妇科合并2型糖尿病患者围手术期应用胰岛素泵的体会

目的：探讨胰岛素泵治疗妇科合并2型糖尿病围手术期的疗效。方法150例合并2型糖尿病的妇科患者围手术期采用胰岛素泵持续皮下注射门冬胰岛素,根据血糖调整基础量及餐前大剂量。比较2组治疗前空腹血糖及餐后2h血糖和治疗后空腹血糖及餐后2h水平,术前控制血糖时间、低血糖发生率、术前血糖达标所用的胰岛素总量、平均住院时间、术后感染及延迟愈合率。结果2组治疗前空腹血糖及餐后2h血糖和治疗后空腹血糖及餐后2 h水平差异均无统计学意义（ P ＞0．05）;术前控制血糖时间、低血糖发生率、术前血糖达标所用的胰岛素总量、平均住院时间、术后感染及延迟愈合率治疗组优于对照组（ P ＜0．05）。结论术前控制血糖时间、低血糖发生率、术前血糖达标所用的胰岛素总量、平均住院时间、术后感染及延迟愈合率治疗组均优于对照组,采用胰岛素泵持续皮下注射胰岛素法更适合妇科患者合并糖尿病围手术期使用。     

胰岛素泵治疗糖尿病合并感染患者的疗效观察

目的探讨胰岛素泵治疗在糖尿病合并感染治疗中的效果。方法在本溪市社会福利院抽取糖尿病合并感染患者65例,分为两组:胰岛素泵持续皮下输注治疗30例(观察组),多次胰岛素皮下注射治疗35例(对照组)。比较两组患者治疗后血糖变化及血糖达标时间、胰岛素泵用量、低血糖发生率、住院时间等的差异。结果治疗后两组患者血糖均明显下降(P<0.01),观察组对空腹血糖的控制优于对照组(P<0.05),血糖达标时间、胰岛素泵用量、低血糖发生率均低于对照组(P<0.05)。结论在糖尿病合并感染患者应用胰岛素泵治疗可迅速控制血糖,缩短血糖达标时间,减少低血糖的发生。     

老年糖尿病患者短期强化治疗方案的综合比较

目的:比较胰岛素泵持续皮下注射与多次胰岛素皮下注射治疗老年糖尿病患者的血糖达标时间及其安全性。方法:选取2013年3月—2014年9月强化治疗的2型糖尿病老年患者186例,根据强化治疗方案分成两组:持续胰岛素泵皮下注射组(CSII组)和多次胰岛素皮下注射组(MDI组),从强化治疗开始计时,以空腹血糖(FBG)<8.0mmol/L,餐后2 h血糖(2 h BG)<11.0 mmol/L为观察终点,比较两组达标时间、胰岛素用量及低血糖发生率。结果:强化治疗前后患者各个时段血糖水平差异无统计学意义(P<0.05),但是MDI组与CSII组比较血糖达标所需时间长(P<0.05),低血糖发生率较高,胰岛素每日总用量大(前者基础量小,餐前追加量大)。结论:CSII组与MDI组比较,二者均能降糖达标,但前者更有效、更安全。     

胰岛素泵与二甲双胍联用治疗糖尿病疗效观察

目的观察胰岛素泵治疗2型糖尿病患者的疗效性和安全性。方法将本院住院患者98例进行随机分为两组,对于随机血糖〉20 mmol/L、空腹静脉血糖〉13.9 mmol/L或血糖日间波动〉11.1mmol/L的患者进行随机分组治疗,治疗组45例,采用胰岛素泵加二甲双胍口服治疗,对照组43例,予以胰岛素笔加用二甲双胍治疗控制血糖。观察两组在胰岛素用量、血糖纠正时间、血糖达标时间和低血糖发生率的变化。结果治疗组3～5 d后血糖基本达标,并根据胰岛素用量改用胰岛素笔或口服药物控制血糖,10 d左右血糖控制达标出院。对照组予以胰岛素笔控制血糖加二甲双胍控制血糖,而血糖达标时间延长,低血糖发生率高。结论胰岛素泵治疗糖尿病血糖波动大及血糖较高者,血糖平稳控制,低血糖发生率低,有利于血糖控制,比较安全。     

糖尿病治疗中胰岛素泵的应用研究效果

目的探讨胰岛素泵应用在糖尿病中的效果。方法抽取我院接诊的糖尿病患者90例进行研究,按照随机数字法分为2组,各45例,两组均采取诺和锐(门冬胰岛素)治疗,其中对照组采取传统注射,研究组采取胰岛素泵泵注。观察记录两组患者治疗前后空腹血糖、餐后2 h血糖,以及血糖达标时间、低血糖发生率,并对比分析。结果两组治疗后空腹血糖、餐后2 h血糖均有明显改善(P<0.05),但研究组改善更明显(P<0.05);研究组血糖达标时间明显更短,而低血糖发生率显著更低,组间对比有统计学意义(P<0.05)。结论胰岛素泵应用在糖尿病患者中可取得不错的效果,提高疗效,减少低血糖发生,值得借鉴。     

胰岛素泵在2型糖尿病患者强化治疗中的护理观察

目的 观察胰岛素泵和胰岛素笔在2型糖尿病患者强化治疗中的效果差异.方法 将2型糖尿病随机分成胰岛素泵组(实验组)和胰岛素笔组(对照组);胰岛素泵组患者采用胰岛素泵对2型糖尿病患者进行强化降糖治疗,胰岛素笔组患者采用胰岛素笔对2型糖尿病患者进行强化降糖治疗.结果 胰岛素泵组与胰岛素笔组相比,在血糖达标所需时间、胰岛素用量、低血糖发生率比较,差异均有统计学意义(P＜0.05).结论 胰岛素泵和胰岛素笔对2型糖尿病患者强化治疗均有效,但胰岛素泵降糖效果优于胰岛素笔,安全性更强.     

胰岛素泵在骨折合并糖尿病患者围手术期的使用护理体会

目的观察骨折合并糖尿病患者围术期应用胰岛素泵进行治疗的效果,探讨其使用效果及护理安全性。方法将40例骨折合并糖尿病患者随机分为观察组和对照组,每组20例,两组患者均采用胰岛素治疗。观察组采用胰岛素泵皮下连续注射法,对照组采用多次皮下注射法。观察并比较两组患者治疗效果,包括空腹血糖、餐后血糖、血糖达标时间、低血糖发生情况。结果两组患者均有效控制血糖;观察组血糖达标时间短于对照组,且并发症均少于对照组。结论胰岛素泵用于骨折合并糖尿病患者控制血糖效果满意,安全性高。     

两种注射胰岛素方式治疗糖尿病效果比较

目的：观察两种不同注射胰岛素方法治疗糖尿病的临床效果,为糖尿病治疗提供参考。方法将我院收治的136例糖尿病患者按照入院时间先后分为对照组与观察组,各68例。对照组采用多次皮下胰岛素注射治疗,观察组采用胰岛素泵连续皮下注射治疗。两组治疗期间严格控制饮食及采用辅助运动治疗,并停用其他降糖药物。对比两组患者治疗过程中空腹血糖、餐后2h 血糖、每日平均胰岛素用量、血糖达标时间、低血糖发生率。结果两组治疗后空腹血糖与治疗前比较、三餐后2h 给药后血糖与给药前比较,均有明显下降,观察组均降至正常,对照组仍略高于正常,两组差异有统计学意义。对照组的平均每日胰岛素用量多于观察组,血糖达标时间长于观察组,治疗过程中低血糖发生率低于对照组,差异有统计学意义。结论糖尿病患者采用胰岛素泵连续皮下注射治疗安全、效果稳定、简单易行,能够满足治疗要求。     

胰岛素泵治疗初诊2型糖尿病的疗效观察

目的伴明显高血糖的初诊2型糖尿病患者104例随机分为CSII组和MDII组,观察空腹血糖、餐后血糖、血糖达标时间、胰岛素平均用量及低血糖发生率的差异。方法观察组持续胰岛素皮下输注(CSII组)52例,采用胰岛素泵持续诺和锐皮下输注,对照组多次胰岛素皮下注射组(MDII组)52例,采用每日三餐前皮下注射诺和锐及睡前皮下注射长秀霖。结果两种方法均可较好地控制血糖(P<0.05),且CSII组,空腹血糖及餐后血糖下降均优于MDII组(P<0.05),血糖达标时间及胰岛素平均用量、低血糖发生率均明显少于MDII组(P<0.01)。结论 CSII更能有效模拟人生理胰岛素分泌,使用胰岛素剂量更少、更安全、更快、更有效控制高血糖,是治疗伴明显高血糖的初诊2型糖尿病患者的有效方法。     

2型糖尿病昏迷时采用来得时与泵治疗的对比

目的探讨2型糖尿病患者在昏迷状态时采用甘精胰岛素与胰岛素泵治疗的临床疗效观察。方法将40例2型糖尿病合并昏迷的患者分为二组,一组采用甘精胰岛素皮下注射降糖治疗,一组采用胰岛素泵给予基础量降糖治疗,比较治疗后两组控制血糖时间、平均空腹血糖、平均随机血糖、胰岛素用量、低血糖发生率、降血糖平均费用。结果甘精胰岛素组在控制血糖时间、平均空腹血糖、平均随机血糖、胰岛素用量、低血糖发生率等方面与胰岛素泵组无显著性差异(p>0.05)。甘精胰岛素组在降血糖的平均费用上显著低于胰岛素泵组(p<0.01)。结论2型糖尿病患者合并昏迷时应用甘精胰岛素治疗其疗效与应用胰岛素泵治疗疗效接近,但治疗费用明显低于胰岛素泵。     

颅脑损伤患者并发肺部感染的护理体会

目的：为了使并发肺部感染的病人更多、更好、更早的痊愈。方法：通过对32例颅脑外伤并发肺部感染病人的严密观察,采取更换体位、超声雾化、有效排痰训练等有效的护理措施干预,从而控制了肺部感染。结果：痊愈17例,占53.1%;显效12例,占37.5%,无效2例,占6.2%;死亡1例,占3.1%;实践证明,有效的护理干预对提高患者治疗成功率有着重要意义。     

卡马西平联用尼美舒利相关粒细胞缺乏症

1例78岁男性患者因带状疱疹神经痛、慢性阻塞性肺疾病合并感染,给予头孢唑肟钠（2.25 g静脉滴注,1次/d）、卡马西平（0.2 g口服,2次/d）、尼美舒利（100 mg口服,2次/d）、二羟丙茶碱（0.5 g静脉滴注,1次/d）、甲钴胺（0.5 mg口服,3次/d）、地塞米松（5 mg,静脉滴注1次）、盐酸哌替啶（25 mg,肌内注射1次）和盐酸布桂嗪（100 mg,肌内注射3次）等药物治疗。第7天,停用头孢唑肟钠,改为磷霉素钠（8 g静脉滴注,1次/d）。第11天,血常规检查示白细胞计数1.6×10^9/L,中性粒细胞0.03,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.9×10^9/L。立即停用所有药物,给予对症支持治疗。第15天,外周血白细胞计数0.9×10^9/L,中性粒细胞0.02,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.7×10^9/L。行骨髓穿刺检查,诊断为粒细胞缺乏症。第17天患者出现右肺气胸、肺不张。第20天出现急性呼吸衰竭、多脏器衰竭合并重症感染,经抢救无效死亡。     

Satisfaction with information and its relationship with adherence in patients with chronic pain

□ Due to the nature of chronic pain it would be expected that patients are highly adherent to their pain medication. However, results from this study have shown that 23 per cent of patients often or always avoid using their pain medication, 13.4 per cent often or always alter dosages, and 10.3 per cent often or always stop taking their medication for a while. This suggests intentional non‐adherence to pain medication □ Less than 50 per cent of respondents were satisfied with information provided on side effects, what to do if side effects occur, and possible interactions with other medication □ Patients' satisfaction with information about their medication was related to self‐reported adherence; greater satisfaction was associated with higher self‐reported adherence     

Genomic profiling associated with recurrence in patients with rectal cancer treated with chemoradiation

PURPOSE: Stage II and III adenocarcinoma of the rectum has an overall 5-year survival rate of approximately 50%, and tumor recurrence remains a major problem despite an improvement in local control through chemotherapy and radiation. The efficacy of chemoradiation therapy may be significantly compromised as a result of interindividual variations in clinical response and host toxicity. Therefore, it is imperative to identify those patients who will benefit from chemoradiation therapy and those who will develop recurrent disease. In this study, we tested whether a specific pattern of 21 polymorphisms in 18 genes involved in the critical pathways of cancer progression (i.e., drug metabolism, tumor microenvironment, cell cycle regulation, and DNA repair) will predict the risk of tumor recurrence in rectal cancer patients treated with chemoradiation. PATIENTS AND METHODS: A total of 90 patients with Stage II or III rectal cancer treated with chemoradiation were genotyped using polymerase chain reaction (PCR)-based techniques for 21 polymorphisms. RESULTS: A polymorphism in interleukin (IL)-8 was individually associated with risk of recurrence. Classification and regression tree analysis of all polymorphisms and clinical variables developed a risk tree including the following variables: node status, IL-8, intracellular adhesion molecule-1, transforming growth factor-beta, and fibroblast growth factor receptor 4. CONCLUSION: Genomic profiling may help to identify patients who are at high risk for developing tumor recurrence, and those who are more likely to benefit from chemoradiation therapy. A larger prospective study is needed to validate these preliminary data using germline polymorphisms on tumor recurrences in rectal cancer patients treated with chemoradiation.     

甘草酸单铵结合氦-氖激光治疗银屑病62例

目的用甘草酸单铵结合低能量氦-氖激光,观察治疗银屑病患者。方法62例寻常型银屑病患者,分为两组,A组用低能量氦-氖激光血管内照射,同时用甘草酸单铵静脉滴注,共36例;B组仅用甘草酸单铵,共26例。通过30d治疗。结果总有效率82.2%,其中A组有效率88.9%,B组73.1%(经Ridit检验,U＝2.76,P＜0.01),两组差异有极显著性意义。结论甘草酸单铵结合氦-氖激光治疗银屑病,比单用甘草酸单铵效果好。     

A fetus with meckel-gruber syndrome associated with isomerism

Abstract. Meckel-Gruber syndrome (MKS) is an autosomal recessive lethal malformation. As far as we know, the rate of incidence for the syndrome is 0.02 per 10,000 births. It is estimated that Meckel-Gruber syndrome accounts for 5% of all neural tube defects in Finland. Objective. The aim of this study is to present a case of a fetus with Meckel-Gruber syndrome associated with complete left isomerism. Method. The fetus was obtained after medical interruption of the pregnancy during the fifteenth gestational week. The mother was 36 years old and in a consanguineous marriage. The antenatal ultrasound examination revealed a polymalformative syndrome, leading to a postmortem examination. The fetopathological study of the fetus was conducted at the Centre for Maternity and Neonatology, Tunis, Tunisia, in 2008. Results. The female fetus had a significantly deformed ballooning abdomen, pes equinovarus, flexion of the wrist and a total posterior cleft palate. The central nervous system abnormalities were occipital encephalocele, cystic dilatation of the fourth ventricle, agenesis of corpus callosum and hydrocephalus. The study of the internal organs found dextrocardia, irregular lobulation of the lungs, left isomerism, and polysplenia. The microscopic examination revealed bilateral cystic dilation of the kidneys, fibrous proliferation of the liver and ectasic dilatation of the billiary ducts, representing a ductal plate malformation of the liver. Conclusion. The case is diagnosed with Meckel-Gruber syndrome associated with complete left isomerism, cleft palate and possibly Dandy-Walker syndrome.