雾化吸入重组人干扰素α1b治疗毛细支气管炎患儿的疗效及影响因素

目的探讨雾化吸入重组人干扰素α1b治疗毛细支气管炎患儿的疗效及影响因素。方法选择2016年7月-2017年6月该院儿科收治的毛细支气管炎患儿90例为研究对象,随机分为观察组(45例)和对照组(45例)。患儿入院后,先对其进行呼吸道病毒检测,对照组予以止咳、平喘、化痰、抗感染等常规方法治疗,观察组在此基础上加入重组人干扰素α1b雾化吸入治疗;观察并比较两组患儿的临床疗效及临床症状缓解情况,观察并记录患儿出现的不良反应;探寻影响雾化吸入重组人干扰素α1b治疗毛细支气管炎疗效的因素。结果治疗后,两组患儿均未出现严重不良反应;观察组总有效率高于对照组,两组比较差异有统计学意义(P0.05);观察组在咳嗽消失时间、发热消失时间、喘憋消失时间、哮鸣音消失时间、三凹征消失时间均短于对照组(均P0.05)。母乳喂养、年龄8个月、RSV阳性双肺广泛哮鸣音患儿疗效更好。结论雾化吸入重组人干扰素α1b治疗毛细支气管炎临床疗效显著,有效缩短病程、减轻患儿病情,未出现严重不良反应。     

重组人干扰素α-1b雾化吸入治疗毛细支气管炎的疗效观察

目的探讨重组人干扰素α-1b雾化吸入治疗毛细支气管炎的疗效。方法选取2012年4月-2015年4月该院收治的120例毛细支气管炎患儿为研究对象。根据患儿入院ID号进行随机选取均分为观察组和对照组各60例。两组患儿均进行常规治疗,对照组在常规治疗基础上,给予患儿异丙托溴铵雾化吸入治疗;观察组在对照组治疗基础上,联合应用重组人干扰素α-1b雾化吸入治疗。治疗后,记录比较两组患儿肺部啰音、三凹征、咳嗽、发热及喘憋改善时间,对比两组患儿的疗效及不良反应状况。结果观察组患儿肺部啰音、三凹征、咳嗽、发热及喘憋改善时间明显短于对照组,差异有统计学意义(t=10.542、3.997、4.971、9.184、4.999,均P0.05),观察组治疗的总有效率(98.33%)明显高于对照组(85.00%),两组比较差异有统计学意义(χ~2=6.982,P0.05)。两组不良反应发生率差异无统计学意义(8.33%vs 11.67%,χ~2=0.370,P0.05)。结论重组人干扰素α-1b雾化吸入治疗毛细支气管炎患儿,疗效显著,安全性良好。     

重组人干扰素治疗毛细支气管炎的疗效观察

目的 观察重组人干扰素-α1b治疗毛细支气炎的疗效.方法 将160例毛细支气管炎患儿随机分为两组,两组均给予常规治疗.此外观察组加用重组人干扰素-α1b治疗,对照组给予利巴韦林治疗.观察两组患儿临床症状体征改善情况及消失的天数.结果 两组治疗后,患儿体温、喘憋、咳嗽、肺部啰音改善比较,差异均有统计学意义(t分别为1.832、2.761、2.650、2.526,均P<0.05).结论 重组人干扰素-α1b治疗毛细支气管炎能明显缩短发热、咳嗽、喘憋、肺部啰音消失的时间,疗效优于利巴韦林.     

异丙托溴铵联合布地奈德和特布他林雾化吸入对哮喘患儿症状及肺功能影响

目的小儿哮喘具有高发病率、反复发作、病情长的特点,对患儿的生活、成长和学习均造成一定程度的影响。本研究观察雾化吸入异丙托溴铵联合布地奈德和特布他林与对哮喘患儿临床症状缓解及肺功能影响。方法选取2016-02-01—2017-01-01本院接治的哮喘患儿作为研究对象,根据性别、年龄和病程组间均衡可比的原则分为观察组和对照组,各36例。对照组使用雾化吸入布地奈德联合特布他林药物治疗,观察组则在对照组基础上加用异丙托溴铵雾化吸入治疗,经过7d治疗后,对比两组患儿临床总有效、临床症状缓解情况、肺功能指标恢复情况。结果治疗后,观察组总有效率为94.44%,高于对照组的77.78%,χ~2=4.181,P=0.041;观察组咳嗽消失时间为(3.12±0.46)d,短于对照组的(4.74±0.53)d,t=13.850,P<0.001;喘息消失时间为(2.34±0.23)d,短于对照组的(3.86±0.49)d,t=16.849,P<0.001;肺部啰音消失时间为(3.25±0.41)d,短于对照组的(5.67±0.73)d,t=17.342,P<0.001。治疗后,观察组第一秒用力呼气容积(forced expiratory volume in one second,FEV1)为(2.36±0.44)L,高于对照组的(1.84±0.33)L,t=5.673,P<0.001;用力呼气量(forced expiratory volume,FVC)为(2.38±0.53)L,高于对照组的(1.89±0.66)L,t=3.473,P=0.001;峰值呼气流速(peak expiratory flow,PEF)为(2.36±0.43)L,高于对照组的(1.82±0.41)L,t=5.453,P<0.001。结论通过异丙托溴铵联合布地奈德和特布他林雾化吸入可明显改善哮喘患儿临床症状,恢复肺功能指标,提高有效率。     

重组人干扰素α-1b联合更昔洛韦对传染性单核细胞增多症患儿免疫功能影响

目的儿童群体传染性单核细胞增生症(infectious mononucleosis,IM)发病率较高,起病较快,严重影响患儿身体健康和正常发育。本研究分析重组人干扰素α-1b联合更昔洛韦对IM患儿免疫功能影响。方法选取西华县人民医院2017-01-12-2018-12-12收治的IM患儿为研究对象,根据性别、年龄、病程等因素组间具有可比性的原则,选择观察组与对照组,每组47例。对照组采取更昔洛韦治疗,观察组采取重组人干扰素α-1b联合更昔洛韦治疗。对比分析两组患儿临床疗效、EBV-DNA转阴率、总蛋白、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)和丙氨酸氨基转移酶(alanine aminotransferase,ALT)、CD3+、CD4+和CD8+水平。结果观察组治疗总有效率为95.74%,高于对照组的80.85%,χ2=5.045,P=0.025;EBV-DNA转阴率为91.49%,高于对照组的65.96%,χ2=9.146,P=0.003。治疗10d后,观察组总蛋白含量为(61.36±7.06)p/(g·L),高于对照组的(55.41±6.69)p/(g·L),t=4.194,P0.001;AST水平为(22.58±3.48)U/L,低于对照组(35.27±4.15)U/L,t=16.063,P0.001;ALT水平为(33.15±4.46)U/L,低于对照组的(41.02±5.18)U/L,t=7.893,P0.001。治疗10d后,观察组CD3+水平为(54.68±4.95)%,低于对照组的(65.29±5.67)%,t=8.025,P0.001;CD8+水平为(24.16±1.77)%,低于对照组的(26.98±1.56)%,t=8.194,P0.001;CD4+水平为(31.66±2.03)%,高于对照组的(28.51±1.14),t=9.276,P0.001;CD4+/CD8+为(1.35±0.20),高于对照组的(1.12±0.14),t=8.194,P0.001。结论对IM患儿采用重组人干扰素α-1b联合更昔洛韦治疗,可提高EBV-DNA转阴率,改善肝功能和免疫功能,临床疗效显著。     

重组人干扰素α-1b雾化治疗毛细支气管炎100例临床疗效观察

目的对比观察注射用重组人干扰素α-1b治疗毛细支气管炎的临床疗效。方法选取2015年11月一2017年4月在山西省儿童医院呼吸科住院的100例轻中度毛细支气管炎患儿,将患儿随机分为治疗组50例,平均年龄(7.4±2.2)月;对照组50例,平均年龄(8.1±2.3)月。治疗组在常规综合治疗的基础上,加注射用重组人干扰素α-lb雾化吸入,对治疗后两组喘息、咳嗽、肺部喘鸣改善时间及疗程等进行对比。结果治疗组咳嗽[(4.4±0.8)d]、喘息[(3.8±1.0)d]、哮呜音[(4.1±1.1)d]的改善时间及疗程[(5.4±0.5)d]缩短天数均优于对照组[依次为(6.2±1.1)d、(5.0±1.4)d、(5.3±1.2)d、(6.1±0.8)d],治疗组呼吸道症状改善的总有效率为92.0%,明显高于对照组的74.0%,差异有统计学意义。结论注射用重组人干扰素α-lb雾化治疗毛细支气管炎患儿临床疗效显著,安全易行,值得推广。     

重组人干扰素α2b雾化吸入联合远红外止咳贴治疗小儿毛细支气管炎的临床效果

目的观察重组人干扰素α2b雾化吸入联合远红外止咳贴治疗毛细支气管炎的效果。方法选取2018年3月至2020年3月玉林市妇幼保健院收治的80例毛细支气管炎患儿,采用随机数字表法分为观察组与对照组,每组各40例。对照组给予常规综合治疗,观察组在常规综合治疗的基础上给予氧气驱动雾化吸入α2b干扰素联合远红外止咳贴治疗。比较两组治疗后的临床疗效、临床症状消失时间、住院时间以及肺部功能。结果观察组临床总有效率高于对照组,差异有统计学意义(P<0.05);观察组喘憋消失时间、咳嗽消失时间、肺部啰音消失时间、体温恢复正常时间、住院时间均短于对照组,差异有统计学意义(P<0.05);观察组治疗后潮气量、达峰时间比、达峰容积比均高于对照组,差异有统计学意义(P<0.05)。结论雾化吸入干扰素α2b联合远红外止咳贴治疗毛细支气管炎对提高治疗有效率,缩短临床症状消失时间、住院时间,改善肺功能具有重要作用,值得临床推广使用。     

α-干扰素治疗毛细支气管炎104例疗效分析

目的探讨治疗毛细支气管炎的有效方法。方法将190例呼吸道合胞病毒(RSV)所致毛细支气管炎住院患儿,随机分为A(104例)、B(86例)两组,分别用基因重组干扰素α-2b(rIFNa-2b)和布地奈德(BUD)治疗。结果用rlFNa-2b治疗的A组患儿入院后病程及咳嗽、憋喘等主要症状和体征的缓解或消失所需时间显著少于用BUD治疗的B组(P<0.05),且无不良反应。结论使用rIFNα-2b治疗毛细支气管炎的疗效好,并能避免使用皮质激素产生的副作用。     

布地奈德联合重组人干扰素α-1b治疗急性婴幼儿毛细支气管炎的临床疗效

目的 探讨布地奈德联合重组人干扰素(rhIFN)α-1 b治疗急性婴幼儿毛细支气管炎(AIB)的临床疗效.方法 选取2017年1月至2019年1月,长江大学附属仙桃市第一人民医院院收治的174例AIB患儿为研究对象.采用随机数字表法,将其分为观察组(n=87)和对照组(n=87).对观察组患儿进行布地奈德雾化+rhIF...     

重组人干扰素α1b注射液配合沙丁胺醇治疗小儿毛细支气管炎的疗效及对T细胞亚群的影响

目的分析重组人干扰素α1b注射液配合沙丁胺醇治疗小儿毛细支气管炎的疗效及对T细胞亚群的影响。方法选取2017年6月-2019年4月收治的114例毛细支气管炎患儿为研究对象,应用随机数字表分为观察组和对照组,每组57例。两组均行常规治疗,对照组加用沙丁胺醇雾化吸入,观察组在对照组基础上给予重组人干扰素α1b注射液雾化吸入。观察两组治疗效果,临床症状、体征消失时间,治疗前后血气分析指标、T细胞亚群及不良反应发生率。结果观察组总有效率为94.74%,显著高于对照组(82.46%)(P0.05)。观察组与对照组咳嗽、细湿啰音、喘息、哮鸣音消失时间比较,差异有统计学意义(P0.05)。治疗后,两组血气分析指标比较差异有统计学意义(P0.05);治疗前后血气分析指标比较差异有统计学意义(P0.05)。治疗后,两组T细胞亚群比较差异有统计学意义(P0.05);治疗前后T细胞亚群比较差异有统计学意义(P0.05)。两组均未出现明显不良反应。结论应用重组人干扰素α1b注射液配合沙丁胺醇治疗小儿毛细支气管炎可获得确切疗效,并能有效改善患儿免疫功能,且安全性好,具有较高临床价值。     

有性才会有健康

性是基本的人权。根据我国著名的性学家史成礼教授的研究,性有“三大功能”:生育功能、享乐功能和健康功能。     

Communicating with people with dementia

It can be very difficult to communicate with people with dementia. Each case requires its own unique handling. Not every scenario is covered, as many times your own judgment is what will work, best according to the circumstances. These can change from dawn to evening and from day to day. Never assume things will be the way they were the last time you communicated. Be on your guard. Be adaptable. The article will help get you started to think of your own ways to communicate.     

经方汗证治验

临床上汗证病情复杂,分自汗、盗汗、黄汗和但头汗出,治疗汗证方药诸多,有益气固表、养阴清热和清热除湿等方法,疗效不一。受恩师刘健主任教导和《伤寒论》《金匮要略》病脉证并治启发,以脉证并治、方证对应思想,浅谈桂枝加附子汤、黄芪芍药苦酒汤、柴胡桂枝干姜汤和三物黄芩汤治疗汗证的经验,为经方治疗汗证提供新思路。     

Working with patients with physical disabilities

Medical practices need to make a number of adaptations to ensure that their facilities and staff are accessible to patients and other office visitors with physical disabilities. This article describes 10 specific strategies for preparing your medical practice for patients with disabilities, both inside and outside your office. It describes minimum standards for office doorways, sidewalk inclines, ramps, reception areas, and other adaptations medical offices need to make. The article also describes specific do and don't advice for communicating with patients with physical disabilities. It suggests strategies for preparing written materials for disabled patients, for communicating verbally, and for providing healthcare education. Finally, it suggests an appropriate role for medical practice staff in the delivery of healthcare services to patients with physical disabilities.     

Coping with Children with ADHD: Coping Styles of Mothers with Children with ADHD or Challenging Behaviours

Parents of children with Attention Deficit Hyperactivity Disorder (ADHD) can experience significant levels of stress in their parenting roles, however, little is known about the specific coping strategies used by these parents. This pilot study Investigated the coping strategies used by mothers of children with ADHD. A 34 item questionnaire was developed to identify maternal coping strategies. A cohort of 38 mothers of children with ADHD and a control group of 30 mothers of children without ADHD or any other disability/illness completed the questionnaire. Factor analysis of responses produced three factors: Aggressive/Confrontive Coping, Rational Coping, and Indirect Coping. These factors are similar to coping dimensions proposed by Folkman and Lazarus. Comparisons between the two groups of mothers revealed that mothers of children with ADHD used significantly more Indirect Coping.     

Problems with measuring satisfaction with social care

The measurement of customer satisfaction has become widespread in both healthcare and social care services, and is informative for performance monitoring and service development. Satisfaction with social care services is routinely measured with a single question on overall satisfaction with care, comprising part of the Adult Social Care Survey. The measurement of satisfaction has been problematised, and existing satisfaction measures are known to be under‐theorised. In this article, the process of making an evaluation of satisfaction with social care services is first informed by a literature review of the theoretical background, and second examined through qualitative interviews conducted in 2012–2013 with 82 service users and family carers in Hampshire, Portsmouth and Southampton. Participants in this study were from white British and South Asian backgrounds, and the influence of ethnicity in the process of satisfaction evaluation is discussed. The findings show that the majority of participants selected a positive satisfaction rating even though both positive and negative experiences with services were described in their narratives. It is recommended that surveys provide opportunity for service users and family carers to elaborate on their satisfaction ratings. This addition will provide more scope for services to review their strengths and weaknesses.     

Ending clinical relationships with people with schizophrenia

The potential for the social worker-client relationship to contribute to therapeutic outcomes is not always apparent with clients who have schizophrenia. Their cognitive impairments often make it difficult for these clients to regulate interpersonal boundaries and for social workers to connect with them. Clinical practice is enhanced, however, by recognizing that severely impaired clients have the capacity and desire for relationships with service providers and others. The manner in which the clinical relationship ends is important for maintaining clinical gains and determining whether the client will risk investing in future relationships. The purpose of this article has been to sensitize social workers to the delicate nature of managing the endings of those relationships.