复方丹参联合硫酸镁治疗妊娠合并慢性高血压并发先兆子痫的临床疗效分析

目的分析复方丹参联合硫酸镁治疗妊娠合并慢性高血压并发先兆子痫的临床疗效。方法随机选取我院2016年5月～2018年5月收治的84例妊娠合并慢性高血压并发先兆子痫患者为研究对象,随机分为对照组(42例:硫酸镁治疗)与试验组(42例:复方丹参联合硫酸镁治疗),比较两组患者临床疗效。结果试验组患者分娩前凝血酶原时间(PT)、D-二聚体(D-D)以及纤维蛋白原(Fg)等凝血指征均明显优于对照组,P0.05;试验组患者治疗后先兆子痫发生率(14.29%)、产妇不良结局发生率(7.14%)及围产儿不良结局发生率(7.14%),均明显低于对照组,P0.05。结论对于妊娠合并慢性高血压并发先兆子痫患者给予复方丹参联合硫酸镁治疗效果相对更优,可明显改善产妇凝血指标,改善母婴结局。     

高血压危象静脉应用硝酸甘油治疗的综合护理干预效果

目的探讨高血压危象给予静脉应用硝酸甘油治疗的综合护理干预效果。方法选择2014年9月~2016年9月收治的高血压危象患者92例,按照随机数表分为2组,各46例。2组均给予静脉滴注硝酸甘油治疗,对照组采用常规护理,观察组采用综合护理干预,对比2组护理前后血压水平和不良反应发生率。结果观察组护理后收缩压、舒张压低于对照组;观察组不良反应发生率低于对照组,比较差异均有统计学意义(P0.05)。结论综合护理干预应用于硝酸甘油静脉滴注治疗高血压危象患者效果显著,可明显降低血压水平,减少不良反应,值得推广。     

微创穿刺引流联合开颅血肿清除术对高血压脑出血合并脑疝患者治疗效果的影响

目的对高血压脑出血合并脑疝患者采用微创穿刺引流术联合开颅血肿清除术的临床效果予以探究。方法纳入某院2014年6月至2016年6月收治的96例高血压脑出血合并脑疝患者,其中48例患者采用开颅血肿清除术治疗作为对照组,48例患者采用微创穿刺引流术联合开颅血肿清除术治疗作为观察组。比较两组患者的生活质量评分、并发症发生率与死亡率。结果观察组患者生活质量评分均高于对照组(P0.05);观察组患者并发症发生率4.16%,低于对照组的20.83%(P0.05);观察组患者术后死亡率2.08%,对照组患者术后死亡率8.33%,两组患者术后死亡率差异无统计学意义(P0.05)。结论高血压脑出血合并脑疝患者采用微创穿刺引流术联合开颅血肿清除术治疗,可降低患者的并发症发生率,提高其生活质量。     

依那普利联合氯沙坦治疗早期2型糖尿病肾病合并高血压的疗效与安全性

将笔者所在医院收治的94例早期2型糖尿病肾病合并高血压患者随机分为对照组和试验组各47例。对照组采用缬沙坦治疗,而试验组采用依那普利联合缬沙坦治疗。比较两组患者24h尿微白蛋白排泄率(UAER)、收缩压(SBP)、舒张压(DBP)及不良反应的差异。结果治疗后试验组UAER降低,也低于对照组,比较有统计学差异(P0.05);治疗后试验组SBP、DBP降低,比较有统计学差异(P0.05),但其稍低于同期对照组,比较差异无统计学意义(P0.05);试验组不良反应发生率为12.8%高于对照组6.4%,比较差异无统计学意(P0.05)。依那普利联合氯沙坦治疗早期2型糖尿病肾病合并高血压效果显著,其能够有效改善患者肾损害,降低其血压水平,同时不良反应少,安全性高,值得临床选择。     

多巴胺联合硝酸甘油在急诊肺心病合并多脏器衰竭治疗中的应用效果

目的研究多巴胺联合硝酸甘油对急诊肺心病合并多脏器衰竭患者预后的影响。方法选取2016年1月至2018年3月100例急诊肺心病合并多脏器衰竭患者,按照随机表法将患者分为对照组与观察组,每组50例。对照组给予硝酸甘油单药治疗,观察组给予多巴胺+硝酸甘油联合治疗。两组均在治疗期间监测患者的各种并发症并计算并发症发生率,在治疗结束后评价治疗效果,计算病死率。结果观察组并发症发生率为18.00%(9/50),低于对照组[36.00%(18/50)],差异有统计学意义(χ~2=4.110,P0.05)。观察组治疗有效率为84.00%(42/50),高于对照组[66.00%(33/50)],差异有统计学意义(χ~2=4.320,P0.05)。观察组病死率为18.00%(9/50),低于对照组[38.00%(19/50)],差异有统计学意义(χ~2=4.960,P0.05)。结论多巴胺联合硝酸甘油可以缓解急诊肺心病合并多脏器衰竭患者的脏器衰竭情况,对患者预后具有一定的改善作用。     

葛根汤辅助治疗糖尿病合并高血压危象患者的临床效果分析

目的:探讨葛根汤辅助治疗糖尿病合并高血压危象患者的临床效果。方法:选取2016年1月~2017年1月我院收治的96例糖尿病合并高血压危象患者作为研究对象,随机分为对照组和观察组,每组48例。对照组采用单一西药治疗,观察组在对照组的基础上加用葛根汤辅助治疗,比较两组患者的临床治疗效果和不良反应发生情况。结果:治疗后,观察组的治疗总有效率为93.75%,高于对照组的79.17%,差异有统计学意义,P0.05;观察组的收缩压、舒张压及空腹血糖指标均低于对照组,差异有统计学意义,P0.05;观察组的不良反应发生率为2.08%,低于对照组的14.58%,差异有统计学意义,P0.05。结论:采用中西医结合的方法治疗糖尿病合并高血压危象患者,可显著提高临床治疗效果,且安全性更高。     

不同部位急性心肌梗死患者发生心律失常的护理干预分析

将笔者所在医院收治的80例急性心肌梗死伴心律失常患者,随机分为对照组40例,采用常规护理;试验组40例,在常规护理基础上采取完善的心电监测护理。比较两组患者心律失常发生率、监测护理效果及护理满意度。结果对照组患者心律失常总发生率42.5%高于试验组20.0%,差异显著(P0.05);对照组患者监测护理有效率80.0%低于试验组95.0%,且护理满意度75.0%低于试验组92.5%,差异显著(P0.05)。采用全面、有效的护理干预,可促进不同部位急性心肌梗死发生心律失常患者康复,减少低并发症,提高护理效果。     

托拉塞米和呋塞米治疗脑出血后急性脑水肿的临床应用分析

探究呋塞米与托拉塞米在脑出血后急性脑水肿患者临床治疗中的应用效果。选取我院收治的112例脑出血后急性脑水肿患者,随机将其划分为两组,对照组给予呋塞米,观察组接受托拉塞米,观察并比较两组患者治疗前后神经功能缺损程度(NIHSS)评分和日常生活能力(ADL)评分,以及临床疗效。观察组患者的治疗总有效率为85.7%,显著高于对照组的66.1%(P<0.05);治疗后,两组患者NIHSS评分和ADL评分改善情况均优于治疗前,且观察组优于对照组(P<0.05);观察组并发症发生率明显低于对照组(P<0.05)。对脑出血后急性脑水肿患者给予托拉塞米治疗,治疗效果要显著优于呋塞米,并发症发生率较低。     

硫酸镁湿敷联合艾灸对心血管疾病合并急性痛风治疗效果的影响

目的:对采用硫酸镁湿敷联合艾灸治疗心血管疾病合并急性痛风的临床护理措施及效果进行分析和研究。方法:将2014年12月~2016年10月我院心血管内科收治的60例心血管疾病合并急性痛风患者作为研究对象,随机等分成试验组和对照组,对照组实施常规治疗和护理,试验组进行硫酸镁湿敷联合艾灸治疗,比较两组治疗前后的疼痛评分和临床效果。结果:通过治疗和护理后,两组患者血尿酸(SUA)和C反应蛋白(CPR)均得到改善,且试验组改善幅度优于对照组,差异有统计意义(P0.05);试验组临床总有效率高于对照组,差异有统计意义(P0.05);试验组患者的疼痛程度低于对照组,差异有统计学意义(P0.05)。结论:对心血管疾病合并急性痛风患者在常规对症治疗和护理基础上进行硫酸镁湿敷和艾灸治疗,临床效果确切,可有效改善患者症状,提高临床疗效。     

小切口白内障摘除治疗急性闭角型青光眼合并白内障效果观察

目的探析小切口白内障摘除治疗急性闭角型青光眼合并白内障的临床应用效果。方法选取2014年1月至2016年6月收治的80例急性闭角型青光眼合并白内障患者,按随机数字法分为试验组与对照组各40例,对照组给予抗青光眼手术治疗,试验组给予小切口白内障摘除术治疗,对比两组患者的眼压、前房深度、视力矫正及并发症发生情况。结果治疗后两组患者眼压均明显下降,且试验组明显低于对照组(P0.05);两组患者前房深度明显增大,且试验组明显大于对照组(P0.05);在视力矫正、并发症发生率方面,试验组明显优于对照组(P0.05)。结论对急性闭角型青光眼合并白内障患者施行小切口白内障摘除术治疗,可以有效降低患者眼压,增大前房深度,矫正视力,减少并发症,可作为临床首选治疗方法予以推广应用。     

Hyponatraemia in Patients with Cirrhosis

Hyponatraemia occurs in nearly half of patients in hospitalwith cirrhosis and ascites, and is due to the excessive retentionof free water which results from the kidney's inability to excreteit normally. The morbidity and mortality associated with hyponatraemiais largely attributable to central nervous system disturbances.The degree to which brain water content increases depends onthe duration of hyponatraemia and on compensatory mechanisms.Altered steroid and peptide hormones in cirrhotic patients maycontribute to the development of hyponatraemia encephalopathy,symptoms of which overlap with hepatic encephalopathy and uraemia.The occurrence of central pontine myelinolysis is unrelatedto the rate of correction of hypnatraemia. The appearance ofhyponatraemia in cirrhotic patients, long regarded as a poorprognostic sign, may be a function of unrecognized underlyingimpaired renal function. Therapy for hyponatraemia remains suboptimal.     

Headache in Patients with Hypertension

SYNOPSIS
The relationship between high blood pressure and headache (HA) was assessed retrospectively among 241 patients attending a hypertension clinic. HA was common (45.6%), particularly among women (68%). Patients with systolic blood pressure higher than 170 mmHg andor diastolic blood pressure higher than 110 mmHg had nocturnal andor early morning HA more often. Fifty-four subjects became HA free during antihypertensive therapy. Their blood pressure (BP) decrease was significantly greater than the BP fall of those whose HA did not disappear with treatment. Nocturnal and early morning HA may be a symptom of hypertension in subjects with markedly elevated BP, and control of BP may be beneficial in some hypertensive patients.     

Headache in Patients with Cancer

Contemporary cancer research has led to unparalleled advances in therapeutics and improved survival. Even as treatment options continue to improve, quality of life should remain a priority. Headache drastically impacts the quality of life of patients with cancer and has a wide etiological scope, making diagnosis a challenge. Intracranial mass lesions are only one cause; others include extracranial tumors, paraneoplastic processes, and the consequences of diagnostic and therapeutic interventions used in cancer care. Fortunately, cancer-related headache is treatable, but a sound understanding of the variable etiologies is crucial to appropriate diagnostic evaluation and treatment. In this review, we highlight the important causes of headache in the patient with cancer, and consider the epidemiology, pathophysiology, clinical course, and treatment options for each.     

Defective Mononuclear Phagocyte Function in Patients with Myelomonocytic Leukemia and in Some Patients with Lymphoma

Mononuclear phagocytes from 8 of 10 patients with myelomonocytic leukemia and 2 of 9 patients with lymphoma phagocytized several species of bacteria but did not inhibit intracellular bacterial replication normally. Intracellular organisms were protected from the lethal effects of antibiotics in the medium. This defect of microbicidal function of malignant monocytes may explain in part the frequency of infection and the mechanism of antibiotic-resistant infection in some patients with malignant myeloproliferative and lymphoproliferative diseases.     

Risk of Dementia in Peritoneal Dialysis Patients Compared with Hemodialysis Patients

♦ Background: Compared with similarly aged controls, patients with end-stage renal disease (ESRD) have a higher prevalence of cognitive impairment and more rapid cognitive decline, which is not explained by traditional risk factors alone. Since previous small studies suggest an association of cognitive impairment with dialysis modality, we compared incident dementia among patients initiating hemodialysis (HD) vs peritoneal dialysis (PD) in a large national cohort.♦ Methods: This is a retrospective cohort study of incident dialysis patients in the United States from 2006 to 2008 with no diagnosis of dementia prior to beginning dialysis. We evaluated the effect of initial dialysis modality on incidence of dementia, diagnosed by Medicare claims data, adjusted for baseline demographic and clinical data from the USRDS registry.♦ Results: Our analysis included 121,623 patients, of whom 8,663 initiated dialysis on PD. The mean age of our cohort was 69.2 years. Patients who initiated PD had a lower cumulative incidence of dementia than those who initiated HD (1.0% vs 2.7%, 2.5% vs 5.3%, and 3.9% vs 7.3% at 1, 2, and 3 years, respectively). The risk of dementia for patients who started on PD was lower compared with those who started on HD, with a hazard ratio (HR) = 0.46 [0.41, 0.53], in an unadjusted model and HR 0.74 [0.64, 0.86] in a matched model.♦ Conclusions: Dialysis modality is associated with incident dementia in a cohort of older ESRD patients. This finding warrants further investigation of the effect of dialysis modality on cognitive function and evaluation for possible mechanisms.     

抑郁症患者注意功能的反应时研究

目的评定抑郁症患者的注意功能。方法 35例根据ICD-10和CCMD-Ⅲ诊断为抑郁症的患者以及与之在受教育程度、年龄、性别相匹配的35名健康人接受了持续注意、选择注意、注意瞬脱测试。结果与健康人相比，抑郁症被试在持续作业测试（CPT）中反应时延长，错误率增加；但反应时段差别无显著性差异。在Stroop颜色命名测试中，抑郁患者选择反应时延长，干扰效应明显。在注意瞬脱范式下，两组被试能同等程度地捕捉靶刺激，均存在注意瞬脱现象，但抑郁患者瞬脱更多，时间更长。结论抑郁症患者警觉性较差，Stroop干扰效应明显，注意瞬脱更多，时间更长。