高压氧对新生儿脑损伤的早期综合康复治疗效果的影响

 目的 观察高压氧对新生儿缺血缺氧性脑病引起的新生儿脑损伤的治疗效果。方法 确诊缺血缺氧性脑病的患儿于入院后 24 h内(病危患儿病情稳定后)开始进行高压氧治疗,氧浓度大于800 ml/L,吸氧治疗时间60 min,1次/d,连续治疗7 d。结果 高压氧干预后,干预组患儿意识障碍、肌张力异常、原始反射异常、惊厥的发生率分别为13.95%、25.58%、11.63%、16.28%,显著低于对照组相应症状的发生率(25.58%、39.53%、27.91%、32.56%),且干预组患儿NBNA评分异常的发生率为41.86%,显著低于对照组的62.79%。CT结果显示干预组患儿脑水肿发生率为23.26%,显著低于对照组的44.19%。结论 新生儿脑损伤早期进行高压氧治疗能够有效逆转神经功能损伤,改善预后。     

新生儿全身亚低温的观察与护理

目的：探讨全身亚低温治疗新生儿缺血缺氧性脑病的护理方法。方法回顾性分析9例新生儿缺血缺氧性脑病患儿的病例资料。结果本组9例患者住院9～21d,平均14d,8例痊愈出院,1例放弃治疗。结论做好各系统的监测及护理,加强基础护理,可预防或减少亚低温治疗期间各类并发症的发生。     

循证护理在新生儿缺血缺氧性脑病中的应用探讨

目的 探讨循证护理在新生儿缺血缺氧性脑病中的应用效果.方法 将出生就诊的40例缺血缺氧性脑病新生儿为研究对象,将患儿按性别病情等进行分组,并采用不同的护理方式进行治疗护理,在治疗后对评价指标内容进行 统计分析对比.结果 采用循证护理的观察组患儿的治疗有效率为95.24%显著优于对照组的78.95%,比较差异值 P<0.05,具有统计学意义.结论 在新生儿缺血缺氧性脑病的治疗中采用循证护理可以显著提高治疗有效率,提升患儿的治疗质量,有效降低患儿的死亡率和致残率,有较高的护理应用价值.     

新生儿缺血缺氧性脑病CT诊断

目的:提高对新生儿缺血缺氧性脑病CT诊断的认识。方法:对53例确诊为新生儿缺血缺氧性脑病者行CT检查,CT扫描时间最早为出生后2h,最迟为出生后17d;对无昏迷的患儿在其安睡时进行CT扫描。53例全部为CT平扫。结果:单纯脑实质内局限或广泛性低密度区21例;脑实质内低密度区伴脑室改变16例;脑实质低密度区伴颅内出血16例,出血类型分别为蛛网膜下腔出血、脑室出血、脑实质出血及混合性颅内出血。结论:CT诊断对新生儿缺血缺氧性脑病的早期诊断、协助制定治疗方案有较高价值。依据脑水肿是否伴脑室改变及颅内出血行CT分型有许多优点。早产儿脑髓质低密度区不一定是脑水肿,应注意区别。     

高压氧治疗新生儿缺氧缺血性脑病

目的：探讨高压氧治疗新生儿缺氧缺血性脑病的疗效。方法：将40例确诊为新生儿缺氧缺血性脑病的患儿随机分为两组,对照组采用常规治疗方法（包括吸氧、止痉、脱水降颅压及使用脑细胞代谢激活剂等治疗）。治疗组在常规治疗的基础上行高压氧治疗。结果：治疗组病情迅速恢复,疗效明显优于对照组。结论：高压氧治疗新生儿缺氧缺血性脑病疗效肯定,安全可靠。     

高压氧舱内昏迷患者常见并发症的护理

在高压氧舱进行抢救与治疗的患者中,昏迷患者占相当的比例,且多由于脑血管病、颅脑损伤、中毒、缺血缺氧性脑病等原因所致.由于自身防御能力降低,生活均不能自理,很容易发生各种并发症,因此在高压氧治疗中,医护人员一定要认真加强病情观察[1],积极预防各种并发症的发生.现将昏迷患者在高压氧舱内抢救治疗中主要并发症的护理总结如下.     

婴幼儿高压氧治疗安全护理要点

我科自 1995年以来 6年中在单人纯氧舱应用高压氧(HBO)已治疗缺血缺氧性脑病、大脑发育不良等婴幼儿两万多人次 ,近 40个病种 ,其中大脑发育不全约占 5 0 %、缺血缺氧性脑病占 2 0 %。未发生过任何差错事故。婴幼儿纯氧舱治疗较之成人患者不安全因素多 ,危险性也大。现就治疗中需注意的几个护理问题报告如下。1.治疗前准备 :患儿前来预约时 ,接诊医生应仔细询问病情 ,认真做好体检 ,严格掌握适应证。护理人员应向入舱人员认真交待入舱注意事项 ,进行安全教育 ,消除顾虑 ,取得理解和合作。合理安排好舱位 ,对年龄超过 4岁且肯合作戴面罩的…     

新生儿缺血缺氧性脑病特殊CT征象分析

目的 用西门子Balance螺旋CT在诊断新生儿缺血缺氧性脑病（HIE）的作用和价值。 方法 用西门子Balance螺旋CT机对75例临床诊断为HIE的患儿进行扫描，分析HIE的CT表现。 结果 75例中，正常7例；HIE68例，其中轻度5例，中度45例，重度25例；伴蛛网膜下腔出血32例。 结论 螺旋CT是诊断新生儿缺血缺氧性脑病（Hypoxic Ischemic En—cephlopcehhy，HIE）的有效方法，其优势在于据查快速、诊断准确和患儿接受的辐射剂量少。HIE是指在围产期窒息缺血缺氧导致的缺血缺氧性损害，是新生儿窒息后的严重并发症，临床上出现一系列脑病的表现。病情重，死亡率高，严重者可产生多种后遗症。CT的出现为诊断HIE提供了可靠的依据。     

新生儿蛛网膜下腔出血新的CT表现

目的：用西门子Balance螺旋CT在诊断新生儿缺血缺氧性脑病（HIE）的作用和价值。方法：用西门子Balance螺旋CT机对75例临床诊断为HIE的患儿进行扫描，分析HIE的CT表现。结果：75例中，正常7例；HIE68例，其中轻度5例，中度45例，重度25例；伴蛛网膜下腔出血32例。结论：螺旋CT是诊断新生儿缺血缺氧性脑病（Hypoxic lschemic En-cephlopcethy，HIE）的有效方法，其优势在于据查快速、诊断准确和患儿接受的辐射剂量少。HIE是指在围产期窒息缺血缺氧导致的缺血缺氧性损害，是新生儿窒息后的严重并发症，临床上出现一系列脑病的表现。病情重，死亡率高，严重者可产生多种后遗症。CT的出现为诊断HIE提供了可靠的依据。     

新生儿缺氧性脑病采用早期静脉氧疗对康复影响探讨

目的：探讨应用早期静脉氧疗法治疗新生儿缺氧性脑病的康复效果。方法选取2011年6月～2013年6月收治的40例新生儿缺氧性脑病患儿，随机分为两组。实验组20例，采用静脉氧疗法；对照组20例，采用高压氧疗法。观察比较两组的康复情况。结果两组在治疗前的GCS无明显差异（ P＞0.05），在治疗三周后，对照组的GCS较治疗前明显升高（P＜0.05）；观察组在治疗一周后，GCS便明显高于治疗前（P＜0.05）；在疗程结束后，GCS显著高于治疗前和对照组（ P＜0.05）。此外，实验组患儿的平均全脑能量评分明显高于对照组（ P＜0.05）。结论静脉氧疗具有操作简便、价格合理、给氧直接、疗效极佳等显著优势，在新生儿缺氧性脑病早期给予静脉氧疗能够有效降低患儿致残率、病死率，提高患儿的脑能量，其作用明显优于高压氧疗法。     

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.