射频消融治疗阵发性室上性心动过速82例经验体会

目的　总结提高射频消融术 (RFCA)治疗阵发性室上性心动过速 (PSVT)的安全性和成功率的经验。方法　回顾分析RFCA治疗PSVT 82例 ,包括房室间折返性心动过速 (AVRT) 4 8例 ,左侧旁道 2 5例 ,右侧旁道 2 0例 ,多条旁道 3例 ,房室结折返性心动过速 (AVNRT) 34例。均先行心内生理检查确定心动过速类型和消融靶点。结果　总成功率 98.78% (81/ 82例 ) ,总复发率 2 .4 7% (2 / 82例 ) ,AVRT和AVNRT各 1例 ,2例再次RFCA均获成功。82例无一例严重并发症和死亡。结论　根据设备条件严格掌握适应症 ,消融前系统电生理检查 ,避免先入为主 ,旁道消融靶点正确标测 ,放电中Ⅲ度房室传导阻滞 (AVB)的识别和消融终点正确判定是提高安全性和成功率的关键。     

导管消融治疗儿童室上心动过速40例观察

目的总结经导管射频消融治疗儿童室上心动过速40例的经验。方法①在X线透视下对40例儿童室上心动过速进行导管射频消融治疗,年龄8.2±3.6(4~14)岁,左侧旁道:15例;右侧旁道:20例;房室结折返性心动过速:5例;②所有患者术后3个月进行随访;结果38例室上心动过速1次消融成功,2例主动放弃治疗;随访3个月,2例房室折返性心动过速和1例房室结折返性心动过速复发。结论我们的经验表明经导管射频消融治疗房室折返性心动过速在不断改进标测方法和丰富电生理知识的前提下,是安全、有效的方法,能够缩短x射线的曝光时间,提高成功率,但希氏束旁道和房室结折返性心动过速应严格适应证。     

老年人阵发性室上性心动过速的导管消融治疗

目的评价老年患者阵发性室上性心动过速(PSVT)射频导管消融(RFCA)治疗的安全性和疗效.方法32例PSVT患者行RFCA治疗.合并冠心病患者RFCA前行冠状动脉造影,根据冠脉造影情况决定是否RFCA;4例患者行右房房速、房室结双径路RFCA时使用了0～1号Swartz鞘;2例主动脉瓣狭窄左侧旁道患者行房间隔穿刺后于二尖瓣瓣上消融;8例左侧旁道合并腹主动脉扭曲畸形患者术中使用长血管鞘,5例左侧旁道合并升主动脉迂曲延长患者术中使用0号Swartz鞘.结果32例患者全部成功完成RFCA,5例冠心病患者冠脉造影病变血管狭窄75%～90%,行经皮冠状动脉介入治疗(PCI)后即刻RFCA;高血压病患者术中有11例出现血压升高需临时加用降压药物;19例合并心脏血管瓣膜病变患者术中使用了特殊的血管鞘和方法,缩短了手术时间.1例术中、2例动脉鞘拔管后即刻出现迷走神经反射介导的心动过缓-低血压现象,1例出现Ⅲ度房室传导阻滞(AVB).术后随访1年以上,无一例复发.结论老年患者PSVT患者行RFCA是安全的,且疗效满意.     

射频消融术治疗阵发性室上性心动过速62例体会

目的 总结室上性心动过速射频治疗的经验.方法 左侧旁道:(1)经动脉逆行途径在二尖瓣环心室侧标测消融,操作简单易行,是消融左侧旁道常用途径;(2)经动脉逆行途径在二尖瓣环心房侧标测消融;(3)穿房间隔途径.右侧旁道多采用股静脉途径消融三尖瓣房侧.房室结双经路选用中位法改良慢径路.结果 房室折返型心动过速32例,右侧旁路5例,左侧旁路27例,房室结折返型心动过速30例,其中一例右侧旁路2个月后复发,再次手术成功,手术成率98％.结论 射频消融治疗室上速安全、有效、复发率低.     

射频消融术治疗52例阵发性室上性心动过速

目的总结射频消融术(RFCA)治疗阵发性室上性心动过速的有关经验.方法分析我院RFCA治疗52例阵发性室上性心动过速的疗效、并发症及随访情况.结果本组房室结双径路(S-F型)15例,房室旁道(AP)37例,43条AP,房室旁道分布左侧游离壁18例,左前游离壁2例,左后间隔3例,右侧游离壁17例,右后间隔2例,右中间隔1例.除1例失败外,余均成功,成功率97%.结论射频消融术是治疗房室折返及房室结折返性心动过速的有效手段.     

射频消融术治疗52例阵发性室上性心动过速

目的 总结射频消融术(RFCA)治疗阵发性室上性心动过速的有关经验。方法 分析我院RFCA治疗52例阵发性室上性心动过速的疗效、并发症及随访情况。结果 本组房室结双径路(S—F型)15例,房室旁道(AP)37例,43条AP,房室旁道分布左侧游离壁18例,左前游离壁2例,左后间隔3洲,右侧游离壁17例,右后间隔2例,右中间隔1例。除1例失败外,余均成功,成功率97％。结论 射频消融术是治疗房室折返及房室结折返性心动过速的有效手段。     

射频消融术治疗快速性心律失常的进展

在过去的20年里,人们对于心律失常病理生理基础的认识突飞猛进,并且推出了精密的心脏电生理检测手段,可对心律失常的起源部位进行定位,使得射频导管消融(RFCA)治疗心律失常成为可能,今天射频导管消融心肌组织的方法已成为控制或根治包括房室结折返性心动过速(AVNRT)、房室折返性心动过速(AVRT)、房性心动过速(AT)、心房扑动(AFL)、心房颤动(AF)以及室性心动过速(VT)等许多快速心律失常的一线疗法.     

阵发性室上性心动过速发作的药物治疗

阵发性室上性心动过速(PSVT)是临床上常见的心律失常。据心脏电生理检查,PSVT 分为房室结折返性心动过速(AVNRT)、隐性预激旁道参与的房室间折返性心动过速(AVRT)、房内折返性心动过速(IART)、窦房结折返性心动过速     

老年人房室结内折返性心动过速射频消融的护理

目的:探讨射老年人房室结内折返性心动过速射频的护理干预措施.方法:对2005年7月～2009年12月我院心内科开展的61例老年人房室结内折返性心动过速射频治疗患者围手术期的护理干预措施进行总结分析.结果:61例RFCA病人中,1例冠心病患者术中出现胸闷、胸痛,含服硝酸甘油后缓解;1例心力衰竭患者术中出现气急,经利尿、扩血管治疗后症状改善;1例出现房室传导阻滞,植入永久性起搏器;有1例患者于术后6个月后复发,再次手术成功.其余患者术后恢复良好.结论:RFCA是治疗老年人房室结内折返性心动过速安全、有效的根治性方法.加强围术期护理干预,可提高手术成功率,降低并发症的发生率.     

射频消融治疗老年阵发性室上性心动过速102例分析

射频消融(RFCA)是根治阵发性室上性心动过速(PSVT)安全有效的方法。但对老年人患PSVT者常有心血管合并症，致使RFCA的操作难度增加，并发症增高。本文旨在探讨老年PSVT患者RFCA的特点，以期减少并发症的发生。现总结102例病例报告如下。     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.