20例压疮患者护理体会

目的总结压疮的护理体会。方法对20例压疮患者应用芦荟治疗并采用综合护理措施。结果 20例中治愈13例(65%);显效4例(20%),好转2例(10%),无效1例(5%)。总有效率95.00%。Ⅳ期压疮平均治愈时间(29.2±10.2)d;Ⅲ期压疮平均治愈时间(20.1±8.8)d;Ⅱ期压疮平均治愈时间(12.1±5.4)d。结论积极做好压疮患者基础、饮食、心理等各项护理措施,可改善创面肉芽组织生长,提高创面愈合率,缩短创面愈合时间。     

海肤康人工皮膜治疗Ⅱ、Ⅲ期压疮疗效观察

目的 探讨海肤康人工皮膜治疗Ⅱ、Ⅲ期压疮的效果.方法 将31例Ⅱ、Ⅲ期压疮患者(共69处疮面)随机分为观察组(15例35处)和对照组(16例34处).两组按同法清创后,对照组采用常规换药法处理疮面,观察组用海肤康人工皮膜处理疮面.结果 观察组疮面愈合时间显著短于对照组(均P＜0.01).结论 海肤康人工皮膜治疗压疮可缩短愈合时间.     

海肤康人工皮膜治疗Ⅱ、Ⅲ期压疮疗效观察

目的探讨海肤康人工皮膜治疗Ⅱ、Ⅲ期压疮的效果。方法将31例Ⅱ、Ⅲ期压疮患者（共69处疮面）随机分为观察组（15例35处）和对照组（16例34处）。两组按同法清创后，对照组采用常规换药法处理疮面，观察组用海肤康人工皮膜处理疮面。结果观察组疮面愈合时间显著短于对照组（均P〈0.01）。结论海肤康人工皮膜治疗压疮可缩短愈合时间。     

自制红丹油剂治疗Ⅱ期压疮效果观察

目的探讨自制红丹油剂治疗Ⅱ期压疮的疗效,寻找一种新的简单有效的压疮处理方法。方法将40例(60处)Ⅱ期压疮患者随机分为观察组(20例,28处)和对照组(20例,32处),观察组采用自制红丹油剂治疗,对照组采用湿润烧伤膏治疗,比较两组压疮愈合时间及治疗效果。结果观察组治疗效果显著优于对照组,治愈时间显著短于对照组(均P0.01)。结论自制红丹油剂用于治疗Ⅱ期压疮的疗效明显优于湿润烧伤膏,是一种更为理想的简单有效的压疮治疗方法。     

三种清创方法结合整体护理干预治疗压疮的效果观察

目的探讨三种清创方法结合整体护理干预治疗Ⅱ～Ⅳ期压疮的效果。方法将48例(74处)Ⅱ～Ⅳ期压疮患者随机分为三组,分别采取自溶清创、保守性锐器清创和自溶联合保守性锐器清创,同时给予减压、营养、活动指导、皮肤护理等整体护理干预。结果总治愈率为94.59%,愈合时间为(83.23±72.59)d。三组治愈率比较,差异无统计学意义(P0.05);三组愈合时间比较,差异有统计学意义(P0.01)。结论三种清创方法均能有效清创,结合全程整体护理干预能提高压疮愈合率和缩短愈合时间,其中以自溶联合保守性锐器清创效果最好。临床应用中应结合患者的自身情况进行综合分析,采取针对性护理干预措施,以提高压疮的治疗效果。     

自制红丹油剂治疗Ⅱ期压疮效果观察

目的探讨自制红丹油剂治疗Ⅱ期压疮的疗效,寻找一种新的简单有效的压疮处理方法。方法将40例（60处）Ⅱ期压疮患者随机分为观察组（20例,28处）和对照组（20例,32处）,观察组采用自制红丹油剂治疗,对照组采用湿润烧伤膏治疗,比较两组压疮愈合时间及治疗效果。结果观察组治疗效果显著优于对照组,治愈时间显著短于对照组（均P〈0．01）。结论自制红丹油剂用于治疗Ⅱ期压疮的疗效明显优于湿润烧伤膏,是一种更为理想的简单有效的压疮治疗方法。     

窒息后喂养不耐受新生儿微量喂养联合非营养性吸吮研究

目的探讨三种清创方法结合整体护理干预治疗Ⅱ～Ⅳ期压疮的效果。方法将48例（74处）Ⅱ～Ⅳ期压疮患者随机分为三组,分别采取自溶清创、保守性锐器清创和自溶联合保守性锐器清创,同时给予减压、营养、活动指导、皮肤护理等整体护理干预。结果总治愈率为94.59%,愈合时间为（83.23±72.59）d。三组治愈率比较,差异无统计学意义（P〉0.05）;三组愈合时间比较,差异有统计学意义（P〈0.01）。结论三种清创方法均能有效清创,结合全程整体护理干预能提高压疮愈合率和缩短愈合时间,其中以自溶联合保守性锐器清创效果最好。临床应用中应结合患者的自身情况进行综合分析,采取针对性护理干预措施,以提高压疮的治疗效果。     

美皮康敷料治疗Ⅰ、Ⅱ期压疮的效果观察

目的:探讨新型敷料芙皮康治疗Ⅰ、Ⅱ期压疮的临床效果.方法:将58例(71处)压疮患者按入院时间先后分为对照组28例(35处)和观察组30例(36处)两组常规清洗创面后,对照组采用碘酊涂擦,红外线灯照射的方法;观察组使用瑞典墨尼克公司生产的软聚硅硐保湿敷料美皮康敷贴.分别观察两组治愈率、换药次数、愈合时间.结果:观察组治愈率、换药次数、愈合时间与对照组相比差异有统计学意义.结论:美皮康治疗Ⅱ、Ⅱ期压疮效果好,可缩短疮面愈合时间,提高治愈率,操作简便,减少护理工作量.     

双料喉风散辅助治疗溃疡期压疮效果观察

目的观察双料喉风散治疗溃疡期压疮的效果。方法将42例(65处)溃疡期压疮患者按入院时间分为对照组20例(30处)和观察组22例(35处)。对照组采用优锁溶液等常规换药治疗;观察组根据压疮分期,在对照组治疗方法的基础上加用双料喉风散外敷,比较两组的治疗效果和压疮愈合时间。结果观察组的治疗效果显著优于对照组,愈合时间显著缩短(均P<0.01)。结论双料喉风散辅助治疗溃疡期压疮效果可靠、安全。     

济安舒能联用蒲黄治疗压疮效果观察

目的 观察济安舒能与蒲黄联合使用对Ⅲ、Ⅳ期压疮的治疗效果.方法 将60例Ⅲ、Ⅳ期压疮患者随机分为观察组和对照组各30例,对照组常规用2.5%碘伏消毒压疮创面及周围皮肤后局部喷洒济安舒能;观察组常规处理创面后局部喷洒济安舒能,再将生蒲黄敷于创面,观察两组压疮愈合情况.结果 观察组总有效率显著高于对照组(P＜0.05),治愈时间显著短于对照组(P＜0.01).结论 济安舒能联合蒲黄对促进Ⅲ、Ⅳ期压疮愈合有显著效果.     

The effects of age and various fat/carbohydrate caloric ratios on nitrogen retention and wound healing in rats

Recent reports have indicated a possible age-related component to the ability of various species to utilize either fat or carbohydrate as their preferential energy source. These studies have demonstrated that infant rats given a high-fat diet (50% fat, 35% carbohydrate, 15% protein) retain a significantly higher amount of nitrogen than do infant rats on a high-carbohydrate diet (82% carbohydrate, 3% fat, 15% protein). Conversely, adult rats maintain a higher positive nitrogen balance when given the high-carbohydrate diet. In light of these studies, and our interest in factors that contribute to wound healing in the surgical patient, we investigated the effects of low-, medium-, and high-fat enteral diets on wound healing and nitrogen balance in surgically stressed rats of various ages. Weanling (45 g) and young adult (175 g) male Sprague-Dawley rats (n = 16 per age group) were housed individually in metabolic cages. All animals had Impra vascular-graft wound cylinders placed subcutaneously in the dorsal midline and were placed in four dietary groups: high fat (50% kcal), medium fat (30% kcal), low fat (2.5% kcal), and chow (Purina Standard Laboratory Rodent Chow, 17% kcal as fat). All test diets were isonitrogenous (3.1 g nitrogen/1,000 kcal) and isocaloric for each age group. Animals in each age group were pair-fed (35 kcal/d, weanlings; 60 kcal/d, young adults) for 10 days and then euthanized. Wound cylinders were removed and analyzed for collagen content.(ABSTRACT TRUNCATED AT 250 WORDS)     

Senescence and the healing rates of venous ulcers

OBJECTIVE: Premature cellular senescence has been linked to venous hypertension and may contribute to delayed healing of venous ulcers. We hypothesized that the percentage of senescent cells in in vitro populations of fibroblasts isolated from venous ulcers is directly related to the clinical time-to-healing. METHODS: Biopsy specimens were obtained from ulcer margins and unaffected dermal tissue of the ipsilateral thigh of seven patients with active venous ulcers. Using explant culture techniques, we obtained populations of wound fibroblasts and normal fibroblasts. The percentage of senescence in these cell populations was determined with X-Gal (5-bromo-4-chloro-3-indolyl beta-D-galactoside), which was used as a stain for B-galactosidase, a biomarker for senescent dermal fibroblasts. The X-Gal stain is a peroxidase stain for B-galactosidase. All patients in the study were treated with compression dressings. On a weekly basis, digital images were taken until ulcers healed. Planimetric healing rates were calculated from these images, and an overall time-to-healing was recorded. All cytologic investigations were performed on first passage cells. RESULTS: The average starting ulcer size was 4.2 cm2. Five of the data points represented healed ulcers. The two remaining patients withdrew from the study to pursue other therapies after having been treated with compression dressings for a long time. Linear regression analysis of healed ulcers identified a relationship between percent of senescence and time-to-healing, which was statistically significant (R2 = 0.81, P =.037). High percentages of senescent cells also had a correlation with slowed planimetric healing, which was not statistically significant. CONCLUSIONS: This study demonstrates a clinical correlation between quantitative in vitro senescence and time-to-healing. A percentage of senescence that is greater than 15% in populations of cells isolated from venous ulcers may identify a "difficult to heal" ulcer. There is no good clinical indicator for determining the likelihood of ulcer healing, but these results indicate that senescence percentage may have potential in this regard.     

重组人粒细胞巨噬细胞集落刺激因子在压疮护理中的应用

目的:探讨重组人粒细胞巨噬细胞集落刺激因子凝胶在Ⅱ~Ⅲ期压疮治疗护理中的临床效果。方法:选取2011年2月~2013年2月Ⅱ~Ⅲ期带压疮入院患者85例(98处),试验组应用重组人粒细胞巨噬细胞集落刺激因子凝胶治疗,对照组创面应用SD-Ag霜。分别对两组疗效、细菌存在情况及PUSH评分进行观察。结果:试验组平均愈合时间为(16.75±1.22)天,有效率96.49%,对照组平均愈合时间为(21.73±4.55)天,有效率78.05%。换药14天后,试验组的PUSH评分为(5.76±2.59)分,对照组为(8.59±3.23)分,各项指标对比均具有显著性差异(P0.01)。结论:重组人粒细胞巨噬细胞集落刺激因子凝胶能减少Ⅱ~Ⅲ期压疮创面细菌繁殖,促进肉芽组织生成,显著缩短愈合时间。     

脐带间充质干细胞联合渗液吸收贴治疗Ⅱ、Ⅲ期压疮研究

目的探讨脐带间充质干细胞联合渗液吸收贴治疗Ⅱ、Ⅲ期压疮的临床效果。方法将36例脊髓损伤合并Ⅱ、Ⅲ期压疮患者随机分为对照组(Ⅱ期18处、Ⅲ期13处)和观察组(Ⅱ期24处、Ⅲ期压疮11处)。对照组采用常规治疗与护理方法;观察组采用脐带间充质干细胞联合渗液吸收贴治疗的方法,即局部清创、消毒后将1mL脐带间充质干细胞混悬液均匀涂抹于创面,并外敷渗液吸收贴。所有患者每2天换药1次,直至创面愈合。结果两组疗效比较,差异有统计学意义(P<0.05);两组显效时间和治愈时间比较,差异有统计学意义(均P<0.01)。结论脐带间充质干细胞联合渗液吸收贴可有效治疗Ⅱ、Ⅲ期压疮,并显著缩短创口治愈时间。     

Long-term enalapril and verapamil in rats with reduced renal mass

The effect of long-term treatment with either enalapril or high dose verapamil on survival, proteinuria, blood pressure and renal morphology was studied in female Wistar rats with markedly reduced renal mass. Four weeks were allowed for remnant kidney hypertrophy before determining the response to renal ablation of individual animals regarding proteinuria and hypertension. At this time, five groups of 18 rats were formed with equal levels of proteinuria and hypertension. Groups E1 and E2 were treated with enalapril, groups V1 and V2 with verapamil, and one group served as control. The daily food allowance was 14 g/rat of a standard rat diet, containing 30% protein and 100 mmol NaCl/kg food in groups E1 and V1. NaCl content was reduced to 20 mmol/kg food in groups E2, V2 and control. The drugs were added to the drinking water, enalapril at a dose of 0.1 g/liter, verapamil at 0.5 to 0.7 g/liter. Drug intake thus amounted to 10 to 25 mg/kg for enalapril and 50 to 140 mg/kg for verapamil. Treatment was continued for 15 weeks. Three of the 18 control rats did not survive up to 15 weeks. Mortality was lower in the enalapril treated groups with a single nonsurvivor in group E1. In contrast, mortality was higher in the verapamil treated animals with seven nonsurvivors in group V1 and eight in group V2. Blood pressure control was excellent in both enalapril treated groups. and proteinuria decreased in most animals of group E1 and all of group 22. Glomerulosclerosis did not develop in the majority of the enalapril treated animals. Despite the high dose, verapamil barely lowered blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)     

Telfairia occidentalis‐supplemented diet induces changes in sperm parameters and testosterone level in rats

The growing patronage on herbal remedies and formulations from natural products in most developing countries has warranted research into certain health challenges including their antifertility effects. This study assessed the effects of boiled Telfairia occidentalis (TO) seed‐supplemented diets on the level of testosterone and semen quality in Wistar rats. Boiled TO seed diets at 10%, 15% and 30% were given to rats for 60 days. Our study showed that sperm quality was impaired as evidenced by the decreased number of motile spermatozoa, epididymal sperm numbers, percentage live/dead ratio and increased numbers of abnormal spermatozoa comparable to control values (p < .05). Feeding of rats with 10% and 15% TO seed‐supplemented diets increased testosterone levels nonsignificantly, while in the 30% TO seed diet animals, the level of serum testosterone was found to decrease significantly compared to control values. Furthermore, TO diet caused a nonsignificant increase in the activity of superoxide dismutase and the concentrations of reduced glutathione and malondialdehyde except for the significant increase in malondialdehyde level in the testes of the 10% TO diet group. A nonsignificant decrease in myeloperoxidase activity was also observed in the 10% and 15% but not 30% TO diet group. Histological damages characterised by severe loss of germ cells were more pronounced in the 10% TO diet group. Fourier transform infrared spectroscopy analysis of boiled TO seeds revealed the presence of esters, alkenes, hydroxyl and alcohol functional groups. Thus, boiled TO seed‐supplemented diet evoked antifertility effects in rats, and the effects on the toxicity end points investigated were not dose‐dependent.     

Influence of the timing of switching a protein‐free to a protein‐containing diet on the wound healing process in a rat all‐layer skin defect

We prepared full thickness skin defects in rats fed on a protein‐free diet as a hypoproteinaemia model, then switched the animals to a diet containing a normal protein level 1, 6 or 12 days after wounding (inflammatory, granulation and rearrangement phases of the wound healing process) to examine whether improvement in the low‐protein state promotes subsequent wound healing. The interval until wound healing in rats fed on a normal protein diet was significantly shorter, whereas that in rats continuously fed on a protein‐free diet was significantly longer than those of other groups. Early correction tended to accelerate wound healing. Although wound contraction in groups receiving a protein‐corrected or protein‐free diet remained similar until 15 days after wounding, thereafter the duration of the rearrangement phase was significantly longer in the protein‐free group than in the other groups. The collagen level per unit of granulation tissue area during wound healing was significantly lower in the protein‐free group than in the other groups. These findings indicate that protein correction at any time after wounding accelerates wound healing, although early correction is more effective, and reduces the duration of the rearrangement phase more than those of the inflammatory and granulation phases because of the deposit of collagen.     

Effect of soy protein added to casein diet on the development of glomerular injury in spontaneous hypercholesterolemic male Imai rats

BACKGROUND: We have already reported an attenuating effect of a semipurified alcohol extract of soy protein (mainly consisting of isoflavones) on glomerular injury. Therefore, in the present study, we investigated whether soy protein itself has an ability to attenuate glomerular injury when added to casein diet in male Imai rats of a spontaneous focal segmental glomerulosclerosis model. METHOD: Male Imai rats were used and allocated into five groups. Group A of control casein diet (Ca) was fed standard diets containing 24.5% casein as a protein source. Group B of control soy protein diet (SP) was fed soy protein diet containing 24.5% protein that substituted a soy protein isolate for casein. Groups C (Ca-SP10) and D (Ca-SP20) were fed a mixture diet of casein (24.5%) and SP (10%) or SP (20%). Group E (Ca-Ca) was fed high casein diet containing the same quantity in protein content (44.5% casein) as the Ca-SP20 diet. Body weight, urinary protein, serum constituents and systolic blood pressure were investigated every 4 weeks from 12 weeks through 24 weeks of age. At 24 weeks of age, rats were studied morphologically. RESULTS: Animals fed control SP diet showed a significantly greater body growth than animals fed the other 4 test diets. No significant differences were found in body growth among the other 4 groups except for group E, which showed a stunt at the end of the experiment. Control SP diet significantly decreased proteinuria and serum cholesterol and attenuated glomerular injury and glomerular hypertrophy as compared with control casein diet. Added SP failed to attenuate glomerular injury, but when compared with high casein diet (group E), added SP resulted in less proteinuria, less hyperlipidemia, less hypoalbuminemia, less glomerular hypertrophy and less renal histological damage despite the quantity being the same in protein content. CONCLUSION: The present study indicates that soy protein added to conventional casein diet did not have the ability to attenuate glomerular injury, but soy protein is not as harmful as casein as a protein source when added to casein diet in the development of glomerular injury in the rat model of spontaneous focal glomerular sclerosis.     

不同比例自体微粒皮与异体脱细胞微粒真皮复合移植的研究

目的 观察阶梯比例自体微粒皮与异体脱细胞微粒真皮混合移植后创面的修复效果。方法 选雄性Wistar大鼠为移植供体,以60只雌性SD大鼠作为受体,制作全层皮肤创面,并按混合的比例不同分为混合皮A、B、C组、自体皮组(D组)、异体皮组(E组),移植扩张比为5:1。比较各组创而愈合率,微血管计数及基质金属蛋白酶(MMP)-1和MMP-2蛋白表达。结果 (1)移植后2、3周,混合皮组创面愈合效果明显高于D组和E组,混合皮组间B、C组创面愈合率(28.94±2.97)％、(30.62±1.94)％;(81.14±9.30)％、(88.00±5.71)％显著高于A组(28.36±2.11)％;(79.81±7.07)％ (P ＜0.05),而且A组有明显脱屑现象。(2)移植后2、3周,混合皮各组微血管数目明显高于D组、E组(P＜0.05);移植后2周混合皮组间A组微血管数目(30.00±1.83)明显少于B、C组( 34.30±1.70)、(35.10±1.79)。(3)MMP-1在创面形成后表达上调,而后下降,但混合皮组MMP-1的表达高于D组,尤以A、B组明显;MMP-2在移植后第3周达高峰,混合皮组表达高于D组(P＜0.05)。结论 自体微粒皮与异体脱细胞微粒真皮移植扩张比为4:1时,达到促进创面愈合的最佳比例,有利于微血管长入及MMP-1、2的适度表达。     

Enalapril and low protein reverse chronic puromycin aminonucleoside nephropathy

The effects of dietary protein and converting enzyme inhibition (CEI) on chronic puromycin aminonucleoside nephropathy (PAN) were studied. PAN was induced with seven SQ injections of puromycin aminonucleoside 20 mg/kg over 10 weeks in male Sprague-Dawley rats. The rats were divided into a 22.5% protein diet group (Gr 1), a 6% protein diet group (Gr 2), and an enalapril-treated group on 22.5% protein diet (Gr 3). Group 4 animals served as age-matched controls. Both diets were isocaloric and had the same phosphorus content. Rats from groups 1, 2, and 4 were sacrificed at 12, 18 and 24 weeks. Five rats of group 3 were sacrificed at 12 weeks, and the others were divided in subgroups 3A (diet changed to 6% protein) and 3B (no changes); half of each subgroup was sacrificed at 18 and 24 weeks, respectively. Group 2 had significantly less proteinuria than group 1 at all times. Group 3 had the same proteinuria as group 1 until 12 weeks and then began to decrease. In group 3A proteinuria decreased to group 2 levels, while in group 3B the decrease was slower but still prominent. Early lesions of focal and segmental glomerular sclerosis/hyalinosis (FSH) were present in groups 1, 2, 3 at 12 weeks (16 +/- 1.2%, 15 +/- 1.3%, 7 +/- 1.3%, respectively, versus 1.3 +/- 0.4% in controls), but by 18 weeks a reversal in FSH was seen in groups 2 and 3A/B (3 +/- 1.6%, 2 +/- 0.4%, and 3 +/- 0.9%, respectively, vs. 14 +/- 1.5% in group 1).(ABSTRACT TRUNCATED AT 250 WORDS)