血液灌流治疗急性重症农药中毒

我院自2001年1月引进河北廊坊爱尔血液净化器材厂生产的YTS—150型炭肾进行血液灌流(HP)治疗急性重症农药中毒,机器用瑞典金宝AK—95机型,为探讨血液灌流治疗急性重症农药中毒临床疗效。将20例急性重症农药中毒病人分为血液灌流组(HP组)和非灌流组(非HP组),两组病人在年龄、临床表现、农药品种方面无显著差异。两组病人首先按内科综合治疗方法急救。HP组进行     

血液灌流联合血液透析抢救重症中毒患者的护理体会

目的为提高急性重症中毒患者的抢救成功率,探讨血液灌流联合血液透析技术在抢救重症中毒患者中的治疗效果。方法对56例重症中毒患者采用血液灌流联合血液透析的临床资料进行分析。结果血液灌流联合血液透析能有效清除体内有毒物质,本组病例有54例治愈,2例因时间过长引起多脏器功能衰竭而死亡。结论血液灌流联合血液透析是抢救急性重症中毒的快速而有效的重要治疗方法。     

血液灌流抢救急性重症有机磷农药中毒的临床研究

目的观察血液灌流抢救急性重症有机磷农药中毒的疗效。方法对49例重症有机磷农药中毒患者,随机分为灌流组25例,非灌流组24例,灌流组在常规洗胃、阿托品、碘解磷定、复能剂和脱水等治疗的基础上,采用血液灌流治疗,并对其结果进行分析。结果血液灌流组治愈23例,治愈率92.0%,非灌流组治愈16例,治愈率66.7%,两组治愈率相比有显著性差异(P<0.05)。灌流组减少了阿托品用量,缩短了昏迷清醒时间、胆碱酯酶恢复及机械通气时间,缩短了平均住院日,与非灌流组相比,两组有显著差异(P<0.05)。结论血液灌流是救治重度有机磷农药中毒的有效方法。     

对于危急重症有机磷中毒患者的临床急救分析

目的：分析研究危急重症有机磷中毒患者的临床急救措施。方法选取在本院治疗危急重症有机磷中毒患者80例,将80例患者平均分成两组,其中一组为对照组,采取常规的急救方法,另一组为观察组,在采取常规急救的方法的同时予以血液灌流对患者进行治疗,观察比较两组患者的临床急救效果。结果观察比较两组患者,观察组治疗后总有效率高于对照组,差异有统计学意义,P＜0.05。结论对于危及重症有机磷中毒急救采取血液灌流的方法在临床上治疗效果更好,治疗时间短,患者病情恢复快,适合临床的广泛使用。     

血液灌流治疗重症过敏性紫癜的临床观察

目的：介绍儿童重症过敏性紫癜（HSP）的血液灌流治疗方法。方法：通过32例重症HSP患儿运用血流灌流联合治疗,总结重症HSP血液灌流的治疗要点及疗效。结果：血液灌流能效缓解各型重症HSP患儿的症状,实验室检查尿蛋白、血沉和大便隐血较治疗前明显好转.差异有统计学意义（P〈0.05）,住院时间3～7d。平均5d,32例患儿经血液灌流治疗后康复出院.2例复发。结论：血液灌能积极阻断HSP的进程,较常规治疗近期疗效显著,住院时问更短。     

重症急性胰腺炎合并急性呼吸窘迫综合征36例临床分析

目的:探讨急性重症胰腺炎并发ARDS综合治疗效果及其意义。方法:对2000-10~2006-10我院收治的重症胰腺炎合并ARDS 36例患者的临床资料进行回顾性分析。结果:I组给予常规治疗基础上行人工呼吸机辅助通气,死亡8例,死亡率47.06%(8/17)。Ⅱ组在常规治疗基础上,尽快应用呼吸机纠正缺氧,强调"最佳"呼气末正压(PEEP),低平台压,适当潮气量,所谓"保护性肺通气"。在Ⅱ组中我们对胆总管下端有梗阻征象的病人(10例)行ERCP及EST术;治愈14例,死亡5例,死亡率26.32%(5/19)。结论:对重症急性胰腺炎合并ARDS综合治疗技术的应用,提高了急性重症胰腺炎并发ARDS的抢救成功率。     

连续性血液净化治疗重症急性胰腺炎疗效分析

目的:观察连续性血液净化(CVVH)治疗重症急性胰腺炎(SAP)的疗效,探讨其治疗机理,为血液净化治疗SAP提供临床依据。方法:选取我院2009年12月~2010年11月期间就诊的重症急性胰腺炎患者,随机分为内科常规治疗组15例和CVVH方法治疗组SAP18例,对两组治疗前后进行血清酶测定、APACHEⅡ评分及不同时点临床疗效的对比观察。结果:(1)和治疗前相比,血液净化组在治疗后血清淀粉酶下降较快,与各时点相比较均有统计学意义,CVVH治疗组各时点之间有统计学意义;(2)CVVH治疗组总有效率高于内科常规治疗组,有统计学意义(P<0.05)。结论:CVVH治疗SAP可明显缩短病程,并能降低死亡率,提高治愈率。     

加贝酯联合血液净化治疗重症急性胰腺炎效果观察

目的：观察加贝酯联合连续血液净化治疗重症急性胰腺炎的临床效果。方法：选择重症急性胰腺炎80例,随机分为观察组和对照组各40例。对照组采用加贝酯、乌司他丁及常规方案治疗,观察组在对照组基础上加用连续血液净化治疗。比较两组生存率、治疗后5天急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、住院时间、腹痛消失时间、血淀粉酶恢复时间,以及治疗前后血清淀粉酶、脂肪酶及C反应蛋白（CRP）水平变化情况。结果：观察组生存率95.0%（38/40）,与对照组的85.0%（34/40）比较差异不显著（P〉0.05）;治疗后5天APACHEⅡ评分、住院时间、腹痛消失时间、血清淀粉酶恢复时间,均显著低于或短于对照组（P〈0.05）。治疗前两组血清淀粉酶、脂肪酶及CRP水平比较,均差异不显著（P〉0.05）;治疗后5天观察组血清淀粉酶、脂肪酶及CRP水平,均显著高于对照组（P〈0.05）。结论：加贝酯联合连续血液净化治疗重症急性胰腺炎效果好,起效快,可显著减轻患者的炎症状态。     

前列腺素E1动脉介入治疗重症急性胰腺炎疗效观察

目的：观察前列腺素E1动脉介入治疗重症急性胰腺炎的疗效。方法：将重症急性胰腺炎68例随机分为两组。静滴组（对照组）35例，在常规治疗同时，采用200μg前列腺素E1加入5％葡萄糖液250～500ml中，静脉滴注，1次／天；介入组（观察组）33例，在常规治疗基础上，将前列腺素E1通过数字减影装置行腹腔动脉及其分支输注，以1．67μg／min连续用药2h。治疗过程中观察症状、体征，胃肠减压量，白细胞计数，血、尿淀粉酶，影像学变化及临床治愈时间。结果：介入组症状改善和临床治愈时间均明显优于静滴组（P〈0．05）。结论：前列腺素E1动脉介入治疗重症急性胰腺炎疗效显著，不良反应少。     

重症急性胰腺炎52例治疗体会

目的：总结重症急性胰腺炎的治疗经验。方法：收集52例重症急性胰腺炎资料,对其治疗进行回顾性分析。结果：52例患者中保守治疗40例,手术治疗12例。47例治愈,死亡5例。结论：重症急性胰腺炎应根据病人的实际情况,综合各种治疗措施,制定个体化治疗方案。     

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.