11.
Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI2) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI2), TXB2 (stabile metabolite of thromboxane A2) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI2 release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB2 (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI2 release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A2, presumably contributing to hemodynamic stability within 30 min after MT.  相似文献   

12.
Don Dame 《Artificial organs》1996,20(5):613-617
Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.  相似文献   

13.
Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.  相似文献   

14.
Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H2O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg−1 followed by 0.15 mg · kg−1 · h−1, n=8) or verapamil (0.1 mg · kg−1 followed by 0.3 mg · kg−1 · h−1, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.  相似文献   

15.
Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.  相似文献   

16.
Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.  相似文献   

17.
Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg?1 i. v. or midazolam 0.05 mg · kg?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg?1 i. v. and 32 μg · kg?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg?1. The mean ED50s, calculated from dose-response curves, were 5.4 mg · kg?1, 3.9 μg · kg?1 and 0.4 mg · kg?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg?1 i. v. or midazolam 0.05 mg · kg?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg?1 and 8 μg · kg?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.  相似文献   

18.
Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg?1 · min?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min?1 · m?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO2I) and oxygen consumption index (VO2I) were also significantly increased in the dopexamine group (DO2I: from 416±91 to 717±110 ml/m2 · m2; VO2I: from 98±25 to 157±22 ml/m2 · m2), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.  相似文献   

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Abstract: Photopheresis is a technique in which peripheral blood mononuclear cells, in the presence of a photoacti-vatable compound, are exposed extracorporeally to ultraviolet A light and reinfused, inducing a host autoregula-tory immune response. Experimental work and ongoing clinical studies are helping to define the role of this novel, safe, and non-toxic immunomodulating technology in the field of transplantation.  相似文献   

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