液氮冷冻联合重组人a-2b干扰素治疗跖疣疗效观察

目的观察跖疣治疗情况及预防复发的治疗方法。方法治疗组,先行液氮冷冻然后联合重组人a-2b干扰素肌内注射治疗;对照组,单纯用液氮冷冻治疗跖疣。两组分别于术后1、2、3、6个月各随访一次,观察并记录疣体消退情况。结果治疗组有效率为91.7%,对照组有效率为73.3%;治疗组的复发率为8.3%,对照组的复发率为26.7%。结论液氮冷冻联合重组人a-2b干扰素治疗跖疣,能提高治愈率。     

治疣汤泡洗联合液氮冷冻治疗跖疣热瘀互结证的疗效观察

目的 观察治疣汤泡洗联合液氮冷冻治疗跖疣热瘀互结证的疗效。方法 选取61例跖疣热瘀互结证患者随机分成2组,对照组28例予液氮冷冻治疗,1次/2周,观察组33例在对照组基础上加用治疣汤泡洗,1次/d,20 min/次,治疗2个月后比较疗效。结果 观察组皮损个数、大小评分均低于对照组,差异有统计学意义(P<0.05)。观察组总有效率87.9%,对照组总有效率64.3%,差异有统计学意义(P<0.05)。观察组疼痛发生率低于对照组,差异有统计学意义(P<0.05)。疗程结束后第4个月随访,对照组复发7例(25%);观察组复发2例(6%);两组复发率比较,差异有统计学意义(P<0.05)。结论 治疣汤外洗联合液氮冷冻治疗跖疣可提高疗效,改善疼痛,降低复发率。     

中药泡脚联合液氮冷冻治疗多发性跖疣的临床观察

目的:探讨中药祛疣汤泡脚联合液氮冷冻治疗多发性跖疣的临床疗效。方法:将2012年2月~2013年8月我科就诊的95例跖疣患者随机分为观察组50例和对照组45例。观察组采用祛疣汤泡脚4周后液氮冷冻治疗,对照组单纯用液氮冷冻治疗。2个月后评价疗效。结果:观察组疗效与对照组比较差异有统计学意义(P0.05)。结论:中药祛疣汤泡脚联合液氮冷冻治疗跖疣,临床疗效明显优于单纯的液氮冷冻治疗,值得临床推广应用。     

CO_2激光联合液氮冷冻治疗跖疣疗效观察及护理

目的探讨CO_2激光联合液氮冷冻治疗跖疣的疗效及总结护理要点。方法对68例跖疣患者采用CO_2激光联合液氮冷冻治疗,并配合做好护理工作。结果 68例患者经1~3次治疗后,痊愈4例(5.9%),显效13例(19.1%),好转45例(66.2%),无效6例(8.8%),总有效率为91.2%。结论CO_2激光联合液氮冷冻是治疗跖疣的有效治疗方法,良好的护理措施能保证和提高CO_2激光联合液氮冷冻治疗跖疣的效果。     

卡介菌多糖核酸联合匹多莫德、30%冰醋酸治疗多发性跖疣临床效果

目的研究卡介菌多糖核酸联合匹多莫德、30%冰醋酸治疗多发性跖疣的临床效果。方法将研究对象通过抽签随机分成试验A组和对照B、C、D组,每组累计完成治疗者30例,共120例。A组采用卡介菌多糖核酸联合匹多莫德、30%冰醋酸治疗,B组采用卡介菌多糖核酸联合30%冰醋酸治疗,C组采用匹多莫德联合30%冰醋酸治疗,D组仅外用30%冰醋酸,治疗4周,对两组进行疗效评价并统计分析,并在治疗结束后第1、2、3、6个月末进行随访,观察复发率。结果各组治愈率分别为76.7%(A组)、50.0%(B组)、40.0%(C组)和20.0%(D组),治愈率比较A组明显大于B、C、D组(χ2=6.944,χ2=4.593,χ2=19.288,P<0.05),B、C组无明显差异(χ2=0.268,P>0.05)。各组复发率分别为6.7%(A组)、23.3%(B组)、33.3%(C组)和30.0%(D组),复发率比较A组与B组无明显差异(χ2=2.091,P>0.05),但明显低于C、D组(χ2=6.667,χ2=5.455,P<0.05)。结论卡介菌多糖核酸联合匹多莫德、30%冰醋酸治疗多发性跖疣的临床效果显著,安全可靠,复发率较低。     

聚肌胞注射液联合针刺治疗多发性跖疣的效果

目的观察聚肌胞注射液联合针刺治疗多发性跖疣的效果。方法将门诊154例多发性跖疣病人随机分为2组。治疗组78例,注射聚肌胞,并对病变部位进行针刺治疗;对照组76例,采用液氮冷冻疗法,两组均间隔15d治疗1次,连续治疗3次。比较两组临床疗效及创面愈合时间,对痊愈病人于治疗结束后3个月进行复发率的评价。结果治疗组总有效率、复发率及创面愈合时间分别为87.18%、8.33%、（10.43±2.44）d,对照组分别为71.05%、22.58%、（13.46±3.20）d,两组比较差异均有统计学意义（χ2=6.081、5.325,t=6.398,P〈0.05）。结论聚肌胞注射液联合针刺治疗多发性跖疣疗效可靠、复发率低、创面恢复快,值得临床推广应用。     

阿维A联合卡介菌多糖核酸治疗多发性跖疣疗效观察

目的 观察阿维A内服联合卡介菌多糖核酸针肌内注射治疗多发性跖疣的疗效.方法 将80例诊断明确的多发性跖疣患者随机分成两组,治疗组采用阿维A顿服联合卡介菌多糖核酸针肌内注射,对照组单用阿维A顿服,两组均外用0.1%维A酸乳膏,观察疗效及不良反应.结果 治疗组痊愈率及有效率均明显高于对照组,不良反应无明显差异.结论 阿维A联合卡介菌多糖核酸治疗多发性跖疣安全有效.     

重组人干扰素Y联合冷冻治疗跖疣的临床观察及护理

目的探讨重组人干扰素Y联合冷冻治疗跖疣的临床疗效及护理。方法将95例跖疣患者随机分为对照组45例和治疗组50例。对照组采用疣体冷冻治疗,治疗组在疣体基底部注射重组人干扰素Y的同时联合液氮冷冻治疗。两组均为7～10天治疗1次,3次为1疗程。结果对照组总有效率为51%,治疗组为88%,两组比较有显著性差异（P〈0.001）。结论重组人干扰素Y联合冷冻治疗跖疣是目前较好的治疗方法之一,且操作简便、安全、不留瘢痕。     

平阳霉素局部注射治疗多发性跖疣177例疗效观察

目的：探讨平阳霉素局部泥射治疗多发性跖疣（VP）的临床效果。方法：将177例多发性跖疣患者按照数字表法随机分为3组,观察组59例给予平阳霉素局部泥射治疗;对照组A组59例给予液氮冷冻治疗;对照组B组59例给予微波局部烧灼治疗。3组治疗1次/4w,共1～2次,治疗4w后若未见疣体脱落予第2次治疗,8w后并比较3组的临床效果。结果：随诊时间12周,观察组总有效率为98.31%,而显著的高于对照A组的76.27%(X2=12.9074,P＜0.05)及对照B组的74.58%(X2=14.1716,P＜0.05);177例患者随访1年,观察组总复发率3.39%,而显著的低于对照A组的15.25%(X2=5.9371,P＜0.05)及对照B组的16.95%(X2=14.1716, P＜0.05)。结论：平阳霉素局部泥射治疗多发性跖疣具有操作简单、疗效高、治疗费用低廉、复发率低、创面损伤小、不留瘢痕、感染率低、患者痛苦小、术后未见明显副作用等优点,是一种理想的治疗方法,而且值得临床大力推广应用。     

木贼草汤联合胸腺肽胶囊治疗泛发型跖疣疗效观察

跖疣是感染引起的足部皮肤良性赘生物，治疗方法有激光、冷冻等，但容易复发，且操作比较复杂。本科采用木贼草汤联合胸腺肽胶囊治疗多发性跖疣，取得了满意疗效，现报道如下。     

冷冻治疗低位吻合口复发直肠癌临床观察

目的探讨低位吻合口复发直肠癌的有效治疗方法。方法回顾性分析11年间冷冻治疗4例直肠癌根治术后低位吻合口复发病例的资料。结果4例病人中1例在11年间冷冻治疗17次仍健康地存活，1例冷冻两次后到外地行放疗引起肠道狭窄，溃疡，疼痛，而行人工肛门后继续冷冻治疗已四年仍健在，1例冷冻治疗4次后不愿继续治疗2年8个月死亡，1例冷冻两次后由于经济原因无法坚持治疗，1年后死亡。结论冷冻治疗低位吻合口复发直肠癌是一种有效治疗方法，具有安全，简单，痛苦少，费用低，疗效好，并发症少等优点。只要制冷器械良好，治疗方法得当，低位吻合口复发直肠癌患者冷冻治疗能减轻病人痛苦，提高生活质量，延长生存时间，是一种较好的治疗方法，有一定的推广价值。     

自身疣体包埋术治疗皮肤疣的临床效果

目的观察自身疣体包埋术治疗皮肤疣的临床效果及安全性。方法对１５６例皮肤疣患者施行自身疣体包埋术,术后观察３个月。结果痊愈５０．０％,显效１４．８％,有效１７．９％,总有效率为８２．７％。在４种类型皮肤疣中扁平疣的疗效最好。不良反应发生率和复发率分别为０．６％和６．５％。结论自身疣体包埋术治疗皮肤疣特别是扁平疣的临床效果好,安全性高,且不易复发。     

冷冻肛肠区病变的研究

目的：探讨冷冻对常见肛肠病的治疗作用。方法：取自西京医院１５年间冷冻治疗肛肠区良性病变７０１８例,恶性病变６３６例,冷冻前后经电镜观察癌细胞变化及应用单克隆技术检测患者Ｔ细胞亚群、Ｂ细胞水平。结果：内痔、混合痔、慢性肛裂的治愈率分别为８３．５％,６６．８％,６２．４％,尖锐湿疣的消除率１００％,早中期直肠癌冷冻能达到临床治愈,５年生存率４１．１％,晚期直肠癌冷冻能减轻症状和延长生命。结论：冷冻治疗是一项安全、有效的方法。     

青光眼阀植入治疗难治性青光眼的围手术期护理

目的总结青光眼阀植入治疗难治性青光眼的围手术期护理体会。方法回顾性分析2009年1月～2011年5月本科室收治的18例行青光眼阀植入治疗难治性青光眼患者的临床资料,并总结围手术期的护理要点。结果患者术程顺利,术后出现前房出血1例,低眼压2例,浅前房3例,引流管内口堵塞2例。术后眼压平均（17.72±5.58）mmHg,较术前明显降低。随访6～12个月,患者的视力恢复情况：2例（11.11%）光感,5例（27.78%）〈0.01,6例（33.33%）0.01～0.1,5例（27.78%）〉0.1。结论青光眼阀植入是治疗难治性青光眼的有效方法,术前做好心理护理,解除患者的疑虑;术后做好伤口及引流管护理,预防并发症,以保证患者能顺利康复,提高患者的治疗效果。     

CO2点阵激光联合伊可尔治疗难治性掌跖疣疗效观察

目的观察CO₂点阵激光联合伊可尔治疗难治性掌跖疣的临床疗效及安全性。方法:选取掌跖部多发,经其他疗法治疗后复发的难治性掌跖疣患者58例,患者平均分为两组,对照组29例先选择激光功率0.5-2W将皮损磨削薄直至焦痂或点状出血,之后采用CO₂点阵模式10-20mJ/cm2治疗,每周治疗一次,连续治疗4周。观察组29例观察组:CO₂点阵激光治疗仪器及治疗方法与对照组相同。激光治疗完毕,使用伊可尔药水棉片湿敷患处2小时,激光治疗后连续湿敷伊可尔棉片5天,停药2天至下一次激光治疗后继续湿敷,连续治疗4周。2组均随访观察6个月。结果:58例患者均完成治疗,治疗4周后,观察组总有效率93.10%,病损清除率为77.82%,均高于对照组的72.41%、60.81%,组间差异均有统计学意义(P<0.05)。6个月后,观察组复发率10.34%,对照组复发率37.93%,组间差异有统计学意义(P<0.05),两组不良反应差异无统计学差异。结论:CO₂点阵激光联合伊可尔治疗难治性掌跖疣疗效优于单用CO₂点阵激光。联用伊可尔降低了难治性掌跖疣的复发率,并且操作简便,安全性高。     

Combined endoscopic treatment of villous adenoma of the stomach and large intestine in middle-aged and elderly patients

Electroexcision combined with laser photocoagulation was performed in 12 patients with creeping neoplasms of the stomach and in 39 patients with the same condition of the large intestine. One-year follow-up studies showed that 2 patients with a malignant gastric tumour had recurrence 9 months after the combined treatment; I patient has recurrence in the same terms after similar treatment of creeping benign adenoma. Combined treatment proved to be more effective in 39 patients with large-intestinal tumour, including invasive cancer, with no recurrence during a year. It follows that the effectiveness of combined treatment was 94.2 per cent.     

Indications and results of cryotherapy of eyelid tumors

Since 1980, 112 patients presenting with tumours of the eyelid were treated by cryotherapy at the First University Department of Ophthalmology in Vienna. In 103 cases, histological examination revealed basal cell epithelioma, in 7 cases spindle cell epithelioma and in 2 cases a naevus. There were 69 female and 43 male patients and the average age was 68 years. Tumour recurrence existed in 29 of these patients who had previously undergone surgical treatment or radiotherapy. The low temperatures required for cryotherapy are produced by the use of liquid nitrogen. Contact freezing was performed in cases of tumours of up to 8 mm diameter; larger tumours or those with an irregular surface were treated by spray freezing. Within a follow-up period of 5 years, 9% of the patients with basal cell epithelioma and spindle cell epithelioma experienced recidivation.     

Mitomycin C: an alternative conservative treatment for refractory esophageal stricture in children?

BACKGROUND AND STUDY AIMS: Mitomycin C is an antiproliferative agent that has been used successfully as an adjunct treatment in ophthalmological procedures, in the management of laryngeal and tracheal stenosis, and more recently to prevent the recurrence of caustic esophageal strictures in children. The aim of this study was to assess the efficacy and safety of local application of mitomycin C to refractory esophageal strictures in children. PATIENTS AND METHODS: We performed a preliminary prospective study of local application of mitomycin C in four children, aged between 1 year and 6 years, who had refractory esophageal strictures. Two of the children presented with strictures caused by caustic ingestion and the other two children had anastomotic strictures following surgical repair of congenital esophageal atresia. The patients had required between four and ten esophageal dilations over a 5-24-month period before mitomycin C application. After an endoscopic dilation, mitomycin C was applied onto the dilation wound using a rigid endoscope. RESULTS: No complications were observed after the procedure. One child required a second application of mitomycin C 2 weeks after the first application because of recurrence of dysphagia. All the children remained asymptomatic and none of them required further dilation over a mean follow-up period of 24 months. Radiological control examinations revealed that there was no recurrence of the esophageal strictures and esophageal biopsies performed during follow-up showed no signs of dysplasia. CONCLUSIONS: Local application of mitomycin C is a potential alternative to iterative dilations, surgery, or stent placement for the treatment of refractory esophageal strictures in children. However, prospective, long-term assessment of outcomes is needed before any definitive conclusion can be drawn about the usefulness of mitomycin C in these patients.     

18F-FDG PET/CT显像在胃癌术后复发和转移中的诊断价值

目的：探讨18F-FDG PET/CT显像在胃癌术后复发及转移灶诊断中的价值。方法：胃癌术后患者112例,共行PET/CT检查150例次,图像分析采用视觉及半定量分析法（SUVave）,病灶根据病理学检查结果、多种影像学检查手段及临床随访确诊,随访时间半年以上。结果：112例患者中,16例存在肿瘤复发和转移,PET/CT诊断残胃复发的灵敏度为81.2%,特异性100%,准确性97.3%。复发病灶SUVave为4.4±1.2,吻合口炎性病灶SUVave为2.6±0.5,两者差异显著（t=3.9370,P=0.0005）。PET/CT诊断胃癌术后肿瘤转移的灵敏度94.1%、特异性96.7%和准确性95.5%。26例行两次以上PET/CT检查,第一次PET/CT检查发现复发或转移15例,经放化疗后6例PET显像示病情好转,随访6个月至2年患者均存活;9例治疗后PET显像示病情无明显变化或者出现新病灶,患者存活时间为3个月至1年。结论：18F-FDG PET/CT在胃癌术后复发和转移中有很好的诊断价值,并在监测胃癌术后复发放化疗疗效有一定的价值。     

Amiodarone in the Management of Patients with Ventricular Tachycardia and Ventricular Fibrillation

Fifty-eight patients with symptomatic ventricular tachycardia (VT) or ventricular fibrillation (VF) were treated with amiodarone. All had clinical episodes of VT/VF or inducible VT during electropharmacologic testing despite treatment with maximumtolerated doses of conventional antiarrhythmic agents. Chronic treatment with amiodarone was begun at a dose of 800–1000 mg per day. Thirty-two patients were also treated with a previously ineffective conventional agent. Thirty patients underwent programmed ventricular stimulation after 2.6 ± 1.7 months (mean ± S. D.) of treatment with amiodarone at a mean daily dose of 588 ± 155 mg. VT was induced in 25 patients (sustained in 20, nonsustained in five). Seventeen patients had a recurrence of VT or VF after 0.5–9 months of treatment with amiodarone (fatal in seven, non-fatal in 10). Forty-one patients (71%) had no recurrence of symptomatic VT or VF while being treated with amiodarone (mean follow-up period, 17.1 ± 12.4 months). Among the 25 patients who had inducible VT with programmed ventricular stimulation while being treated with amiodarone, 19 patients (76%) have had no recurrence of symptomatic VT or VF overa follow-up period of 21.5 ± 7.3 months. Ambulatory electrocardiographic recordings obtained after one week of treatment with amiodarone were not helpful in predicting clinical response. Twenty-two patients (38%) developed ataxia and/or an intention tremor which improved with a decrease in the amiodarone dose. Amiodarone, either by itself or in combination with conventional antiarrhythmic drugs, has a significant therapeutic effect in high risk patients with refractory VT. The finding of inducible VT during electropharmacologic testing in patients taking amiodarone does not preclude a favorable clinical response. Neurologic toxicity is common in patients treated with 600–800 mg per day of amiodarone.