急性重症胆管炎的治疗

急性重症胆管炎(ACST)可出现严重的休克、败血症及肝衰、肾衰等多器官功能衰竭(MOF)，治疗上极为棘手，是良性胆道疾病最主要、最直接的死亡原因。国内报道其死亡率高达33．6％。近年来，我院通过采用快速有效的抗休克治疗，适当及时的手术，防治MOF等措施救治ACST病人189例，效果满意，报告如下。     

9例重症急性胆管炎术后心力衰竭的治疗

重症急性胆管炎(ACST)或称急性梗阻性化脓性胆管炎(AOSC)是外科重危急症。亦是胆道疾病患者死亡的最重要、最直接原因。其病死率国内各组报道为6.7～56%,差别较大。导致 ACST 患者死亡的主要原因是败血症、中毒性休克、胆源性肝脓肿、胆道出血及 MSOF。我院近五年来收治的78例 ACST 患者中,术后发生心力衰竭     

重症急性胆管炎260例临床分析

重症争性胆管炎(ACST)是胆道系中最严重的疾病,起病急(?),死亡率高。我院1981年1月～1990年12月共收治ACST(均符合ACST 诊断标准)260例,分析如下。     

重症急性胆管炎头孢匹美治疗的临床疗效分析

目的：评价头孢匹美(马斯平)在重症急性胆管炎(ACST)围手术期治疗的疗效及安全性。方法：25例ACST患者采用头孢匹美治疗，剂量1g，q8h静脉注射，疗程5～7d。结果：总有效率为96％，细菌清除率为94.7％．细菌转阴率为96％,无不良反应。57株致病菌作药敏试验，头孢匹美的敏感率96.5％，较头孢哌酮、头孢唑林、环丙沙星、替硝唑的敏感率高。结论：ACST并肺部感染用头孢匹美治疗安全、有效。     

重症急性胆管炎非手术疗法探讨(附24例分析)

重症急性胆管炎（acutecholangitisofseveretype.ACST）发病急，死亡率高。有报道其死亡率高达33％。多数作者认为，手术是ACST的保证一治疗手段。1982年1月至1990年12月我院收治的符合ACST诊断标准的24例病人，因限于患者条件，再次手术有困难，如患者年龄大，一般情况差或既往曾行多次胆道手术等原因而采用非手术治疗。现将该24例患者的临床资料作一回顾性分析。1临床资料1．1性别与年龄24例中，男性11例，女性13例，年龄29岁～84岁，平均557岁，＞55岁16例，占667％1．2病史均有Charcot三联征。既往胆道手术史12例，2次以上手术者7…     

63例急性重症胆管炎的救治体会

急性重症胆管炎(ACST)是临床上常见的外科凶险急危重症,其病死率高达33.6%[1].积极有效地实施抢救,及时给以紧急胆道减压,解除梗阻,以控制胆道感染,可降低其死亡率.我院1990～2000年收治ACST 63例,均符合ACST诊断标准[2].现将救治经验介绍如下.     

老年重症急性胆管炎围手术期处理(附48例临床分析)

急性重症胆管炎(ACST)是临床常见的严重胆道疾患,发病急骤,病情严重,病死率高。我院自1985年1月至1994年12月10年间共收治60岁以上,符合ACST诊断标准者48例,占同期ACST141例的34％,现将48例老年ACST围手术期处理分析如下:     

老年急性重症胆管炎的救治：附38例临床分析

对比分析了38例老年重症胆管炎(ACST)和104例非老年 ACST 的临床资料,发现老年 ACST病死率高、围手术期并发症多,且急诊手术治疗的老年 ACST 组的存活率较保守治疗组高,提示对老年ACST 的处理应更加积极有效,急诊胆道探查外引流术是其首选方式,围手术期的系统器官扶植是救治老年ACST 的关键。     

急性梗阻性化脓性胆管炎治疗体会

急性梗阻性化脓性胆管炎（ACST）可出现严重的休克、败血症及肝衰、肾衰等多器官衰竭（MOF），治疗上极为棘手，是良性胆道疾病最主要、最直接的死亡原因。国内报道其死亡率高达13．7％。近年来，我院通过采取快速有效的抗休克治疗方法，并配合适当、及时的手术防治MOF等措施救治ACST息者35例，效果满意，现报告如下。     

胆道厌氧菌感染的诊治

一般胆道感染分三大类,即慢性、急性和合并厌氧菌感染。每类又有明确的诊断和治疗特点,如急性胆道感染分急性胆囊炎、急性化脓性胆囊炎、急性合并厌氧菌感染胆囊炎(容易引起穿孔);急性胆管炎分一般性、急性重症胆管炎(ACST)、ACST合并厌氧菌感染(常并发肝脓疡)。其他如胆道蛔虫、胆总     

The meaning of being a mother of a child with a heart disease: a phenomenological study

The objective of this study is to understand what it means to a mother to have a child with a heart disease. In order to do so, a phenomenological approach was used. The study was carried out with mothers of children with congenital cyanotic cardiopathy at the Infant Cardiology Center of a public hospital in Campo Grande, State of Mato Grosso do Sul. Ten open interviews were made based on the following guiding question: What does it mean to you to have a child with a heart disease? The comprehensive analysis of the reported speeches made possible the construction of three categories: "Discovering the disease: being up against the unknown"; "Living together with cardiopathy: being with the child in the disease", and "Believing in a stronger force: the necessary support". The impact of the disease on the mother begins the moment the child is born. Desperation, guilt and insecurity are mentioned as present feelings. It is in God, however, that such mothers look for the necessary support to follow this new path--a path of pain and faith.     

社区发烧、咳嗽初诊病例讨论

目的：1．根据循证医学指南知识诊治社区肺炎病人；2．根据指征安排病人门诊或住院；3．了解下呼吸道感染病人的药物选择；4．评估头孢菌素在下呼吸道感染病人治疗中的作用；5．正确诊断出现并发症的下呼吸道感染病人；6．合理使用抗生素，避免滥用抗生素和产生抗药性；     

The first example of a Raddon-like antibody as a cause of a transfusion reaction

A serum Raddon defining a low-frequency red blood cell antigen FR, and its association with the Miltenberger complex of antigens, were reported in 1977. An antibody of the same serological specificity was the cause of a transfusion reaction. The patient's reaction and serological response, as well as the frequency of Raddon and its inheritance, are described.     

Biopsychosocial approach in a multidisciplinary intervention: a report of a case of a newborn with mentally disabled parents

A case report is presented of a newborn who was seen by the paediatric nurse a Primary Care clinic, and whose parents had mental disabilities. They had been followed up for years by the social services in their area, due to difficulties and limitations in their personal, social and employment development. They were also living in unhealthy conditions, so in order to address the problem, a multidisciplinary team of professionals from different areas was formed. We prepared a standardised care plan based on the model of the basic needs of Virginia Henderson. Using taxonomies of the North American Nursing Diagnosis Association (NANDA), Nursing Outcomes Classification's (NOC) and Nursing Interventions Classification (NIC) "knowledge poor" and "parental impairment" diagnoses were made. The nursing and social work goals were to make an assessment, support and use comprehensive biopsychosocial family monitoring to enable the child to grow and develop in the best possible conditions, to monitor child protection and try to improve the living conditions of the home. The child and parents were initially monitored weekly and then monthly. The assessment showed an improvement in care: "background: infant care," "risk control: drug abuse" "child care: psychological security" and "execution of the role of parents." The joint and coordinated work of the various services involved was focused towards achieving the goals set, in order to give biopsychosocial care to the baby and family.