保留悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停低通气综合征的疗效观察

目的 探讨保留悬雍垂腭咽成形术(H-UPPP)治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床疗效及安全性.方法 选择40例OSAHS患者采用H-UPPP治疗,随访1年评价疗效.结果 治疗前睡眠呼吸暂停低通气指数(AHI)为每小时(23.89±5.03)次,最低血氧饱和度(LSaO2)为(73.90±6.35)％;手术后1年AHI为每小时(12.26±3.75)次,LSaO2为(86.52±4.88)％,差异有统计学意义(P＜0.05).治愈34例、显效4例、有效1例和无效1例,无严重并发症发生.结论 H-UPPP治疗腭咽平面阻塞的OSAHS临床疗效显著,术后恢复较快,并发症发生率,安全性高.     

腭咽成形术治疗阻塞性睡眠呼吸暂停综合征

阻塞性睡眠性呼吸暂停综合征 (ＯＳＡＳ)是一种较为常见的疾病 ,临床上以打鼾、呼吸暂停、白天嗜睡为特征 ,其反复发作的呼吸暂停会导致低氧血症和高碳酸血症 ,可继发高血压、冠心病、肺心病等严重的心脑血管疾病 ,更有甚者会导致夜间睡眠时猝死。过去未引起人们足够的重视 ,随着生活水平及人们对健康要求的提高 ,国内在 2 0世纪 80年代后期已广泛开展研究 ,对其病因、发病机理以及诊断、治疗均有了较为深刻的认识。我院自 2 0 0 1年 5月至 6月收治ＯＳＡＳ患者 6例 ,均采取国内广泛开展的悬雍垂腭咽成形术 (ＵＰＰＰ) ,取得较好疗效 ,报告…     

悬雍垂腭咽成形术对阻塞性睡眠呼吸暂停低通气综合征血压影响的动态观察

目的 探讨悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)对合并高血压的阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者的血压影响。方法 对52例OSAHS患者(轻度11例、中度34例,重度7例)连续观察,术前、术后1个月、术后6个月、术后1年、术后3年时的睡眠呼吸暂停低通气指数(apnea-hypop-nea index,AHI)血压变化。结果 按照杭州会议疗效评定标准,术后1月有效率为100％,6个月为98.08％,1年为84.62％,3年为76.9％,手术后3年体重指数、血压较术前均有明显下降。结论 UPPP能改善OSAHS患者的低氧血症,降低血压;远期疗效差于近期疗效。     

保留悬雍垂改良腭咽成形术治疗睡眠呼吸暂停低通气综合征的临床探讨

目的探讨保留悬雍垂改良悬雍垂腭咽成形术治疗睡眠呼吸暂停低通气综合征的临床应用。方法：回顾2006年10月至2008年10月,本院采用HUPPP治疗51例OSAHS患者51例临床资料进行总结分析。结果51例手术均顺利。术后6月～1年观察,经多导睡眠呼吸监测（polysomnography,PSG）治愈30例,显效10例,有效9例,无效2例。总有效率96．07％。结论保留悬雍垂改良悬雍垂腭咽成形术疗效确切,术后并发症少,方法简便易行,减少了创伤,有利于生理功能的恢复。     

改良悬雍垂腭咽成形术与鼻腔扩容术治疗阻塞性睡眠呼吸暂停低通气综合征的疗效比较

目的探讨比较改良悬雍垂腭咽成形术(UPPP)与鼻腔扩容术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床效果。方法回顾性分析92例阻塞性睡眠呼吸暂停低通气综合征患者病例资料,根据治疗方法不同分为对照组(42例)和观察组(50例)。对照组患者全身麻醉后单纯行鼻腔扩容术,观察组患者行改良悬雍垂腭咽成形术。比较两组多导睡眠监测(PSG)指标、Epworth嗜睡评分表(ESS)评分以及治疗效果。结果术后1个月,两组患者呼吸暂停低通气指数(AHI)、微觉醒指数(AI)、ESS评分均低于手术前,最低脉搏氧饱和度(LSaO2)水平高于手术前,且观察组的AHI(12.35±2.78)次/h、AI(12.14±6.25)次、ESS(3.55±1.24)分均低于对照组的(18.74±3.27)次/h、(19.55±8.45)次、(5.87±1.96)分,LSaO2(92.32±5.21)%高于对照组的(82.61±4.58)%,差异具有统计学意义(P<0.05)。观察组治疗总有效率92.0%明显高于对照组的71.4%,差异具有统计学意义(P<0.05)。结论改良悬雍垂腭咽成形术对于多平面狭窄OSAHS患者治疗效果显著,可显著提高患者通气质量。     

腭咽成形术治疗阻塞性睡眠呼吸暂停综合征术中护理体会

腭咽成形术（ＰＰＰ）是近年来治疗阻塞性睡眠呼吸暂停综合征（ＯＳＡＳ）有效的手术方法。我院自１９９５年来开展ＰＰＰ手术３５例，具有疗效显著、安全可靠、并发症少的特点。术中护理工作的配合是保障手术成功关键之一。应着重于：①心理护理：稳定病人情绪，使病人心理、精神安定，处于最佳状态。②借助多功能监护仪密切观察病人的生命体征，尤其注意血压、血氧饱和度变化及术中出血情况。③保持呼吸道和静脉通道的畅通，及时吸     

H—UPPP治疗阻塞性睡眠呼吸暂停低通气综合征

目的探讨保留悬雍垂腭咽成形术（H—UPPP）治疗阻塞性睡眠暂停低通气综合征（OSAHS）的临床疗效。方法根据术前定位诊断结果,30例OSAHS患者行多平面H—UPPP治疗,比较治疗前后呼吸暂停低通气指数（AHI）、最低血氧饱和度（SaO2）、睡眠参数及Epworth嗜睡评分（ESS）。结果术后1年治愈率为30％,显效率为56．7％,有效率为10％,总有效率为96．7％,术后6个月及1年AHI、最低SaO2及ESS嗜睡评分均较术前明显改善（P〈0．01）。结论应用H—UPPP手术治疗OSAHS,治疗效果明显,术后咽腔接近正常解剖形态,患者并发症少,易接受,具有临床推广应用价值。     

悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停综合征

阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apneahypopnea syndrome，OSAHS)是发病率较高且具有潜在危险的一种临床常见病。笔者对我院自1995年以来收治的38例OSAHS患者资料进行回顾性分析，就基层医院诊治OSAHS体会作一报道。     

悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停综合征疗效观察

总结 4a来阻塞性睡眠呼吸暂停综合征 (OSAS)施行悬雍垂腭咽成形术 (UPPP)的患者共 6例 ,证实 U PPP是治疗 OSAS的有效手术方法 ,但应严格选择其适应症 ;手术时选择局麻较为安全 ,严重病例可以在麻醉师监护及高流量吸氧下进行手术。     

改良腭咽成形术治疗阻塞性睡眠呼吸暂停综合征的临床疗效对比

目的 探讨改良腭咽成形术（H-UPPP）治疗阻塞性睡眠呼吸暂停综合征（OSAS）的临床疗效.方法 选取1993年12月～2005年12月采用传统悬雍垂腭咽成形术（UPPP）治疗OSAS患者78例为对照组.按1∶1比例选取2006年1月～2012年1月采取改良悬雍垂腭咽成形术（H-UPPP）治疗OSAS患者78例为观察组,随访1年观察两组患者的临床疗效及术后并发症.结果 两组患者术后自觉症状均有明显改善,但观察组改善较对照组更为显著.术后1年经多导睡眠呼吸监测（PsG）,对照组总临床有效率和并发症的发生率均低于观察组,差异有统计学意义（P ＜ 0.05）.结论 H-UPPP通过保留悬雍垂,保留咽腔基本结构,提高了手术疗效,降低了并发症,是治疗OSAS的有效方法.     

厄贝沙坦治疗轻、中度高血压病

目的 :评价厄贝沙坦治疗轻、中度高血压病的临床疗效和安全性。方法 :选取轻、中度高血压病病人 ,采用双盲双模拟、随机对照法 ,比较厄贝沙坦与氯沙坦的降压效果。经 2wk安慰剂导入期后 ,服厄贝沙坦 (5 8例 ) 75mg ,qd或氯沙坦 (5 9例 ) 5 0mg ,qd ,于wk 4末坐位舒张压≥ 12kPa者则剂量加倍 ,继续服用 4wk。厄贝沙坦组 17例病人与氯沙坦组 14例病人 ,分别于治疗前及治疗wk 8末行 2 4h动态血压监测。结果 :8wk治疗末 ,有效率厄贝沙坦组 83%、氯沙坦组 78% ,2组比较差异无显著意义 (P >0 .0 5 )。厄贝沙坦的谷 /峰值收缩压为 81% ,舒张压为 70 % ,氯沙坦分别为 75 % ,71%。 2组最常见的不良反应是头晕。结论 :对轻、中度高血压病 ,厄贝沙坦是一种有效、安全且耐受性好的降压药     

Comparison of nicardipine and propranolol in the treatment of mild and moderate hypertension

Summary In a double-blind controlled trial 22 patients with mild or moderate essential hypertension were treated with nicardipine 30 mg t.d.s. and 19 patients with propranolol 80 mg t.d.s. as monotherapy for 24 weeks. Blood pressure in both groups at the end of trial was equally and significantly reduced; systolic pressure 22.2 mmHg and diastolic pressure 15.5 mmHg in the supine position, and 24.4 mmHg and 18.4 mmHg, respectively, in the standing position in those on nicardipine, and by 23.7 and 16.2 mmHg and 28.0 and 19.2 mmHg, respectively, in the propranolol group. There was an initial increase in heart rate in the nicardipine group, but the rise was only moderate (3 beats/min supine p=0.3219, and 7 beats/min standing, p=0.0203) at the end of the 24 weeks. In the propranolol group heart rate was reduced markedly. Adverse effects occurred in 77% of patients on nicardipine and in 63% of those on propranolol, and there were no unexpected findings. The effects were mild in both groups and did not lead any patient to stop medication. One patient on propranolol was withdrawn from the trial because of poor blood pressure control and suspected angina pectoris after 5 weeks on active medication. There were no significant changes in blood chemistry, including lipoprotein classes. Overall, in comparison with propranolol, nicardipine was effective, well-tolerated and safe to use in the monotherapy of mild or moderate essential hypertension.     

Once daily propranolol in the treatment of mild to moderate hypertension

Summary Propranolol was administered in a single dose of 80 mg, 120 mg, 160 mg, 240 mg, or 320 mg, to 23 patients with essential mild to moderate hypertension in a randomised, double-blind cross-over study. All treatments produced a significant fall in lying and standing blood pressures compared with placebo, but there was no statistically significant difference in the effects of the different doses. The percentage of patients showing a satisfactory fall in blood pressure was not different in the five treatment groups. The major anti-hypertensive effect of each dose was present by two weeks. The frequency of side-effects were similar on all the doses.     

厄贝沙坦治疗轻中度原发性高血压的临床研究

目的　评价国产厄贝沙坦治疗轻中度原发性高血压的有效性及安全性。方法　采用随机双盲平行对照的临床设计 ,将5 7例轻中度原发性高血压病患者分成试验组 (厄贝沙坦组 ) 2 7例和对照组 (缬沙坦组 ) 30例 ,起始剂量分别为 75mg·d-1和80mg·d-1,2周后如DBP仍≥ 90mmHg ,则加量至 15 0mg·d-1和 16 0mg·d-1,疗程 4周。结果　试验组与对照组血压均明显下降。试验组总有效率 86 .6 % ,不良反应发生率 7.4 %。对照组总有效率 93.3% ,不良反应发生率 10 .0 %。两组疗效和不良反应发生率均无显著性差异。结论　国产厄贝沙坦是一种安全有效的治疗轻、中度原发性高血压的药物 ,其降压效果和不良反应均与缬沙坦相似     

盐酸马尼地平片治疗轻中度原发性高血压的疗效和安全性

目的评价盐酸马尼地平片治疗轻中度原发性高血压的疗效和安全性。方法用随机双盲对照研究,设苯磺酸氨氯地平片为对照药物。随机入选病人共60例但脱落1例完成59例,马尼地平组30例,苯磺酸氨氯地平组29例。2组每天分别服用盐酸马尼地平片10～20 mg和苯磺酸氨氯地平片5～10 mg,两药均为每日1次,共8周。结果治疗8周后,盐酸马尼地平片组收缩压和舒张压分别下降(8.70±13.11)mmHg和(7.90±5.54)mmHg,苯磺酸氨氯地平片组分别下降为(13.28±13.40)mmHg和(11.66±7.66)mmHg,与治疗前相比均有统计学意义(均P<0.05)。2组均无严重不良事件发生。结论盐酸马尼地平片每日服用1次,可显著地、平稳地降低血压,患者耐受性较好。     

安佳欣胶囊治疗轻中度抑郁症疗效和安全性研究

目的:评价安佳欣对轻中度抑郁症的疗效和安全性。方法:采用随机、双盲双模拟、活性药对照、多中心临床研究方法。轻中度抑郁症患者480例,试验组(n=360)口服安佳欣1440 mg·d~(-1),对照组(n=120)口服氟西汀20 mg·d~(-1),疗程6周。以汉密尔顿抑郁量表(HAMD)作为主要疗效评价指标;以不良事件、实验室检查和心电图检查等评价安全性。结果:安佳欣组与氯西汀组有效率分别为67．5％和72．6％,痊愈率分别为38．7％和40．2％,两组差异无统计学意义。安全性研究表明,安佳欣组与氟西汀组不良事件总发生率分别为20．2％和29．1％;药物相关不良事件发生率分别为12．6％和21．4％;安佳欣组均低于氟西汀组(P＜0．05)。结论:安佳欣治疗轻中度抑郁症有肯定的疗效,与氟西汀疗效相当,总的不良反应发生率较低。     

金玉康胶囊治疗轻中度抑郁症的疗效和安全性

目的:评价金玉康胶囊治疗轻中度抑郁症的有效性和安全性。方法:采用多中心、随机、双盲、双模拟、活性药物平行对照设计。入选293例轻中度抑郁症患者,随机分为试验组145例和对照组148例,分别口服金玉康胶囊600 mg·d-1或盐酸氟西汀片20 mg·d-1,疗程均为6周。疗效观察指标包括基线以及治疗不同阶段的17项汉密尔顿抑郁量表(Hamilton rating scale for depression,HAMD17)、汉密尔顿焦虑量表(Hamilton rating scale for anxiety,HAMA)、临床总体印象量表(Clinical Global Impression scale,CGI)评分,以HAMD17作为主要疗效指标。结果:治疗结束时,两组的HAMD17总分与基线相比均明显降低,但两组间差异无显著性;两组的HAMD减分率接近,分别为55．77％和59．95％;以HAMD17减分率判断有效率,两组间差异也无显著性。两组的不良反应发生频率相当;体重在治疗结束时金玉康组较基线有所增加而氟西汀组没有明显变化,组间比较差异有统计学意义(F=5．014,P=0．026)。结论:金玉康胶囊治疗轻中度抑郁症安全、有效。     

缬沙坦治疗轻中度高血压病的临床疗效

目的 研究新型的降压药物——血管紧张素受体拮抗剂缬沙坦治疗轻中度高血压病的临床疗效。方法80例患者随机分成2组,缬沙坦80mg/d或依那普利5mg/d,2周后SIDBP≥90mmHg,则剂量加倍,4周后SIDBP≥90mmHg则加服双氢克尿噻25mg/d。结果 两组药物均有明显降压作用。缬沙坦有效率为86.8％,依那普利有效率为88.2％,两组间比较无统计学显著差异性(P>0.05)。缬沙坦和依那普利组分别有40％和42.5％加用利尿剂。结论 缬沙坦治疗轻中度高血压疗效确切,耐受性好,副作用少,每日服1次能维持24小时降压效应。     

Once daily amlodipine in the treatment of mild to moderate hypertension.

1. The antihypertensive efficacy of once-daily amlodipine was studied in a group of 30 patients with mild to moderate hypertension in a double-blind, placebo controlled parallel group study. The dose range of amlodipine was 2.5-10 mg daily titrated at 2 weekly intervals for a total treatment period of 8 weeks. 2. Amlodipine produced a significant reduction in blood pressure compared with placebo, the mean difference between baseline and 8 weeks (corrected for placebo effect) being 16/12 mm Hg supine, 14/4 mm Hg standing. 3. Blood pressure returned to baseline values during a terminal 4 week washout period on placebo. 4. There were no significant effects on heart rate. 5. Two patients experienced slight ankle oedema while receiving amlodipine 10 mg daily but the active drug was otherwise well tolerated. 6. Plasma concentration of amlodipine, sampled 24 h after the preceding dose, increased as the dose titration sequence was followed, averaging 2.5 ng ml-1 on 2.5 mg, 4.9 ng ml-1 on 5 mg and 10.5 ng ml-1 on 10 mg.     

Review article: treatment of mild to moderate ulcerative colitis and pouchitis

The meta-analyses of published trials have shown topical therapy with 5-aminosalicylic acid (5-ASA) to be the treatment of choice in active distal ulcerative colitis. Oral aminosalicylates are effective for both distal and extensive ulcerative colitis, but in distal colitis the rates of improvement and remission are usually lower than those reported for rectal 5-ASA therapy. An alternative to 5-ASA therapy is represented by the new steroids; budesonide and beclometasone dipropionate (BDP) enemas, the most extensively studied, have been shown to be as effective as conventional steroids but with a significantly lower inhibition of plasma cortisol. Patients who do not respond to 5-ASA or new steroids should be treated with oral steroids. Azathioprine or 6-mercaptopurine may be effective in patients who do not respond or cannot be weaned off steroids. Treatment of pouchitis is largely empirical and few controlled studies have been carried-out. Antibiotics are the treatment of choice and most patients make a good response to metronidazole or ciprofloxacin. Chronic refractory pouchitis may benefit from a prolonged course of a combination of antibiotics. Highly concentrated probiotics (VSL#3) are effective both for the prevention of pouchitis onset and the prevention of relapses.