雾化吸入普米克令舒辅助治疗儿童哮喘效果观察

目的 探讨雾化吸入普米克令舒辅助治疗儿童哮喘的效果。方法 将79例哮喘急性发作期患儿随机分为观察组（44例）和对照组（35例），对照组行常规平喘、抗感染及对症处理，观察组在此基础上雾化吸入普米克令舒。结果 观察组治疗后FVC、FEV，及PEF值较治疗前显著改善（均P〈0．01），与对照组比较，差异有显著性意义（均P〈0．05）；观察组治疗效果明显优于对照组（P〈0．01），且住院时间明显缩短（P〈0．01）。结论 雾化吸入普米克令舒对儿童哮喘具有良好的治疗效果，且安全、经济。     

布地奈德雾化吸入治疗小儿急性感染性喉炎的疗效观察

目的:探讨布地奈德雾化吸入治疗小儿急性感染性喉炎的疗效。方法:将61例喉炎患儿随机分为两组,两组均采用综合治疗,治疗组用布地奈德雾化吸入,对照组用地塞米松静脉注射,治疗3h后比较两组临床疗效。结果:治疗组在声嘶、喉梗阻症状的缓解方面与对照组差异有统计学意义(P<0.05)。结论:布地奈德雾化吸入治疗小儿急性感染性喉炎,快速、有效、简单、安全,值得临床推广。     

雾化吸入普米克令舒辅助治疗儿童哮喘效果观察

目的探讨雾化吸入普米克令舒辅助治疗儿童哮喘的效果。方法将79例哮喘急性发作期患儿随机分为观察组(44例)和对照组(35例),对照组行常规平喘、抗感染及对症处理,观察组在此基础上雾化吸入普米克令舒。结果观察组治疗后FVC、FEV1及PEF值较治疗前显著改善(均P<0.01),与对照组比较,差异有显著性意义(均P<0.05);观察组治疗效果明显优于对照组(P<0.01),且住院时间明显缩短(P<0.01)。结论雾化吸入普米克令舒对儿童哮喘具有良好的治疗效果,且安全、经济。     

普米克令舒联合沙丁胺醇溶液雾化吸入治疗儿童哮喘急性发作的护理体会

目的:观察普米克-令舒联合沙丁胺醇溶液雾化吸入治疗儿童哮喘急性发作的疗效及不良反应.方法:将84例哮喘急性发作患儿采取随机分组.治疗组:采用普米克-令舒联合沙丁胺醇溶液通过高频超声雾化吸入,对照组:给予常规治疗,观察两组治疗后症状体征平均消失天数.结果:两组治疗后,症状体征平均消失天数有显著性差异.     

布地奈德混悬液雾化吸入治疗小儿轻中度喉炎疗效观察

目的:探讨布地奈德混悬液治疗小儿急性喉炎的临床疗效。方法:将60例急性喉炎患儿随机分为观察组和对照组各30例。两组均给予积极抗感染、吸氧、补痰、化痰、止咳对症等治疗。两组中若出现Ⅱ度喉梗阻患儿均给予静脉注射地塞米松。观察组在常规治疗基础上给予布地奈德混悬液雾化吸入;对照组在常规治疗基础上给予地塞米松注射液雾化吸入。观察两组患儿症状、体征消失时间、住院时间及不良反应情况。结果:观察组总有效率明显高于对照组(P<0.05);观察组症状和体征消失时间均低于对照组(P<0.05)。结论:布地奈德混悬液雾化吸入治疗小儿急性喉炎具有疗效好、见效快、不良反应少等优点,值得临床推广应用。     

CPAP联合普米克令舒氧气驱动雾化吸入治疗肺透明膜病60例分析

目的 观察CPAP联合普米克令舒氧气驱动雾化吸入治疗新生儿肺透明膜病的疗效.方法 治疗组为笔者所在医院2008年5月~2011年5月收治的肺透明膜病新生儿60例,在生后4~6h内给予CPAP,联合普米克令舒氧气驱动雾化吸入.对照组为2005年1月~2008年3月收治的条件相同的仅给予CPAP而未使用雾化吸入的肺透明膜病患儿55例.结果 治疗组60例肺透明膜病患儿中出现症状加重需应用肺表面活性物质及进一步呼吸支持的仅5例,其中气管内滴入肺表面活性物质的2例,气管插管呼吸机辅助呼吸的3例;对照组55例出现上述情况的达20例,其中应用肺表面活性物质的15例,气管插管呼吸机辅助呼吸的5例.结论 CPAP联合普米克令舒氧气驱动雾化吸入治疗早产儿肺透明膜病有显著疗效,方法简便,节约经济,创伤少,患儿后期恢复快,值得在基层医院及专科医院推广.     

慢性阻塞性肺疾病患者长期雾化吸入普米克令舒疗效观察

目的 探讨慢性阻塞性肺疾病(COPD)患者长期雾化吸入普米克令舒的效果.方法 28例COPD住院患者,住院期间及病情稳定出院时均给予雾化吸入指导,出院后继续雾化吸入普米克令舒治疗,观察疗效并记录症状改善情况,出院时、出院后3、6及12个月检查肺通气功能.结果 患者出院后不同时间,咳嗽、气促、咳痰显著减轻(均P＜0.05).结论 长期雾化吸入普米克令舒能改善COPD患者的自觉症状,提高生活质量.     

术前应用普米克令舒雾化吸入对老年肿瘤患者肺部感染并发症的影响

目的探讨术前应用普米克令舒雾化吸入对老年肿瘤患者肺部并发症的影响。方法将50例老年胃肠道肿瘤患者随机分为观察组(22例)与对照组(28例)。2组均行普米克令舒雾化吸入,对照组术后连续使用7 d,观察组从术前3 d至术后7 d持续性给予。观察2组患者肺部并发症情况。结果观察组术后肺部并发症发生率36.3%,对照组为39.3%,2组比较,差异无统计学意义(P>0.05)。结论对老年肿瘤患者术前应用普米克令舒雾化吸入对其肺部感染等并发症无明显影响,不能降低并发症发生率。     

雾化吸入布地奈德治疗小儿轻中度急性喉炎的临床观察

目的观察雾化吸入布地奈德混悬液治疗小儿轻中度急性喉炎的疗效。方法将2009年10月～2010年10月在笔者所在医院治疗的65例轻中度急性喉炎患儿随机分为治疗组33例和对照组32例。两组均给予抗病毒药物、抗生素和对症治疗等综合治疗,在此基础上,治疗组给予布地奈德混悬液雾化吸入,对照组给予地塞米松静脉滴注。观察两组症状、体征消失时间。结果治疗组显效22例,有效9例,无效2例,有效率为93.94%;对照组显效21例,有效8例,无效3例,有效率为90.63%,两组相比差异无统计学意义（P〉0.05）。治疗组喉鸣、声嘶、犬吠样咳嗽等症状消失时间明显短于对照组,差异有统计学意义（P〈0.05）。结论雾化吸入布地奈德混悬液治疗小儿轻中度急性喉炎直接作用于局部,可以提高治疗效果、缩短治疗时间。     

普米克令舒联合免疫球蛋白治疗毛细支气管炎疗效观察

目的:探讨普米克令舒联合免疫球蛋白(IVIG)治疗毛细支气管炎(毛支)疗效.方法:将121例毛支患儿随机分威两组,对照组(60例)采用综合治疗,治疗组(62例)在此基础上加用普米克令舒雾化吸入治疗,用法为每次1mL(含布地奈德0.5mg),加生理盐水至2～3mL,由空气压缩泵雾化吸入,每日3次,每次吸入10-15min,疗程为5～7d.同时应用IVIG400 mg/(kg·d)静滴,连用3-5d.比较治疗后两组症状体征平均特续时间.结果治疗组在缓解喘憋、咳嗽消失时间、肺部体征消失时间和住院时间上明显优于对照组(P<0.01).结论:普米克令舒联合IVIG治疗毛支效果确切.     

小儿七氟醚麻醉诱导方法的比较

目的 观察七氟醚诱导方法 在小儿腹腔镜短小手术中的应用效果.方法 将择期行腹腔镜腹股沟斜疝结扎术3～6岁患儿60例,随机均分为面罩肺活量吸入法诱导组(A组)与面罩潮气量吸入法诱导组(B组).记录睫毛反射消失时间、气管插管时间、血流动力学指标、拔管时间、意识恢复时间及不良反应.结果 A组睫毛反射消失时间(43.5±4.4)s,明显短于B组的(68.8±7.6)s(P<0.01);A组气管插管时间(3.5±0.7)min,明显短于B组的(6.7±1.4)min(P<0.01);两组拔管时间、意识恢复时间、不良反应的发生率差异无统计学意义.结论 两种七氟醚吸入诱导方法 均可获得良好的气管插管条件;面罩肺活量吸入诱导法起效更为迅速.     

333例小儿吸入性损伤临床分析

目的　分析小儿吸入性损伤的临床特征 ,探讨其临床防治措施。　方法　统计 333例小儿烧伤合并吸入性损伤 ,分析其与烧伤面积、休克、感染及预后之间的关系。　结果　小儿吸入性损伤的休克和菌血症发生率分别为 4 1.14 %和 18.92 % ,中、重度吸入性损伤的发生率分别高达5 8 76 %和 31.96 % ;休克组菌血症发生率为 2 4 .82 %。 6 7例死亡中 ,5 8.2 1%并发菌血症 ,34.33%直接死于菌血症。对有适应证者早期气管切开较晚期手术复苏时间短 ,电解质与胶体补液量减少。　结论　感染是影响吸入性损伤预后的重要因素 ;吸入性损伤、休克是感染的重要诱因 ;防治休克以及对高危感染患者早期应用高效抗生素 ,可望降低感染发生率 ,提高吸入性损伤的治愈率 ;早期气管切开有利于休克复苏     

喜炎平雾化吸入联合利巴韦林治疗小儿疱疹性咽峡炎的效果观察

目的：探讨喜炎平雾化吸入联合利巴韦林治疗小儿疱疹性咽峡炎的临床疗效。方法选取我院48例患儿,随机分为观察组和对照组,每组24例,对照组给予利巴韦林10mg/（kg·d）,静脉滴注,1次/d;观察组在对照组基础上给予喜炎平5mg/kg 加入生理盐水10mL 雾化吸入,2次/d。观察比较两组的临床疗效以及体温恢复正常时间、疱疹消失时间。结果观察组总有效率为91.67%,明显优于对照组的83.33%,差异有统计学意义（P ＜0.05）;治疗后观察组体温恢复正常时间、疱疹消失时间均明显短于对照组,差异具有统计学意义（P ＜0.05）。结论喜炎平雾化吸入联合利巴韦林治疗小儿疱疹性咽峡炎临床效果显著,且不良反应少,值得临床推广应用。     

Clinical characteristics and prognosis of peritoneal dialysis treatment in children with acute kidney injury

Objective To investigate the efficiency and safety of peritoneal dialysis (PD) in pediatric patients with acute kidney injury (AKI). Method A retrospective study of children who underwent PD for AKI in the First Affiliated Hospital of Xi’an Jiaotong University from 2003 to 2013 was performed, and the laboratory examinations, the causes, the complication, the prognosis and the risk factors were evaluated. Results The study included 48 children, with the age of (67.6±51.7) months (ranging from 3 months to 15 years old), including 31 males (64.6%) and 34 co-infections (70.8%). Primary glomerulonephritis (27.1%) was the most common cause of AKI, followed by the hemolytic uremic syndrome (18.7%) and drug induced AKI (18.7%). Peritoneal dialysis was performed manually using percutaneous or adapted catheters. The duration of PD during hospitalization was 11(7,14) days. PD treatment was highly effective in attenuation of toxics retention and correction of electrolyte disturbances (all P＜0.05). There were 3 cases of PD-related complications, including 1 case of peritonitis, 1 case of catheter outflow obstruction, 1 case of catheter exit site hematoma, and no child patient died of PD complications. Among the AKI children, 37 cases (77.1%) recovered with the PD treatment and had the catheter successfully removed till discharge, 7 cases (14.6%) needed further peritoneal dialysis and 4 cases (8.3%) died. The serum albumin level was significantly higher in patients who got recovered with PD treatment than other unrecovered cases [(32.6±6.7) g/L vs (23.2±4.3) g/L, t=-3.994, P＜0.001]. Conclusions PD can be safely and efficiently performed for the treatment of pediatric AKI. Low albumin level may be related to poor prognosis of AKI.     

消风散联合地氯雷他定治疗小儿慢性特发性荨麻疹的疗效观察

目的研究消风散联合地氯雷他定治疗小儿慢性特发性荨麻疹的临床疗效。方法选取120例小儿慢性荨麻疹患儿,随机分为治疗组与对照组各60例,其中对照组仅采用地氯雷他定治疗,而治疗组应用消风散与地氯雷他定联合治疗,比较两组疗效。结果两组治愈率、总有效率及复发率对比差异显著,具有统计学意义（P〈0．05）。结论消风散联合地氯雷他定治疗小儿慢性特发性荨麻疹具有较好的疗效,值得临床推广。     

Nonoperative treatment of acute appendicitis in children

Background/Purpose

Appendicitis is considered by many surgeons to be a surgical emergency for which necessary to avoid perforation of the appendix. Although it has also been treated nonoperatively using antibiotic therapy, experience in such treatment in children with acute appendicitis (AA) is extremely limited. In addition, previous studies on nonoperative treatment (NT) showed it to be a cause of morbidity and mortality. The authors hold that not all appendicitis cases respond to NT because only some of the cases recover. In the present study, 16 of 95 cases with AA were selected for NT according to physical and ultrasound examinations. The clinical and ultrasonographic findings of the cases are presented.

Methods

The medical records of all children with appendicitis treated between August 2003 and March 2006 were retrospectively reviewed . Patients who had history of abdominal pain for less than 24 hours with localized abdominal tenderness and hemodynamic stability underwent NT. Children were treated with parenteral antibiotics (ampicillin with sulbactam, 100 mg · kg⁻¹ · 24 h⁻¹, divided into 3 doses daily, and ornidasole, 20 mg · kg⁻¹ · 24 h⁻¹, divided intro 2 doses daily), intravenous fluid, and nothing by mouth for at least 48 hours.

Results

A total of 136 patients with appendicitis were treated. Of the cases, 95 (70%) were AA, and 41 (30%) had perforated appendicitis. Sixteen (16.8%) cases of AA were selected for NT (12 boys and 4 girls; age range, 5-13 years; mean age, 9 years). The mean anteroposterior diameter of the appendix at the presentation was 7.11 ± 1.01 mm (range, 6-9.5 mm). Ultrasound examination was repeated after 48 hours of treatment. The mean diameter of the appendix was 4.64 ± 0.82 mm (range, 3.6-6.8 mm). The difference was statistically significant (t = 9.63, P < .0001). Nonoperative treatment was successful in 15 (93.7%) of the 16 patients.

Conclusion

Hyperplasia of the appendiceal lymphoid follicle frequently causes luminal obstruction. Antibiotic therapy probably causes regression of lymphoid hyperplasia because of suppression of bacterial infection and prevents ischemia and bacterial invasion in the early stage of appendicitis. We found that some of the patients who had a history of abdominal pain for less than 24 hours with localized abdominal tenderness and hemodynamic stability could be treated nonoperatively.     

分阶段营养支持对重症急性胰腺炎患者感染性并发症的影响

目的探讨分阶段、不同方式的营养支持对重症急性胰腺炎(severe acute pancreatitis,SAP)患者感染性并发症的影响。方法对发病48 h以内,首诊于本科的SAP患者(A组,70例)行分阶段营养支持,并与同期行肠外营养支持的SAP患者(B组,25例)进行对比研究。结果A组在入组第14与21天,APACHEⅡ评分和内毒素水平分别为(2.5±1.1)分、(0.906±0.124)EU/ml与(2.3±0.4)分(、0.865±0.107)EU/ml,均显著低于B组的(4.6±1.2)分、(1.972±0.381)EU/ml和(3.5±0.9)分(、1.594±0.216)EU/ml(P<0.05或P<0.01)。A组住院期间中转手术率、术中坏死组织细菌培养阳性率及感染性并发症发生率分别为44.29%、25.81%和11.43%,均显著低于B组的68%、58.82%和40%(P<0.05)。结论分阶段营养支持对SAP患者是一种合理有效的营养方式,在减少SAP患者感染性并发症的发生及改善转归和预后方面明显较仅行肠外营养支持优越。     

针灸治疗脑瘫患儿语言障碍的分析

目的：探讨针灸治疗脑瘫患儿语言障碍的研究进展。方法选择2013年1~12月我院收治的脑瘫患儿30例,将这30例患儿随机分成两组,每组15例患儿,分别命名为治疗组和对照组,对照组的15例患儿采取常规语言训练,治疗组的15例患者在采取常规语言训练的基础上,进行针灸治疗,观察两组患儿的临床治疗效果。结果治疗组临床治疗的总有效率为96.8%。对照组临床治疗的总有效率为77.4%。治疗组患儿临床治疗的总有效率明显的高于对照组。两组总有效率比较,差异有统计学意义（P＜0.05）。结论针灸治疗脑瘫患儿的语言障碍具有良好的效果,该种方法值得临床推广。     

Management of complicated acute appendicitis in children:Still an existing controversy

Complicated acute appendicitis(CAA) is a serious condition and carries significant morbidity in children. A strict diagnosis is challenging, as there are many lesions that mimic CAA. The management of CAA is still controversial.There are two options for treatment: Immediate operative management and nonoperative management with antibiotics and/or drainage of any abscess or phlegmon. Each method of treatment has advantages and disadvantages.Operative management may be difficult due to the presence of inflamed tissues and may lead to detrimental events. In many cases, non-operative management with or without drainage and interval appendectomy is advised. The reasons for this approach include new medications and policies for the use of antibiotic therapy. Furthermore, advances in radiological interventions may overcome difficulties such as diagnosing and managing the complications of CAA without any surgeries. However, questions have been raised about the risk of recurrence,prolonged use of antibiotics, lengthened hospital stay and delay in returning to daily activities. Moreover, the need for interval appendectomy is currently under debate because of the low risk of recurrence. Due to the paucity of high-quality studies, more randomized controlled trials to determine the precise management strategy are needed. This review aims to study the current data on operative vs non-operative management for CAA in children and to extract any useful information from the literature.