综合性口腔护理预防系统性红斑狼疮患者口腔感染

目的探讨综合性口腔护理预防系统性红斑狼疮（SLE）患者口腔感染的效果。方法将129例SLE患者按入院顺序分为对照组（64例）和实验组（65例），对照组采用常规口腔护理方法，实验组根据患者口腔pH值及局部培养结果选择口腔护理溶液及局部应用抗生素，观察两组患者口腔pH值、口腔感染发生率。结果实验组发生口腔感染14例（21．54％），对照组为28例（43．75％），两组比较，差异有统计学意义（P＜O．01）；实验组真菌感染发生率显著低于对照组（P＜0．05）；实验组患者从入院第7天开始口腔pH值趋于碱性（6．90土1．35），第10天显著高于对照组（P＜0．01）。结论综合性口腔护理干预能有效提高SLE患者口腔pH值，减少和预防口腔感染尤其是真菌感染的发生。     

综合性口腔护理预防系统性红斑狼疮患者口腔感染

目的 探讨综合性口腔护理预防系统性红斑狼疮(SLE)患者口腔感染的效果.方法 将129例SLE患者按入院顺序分为对照组(64例)和实验组(65例),对照组采用常规口腔护理方法,实验组根据患者口腔pH值及局部培养结果选择口腔护理溶液及局部应用抗生素,观察两组患者口腔pH值、口腔感染发生率.结果 实验组发生口腔感染14例(21.54%),对照组为28例(43.75%),两组比较.差异有统计学意义(P＜0.01);实验组真茵感染发生率显著低于对照组(P＜0.05);实验组患者从入院第7天开始口腔pH值趋于碱性(6.90±1.35),第10天显著高于对照组(P＜0.01).结论 综合性口腔护理干预能有效提高SLE患者口腔pH值,减少和预防口腔感染尤其是真菌感染的发生.     

系统性红斑狼疮并发肺部感染的口腔相关因素及护理研究进展

系统性红斑狼疮患者由于免疫功能下降、口腔环境发生变化等原因,容易并发肺部感染。做好口腔护理,选择适当的口腔护理用药,密切观察病情变化可防范肺部感染发生。     

甲硝唑注射液含漱治疗口腔感染

各种原因引起的口腔感染常令患者寝食难安。甲硝唑作为抗厌氧菌药物一直以静脉或口服给药方式应用于各种口腔厌氧菌感染,并取得较好效果。然而甲硝唑对胃肠道刺激大,还有可能抑制白细胞等不良反应。目前虽有许多甲硝唑的换代产品,如替硝唑、奥硝唑等,但边远地区患者大多数受经济的限制而不能随意使用。2002年8月至2005年2月我们尝试对神经系统疾病并发口腔感染患者采用甲硝唑注射液含漱治疗,疗效满意,介绍如下。1资料与方法1.1一般资料本组6 8例,男3 6例、女3 2例,年龄3 8~8 4岁。其中高血压并存脑梗死2 0例,高血压、糖尿病并存脑出血2 0例,…     

应用口腔冲洗预防肺部感染

ICU（重症监护室）患者病情危重，往往合并多脏器损伤，极易并发肺部感染等多种感染并发症。为预防肺部感染的发生，2003年3月至2004年10月对8例1CU患者进行口腔冲洗，收到较好的效果。报告如下。     

应用口腔冲洗预防肺部感染

ICU(重症监护室)患者病情危重,往往合并多脏器损伤,极易并发肺部感染等多种感染并发症.为预防肺部感染的发生,2003年3月至2004年10月对8例ICU患者进行口腔冲洗,收到较好的效果,报告如下.     

3％碳酸氢钠联合制霉菌素甘油及碘甘油预防肝移植术后口腔并发症及肺部感染

目的探讨3％碳酸氢钠液漱口联合制霉菌素甘油及碘甘油进行口腔护理预防肝移植术后口腔并发症及肺部感染的效果。方法将166例肝移植术后患者随机分为对照组（79例）和观察组（87例）,对照组按常规采用生理盐水进行口腔护理，观察组采用3％碳酸氢钠液漱口联合制霉茼素甘油和碘甘油进行口腔护理,观察并记录术后肺部感染和口腔并发症的发生情况。结果观察组口腔并发症及肺部感染发生率显著低于对照组（均P〈：0．01）。结论3%碳酸氢钠液漱口联合制霉菌素甘油和碘甘油进行口腔护理对降低肝移植术后口腔并发症及肺部感染起看非常重要的作用。     

口腔擦洗结合牙龈按摩预防脑卒中患者肺部感染和口腔异味

目的探讨口腔擦洗结合牙龈按摩预防脑卒中患者肺部感染及去除口腔异味的作用。方法将200例脑卒中患者随机分为两组各100例。对照组使用湿棉球行常规口腔护理,观察组使用湿纱布擦洗并给予牙龈按摩。结果观察组肺部感染率及1级以上口腔异味发生率显著低于对照组(P<0.05,P<0.01)。结论口腔擦洗结合牙龈按摩可以减少脑卒中患者肺部感染和口腔异味的发生率。     

益口含漱液用于乳腺癌患者化疗过程中口腔护理的效果观察

肿瘤患者接受化疗后(外科手术后、肿瘤病人)免疫力低下，容易造成口腔正常菌群失调，厌氧菌、真菌等口腔细菌引发院内感染。由此提出对口腔护理技术的新需求。我们应用益口口腔含漱液进行口腔护理，对清除口腔异味、减少口腔溃疡、预防真菌感染等，达到了控制院内感染的作用，现报告如下：     

决明子含漱液治疗重型肝炎患者口腔疾患

目的观察决明子含漱液对重型肝炎患者口腔问题的治疗效果,以寻求解决患者口腔问题最佳方法,提高患者的生存质量。方法将120例有口腔疾患的重型肝炎患者随机分为观察组和对照组,对照组58例采用生理盐水棉球进行常规口腔护理,观察组62例采用决明子含漱液进行含漱,14 d观察并记录腔护理效果。结果观察组口臭、口腔溃疡治疗效果显著优于对照组(均P<0.01),两组牙龈出血程度比较,差异无统计学意义(P>0.05)。结论决明子含漱液作为局部用药,可以减轻重型肝炎患者牙龈出血问题,尤其在调治口臭和口腔溃疡方面有显著疗效。     

Vitamin D deficiency in patients with active systemic lupus erythematosus

Summary  We investigated the effects of disease activity on bone metabolism in 36 patients with systemic lupus erythematosus (SLE). Changes in bone remodeling were not explained by corticosteroid use. A high prevalence of 25OHD deficiency in SLE patients indicates the need for vitamin D replacement, mainly during high disease activity periods. Introduction  We investigated the effects of SLE disease activity on bone metabolism, their relation to inflammatory cytokines and vitamin D levels. Methods  We performed a cross-sectional analysis of 36 SLE patients classified according to the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) in high activity (group I: 12 patients, mean age 29.6 years) or in minimal activity (group II: 24 patients, mean age 30.0 years), and compared them to normal controls (group III: 26 women, 32.8 years). Serum calcium, phosphorus, parathyroid and sex hormones, bone remodeling markers, interleukin (IL)-6, soluble IL-6 receptor (sIL-6R), IL-1, tumor necrosis factor-α (TNF), 25-hydroxivitamin D (25OHD), and 1,25-dihydroxyvitamin D3 were measured, plus bone mineral density. Results  All cytokines were significantly higher in SLE groups; IL-6 could differentiate SLE patients from controls. In group I, 25OHD levels were lower (P < 0.05), which was related to the SLEDAI (R = -0.65, P < 0.001). In multiple regression analysis, the 25OHD level was associated with SLEDAI, osteocalcin and bone-specific alkaline phosphatase. The SLEDAI score was positively correlated with all measured cytokines and especially TNF (R = 0.75, P < 0.001). Conclusions  SLE patients demonstrated changes in bone remodeling strongly related to disease activity. A high prevalence of 25OHD deficiency was observed in SLE patients, indicating the need for vitamin D replacement.     

Surgical morbidity in patients with systemic lupus erythematosus

Thirty-six surgical procedures were performed on 29 patients with systemic lupus erythematosus (SLE). Nineteen cases involved active lupus at the time of surgery and 11 were performed on an emergent basis. Most patients had multiple organ involvement and were on some form of systemic therapy at the time of surgery. Thirty-seven postoperative complications were confined to 20 of these cases. Comparing this complicated group with the remaining 16 uncomplicated cases, the patients in the former group had a higher mean dose of steroid preoperatively, more organ involvement by SLE, and more frequent renal involvement; a higher percentage of the cases in this group were emergent rather than elective. The majority of factors examined failed to show predictive value in the outcome of surgery in lupus patients. We conclude that surgical complications are frequent in SLE patients and have identified four factors predictive of increased morbidity.     

Glomerular podocytopathy in patients with systemic lupus erythematosus

A series of patients with systemic lupus erythematosus (SLE) and proteinuria were studied to determine whether nephrotic-range proteinuria was associated with diffuse epithelial cell foot process effacement in the absence of peripheral glomerular immune aggregate deposition. Biopsies from patients with known or suspected SLE and a histologic diagnosis of (1) normal by light microscopy, (2) mesangial proliferative glomerulonephritis, or (3) focal segmental glomerulosclerosis were studied. Biopsies were excluded when they demonstrated endocapillary proliferation or necrosis by light microscopy or electron-dense glomerular basement membrane deposits by electron microscopy. Patients were required to fulfill four of 11 American Rheumatologic Association criteria for the diagnosis of SLE, and proteinuria could not be associated with nonsteroidal anti-inflammatory drug use. Eighteen biopsies were studied, eight from patients with nephrotic-range proteinuria (>/=3 g/d) and 10 from patients with non-nephrotic proteinuria. The time from diagnosis of SLE to biopsy was shorter for nephrotic patients that for nonnephrotic patients. Seven of eight biopsies from nephrotic patients demonstrated at least 80% foot process effacement, whereas no biopsy from a nonnephrotic patient exhibited >20% effacement. There were no other significant pathologic differences between the nephrotic and nonnephrotic patients. The single common morphologic feature associated with nephrotic proteinuria was diffuse visceral epithelial cell foot process effacement. It is concluded that the development of nephrotic-range proteinuria in patients with SLE without peripheral immune aggregate deposition or endocapillary proliferation on renal biopsy is more likely a manifestation of SLE than the coexistence of idiopathic minimal-change glomerulopathy and SLE.     

Fragmented QRS in patients with systemic lupus erythematosus

Introduction. Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with a variety of clinical features. Cardiac involvement is present in more than half of the patients with SLE. Fragmentation of QRS (fQRS) is presumed marker of cardiovascular risk and has not been previously evaluated in SLE. Methods. A total of 56 women previously diagnosed with SLE were recruited. In addition, a control group consisting of 51 healthy people was formed. QRS complexes were also evaluated in terms of fragmentations. All patients with SLE and control subjects underwent transthoracic echocardiographic examination. Erythrocyte sedimentation rate and C-reactive protein levels were also obtained. Results. Frequency of fQRS was higher in patients with SLE (41% vs. 21%, p = 0.03). Left ventricular posterior wall thickness and mass index were higher in the patients with SLE. CRP levels and age were significantly higher, and disease duration was significantly longer in the fQRS(+) group (p = 0.02, 0.01, and 0.006, respectively). Conclusion. A careful cardiovascular evaluation and follow-up is essential to continuously improve survival in SLE. For this purpose, fQRS may be used for the early detection in patients with SLE.     

Celiac disease in patients with systemic lupus erythematosus

ObjectivesCeliac disease (CD) is one of the most common chronic diseases. Celiac disease has been associated with several autoimmune disorders, but the association with systemic lupus erythematosus (SLE) as a systemic autoimmune disease is still controversial. In this study, we aimed to determine the prevalence of biopsy-proven CD in patients with SLE, and to determine the clinical symptoms and laboratory data in these patients.Material and methodsIn a cross-sectional study, SLE patients at a referral clinic were evaluated for gastrointestinal symptoms between March and December 2016. Patients were evaluated by a gastroenterologist, and upper gastrointestinal endoscopy with intestinal biopsy was performed if deemed necessary. The clinical symptoms, laboratory data, and endoscopy results were recorded and compared between groups.ResultsIn total, 130 patients were evaluated in this study. Gastrointestinal symptoms were present in 40% of the patients. Endoscopy was performed in all SLE patients with gastrointestinal symptoms. Four patients (3%) were diagnosed as having CD based on biopsy results and response to a gluten-free diet. Anti-endomysium antibody (AEA) was found to be 100% sensitive and 99.2% specific for the diagnosis of CD in SLE patients, and anti-gliadin antibody (AGA) had a 50% sensitivity and 98% specificity. Patients with comorbid CD and SLE were significantly more likely to have diarrhea, abdominal pain, nausea/vomiting, recurrent oral aphthosis, and anemia.ConclusionsThe results of this study suggest that a significant association is present between CD and SLE. We found a prevalence of 3% for biopsy-proven CD in patients with SLE, which is five times the prevalence of CD in the general population.     

Cardiac surgery in patients with systemic lupus erythematosus

Cardiac surgery was infrequently performed in patients with systemic lupus erythematosus (SLE), and its clinical outcome was reported only in small series. We sought to evaluate the clinical outcome of cardiac operation in patients with SLE. Between January 1996 and March 2005, 9 patients with SLE underwent cardiac surgery at the authors' hospital. Six patients underwent coronary artery bypass grafting (three conventional and three on-pump beating heart), two patients underwent valve replacement and 1 patient underwent simultaneous heart-kidney transplantation. All 6 patients with coronary artery bypass grafting had saphenous venous grafts and two of them had additional left internal mammary artery graft. The overall in-hospital mortality rate was 11% (1/9). Major postoperative complications occurred in 4 patients (44%) including profuse postoperative bleeding, ventricular tachycardia and early graft thrombosis. There were two late deaths including sudden cardiac death and sepsis. The median follow-up duration was 23 months (range, 1-110). In conclusion, although the postoperative complication was common, cardiac operation could be performed in patients with SLE.     

Hip arthroplasty in patients with systemic lupus erythematosus

Forty-three prosthetic hip replacements (twenty-nine conventional total hip replacements and fourteen bipolar endoprosthetic replacements) were implanted between January 1971 and June 1982 in thirty-one patients who had systemic lupus erythematosus. All but four patients had stage-III or IV osteonecrosis of the femoral head. The median age at operation was forty-three years, and the median length of follow-up was fifty-seven months. Ratings were good or excellent for all but three total hip arthroplasties at a mean of sixty-six months of follow-up. Complications included delayed wound-healing (in approximately 15 per cent) and superficial wound infection (in approximately 10 per cent). The occurrence of these complications could not be correlated with the use of corticosteroids at the time of the operation. Twenty-five per cent of the patients, who were a mean of forty-three years old at operation, died less than five years postoperatively from complications related to systemic lupus erythematosus. Conclusions regarding the systemic effects of hip arthroplasty in patients with systemic lupus erythematosus could not be drawn on the basis of this study. Total hip arthroplasty uniformly provided a good or excellent result in patients of all ages who had systemic lupus erythematosus at a mean length of follow-up of sixty-six months. An increased incidence of local wound complications, which were unrelated to the use of corticosteroids, should be expected in patients with systemic lupus erythematosus who undergo prosthetic arthroplasty of the hip.     

Pneumococcal infection in patients with systemic lupus erythematosus

Objective

Our study aimed to analyze the risk factors associated with the occurrence and severity of pneumococcal infection (PI) in systemic lupus erythematosus (SLE) patients.