简易CPAP鼻塞治疗新生儿肺透明膜病的临床应用

持续气道正压 (CPAP)给氧 ,在临床上主要用于新生儿常见的呼吸系统的疾病 ,如新生儿肺透明膜病 (HMD) ,本病多见于早产儿、剖宫产儿和糖尿病母亲所生的新生儿。新生儿肺透明膜病 (HMD)患儿 ,在有自主呼吸的情况下 ,早用CPAP治疗是降低病死率的关键。我科采用自制简易CPAP鼻塞治疗HMD ,1998年 1月至 2 0 0 1年 12月共治疗 6 3例 ,临床效果良好。资料与方法1 鼻塞制作　将橡皮管 1根 ,长约 30cm ,新生儿用的一次性吸痰管 1根。将吸痰管剪成 1.5cm长的短截 ,在橡皮管的中段纵行刺 2个洞 ,其间距分两种规格 0 .8cm ,1.2cm ,将截短的吸…     

PRVC模式治疗新生儿肺透明膜病

目的 探讨PRVC模式在新生儿HMD治疗中的应用。方法 对我院NICU中确诊的22例新生儿HMD行气管插管及PRVC模式呼吸机辅助呼吸进行分析。结果 PRVC模式的小通气量能降低新生儿HMD死亡率；结论 PRVC模式适于新生儿HMD。     

呼吸机鼻塞持续气道正压呼吸治疗新生儿肺透明膜病临床观察

目的观察改良的呼吸机鼻塞法持续气道正压呼吸(CPAP)治疗新生儿肺透明膜病的疗效和不良反应。方法将传统的简易鼻塞CPAP方法进行改良,接水封瓶一端导管夹闭,另一端接呼吸机。改良CPAP组30例为治疗组,简易CPAP组25例为对照组,比较分析两组病例的临床资料。结果治疗组总有效率为93.33%,对照组总有效率为68.00%,两组比较有显著性差异。结论呼吸机鼻塞CPAP比传统的简易CPAP具有疗效好,不良反应少等优点。     

简易鼻塞式CPAP在新生儿呼吸衰竭的应用

目的：探讨简易鼻塞式持续呼吸道正压给氧（CPAP）治疗新生儿呼吸衰竭（呼衰）的疗效。方法：采用简易鼻塞式CPAP对42例呼衰新生儿进行给氧，在CPAP前后作动脉血气对比分析。结果：CPAP后动脉血氧分压（PaO2）经皮测血氧饱和度（SaO2）明显升高，差异有显著性意义（p＜0.01），血pH值，动脉血二氧化碳分压（PaCO2）变化差异无显著性意义（p＞0．05）。结论：CPAP可以改善呼衰新生儿的缺氧症状，提高血PaO2，但不能明显缓解血二氧化碳潴留，降低血PaCO2。     

肺表面活性物质替代治疗新生儿肺透明膜病临床研究

目的分析肺表面活性物质治疗肺透明膜病(HMD)的疗效及临床价值.方法观察20例HMD患儿Exsurf治疗前后肺功能机械通气参数及肺泡充气程度的变化.结果用药前后PaO2、动脉-肺泡氧分压比值上升为44±15～93±44mmHg、0.11±0.05～0.22±0.04,PaO2、PaCO2、氧合指数、动脉-肺泡氧分压比值治疗前后比较差异均有非常显著性(p<0.01),用药后12h机械通气参数较治疗前明显下降(p<0.05～0.01),用药后12h胸片提示肺部病变明显改善.用药后肺炎,颅内出血并发症为70%和35%.结论HMD患儿Exsurf治疗后肺功能和肺泡充气程度明显改善.     

简易鼻塞CPAP联合大剂量沐舒坦治疗HMD的临床分析

新生儿肺透明膜病(hyaline membrane disease,HMD),又称新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS),多发生于早产儿,是由于缺乏肺表面活性物质(pulmonary suffactant,PS)所引起,临床表现为生后不久即出现进行性呼吸困难和呼吸衰竭[1],因此临床上必须采取快速而有效的方法缓解缺氧,我们给予简易鼻塞CPAP联合大剂量沐舒坦治疗30例新生儿肺透明膜病,取得良好效果,现分析如下.     

肺泡表面活性物质治疗新生儿肺透明膜病的临床观察

目的观察气管内滴注PS治疗早产儿HMD的临床疗效.方法选用固尔苏按100mg/kg分三个体位气管内给药1次,病情无缓解,加用1 次.结果治疗后,患儿呼吸困难,青紫明显改善,并发动脉导管未闭4例(4/11),颅内出血3例(3/11),肺出血1例(1/11).结论 PS能够明显缓解临床症状,改善肺氧合功能,并减少并发症的发生.     

肺表面活性物质替代治疗新生儿肺透明膜病临床研究

目的分析肺表面活性物质治疗肺透明膜病(HMD)的疗效及临床价值.方法观察20例HMD患儿Exsurf治疗前后肺功能机械通气参数及肺泡充气程度的变化.结果用药前后PaO2、动脉-肺泡氧分压比值上升为44±15～93±44mmHg、0.11±0.05～0.22±0.04,PaO2、PaCO2、氧合指数、动脉-肺泡氧分压比值治疗前后比较差异均有非常显著性(p<0.01),用药后12h机械通气参数较治疗前明显下降(p<0.05～0.01),用药后12h胸片提示肺部病变明显改善.用药后肺炎,颅内出血并发症为70%和35%.结论 HMD 患儿Exsurf治疗后肺功能和肺泡充气程度明显改善.     

新生儿肺透明膜病的X线诊断分析

目的探讨新生儿肺透明膜病的X线特征。方法对49例经临床和X线确诊为肺透明膜病的新生儿的胸部X线表现进行回顾分析。结果本组病例中,Ⅰ级6例,占12.2%;Ⅱ级17例,占34.7%;Ⅲ级22例,占44.9%。Ⅳ级4例,占8.2%。结论胸部X线检查是临床诊断肺透明膜病的重要依据,对新生儿肺透明膜病的早期诊断、早期治疗及疗效评估有着重要意义。     

肺泡的发育与新生儿肺透明膜病

新生儿肺透明膜病 (hyaline membranedisease,HMD)发生在新生儿出生后不久 ,多见于未成熟的早产儿。 HMD占新生儿死亡率的 3 0 % ,是一种早产儿和新生儿常见的严重疾病。 HMD的发病是由于胎儿肺发育不全、缺乏肺泡表面活性物质引起的。临床上表现婴儿低氧血症 ,进行性呼吸困难、青紫和呼吸衰竭等症 ,所以 HMD又称之为“新生儿呼吸窘迫综合症”。1　肺泡的发育与分化1 .1　肺的形态发生　人胚第 4周初 ,原始咽尾端底壁内胚层正中出现一纵行浅沟 ,此沟逐渐加深形成的喉气管憩室 (laryngo-tracheal diverticulum) ,即为喉、气管、支气管和…     

A Study of Human Interstitial Lung Diseases with Special Reference to Immune Complexes and Hyaline Membrane

To evaluate the pathogenetic roles of immune complexes and alveolar hyaline membrane in idiopathic interstitial pneumonia (IIP), immunohistological and ultrastructural studies of the kidney and lung were performed in 23 cases of IIP, 19 cases of autoimmune diseases, 17 cases of interstitial pneumonia other than IIP, and 11 cases of bronchopneumonia as a control group. None of the cases of IIP or interstitial pneumonia other than IIP showed immune complexes in the alveolar and glomerular capillary walls. On the other hand, one case of SLE was positive for IgG and components of complement along the alveolar and glomerular capillary walls. The alveolar hyaline membrane in the present cases revealed immunoglobulins as well as components of complement, which were poorly soluble in chaotropic solution or acidic buffer. These results indicate that circulating immune complexes play a minor role in the pathogenesis of IIP and other types of interstitial pneumonia, and that there is no relationship between immune complex deposition in alveoli and the alveolar hyaline membrane. It is necessary to further investigate factors other than immune complexes involved in alveolar tissue damage and to clarify the significance of the hyaline membrane in the processes occurring from acute changes to pulmonary fibrosis in IIP.     

Neuronal Hyaline Inclusions Observed in an Autopsy Case of Behçet's Disease

An autopsy case of Behçet's disease is reported. The patient, a 59 year old Japanese woman, died of intestinal bleeding after a 34 year clinical course of Behçet's disease. She also suffered from recurrent oral aphthous ulcers, erythema nodosum like cutaneous lesions and genital ulcerated lesions. Autopsy revealed marked atherosclerosis of the aorta and multiple deep ulcerations in the terminal ileum with no significant vascular lesions. Lewy bodies and globular hyaline inclusions in the neurons of the central nervous system were noted, although there were no clinical symptoms of Parkinson's disease throughout the clinical course. These findings appear to suggest that the patient was probably in the preclinical or early stage of Parkinson's disease. However, the presence of Lewy bodies in the 6th decade without any accompanying symptoms is very rare. This case seems to draw attention to the presence of these neuronal inclusions in Behçet's disease.     

Stimulation of Regeneration of Hyaline Cartilage in Experimental Osteochondral Injury

A model of osteochondral intra-articular defect in rats is presented. During spontaneous healing, the stage of formation of granulation tissue is followed by its replacement with bone and fibrous tissue. Chondroinductive properties of collagen 1 sponge used for defect filling manifested in the formation of fibrous cartilage with fields of hyaline cartilage. Filling of the defect with collagen 1 sponge containing bone powder stimulated regeneration of the bone tissue and hyaline cartilage. Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 146, No. 11, pp. 597–600, November, 2008     

阿替普酶联合华法林治疗慢阻肺合并肺栓塞的有效性分析

目的 分析阿替普酶联合华法林治疗慢阻肺（COPD）合并肺栓塞的有效性。方法 回顾分析2017年10月~2018年10月在我院诊治的90例慢阻肺合并肺栓塞患者临床资料,将其随机分为对照组和观察组,各45例,对照组采用肝素联合华法林治疗,观察组采用阿替普酶联合华法林治疗,对比两组临床治疗有效率、凝血功能指标（PT、APTT、TT、Fbg）、动脉血PO2、PCO2、血清心肌肌钙蛋白Ⅰ( cTnⅠ)以及不良反应。结果 观察组治疗总有效率（95.55%）与对照组（91.11%）对比,差异有统计学意义（P＜0.05）;治疗后两组患者PT、APTT、TT 较治疗前降低,Fbg升高,组间比较差异有统计学意义（P＜0.05）;治疗后两组动脉血PO2升高,动脉血PCO2、cTnⅠ降低,与治疗前对比,组间对比差异有统计学意义（P＜0.05）;两组均未发生明显不良反应。结论 阿替普酶联合华法林治疗COPD合并肺栓塞具有良好的有效性,且用药安全,同时在改善心肌损伤方面具有良好的效果。     

肺表面活性物质联合CPAP治疗NRDS的疗效

目的 观察肺表面活性物质（PS）联合持续气道正压通气（CPAP）治疗新生儿呼吸窘迫综合征（NRDS）的疗效。方法 选择2016年6月~2019年5月我院收治的62例NRDS患儿,按随机数字表法分为对照组和观察组,各31例。对照组接受CPAP治疗,观察组在对照组基础上联合PS治疗。比较两组临床疗效、pH、动脉二氧化碳分压（PaCO2）、动脉血氧分压（PaO2）、氧合指数（OI）、住院时间及并发症发生情况。结果 观察组总有效率为93.55%,高于对照组的74.19%,差异有统计学意义（P＜0.05）;观察组pH、PaO2、OI均高于对照组,PaCO2低于对照组,差异均有统计学意义（P＜0.05）;观察组支气管肺发育不良发生率低于对照组,差异有统计学意义（P＜0.05）;两组肺不张、气胸及腹胀发生率比较,差异无统计学意义（P＞0.05）;观察组住院时间短于对照组,差异有统计学意义（P＜0.05）。结论 NRDS患儿接受PS联合CPAP治疗有利于改善动脉血气指标,提升呼吸功能,缩短住院时间,降低相关并发症发生率。     

射频治疗鼻衄疗效的临床与病理96例报告

作者采用射频技术治疗96例鼻衄，治疗有效率达94.7％，治疗痊愈率达84.3％．文章对鼻衄的发病率、鼻衄的部位、儿童鼻衄的年龄特征、分析了射频治疗的机理与治疗效果并推荐射频治疗为鼻衄治疗的一种安全有效方法．     

Aggregates of Cytofilaments as the Cause of the Appearance of Hyaline Tumor Cells

Cells resembling the hyaline cells of mixed salivary tumors have been identified in islet cell tumors, basal cell carcinoma, epithelioid leiomyoma, and an hepatic apudoma. Cytofilaments of intermediate size were present in these cells on electron microscopy and the distinctive hyaline appearance of cytoplasm is ascribed to large aggregates of these.