氟康唑治疗真菌性角膜溃疡的护理体会

角膜真菌病是一种广泛化脓性炎症，氟康唑作为一类抗真菌新药，具有抗菌谱广，副作用小，有较好的组织亲和性和使用方便等特点，报告２０例氟康唑治疗真菌性角膜溃疡的护理体会，认为：治疗前责任护士应进入入院评估，做好心理护理，直接采样取材，尽快确定病原。治疗过程中应认真观察并发症并及时对症处理，观察用药反应，确保用药及时准确，同时做好病区的清洁，通风，消毒和提高病人的防病意识，做好卫生健康教育，这样有利于治疗     

复方磺胺甲基异(口恶)唑治疗肾移植术后卡氏肺囊虫性肺炎患者的护理

目的探讨肾移植术后并发卡氏肺囊虫性肺炎(PCP)患者的用药护理经验.方法针对患者的病情和复方磺胺甲基异NFDA1唑(SMZco)的用药特点,做好输液护理和肝肾功能监测,严密观察用药后反应,并遵医嘱及时做好剂量调整.结果14例患者无1例因药物的毒副作用而中断治疗.结论做好SMZco用药的观察和护理,有利于患者坚持治疗和早日康复.     

鼻咽癌放疗患者行尼妥珠单抗治疗的护理

通过对34例鼻咽癌放疗患者联合使用靶向药物尼妥珠单抗治疗过程的观察与护理,加强患者心理护理,做好用药指导,及时观察患者用药后的反应并及时给予相应的护理措施,预防并减少了并发症的发生,使34例患者顺利完成了治疗。     

复方磺胺甲基异噁唑治疗肾移植术后卡氏肺囊虫性肺炎患者的护理

目的 :探讨肾移植术后并发卡氏肺囊虫性肺炎 (PCP)患者的用药护理经验。方法 :针对患者的病情和复方磺胺甲基异唑 (SMZco)的用药特点 ,做好输液护理和肝肾功能监测 ,严密观察用药后反应 ,并遵医嘱及时做好剂量调整。结果 :1 4例患者无 1例因药物的毒副作用而中断治疗。结论 :做好SMZco用药的观察和护理 ,有利于患者坚持治疗和早日康复     

尼妥珠单抗联合化疗治疗晚期非小细胞肺癌的护理

总结21例晚期非小细胞肺癌化疗患者联合使用靶向药物尼妥珠单抗治疗过程的观察与护理,加强患者心理护理,做好用药指导,及时观察患者用药后的反应并及时给予相应的护理措施,预防并减少了并发症的发生,21例患者顺利完成治疗。     

2例抗肾小球基底膜病患者的护理

目的总结2例抗肾小球基底膜病患者治疗的护理要点。方法密切观察患者病情,做好用药护理、双膜血浆置换治疗的护理,同时做好患者及家属的心理护理。结果 2例患者经治疗外周血中抗肾小球基底膜抗体明显下降,血肌酐下降,肾脏功能明显改善。结论严密观察肾脏和肺的病变,及时准确地遵医嘱用药,并做好药物疗效和不良反应的观察,积极预防双膜血浆置换治疗的并发症,是抗肾小球基底膜病患者康复的关键。     

鼻内镜术后氟康唑灌洗治疗真菌性鼻窦炎的观察和护理

总结了36例真菌性鼻窦炎病人行鼻内镜手术后予氟康唑灌洗治疗的护理体会.包括心理护理、严密观察病情、预防感染、合理饮食、术后出血的护理、术腔的护理、并发症的观察、上颌窦腔内灌洗氟康唑的护理及做好出院指导等.认为准确评估疾病症状,有针对性的护理,予局部抗真菌性药物灌洗治疗是提高手术效果的重要保证.     

肝切除患者术后谵妄的观察及护理

总结102例患者肝切除术后谵妄的观察及护理。认为护理重点为密切观察病情,及时发现谵妄;做好心理护理、睡眠护理、疼痛护理,及时吸氧,预防谵妄发生;发生谵妄后正确用药并做好药物疗效及副作用的观察,同时做好安全护理。102例中发生谵妄11例,经治疗及护理,6d后症状基本缓解。     

两性霉素B治疗126例霉菌性鼻窦炎的观察和护理

目的：探讨两性霉素B治疗霉菌性鼻窦炎的观察和护理。方法：河北省秦皇岛市第一医院收治126例霉菌性鼻窦炎患者均采用两性霉素B治疗。在用药过程中,会出现严重的不良反应。针对不良反应,合理掌握用药方法和用药剂量,以及做好认真仔细的观察和护理,才能及时采取有效的防治措施。结果：治愈108例,好转17例,死亡1例。治愈好转率为99.2%。结论：两性霉素B治疗霉菌性鼻窦炎的过程中,做好对不良反应的观察和护理是减轻患者痛苦和提高治愈率的关键。     

婴幼儿丙酸血症5例的护理

总结5例丙酸血症患儿的护理。护理重点为加强病情观察,及时纠正高血氨和酸中毒,及时发现低血糖及低血钾并做好对症处理,重视饮食护理、输液护理及用药护理,对家长做好健康教育。5例患儿治疗5~8d,病情好转出院。     

静脉麻醉下行人工流产的探讨

对２６８ 名门诊自愿要求无痛人流者采用异丙酚全麻行人工流产进行观察,结果表明：异丙酚确系一种安全有效的麻醉剂,其有循环抑制和呼吸抑制等不良反应,通过术中对生命体征的监测及采取适当的措施,一些不良反应是可以避免的。异丙酚是一种脂肪乳剂,曾有３ 例发生过敏反应,提示用药前应询问过敏史,用药后注意有无过敏反应的发生。认为：护理中应注意患者的安全,密切监测生命体征的变化及其有无不良反应的发生。     

Absence of significant interaction of fluconazole with cyclosporin

The effect of a new azole antifungal drug, fluconazole, on cyclosporin concentration and pharmacokinetics was studied in ten bone marrow transplant recipients. There were no significant statistical or clinical differences in mean cyclosporin trough concentrations, peak concentrations and AUCs after fluconazole given either as a single 100 mg oral dose or as 100 mg daily for 14 days. Fluconazole was well tolerated without drug related side effects. Slight to moderate increases of liver laboratory parameters were observed in four patients during the multiple dose sequence, but these changes might be attributable, in part, to the underlying diseases or concomitant therapies. The data suggest a lack of clinically relevant pharmacokinetic interaction of fluconazole with cyclosporin. It is concluded that fluconazole may be administered to cyclosporin treated patients without enhanced risk of toxicity.     

中西医结合治疗慢性粒细胞白血病加速期

目的：探求慢性粒细胞白血病加速期的新治疗方案。方法：分别采用中西医结合治疗（治疗组２５例）与单纯西药治疗（对照组２０例）成人慢性粒细胞白血病加速期患者，观察比较临床疗效及其骨髓象、血象的变化。结果：治疗组在发热、出血、骨痛等症状缓解及脾脏缩小、白细胞总数下降等方面疗效明显优于对照组，且能推迟病情向急变期演变，延长了生存期。结论：中西医结合治疗慢性粒细胞白血病加速期为传统药物治疗无效的病例增加了一种新的治疗方案，但不能阻止其向急变期演变的最终结局     

Antigen Clearance during Treatment of Disseminated Histoplasmosis with Itraconazole versus Fluconazole in Patients with AIDS

Antifungal treatment reduces the concentration of Histoplasma antigen in blood and urine, supporting a hypothesis that antigen clearance could be used to compare the activity of new agents for treating histoplasmosis. In separate trials in patients with AIDS, clinical response was similar with itraconazole (85%) and fluconazole (74%). Fungal blood cultures at week 4, however, were negative in a significantly higher proportion of patients treated with itraconazole (92.3%) than in those treated with fluconazole (61.9%) (P = 0.017). Baseline antigen concentrations were similar in the two groups: serum, P = 0.7235; and urine, P = 0.1360. After 4 weeks of treatment, the decline in antigen from baseline in serum was similar in the two treatment groups (P = 0.5237), as it was in urine (P = 0.4679). At week 12, the decline in antigen from baseline in serum also was similar in the two groups (P = 0.4911) and in urine (P = 0.2786). More rapid clearance of fungemia suggests that itraconazole is more effective than fluconazole in treating histoplasmosis. This study demonstrates that clearance of fungemia is a better measure of antifungal effect than clearance of antigen.     

碘酊烧灼联合氟康唑治疗真菌性角膜炎临床观察

目的探讨碘酊烧灼联合氟康唑(普芬)治疗真菌性角膜炎的疗效。方法对25例真菌性角膜炎患者的溃疡部采取碘酊烧灼联合氟康唑眼液治疗,观察治疗效果。结果经碘酊烧灼联合氟康唑治疗,真菌性角膜炎轻度者治愈率为100%,中度者治愈率为68.75%,重度者治愈率为25.00%。结论碘酊烧灼联合氟康唑滴眼液治疗轻、中度真菌性角膜炎效果较好,对重度者效果欠佳。     

Effects of fluconazole and clarithromycin on rifabutin and 25-O-desacetylrifabutin pharmacokinetics

Ten human immunodeficiency virus-infected patients were given rifabutin in addition to fluconazole and clarithromycin. There was a 76% increase in the area under the concentration-time curve of rifabutin when either fluconazole or clarithromycin was given alone and a 152% increase when both drugs were given together with rifabutin. Patients should be monitored for adverse effects of rifabutin administered concomitantly with clarithromycin and/or fluconazole.     

Safety and Tolerability of Fluconazole in Children

The safety profile of fluconazole was assessed for 562 children (ages, 0 to 17 years) comprising 323 males and 239 females. The data are derived from 12 clinical studies of fluconazole as prophylaxis or treatment for a variety of fungal infections in predominantly immunocompromised patients. Most children received multiple doses of fluconazole in the range of 1 to 12 mg/kg of body weight; a few received single doses. Administration was mainly by oral suspension or intravenous injection. Overall, 58 (10.3%) children reported 80 treatment-related side effects. The most common side effects were associated with the gastrointestinal tract (7.7%) or skin (1.2%). Self-limiting, treatment-related side effects affecting the liver and biliary system were reported in three patients (0.5%). Overall, 18 patients (3.2%) discontinued treatment due to side effects, mainly gastrointestinal symptoms. Dose and age did not appear to influence the incidence and pattern of side effects. Treatment-related laboratory abnormalities were uncommon, the most frequent being transient elevated alanine aminotransferase (4.9%), aspartate aminotransferase (2.7%), and alkaline phosphatase (2.3%) levels. Although 98.6% of patients were taking concomitant medications, no clinical or laboratory interactions were observed. The safety profile of fluconazole was compared with those of other antifungal agents, mostly oral polyenes, by using a subset of data from five controlled studies. Side effects were reported by more patients treated with fluconazole (45 of 382; 11.8%) than by those patients treated with comparable agents (25 of 381; 6.6%); vomiting and diarrhea were the most common events in both groups. The incidence and type of treatment-related laboratory abnormalities were similar for the two groups. In conclusion, fluconazole was well tolerated by the pediatric population, many of whom were suffering from severe underlying disease and were taking a variety of concurrent medications. The safety profile of fluconazole in children mirrors the excellent safety profile seen in adults.     

正康脑明注射液、黄芪注射液和硝普钠治疗缺血性心力衰竭疗效观察

目的：探讨正康脑明注射液、黄芪注射液和硝普钠治疗缺血性心脏病心力衰竭的疗效。方法：１０４例缺血性心脏病心力衰竭患者随机分２组,治疗组５２例在常规洋地黄、利尿剂和扩血管药治疗的基础上用正康脑明注射液４００ｍｇ、黄芪注射液１５～２０ｍｌ加入５％葡萄糖２５０ｍｌ中静滴;硝普钠５０ｍｇ加入１０％葡萄糖５００ｍｌ中静滴,每日１次,１０日为１个疗程。对照组仅给常规洋地黄、利尿剂和扩血管剂治疗。治疗１０日为１个疗程。结果：治疗组显效率（６３．５％）和总有效率（９２．３％）显著高于对照组（３４．６％和７６．９％,Ｐ＜０．０１和Ｐ＜０．０５）;并且治疗组心功能及血液流变性的改善均显著优于对照组（Ｐ＜０．０１和Ｐ＜０．０５）,未见严重不良反应。结论：在常规治疗基础上加用正康脑明注射液、黄芪和硝普钠治疗缺血性心脏病心力衰竭疗效显著,优于常规治疗,值得临床推广应用     

Treating onychomycosis

Onychomycosis accounts for one third of fungal skin infections. Because only about one half of nail dystrophies are caused by fungus, the diagnosis should be confirmed by potassium hydroxide preparation, culture or histology before treatment is started. Newer, more effective antifungal agents have made treating onychomycosis easier. Terbinafine and itraconazole are the therapeutic agents of choice. Although the U.S. Food and Drug Administration has not labeled fluconazole for the treatment of onychomycosis, early efficacy data are promising. Continuous oral terbinafine therapy is most effective against dermatophytes, which are responsible for the majority of onychomycosis cases. Intermittent pulse dosing with itraconazole is as safe and effective as short-term continuous therapy but more economical and convenient. With careful monitoring, patients treated with the newer antifungal agents have a good chance of achieving relief from onychomycosis and its complications.     

中药加高渗腹透液灌肠治疗尿毒症疗效观察

目的：评价中药加高渗腹透液及单纯高渗腹透液灌肠治疗慢性肾功能衰竭（ＣＲＦ）尿毒症期患者的疗效。方法：６１例患者随机分为２组。治疗组用中药加４．２５％Ｂ５１８５高渗腹透液灌肠，对照组单纯应用４．２５％Ｂ５１８５高渗腹透液灌肠，每次３００ｍｌ，每日２次，每次保留２小时以上。结果：治疗组总有效率８８．５７％，对照组总有效率８０．７７％，２组比较无显著性差异（Ｐ＞０．０５）。２组治疗后血尿素氮、肌酐和肌酐清除率均有明显改善（Ｐ均＜０．０５）。结论：中药加高渗腹透液灌肠或单纯高渗腹透液灌肠，均为治疗ＣＲＦ尿毒症期的有效药物。此方法操作简便，患者痛苦小，费用低，能明显提高患者的生活质量，延长存活时间，是一种值得研究的治疗方法。