阿奇霉素联合痰热清注射液治疗小儿肺炎支原体肺炎效果观察

［摘要］　目的　观察阿奇霉素联合痰热清注射液治疗小儿肺炎支原体肺炎（MPP）的效果。方法　将MPP患儿100例随机分为观察组和对照组各50例,观察组采用阿奇霉素联合痰热清注射液治疗,对照组单用阿奇霉素治疗。比较两组的疗效。结果　观察组治疗后体温恢复正常时间、咳嗽症状消失时间、肺部体征消失时间、X线胸片吸收好转时间、总病程等方面较对照组明显缩短,差异有统计学意义（P<0.01）;观察组疗效优于对照组,差异有统计学意义（P<0.01）;观察组无复发,对照组复发4例（8.0%）。结论　阿奇霉素联合痰热清注射液治疗小儿MPP疗程短、治愈率高、复发率低,值得临床上推广应用。     

痰热清注射液辅助治疗小儿支原体肺炎的疗效观察

目的探讨痰热清注射液辅助红霉素与阿奇霉素序贯治疗小儿支原体肺炎的临床效果。方法选择60例小儿支原体肺炎患者,随机分为对照组和观察组,每组30例。对照组采用红霉素与阿奇霉素序贯治疗,观察组在对照组的基础上给予痰热清注射液治疗,观察两组患儿疗效以及退热时间、咳嗽及肺部啰音消失时间、X线炎症吸收时间、平均住院时间及不良反应发生情况。结果观察组疗效总有效率显著高于对照组（P〈0.05）,观察组患儿退热时间、咳嗽及啰音消失时间、X线炎症吸收时间、平均住院时间均较对照组明显缩短（P〈0.05）,两组不良反应无统计学差异（P〉0.05）。结论痰热清注射液改善红霉素与阿奇霉素序贯治疗小儿支原体肺炎的临床疗效。     

阿奇霉素序贯疗法治疗小儿支原体肺炎的临床疗效

目的探讨阿奇霉素序贯疗法治疗小儿支原体肺炎的临床疗效。方法选取2014年5月—2016年4月中南大学湘雅医院收治的小儿支原体肺炎患儿102例,采用随机数字表法分为对照组50例与观察组52例。对照组患儿予以阿奇霉素治疗,观察组患儿予以阿奇霉素序贯疗法治疗。比较两组患儿临床疗效、不良反应发生率、体温恢复正常值时间、住院时间。结果观察组患儿总有效率高于对照组(P0.05)。观察组患儿不良反应发生率低于对照组(P0.05)。观察组患儿体温恢复正常值时间、住院时间短于对照组(P0.05)。结论阿奇霉素序贯疗法治疗小儿支原体肺炎的临床疗效确切,可降低不良反应发生率,缩短体温恢复正常值时间和住院时间。     

阿奇霉素序贯疗法联合孟鲁司特治疗儿童支原体肺炎的疗效分析

目的探讨阿奇霉素序贯疗法联合孟鲁司特治疗儿童支原体肺炎的疗效。方法将60例支原体肺炎患儿随机分为两组,对照组30例予以阿奇霉素静脉滴注并序贯口服治疗,治疗组30例在静脉滴注并序贯口服阿奇霉素基础上加用孟鲁司特口服,对比两组患者总有效率,观察临床症状、体征消失时间,不良反应。结果治疗组体征消失时间均短于对照组;住院时间也显著短于对照组(P0.05);治疗组总有效率为96.7%,对照组的总有效率为86.7%,显著高于对照组(P0.05);治疗组在治疗过程中未发现与孟鲁司特相关的不良反应。结论阿奇霉素序贯疗法联合孟鲁司特可有效改善支原体肺炎患儿临床症状,缩短病程,提高儿童肺炎支原体肺炎的防治水平。     

阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的疗效观察

目的观察阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的临床疗效。方法选取我院2011年1月—2013年11月收治的肺炎支原体肺炎患儿84例,采用随机数字表法将所有患儿分为观察组和对照组,每组42例。两组患儿入院后均给予常规治疗,包括退热、止咳、祛痰等,并为患儿创造良好的住院环境。观察组患儿给予阿奇霉素序贯疗法,对照组患儿给予乳酸红霉素静脉滴注。观察两组患儿临床疗效、临床症状或体征(发热、咳嗽、肺部啰音)消失时间及住院时间、治疗期间不良反应情况等。结果观察组患儿总有效率为97.62%,高于对照组的80.95%(P0.05)。观察组患儿发热、咳嗽、肺部啰音消失时间及住院时间均短于对照组(P0.05)。观察组患儿治疗期间局部疼痛、皮疹、胃肠道反应、ALT升高、肝功能异常发生率均低于对照组(P0.05)。结论阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎疗效较好,不良反应少,安全性较高,值得临床推广应用。     

甲泼尼龙联合阿奇霉素序贯疗法治疗小儿支原体肺炎的临床疗效及其对血清C反应蛋白、可溶性髓系细胞触发受体1水平的影响

目的观察甲泼尼龙联合阿奇霉素序贯疗法治疗小儿支原体肺炎的临床疗效,探讨其对血清C反应蛋白(CRP)、可溶性髓系细胞触发受体1(s TREM-1)水平的影响。方法选取2015年1月—2017年1月华中科技大学同济医学院附属武汉儿童医院儿科收治的支原体肺炎患儿120例,根据入院顺序分为对照组和观察组,每组60例。在对症治疗基础上,对照组患儿采用阿奇霉素序贯疗法治疗,观察组患儿采用甲泼尼龙联合阿奇霉素序贯疗法治疗。比较两组患儿临床治疗有效率、症状消失时间、治愈时间及治疗前后血清CRP、s TREM-1水平。结果观察组患儿临床治疗有效率高于对照组(P<0.05)。观察组患儿退热时间、咳嗽消失时间及治愈时间短于对照组(P<0.05)。治疗前两组患儿血清CRP、s TREM-1水平比较,差异无统计学意义(P>0.05);治疗后观察组患儿血清CRP、s TREM-1水平低于对照组(P<0.05);治疗后两组患儿血清CRP、s TREM-1水平均低于治疗前(P<0.05)。结论甲泼尼龙联合阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的临床疗效确切,可快速有效地改善患儿临床症状并抑制炎性反应,降低血清CRP和s TREM-1水平。     

阿奇霉素与红霉素治疗小儿支原体肺炎的临床对比研究

目的探讨阿奇霉素治疗小儿支原体肺炎的临床疗效及安全性。方法将96例临床诊断为支原体肺炎的患儿随机分成两组,红霉素组和阿奇霉素组,观察两组患儿临床有效率,临床症状体征消失时间及不良反应率。结果(1)阿奇霉素组临床有效率(92.73%)明显高于红霉素组(75.61%);(2)阿奇霉素组退热时间、咳嗽好转时间、肺部啰音消失时间、白细胞恢复正常时间、胸片吸收时间明显短于红霉素组;(3)阿奇霉素组不良反应率(16.36%)明显低于红霉素组(46.34%)。结论阿奇霉素治疗小儿支原体肺炎安全、有效。     

痰热清注射液联合阿奇霉素治疗小儿支原体肺炎的临床观察

目的探讨痰热清注射液联合阿奇霉素序贯治疗小儿支原体肺炎的临床疗效。方法将88例小儿支原体肺炎患者随机分入对照组与观察组,给予42例对照组患者阿奇霉素序贯治疗,46例观察组患者接受痰热清注射液联合阿奇霉素序贯治疗。比较两组临床疗效、不良反应发生率及血清超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的差别。结果观察组与对照组治疗总有效率分别为95.7%和69.0%,差别具有统计学意义(P<0.05);观察组不良反应发生率显著少于对照组(21.7%vs 88.1%,P<0.05);两组治疗后血清hs-CRP、IL-6和TNF-α水平较治疗前均显著降低(P<0.05),但两组间无显著差别(P>0.05)。结论痰热清注射液联合阿奇霉素序贯治疗小儿支原体肺炎可显著提高临床疗效,减少不良反应。     

神阙贴穴位贴敷辅助治疗小儿支气管肺炎的临床观察

［摘要］　目的　观察神阙贴穴位贴敷辅助治疗小儿支气管肺炎的治疗效果。方法　选择2012-02～2013-08收治的1～12个月的小儿支气管肺炎患儿82例,随机分为观察组和对照组,两组均予以常规综合治疗,观察组在综合治疗的基础上加神阙贴穴位贴敷辅助治疗,对照组仅予以常规综合治疗。结果　(1)观察组总有效率优于对照组,差异有统计学意义(P<0.05);（2）两组临床指标（症状、体征消失时间和住院天数）比较差异无统计学意义(P>0.05);（3）治疗后7 d胸片炎症阴影的恢复观察组明显优于对照组,差异有统计学意义(P<0.05);（4）两组均未见明显不良反应,治疗后WBC、GRAN#、CRP、HsCRP、HGB、MCV的变化比较差异无统计学意义(P>0.05)。结论　神阙贴穴位贴敷有助于促进小儿支气管肺炎炎症吸收,提高疗效的作用,是辅助治疗小儿支气管肺炎的一种疗效确切、方法简便、价格低廉、无毒副作用的方法,值得临床推广。     

特布他林序贯治疗小儿支原体肺炎的临床研究

目的探讨特布他林治疗小儿支原体肺炎的临床效果。方法将我院90例支原体肺炎患儿按随机数表法分为观察组与对照组各45例。两组均给予阿奇霉素序贯治疗,观察组同期另给予特布他林。对比两组临床疗效、临床症状消失时间、气道炎症相关因子及肺功能指标变化,并记录不良反应发生率。结果观察组总有效率95.56%高于对照组82.22%(P0.05)。观察组发热消失时间、咳嗽消失时间、肺部啰音消失时间、喘息消失时间均显著短于对照组(P0.05)。观察组治疗后EOS、IL-2低于对照组,IL-4、FEV1、PEF、FEV1/FVC高于对照组(P0.05)。不良反应发生率比较无统计学意义(P0.05)。结论特布他林联合阿奇霉素序贯治疗小儿支原体肺炎可减轻气道炎症反应,改善肺功能,安全性高。     

Treatment of patients with Eisenmenger's syndrome with Bosentan

We treated prospectively 14 patients with Eisenmenger's syndrome, with a mean age of 10 years, ranging from 3 to 18 years. Treatment continued for 12 months, and demonstrated a lasting symptomatic improvement, but no improvement in terms of mean saturation of oxygen over 24 hours. Exercise capacity, as judged by peak uptake of oxygen, worsened in the six patients able to perform a treadmill test. The symptomatic benefit from dual blockage of endothelin receptors in these patients may be due to mechanisms other than selective pulmonary vasodilatation alone.     

Satisfaction with ambulatory care of persons with AIDS

OBJECTIVE: To examine the relation of patient characteristics and site of care to the perception of ambulatory care quality by persons with AIDS (PWAs). DESIGN: Patient surveys and medical record review were used to determine PWAs’ perceptions of their ambulatory care, self-perceived health status, primary care relationships, sociodemographic characteristics, and severity of illness. SETTING: A public-hospital HIV clinic, an academic group practice, and a staff-model health maintenance organization (HMO) that together care for 20% of all Massachusetts PWAs. PATIENTS: All active patients as of February 12, 1990, and all new AIDS patients at each of the three sites during the subsequent 13 months. MEASUREMENTS AND MAIN BESULTS: The primary outcome measure was a six-item scale of patient-rated quality of care (PRQC), a newly developed measure that combined patients’ ratings of their physician care, nursing care, involvement in medical decisions, and overall quality of care. Multiple logistic regression was carried out with low PRQC (lowest quart He) as the dependent variable, to identify correlates of patient perceptions of poor quality. Patients who had a primary nurse were significantly less likely to have low PRQC scores (OR=0.50, 95% CI=0.26 to 0.97). Black patients and patients who used injection drugs were significantly more likely to rate their care in the lowest quartile (OR=2.22, 95% CI=1.04 to 4.78; and OR=2.43, 95% CI=1.13 to 5.23, respectively), as were those who had lower self-perceived health status, after controlling for confounders; no association was found by site or severity. CONCLUSIONS: These results show that primary nursing may be an important determinant of how PWAs rate the quality of their ambulatory care. Furthermore, PWAs who are black or who are injection drug users are less satisfied than are others with the quality of their ambulatory AIDS care. Presented in part at the annual meeting of the Society of General Internal Medicine, April 30, 1993, Arlington, Virginia. Supported by the Agency for Health Care Policy and Research, grant number HS06239.     

Experience with the treatment of patients with hypertrophic cardiomyopathy with obsidan and isoptin

Forty-five patients with hypertrophic cardiomyopathy were examined clinically and echocardiographically. The results of their treatment with obsidan and isoptin in relation to various types of central hemodynamic disorders are presented. The data have been obtained making it possible to treat patients differentially with regard to the form of the disease. The treatment of this category of patients requires the echocardiographic monitoring of the parameters of the central hemodynamics and myocardial contractility.     

分析老年糖尿病患者应用甘精胰岛素联合阿卡波糖治疗的效果

目的探讨甘精胰岛素联合阿卡波糖在老年糖尿病患者中的临床疗效。方法选取该院2018年7月—2019年7月收治的113例老年糖尿病患者作为研究对象,经随机数字表法,划分A组(n=56,阿卡波糖)和B组(n=57,甘精胰岛素+阿卡波糖),比较两组临床疗效、血糖指标。结果B组患者临床治疗总有效率显著高于A组;经治疗,B组患者空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAlc)水平明显低于A组。两组之间比较差异有统计学意义(P<0.05)。结论在老年糖尿病患者中应用甘精胰岛素+阿卡波糖,临床疗效显著,使患者的空腹血糖、餐后2 h血糖、糖化血红蛋白等指标得到了明显改善,安全性强。     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.