Colfex装置治疗老年退行性腰椎管狭窄症的术后护理体会

目的 分析Colfex装置治疗老年退行性腰椎管狭窄症的术后护理方法和效果。方法 回顾性分析30例行Colfex装置治疗退行性腰椎管狭窄症老年患者的临床护理资料,总结其护理方法和效果。结果 本次研究中30例患者均成功实施手术,术后出现1例便秘,经对症治疗后好转,未发生切口感染、脑脊液渗漏、Colfex装置松动、神经根损伤等并发症,18例下腰痛消失,12例腰痛得到明显改善,术后间隙性跛行基本消失,平均行走距离超过1000 m。结论 对接受Colfex装置治疗老年退行性腰椎管狭窄症患者术后给予完善的临床护理,有利于减少并发症,促进患者腰椎功能恢复。     

丁咯地尔治疗下肢动脉缺血症多中心临床研究

目的 :观察丁咯地尔针剂用于治疗下肢动脉缺血症病人的疗效和安全性。方法 :采用多中心方法 ,同步开放给药 ,应用丁咯地尔针剂治疗 83例( 130侧肢体 )下肢动脉缺血症病人。剂量2 0 0mg·d- 1,连续静滴 3wk。结果 :治疗末期 ,患肢间隙性跛行、静息痛、皮肤麻痹症状及溃疡情况有不同程度改善 ,有效率分别为 61% ,91% ,80 %和55% ,总有效率为 80 %。用药期间未发现严重不良反应。结论 :丁咯地尔治疗下肢动脉缺血症 ,疗效显著 ,并且安全     

口腔颌面部间隙感染41例临床分析

目的探讨口腔颌面部间隙感染的临床特点和治疗效果。方法对本院2008年1月至2013年1月收治的口腔颌面部间隙感染41例患者进行临床分析。结果该病感染的病因以牙源性感染为多见,感染部位主要为颌下间隙感染。41例患者经治疗后痊愈或症状缓解。结论口腔颌面部间隙感染的治疗应采取全身抗炎、支持疗法与局部治疗相结合的综合治疗原则。     

口腔颌面部间隙感染86例临床治疗体会

目的探讨口腔颌面部间隙感染的特点、病因、临床治疗方法及疗效。方法收集86例口腔颌面部间隙感染患者的临床资料进行回顾性分析,对患者给予全身联合用药控制感染,治疗全身性疾病,局部切开排脓,治疗病灶牙。结果口腔颌面部间隙感染中成人以牙源性最为常见,儿童以腺源性最为常见。经积极治疗一般预后较好。患严重全身性疾病的患者病程延长,甚至死亡。结论口腔颌面部感染以混合性感染为主,多间隙感染者应积极抗感染治疗,根据情况早期行切开引流术,同时治疗全身性疾病。     

成年人口腔颌面部间隙感染33例临床分析

目的对33例成年人口腔颌面部间隙感染的临床特点、病因、诊断进行了分析,探讨成年人口腔颌面部间隙感染的临床特点和治疗效果。方法采用回顾性分析的方法对我院2009年1月至2011年12月期间收治的成年人口腔颌面部间隙感染者33例的临床资料包括临床表现、感染部位、细菌培养结果、致病原因及治疗效果、治愈率进行分析。结果 33例患者中,以牙源性感染(如根尖周炎、冠周炎、颌骨骨髓炎等)24例居首约占72.7%,其次为腺源性感染(如扁桃体炎、涎腺化脓病变、颌面部淋巴结炎等)8例约占24.2%,另有1例外伤性感染(如口腔黏膜溃疡等)仅占3.1%。经治疗后,33例患者痊愈32例,治愈率为97.0%,仅1例出现并发症,经积极治疗后痊愈。结论成年人口腔颌面部间隙感染以牙源性感染和腺源性感染为主要因素,起病急、病情重,应根据药敏实验结果选用适合的抗生素并与全身治疗、手术治疗或局部治疗进行联合治疗。     

椎间盘镜治疗腰椎间盘突出症疗效观察

2007年2月至2009年2月,我院应用椎间盘镜系统手术治疗腰椎间盘突出症78例,取得良好疗效,报道如下。1资料与方法1.1一般资料本组78例中,男48例,女30例;年龄22~70岁,平均年龄40.5岁;病程10d~5年,平均6个月;男52个椎间盘,女46个椎间盘;单纯下肢疼痛、麻木15例,腰痛伴下肢疼痛麻木42例,有间隙性跛行19例,直腿抬高试验阳性69例,     

间歇性跛行的现代认识和疗法

间歇性跛行是动脉粥样硬化累及下肢动脉最常见的临床表现。本病多见于老年人,发病率是糖尿病或中风的2～3倍。近10年来,由于一些新药和介入技术的出现,对跛行的治疗上已有显著的进展。一、临床表现跛行(claudication)一词源于拉丁语,但它并非本病典型特征。具有特征性的主诉有肌肉痛、痉挛或疲劳,均因局部肌肉缺血所引起。这些表现可在同一运动量后发生,而在下肢垂直休息1～5分钟后随即消失。跛行的定位可提供引起臀部、大腿和腓肠肌跛行的具有髂主     

40例儿童口腔颌面部间隙感染临床分析

目的对40例儿童颌面部间隙感染的临床特点、病因、治疗和诊断进行了分析,认为儿童口腔颌面部间隙感染以腺源性为主。方法颌面部间隙感染的治疗,主要是全身抗炎给予联合用药控制感染及治疗感染牙。局部形成脓肿的切开引流。结果 40例患儿均痊愈,感染源以腺源性（如颌面部淋巴结炎、扁桃体炎、涎腺化脓病变等）28例居首位占70%。其次为牙源性（如冠周炎、根尖周炎、颌骨骨髓炎等）11例占27.5%。外伤性感染（如外伤、口腔黏膜溃疡等）1例占0.25%。感染部位以颌下间隙最多,口底间隙、眶下间隙及咬肌间隙次之。结论颌面部感染以混合性感染为主,正确处理原发灶,熟练掌握口腔解剖生理了解儿童本身疾病特点,均能很好解决儿童间隙感染,防止严重并发症的发生。     

老年人口腔颌面部间隙感染的特点与治疗

目的：探讨老年人口腔颌面部间隙感染的诊断和治疗水平。方法：收集25例口腔颌面部感染患者,由内分泌科与口腔颌面外科联合诊治．对其临床特点和治疗结果进行分析总结。结果：老年人颌面部间隙感染均为继发性,常见为牙源性感染,经多学科联合治疗后,治愈率92．0％,术后并发症发生率24．0％。结论：老年口腔颌面部重症间隙感染患者,采用全身加局部治疗方法,可取得较好的治疗效果。     

间隙依赖性尖端扭转型室性心动过速的治疗

目的 分析缓慢性心律失常发作间隙依赖性尖端扭转型室性心动过速（TdP）的特点和治疗措施。方法 回顾分析6年来因缓慢性心律失常而安置埋藏式起搏器的137例患者中伴有尖端扭转型室性心动过速7例。结果 137例缓慢性心律失常患者中7例发作TdP（5．11％）,共12阵次,伴发TdP的患者发作前均有室性早搏,其中6例QT间期延长;7例患者采用起搏器治疗,起搏频率〈80次／分不能有效抑制TdP发作,频率80-90次／分起搏加β-受体阻滞剂能有效抑制TdP发作。结论 起搏器加β-受体阻滞剂治疗能缩短QT间期和抑制室性早搏,对间隙依赖性尖端扭转型室性心动过速起到有效的治疗作用。     

间断和周期性羟乙膦酸二钠防治绝经后骨质疏松观察

目的：观察羟乙膦酸二钠间断和周期性防治绝经后骨质疏松的临床疗效。方法：７２例腰椎（Ｌ２￣４）骨矿密度（ＢＭＤ）低于本地区２０￣４０岁健康女性均值减１．０标准差的绝经后妇女,双盲随机分为两组各３６例。羟乙膦酸二钠治疗组３６例,给予羟乙膦酸二钠４００ｍｇ／日,连服２周,停药１０周,重复３次共３６周。对照组服安慰剂,程序同治疗组。观察期间两组均每日加服钙剂和维生素Ｄ。试验前后用双能Ｘ线吸收法（ＤＥＸＡ）     

空气波压力治疗仪治疗脑卒中后肩手综合征的疗效分析

目的观察空气波压力治疗仪治疗脑卒中后肩手综合征的疗效。方法将93例脑卒中后并发肩手综合征患者随机分为治疗组和对照组,两组均行常规康复治疗,治疗组还加用空气波压力治疗仪治疗,治疗1个月后评定疗效。结果经空气波压力治疗仪治疗后患者上肢运动功能较治疗前有显著改善,视觉模拟评分有了明显降低。结论空气波压力治疗仪治疗脑卒中后肩手综合征疗效显著,值得临床应用。     

间断陛与持续缓慢低效血液透析法治疗心肾综合征的临床分析

目的比较间断性与持续缓慢低效血液透析法治疗心肾综合征（CRS）的效果。方法选择本院2012年1月～2012年11月收治的CRS患者140例,将其随机分为间断性血液透析法治疗组与持续缓慢低效血液透析法治疗组,每组各70例,观察两组治疗效果。结果两组患者治疗前后心率、血肌酐、尿素氮差异均有统计学意义（P〈0．05）,且治疗后持续缓慢低效血液透析法治疗组的上述指标及心、肾功能均优于间断性血液透析法治疗组（P〈0．05）。结论两种治疗方法对于CRS均有一定的效果,但持续缓慢低效血液透析法的疗效更为显著,值得临床研究推广。     

Costs and efficacy of three different esomeprazole treatment strategies for long-term management of gastro-oesophageal reflux symptoms in primary care

BACKGROUND: A prospective, open, randomized multi-centre study with parallel group design was conducted in 155 general practice clinics, and included 1357 endoscopically uninvestigated patients with symptoms suggestive of gastro-oesophageal reflux disease. AIM: To assess the differences in direct medical costs between a patient-controlled on-demand treatment strategy with esomeprazole, 20 mg daily, and general practitioner-controlled intermittent treatment strategies with esomeprazole, 40 mg daily, for either 2 or 4 weeks. Secondary objectives were to measure other costs, total costs, patient satisfaction and time to first relapse. METHODS: The primary cost analysis was carried out as a cost minimization analysis, comparing the direct medical costs in patients allocated to on-demand treatment vs. those in patients allocated to either of the intermittent treatment strategies. RESULTS: The mean direct medical costs were 182, 221 and 195 euros for patient-controlled on-demand treatment and 2 weeks and 4 weeks of general practitioner-controlled intermittent treatment, respectively, showing no statistically significant difference. The comparable mean total costs were 211, 344 and 300 euros, i.e. significantly lower for patients treated on-demand compared with either of the general practitioner-controlled intermittent treatment strategies. CONCLUSIONS: The mean total costs, but not the mean direct medical costs, were higher in general practitioner-controlled intermittent treatment strategies with esomeprazole compared with a patient-controlled on-demand treatment strategy.     

The effects of withdrawing tegaserod treatment in comparison with continuous treatment in irritable bowel syndrome patients with abdominal pain/discomfort, bloating and constipation: a clinical study

BACKGROUND: The post-withdrawal characteristics of tegaserod treatment in patients with irritable bowel syndrome with constipation remain undefined. AIM: To evaluate the effects of continuous tegaserod treatment, versus intermittent or withdrawal of treatment in patients with irritable bowel syndrome with constipation. METHODS: In a randomized, open-label trial, all patients initially received tegaserod 6 mg b.d. Responders were randomized to continue or withdraw from treatment for 8 weeks and symptom recurrence was assessed. Tegaserod was re-introduced in withdrawal patients who experienced symptom recurrence, allowing an assessment of intermittent treatment. Two separate analyses assessed the effects of intermittent and withdrawal of treatment on symptom recurrence. RESULTS: Five hundred irritable bowel syndrome with constipation patients initially received tegaserod; 410 completed treatment. Time to symptom recurrence was shorter in withdrawal patients than those maintained on tegaserod. Significantly more patients maintained on tegaserod had not experienced symptom recurrence by week 8, compared with intermittent (86.5% vs. 58.1%, respectively) or withdrawal of treatment (69.2% vs. 11.3%, respectively) (P < 0.0001 for both). Significant treatment effects were observed for bloating (P < 0.01) and abdominal pain/discomfort (P < 0.02). Most adverse events were mild to moderate. CONCLUSIONS: Irritable bowel syndrome with constipation patients who receive continuous or intermittent tegaserod are less likely to experience symptom recurrence than patients withdrawn from treatment.     

小剂量间歇补铁法在小儿缺铁性贫血治疗中的疗效观察

目的研究小剂量间歇补铁法治疗小儿缺铁性贫血（IDA）的临床疗效及副作用。方法对138例缺铁性贫血患儿进行分组,小剂量组70例,常规剂量组68例,分别进行小剂量间歇补铁治疗及常规剂量每日补铁治疗,每周复查血红蛋白（Hb）,观察治疗效果。结果小剂量组与常规剂量组比较血红蛋白上升速度相同,差异无统计学意义（P〉0．05）,常规剂量组副作用发生率高于小剂量组,差异有统计学意义（P〈0．05）。结论小剂量间歇补铁法与常规剂量补铁法治疗小儿IDA疗效相同,且副反应发生率低、程度轻,认为小剂量补铁法较好,值得临床推广。     

临床药师参与1例反复间歇发热患者治疗的药学实践

目的:评估1例反复间歇发热患者的抗感染药学实践,以达到最佳药物治疗效果。方法:临床药师参与1例反复间歇发热患者的会诊,分析患者病情,准确判断疾病类型,协助医师从抗感染药物、增强免疫力等方面制订治疗方案。结果:抗感染药物使用头孢西丁,增强免疫力采用胸腺肽或人参多糖。患者病情好转出院。结论:临床药师参与反复间歇发热患者的临床药物治疗,协助制订治疗方案,有利于提高药物治疗水平,促进合理用药。     

间歇蓝光与持续蓝光治疗足月新生儿高胆红素血症的疗效对比分析

目的对比间歇蓝光与持续蓝光治疗足月新生儿高胆红素血症的临床疗效。方法选取我院2009年至2012年收治的60例高胆红素血症足月新生儿,随机分为对照组和实验组各30例。对照组采用持续蓝光治疗,实验组采用间歇蓝光治疗。结果对照组治疗前血清间接胆红素为（275．7±35.3）μmol／L,治疗后血清间接胆红素为（103．9±9．5）μmol／L;实验组治疗前血清间接胆红素为（272．2±34．1）μmol／L,治疗后血清间接胆红素为（105．2±7．7）μmo]／L。对照组腹泻11例、发热6例、皮疹16例,实验组腹泻3例、发热1例、皮疹7例。结论采用间歇蓝光与持续蓝光治疗足月新生儿高胆红素血症都能取得较好的疗效,但是问歇蓝光对患儿造成的不良反应较少,在临床上具有推广意义。     

Intermittent claudication: pharmacoeconomic and quality-of-life aspects of treatment

The purpose of this article is to review the literature on the pharmacoeconomics of treatment for intermittent claudication and to discuss the importance of quality-of-life assessment for evaluating treatment strategies. Systemic risk reduction is the primary objective in the treatment of patients with intermittent claudication, as these patients have a high future risk of cardiovascular morbidity and mortality. Modification of cardiovascular risk factors accompanied by antiplatelet therapy is likely to improve overall survival, reduce myocardial infarction and stroke, and will, perhaps, also reduce the risk of ulcers and amputation at acceptable cost-effectiveness ratios. The second goal in the treatment of patients with intermittent claudication is to improve their walking capacity and community-based functional status. Supervised exercise training is the most effective noninvasive intervention to improve walking capacity, but may have elevated indirect costs. Among patients with disabling claudication who are candidates for invasive therapeutic procedures, angioplasty is cost effective in those with femoropopliteal stenosis or occlusion and in those with critical limb ischaemia and a stenosis. For all these therapeutic strategies there is a need to relate the costs to a relevant and comprehensive measure of effectiveness. Quality-of-life evaluation by using questionnaires exploring the specific problems encountered by patients with intermittent claudication in their daily life appear to be the most appropriate tool to evaluate the net result of a treatment. Cost-utility studies by combining pecuniary and quality-of-life evaluations provide information that is extremely useful to patients with intermittent claudication, regulatory authorities, the pharmaceutical industry and healthcare providers.     

两种机械通气模式对创伤性连枷胸并肺挫伤的应用比较

目的比较创伤性连枷胸并肺挫伤治疗经面罩无创持续气道正压通气(CPAP)通气模式和经气管插管同步间歇指令通气(SIMV)+呼气末正压通气(PEEP)的通气模式临床效果。方法 50例肺挫伤患者随机分为两组:FM组(25例)采用经面罩无创CPAP模式机械通气;ETI组(25例)采用气管插管SIMV+PEEP模式机械通气。观察和比较两组的主要并发症、动脉血氧分压(PaO2)、ICU住院时间及ICU期内的存活率。结果 FM组有3例继发肺感染,ETI组有13例继发肺感染,两组比较有显著性差异(P<0.01)。ETI组的PaO2在开始第1天较FM组明显增高,但之后无明显差异,两组入住ICU时间无明显差异(P>0.05)。FM组存活25例,ETI组存活18例,两组比较有显著性差异(P<0.05)。结论经面罩无创CPAP通气治疗创伤性连枷胸并肺挫伤能有效减少继发性肺感染的发生,降低病死率,值得临床推广。