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1.
  目的  分析基于加速康复外科理念的改良延续性护理对经腹腔镜远端胃切除术后的胃癌患者手术应激及免疫功能的影响。  方法  选择2018年6月—2020年6月新疆医科大学第一附属医院98例行经腹腔镜远端胃切除术的胃癌患者,并按随机数字表法分为观察组(49例)和对照组(49例),对照组采用常规护理,观察组采用基于加速康复外科理念的改良延续性护理,比较术后不同阶段应激功能指标的变化;比较2组患者免疫功能指标的变化。  结果  2组患者术后第1、4、7天IL-6、IL-8、IL-10较术前均有所升高,且观察组术后第1、4、7天IL-6、IL-8水平明显低于对照组(均P<0.05);2组患者术后第1、4天CD4+、CD8+、CD4+/CD8+均有所下降,而术后第7天CD4+较术前升高,差异有统计学意义(均P<0.05),组间差异无统计学意义(P > 0.05);2组患者术后第1、4天的IgA、IgG、IgM水平均相较于术前有所降低,组间差异有统计学意义(均P<0.05),第7天IgA、IgG、IgM基本回到术前水平,且观察组第1、4、7天IgA、IgG均高于对照组,组间差异有统计学意义(均P<0.05)。  结论  基于加速康复外科理念的改良延续性护理可有效提高行经腹腔镜远端胃切除术的胃癌患者的临床效果,降低其应激炎性反应,并一定程度促进患者免疫功能的恢复与改善,进而促进术后胃癌患者的康复。   相似文献   

2.
目的:探讨宫颈癌患者术后康复期应用心理护理干预对患者的不良情绪及细胞免疫功能的改善作用。方法:选取2015年3月-2017年2月入住本院的宫颈癌行根治术患者126例。按照随机数字表法将其分为观察组和对照组,各63例。对照组采用常规护理,观察组在对照组基础上行心理护理干预。比较两组护理前后的不良情绪(HAMD、HAMA评分)、自我效能感评分及细胞免疫因子(CD3~+、CD8~+、CD4~+/CD8~+、NK细胞)变化情况。结果:护理6个月后,两组HAMD、HAMA评分均低于护理前,且观察组均低于对照组,差异均有统计学意义(P0.05);护理6个月后,观察组C-SUPPH评分均高于护理前及对照组(P0.05),但对照组护理前后C-SUPPH评分比较,差异无统计学意义(P0.05);护理3个月后,观察组CD3~+、CD4~+/CD8~+、NK细胞均高于护理前及对照组,CD8~+细胞均低于护理前及对照组,差异均有统计学意义(P0.05)。结论:宫颈癌患者在术后康复期行心理护理干预能够降低患者不良情绪,提高患者自我效能感,改善患者细胞免疫功能,有利于临床康复。  相似文献   

3.
目的 探讨正常人群、HIV感染者及AIDS患者外周血CD28分子表达变化及临床意义.方法 选取AIDS患者、HIV感染患者及正常健康者各50例,分别设为A、B、C三组,比较三组间CD4+CD28+、CD8+CD28+T淋巴细胞计数和百分比,并分析血浆HIV病毒载量与CD4+、CD4+CD28+T淋巴细胞计数相关性.结果 A、B组CD4+T淋巴细胞计数和百分比水平显著低于C组,差异有统计学意义(P<0.05);A组CD4+T淋巴细胞计数和百分比水平显著低于B组,差异有统计学意义(P<0.05);B组CD8+T淋巴细胞计数水平显著高于A、C组,差异有统计学意义(P<0.05);A、B组CD8+T淋巴细胞百分比水平显著高于C组,差异有统计学意义(P<0.05);A组CD8+T淋巴细胞百分比水平显著高于B组,差异有统计学意义(P<0.05);A、B组CD4+CD28+T淋巴细胞计数和百分比水平显著低于C组,差异有统计学意义(P<0.05);A组CD4+CD28+T淋巴细胞计数和百分比水平显著低于B组,差异有统计学意义(P<0.05);A组CD8+CD28+T淋巴细胞计数水平显著低于B、C组,差异有统计学意义(P<0.05);A、B组CD8+CD28+T淋巴细胞百分比水平显著低于C组,差异有统计学意义(p<0.05);A组CD8+CD28+T淋巴细胞百分比水平显著低于B组,差异有统计学意义(P<0.05);A组血浆HIV病毒载量水平显著高于B组,差异有统计学意义(p<0.05);CD4+和CD4+CD28+T淋巴细胞计数与血浆HIV病毒载量呈负相关(r=-0.781,-0.549,P=0.001,0.003).结论 HIV感染和AIDS患者随病情进展外周血T淋巴细胞CD28分子水平下降,可作为预后评价重要指标之一.  相似文献   

4.
彭莉  杨华  车莉 《西部医学》2018,30(7):1060-1063,1068
目的 探讨加速康复外科理念对结肠癌手术患者临床症状及免疫功能的影响。方法 回顾性分析自贡市第四人民医院普外一科及南充市中心医院普外科接受手术治疗的38例结肠癌患者的临床资料,依据围手术期处理方法的不同分为对照组18例及观察组20例,对照组患者接受常规处理方法,观察组患者接受加速康复处理方法,比较两组患者手术前后临床表现相关指标、炎症指标、免疫球蛋白水平和细胞免疫功能。结果 观察组患者口渴、饥饿发生率及住院时间、首次排气时间、首次排便时间、首次接受半流质时间均优于对照组,差异有统计学意义(P<0.05);两组患者手术时间比较差异无统计学意义(P>0.05)。观察组患者CRP、IL-6表达水平低于对照组,差异有统计学意义(P<0.05)。两组患者T0时点IgA、IgM、IgG水平比较,差异无统计学意义(P>0.05);观察组患者T1、T2时点IgA、IgM、IgG水平显著低于对照组,差异有统计学意义(P<0.05)。两组患者T0时点CD3、CD4、CD8、CD4/CD8比较,差异无统计学意义(P>0.05);观察组患者T1、T2时点CD3、CD4、CD8、CD4/CD8水平优于对照组,差异有统计学意义(P<0.05)。结论 加速康复外科理念可显著优化结肠癌患者术后临床指标,提高机体细胞免疫功能,可推荐应用。  相似文献   

5.
目的:探讨原发性胃癌患者胃癌根治术后化疗对患者外周血T细胞亚群及NK细胞的影响及临床意义.方法:选择2010年11月~2013年11月入住我院35例行胃癌根治术的原发性胃癌患者作为观察组,采用EP化疗方案:100 mg/m2足叶乙苷,d13,静脉滴注;25 mg/m2顺铂,d1-3,静脉滴注.另外选择同期于我院进行体检的健康者35名作为对照组.比较化疗前后外周血白细胞总数、淋巴细胞百分比、淋巴细胞绝对值、外周血T细胞亚群相关指标(CD3+、CD4+、CD8+、CD4 +/CD8+及CD45RA+/RO+)及NK细胞.结果:(1)观察组化疗前后白细胞总数、淋巴细胞百分比及淋巴细胞绝对值差异均具有统计学意义(P<0.05),但观察组化疗后上述指标与对照组相比,差异无统计学意义(P>0.05);(2)观察组化疗后外周血T细胞亚群相关指标(CD3+、CD4+、CD8+及CD4+/CD8+、CD45RA+、CD45RA+绝对值、CD45RO+绝对值、CD45RA+/RO+)及NK细胞水平均显著高于化疗前(P<0.05).结论:原发性胃癌根治术后化疗可有效提高机体外周血T细胞亚群及NK细胞水平,对患者生活质量的改善及疾病的康复具有十分重要的临床意义.  相似文献   

6.
《中国现代医生》2020,58(28):59-62
目的 探讨对成人再生障碍性贫血伴严重感染患者实施造血生长因子治疗的效果。方法 随机将2018年1月~2019年7月我院62例再生障碍性贫血伴严重感染患者分为对照组(31例,应用免疫抑制治疗)和观察组(31例,在对照组治疗基础上应用造血生长因子治疗)。对比两组治疗总有效率、症状缓解时间、T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+值)水平及不良反应总发生率。结果 观察组治疗总有效率(93.55%)高于对照组(74.19%),差异有统计学意义(P<0.05);观察组体温恢复时间、咳痰消失时间、肺部啰音消失时间均较对照组更短,差异有统计学意义(P<0.05);观察组治疗后CD3+、CD8+较对照组更低,CD4+、CD4+/CD8+值较对照组更高,差异有统计学意义(P<0.05);观察组不良反应总发生率和对照组比较,差异无统计学意义(P>0.05)。结论 对成人再生障碍性贫血伴严重感染患者实施造血生长因子治疗有助于增加T淋巴细胞免疫力,对病情恢复具有较好促进作用。  相似文献   

7.
儿童重型与轻型支原体肺炎免疫变化及临床意义   总被引:2,自引:0,他引:2  
目的 检测儿童重型肺炎支原体肺炎(MPP)与轻型MPP的体液免疫及细胞免疫状况,为临床免疫治疗寻找依据.方法 157例MPP患儿按病情分为轻症组(132例)和重症组(25例),以同期儿科门诊体检的健康儿童25例为对照组,检测上述所有患儿急性期免疫指标.结果 轻症组及重症组患儿IgG、IgM水平均高于对照组(均P <0.05),重症组患儿IgM较轻症组患儿水平高(P<0.05).两组MPP患儿IgA与对照组比较,差异均无统计学意义(P<0.05);轻症及重症组惠儿CD4+T细胞比例、CD4+/CD8+T细胞比值均低于对照组(均P<0.05),两组MPP患儿CD19+、CD8+T细胞比例均高于对照组,差异有统计学意义(P<0.05),且重症组CD19+T细胞比例高于轻症组,差异有统计学意义(P<0.05);重症组患儿CD3+、CD16+CD56+T细胞比例明显低于轻症组(均P <0.05).结论 MPP感染患儿B淋巴细胞异常活化且T淋巴细胞和自然杀伤细胞(NK)免疫功能低下,重症组更明显.免疫制剂对MPP患儿临床治疗有效,对重症MPP疗效更明显.  相似文献   

8.
目的:评价补肺健脾益肾方治疗老年慢性阻塞性肺疾病(COPD)稳定期的疗效及对患者外周血T淋巴细胞亚群、BODE指数及生活质量的影响.方法:将80例中医辨证为肺脾肾气虚型COPD稳定期患者随机分组,对照组(40例)仅采取常规西医治疗,而观察组(40例)在常规西医治疗的基础上联合补肺健脾益肾汤,治疗8周后比较临床疗效及患者外周血T淋巴细胞亚群、BODE指数及生活质量的变化.结果:经治疗后观察组BODE指数及BMI积分、FEV1积分、MMRC积分、6MWT积分均较对照组明显减少,差异具有统计学意义(P<0.05);经治疗后观察组CD3+、CD4+及CD4+/CD8+较对照组明显升高,CD8 +水平较对照组明显降低,差异具有统计学意义(P<0.05);两组经治疗后肺功能指标FEV1和FEV1/FVC均较治疗前有明显改善,差异具有统计学意义(P<0.05);两组治疗后SGRQ评分均较治疗前明显降低,但观察组治疗后SGRQ评分明显低于对照组,差异具有统计学意义(P<0.05).结论:补肺健脾益肾方用于老年COPD稳定期治疗可改善患者肺功能及BODE指数,提高生活质量,增强细胞免疫功能.  相似文献   

9.
王洁妤  冯明  汤哲 《中国全科医学》2010,13(22):2504-2506
目的 研究日常生活能力及情感障碍对老年医院获得性肺炎(HAP)发生的影响,探讨日常生活能力及情感障碍与免疫功能的关系.方法 以50例老年医院获得性肺炎患者为(HAP组),同时期住院的未发生医院获得性肺炎的老年患者50例为对照组.对每一位患者进行日常生活能力量表(ADL)评分、汉密顿抑郁量表(HAMD)评分及汉密顿焦虑量表(HAMA)评分.检测其免疫功能指标:免疫球蛋白G(IgG),免疫球蛋白A(IgA),T淋巴细胞亚群CD3+,CD4+/CD8+;营养指标血清清蛋白(ALB),对结果进行统计学分析.结果 (1)老年HAP组患者的ADL评分、HAMD评分、 HAMA评分与对照组比较,差异均有统计学意义(P<0.05).(2)老年HAP组患者的免疫指标IgG 、IgA、CD3+、CD4+/CD8+检测结果与对照组比较差异均有统计学意义(P<0.01);营养指标血清清蛋白水平老年HAP组与对照组比较差异均有统计学意义(P<0.05).(3)ADL水平与免疫功能指标呈负相关(P<0.05),与情感状态亦存在相关性(P<0.05).结论 老年人日常生活能力障碍及存在焦虑、抑郁情感障碍与老年医院获得性肺炎的发生相关;老年人日常生活功能障碍越明显,则免疫功能越差;有日常生活功能障碍的老年人易患抑郁、焦虑症.  相似文献   

10.
目的 探讨特殊护理小组干预对门诊部情绪波动较大患者的影响.方法 选取门诊部情绪波动较大的患者52例,按随机数字表法分为对照组(实施常规心理干预)和观察组(实施特殊护理小组干预).对比2组患者护理前后汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)分值和护理效果,护理后幸福进取者问卷(happy enterprising individual questionnaire,HEIQ)分值,对比2组依从性和护理满意率.结果 护理前2组HAMD和HAMA分值差异均无统计学意义(P>0.05);护理后观察组HAMA及HAMD分值均较对照组低,差异有统计学意义(P<0.05).护理后观察组HEIQ中自我肯定、克服困难、幸福感分数均较对照组高,差异有统计学意义(P<0.05).观察组HAMA(88.46%)及HAMD干预总有效率(80.77%)均明显高于对照组(分别为76.92%、69.23%);观察组依从性(92.31%)和患者对护理满意率(84.62%)均高于对照组(分别为76.92%、73.08%),差异有统计学意义(P<0.05).结论 特殊护理小组干预能显著缓解门诊情绪波动较大患者的负面情绪,使其建立积极心态,积极配合治疗和护理.  相似文献   

11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

12.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

13.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

14.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

15.
Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P<0.01);the MAP decreased(P<0.01)and the HR increased drastically(P<0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.  相似文献   

16.
Objective:To investigate the gene expression of osteoprotegerin(OPG) and osteoclast differentiation factor(ODF) in the bone tissue of patients with hip fracture due to osteoporosis. Methods:OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers(over 50 years old) with hip fracture(Observer Group) and 30 cases of hip facture sufferers with no osteoporosis(Control group) were analyzed with the Semi-Quantitative RT-PCR method. Results:The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion:Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.  相似文献   

17.
Objective:To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas(SPTP). Methods:Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin(HE) staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results:Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin(9/9 cases), AAT(9/9 cases), NSE(9/9 cases), ACT(7/9 cases), CK20(2/9 cases), CgA(1/9 cases), S-100(3/gcases), PR(4/gcases), Syn(3/9 cases) and CD56(5/9cases), negative in CEA and ER. Conclusion:SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.  相似文献   

18.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

19.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

20.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

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