头孢唑肟钠联合蒙脱石散治疗小儿细菌性腹泻的疗效观察

为观察头孢唑肟钠联合蒙脱石散治疗小儿细菌性腹泻的疗效,将60例细菌性腹泻患儿随机分为对照组和观察组,每组30例.对照组患儿采用蒙脱石散治疗,观察组患儿采用蒙脱石散联合头孢唑肟钠治疗,比较2组患儿的疗效、临床症状改善时间及不良反应发生情况.结果显示,观察组患儿总有效率高于对照组(P<0.05),观察组患儿退热时间、腹泻停...     

双氯芬酸钠联合阿托品用于肾绞痛镇痛的效果观察

为探讨双氯芬酸钠、阿托品联合用于肾绞痛镇痛的疗效。将 2 30例肾绞痛病人随机分为 3组 ,观察组 (92例 )肌内注射双氯芬酸钠加阿托品 ;对照 1组 (6 5例 )单纯肌内注射双氯芬酸钠 ,对照 2组 (73例 )肌内注射阿托品 ,观察镇痛程度及治疗后不良反应。结果镇痛效果观察组与对照 1组比较 ,差异无显著性意义 (P >0 .0 5 ) ,但在镇痛有效级别上差异有显著性意义 (P <0 .0 1) ,对照 2组镇痛效果明显低于上述两组 ;不良反应观察组与对照 1组类似 ,与对照 2组比较 ,恶心、呕吐、眩晕等不良反应明显减少。提示双氯芬酸钠联合阿托品用于肾绞痛镇痛效果确切 ,不良反应少。     

头孢唑肟钠对急性细菌性感染者的细菌学疗效与血清白细胞介素6及超敏C-反应蛋白影响

目的研究头孢唑肟钠对急性细菌性感染者的细菌学疗效以及对血清白细胞介素6(IL-6)和超敏C-反应蛋白(hs-CRP)水平的影响。 方法选取2017年1月至2017年8月于泰康仙林鼓楼医院接受治疗的急性细菌性感染者180例,按照随机数字表法分为对照组(90例)和观察组(90例)。对照组患者静脉注射头孢曲松钠,2.0 g/次、2次/d;观察组患者静脉注射头孢唑肟钠,2.0 g/次、2次/d。比较两组患者的细菌学疗效以及治疗前后血清IL-6和hs-CRP水平。 结果对照组和观察组患者有效率分别为92.22%和93.33%,差异无统计学意义(χ²= 1.267、P = 0.058)。两组患者细菌培养阳性率和细菌清除率差异均无统计学意义(χ²= 1.274、P = 0.062,χ²= 2.266、P = 0.067)。对照组和观察组患者治疗后血清IL-6水平均较治疗前显著降低,差异有统计学意义(t = 12.471、P= 0.032,t = 13.892、P = 0.031)。对照组和观察组患者治疗后hs-CRP水平均较治疗前显著降低,差异有统计学意义(t = 11.533、P= 0.023,t = 14.791,P = 0.019)。 结论头孢唑肟钠对急性细菌性感染者疗效较好,与头孢曲松钠疗效相当,能显著降低患者血清IL-6和hs-CRP水平。     

头孢吡肟治疗急性泌尿系统感染的临床研究

目的 评价国产头孢吡肟治疗急性泌尿系统感染的安全性和有效性。方法 35例泌尿系统感染患者分为两组，分别给予国产头孢吡肟(试验组)和进口头孢吡肟(对照组)2g做，2次／d，疗程7～14d。观察临床表现、病原菌清除情况和副作用。结果 两组患者在用药治疗后体温降至正常的比例均为100％。试验组中急性肾盂肾炎16例，痊愈15例；单纯性尿路感染1例，痊愈。对照组中急性肾盂肾炎17例，痊愈17例；单纯性尿路感染1例，痊愈。两组患者用药治疗后的痊愈率分别为94％和100％，有效率为100%，无显著差异。试验组中15例细菌培养阳性，15例清除，细菌清除率为100％；对照组中有16例细菌培养阳性，16例清除，细菌清除率为100％；试验组出现2例(11．76％)不良事件。结论 国产头孢吡肟在治疗中重度泌尿道感染中是安全、有效的。     

医用透明质酸钠凝胶对人工流产后预防宫腔粘连的作用

目的探讨医用透明质酸钠凝胶对人工流产后预防宫腔粘连的作用。方法回顾性分析本院宫腔粘连患者的临床资料,按治疗方法的不同．随机分为治疗组（25例）及对照组（25例）。其中对照组行采用全景式硬管镜常规探查后扩宫,行分离粘连治疗;治疗组在对照组的基础上加用医用透明质酸钠凝胶。根据宫腔恢复情况、输卵管通畅情况、月经恢复情况、痛经情况等来评价医用透明质酸钠凝胶应用于人工流产后宫颈粘连的效果及安全性。结果治疗组与对照组比较,除术后经量减少1／3比例比较外,其他差异均有显著统计学意义（P〈0．05）。不良反应情况的结果显示,治疗组无再次粘连的发生,对照组出现3例再次粘连的情况,差异有统计学意义（P〈0．05）。结论医用透明质酸钠凝胶有预防宫腔粘连、促进愈合、降低再次粘连的发生率等作用,可用于人工流产术宫腔粘连的治疗,安全有效。     

糖尿病合并不同临床表型肺部感染者的细菌谱分析

目的探讨糖尿病合并不同临床表现肺部感染者的细菌分布情况,有针对性地制定抗感染对策。 方法根据208例糖尿病合并肺部感染者的不同临床表现分为呼吸道症状组（RS）、全身症状组（SS）及综合症状组（CS）共3组,取其痰分泌物进行病原学培养,培养菌株232株,统计学分析采用SPSS软件。 结果CS组混合感染（19.13%）较RS组（4.00%）和SS组患者（11.39%）显著上升（χ²= 5.41,P=0.01）;RS组患者革兰阳性球菌（G⁺C）感染仅占20%,SS组患者G⁺C感染占69.6%,CS组患者G⁺C感染为33.9%（χ²= 9.90,P=0.001）;RS组患者革兰阴性杆菌（G^－B）感染占76%,SS组患者G^－B感染仅占25.3%,CS组患者G^－B感染为59.3%（χ²= 14.87,P=0.001）;RS组患者葡萄球菌对莫西沙星、阿奇霉素、克林霉素、庆大霉素、左氧氟沙星、环丙沙星、四环素、青霉素、利福平、头孢呋辛和头孢唑肟耐药率显著低于SS组和CS组（P均< 0.05）。SS组患者链球菌对莫西沙星、阿奇霉素、克林霉素、四环素、头孢呋辛及头孢唑肟耐药率显著低于CS组（P均< 0.05）;SS组患者ECO对莫西沙星、庆大霉素及头孢唑肟耐药率显著低于CS组（P均< 0.05）;RS组患者肺炎克雷伯菌对亚胺培南、头孢哌酮舒巴坦、哌拉西林他唑巴坦、头孢吡肟、头孢噻汚、头孢他啶、头孢唑肟、庆大霉素、环丙沙星、左氧氟沙星、氨曲南和氨苄西林耐药率显著低于SS组和CS组患者（P均< 0.05）;RS组患者中铜绿假单胞杆菌和鲍曼/溶血不动杆菌对头孢哌酮舒巴坦、哌拉西林他唑巴坦、头孢吡肟、头孢噻汚、头孢他啶、头孢唑肟、庆大霉素、环丙沙星、左氧氟沙星、氨曲南及氨苄西林耐药率显著低于SS组和CS组患者（P均< 0.05）。 结论糖尿病合并不同临床表型肺部感染患者的细菌谱分布存在差异;针对以上感染特点有助于指导临床进行抗感染治疗。     

重型肝炎患者肝移植术后细菌感染的防治

目的探讨头孢吡肟治疗重型肝炎肝移植术后细菌感染的疗效。方法对2005年1月至2005年6月我中心46例重型肝炎肝移植患者术后细菌感染情况和头孢吡肟的疗效进行分析。结果本组患者术后细菌感染率为80．4％（37／46），共分离出细菌61株，其中革兰氏阴性（G）杆菌占68．9％（42／62）；革兰氏阳性（G^＋）球菌占31．1％（19／61）。G^-杆菌对头孢吡肟的耐药率为33．3％，明显低于对头孢他啶（64．3％）、头孢曲松（76．2％）和头孢噻肟（61．9％）的耐药率（x^2=8．052，15．570，6．873，P〈0．01）。经验治疗临床有效率为78．1％，患者使用过程中无明显不良反应。结论对肝移植术后常见G^-杆菌的耐药率较多数三代头孢菌素低，头孢吡肟作为重型肝炎患者肝移植术后经验治疗用药是安全有效的。     

透明质酸钠预防屈肌腱粘连的临床研究

目的　评价透明质酸钠预防术后屈肌腱粘连的临床效果。方法　 1998年～ 1999年对 47例屈肌腱手术者 ,于肌腱损伤修复部鞘内或局部分别注入两种透明质酸钠凝胶制剂。 A组注入透明质酸钠 I号 ,2 0 m g/ 2 ml,17例 ;B组注入透明质酸钠 号 ,2 0 mg/ 2 ml,16例 ;C组除不用透明质酸钠外 ,其它治疗与 A、B组相同 ,14例。于术后 1、2和 3个月测定相关部位的功能、疼痛和肿胀等情况 ,按关节功能和握拳功能评价透明质酸钠预防粘连的效果。结果　 47例经 1～ 3个月随访 ,A组优良率为 6 4.71% ,B组为 6 8.75 % ,C组为 42 .86 % ,A及 B组与 C组比较有统计学意义 (P<0 .0 5 ) ;各组均未见明显毒副作用。结论　两种透明质酸钠凝胶均有明显抑制术后屈肌腱粘连形成的作用 ,且使用安全方便     

头孢吡肟在胰腺组织及胰液中的浓度测定及其临床意义

目的探讨头孢吡肟在胰腺外科中预防和治疗感染的效果。方法收集从2004年10月至2005年2月各类胰腺疾病手术患者20例,在静脉应用头孢吡肟后,测定血清、胰腺组织和胰液中头孢吡肟浓度。结果头孢吡肟在血清中的平均浓度为(2.23±0.24)μg/ml(0.23~4.66μg/ml),胰液中的平均浓度为(6.52±2.07)μg/ml,胰腺组织中的平均浓度为(10.93±1.52)μg/g;头孢吡肟在胰液中的浓度要高于血清中浓度(6.52μg/ml vs 2.23μg/ml,P=0.046)。头孢吡肟在各种胰腺疾病之间的血清中浓度无差异(P>0.05),但在慢性胰腺炎患者中头孢吡肟在胰液和胰腺组织中的浓度要大于其他疾病患者(P<0.05)。结论头孢吡肟能有效地通过血胰屏障,对于胰腺疾病和胰腺手术患者可起到良好的预防和治疗感染效果。     

孟鲁司特钠治疗小儿变异性哮喘的临床疗效探讨

目的：探讨孟鲁司特钠治疗小儿变异性哮喘的临床疗效。方法选取我院2011年4月～2014年1月收治的180例小儿变异性哮喘患者作为研究对象,随机分为实验组和对照组各90例,对照组患者仅给予常规对症治疗,实验组患者在常规治疗的基础上加用孟鲁斯特钠治疗,比较两组患者临床治疗效果、各项症状缓解时间以及肺功能改善情况。结果实验组患者临床治疗效果总有效率显著优于对照组（P＜0.05）。实验组患者咳嗽消失时间、哮鸣音消失时间以及哮喘持续时间均明显短于对照组患者,两组间比较差异有统计学意义（P＜0.05）。治疗后两组患者FEV1和PEF（%）均较治疗前得到一定改善,差异有统计学意义（P＜0.05）,其中实验组患者改善较明显,与对照组比较差异有统计学意义（P＜0.05）。对照组患者不良反应发生率显著高于实验组患者,差异有统计学意义（x2=4.185,P＜0.05）。结论小儿变异性哮喘应用孟鲁斯特钠治疗可以有效改善肺部功能,迅速缓解临床症状,同时其安全性较高,值得在临床治疗中推广应用。     

Diagnostic value of urinary sodium, chloride, urea, and flow

Up to 30% of hospitalized critically ill patients may have a rise in serum creatinine concentration. In addition to history and physical examination, there is diagnostic value in assessing urinary electrolytes, solute excretion, and urine flow in these patients. The correct interpretation of these urinary parameters can avoid unnecessary volume overload and mechanical ventilation, risk factors for increased mortality in patients with rising serum creatinine. The present article also discusses the role of arterial underfilling in causing prerenal azotemia in the presence of an increase in total body sodium and extracellular fluid expansion. As with extracellular fluid volume depletion, arterial underfilling secondary to impaired cardiac function or primary arterial vasodilation can delay or prevent recovery from ischemic or toxic acute tubular necrosis. The present brief review discusses the various aspects of the correct interpretation of urinary electrolytes, solute excretion, and urine flow in the setting of a rising serum creatinine concentration.     

Changes in serum sodium,sodium balance,water balance,and plasma hormone levels as the result of pelvic surgery in women

Postoperative hyponatremia in women has been associated with the development of serious neurological disorders and even death, with a predisposition for menstruant women. The objective of this study was to evaluate the immediate hormonal, water and electrolyte responses to pelvic surgery in both pre and postmenopausal women. Of the twenty-five consecutive women studied, twenty were premenopausal while five were postmenopausal. Mean age was 45.4 ± l.6 years. Measurements of plasma renin activity, follicular stimulating hormone and luteinizing hormone showed no significant change pre to postoperatively. There was a significant decrease in pre to postoperative values of estrogen, 97.4 ± 20.3 to 36.3 ± 7.5 pg/mL (p < 0.05). There was also a significant decline in postoperative values for plasma aldosterone and plasma progesterone. Data were similar in pre and postmenopausal patients. Serum sodium levels decreased from 141.5 ± 0.5 to 137.2 ± 0.5 mEq/L (p < 0.0l). During the twenty-four hours following surgery, mean net sodium balance was positive 122 mEq and mean measured fluid balance was positive 1108 mL. Ringers lactate or normal saline were used. On the first postoperative day, plasma arginine vasopressin levels were elevated at 4.0 ± 0.8 pg/mL, with a mean urine osmolality of 504 ± 29 mOsm/kg H₂O. The data illustrate that women undergoing pelvic surgery decrease their serum sodium in the immediate postoperative period. Despite both positive sodium and water balance, there is a stronger tendency to conserve water. Decreased estrogen levels occur and this decrease may facilitate brain cell adaptation to plasma hypotonicity. Since the administration of isotonic fluid will not protect against the decrease in serum sodium, postoperative sodium concentration should be carefully monitored.     

The effects of rapid saline infusion on sodium excretion, renal function, and blood pressure at different sodium intakes in man

To examine the effects of increasing dietary sodium intake on natriuresis, filtration rate, and renal blood flow following rapid volume expansion, we infused 2-liter normal saline over 2 hr into normal men in balance at 10, 300, 600, and 800 mEq/day sodium intake. Natriuresis and kaliuresis were related to prior sodium intake. Fractional excretion of sodium (6%-7%) was maximal at the 600 mEq/day sodium intake and increased no further at the 800 mEq/day sodium intake. Although blood pressure increased with rapid saline infusion, natriuresis and blood pressure were not associated. Creatinine clearance decreased or remained constant, while PAH clearance decreased during saline infusion at each level. The data suggest that although natriuresis following rapid saline infusion is dependent upon prior sodium intake, under given circumstances it may be independent of glomerular filtration rate, renal blood flow, or blood pressure.     

The choleretic mechanisms of sodium taurocholate, secretin, and glucagon.

Mongrel dogs were prepared by cholecystectomy, ligation of the lesser pancreatic duct, and insertion of modified Thomas cannulas into the duodenum and stomach. After recovery from surgery, experiments were performed by cannulation of the common bile duct for bile collection through the duodenal cannula. Bile flow and composition and the biliary clearance of erythritol were observed during secretin, glucagon, or sodium taurocholate choleresis and were compared with control studies. All test substances caused increased bile secretion. Sodium taurocholate caused a marked increase in bile salt output and in the biliary clearance of erythritol. Secretin caused a large increase in bile flow, no increase in bile salt output, and a very small increase in the biliary clearance of erythritol. The results indicate marked differences in the choleretic mechanism of sodium taurocholate and secretin and suggest that the principal action of taurocholate was on the canaliculi and the principal action of secretin was on the ducts.     

Passive accumulation of magnesium,sodium, and potassium by chick calvaria

Summary Four-day-old chick calvaria were used to determine the passive concentrations of magnesium, sodium, and potassium in metabolically poisoned bone. When incubated in buffers containing the blood levels of sodium and magnesium, these calvaria contained sodium and magnesium at the identical concentrations found in freshly dissected calvaria. Calvarial sodium and magnesium levels could be varied by altering the buffer concentrations of these cations. The potassium content of metabolically poisoned calvaria incubated in buffers containing 4 mM potassium was less than 20% of the content of freshly dissected calvaria. When the buffer concentrations of sodium and potassium were systematically varied, ouabain-poisoned calvaria concentrated these cations in the bone extracellular fluid by a factor of approximately two above buffer cation levels. Presumably, the hydroxyapatite crystal zeta potential is responsible for this concentrative phenomenon. These results are discussed in terms of the control of the ionic content of the bone extracellular fluid by the postulated “bone membrane.”