胸腰椎骨折所致腹胀便秘的护理体会

目的:探讨胸腰椎骨折后引起腹胀、便秘的护理.方法:将62例胸腰椎骨折病人随机分为观察组与对照组.观察组32例采取腹部热敷、按摩、口服缓泻剂、空腹服用麻油等方法；对照组30例采取腹部热敷、按摩、口服缓泻剂等方法.结果:观察组总有效率为96.9％,对照组为76.7％,两组比较,差异有统计学意义(P＜0.05).结论:空腹服用麻油辅助进食等防治胸腰椎骨折病人腹胀便秘的效果明显优于腹部热敷、按摩、口服缓泻剂等方法.     

中药封包配合天枢穴按摩防治胸腰椎骨折后腹胀的护理观察

目的观察中药封包配合天枢穴按摩防治胸腰椎骨折后腹胀的护理效果。方法将86例胸腰椎骨折患者随机分为对照组和观察组,对照组应用常规护理,观察组运用中药封包外敷患者中腹部,并配合天枢穴按摩。结果两组胸腰椎骨折后患者腹胀防治效果比较,观察组总有效率95.66%,与对照组比较差异具有统计学意义(P<0.05)。结论中药封包配合天枢穴按摩能有效地防治胸腰椎骨折后腹胀。     

中药敷脐治疗胸腰椎骨折后腹胀便秘的疗效观察

目的观察大黄厚朴煎剂加乙醇热敷脐部治疗胸腰椎骨折患者腹胀、便秘的疗效。方法将始兴县人民医院外科胸腰椎骨折后出现腹胀便秘的患者80例分成两组,观察组用大黄厚朴煎剂加乙醇热敷脐部;对照组用开塞露塞肛。观察两组患者肛门排气、排便,腹胀消除及停药复结情况。结果观察组总有效率95%,对照组70%;腹胀减轻情况：观察组95%,对照组50%;停药复结情况：观察组5%,对照组47.5%。结论使用大黄厚朴煎剂加乙醇热敷脐治疗胸腰椎骨折患者腹胀便秘效果明显优于开塞露塞肛。     

中药外敷对胸腰椎骨折患者便秘的疗效观察

目的 探讨中药外敷对胸腰椎骨折患者便秘的疗效.方法 将60例胸腰椎骨折伴便秘患者,随机分为研究组和对照组,每组30例.对照组采用饮食指导、腹部按摩、情志护理等常规护理,研究组在对照组的基础上外加中药外敷,3天为一疗程,观察记录两组患者疗效并进行对比分析.结果 研究组患者治疗后有效率为80.00％,对照组治疗有效率为50.00％,两组比较差异有统计学意义(x2=21.87,P=0.001).结论 中药外敷对胸腰椎骨折患者便秘有较好疗效,能减轻患者痛苦,提高患者生活质量.     

中药敷脐联合耳穴埋豆治疗早期胸腰椎骨折后便秘效果观察

目的探讨中药敷脐联合耳穴埋豆治疗早期胸腰椎骨折后便秘的效果。方法 2012年10月至2013年10月该院骨科收治的早期胸腰椎骨折后便秘患者56例,按入院先后顺序不同分为对照组和观察组,每组28例。对照组给予常规护理,观察组在常规护理基础上给予中药敷脐联合耳穴埋豆,观察两组患者疗效。结果观察组治愈率、总有效率均明显高于对照组,差异有统计学意义。结论中药敷脐联合耳穴埋豆治疗早期胸腰椎骨折后便秘有较好效果,且方法操作简便,易被患者接受。     

胸腰椎骨折患者胃肠道功能紊乱的原因分析及护理对策

目的探讨胸腰椎骨折后引起胃肠道功能紊乱的原因及护理干预措施。方法选取2013年9月~2015年3月我科收治的胸腰椎骨折患者88例,将其随机分为实验组和对照组,实验组46例,患者入院后采取综合护理措施,对照组42例采用骨科常规护理,比较两组患者腹胀、便秘的发生率以及腹胀、便秘症状消失时间。结果实验组患者腹胀、便秘的发生率明显低于对照组,差异有统计学意义(P0.05),实验组腹胀、便秘症状消失时间明显短于对照组,差异有统计学意义(P0.05)。结论采用综合护理措施能够降低胸腰椎骨折患者胃肠道功能紊乱的发生率,对促进患者康复和改善预后等方面具有重要的临床意义。     

吴茱萸热熨联合耳穴磁珠贴压治疗腰椎骨折后腹胀便秘疗效观察

目的观察吴茱萸热熨联合耳穴磁珠贴压治疗腰椎骨折后腹胀便秘的临床疗效。方法:选取2011年1月~2013年8月骨科腰椎骨折后出现腹胀便秘的患者100例,随机分为观察组及对照组,观察组50例,采用吴茱萸热熨联合耳穴磁珠贴压方式治疗;对照组50例常规用开塞露塞肛方式进行治疗。观察两组患者排便,腹胀消除情况。结果观察组显示总有效率为92.0%,有效12例,治愈34例,无效4例;对照组总有效率为76.0%,有效8例,治愈20例,无效12例。结论使用吴茱萸热熨联合耳穴磁珠贴压治疗腰椎骨折后腹胀便秘的效果明显优于开塞露塞肛,易于患者及家属操作,值得临床推广。     

自拟通下散神阙穴贴敷对腰椎骨折后腹胀便秘的影响观察

目的:探讨自拟通下散神阙穴贴敷对腰椎骨折后腹胀便秘的影响.方法:从我院收治的腰椎骨折后腹胀便秘患者中抽选98例作为研究对象.随机分组:对照组49例,采用西药治疗;观察组49例,采用自拟通下散神阙穴贴敷治疗.对两组临床治疗效果进行评估和对比.结果:与对照组相比,观察组治疗总有效率明显更高,差异有统计学意义(P<0.05).结论:自拟通下散神阙穴贴敷治疗腰椎骨折后腹胀便秘的疗效良好,值得推广.     

胸腰椎骨折术后腹胀、便秘的干预性护理方式研究

目的:探讨胸腰椎骨折术后腹胀、便秘的干预性护理方式。方法:将2016年5月-2018年5月78例胸腰椎骨折术后腹胀、便秘患者随机分组,对照组遵循常规护理,实验组落实干预性护理方式。比较两组胸腰椎骨折术后腹胀、便秘患者满意水平;腹胀消失时间、排便恢复正常时间、住院时间;护理前后患者焦虑症状、抑郁症状、VAS程度。结果:实验组胸腰椎骨折术后腹胀、便秘患者满意水平高于对照组,P0.05;实验组腹胀消失时间、排便恢复正常时间、住院时间优于对照组,P0.05;护理前两组焦虑症状、抑郁症状、VAS程度相似,P0.05;护理后实验组焦虑症状、抑郁症状、VAS程度优于对照组,P0.05。结论:干预性护理方式在胸腰椎骨折术后腹胀、便秘护理中的干预结果确切,可有效缓解腹胀和改善排便情况,减轻患者焦虑抑郁,减轻患者痛苦,加速出院和提高满意度。     

胸腰椎骨折术后腹胀便秘的中西医结合护理干预78例

目的观察中西医结合护理干预对胸腰椎骨折术后腹胀便秘的影响。方法以数字表法将156例胸腰椎骨折术后腹胀便秘患者随机分为对照组和观察组各78例,对照组给予西医常规护理,观察组给予中西医结合护理干预,72 h后对比两组疗效。结果观察组总有效率97.43%优于对照组的85.89%,差异有统计学意义(P<0.05)。结论中西医结合护理干预可加快胸腰椎骨折术后腹胀便秘缓解,改善患者预后,疗效优异。     

原发胃癌恶性表型与患者自发淋巴细胞微核形成的关系

目的 探讨淋巴细胞微核形成与胃癌恶性度的关系.方法 术前取外周血采用体内微核实验方法检测130例胃癌患者(胃癌组)、13例良性胃肠病变(良性病变组)及59例正常人(对照组)淋巴细胞微核率(MNF).结果 胃癌组淋巴细胞MNF为(1.93±0.93)‰,明显高于良性病变组的(0.62士0.49)‰和对照组的(0.51±0.45)‰(P＜0.01);MNF随着胃癌组分化度降低及淋巴结转移率的增加而逐渐上升(P＜0.01).结论 淋巴细胞微核形成与胃癌恶性度密切相关,为胃癌患者的术前恶性度的判断和高危人群筛查提供了一个有用的生物学标志物.     

Disposcope无线传输气管插管内视镜在困难气管插管中的应用

目的 观察Disposcope内视镜在困难气道气管插管的应用效果.方法 困难气管插管成人患者40例随机均分为Disposcope内视镜(A)组和McCoy喉镜(B)组.记录麻醉诱导前(T0)、诱导后(T1)、插管后即刻(T2)、插管后1 min(T3)的平均动脉压(MAP)、心率(HR)及气管插管时间、次数和并发症.结果 与T1时比较,两组T2、T3时的MAP明显增高(P＜0.05);A组T2时的MAP和HR明显低于B组(P＜0.05).A组插管时间较B组明显缩短[(43.9±14.5)s vs.(90,4±26.6)s](P＜0.01)、一次插管成功率明显高于B组(85.0％ vs.60.0％) (P＜0.05).结论 与McCoy喉镜比较,Disposcope内视镜用于困难气道气管插管一次插管成功率高、插管时间短、应激反应轻.     

Absence of respiratory effects with ivabradine in patients with asthma

AIM

β-Blockers are commonly prescribed for stable angina and are recommended as initial therapy. However, β-blockers are contraindicated in patients with obstructive airway disease because of a risk of bronchoconstriction. Ivabradine is a specific heart rate-lowering agent that acts via I_f pacemaker channels in the sinoatrial node with no β-adrenoreceptor activity. Ivabradine has been recently approved for the treatment of stable angina. This study assessed the effects of repeated administration of ivabradine on lung function in patients with asthma.

METHODS

In this double-blind, placebo-controlled, crossover study, 20 subjects with asthma received either oral ivabradine 10 mg b.i.d. or placebo for 4.5 days. Forced expiratory volume in 1 s (FEV₁) and peak expiratory flow rate (PEFR) were designated as the main outcome variable. Diary cards were used to monitor asthma symptoms on a five-point scale, rescue medication usage, and adverse events.

RESULTS

There were no significant differences in mean variation of FEV₁ (ivabradine P = 0.664; placebo P = 0.652) or PEFR (ivabradine P = 0.153; placebo P = 0.356) from baseline following administration of ivabradine. There was also no significant difference in maximum percent variation in FEV₁ or PEF between treatment groups (P = 0.994; FEV₁ and P = 0.704; PEF). On a similar note, there was no significant difference in asthma symptoms or rescue medication usage reported between the two groups. Adverse events were generally mild-to-moderate in intensity and no cardiovascular or serious adverse events were recorded.

CONCLUSIONS

This study confirms that ivabradine does not affect respiratory function or symptoms in patients with asthma and therefore represents a valuable therapeutic alternative to β-blockers for treating patients with stable angina and asthma.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• Ivabradine is a new heart rate-lowering agent that acts specifically on the sinoatrial node via the I_f pacemaker channels.
• Ivabradine has demonstrated similar efficacy to β-blockers.
• As β-blockers are contraindicated in patients with obstructive airway disease, this study was conducted to assess the safety of ivabradine in patients with asthma.

WHAT THIS STUDY ADDS

• This study demonstrates that ivabradine has no effect on the pulmonary functions in patients with asthma and can be safely used a heart rate-lowering agent in patients with angina and coexistent airflow obstruction.

     

重症胰腺炎血小板计数的动态变化与预后的关系

目的探讨血小板计数变化对重症急性胰腺炎(SAP)并发腹膜后出血、多脏器功能衰竭及死亡率的的影响。方法将该院2009年10月～2011年8月收治的73例SAP患者,按血小板计数的动态变化,分成血小板降低组(100×109.L-1)和血小板正常组(≥100×109.L-1)。分析两组血小板计数动态变化对胰腺炎并发腹膜后出血、多脏器功能衰竭及死亡率的影响。结果血小板计数降低组47例,占64.4%;血小板计数正常组26例,占35.6%。两组在并发腹膜后出血、多脏器功能衰竭发生率及死亡率上均有统计学意义(P0.05)。结论血小板计数动态变化对提示重症胰腺炎的预后有一定的临床指导意义。     

拉氧头孢联合罗红霉素治疗支气管扩张症继发肺部感染疗效观察

目的观察拉氧头孢联合罗红霉素治疗支气管扩张症继发肺部感染的疗效和不良反应。方法选取38例支气管扩张症继发肺部感染的患者,对比拉氧头孢联合罗红霉素治疗前后的临床情况、炎症指标、肺通气功能参数、细菌学评价,分析其疗效和观察不良反应。结果在全部38例病人中,痊愈18例,显效8例,进步6例,无效6例,总有效率84.2%（32/38）,细菌清除率为82.4%,没有发现严重不良反应。结论拉氧头孢联合罗红霉素可以作为支气管扩张症继发肺部感染的治疗方案之一。     

Improvement in quality of life with omalizumab in patients with severe allergic asthma

ABSTRACT

Background: Patients with severe persistent asthma experience daily symptoms and frequent serious exacerbations that contribute to a significant impairment of health-related quality of life (QoL).

Methods: A pooled analysis was completed of six controlled clinical trials that evaluated the effect of add-on omalizumab on asthma-related QoL in patients with severe persistent allergic (IgE-mediated) asthma. Asthma-related QoL was assessed at baseline and treatment endpoint using the well-validated Juniper Asthma Quality of Life Questionnaire (AQLQ). Change from baseline in AQLQ total score was compared between treatments using analysis of covariance methods. The percentage of patients who achieved a clinically meaningful (≥ 0.5-point) improvement in AQLQ total score was compared using the Mantel–Haenszel Chi-square test.

Results: The pooled patient population comprised 2548 patients (omalizumab, n = 1342; control, n = 1206), of whom 96% had severe persistent asthma according to the GINA 2002 classification. Omalizumab produced significantly greater improvements in AQLQ total score vs the control group (mean increases of 1.01 and 0.61 points, respectively; p < 0.001). In addition, significantly more omalizumab-treated patients achieved a clinically meaningful improvement in AQLQ total score than patients in the control group (66.3% vs 52.4%; p < 0.001).

Conclusions: Add-on therapy with omalizumab improves QoL to a significant and clinically meaningful level in patients with severe persistent allergic asthma.     

氟比洛芬酯脂微球注射液用于子宫切除术后PCIA的临床研究(附120例分析)

目的比较观察氟比洛芬酯脂微球注射液用于子宫切除术后病人自控静脉镇痛(PCIA)的镇痛效果和安全性。方法选择在腰、硬膜外联合麻醉下行子宫切除术、术毕行PCIA的120例患者随机分成四组,每组30例。A组应用氟比洛芬酯脂微球注射液150 mg;B组氟比洛芬酯脂微球注射液150 mg 芬太尼0.4 mg;C组氯诺昔康40 mg;D组芬太尼20μg.kg-1。镇痛时间48 h。观察PCIA开始和开始后2、4、8、12、16、24、36、48h的镇痛效果、镇静程度、不良反应和术前、PCIA结束时的肝肾功能、凝血功能变化。结果镇痛效果A组与其他三组相似,B组镇痛质量明显提高。不良反应A组与C组相似,明显少于D组,B组不良反应相对小。术后肠功能恢复时间A组与C组相似,明显短于D组,B组未见明显延长。病人镇痛质量评价为B组>A组>C组>D组。结论氟比洛芬酯脂微球注射液用于子宫切除术后PCIA镇痛效果良好、副反应少、安全性高,若复合小剂量芬太尼可提高病人的镇痛效果和镇痛质量。