宫颈环形电切术治疗宫颈糜烂疗效观察

Objective To observe the clinical curative effect of cervical loop electrosurgical excision procedure in treatment of patients with cervical erosion by LEEP.Methods 268 patients whose cervical erosions were above Ⅱ°were treated by LEEP,and the length of operation time,bleeding volume in the operation, amount of vaginal discharge after the operation,the length of bleeding time and cervical repair were observed.Results Follow-up was 12 weeks.262 cases (97.76% ) were cured, 6 cases (2.24% ) were effective.The bleeding amount was less than 10ml.The average surgery time was(2.62 ±0.58) minutes.18 cases(6.71% ) had the colporrhagia.No infectious case was found.Conclusion The curative effect of LEEP for cervical erosion was significant,and operation was simple and safe.LEEP was a well treatment method of cervical erosion.     

剖宫产同时行子宫肌瘤切除术安全性分析

目的 评价剖宫产同时行子宫肌瘤切除术的可行性和安全性.方法 分析2003年1月至2009年12月期间在广东省湛江市第二人民医院接受剖宫产同时行子宫肌瘤切除术的42例患者(研究组)和单纯行剖宫产术的80例产妇(对照组)的临床资料.比较2组的术中及术后情况.结果 研究组手术时间为[(84.5±14.8)min]明显长于对照组[(63.0±10.7)min,P<0.05];2组间术中和术后24 h的出血量[分别为(300±96)ml比(285±61)ml,(185±57)ml比(175±46)m1]、术后体温恢复时间[(29.8±13.2)h比(26.5±8.6)h]、产褥病发生率[2例(4.8%)比2例(2.5%)]及术后住院时间[(6.7±1.9)d比(6.1±1.8)d]差异均无统计学意义.结论 在严格掌握手术适应证及充分准备的情况下,剖宫产同时行子宫肌瘤切除术是安全可行的.

Abstract：

Objective To evaluate the feasibility and safety of myomectomy during cesarean section. Methods The clinical data of 42 patients who underwent myomectomy during cesarean section (study group) and 80 matched pregnant women without uterine myoma who underwent cesarean section alone (control group) from Ja-nunary 2003 to December 2009 were reviewed. The data during and after surgery between two groups were compared. Results The average duration of operation was longer in the study group than that in the control group ( P < 0.05). However, there was no significant difference of blood loss during operation or within 24 hours after operation , incidence of postoperative fever or complication and hospital stay between study group and control group. ConclusionMyomectomy during cesarean section is safe and feasible.     

氟伐他汀对缺血性脑卒中患者的疗效观察及护理措施

Objective To explore the effect and nursing main points of fluvastatin on the patients with cerebral arterial thrombosis. Methods Eighty-five patients with cerebral arterial thrombosis were randomly divided into three groups. Group Ⅰ was the negative control group. Group Ⅱ was the conventional-dose therapy group and group Ⅲ was the high-dose therapy group. Each group was treated with related therapy and care. The blood lipids in all groups were tested before the treatment, 4 weeks, 12 weeks and 24 weeks after the treatment; the carotid intima-media thickness (IMT) were measured by the Germany SEQUOIAS-512-B ultra machine before the treatment and 24 weeks after the treatment; At the same time, the side effects of fluvastatin were recorded. Results The results of blood lipid tests showed that the LDL, TC and TG in two treated groups were significantly decreased compared to negative control group (P<0.05). After treated for 24 weeks, the carotid intima-media thickness (IMT) in two treated groups were significantly reduced (P<0.05); the side effects of fluvastatin were infrequent and there was no significant different among the three groups (P>0.05). Conclusion The effects of different doses of fluvastatin on cerebral arterial thrombosis were significantly different. With the dose of fluvastatin increased, the serum LDL-L and TC reduced more obvious and the inhibition on carotid atherosclerosis shows more obvious, and the side effects did not increased.     

氟伐他汀对缺血性脑卒中患者的疗效观察及护理措施

Objective To explore the effect and nursing main points of fluvastatin on the patients with cerebral arterial thrombosis. Methods Eighty-five patients with cerebral arterial thrombosis were randomly divided into three groups. Group Ⅰ was the negative control group. Group Ⅱ was the conventional-dose therapy group and group Ⅲ was the high-dose therapy group. Each group was treated with related therapy and care. The blood lipids in all groups were tested before the treatment, 4 weeks, 12 weeks and 24 weeks after the treatment; the carotid intima-media thickness (IMT) were measured by the Germany SEQUOIAS-512-B ultra machine before the treatment and 24 weeks after the treatment; At the same time, the side effects of fluvastatin were recorded. Results The results of blood lipid tests showed that the LDL, TC and TG in two treated groups were significantly decreased compared to negative control group (P<0.05). After treated for 24 weeks, the carotid intima-media thickness (IMT) in two treated groups were significantly reduced (P<0.05); the side effects of fluvastatin were infrequent and there was no significant different among the three groups (P>0.05). Conclusion The effects of different doses of fluvastatin on cerebral arterial thrombosis were significantly different. With the dose of fluvastatin increased, the serum LDL-L and TC reduced more obvious and the inhibition on carotid atherosclerosis shows more obvious, and the side effects did not increased.     

氟伐他汀对缺血性脑卒中患者的疗效观察及护理措施

Objective To explore the effect and nursing main points of fluvastatin on the patients with cerebral arterial thrombosis. Methods Eighty-five patients with cerebral arterial thrombosis were randomly divided into three groups. Group Ⅰ was the negative control group. Group Ⅱ was the conventional-dose therapy group and group Ⅲ was the high-dose therapy group. Each group was treated with related therapy and care. The blood lipids in all groups were tested before the treatment, 4 weeks, 12 weeks and 24 weeks after the treatment; the carotid intima-media thickness (IMT) were measured by the Germany SEQUOIAS-512-B ultra machine before the treatment and 24 weeks after the treatment; At the same time, the side effects of fluvastatin were recorded. Results The results of blood lipid tests showed that the LDL, TC and TG in two treated groups were significantly decreased compared to negative control group (P<0.05). After treated for 24 weeks, the carotid intima-media thickness (IMT) in two treated groups were significantly reduced (P<0.05); the side effects of fluvastatin were infrequent and there was no significant different among the three groups (P>0.05). Conclusion The effects of different doses of fluvastatin on cerebral arterial thrombosis were significantly different. With the dose of fluvastatin increased, the serum LDL-L and TC reduced more obvious and the inhibition on carotid atherosclerosis shows more obvious, and the side effects did not increased.     

氟伐他汀对缺血性脑卒中患者的疗效观察及护理措施

Objective To explore the effect and nursing main points of fluvastatin on the patients with cerebral arterial thrombosis. Methods Eighty-five patients with cerebral arterial thrombosis were randomly divided into three groups. Group Ⅰ was the negative control group. Group Ⅱ was the conventional-dose therapy group and group Ⅲ was the high-dose therapy group. Each group was treated with related therapy and care. The blood lipids in all groups were tested before the treatment, 4 weeks, 12 weeks and 24 weeks after the treatment; the carotid intima-media thickness (IMT) were measured by the Germany SEQUOIAS-512-B ultra machine before the treatment and 24 weeks after the treatment; At the same time, the side effects of fluvastatin were recorded. Results The results of blood lipid tests showed that the LDL, TC and TG in two treated groups were significantly decreased compared to negative control group (P<0.05). After treated for 24 weeks, the carotid intima-media thickness (IMT) in two treated groups were significantly reduced (P<0.05); the side effects of fluvastatin were infrequent and there was no significant different among the three groups (P>0.05). Conclusion The effects of different doses of fluvastatin on cerebral arterial thrombosis were significantly different. With the dose of fluvastatin increased, the serum LDL-L and TC reduced more obvious and the inhibition on carotid atherosclerosis shows more obvious, and the side effects did not increased.     

氟伐他汀对缺血性脑卒中患者的疗效观察及护理措施

Objective To explore the effect and nursing main points of fluvastatin on the patients with cerebral arterial thrombosis. Methods Eighty-five patients with cerebral arterial thrombosis were randomly divided into three groups. Group Ⅰ was the negative control group. Group Ⅱ was the conventional-dose therapy group and group Ⅲ was the high-dose therapy group. Each group was treated with related therapy and care. The blood lipids in all groups were tested before the treatment, 4 weeks, 12 weeks and 24 weeks after the treatment; the carotid intima-media thickness (IMT) were measured by the Germany SEQUOIAS-512-B ultra machine before the treatment and 24 weeks after the treatment; At the same time, the side effects of fluvastatin were recorded. Results The results of blood lipid tests showed that the LDL, TC and TG in two treated groups were significantly decreased compared to negative control group (P<0.05). After treated for 24 weeks, the carotid intima-media thickness (IMT) in two treated groups were significantly reduced (P<0.05); the side effects of fluvastatin were infrequent and there was no significant different among the three groups (P>0.05). Conclusion The effects of different doses of fluvastatin on cerebral arterial thrombosis were significantly different. With the dose of fluvastatin increased, the serum LDL-L and TC reduced more obvious and the inhibition on carotid atherosclerosis shows more obvious, and the side effects did not increased.     

氟伐他汀对缺血性脑卒中患者的疗效观察及护理措施

Objective To explore the effect and nursing main points of fluvastatin on the patients with cerebral arterial thrombosis. Methods Eighty-five patients with cerebral arterial thrombosis were randomly divided into three groups. Group Ⅰ was the negative control group. Group Ⅱ was the conventional-dose therapy group and group Ⅲ was the high-dose therapy group. Each group was treated with related therapy and care. The blood lipids in all groups were tested before the treatment, 4 weeks, 12 weeks and 24 weeks after the treatment; the carotid intima-media thickness (IMT) were measured by the Germany SEQUOIAS-512-B ultra machine before the treatment and 24 weeks after the treatment; At the same time, the side effects of fluvastatin were recorded. Results The results of blood lipid tests showed that the LDL, TC and TG in two treated groups were significantly decreased compared to negative control group (P<0.05). After treated for 24 weeks, the carotid intima-media thickness (IMT) in two treated groups were significantly reduced (P<0.05); the side effects of fluvastatin were infrequent and there was no significant different among the three groups (P>0.05). Conclusion The effects of different doses of fluvastatin on cerebral arterial thrombosis were significantly different. With the dose of fluvastatin increased, the serum LDL-L and TC reduced more obvious and the inhibition on carotid atherosclerosis shows more obvious, and the side effects did not increased.     

氟伐他汀对缺血性脑卒中患者的疗效观察及护理措施

Objective To explore the effect and nursing main points of fluvastatin on the patients with cerebral arterial thrombosis. Methods Eighty-five patients with cerebral arterial thrombosis were randomly divided into three groups. Group Ⅰ was the negative control group. Group Ⅱ was the conventional-dose therapy group and group Ⅲ was the high-dose therapy group. Each group was treated with related therapy and care. The blood lipids in all groups were tested before the treatment, 4 weeks, 12 weeks and 24 weeks after the treatment; the carotid intima-media thickness (IMT) were measured by the Germany SEQUOIAS-512-B ultra machine before the treatment and 24 weeks after the treatment; At the same time, the side effects of fluvastatin were recorded. Results The results of blood lipid tests showed that the LDL, TC and TG in two treated groups were significantly decreased compared to negative control group (P<0.05). After treated for 24 weeks, the carotid intima-media thickness (IMT) in two treated groups were significantly reduced (P<0.05); the side effects of fluvastatin were infrequent and there was no significant different among the three groups (P>0.05). Conclusion The effects of different doses of fluvastatin on cerebral arterial thrombosis were significantly different. With the dose of fluvastatin increased, the serum LDL-L and TC reduced more obvious and the inhibition on carotid atherosclerosis shows more obvious, and the side effects did not increased.     

氟伐他汀对缺血性脑卒中患者的疗效观察及护理措施

Objective To explore the effect and nursing main points of fluvastatin on the patients with cerebral arterial thrombosis. Methods Eighty-five patients with cerebral arterial thrombosis were randomly divided into three groups. Group Ⅰ was the negative control group. Group Ⅱ was the conventional-dose therapy group and group Ⅲ was the high-dose therapy group. Each group was treated with related therapy and care. The blood lipids in all groups were tested before the treatment, 4 weeks, 12 weeks and 24 weeks after the treatment; the carotid intima-media thickness (IMT) were measured by the Germany SEQUOIAS-512-B ultra machine before the treatment and 24 weeks after the treatment; At the same time, the side effects of fluvastatin were recorded. Results The results of blood lipid tests showed that the LDL, TC and TG in two treated groups were significantly decreased compared to negative control group (P<0.05). After treated for 24 weeks, the carotid intima-media thickness (IMT) in two treated groups were significantly reduced (P<0.05); the side effects of fluvastatin were infrequent and there was no significant different among the three groups (P>0.05). Conclusion The effects of different doses of fluvastatin on cerebral arterial thrombosis were significantly different. With the dose of fluvastatin increased, the serum LDL-L and TC reduced more obvious and the inhibition on carotid atherosclerosis shows more obvious, and the side effects did not increased.     

巴曲亭在甲状腺术中的止血效果及对凝血功能影响的应用体会

目的观察巴曲亭在甲状腺术中、术后的止血效果及对凝血功能的影响。方法随机将甲状腺腺叶切除术80例患者分成巴曲亭组和对照组,观察创面止血时间、术中出血量、术后2d创面出血及渗血量及对患者凝血功能的影响。结果巴曲亭组切口止血时间、切口单位面积出血量、术中出血量、术后引流量均少于对照组(P<0.05),两组术前术后凝血功能无显著性差异。结论巴曲亭在甲状腺术中、术后具有较好的止血效果,对患者的凝血功能无影响,是安全有效的止血药物。     

剖宫产术中宫体注射卡前列素氨丁三醇预防产后出血的效果评价

目的 探讨剖宫产术中宫体注射卡前列素氨丁三醇预防产后出血的效果.方法 选择本院2013年1月至2014年5月收治的具有高危产后出血因素的产妇80例作为研究对象,将其随机分成实验组和对照组,各40例.对照组给予缩宫素+米索前列醇+垂体后叶素+葡萄糖酸钙,实验组给予缩宫素+卡前列素氨丁三醇.观察并比较两组出血情况以及治疗效果.结果 实验组术中出血量[(257.9±76.4)ml vs.(388.7±90.1)ml]、产后2 h[(101.7±29.7)ml vs.(198.6±34.9)ml]以及产后24 h[(299.8±68.4)ml vs.(488.6±59.3)ml]的出血量均显著小于对照组(P＜0.05);实验组与对照组止血时间分别为(18.7±12.1)min和(45.6±16.2) min,差异具有统计学意义(P＜0.05);同时实验组输血例数(3例vs.12例)和子宫切除例数(0例vs.2例)均少于对照组,两组输血例数比较差异具有统计学意义(P＜0.05).结论 使用缩宫素与卡前列素氨丁三醇联合预防剖宫产产后出血具有明显的效果,适合在临床上推广应用.     

血凝酶在心胸外科手术中的应用

目的 :观察血凝酶在心胸外科手术术中、术后的止血效果。方法 :12 8例心胸外科手术病人随机分 2组。血凝酶组 80例 ,应用血凝酶 ,对照组 4 8例 ,使用酚磺乙胺和氨甲苯酸。普胸手术术前30min开始给药 ,观察术中切口出血量和术后 1,2 ,3d引流量。心脏手术开始缝合心包时开始给药 ,观察术后 1,2 ,3d引流量。检测 2组用药前、用药后 30min、术后d 1和d 7凝血功能。结果 :血凝酶组普胸手术病人的术中止血时间、出血量均少于对照组 (P <0 .0 1)。血凝酶组术后d 1,2 ,3及总的胸液引流量较对照组明显减少 (P <0 .0 1)。术后 30min ,d 1和d 7,2组凝血酶原时间和纤维蛋白原与治疗前相比无显著差异 ,2组间相比差异亦无显著意义 (P >0 .0 5 )。血凝酶组未出现全身及局部不良反应。结论 :在心胸外科手术术中、术后使用血凝酶对于心胸手术有较好的预防和治疗出血的作用 ,无明显不良反应。     

血凝酶与抑肽酶在人工关节置换术中的应用

目的:评价血凝酶与抑肽酶减少手术出血量的效果及安全性。方法:75例全髋关节置换术患者随机分为Ⅰ、Ⅱ、Ⅲ组,每组25例。术前15min,3组分别静脉注射血凝酶2kU、抑肽酶278IU、注射用水10ml。结果:Ⅰ、Ⅱ组术后24h出血量及术后输血量分别为(286.9±65.6)、(301.9±81.1)ml及(101.8±29.6)、(98.3±36.1)ml,比Ⅲ组的(369.2±59.3)、(220.2±48.5)ml显著减少(P<0.01)。3组术毕血红蛋白、血小板、纤维蛋白原比术前明显降低(P<0.01),但均在正常范围。Ⅱ组有1例发生严重过敏反应。结论:术中应用血凝酶或抑肽酶均有明显的止血效果,但血凝酶更安全。     

不同剂量血凝酶在先天性心脏病手术中的临床效果观察

目的:观察不同剂量血凝酶在先天性心脏病手术中的临床效果。方法:筛选先天性心脏病手术患者84例,随机分为常规血凝酶组(n=28)、加倍血凝酶组(n=28)和对照组(n=28),常规血凝酶组和加倍血凝酶组在撤离体外循环、开始缝心包时经中心静脉分别给予常规剂量血凝酶、加倍剂量血凝酶静脉推注,对照组不用止血药。观察用药24h内胸腔引流量、输血量、输血浆量及血压、心率、呼吸及全身情况。结果:加倍血凝酶组术后24h内胸腔引流量、输血量及输血浆量少于常规血凝酶组(P<0·05),显著少于对照组(P<0·05),且不增加不良反应及并发症。结论:在先天性心脏病手术中应用加倍剂量血凝酶,临床效果良好且安全。     

胆肠吻合加胃肠吻合术治疗老年壶腹周围癌的疗效及患者耐受性观察

目的 胆肠吻合加胃肠吻合术(姑息性旁路手术)治疗老年壶腹周围癌的疗效及患者耐受性观察.方法 选取本院2010年1月至2011年1月64例老年壶腹周围癌患者为研究对象,将患者抽签随机分为观察组与对照组,每组32例.观察组给予姑息性旁路手术治疗,对照组给予根治性手术治疗,比较两组患者术中出血量、手术时间、住院时间、减黄效果、术后情况及并发症发生率.结果 观察组术中出血量少于对照组[(136.42±89.43)ml vs.(279.62±124.65)ml],手术时间短于对照组[(219.93±67.82)min vs.(347.61±83.60) min]、住院时间短于对照组[(16.86±7.16)d vs.(27.47±11.36)d],两组比较差异有统计学意义(P＜0.05).观察组减黄效果有效率高于对照组(93.75％vs.71.88％),两组比较差异有统计学意义(P＜ 0.05).观察组复发率、术后出血率及腹腔感染、伤口感染发生率低于对照组(P＜0.05).观察组并发症发生率低于对照组(15.63％ vs.46.88％),两组比较差异有统计学意义(P＜0.05).结论 姑息性旁路手术治疗老年壶腹周围癌的疗效显著,手术时间短,出血量少,可促进患者更快康复,降低术后复发率、出血率及感染发生率,并发症较少,患者耐受性高,可在临床推广使用.     

泮托拉唑联合凝血酶对上消化道出血治疗效果及对凝血功能指标的影响

目的:观察泮托拉唑联合凝血酶对上消化道出血患者临床效果及凝血功能指标的影响。方法:选择2019年1月至2020年10月驻马店市中心医院收治的上消化道出血患者86例,按随机数字表法分为两组,各43例。在常规治疗基础上,对照组给予泮托拉唑治疗,观察组给予泮托拉唑联合凝血酶治疗,共治疗7 d。比较两组临床疗效、凝血功能指标、止血时间、输血量及不良反应。结果:观察组临床总有效率为97.67%,高于对照组的81.40%,差异有统计学意义(P<0.05)。两组治疗后凝血酶时间(TT)、部分凝血酶活时间(APTT)、凝血酶原时间(PT)均短于治疗前,且观察组TT(17.49±1.20)s、APTT(34.15±2.89)s、PT(12.03±0.84)s,短于对照组,差异有统计学意义(P<0.05)。观察组止血时间(29.83±3.66)h,短于对照组,输血量(523.26±31.53)mL,少于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率相比,差异无统计学意义(P>0.05)。结论:泮托拉唑联合凝血酶治疗上消化道患者,能有效缩短TT、APTT、PT及止血时间,减少输血量,临床治疗安全有效。     

血凝酶在腺样体手术中应用的疗效观察

目的:探讨在腺样体手术中应用血凝酶对出血量、凝血功能及血小板功能的影响。方法:采用随机对照方法,将240例行腺样体手术患者分为试验组(应用血凝酶)与对照组(不用血凝酶)。分别检测给药前、后凝血功能和血小板功能,计算术中出血量和术后出血量。结果:2组间术中出血量、痰液中血红蛋白含量、手术时间比较,差异均有统计学意义(P<0.05)。除纤维蛋白原外,凝血功能其余指标和血小板功能各指标2组差异均无统计学意义(P>0.05)。结论:在腺样体手术中应用血凝酶能有效减少术中出血量,减少术后创面渗血,不影响机体凝血功能和血小板功能。     

后腹腔镜与开放性手术治疗肾盂输尿管连接部梗阻的比较

目的 比较应用后腹腔镜技术与开放手术治疗肾盂输尿管连接部梗阻的效果.方法 采用后腹腔镜技术治疗肾盂输尿管连接部梗阻22例（后腹腔镜组）,开放手术21例（开放手术组）,两组分别就手术时间、出血量、术后排气时间、术后住院日等进行比较.结果 后腹腔镜组手术出血量（32.0±10.0）ml、术后排气时间（31.0±5.7）h、平均住院时间（7.0±1.6）d,均明显少于开放手术组的（70.0±11.9）ml、（52.0±6.9）h、（14.0±1.4）d;手术时间（113.0±7.6）min,长于开放手术组的（72.0±6.8）min,差异均有统计学意义（t=7.06,8.14,11.37,11.36,均P＜0.05）.结论 后腹腔镜技术治疗肾盂输尿管连接部梗阻途径直接,不会对腹腔内脏器造成干扰和污染,且损伤小、痛苦少、康复快、住院时间短.随着熟练和技术水平的提高加之相关操作器械的更新,能够缩短手术时间,可以替代开放性手术.     

腹腔镜辅助手术治疗胃肠道肿瘤的效果研究

目的 比较腹腔镜辅助手术与传统开腹手术治疗胃肠道肿瘤的临床效果.方法 选取2012年8月至2015年8月本院收治的胃肠道肿瘤患者87例,行传统开腹手术治疗43例,纳入对照组,腹腔镜手术治疗44例,纳入观察组.比较两组手术效果及并发症情况.结果 观察组手术时间[(109.53± 29.65) min]、术中出血量[(35.71 ± 20.16) ml]、切口总长度[(38.45± 18.52) mm]、术后排气时间[(31.26±6.81)h]、术后进食流食时间[(37.43± 5.82)h]、术后卧床时间[(20.64±4.22)h]、住院天数[(8.17± 1.26)d]均明显少于对照组(P＜ 0.05);观察组并发症发生率4.55％,显著低于对照组的20.93％(P＜0.05).结论 与传统开腹手术相比,腹腔镜辅助手术在缩短胃肠道肿瘤手术时间、减少创伤、提高恢复时间以及降低并发症等方面更具优势,值得在临床上推广应用.