紫花烧伤膏加艾灸治疗Ⅱ期和Ⅲ期压疮的效果与护理

[目的]探讨紫花烧伤膏加艾灸治疗Ⅱ期、Ⅲ期压疮的效果.[方法]将61例(79处)入院即带有压疮的病人按住院日分为观察组和对照组,观察组采用紫花烧伤膏加用艾灸疗法治疗压疮,对照组采用常规综合疗法治疗压疮,同时密切观察病人病情,加强营养支持,做好心理护理.[结果]观察组、对照组痊愈率分别为85.0%,51.3%,差异有统计学意义(P＜0.05).[结论]紫花烧伤膏加艾灸治疗Ⅱ期、Ⅲ期压疮效果优于常规综合疗法.     

GSE长效抗菌洗剂联合长效抗菌贴治疗Ⅱ期和Ⅲ期压疮的效果观察

[目的]观察葡萄柚提取物(GSE)长效抗菌剂洗剂联合长效抗菌贴治疗Ⅱ期、Ⅲ期压疮的效果.[方法]将21例(76处)Ⅱ期、Ⅲ期压疮病人随机分为两组,观察组16例(65处)采用GSE长效抗菌剂洗剂联合长效抗菌贴治疗,对照组5例(11处)采用传统换药方法治疗.比较两组病人治疗效果及压疮愈合时间.[结果]观察组总有效率高于对照组(P<0.05);观察组压疮愈合时间短于对照组(P<0.05).[结论]GSE长效抗菌洗剂联合长效抗菌贴治疗Ⅱ期和Ⅲ期压疮的效果优于传统换药方法.     

康复新液治疗Ⅲ期和Ⅳ期压疮的疗效观察

[目的]观察康复新液治疗Ⅲ期和Ⅳ期压疮的临床效果.[方法]将60例Ⅲ期和Ⅳ期压疮病人随机分为观察组与对照组,观察组用康复新液换药,对照组用碘伏涂擦.[结果]观察组治愈19例.好转10例,疮面愈合时间为14.40 d±11.73 d;对照组治愈13例,好转10例,疮面愈合时间为20.47 d±14.77 d,两组差异有统计学意义(P<0.05).[结论]用康复新液治疗Ⅲ期和Ⅳ期压疮病人疗效显著,如肉芽生长快、结痂早、疗程短,在溃疡期压疮病人中可优先选用.     

氦-氖激光治疗对截瘫后压疮愈合的影响分析

[目的]探讨氦-氖激光治疗对截瘫后压疮愈合的效果.[方法]对入住本的Ⅰ、Ⅱ及浅Ⅲ期、深Ⅲ期87例压疮患者,分别采用氦-氖激光治疗（观察组,n =47）和常规护理换药治疗（对照组,n=40）.比较两组患者压疮的愈合时间及治疗14d时两组的疗效.[结果]观察组压疮愈合时间（8.7±1.2）d,短于对照组的（11.2±6.4）d,但无统计学意义,而在深Ⅲ期压疮观察组平均治愈时间（12.8±7.3）d显著短于对照组（20.2±8.1）d优良率显著高于对照组,差异有统计学意义（P＜0.05）.[结论]截瘫后压疮采用氦-氖激光治疗,效果优于常规换药.     

京万红软膏联合蒲黄治疗压疮的效果观察

[目的]观察京万红软膏与蒲黄联合使用对Ⅱ期、Ⅲ期压疮的治疗效果.[方法]将56例压疮病人随机分为观察组和对照组各28例,对照组常规处理创面后局部涂抹京万红软膏,观察组常规处理创面后局部涂抹京万红软膏,再将生蒲黄敷于创面,观察两组压疮愈合情况.[结果]观察组总有效率显著高于对照组,治愈时间短于对照组.[结论]京万红软膏联合蒲黄治疗压疮可缩短创面愈合时间且经济适用.     

10%聚维酮碘乳膏联合重组人表皮生长因子治疗Ⅲ期压疮的效果观察及护理

[目的]观察10%聚维酮碘乳膏联合重组人表皮生长因子治疗Ⅲ期压疮的效果,总结其护理.[方法]将100例Ⅲ期压疮病人随机分为观察组和对照组,每组50例,对照组采用常规治疗,观察组采用10%聚维酮碘乳膏联合重组人表皮生长因子治疗.比较两组病人的治疗效果.[结果] 观察组总有效率为98.0%,对照组为84.0%,观察组总有效率高于对照组（P＜0.05）;观察组治愈时间短于对照组（P＜0.05）;观察组治疗后6 d、9 d创面羟脯氨酸含量高于对照组P＜0.05）.[结论]10%聚维酮碘乳膏联合重组人表皮生长因子治疗Ⅲ期压疮临床效果明显,能够有效改善病人的病情和预后.     

GSE抗菌洗液联合鸡蛋内膜治疗Ⅱ期和Ⅲ期压疮的疗效观察

[目的]观察GSE抗菌洗液联合鸡蛋内膜治疗Ⅱ期、Ⅲ期压疮的临床效果.[方法]选择70例Ⅱ期、Ⅲ期自带压疮病人并随机分为观察组(35例)和对照组(35例).对照组单纯采取鸡蛋内膜治疗压疮;观察组采取GSE抗菌洗液联合鸡蛋内膜治疗.治疗10 d后观察两组愈合情况以及总体愈合时间.[结果]观察组总有效率明显高于对照组,且愈合时间明显缩短(P＜0.01).[结论]GSE抗菌洗液联合鸡蛋内膜治疗Ⅱ期、Ⅲ期自带压疮较单纯使用鸡蛋内膜起效快、疗程短.     

四黄散湿敷联合红外线照射治疗Ⅲ期压疮的临床效果观察

[目的]探讨四黄散湿敷联合红外线照射照护法治疗长期卧床Ⅲ期压疮病人的临床效果。[方法]按照随机数字表法将2018年1月—2018年12月骨科病区60例发生Ⅲ期压疮病人分为观察组与对照组各30例。对照组采取常规压疮护理,观察组在常规压疮护理基础上应用四黄散湿敷联合红外线照射。2周后比较两组病人压疮面积、创面愈合时间、肉芽生长情况、创面愈合效果。[结果]观察组病人护理2周后创面面积小于对照组,愈合时间短于对照组,肉芽生长状态优于对照组,创面愈合效果优于对照组(P0.05)。[结论]长期卧床Ⅲ期压疮病人行四黄散湿敷联合红外线照射治疗能加快创面康复进程,促进肉芽组织生长,缩短创面愈合时间。     

藏红花乙醇溶液涂抹联合黄柏液、诺和灵湿敷治疗糖尿病合并压疮效果观察

[目的]观察藏红花乙醇涂抹压疮周围皮肤联合黄柏液、诺和灵湿敷压疮创面对糖尿病合并压疮病人治疗效果.[方法]选择糖尿病Ⅲ期压疮病人40例（60处）,随机分为观察组和对照组各20例（30处）.对照组按常规方法换药,用自制藏红花乙醇溶液涂擦创面周围皮肤;观察组在对照组的基础上加用黄柏液、诺和灵湿敷创面,观察两组疗效和治愈时间.[结果]观察组疗效优于对照组（Z=-2.260,P＜0.05）,治愈时间较对照组缩短（t＝-3.986,P＜0.05）.[结论]采用黄柏液、诺和灵湿敷糖尿痛合并压疮创面,用藏红花乙醇涂擦创面周围皮肤,可提高疗效,缩短治愈时间.     

氧化锌油治疗Ⅱ、Ⅲ期压疮疗效观察

目的 探讨氧化锌油治疗Ⅱ、Ⅲ期压疮的临床疗效.方法 根据压疮分期,将60例Ⅱ、Ⅲ期压疮患者随机分成治疗组和对照组,每组各30例.在常规压疮护理方法和外科换药基础上,对照组给予庆大霉素联合红外线治疗,治疗组给予氧化锌油联合红外线治疗.观察两组的临床效果,分别观察两组治愈率和治愈时间.结果 治疗组的治愈率和总有效率高于对照组,而在治愈时间比较上,治疗组明显优于对照组.结论 氧化锌油配合红外线治疗Ⅱ、Ⅲ期压疮能提高压疮治愈率,缩短愈合时间,是临床上可以推广的一种治疗方法.     

Acquired predisposition to mycobacterial disease due to autoantibodies to IFN-gamma

Genetic defects in the IFN-gamma response pathway cause unique susceptibility to intracellular pathogens, particularly mycobacteria, but are rare and do not explain mycobacterial disease in the majority of affected patients. We postulated that acquired defects in macrophage activation by IFN-gamma may cause a similar immunological phenotype and thus explain the occurrence of disseminated intracellular infections in some patients without identifiable immune deficiency. Macrophage activation in response to IFN-gamma and IFN-gamma production were studied in whole blood and PBMCs of 3 patients with severe, unexplained nontuberculous mycobacterial infection. In all 3 patients, IFN-gamma was undetectable following mitogen stimulation of whole blood, but significant quantities were detectable in the supernatants of PBMCs when stimulated in the absence of the patients' own plasma. The patients' plasma inhibited the ability of IFN-gamma to increase production of TNF-alpha by both autologous and normal donor PBMCs, and recovery of exogenous IFN-gamma from the patients' plasma was greatly reduced. Using affinity chromatography, surface-enhanced laser desorption/ionization mass spectrometry, and sequencing, we isolated an IFN-gamma-neutralizing factor from the patients' plasma and showed it to be an autoantibody against IFN-gamma. The purified anti-IFN-gamma antibody was shown to be functional first in blocking the upregulation of TNF-alpha production in response to endotoxin; second in blocking induction of IFN-gamma-inducible genes (according to results of high-density cDNA microarrays); and third in inhibiting upregulation of HLA class II expression on PBMCs. Acquired defects in the IFN-gamma pathway may explain unusual susceptibility to intracellular pathogens in other patients without underlying, genetically determined immunological defects.     

Immunoglobulin administration to fetuses with anemia due to alloimmunization to D

BACKGROUND: The purpose of this study was to examine fetal tolerance of high-dose intravenous immunoglobulin (IVIG), given directly at the time of intravascular transfusion, and its effects on fetal hemolysis and pregnancy outcome in the setting of alloimmunization to D.
STUDY DESIGN AND METHODS: Thirteen consecutive D+ fetuses requiring transfusion for maternal alloimmunization received high-dose IVIG (1.0 g/kg) and red cell transfusions. Twenty-four previous, consecutive fetuses with maternal anti-D served as controls. The schedules for subsequent transfusions were the same in the two groups.
RESULTS: High-dose IVIG was well tolerated by all fetuses. In the IVIG group, daily decreases in hematocrit were smaller than those in controls after the second administration of IVIG (mean hematocrit decrease, 0.72 percent/day vs. 1.45 percent/day; p = 0.007). No significant difference was found in the total number of fetal transfusions, the gestational age at delivery, the duration of neonatal intensive care, the number of neonates requiring postnatal transfusion therapy, and perinatal mortality.
CONCLUSION: In this small pilot study, direct administration to fetuses of IVIG with red cell transfusions was well tolerated and appeared to have a beneficial effect on fetal hemolysis.