阿瑞匹坦预防化疗引起恶心呕吐的疗效及安全性

 目的 观察阿瑞匹坦对减轻化疗所致恶心呕吐的疗效及安全性。方法 将80例接受含顺铂化疗患者随机分为观察组和对照组, 观察组采用阿瑞匹坦与昂丹司琼、地塞米松联合止吐, 对照组采用帕洛诺司琼与昂丹司琼、地塞米松联合止吐, 观察两组疗效及不良反应。结果 观察组呕吐的完全缓解率和恶心控制率分别为80%和77.5%,优于对照组的47.5%和37.5%,皆有统计学意义(P<0.01)。两组中出现最多的不良反应主要有便秘、腹泻、呃逆、食欲减退、疲乏、失眠、转氨酶升高等, 均为轻度。结论 阿瑞匹坦对化疗所致恶心呕吐有明显的预防作用,且不良反应轻,具有临床应用前景。     

昂丹司琼预防和治疗腹腔镜胆囊切除术后恶心呕吐的疗效观察

目的：观察并分析昂丹司琼预防和治疗腹腔镜胆囊切除术后恶心、呕吐反应的临床效果。方法86例慢性结石性胆囊炎患者在全麻下接受常规腹腔镜胆囊切除术。将其分为术前用药组36例、术后用药组25例和对照组25例。术前用药组于麻醉前30分钟通过静脉注射盐酸昂丹司琼8 mg、术后用药组麻醉清醒后立即给予静脉注射盐酸昂丹司琼8 mg,对照组不给予任何止吐药物。观察至术后48小时,统计各组中恶心、呕吐反应的发生例数和药物不良反应情况。结果86例患者共有25例发生恶心、呕吐反应。术前用药组、术后用药组和对照组的恶心、呕吐发生率分别为27.8%、12.0%和48.0%。术后用药组与对照组相比有统计学意义（χ^2=7.71,P＜0.05）,说明术后用药可减少术后恶心、呕吐的发生;术前用药组与对照组比较无统计学意义（χ^2=2.61,P＞0.05）,说明术前用药不能预防术后恶心、呕吐的发生。25例患者术后发生恶心、呕吐,给予经静脉注射盐酸昂丹司琼8 mg,有21例患者缓解,缓解率为84.0%,用药过程中未发生药物不良反应。结论盐酸昂丹司琼预防和治疗LC术后恶心、呕吐是安全、有效的,预防性用药最佳时机应该为麻醉清醒时。     

姜末穴位外敷预防含铂化疗药物介入治疗肝癌及转移性肝癌后恶心呕吐的研究

目的 比较姜末穴位外敷加恩丹西酮与单用恩丹西酮在预防含铂化疗药介入后恶心呕吐的效果.方法 肝癌患者将接受含铂化疗药物动脉灌注,并且加用恩丹西酮预防恶心呕吐,以姜末(试验组)或安慰剂(对照组)穴位贴敷,采用罗德恶心呕吐指数表对试验组31例和对照组31例肝癌患者进行调查.结果 ①姜末穴位贴敷可明显降低患者介入治疗后恶心呕吐发生率:介入后0～12、12～24、24～36、36～48、48～60、60～72 h试验组恶心、呕叶等方面发生人数明显低于对照组(P<0.05).48～60 h试验组干恶的发生率无显著改善(P>0.05),其他时段干恶发生率明显低于对照组(P<0.05).②姜末穴位贴敷使得介入后恶心呕吐程度明显减轻:试验组在61～72 h时所测得的恶心、呕吐、干恶程度均值为0.45、0.25、0.19,而对照组恶心、呕吐、干恶程度均值分别为:2.77、0.87、0.97(P<0.05).结论 姜末穴位贴敷可明显降低肝癌患者使用含铂化疗药介入后恶心呕吐发生率,减轻肝癌患者使用含铂化疗药介入后恶心呕吐反应程度     

5-羟色胺受体拮抗药预防腰麻后头痛效果观察

目的:观察静脉预先注射昂丹司琼和格雷司琼预防腰麻后头痛的效果。方法:将腰麻病人500例随机分为3组。对照组166例静脉注射生理盐水6ml;昂丹司琼组168例静脉注射昂丹司琼液6ml(8mg);格雷司琼组166例静脉注射格雷司琼液6ml(6mg)。术后15天连续观察病人头痛发生情况。结果:昂丹司琼组头痛发生率3.6%,格雷司琼组4.8%,均明显低于对照组(11.5%,P<0.05);两观察组疼痛程度明显较对照组轻(P<0.05),但两观察组之间差异不显著(P>0.05)。3组腰麻后头痛发生时间基本一致,但两观察组持续时间比对照组短。结论:昂丹司琼和格雷司琼均可明显降低腰麻后头痛的发生率及其疼痛程度。     

艾迪联合长春瑞滨加顺铂方案治疗晚期非小细胞肺癌疗效观察

目的观察和评价艾迪注射液联合长春瑞滨加顺铂方案（NP方案）治疗晚期非小细胞肺癌的疗效和毒性。方法将我科近几年收治的52例晚期非小细胞肺癌患者随机分为联合治疗组和化疗组：联合治疗组采用艾迪注射液联合长春瑞滨加顺铂方案，化疗组采用长春瑞滨加顺铂方案（NP方案）。3周期化疗后进行疗效，毒性对比研究。结果联合治疗组和化疗组近期有效率分别为46％和42％，疾病进展时间（TTP）分别为6．8月和5.3月．中位生存时间分别为10．7月和9．4月，1年生存率分别为42％和38％。两组间比较差异均无显著性（P〉0．05）。联合治疗组在恶心、呕吐、骨髓抑制等毒性反应发生率方面低于化疗组，差异有显著性（P〈0．05）。结论艾迪注射液联合长春瑞滨加顺铂方案与NP方案相比．疗效相似，但毒性反应低于NP组，患者更易接受，可广泛用于临床。     

格拉司琼预防化疗所致消化道反应的临床疗效分析

目的探讨格拉司琼预防化疗所致消化道反应的临床效果。方法40例恶性肿瘤患者，化疗当天及第2～5天每日静滴格拉司琼3mg一次。结果用格拉司琼后在化疗第1～5天无恶心和轻度恶心的患者占62．5％～82．5％，对急性呕吐的有效率达92．5％，对迟发性呕吐有效率在82．5％～97．5％之间。结论格拉司琼对减轻化疗药物所致的恶心反应、对控制急性呕吐及迟发性呕吐疗效与恩丹西酮相当，明显优于胃复安，且副作用小，是一种安全有效的止呕药。     

三种不同止吐方案预防化疗所致恶心呕吐的费用-效果分析

目的：从几组化疗止吐剂中筛选一贴经济有效、便于推广应用的止吐处方。方法：采用CCT将149例非顺铂化疗病人分为A、B、C三组。A组52例，使用国产格拉司琼；B组47例，用恩丹西酮；C组50例，用胃复安 地塞米松。以止吐效果为主要指标进行多侧面观察比较。结果：止恶心、止吐有效率，A组有效率分别为92．3％-94．2％，B组为87．2％-89．3％，C组有效率分别分48．0％-68．0％。A、B、C三组的不良反应发生率分别为25．0％、36．2％、52．0％。结论：格拉司琼可作为非顺铂化疗止吐首选用药，恩丹西酮可作为非顺铂化疗止吐次选用药，胃复安 地塞米松可作为经济负担较为困难的化疗病人止吐用药。     

昂丹司琼预防治疗卡前列素氨丁三醇所致恶心呕吐的临床观察

目的 观察昂丹司琼能否有效地预防治疗卡前列素氨丁三醇注射液（商品名：欣母沛）所致恶心呕吐等副作用并了解合适的给药时机.方法 选择存在宫缩乏力危险因素的择期剖宫产产妇90 例.按双盲原则随机均分为3组,A组：在新生儿断脐后即刻给予昂丹司琼4mg,5min后由手术医生经宫体注射卡前列素氨丁三醇250μg;B组：在新生儿断脐后即刻由手术医生经宫体注射卡前列素氨丁三醇250μg,5min后给予昂丹司琼4mg;C 组：在新生儿断脐后即刻给予0.9%生理盐水4ml,5min后由手术医生经宫体注射卡前列素氨丁三醇250μg,监测记录不同时点的平均压（MAP）、心率（HR）、呼吸（RR）、脉搏血氧饱和度（SpO2）.记录手术时间,术中输液量及产妇恶心呕吐、胸闷、烦躁和面部潮红等不良反应发生情况.结果 A组和B组恶心呕吐发生率明显低于C组（P〈0.05）.A组恶心和呕吐发生率低于B组（P〈0.05）.结论 昂丹司琼能够有效预防和治疗欣母沛引起的恶心呕吐,且提前给药效果更佳.     

穴位按压法对含铂类药物化疗后所致恶心呕吐的疗效观察

 目的 评价穴位按压对含铂类药物化疗所致恶心呕吐的疗效。方法 选择2016-01至2017-08住院的肿瘤化疗患者200例,随机分为两组,对照组应用常规止吐药物,观察组在对照组基础上加用穴位按压(合谷+内关穴),每日一次,每穴按压3 min,7 d为一疗程。比较两组治疗后的临床效果。结果 观察组治疗后第1、3、7天有效率分别为70%、90%和95%,均高于对照组(50%、55%、58%),差异有统计学意义(P<0.05);治疗后第3、7天观察组KPS评分均比对照组高,差异均有统计学意义(P<0.05)。结论 按压合谷+内关穴可以缓解铂类药物所致恶心呕吐的效果确切。     

格拉司琼与顺铂氟尿嘧啶配伍的相互作用研究

目的：研究格拉司琼与2种抗癌药顺铂,氟尿嘧啶在0．9％氯化钠注射液中的配伍稳定性。方法：采用紫外分光光度法,考察格拉司琼与上述2种药物在8h内的含量变化情况,同时观察外观,pH值及薄层层析检查。结果：在室温条件下,格拉司琼与顺铂,氟尿嘧啶在0－8h内外观稳定,含量,pH值无明显变化,薄层层析检查无新物质产生,结论：格拉司琼与顺铂,氟尿嘧啶在0．9％氯化钠注射液中可以配伍使用。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.