微创置管胸腔内灌注顺铂和紫杉醇治疗肺癌恶性胸腔积液

摘要: 目的 评价微创置管胸腔闭式引流结合胸腔内局部灌注顺铂和紫杉醇联合化疗治疗恶性胸腔积液的临床价值。方法 45例肺癌恶性胸腔积液患者被单盲随机分为联合化疗组和对照组，两组均应用微创置管胸腔闭式引流结合局部化疗，联合化疗组所用药物为顺铂＋紫杉醇，对照组所用药物为单药顺铂，观察胸腔积液控制情况及患者生活质量。 结果 联合化疗组胸液控制有效率为86.96％，完全缓解率69.57％； 对照组有效率为50.00％，完全缓解率为36.36％，差异有统计学意义（P＜0.05）。联合化疗组生活质量好转优于对照组。 结论 微创置管胸腔闭式引流结合局部顺铂和紫杉醇联合化疗在有效控制肺癌恶性胸腔积液、提高患者生存质量方面明显优于单药化疗,值得推广应用。     

顺铂联合香菇多糖局部治疗肺癌恶性胸腔积液的临床研究

目的：探讨顺铂联合香菇多糖局部胸膜腔内注射治疗肺癌合并恶性胸腔积液的近期疗效及安全性。方法将明确诊断为肺癌合并恶性胸腔积液的80例患者随机分为联合组和非联合组各40例。在尽可能将胸腔积液引流干净后,联合组予香菇多糖注射液2 mg＋顺铂40～60 mg＋地塞米松5 mg＋2％利多卡因5 ml＋生理盐水40 ml胸膜腔内注射;非联合组予顺铂40～60 mg＋地塞米松5 mg＋2％利多卡因5 ml＋生理盐水40 ml胸膜腔内注射。两组均于第1、7日注射2次。治疗4周后比较两组近期疗效、生活质量和不良反应情况。结果80例均顺利配合完成治疗。联合组有效率为78％、控制率为90％、生存质量改善率为78％,明显优于对照组单独采用顺铂的55％、73％、55％（P均＜0.05）。两组患者发热、胸痛、消化道反应及骨髓抑制等不良反应比较差异无统计学意义（P均＞0.05）。结论香菇多糖联合顺铂胸膜腔内注射治疗肺癌合并恶性胸腔积液近期疗效优于单用顺铂治疗,且不增加不良反应发生率。     

复方苦参注射液联合顺铂治疗肺癌引致恶性胸腔积液临床疗效及安全性评价

目的探究复方苦参注射液联合顺铂在肺癌引致恶性胸腔积液治疗中的疗效及安全性,为临床医师选择合理用药方案提供参考。方法选取某院2014-01—2015-12收治的肺癌致恶性胸腔积液患者60例,随机分成两组。对照组采用单一顺铂灌注治疗,观察组采用复方苦参注射液联合顺铂灌注治疗。对比分析两组患者的治疗总有效率、生活质量和不良反应情况。结果患者均完成灌注治疗,且观察组的治疗总有效率(80.00%)显著高于对照组(56.66%),生活质量改善率(80.00%)显著高于对照组(53.33%),差异具有统计学意义(P0.05),而不良反应显著少于对照组,差异均具有统计学意义(P0.05);观察组患者的中性粒细胞减少和消化道反应不良反应多为Ⅰ~Ⅱ级,对照组患者的不良反应有约一半左右为Ⅲ~Ⅳ级,差异均具有统计学意义(P0.05)。结论复方苦参注射液联合顺铂治疗肺癌引致恶性胸腔积液具有显著的临床疗效,能显著改善患者的生活质量,且安全性较好。     

顺铂联合香菇多糖与单用顺铂治疗恶性胸腔积液疗效比较

目的探讨超声引导下胸腔置管引流后灌注顺铂联合香菇多糖治疗恶性胸腔积液的疗效。方法病理确诊的恶性胸腔积液患者50例,经超声引导下置管引流排净胸腔积液后,随机分为两组。治疗组(26例)胸腔内注入顺铂60mg,3日后注入香菇多糖8mg,1周后重复,各灌注3次;对照组(24例)在胸腔内注入顺铂60mg,1周后重复,灌注3次。结果治疗组、对照组总有效率分别为88.5%(23/26)、66.7%(16/24);Karnofsky评分有效率分别为85%和50%,差异均有显著性。结论超声引导下胸腔置管引流后灌注顺铂联合香菇多糖能有效控制恶性胸腔积液,提高患者生活质量,且不良反应可耐受。     

高聚生联合顺铂治疗恶性胸腔积液的临床观察

目的：观察高聚生联合顺铂胸腔内灌注对恶性胸水的疗效。方法：60例肺癌继发恶性胸腔积液在胸腔置入中心静脉导管引流胸液后灌注高聚生及顺铂与单用顺铂疗效对照。结果：高聚生＋顺铂组60例,有效率81．7％;单纯灌注顺铂54例,有效率46．3％（P〈0．05）。局部化疗后KPS评分比治疗前明显上升。经中心静脉导管置入胸腔引流胸液安全有效,副作用小,患者能接受。结论：中心静脉导管置入胸腔灌注高聚生加顺铂,疗效明显优于胸腔内单纯灌注顺铂,因此生物制剂高聚生加顺铂经中心静脉导管置入胸腔内灌注为治疗恶性胸水的有效方法之一。     

复方苦参注射液胸腔灌注治疗癌性胸腔积液疗效观察

目的:观察复方苦参注射液胸腔灌注治疗癌性胸腔积液的近期治疗效果。方法:癌性胸腔积液患者100例随机分为对照组及治疗组各50例。治疗组给予胸腔积液引流联合复方苦参注射液胸腔灌注治疗;对照组给予胸腔积液引流联合丝裂霉素胸腔灌注化疗,比较2组胸腔积液控制率、生活质量改善率、不良反应。结果:治疗组完全缓解16例,部分缓解12例,总有效率56%;对照组完全缓解15例,部分缓解14例,总有效率58%,2组比较差异无统计学意义(P>0.05)。2组治疗后生活质量有效率均为66%,2组比较差异无统计学意义(P>0.05)。治疗组不良反应发生率16%低于对照组56%(P<0.05)。结论:复方苦参注射液胸腔灌注治疗癌性胸腔积液较丝裂霉素不良反应轻。     

复方苦参注射液胸腔灌注治疗癌性胸腔积液疗效观察

目的:观察复方苦参注射液胸腔灌注治疗癌性胸腔积液的近期治疗效果.方法:癌性胸腔积液患者100例随机分为对照组及治疗组各50例.治疗组给予胸腔积液引流联合复方苦参注射液胸腔灌注治疗;对照组给予胸腔积液引流联合丝裂霉素胸腔灌注化疗,比较2组胸腔积液控制率、生活质量改善率、不良反应.结果:治疗组完全缓解16例,部分缓解12例,总有效率56%;对照组完全缓解15例,部分缓解14例,总有效率58%,2组比较差异无统计学意义(P>0.05).2组治疗后生活质量有效率均为66%,2组比较差异无统计学意义(P>0.05).治疗组不良反应发生率16%低于对照组56%(P<0.05).结论:复方苦参注射液胸腔灌注治疗癌性胸腔积液较丝裂霉素不良反应轻.     

复方苦参配合顺铂胸腔灌注对恶性胸腔积液疗效观察

[目的]探讨复方苦参配合顺铂胸腔灌注对恶性胸腔积液的疗效.[方法]对本院收治的180例恶性胸腔积液患者随机分为试验组以及对照组,试验组采用复方苦参配合顺铂进行治疗,对照组单纯采用顺铂进行治疗.[结果]试验组患者治疗有效率为87.8％明显高于对照组的55.6％.试验组患者毒副反应发生例数明显低于对照组(P＜0.05)；试验组患者治疗后kamofsky评分以及体重提高例数明显高于对照组(P＜0.05).[结论]对恶性胸腔积液患者采用复方苦参配合顺铂进行治疗可明显改善患者预后,提高患者生存质量.     

胸腔内注射不同药物治疗肺癌恶性胸腔积液疗效观察与护理

目的:观察不同药物注射治疗肺癌胸腔积液的临床疗效,并对患者的护理过程进行总结。方法:选取2011年1月~2014年1月于我院内科确诊的肺癌合并恶性胸腔积液患者80例作为研究对象,随机等分为对照组和试验组,对照组患者进行顺铂注射,试验组患者进行顺铂联合金葡素注射,并对两组患者辅以心理、生理各方面的护理干预,观察比较两组患者病情好转、不良反应的发生率。结果:试验组患者临床治疗效果明显优于对照组,且用药后不良反应发生低于对照组,差异均有统计学意义(P0.05)。结论:较传统的顺铂治疗方式,金葡素联合顺铂胸腔内注射能有效控制肺癌所致恶性胸腔积液,且降低了用药后不良反应,值得推广。     

胸腔镜胸膜固定术联合顺铂和鸦胆子油 治疗恶性胸腔积液疗效观察

目的探讨胸腔镜胸膜固定术联合顺铂和鸦胆子油治疗恶性胸腔积液(MPE)的临床疗效。方法将66例MPE患者平均随机分为A、B、C3组,A组接受顺铂胸膜腔内灌注治疗;B组接受胸腔镜胸膜固定术联合顺铂胸膜腔内灌注治疗;C组接受胸腔镜胸膜固定术联合顺铂及鸦胆子油胸膜腔内灌注治疗。观察并比较以上3组患者的临床治疗总有效率、Karnofsky生活质量评分(KPS)以及不良反应发生率。结果 A、B、C组治疗有效率分别为72.72%、90.90%以及95.45%,B组及C组显著高于A组(P<0.05);所有患者治疗后KPS评分均显著升高(P<0.05),治疗后B组及C组显著高于A组(P<0.05),同时C组显著高于B组(P<0.05);不良反应发生率C组显著低于A组及B组(P<0.05)。结论胸腔镜胸膜固定术联合顺铂和鸦胆子油治疗恶性胸腔积液疗效肯定,可改善患者生活质量并减轻不良反应。     

Interaction of peptidoglycans with anti-IgGs and with complement.

This report describes the interaction of peptidoglycan (Streptococcus group A, Staphylococcus epidermidis and Micrococcus lysodeikticus) with 2 serum mediator systems, namely with the anti-IgG system and with complement. The observation that the majority of rabbits hyperimmunized with A-variant streptococcal vaccine produced anti-group carbohydrate antisera containing anti-IgGs and antibodies directed to peptidoglycan suggested that the production of these 2 latter antibodies was related. This view was supported by the finding of a monoclonal 7S anti-IgG with antibody specificity for the pentapeptide of peptidoglycan as evidenced by inhibition of the coprecipitation of 7S anti-IgG with antigen-antibody complexes by the pentapeptide. Inhibition of the anti-idiotype reaction by the pentapeptide provided further evidence for the antibody specificity of 7S anti-IgG for peptidoglycan. When added to normal human sera all peptidoglycan preparations inhibited the hemolytic activity of the sera. Consumption of C3 in C2 deficient serum and consumption of C2 in normal serum indicated the activation of both known complement pathways. Activation of the classical pathway of complement was more efficient since 50 mug of peptidoglycan consumed approximately 70% of C2 per ml normal serum whereas more than 2 mg of the same preparations was required to inactivate 17-24% of C3 in C2 deficient sera. Each of the different peptidoglycan preparations consumed similar amounts of complement in all 20 sera tested. This finding suggested that activation of the classical complement pathway by peptidoglycan was not mediated by anti-peptidoglycan antibodies present in only 20-40% of normal human sera.     

异病酚静脉全麻下复合氯胺酮或曲马多行纳屈酮快速阿片脱毒的效果比较

Toreleasetheseverewithdrawalsymptomsoftheheroinad-dicts,weinjecttheNaloxineinthegeneralanesthesia.160volun-teersreceivedRODwereperformedunderthecombinedanesthesiawithpropofol,midazolamandketamine.1Subjectsandmethods1.1Subjects160volunteerswhoaccordingwiththediagnosticstandardoftheICD-10abouttheopiate-addiction,male:145,fe-male15.Age:(30±6),theeldestwas45yearsold.Themeanbodyweightwasabout(58±8)kg.Educationalbackground:pri-maryschool118cases,juniorhighschool:24casesandseniorhighschool/seco…     

艾滋病合并结核病及马尔尼菲青霉病患者的护理

目的 通过分析艾滋病合并结核病及马尔尼菲青霉病患者的临床资料,提高对三病并存的护理认识.方法 分析并总结26例艾滋病合并结核病及马尔尼菲青霉病住院患者的临床特点、治疗及护理方法.结果 本组患者治愈5例,好转13例,死亡8例.存活患者随访6～30个月均未复发.结论 三病并存时临床表现复杂,无特异性,护理难度大,应仔细观察病情,及早诊治,精心护理,对改善预后有重要意义.     

艾滋病合并结核病及马尔尼菲青霉病患者的护理

目的通过分析艾滋病合并结核病及马尔尼菲青霉病患者的临床资料,提高对三病并存的护理认识。方法分析并总结26例艾滋病合并结核病及马尔尼菲青霉病住院患者的临床特点、治疗及护理方法。结果本组患者治愈5例,好转13例,死亡8例。存活患者随访6～30个月均未复发。结论三病并存时临床表现复杂,无特异性,护理难度大,应仔细观察病情,及早诊治,精心护理,对改善预后有重要意义。     

替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的观察与护理

[目的]总结替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的观察与护理。[方法]对25例无法手术切除的晚期结直肠癌病人采用替吉奥胶囊联合亚叶酸钙、奥沙利铂方案进行治疗,同时加强心理护理、毒副反应的观察与护理等。[结果]治疗过程中出现Ⅰ级和Ⅱ级神经毒性8例,恶心、呕吐、食欲下降12例,骨髓抑制5例,变态反应1例,经处理后均好转;1例病人死亡,其余病人均顺利进行治疗。[结论]加强替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的护理,可保证治疗的顺利进行。     

肿瘤血液透析患者的心理分析及护理

目的评价为肿瘤血液透析患者实施心理护理的效果。方法肿瘤血液透析患者38例实施自身对照,观察心理护理前后其心理状态的变化。结果经过心理护理,患者心态变得平稳,依从性增强,能更好地配合治疗。结论有针对性的心理护理能帮助患者以积极的心态面对困难,增强战胜疾病的信心,更好地配合治疗,并有助于血液透析治疗的顺利进行。     

913例住院患者满意度调查分析

目的:通过住院患者满意度调查分析,提高护理质量,促进和谐护患关系的发展。方法:选择2009年1～6月入住本院妇科的913例患者,主要针对护士的服务态度、操作技术、与患者沟通情况、护士对患者的关怀及健康教育5个方面,在患者出院时进行满意度调查。结果:患者对护士服务的总体满意度为92.94%,对护士的服务态度、操作技术的满意度最高,对护士操作时尊重患者隐私及护士所作的药物指导满意度最低,不同文化程度、不同职业、不同住院次数的患者满意度有一定的差距。结论:医疗机构应科学配备护理人员,培养护士的人文关怀精神,进一步拓宽健康教育的深度及广度,努力构建和谐护患关系。     

An electroencephalographic comparison of alfentanil with other narcotics and with thiopental

Using aperiodic analysis, we compared the EEC produced by alfentanil with the EEGs produced by two other opiates—fentanyl and sufentanil—on the one hand and with the EEG produced by a barbiturate—thiopental—on the other hand. Alfentanil and thiopental were injected over 1 minute: fentanyl and sufentanil were injected over 10 to 15 minutes. From the aperiodic analysis we derived up to seven single-number variables computed over 30- or 60-second epochs. All the opiates induced EEGs that were qualitatively similar to each other, although the maximum or minimum values tended to be greater and the time course more rapid with alfentanil than with the other two opiates. This finding may have been related to the fact that we injected relatively more alfentanil and administered it more rapidly. The EEGs produced by alfentanil and thiopental differed markedly, both qualitatively and quantitatively. The total power at 1 Hz and cumulative power at 3 Hz went to higher peak values with alfentanil, the latter tending to decrease with thiopental. The total number ot waves per epoch went to lower peak values with alfentanil; there was little change with thiopental. The frequency below which 90% ot the power resides went to considerably lower peak values with alfentanil than with thiopental. Finally, total power at 10 to 12 Hz (alpha waves; and average power at 17 to 19 Hz (beta waves) went to very high peak values with thiopental, but decreased with alfentanil. In spite ot differences in the opiate studies in the timing ot injection and the relative amount ot drug injected, the variables that proved useful in their response to fentanyl and sutentanil also proved useful with altentanil. In contrast, almost all variables showed a difference in response between alfentanil and thiopental. Supported in part by Janssen Pharmaceutics, Inc. Pisacataway, NJ, and by Diatek Corporation, and the Veterans Administration Medical Center, San Diego, CA.     

The comparison of effects of rapid opiate detoxification with ketamine complex and with tramadol and naltrexone under general anesthesia with propofol

Objective To release the heroin addicts‘ sufferings,we made rapid opiate detoxification by injecting naloxine under the general anesthesia.Method 160 volunteers were divided at randon into two groups:Group A were performed under the combined anesthesia with propofol,midazolam and kelamine.Group B were performed under the combined anesthesia with propofol with midazolam and tramadol.The vital signs were recorded and the withdrawal syndrome of the volunteers were assessed during the whole process.Result All of the withdrawal symptoms scores 24 hours after ROD in group B were lower than its pre-treatment;The symptoms of the thirs,tsleeping disturbance,nausea and vomiting,skeletal muscular pains and anorexia scores in group A were also lower than its pre-treatment;and no too much differeence belween group A and group B.But tearing,anxiety and diarrhea scores in group A were almost the same as the pre-treatment and higher than group B.Both groups received of the naloxone treatment smoothly,and remained in the hospital for about 3 days.Conclusion The effect of rapid opiate detoxification of naltrexone with the ketamine or tramadol under anesthesia is obvious.The tramadol is better than others.     

小儿哮喘患儿经普米克令舒联合孟鲁司特治疗前后肺功能及免疫学细胞因子水平变化研究

目的 分析小儿哮喘患儿经普米克令舒联合孟鲁司特治疗前后肺功能及免疫学细胞因子水平变化.方法 选取2018年3月至2019年3月本院儿科收治的哮喘患儿86例,中途退出4例,最终纳入82例.按照治疗方法将其分为联合组和单一组,各组41例.单一组在常规治疗基础上增加孟鲁司特钠咀嚼片,联合组在单一组基础上增加普米克令舒.比较治...