脊髓损伤患者的间歇性清洁导尿

目的探讨脊髓损伤患者的间歇性清洁导尿的护理方法,从而促进患者膀胱功能的康复。方法对我院2010年5月至2011年12月收治的88例脊髓损伤患者采用间歇性清洁导尿的护理方法,并进行回顾性地分析、总结。结果本组患者膀胱容量均正常或接近正常,残余尿量均<100mL,12例残余尿量<30mL;63例形成反射性膀胱,25例膀胱充盈后可自行排尿,无严重尿路感染及肾积水等并发症。结论对脊髓损伤患者应用间歇性清洁导尿,不仅操作简便,而且效果可靠,是解除脊髓损伤患者膀胱排尿功能障碍的有效方法。     

间歇性导尿术在防治脊髓损伤患者尿路感染中的应用

目的评价间歇性导尿术在治疗远期脊髓损伤患者无症状细菌尿中的作用。方法40例唐山地震脊髓损伤无症状细菌尿患者采用间歇性导尿术治疗4周,分别在治疗前后对患者行中段尿细菌培养和尿常规检查。结果间歇性导尿术治疗后无症状细菌尿发生率与治疗前相比明显减少（100％比35％,x2=38．52,P〈0．05）。结论间歇性导尿术能够降低远期脊髓损伤患者无症状细菌尿的发生率,可避免尿路感染进一步加重。     

脊髓损伤患者留置导尿与间歇导尿对尿路感染的观察

目的脊髓损伤患者晚期死亡原因主要是尿路感染所引起的尿毒症和慢性肾功能衰竭。探讨间歇导尿与留置导尿对脊髓损伤患者尿路感染的影响。方法对100例脊髓损伤患者分别施行留置导尿术与间歇导尿术,于分组时、间歇导尿15d、间歇导尿30d取患者尿液进行细菌培养计数。结果间歇导尿15、30d的尿路感染发生率明显低于留置导尿尿路感染发生率。结论脊髓损伤患者间歇导尿与留置导尿相比能降低尿路感染的发生率。     

脊髓损伤后排尿障碍患者早期实施清洁间歇性导尿的临床效果观察及护理体会

<正>排尿功能障碍是康复医学中最常见的合并症之一。脊髓损伤后受损的平面以下感知功能、反射功能、运动功能、排尿功能以及性功能均发生一系列的障碍[1]。尤其是在脊髓损伤早期因膀胱可完全丧失神经支配,引起膀胱内尿液潴留,后期可能由于大量残余尿而产生尿流不止,所以一般在脊髓损伤后两周内要给与患者留置导尿。脊髓损伤的主要症状表现为排尿障碍,患者大多数都需要留置导尿管。但是长期的留置尿管不仅增加了患者尿路感染的风险,还会导致患者产生自卑消极心理及失去战胜疾病的信心。因此脊髓损伤康复阶段的主要护     

间歇性导尿在脊髓损伤患者神经源性膀胱护理中的应用研究进展

神经源性膀胱作为脊髓损伤患者常见并发症,临床上多以尿潴留、尿失禁、残余尿量增多等症状为主要表现,需及时采取有效措施解除此类病理反应,避免患者膀胱输尿管反流,引发肾积水、泌尿系统感染和肾功能减退等危险病症,危害其身心健康.临床最有效且安全性最高的干预手段是排空患者膀胱.基于此,针对脊髓损伤患者神经源性膀胱护理,本研究现总...     

间歇性导尿在脊髓损伤后神经源性膀胱的临床康复护理应用

目的观察间歇性导尿在脊髓损伤后神经源性膀胱的临床康复护理疗效。方法将30例脊髓损伤后神经源性膀胱患者进行间歇性导尿4周,疗效根据尿流动力学检查、尿中白细胞数的定量变化进行评定。结果间歇性导尿对脊髓损伤后神经源性膀胱效果显著,总有效率93.3%。结论间歇性导尿能明显改善脊髓损伤后神经源性膀胱患者的膀胱功能,从而减少尿路感染与防止肾功能损害,具有显著的临床疗效。     

间歇性导尿在腹部外科手术患者护理中的应用

目的探讨间歇性导尿在腹部外科手术患者护理的应用效果。方法对在2011年6月-2013年8月接受过腹部外科手术治疗的84例患者的临床资料进行回顾性分析,将其分为试验组和对照组各42例。对照组采用常规性导尿处理,试验组采用间歇性导尿处理及心理护理。比较2组患者的重置尿管例数、发生尿道损伤和尿路感染的例数。结果试验组重置尿管、发生尿道损伤和尿路感染例数均高于对照组,差异有统计学意义（P〈0.01）。结论采用间歇性导尿对腹部手术患者进行护理,有利于患者尽早的恢复自行排尿,提高患者的生活质量,值得临床推广。     

脊髓损伤伴神经源性膀胱患者实施间歇性导尿的护理体会

目的探讨脊髓损伤伴神经源性膀胱患者实施间歇性导尿的护理。方法对20例脊髓损伤伴神经源性膀胱患者实施间歇性导尿,制订饮水计划,严格控制液体摄入量,制订个性化间歇性导尿方案。结果通过间歇性导尿,患者膀胱功能明显改善,膀胱容量均正常或接近正常,且残余尿量降至100 mL以下。结论间歇性导尿是脊髓损伤伴神经源性膀胱功能障碍患者进行膀胱护理最安全的方法,可提高患者生活质量,让患者回归家庭、回归社会。     

间歇导尿综合疗法对脊髓损伤患者膀胱功能恢复影响的探讨

目的 观察间歇导尿综合疗法对脊髓损伤患者膀胱功能恢复的影响.方法 SCI患者60例,随机分为2组各30例,观察组行无菌性间歇性导尿术、膀胱功能训练、针刺及心理护理等综合疗法;对照组进行留置导尿及常规护理.结果 随访6个月,观察组建立反射性膀胱的有效率明显高于对照组(95%与45.7%,P<0.05);尿路感染发生率及排...     

间歇导尿对不完全性脊髓损伤患者膀胱功能恢复的作用和护理探讨

目的观察分析间歇导尿对不完全性脊髓损伤患者膀胱功能恢复的作用及护理方法。方法选取2014年8月至2015年9月,在我院接受治疗的60例不完全性脊髓损伤患者,随机分为观察组和对照组,每组30例。观察组患者给予间歇导尿技术进行护理,对照组患者给予常规的保留尿管进行护理,两组患者均进行1个月的治疗,观察比较两组患者在接受治疗后的尿常规、尿培养、膀胱残余尿量的情况。结果观察组患者的感染率13.3%显著优于对照组患者的感染率40.0%(P>0.05);观察组16.7%的患者膀胱残余尿量>100,83.3%的患者膀胱残余尿量≤100优于对照组90.0%的患者膀胱残余尿量>100,10.0%的患者膀胱残余尿量(P<0.05),具有统计学意义。结论不完全性脊髓损伤患者给予间歇导尿能够有效恢复患者的膀胱功能,而且降低并发症的发生率,值得临床推广和应用。     

脊髓损伤患者膀胱功能康复训练及效果分析

目的:探讨早期训练对脊髓损伤患者膀胱功能康复疗效．方法:采用各种刺激使脊髓低级排尿中枢引起反射性尿道外括约肌协同松驰这一原理,综合设定有效的耐力训练、定时的手法按摩及夹闭尿管定时放尿的方法进行早期膀胱功能训练,促进反射性膀胱功能的形成。结果:76例患者中67例(88．16％)在2—3周内建立反射性膀胱功能,达到优良标准。膀胱训练后,残余尿测定成功率达89．47％,泌尿系统感染下降率为87．5％。出院1年后跟踪观察均能顺利排尿。结论:有效的耐力训练与定时的手法按摩是脊髓损伤患者膀胱功能早期康复的有效方法。值得临床推广应用.     

前路减压手术治疗颈脊髓损伤疗效观察

目的 探讨前路减压手术治疗颈脊髓损伤的治疗效果.方法 应用颈前路手术治疗颈椎骨折脊髓损伤24例.本组中,骨折者16例,脱位者6例,骨折并脱位者2例.损伤部位:C4:4例,C5:8例,C6:8例,C7:4例.发生四肢不全瘫痪者20例,四肢完全瘫者4例.根据北医三院的评定标准,肢体残疾一级者6例,二级者10例,三级者8例.平均伤史6.5d(3h～8周).结果 术后随访0.5～6年,平均2.5年,根据北医三院的疗效标准,结果为:优5例(20.8%),良7例(29.2%),有效4例(16.7%),差8例(33.3%).优良率为50.0%,总有效率为66.7%.结论 前路减压手术治疗颈脊髓损伤可获一定疗效.     

急性颈脊髓损伤急救时效性与功能恢复探讨

目的 探讨急性颈脊髓损伤急救时效性.方法 对成都市第五医院自2006年6月-2012年12月收治的298例急性颈脊髓损伤患者的临床资料进行分析,其中2006年6月-2008年12月收治的140例患者作为对照组,2009年1月-2012年12月收治的158例患者作为观察组.总结与时效性相关的临床特征.结果 观察组术前准备时间、受伤至手术、使用脱水剂和MP治疗时间均短于对照组,且差异有统计学意义（P＜0.05）.观察组随访的有效率（67.9%）高于对照组（51.4%）,差异有统计学意义（P＜0.05）.结论 对患者进行及时抢救有助于提高患者的存活率,对患者的早期处理和患者的预后都有着积极作用.     

1例儿童脐血移植后肝功能损伤病例分析

目的:探讨临床药师参与儿童脐血移植后肝功能损伤病例的思维模式及作用。方法:临床药师参与1例脐血移植后患儿的用药过程,对其出现肝功能损伤的情况进行分析并给出用药建议。结果:该患儿肝功能损伤情况好转,顺利出院。结论:临床药师在参与临床治疗的过程中,应积极发挥作用,从多角度思考问题,并给出合理的用药建议。     

4-Aminopyridine Improves Pulmonary Function in Quadriplegic Humans with Longstanding Spinal Cord Injury

Study Objective . To test the hypothesis that 4-aminopyridine (4-AP) might cause clinically evident improvement in pulmonary function in humans with chronic spinal cord injury (chronic SCI). Design . Balanced, open-label study with subjects consecutively enrolled. Setting . Spinal Cord Injury Service, university-affiliated tertiary level care Department of Veterans Affairs Medical Center. Patients . Seventeen healthy men and women suffering from traumatic SCI (11 quadriplegic, 6 paraplegic patients) for more than 1 year. Interventions . Each subject was given a single dose of 4-AP 10 mg orally in an immediate-release formulation. Measurements and Main Results . Significant increases in mean values of forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) that persisted for at least 12 hours were demonstrated in quadriplegic patients beginning 6 hours after 4-AP administration. Tests of pulmonary function that demonstrated statistically significant increases at any time were also numerically, if not statistically, increased at 24 hours compared with pretreatment values obtained in 4-AP-naive subjects. Conclusions . The administration of a single dose of an immediate-release formulation of 4-AP to humans with longstanding, traumatic quadriplegia is associated with sustained, clinically meaningful, and statistically significant improvements in pulmonary function. We suggest that the administration of 4-AP may have a salutary effect in patients suffering from SCI and appears to be associated with potentially clinically significant reductions in the pathophysiologic pulmonary sequelae of SCI.     

胰岛素在急性脊髓损伤修复中的作用

胰岛素及其受体广泛分布于中枢神经系统，胰岛素对维持神经元的存活，刺激神经元再生及神经元的突触分化和成熟，抑制损伤神经细胞的凋亡，以及脊髓损伤后神经元的恢复有重要意义。试验证明，外周胰岛素通过特殊途径进入中枢神经系统，在脊髓损伤中对神经细胞有明显的保护作用，这为脊髓损伤的治疗开辟了一个新的途径。     

Loss of hsp70.1 Decreases Functional Motor Recovery after Spinal Cord Injury in Mice

Heat shock proteins (HSPs) are specifically induced by various forms of stress. Hsp70.1, a member of the hsp70 family is known to play an important role in cytoprotection from stressful insults. However, the functional role of Hsp70 in motor function after spinal cord injury (SCI) is still unclear. To study the role of hsp70.1 in motor recovery following SCI, we assessed locomotor function in hsp70.1 knockout (KO) mice and their wild-type (WT) mice via the Basso, Beattie and Bresnahan (BBB) locomotor rating scale, before and after spinal hemisection at T13 level. We also examined lesion size in the spinal cord using Luxol fast blue/cresyl violet staining. One day after injury, KO and WT mice showed no significant difference in the motor function due to complete paralysis following spinal hemisection. However, when it compared to WT mice, KO mice had significantly delayed and decreased functional outcomes from 4 days up to 21 days after SCI. KO mice also showed significantly greater lesion size in the spinal cord than WT mice showed at 21 days after spinal hemisection. These results suggest that Hsp70 has a protective effect against traumatic SCI and the manipulation of the hsp70.1 gene may help improve the recovery of motor function, thereby enhancing neuroprotection after SCI.     

氟康唑治疗泌尿系统真菌感染

目的：观察氟康唑对泌尿系统真菌感染的治疗效果.方法：泌尿系统真菌感染15例,用氟康唑200 mg,静脉滴注,bid,疗程一般为7～10 d,临床症状基本控制后改为氟康唑100 mg,bid,po,维持治疗15～20 d.结果：总有效率为93.3%,真菌清除率为86.7%,不良反应发生率为20.0%,无严重不良反应.结论：氟康唑为治疗泌尿系统真菌感染安全而有效的药物.     

Neuroprotective Effect of Ginsenoside Rd in Spinal Cord Injury Rats

In this study, the neuroprotective effects of ginsenoside Rd (GS Rd) were evaluated in a rat model of spinal cord injury (SCI). Rats in SCI groups received a T8 laminectomy and a spinal contusion injury. GS Rd 12.5, 25 and 50 mg/kg were administered intraperitoneally 1 hr before the surgery and once daily for 14 days. Dexamethasone 1 mg/kg was administered as a positive control. Locomotor function was evaluated using the BBB score system. H&E staining and Nissl staining were performed to observe the histological changes in the spinal cord. The levels of MDA and GSH and the activity of SOD were assessed to reflect the oxidative stress state. The production of TNF‐α, IL‐1β and IL‐1 was assessed using ELISA kits to examine the inflammatory responses in the spinal cord. TUNEL staining was used to detect the cell apoptosis in the spinal cord. Western blot analysis was used to examine the expression of apoptosis‐associated proteins and MAPK proteins. The results demonstrated that GS Rd 25 and 50 mg/kg significantly improved the locomotor function of rats after SCI, reduced tissue injury and increased neuron survival in the spinal cord. Mechanically, GS Rd decreased MDA level, increased GSH level and SOD activity, reduced the production of pro‐inflammatory cytokines and prevented cell apoptosis. The effects were equivalent to those of dexamethasone. In addition, GS Rd effectively inhibited the activation of MAPK signalling pathway induced by SCI, which might be involved in the protective effects of GS Rd against SCI. In conclusion, GS Rd attenuates SCI‐induced secondary injury through reversing the redox‐state imbalance, inhibiting the inflammatory response and apoptosis in the spinal cord tissue.