纤维支气管镜诊治支气管异物78例分析

目的探讨纤维支气管镜在支气管异物诊治中的作用。方法回顾性分析经纤维支气管镜诊治的支气管异物78例。结果支气管异物右侧多见,以植物性异物多见,纤维支气管镜钳取支气管异物成功率达92.3%。结论异物吸入史不明确的支气管异物容易误漏诊。纤维支气管镜检查是诊治支气管异物的重要手段。     

2010-2014年湖南省某儿童医院异物伤害住院病例特征分析

目的 分析湖南省某儿童医院儿童异物伤害住院病例特征,为儿童异物伤害的防控提供一定依据。方法 从湖南省某儿童医院的医院信息系统中收集2010-2014年间确诊为异物伤害的患儿有关信息,采用描述性及单因素分析方法分析异物伤害的有关特征。结果 2010-2014年间异物伤害患儿住院3 782人次,患儿人次数呈逐年增加趋势,男女比例为1.77:1,呼吸道异物伤害性别比高于消化道异物伤害和其他异物伤害,异物伤害的高发年龄段为1~2岁,呼吸道异物伤害在儿童1～3月易发生,不同部位异物伤害治愈率均高于90%,住院天数逐年下降,而住院费用逐年上升,其中呼吸道异物伤害住院天数和住院费用均大于消化道和其他异物伤害。结论 应根据异物伤害住院病例特征,针对高危人群,高发年龄段,高发季节采取强化防控措施。     

食管异物含钡棉造影检查的临床价值

目的：评价食管异物含钡棉造影检查的临床价值。方法：食管异物患者36例,1例直接透视下见一较大高密度异物影。35例需行含钡棉造影。结果：33例细小异物,经过1次～4次钡棉造影,异物勾挂,异物下行至胃内。结论：食管异物含钡棉造影检查有利于处理细小异物。     

和家长谈谈儿童气道异物

正儿童气道异物是常见疾病,包括鼻腔、鼻窦异物、咽异物、喉异物、气管支气管异物、食管异物等。其中喉异物、气管异物属于儿童急重疾病,需要及时处理;而鼻腔鼻窦异物、食道异物在手术处理中及术后会有较为严重的并发症,也是需要引起高度重视的。鼻腔异物为儿童常见异物性疾病,绝大多数只需在门诊处理即可,部分病人需要在麻醉下经鼻内镜手术取出。临床症状有:     

耳鼻咽喉异物的临床诊治与分析

目的研究耳鼻咽喉医务的临床诊断及治疗分析。方法选择我院2010年1月～2012年1月期间在我院进行治疗的980例耳鼻咽喉存在异物的患者资料,总结其异物的种类及存在的部位,分析其误诊的可能原因。结果980例患者中,咽部异物患者最多,占92％,食管异物患者占3％,鼻腔异物与外耳道异物的患者均占4％,支气管异物患者占1％。结论耳鼻咽喉异物患者中,咽部异物患者较多,食管异物、鼻腔异物、外耳道异物惠者数量相当。临床医生在询问病史时,要认真细致的进行询问,仔细检查,避免漏诊误诊。     

自制鼻腔异物取出器的设计与临床应用

目的：探讨和研究应用自制小儿鼻腔异物取出器治疗小儿圆形类鼻腔异物的疗效及其影响.方法：回顾分析172 例鼻腔异物患儿使用自制小儿鼻腔异物取出器在门、急诊治疗小儿鼻腔异物患儿的临床资料.结果：172 例患儿鼻腔异物全部一次性取出,成功率100%,未出现鼻出血、气管异物及食管异物等并发症.结论：自制小儿鼻腔异物取出器设计合理,操作简单,且并发症少,特别是解决了以往临床医生对于鼻腔异物患儿内球形及表面光滑异物的治疗,填补了无专用该类器械的空白,值得进一步在临床上推广应用.     

面颈部异物存留39例临床分析

面颈部异物是口腔颌面外科近年来常见的病种。日常工作和生活中，因外伤造成面颈部异物存留时有发生。存留异物分金属性异物和非金属性异物，金属性异物可通过X线确诊，而非金属异物在X线上不显影，诊断上有一定困难，常易漏诊。我科自1989年～2003年共收治面颈部异物存留病例39例，现报告如下。     

谈谈对眼角膜异物取出的体会

目的:探讨对眼角膜异物的取出术。方法:掌握确定了异物的种类及异物的位置,小心进行清除。结果:通过数例眼角膜异物的清除,效果都非常好。结论:只要细心、耐心、小心取眼角膜异物,所有异物都能取出来。     

气管异物，险!现场抢救，快!

孩子发生气管异物，家长必须谨记：“异物堵喉间，生死一瞬间”。因为当孩子发生气管异物时，若异物完全堵住气管，不迅速排出异物，几分钟就可能窒息致命，假若延时排除异物，也可能会留下真正的“脑残”。气管异物多发生于5岁以下的小儿，其原因主要有以下6点。     

小儿异物的预防及处理

小儿异物在生活中比成人异物常见,危害性大,为小儿急症,是引起小儿死亡的常见原因之一。小儿异物的表现、急救及预防又与成人异物有所不同。结合2013~2019年我们在值班工作中遇到的小儿异物病例,本文着重就小儿异物的表现、急救及预防给大家进行简单科普。     

多层螺旋CT在食管食源性骨性异物穿孔中的诊断价值

目的分析食管食源性骨性异物穿孔多层螺旋CT表现,提高对食管异物穿孔诊断及并发症的认识。方法搜集行CT检查的食管异物患者资料45例,并结合X线表现进行回顾性对比分析。结果 X线表现：①食管穿孔14例,大块骨异物35例,小块骨异物8例,未发现异物2例。②CT表现：食管穿孔45例,食管周围炎31例,食管脓肿4例,食管-气管瘘2例,食管-纵隔瘘3例,吸入性肺炎5例,气胸1例。结论多层螺旋CT采用VR、MIP等后处理技术是诊断食管食源性骨性异物穿孔的首选方法,对发现食管小骨块异物穿孔等并发症的检出率显著高于食道造影检查,具有很高的敏感性。     

胃镜下取食道异物21例临床资料分析

近2年6374例胃镜检查者中，发现食道异物21例，检出率为0．33％，男性为主16例(76％)，年龄在20～60岁占多数，13例(62％)，异物类型以金属物多见13例(62％)，多嵌于食管上段14例(66．7％)，成功取出19例(90．5％)，患者多伴有胸骨后疼痛，吞咽困难等不适。目前，胃镜下异物钳取术仍是首选方法。     

野战清创冲洗机的研制

目的:为满足野战条件下的清创需要,研制一种携带、使用方便,清创效果好的野战清创冲洗机.方法:根据脉冲水流能高效清除异物的原理设计该清创机,它由外壳、电池、水泵、压力调节器、脉冲控制器、喷嘴等组成.结果:该机质量小,结构紧凑,在临床应用中取得了较好的效果.结论:该机携带、使用方便,能有效提高野战清创的效果,降低感染率.     

我院DR摄影重复检查的原因分析

目的分析我院DR重复摄影的原因及预防措施。方法应用KODAK DR7500;PHILIPSDR2.0,对我院2008年10月至2010年12月,DR重复摄片413例（男254例、女159例）进行分析。结果所拍部位影像包括不全,影响诊断152例;患者不能很好配合132例;拍片位置不正确49例;技术操作人员操作失误18例;体外异物产生伪影27例;机器故障引起图像信息丢失3例;拍片部位与申请单不符15例。结论 DR摄影重复检查率相比CR及传统摄影已大幅下降,但重复检查还是无法避免。从对413例重复检查的原因分析可以看出,许多重复检查可以通过操作人员的努力、患者及其陪护人员的积极配合减到最低程度。     

桐乡市0~14岁儿童意外伤害发生情况及危险因素研究

【目的】 分析0~14岁儿童意外伤害的发生情况及其相关因素,为制定相关干预措施提供依据。 【方法】 以2009-2011年在桐乡市第二人民医院首次就诊的意外伤害儿童为对象,采用横断面调查的方法对4 661例意外伤害儿童所填写的《浙江省医院伤害监测病例登记表》进行资料分析。 【结果】 儿童意外伤害占全部意外伤害的10.07%,男童占63.25%,明显高于女童;2~3岁儿童的意外伤害为高发年龄段;10月份为儿童意外伤害发生最多月份;意外伤害发生原因居于前三位的分别为跌伤/坠落(54.2%)、交通伤(13.5%)、异物入眼耳鼻咽(8.7%);导致严重伤害的主要以交通伤为主。 【结论】 相关部门应针对儿童意外伤害发生情况采取有重点的各类干预措施,降低其死亡率和致残率。     

An Outbreak of Pruritic Skin Lesions in a Group of Laboratory Workers A Case Report

In May 1993, an outbreak of pruritic skin lesions occurred amonga group of employees located in tour laboratories in the basementof an office building. Medical interviews with the affectedworkers were performed and an industrial hygiene survey of thesite was conducted. Workers commonly reported a prickling sensationon exposed skin. Four of the workers had small (<5mm) erythematouspapules on their forearms. Just prior to the outbreak, the installationof fibrous glass insulation had commenced in the mechanicalrooms which provided air to the basement of the building. Becauseof the nature of the symptoms and the temporal relationshipwith the nearby insulation work, direct skin contact with fibrousglass fibres was thought to be the cause of the outbreak. Thepoorly maintained air handling unit supplying air to the laboratoriesprobably contributed to this outbreak by inefficient filteringof the circulating air.     

Les cellules endothéliales du tissu adipeux

The adipose tissue plays a major role in energy homeostasis through the storage and release of fatty acids as well as adipokine production. The endothelial cells of the adipose tissue vascular network constitute a barrier between the blood and the adipocyte compartments. They are key players in the metabolic status of the fat mass controlling the exchanges of nutrients, hormones, oxygen and immune-inflammatory cells. Recent data highlight the process of lipid handling at the endothelial cell surface and of the transendothelial transit of fatty acids. The extension of the vascular network and its functionality are necessary for the adipose tissue integrity. Insufficient oxygen supply generates hypoxic area within the tissue that favors metabolic abnormalities and the recruitment of immuno-inflammatory cells. The present review relates to the role of adipose tissue endothelial cells in the adipose tissue physiology. Their involvement and more particularly the role of accelerated ageing, in the link between obesity and associated metabolic and cardiovascular pathologies are described.     

Ethical requirements for occupational health research--compliance arrangements for a single company in relation to a recent major nuclear industry study.

The media coverage given to occupational health studies in the field of ionizing radiation has, on occasion, been the cause of very real distress to radiation workers and their families. In response to this situation the Chief Medical Officers of the major UK nuclear companies developed an ethical policy for future involvement in research, based on the duty of care which researchers owe to a key customer of such studies: the worker. The policy consists of four principal elements: medical confidentiality; worker information; worker consent and the guarantee of the availability to the workers of pre-publication knowledge of the results. The policy issued in 1991/92 has achieved growing acceptance among researchers and medical journals, though the medical officers involved have been aware of some scepticism, particularly in relation to the practicalities of the dissemination of pre-publication information. The Record Linkage Study published in November 1997 marked a major piece of research work involving data from 120,000 radiation workers that had been carried out since the development of the policy. This paper reports on the successful compliance arrangements to meet the ethical requirements of that study within a single UK nuclear company, and is published to demonstrate that with commitment from researchers, the journal and occupational health staff such ethical requirements, and particularly the need for pre-publication information can be met in full.     

Occupational Health Services in Manufacturing Industries in Nigeria

The provision of adequate health care facilities to cater forthe health of workers is an important consideration in the managementof manufacturing industries, since productivity is dependenton the health status of the workers. There are very few studiesevaluating the health care provision in Nigerian industries.This study elucidates such health care services in Edo and DeltaStates of Nigeria. One hundred and thirty-five (56%) of the241 registered manufacturing industries in Edo and Delta Statesof Nigeria were randomly selected and investigated. The responserate was 91.1% and the result showed that the medical staffcomprised 2.5% of the total workforce, with the large scaleindustries contributing the highest proportion of these. Fourpoint five per cent of the medical staff had formal trainingin occupational health and 15.6% of them visited the factoryshop floor. The doctor:staff ratio in the medium and large scaleindustries were 1:819 and 1:618 respectively. It was found thatall the industries used the health care facilities providedby the government, there were no clinics in all the small scaleindustries and group practice was not used by any of the industriesstudied. Pre-employment medical examinations were carried outin each of the groups of industries (100%, 39.4% and 5%) respectively,as were periodic medical examinations during employment, althoughto a lesser extent (100%, 13.2%, 0%) for the large, medium andsmall scale industries respectively. These finding suggest theavailability of a reasonable standard of health care provisionfor large scale industries and somewhat less availability formedium and small scale industries. Health education of boththe employers of labour, and the employees and the enforcementof existing laws are needed to improve the existing standardof occupational health services.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.