小细胞肺癌患者的护理措施

1 化疗的护理 (1)胃肠道反应:应用化疗药物时常出现恶心、呕吐、食欲不振等不良反应.出现恶心、呕吐时,应减慢药物滴注速度;遵医嘱应用灭吐灵、氯丙嗪等药物,有助于缓解恶心,呕吐.化疗前、后2h内避免进食;少量多餐;避免不良气味刺激等,也有助于减轻恶心、呕吐.进食色,香、味俱全,清淡,适合病人口味的食物及良好的进餐环境,可促进食欲.     

健康教育减轻化疗后恶心、呕吐的效果观察

化疗是治疗恶性肿瘤的重要方法之一。恶心、呕吐反应是患者对化疗最常担忧和恐惧的不良反应。大量临床资料表明，尽管在化疗过程中使用不断更新的止吐药，仍有60％的化疗患者出现恶心、呕吐，进而影响患者食欲，严重危害其身心健康。健康教育作为一种辅助性治疗手段，可减轻化疗引起的恶心、呕吐症状。2004年10月～2006年1月，我院对64例化疗患者，实施了健康教育，取得了一定效果，报告如下。     

滋养细胞肿瘤化疗反应的护理

近年来我院收治滋养细胞肿瘤化疗病人 30例 ,现就护理体会报告如下。1　临床资料30例化疗病人中出现消化道反应 15例 ,阴道流血 6例 ,皮肤粘膜改变 4例 ,脱发 4例。2　护理2 1　体重护理据统计有 16 6 7%患者体重减轻 ,使抵抗力下降。故应少量多餐 ,增加多种营养物质及少量元素 ,严重者给予血浆蛋白、氨基酸等。2 2　消化道护理化疗后病人出现食欲不振、恶心呕吐、腹泻等消化道反应。因此 ,化疗期间应保证营养与水份的摄取。病人因病程较长 ,身体消耗较大 ,加上药物反应常影响食欲、故应给予高蛋白、高维生素、高热量饮食。要了解病人的…     

探索抗结核药物治疗后肝损伤相关症状与肝损伤的关系

目的:探讨并研究肺结核患者在接受抗结核药物治疗后肝损伤相关症状和肝损伤的相关性。方法:选取320例肺结核患者,记录抗结核药物服药和不良反应发生情况,并分析相关症状和肝损伤的关联。结果:320例肺结核患者中,有170例出现肝损伤相关临床症状,分析显示:女性、既往化疗史、每天服药的患者在服药后出现肝损伤相关症状的几率更高,差异有统计学意义(P<0.05);以出现肝损伤为因变量,构建多因素Logistic回归分析模型,将相关临床症状作为自变量纳入分析。结果显示恶心呕吐、纳差、腹胀腹泻、出疹是导致肝损伤的危险因素。结论:肺结核患者在抗结核药物治疗时,患者出现肝损伤的相关临床症状较高;当发现患者出现恶心、呕吐、腹胀、腹泻、纳差、出疹等症状,则出现肝损伤的危险性较高。     

香砂六君子汤联合昂丹司琼治疗化疗后消化道不良反应50例疗效观察

目的观察香砂六君子汤治疗恶性肿瘤化疗后消化道不良反应恶心、呕吐、腹泻食欲不振的疗效.方法 将100例恶性肿瘤进行化疗之患者随机分为两组各50例治疗.对照组:单纯使用西药昂丹司琼、胃复安等治疗,治疗组:在对照组治疗基础上同时服用香砂六君子汤水煎剂.两组临床资料相同,观察治疗前后恶心、呕吐腹泻食欲不振变化情况及临床疗效.结果 总有效率(显效+有效率治疗组为96﹪,对照组60﹪.两组总有效率比较有显著差异(p<0.01).结论 香砂六君子汤联合昂丹司琼对治疗恶性肿瘤所致消化道不良反应可有效改善临床症状,有良好的疗效.     

漫话乙型肝炎

已为人们所熟知,乙型肝炎是感染乙型肝炎病毒引起。感染后要经过一段比甲型肝炎较长的潜伏期(6周～6个月)方开始发病。出现临床症状,如食欲不振、乏力、腹胀、恶心、呕吐等,部分病人出现黄疸。大多数病人经过3～4个月可完全恢复健康,只     

胃复安预防化疗胃肠道反应而引起锥体外系症状30例分析

<正> 胃复安(灭吐灵)为胃肠系统疾病常用的止吐药物,在肿瘤化疗中常用以减轻化疗药物引起的恶心、呕吐胃肠道副反应,保证化疗顺利进行,但胃复安用量较大,易引起锥体外系症状的副作用。近10年我院共发现化疗患者出现锥体外系症状30例,现分析如下。 1 临床资料 1.1 一般资料 30例患者均为本院病人,其中男性13例,女性17例;年龄1～70岁,平均年龄41.2岁。30例化疗患者既往无神经系统病史,在化疗中使用胃复安后才出现锥体外系症状,停服此药或使用费定后,锥体外系症状消失。     

压力与适应理论在胃癌术后化疗所致功能性消化不良患者护理中的应用效果

目的:观察压力与适应理论在胃癌术后化疗所致功能性消化不良(FD)患者护理中的应用效果。方法:选取90例胃癌术后化疗所致FD患者为研究对象,按照随机数字表法分为研究组46例与对照组44例。对照组采用常规护理,研究组在对照组基础上采用基于压力与适应理论的护理,比较两组临床症状(反酸嗳气、呕吐恶心、腹痛腹胀、食欲不振)消失时间、自我护理能力测定表(ESCA)评分、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分和护理满意度。结果:研究组反酸嗳气、呕吐恶心、腹痛腹胀、食欲不振等临床症状消失时间均短于对照组,差异有统计学意义(P<0.05);出院时,两组ESCA评分均高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05);出院时,两组SAS和SDS评分均低于护理前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组护理满意度为95.65%,明显高于对照组的75.00%,差异有统计学意义(P<0.05)。结论:在常规护理基础上采用以压力与适应理论为指导的护理可有效缩短胃癌术后化疗所致FD患者的临床症状消失时间,提高其ESCA评分和护理满意度,降低其SAS和SDS评分,效果优于单纯常规护理。     

化疗引起恶心、呕吐的观察和护理

化疗是目前治疗恶性肿瘤的主要手段之一 ,其副作用恶心、呕吐是一个常见的并发症 ,若治疗护理不当 ,则影响病人治疗的连续性。如何预防和控制化疗引起的恶心、呕吐 ,保证肿瘤病人药物治疗的顺利进行 ,是肿瘤护理工作者的一项新课题。笔者将在临床观察中的护理体会总结如下。1　临床资料1 .1　一般资料　本组化疗例数 98例 ,其中男性 70例 ,女性 2 8例 ,年龄 35～ 68岁 ,发生恶心、呕吐 30例 ,经密切观察及药物治疗和护理 ,恶心、呕吐症状得到有效控制 ,病人均安全度过化疗期。1 .2　临床观察1 .2 .1　恶心、呕吐的表现形式　 ( 1 )立即呕吐 …     

米氮平治疗化疗患者恶心呕吐的自身对照研究

采用自身对照研究的方法,化疗中出现恶心呕吐的患者下周期化疗入试验组,止吐治疗方案：与上周期相同的5-羟色胺阻滞剂等常规止吐治疗的基础上加用米氮平30 mg口服每晚,化疗前1 d、化疗当天和化疗结束后1 d,连用3 d,共入组54例患者。不良反应参照美国国立癌症研究所的常规毒性判定标准 NCI-CTCAE 3.0。结果显示试验组发生恶心呕吐46例,发生率85.2%,较对照组差异有统计学意义(P<0.05)。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.