老年肺心病并发心律失常127例分析

目的：探讨肺心病并发心律失常的临床特点。方法：选择180例老年肺心病患者中并发心律失常的127例进行回顾性分析。结果：本组180例肺心病心律失常检出率70.56%,其心律失常类型以房性早搏为主,其次为右束支传导阻滞,再次为窦性心动过速,多数患者同时兼有两种以上心律失常。结论：肺心病心律失常发生率较高,且与肺心病患者病情严重程度密切相关,而心律失常治疗应通过积极的病因和合并症治疗,使用抗心律失常药物不是首选治疗方法。     

高原肺心病伴心律失常116例

慢性肺源性心脏病 (肺心病 )伴心律失常较常见。1980年以来 ,我院 (驻地海拔 2 80 8ｍ )共收治肺心病伴心律失常 116例 ,分析报告如下。1　临床资料1 1　一般情况　本组男 87例 ,女 2 9例 ;年龄 3 178岁 ,平均 5 3岁。按 1977年第 2次全国肺心病会议修订的诊断标准 ,均为肺心病急性加重期合并心律失常。病程 63 0年。原发病 :慢性支气管炎肺气肿 10 8例 ,支气管哮喘 4例 ,肺结核 2例 ,支气管扩张症 2例。1 2　心电图检查　肺心病伴心律失常 116例中 ,合并2或 3种心律失常 2 8例 ( 2 4 1% ) ,共发生心律失常15 4例次 :房性早搏 3 8例次 ( 2 4…     

丹红注射液预防肺心病急性发作并发心律失常效果观察

目的：观察丹红注射液预防慢性肺源性心脏病（肺心病）急性发作期并发心律失常的效果及不良反应。方法：选择慢性肺心病急性发作期患者102例,随机分为观察组52例和对照组50例。对照组采用吸氧、改善通气、控制感染、祛痰平喘等常规治疗;观察组在对照组基础上,给予丹红注射液30ml,加入到5%葡萄糖液250ml中静脉滴注,每天1次。两组均治疗10天。治疗结束后,评定两组心律失常发生情况等。结果：观察组发生激动传到异常心理失常和激动起源异常心律失常5例（9.6%）与15例（28.8%）,对照组发生11例（22.0%）与33例（66.0%）;两组比较,差异显著或非常显著（P〈0.05,P〈0.01）。观察组发生轻度头晕、面部潮红3例;两组治疗期间未见血常规、肝肾功能、电解质等异常。结论：丹红注射液可减少肺心病急性发作期心律失常的发生,且较安全。     

肺心病心律失常临床分析

心律失常是慢性肺源性心脏病(以下简称肺心病)的常见并发症之一,我院1980年元月至1994年3月收治239例肺心病并发心律失常79例。为探讨我地区肺心病心律失常特点。现分析如下:1 临床资料 本组病例均于入院前后作过心电图,常规12导联描记;急重病人心律失常者及时听诊并描记心电图;摄胸片、查肝功、肾功、生化以及血、尿、大便等有关检查。239例均符合1977年全国肺心病专业会议拟订的肺心病     

老年冠心病心律失常治疗中的药物不良反应

冠心病是老年常见病,心律失常是冠心病的主要症状。近年来尽管射频消融等介入疗法用于治疗心律失常,但抗心律失常药物仍是主要治疗手段,尤其是对老年病人。鉴于老年病人生理和病理因素影响,药代动力学与青年人有明显差别,临床发生副作用即药物不良反应(ADR)机率高。为了探讨老年冠心病心律失常病人治疗中发生ADR的危险因素,减少药源性疾病的发生,我们对184例老年冠心病心律失常治疗中ADR情况进行分析,以期对老年冠心病心律失常病人临床合理用药引起重视。     

老年心血管病合并焦虑抑郁症患者心律失常的动态心电图分析

目的 探讨动态心电图监测下,老年心血管病患者伴焦虑抑郁症与心律失常的关系.方法 选取2011-01至2012-08期间我院收治的伴焦虑抑郁症的老年心血管病患者80例作为观察组,以不伴有焦虑抑郁症的老年心血管病患者70例作为对照组,观察动态心电图监测下的心律失常发生情况,阐明焦虑抑郁症与心律失常之间的关系.结果 观察组患者心律失常检出率明显高于对照组,数据分析发现其差异具有统计学意义（P〈0.05）.结论 通过动态心电图对伴焦虑抑郁症老年心血管病患者进行监测,可明显发现心血管病患者其焦虑抑郁症患者与心律失常的发生密切相关,具有广泛的应用前景,值得在临床上推广使用.     

住院老年人猝死45例临床分析

本文对45例老年猝死原因分析。室性心律失常是任何原因所致的急慢性心力衰竭、急性心肌梗塞、心肌病及肺心病等的主要致死因素。有原发性室颤病史者有高度再发猝死的危险;心前区隐痛不适,烦燥不安,胸闷气短,便意频发及抽搐等是猝死先兆;疲劳、暴饮暴食、情绪波动是诱发恶性心律失常的主要因素。对高危猝死者宜住入心脏病监护病房(ICU)监护。     

老年多发病患者动态心电图特点及治疗探讨

目的分析老年多发病患者动态心电图特点和优化治疗。方法选择2008年6月~2009年7月住本院地方干部病房患者700例,男性506例（72．3％）,女性194例（27．7％）;年龄60～96岁（平均78．1岁）,所患疾病主要为高血压病、冠心病、脑血管病、癌瘤、慢性支气管炎、肺气肿、肺心病、肺炎、糖尿病、前列腺增生等老年多发病中3种以上。全部病例均先作12导联心电图检查,然后用美国MortaraInstrumentIncH—Scribe12＋型动态心电图仪12导监测记录24h心电图。结果室性心律失常554例（79．1％）,Lown3级以上为329例（47．0％）;房性心律失常683例（97．6％）,其中频发房早,成对、短阵房速340例（48．6％）,心肌缺血130例（18．6％）,且多为心肌缺血（SMI）无临床症状。结论老年多发病患者动态心电图特点是两高（心律失常发生率高,恶性室性心律失常高）,两低（心肌缺血检出率低,临床症状出现率低）,胺碘酮有广泛抗心律失常作用,疗效好,促心律失常作用小,可为多种心律失常治疗之首选。     

中度高原老年肺心病急性期血气和酸碱失衡特点的探讨

本文对西宁地区(海拔2260m)1984～1988年我院收治的60岁以上老年和59岁以下非老年慢性肺心病的血气和酸碱测定结果作一分析,并将老年组与平原老年肺心病对照,以探讨中度高原老年肺心病血气和酸碱失衡的特点。 对象和方法 老年组:82例,男60例,女22例,年龄60～68岁,平均67岁。 非老年组:86例,男64例,女22例,年龄30～59岁,平均54岁。 两组均符合1983年全国第四次肺心病专业会议修订的慢性肺心病急性发作期诊断标准。同步测定动脉血气(PH、PO_2、PCO_2、BE、HCO_3~-)和静脉血电解质(Na~+、K~+、CI~-)。     

老年慢性心力衰竭的多病因性及心衰类型分析

目的探讨老年慢性心力衰竭的多病因性及心衰类型,为临床老年慢性心衰的多元化及个性化治疗提供依据。方法对本科2008年2月～2009年2月收治的206例老年心衰患者,根据不同年龄段分成3组,对其多病因构成特点、心衰类型进行临床分析,并根据超声心动图对E／A、EF的测定结果进行心功能判断。结果老年心衰患者中,94．7％为多病因,基础疾病以冠心病、高血压、肺心病为主,合并疾病以COPD、糖尿病、心律失常为主,常见老年人心衰主要以舒张性心衰为主,占66．99％。结论老年心衰患者主要以冠心病、高血压、肺心病等为主要基础疾病,且主要以舒张性心衰为主,在治疗上应考虑到心衰的多病因性,进行多元化及个体化防治。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.