胃镜下检测空腹胃酸pH值668例分析

胃酸是由胃壁细胞分泌 ,可杀死胃内的细胞 ,激活胃蛋白原 ,并提供其所需的酸性环境 ,进入小肠后还可以促进促胰液素的释放从而促进胰液、胆汁和小肠液的分泌。但胃酸分泌过多又是消化性溃疡的致病因子。本文通过胃镜下检测患者空腹胃酸ｐＨ值 ,以探讨其临床应用价值。1　　临床资料和方法1 1　一般资料　本组共 6 6 8例 ,均为我院 1999年 3月～2 0 0 0年 3月行胃镜检查的患者 ,其中十二指肠溃疡 (ＤＵ) 114例 ,男 88例 ,女 2 6例 ,年龄 17～ 4 3岁 ,平均 2 7 5岁 ;胃溃疡(ＣＵ) 5 3例 ,男 36例 ,女 17例 ,年龄 2 3～ 6 6岁 ,平均 32岁 ;胃炎…     

中西医结合治疗痛风性关节炎90例

近 6ａ来 ,我们采用中西医结合的方法治疗痛风性关节炎 90例 ,疗效满意 ,现报告如下。1　资料和方法1 1　一般资料　本组 180例 ,均门诊治疗 ,符合 1995年中国中医药管理局《痛风诊断依据分类》的诊断标准。确诊后随机分为治疗组和对照组 ,治疗组 90例 ,男 84例 ,女 6例 ,年龄2 6～ 72岁 ,平均 (4 9 37± 13 31)岁 ;病程 1周～ 2 0ａ ,平均(7 42± 4 6 7)ａ ;发病以单侧跖趾 (指 )关节为主 6 9例 ,踝关节8例 ,多关节 13例。对照组 90例 ,男 82例 ,女 8例 ,年龄 2 6～78岁 ,平均 (4 8 33± 12 46 )岁 ;病程 4ｄ～ 17ａ ,平均 (7 12±4 10 )…     

雷尼替丁联合帕罗西汀治疗消化性溃疡54例临床观察

消化性溃疡是一种心身疾病 ,部分患者经单纯的抑制胃酸治疗往往疗效差 ,且易复发。有报告发现抑制胃酸剂合用抗焦虑、抑郁药多虑平治疗消化性溃疡疗效显著[1] 。但由于多虑平副作用大 ,特别是体弱者及老年患者难以忍受。 1997年 3月～ 2 0 0 2年 1月 ,我科采用新型抗抑郁药帕罗西汀 (赛乐特 )联合雷尼替丁治疗消化性溃疡 5 4例 ,并以单剂服用雷尼替丁组 5 4例作为对照组进行治疗观察 ,总结报告如下。1　资料和方法1 1　一般资料　本组 10 8例随机分为 2组 ,治疗组 5 4例 ,男40例 ,女 14例 ,年龄 18～ 32岁 ,平均 (2 5± 6 .4)岁 ;其中胃溃疡…     

雷尼替丁预防肺性脑病上消化道出血11例

1995年 12月～ 1996年 12月 ,我们应用雷尼替丁预防肺性脑病上消化道出血 11例 ,疗效确切。1　临床资料1 1　一般情况　本组男 9例 ,女 2例 ;年龄 6 5～ 91岁 ,平均6 8岁。发病年限 :4～ 9年 ,平均 6年。患者入院后经综合病史和各种检查确诊为肺性脑病。血气分析 :ｐＨ 7 18～ 7 34,平均 7 31;动脉血ＰａＯ2 3 7～ 10 0ｋＰａ ,平均 8ｋＰａ;动脉血ＰａＣＯ2 7 3～ 14ｋＰａ平均 8 6ｋＰａ。1 2　治疗方法　开始用雷尼替丁 0 3ｇ加入 5 %葡萄糖液2 0 0ｍｌ静滴 ,每日 1次 ;意识清醒后再改口服 ,每次 0 15 ｇ ,每日 2次 ;4周后改维持量 0 …     

针刺人中加中药外敷治疗急性腰扭伤55例

1997年～ 2 0 0 0年 ,我们运用针刺人中加中药外敷治疗急性腰扭伤 5 5例 ,疗效满意 ,现报告如下。1　资料和方法1 1　一般资料　治疗组 5 5例 ,男 46例 ,女 9例 ;年龄最大5 4岁 ,最小 14岁 ,平均 2 4 4岁 ;病程 2ｈ～ 8ｄ ,平均 2 12ｄ。对照组 5 2例 ,男 48例 ,女 4例 ;年龄最大 5 2岁 ,最小 15岁 ,平均 2 5 5岁 ;病程 3ｈ～ 9ｄ ,平均 2 18ｄ。 2组在性别、年龄、病程、病位等方面差异无显著性意义 (Ｐ >0 0 5 )。1 2　诊断标准　受伤时常有腰骶部撕裂感或闻及响声 ,腰部一侧或双侧疼痛剧烈 ,无法屈伸、俯仰 ,腰部呈强直状 ,严重者不…     

单味牛西西治疗上消化道出血38例

1990～1994年我们采用单味牛西西治疗上消化道出血38例，取得满意疗效，现报寄如下。1临床资料1·至一般情况，所有病例均因呕血或黑便急诊入院，经纤维胃镜检查确诊。确诊后按人院先后将病人随机分为治疗组和对照组。治疗组38例，男30例，女8例，年龄27～72岁，平均58岁。其中十二指肠球部溃疡25例，胃溃疡7例，早期胃癌3例，急性胃粘膜病变3例。对照组36例，男28例，女8例，年龄16～68岁，平均47岁。其中十二指肠球部溃疡16例，早期胃癌2例，急性胃粘膜病变2例，胃溃疡16例。l·2治疗方法所有病例均补充血容量及对症、支持疗法，在此基础…     

天麻钩藤四物汤治疗偏头痛效果观察

1997年以来 ,笔者采用自拟天麻钩藤四物汤治疗偏头痛 6 0例 ,同期采用正天丸作对照 ,前者效果满意。1　对象和方法1 1　对象　 10 0例均为门诊病人 ,随机分为治疗组和对照组。治疗组 6 0例 ,男 12例 ,女 4 8例 ,年龄12～ 6 3岁 ,平均 4 1 5岁 ,病程 3个月～ 11年。对照组 4 0例 ,男 8例 ,女 32例 ,年龄 14～ 6 9岁 ,平均 4 3岁 ,病程 5个月～ 12年。两组资料经统计学处理 ,差异不显著 (Ｐ >0 0 5 )。 80 %病人曾服用过营养脑神经及血管扩张类药物无效 ,而求助于中医治疗。所有病例病程均在 3个月以上 ,反复发作 ,痛势甚剧 ,痛止如常人 ,发…     

"云克"治疗股骨头无菌性坏死

笔者用99Tc 亚甲基二膦酸盐 (“云克”)治疗了股骨头无菌性坏死 (ANFH)患者 33例 ,现报道如下。一、资料与方法1.临床资料。中、晚期ANFH患者 5 7例 ,病程 0 .5～ 3年 ,按ARCO分期法[1 ] 分为 5期 (0～Ⅳ期 )。其中“云克”治疗组 33例 ,男 15例 ,女 18例 ,年龄 4 8～ 78岁 ,平均 6 3岁 ,分期为Ⅱ期 3例 ,Ⅲ期 2 4例 ,Ⅳ期 6例 ;常规保守治疗对照组 2 4例 ,男 8例 ,女 16例 ,年龄 5 7～ 6 8岁 ,平均 6 1岁 ,分期为Ⅱ期 9例 ,Ⅲ期 12例 ,Ⅳ期 3例。2 .方法。①“云克”A、B剂由成都云克药业有限公司提供。 2 0 0mg (5mg×4 0瓶 )“云克…     

“广五溃疡片”治疗消化性溃疡40例

“广五溃疡片”是我院的传统制剂，经本院20多年临床应用，疗效满意。我们对本药与西咪替丁片各40例进行了临床治疗对照观察。现将两组治疗结果报告如下。临床资料一、一般资料治疗组男30例，女10例；年龄20～25岁者8例；26～39岁24例，40～62岁8例，平均年龄32．5岁；病程在5年之内者8例，5～10年广例，11～14年9例．15年以上8例；40例中，胃溃疡9例．其中多发性溃疡2例；十二指肠球部溃疡28例，复合性溃疡3例。对照组男32例，女8例，年龄20～25岁者7例，26～39岁23例，4O～62岁10例，平均34岁；病程5年以内者9例，5～10年14例．11～14年9…     

膀胱肉瘤11例临床分析

膀胱肉瘤临床甚为少见 ,且预后不佳。天津市肿瘤医院自 1 986年— 2 0 0 0年共收治 1 1例 ,均经病理证实 ,报告如下。1　临床资料男 8例、女 3例。年龄 3～ 78岁 ,平均 4 7岁。本组横纹肌肉瘤 6例 ,年龄 3～ 78岁 ,平均 4 4 3岁。平滑肌肉瘤4例 ,1 7～ 6 0岁 ,平均 4 7 5岁。纤     

Dealing with cancer--conversations with radiotherapy patients

Thirty in-patients treated by radiotherapy were questioned in qualitative interviews about the information they had received from the physicians and their way to deal with the disease and the physicians. Furthermore 18 persons out of this group were accompanied continuously. The confidential relationships between the patients and the author of the study brought about spontaneous conversations showing some new aspects of the way to experience disease and therapy. Despite a poor prognosis and an initially insufficient information, the patients formulated their questions openly. Generally they desired a clearer communication. They criticized above all the lack of information and attention from the physicians. A need for confidence, frankness, and the conveyance of a justified hope was expressed. The physician's stress and resulting lack of time was complained of. During the time of accompanying which lasted several weeks, it became evident that information means a way to deal with the disease to which the patient can make his individual contribution. The majority of questions as well as emotional reactions as fear or depression came from those patients who seemed to be quiet persons.     

Radiochemotherapy with temozolomide for patients with glioblastoma

Background

The objective of this retrospective analysis was to assess long-term outcome and prognostic factors of unselected patients treated for glioblastoma (GB) at a single center with surgery, standard radiotherapy (RT), and concomitant temozolomide (TMZ). From 1999?C2005, the institutional protocol included surgery and RT with TMZ. From 2005 on, adjuvant TMZ was routinely added.

Patients and Methods

Between April 1999 and September 2009, 181 patients with GB were treated with RT (60 Gy in 30 fractions) and concomitant TMZ (75 mg/m²/day throughout RT). Biopsy only had been performed in 53 patients (29.3%), 128 patients (70.7%) had undergone resection, which was complete based on postoperative MRI in 51 patients (28.2%). Adjuvant TMZ was applied in 67 of 181 patients (37%).

Results

Median overall survival (OS) and progression-free survival (PFS) were 15.0 (95% CI, 13.1?C16.8) and 7.2 months (95% CI, 5.9?C8.5), respectively. After complete resection, partial/subtotal resection and biopsy, median OS was 23.20, 14.75, and 7.89 months (p < 0.001), respectively. In multivariate Cox proportional hazards regression models, extent of resection (p < 0.0001), Karnofsky??s performance score (p < 0.0001) and adjuvant TMZ (p = 0.001) were significant independent prognostic factors for OS. RT with concomitant TMZ was well tolerated in the majority of patients and could be completed as scheduled in 146 patients (80.7%), while 11 patients (6.1%) discontinued RT. Another 35 patients (19.3%) interrupted concomitant chemotherapy.

Conclusion

RT with concomitant TMZ is a feasible regimen with acceptable toxicity in routine practice. Our data are compatible with a beneficial effect of adjuvant TMZ on OS and PFS.     

湿润烧伤膏与手术联合治疗褥疮的护理

目的 :减少溃疡期褥疮的术前准备时间 ,缩短褥疮的总病程。方法 :将 1996年 5月至 2 0 0 2年 5月收住院的 4 2例溃疡期褥疮病人按随机原则分为 2组 ,2 1例术前用湿润烧伤膏纱换药处理 ,为A组 (试验组 ) ;2 1例用庆大霉素紫草油纱布换药处理 ,为B组 (对照组 )。 2组病例的年龄、性别、发病原因、病灶部位、病灶范围等经统计学处理 ,无显著性差别 ,有可比性。两组病人均换药至创面新鲜行皮瓣转移手术 ;比较两组平均术前换药时间 ,及换药 +手术的总住院日。术前术后两组患者均运用护理程序施行整体护理。结果 :A组术前平均换药时间为 8 4 9± 2 2 3天 ,B组为 15 6 0± 6 70天 ;A组平均治愈时间为 2 0 5 0± 4 81天 ,B组为 35 31± 7 70天。结论 :湿润烧伤膏换药与庆大霉素紫草油纱布换药比较 ,前者可明显缩短褥疮手术的术前准备时间及病人的总住院天数。     

Bronchogenic carcinoma: staging with MR compared with staging with CT and surgery

Thirty-three patients suspected of having bronchogenic carcinoma were studied prospectively using magnetic resonance (MR). In this group, 30 underwent examination with computed tomography (CT), 15 underwent thoracotomy, six had mediastinal biopsy procedures performed, and eight underwent bronchoscopy. MR studies, which included transaxial spin-echo imaging (TR, 0.5 and 2.0 sec; TE, 28 and 56 msec) of all patients and sagittal or coronal imaging of 18, were performed without knowledge of CT findings, using only plain radiographs as a guide. CT and MR studies were interpreted separately. CT and MR provided comparable information regarding the presence and size of mediastinal lymph nodes. MR better discriminated mediastinal nodes from vascular structures. However, in two of 11 patients who had multiple mediastinal lymph nodes that were normal in size at CT examination and surgery, MR suggested a confluent abnormal mass, probably because of its poorer spatial resolution. MR was superior to CT in showing enlarged hilar lymph nodes, but CT was better for demonstrating bronchial abnormalities. In three of four patients who had a proved hilar mass with distal obstructive pneumonia, MR (TR, 2.0 sec) helped distinguish between the mass and collapsed lung.     

Tumor Burden Assessment with Positron Emission Tomography with

Objective: In patients with advanced cancer, total tumor burden affects the likelihood of tumor response and has important implications for prognosis. The aim of this study was to select the optimum 2-[F-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG PET) tumor uptake parameter to accurately measure tumor burden in advanced metastatic renal cell cancer, in comparison with volumes measured with computed tomography (CT), as a reference test.Materials and Methods: Six patients with metastatic renal cell carcinoma measurable on CT were studied. CT and FDG PET scans were carried out on all patients within 4 weeks prior to their entry into a phase I-II radioimmunotherapy trial. CT-based evaluation of disease extent (tumor volume) and 4 PET-based measurements (standardized uptake value[SUVmax], SUVav, volume, and total lesion glycolysis [TLG]) were performed independently by a radiologist (VN) and a nuclear medicine physician (TA). The degree of correlation between conventional (CT) extent of disease and parameters describing tumor concentration of FDG was then determined.Results: Fifty-seven CT-measurable metastatic lesions in lung, abdomen, and scalp were evaluated in 6 patients. There was a high correlation between CT and FDG PET volume estimates for lesions greater than 5 cm(3) in size. However, a PET-derived parameter that embodies both FDG uptake and lesion size, the TLG, correlated better with CT-derived tumor volume than did FDG PET volume alone.Conclusion: Using CT volume as a gold standard, the optimal PET-based estimate of total tumor burden in patients with metastatic renal cancer is the sum over all lesions of the total lesion glycolysis.     

MEBO药纱门诊治疗烧(烫)伤71例的体会

作者报道用MEBO药纱敷盖门诊治疗烧（烫）伤71例，均获治愈。经随访1年，深Ⅱ度创面疤痕发生率为15％（3／20），浅Ⅲ度创面疤痕发生率为38．9％（7／18）。     

臭氧治疗船员下肢损伤89例

2006年10月至2007年4月,我科采用引进的德国赫尔曼Medozon型臭氧发生装置系统产生的臭氧治疗船员下肢损伤89例,疗效满意.现报告如下.