皮肤环切术治疗大隐静脉曲张合并小腿溃疡25例

1 临床资料 总结两家基层医院5年中手术治疗的112例大隐静脉曲张,对其中合并小腿溃疡者25例,行皮肤环切术。25例中工人8例(占32％),农民17例(占68％),年龄22～69岁,均值47.5岁,男20例(占80％),女5例(占20％),溃疡病程半年～14年不等,单侧溃疡21例,双侧4例,溃疡1个18例,2个4例,3个3例,溃疡面直径最小3.0cm,最大10.0×13.0cm,合并大隐静脉血栓者7例,25例均存在静脉炎及腹股沟淋巴结肿大。     

阴茎下疳样脓皮病2例

例1:男,32岁。2007年9月4日以阴茎无症状溃疡7d就诊。患者7d前发现阴茎冠状沟溃疡,无明显痒、痛等症状,无尿路刺激征,未治疗。既往无同类病史,5年前(结婚前)有冶游史,曾因尿道灼痛、溢脓以“尿道炎”在外院治疗后痊愈(具体诊断与用药不详),之后无婚外性接触史。查体:生命体征好     

雷贝拉唑与奥美拉唑对十二指肠溃疡短期疗效

目的:探讨雷贝拉唑和奥美拉唑对十二指肠溃疡短期疗效.方法:选择本院2014年12月～2015年12月收治的十二指肠溃疡疾病60例患者作为研究对象,随机分为两组:对照组和实验组,两组各30例.对照组给予奥美拉唑进行治疗,实验组给予雷贝拉唑进行治疗,两组均连续用药一周,一周后对两组症状缓解情况进行对比分析.结果:实验组腹痛缓解28例(93.3％),反酸缓解30例(100％),腹胀缓解19例(63.3％),嗳气缓解26例(86.7％);对照组腹痛缓解24例(80％),反酸缓解27例(90％),腹胀缓解15例(50％),嗳气缓解22例(73.3％).两组比较具有显著差异(P＜0.05).结论:针对十二指肠溃疡给予雷贝拉唑与奥美拉唑进行治疗均有显著效果,但是在短期内雷贝拉唑缓解十二指肠溃疡症状明显优于奥美拉唑,在临床值得推广.     

幽门螺杆菌相关的消化性溃疡患者的护理

目的探讨Hp相关消化性溃疡患者的护理方法。方法通过对118例Hp相关消化性溃疡患者的临床资料进行分析,总结此类患者的护理方法。结果溃疡治疗显效率为94.9%(112/118);护理组HP根除率为91.5%(108/118),显著高于对照组77.6%(x2=6.15,P<0.05)。结论严格、科学的护理是HP相关消化性溃疡治疗的重要环节。     

脂肪肝超声表现与甘油三脂改变相关分析

目的B超扫描结合实验室检验分析脂肪肝与年龄以及血液中甘油三脂浓度的相关性。方法从参加健康体检经B超确认为脂肪肝的2106例中随机抽样276例,按年龄分成3组：35岁及以下组(A组)、35～55岁组(B组)、55岁及以上组(C组),统计年龄与脂肪肝程度的相关性;实验室检验分析血液中甘油三脂的浓度,并结合声像图表现,比较得出甘油三脂浓度与脂肪肝程度的相关性。结果276名脂肪肝患者中．男性242例(87．68％);A、C组以轻度脂肪肝居多,B组以中、重度脂肪肝居多;轻度脂肪肝101例中,22例(21.78％)甘油三脂升高,中度及重度脂肪肝175例中,88例(50．29％)甘油三脂升高。结论对于早期脂肪肝,超声检查比实验室甘油三脂检测有着更高的灵敏度;通过声像图及实验室检验对比分析可得脂肪肝程度与血液中甘油三脂水平超标比例呈正相关。     

Fleroxacin与TMP-SMZ治疗男性软下疳的随机双盲研究

采用双盲、随机法对比了氟罗沙星(fleroxacin)与TM-SMZ治疗经培养证实的男性软下疳的疗效。 98例伴有人免疫缺陷病毒Ⅰ型(HIVI)男性患者罹患软下疳。年龄在18～65岁。随机49例接受氟罗沙星,49例接受TMPSMZ。氟罗沙星的用量为400mg,每日1次;TMP剂量为160mg,SMZ800mg,每日2～3次。用药3天。2周和4周的随访率分别为63%和45％。最常见的溃疡部位是阴茎(49％)、冠状     

绝经后阴道出血病因分析

目的探讨绝经后阴道出血(PMB)的病因。方法对112例患者绝经后阴道出血的原因进行回顾性分析。结果112例患者中生殖器官炎症69例(61．6％),功能性子宫出血21例(18．7％),恶性肿瘤9例(8.04％),子宫肌瘤4例(3．57％),宫内节育器5例(4.46％),其他疾病4例(3．57％)．结论引起PMB的主要原因是生殖器官炎症及功能性子宫出血,随着年龄的增长,绝经时间的延长,绝经后阴道出血恶性肿瘤发病率有所增高。     

铝碳酸镁咀嚼片治疗胃溃疡疗效观察

目的：探讨铝碳酸镁咀嚼片对消化性溃疡愈合的影响。方法：将112例胃溃疡随机分为：A组56例,B组56例,两组均先给予标准3联疗法根除HP。1周后A组：兰索拉唑30mg每日2次＋铝碳酸镁咀嚼片1000mg每日3次;B组：兰索拉唑30mg每日2次＋硫糖铝1000mg每日3次,继续治疗5周,停药4周后观察溃疡愈合及S期S2期获得率。结果：停药4周后内镜下A、B组溃疡S期、S2期获得率分别为95．2％、80．5％;73．4％、33．6％。A组溃疡愈合显著优于B组。结论：铝碳酸镁咀嚼片作为黏膜保护剂,可促进溃疡愈合,显著优于硫糖铝。     

保妇康栓治疗宫颈糜烂临床分析

目的 探讨保妇康栓治疗宫颈糜烂的疗效.方法 对232例宫颈糜烂患者随机抽样分为治疗组120例、对照组112例,治疗组应用保妇康栓,对照组用甲硝唑栓.结果 治疗组在宫颈糜烂的糜烂面积和糜烂型的改善方面明显优于对照组[总有效率分别为93.3％ (112/120)比67.8％ (76/112),90.0％(108/120)比53.6％ (60/112)],差异有统计学意义(均P＜0.01).结论 保妇康栓治疗宫颈糜烂疗效确切,值得临床推广应用.     

胃高位溃疡142例临床分析

我院自1978年来经内镜检出胃高位溃疡142例均经病理或手术证实,其中良性溃疡121例,恶性溃疡21例,现分析如。一般资料一,性别与年龄男112例,女30例。其中恶性溃疡男16例,女5例。年龄30～80岁。<40岁32例,均为良性溃疡,40～60岁38例,(恶性溃疡12例),>61岁72例(恶性溃疡9例)。二、临床表现:1/4患者缺乏典型消化性溃疡的症状。不规则疼痛82例.嗳气泛酸68例,呕吐24例,呕血22例,黑便82例。     

袖套式阴茎固定术治疗隐匿型阴茎

目的探讨隐匿性阴茎的的分类和手术治疗方法。方法对2003年7月-2005年12月年龄从3岁到15岁（平均年龄10岁）20例的隐匿性阴茎病人采用袖套式阴茎固定方法。结果1例术后阴茎回缩,二次再手术成功;其余均一次手术成功。达到了类似于包皮环切的外观效果。总的成功率98%。结论袖套式阴茎固定术是目前治疗隐匿性阴茎最简单和有效的方法之一。     

The use of proprietary medicines by patients presenting with peptic ulcer haemorrhage.

1. Medication, social and symptom histories were compared in patients with severe haemorrhage from a peptic ulcer (n = 71) and matched control subjects. Self-medication with proprietary agents was catalogued in addition to therapy prescribed by general medical practitioners. 2. Prior to the bleed, only 4% of ulcer patients had been free of symptoms normally associated with peptic ulceration, whereas 76% of the control group had been asymptomatic. 3. Gastro-irritant proprietary medicines were used regularly by 23% of ulcer patients compared with only 4% of controls. However, proprietary antacids were used chronically by 46% of ulcer patients compared with only 7% of controls. Bicarbonate was the antacid of choice used by 13% of ulcer patients. The odds ratio for the association between development of bleeding peptic ulcer and the use of indigestion remedies was 11.5% (95% CI 1.1, 121). 4. Fifty-one percent of ulcer patients were prescribed agents known to cause gastro-intestinal damage, whereas only 25% of the control group were prescribed similar agents. Only 7% of the control group were prescribed anti-ulcer therapy compared with 37% of those with bleeding ulcer. 5. A large proportion of patients with haemorrhage from a peptic ulcer had had symptoms sufficient to warrant recourse to self-medication with antacids without medical knowledge. Exacerbation of peptic ulcer by self-medication with proprietary products is likely to be of lesser significance.     

单纯修补术治疗胃十二指肠溃疡穿孔远期疗效观察

目的观察对胃十二指肠溃疡穿孔患者采用单纯修补术的远期效果。方法对1990年2月至2005年5月间收治的胃十二指肠溃疡穿孔行单纯穿孔修补术患者74例进行随访。结果74例患者均获完整资料,术后溃疡症状复发率（visickⅢ—Ⅳ）为14．9％（11／74）,其中胃溃疡复发率26．9％（7／26）,十二指肠溃疡复发率8．3％（4／48）,两者差异有统计学意义（x^2=4．782,P〈0．05）;术后半年复查56例,溃疡愈合率91．1％（51／56）,术后一年复查46例,溃疡复发率10．9％（5／46）,胃溃疡复发率（26．8％）明显高于十二指肠溃疡（3．1％）（x^2=4．651,P〈0．05）。结论单纯修补术治疗胃、十二指肠溃疡穿孔远期效果满意,对十二指肠溃疡穿孔治疗效果更佳。     

Maintenance therapy in duodenal and gastric ulcer disease: survey of practice amongst British gastroenterologists

We have used a postal questionnaire to obtain data on the practice of maintenance therapy for peptic ulcer disease by members of the British Society of Gastroenterology. Completed questionnaires were returned by 434 members. Ninety-six per cent used maintenance therapy for patients with duodenal ulcer and 81% for gastric ulcer. Maintenance therapy was considered to be safe (duodenal ulcer 91%; gastric ulcer 78%), acceptable to patients (duodenal ulcer gastric ulcer 89%; gastric ulcer 80%) and to reduce the incidence of ulcer complications (duodenal ulcer 81%; gastric ulcer 68%). There was consensus that increasing age of patient, current use of non-steroidal anti-inflammatory drugs, previous ulcer complications, and ulcer relapse after surgery were relatively strong indications for maintenance therapy. However, the proportion of patients who received maintenance therapy varied widely amongst respondents (from < 10% to > 50%). There was no agreement on the optimal duration of therapy, nor on management of patients who relapsed during maintenance therapy. It appears that the criteria for use of maintenance therapy need to be better defined, and that established knowledge about the practice of maintenance therapy should be better disseminated and acted upon.     

Effect of Helicobacter pylori eradication on duodenal ulcer scar in patients with no clinical history of duodenal ulcer

BACKGROUND: Helicobacter pylori eradication has become the standard treatment for duodenal ulcer. However, there is no relevant evidence for antibacterial treatment of the white scar stage of duodenal ulcer (duodenal ulcer scar) in patients with no past history of duodenal ulcer. AIM: To investigate whether H. pylori eradication could decrease duodenal ulcer recurrence in patients with duodenal ulcer scar and no past history of duodenal ulcer. PATIENTS AND METHODS: We prospectively enrolled 66 patients with duodenal ulcer scar: 53 were H. pylori-positive and 13 were H. pylori-negative. H. pylori-positive patients were randomly assigned into two groups (two-to-one allocation): 36 patients were assigned to the treatment group and 17 to the follow-up group. Thirteen H. pylori-negative patients were followed up according to the study protocol. Follow-up endoscopy was performed to evaluate ulcer scar changes and H. pylori status 6 weeks after anti-H. pylori treatment and then every 6 months for up to 30 months. RESULTS: Active duodenal ulcer recurrence was identified in seven of 23 H. pylori-positive/non-cured patients (30%). There was no duodenal ulcer recurrence in 43 H. pylori-negative/cured patients (0%), which was significantly different in terms of duodenal ulcer recurrence (P=0.001). CONCLUSIONS: H. pylori eradication is effective at preventing active duodenal ulcer recurrence in patients with duodenal ulcer scar and no past history of duodenal ulcer.     

Nine years of maintenance treatment with ranitidine for patients with duodenal ulcer disease

Four hundred and sixty-four patients with duodenal ulcer disease received continuous maintenance treatment with ranitidine for up to 9 years. Treatment failure was defined as either the first symptomatic recurrence of ulcer or the first ulcer recurrence accompanied by haemorrhage. Life tables were constructed using the Kaplan-Meier product-limit method; comparisons of survival curves were performed using the log-rank test; and multivariate analysis was carried out using the Cox proportional hazards model. Results. The proportion of patients remaining free from symptomatic recurrence of ulcer during maintenance treatment with either 150 mg/day or 300 mg/day ranitidine was: 95% at 1 year; 88% at 3 years; 86% at 5 years; and 81% at 7 and 9 years (95% C.I. 76-86%). Young age and the absence of exposure to non-steroidal anti-inflammatory drugs (NSAIDs) at the time of diagnosis of ulcer were shown to increase the likelihood of developing ulcer recurrence. The rate of ulcer recurrence after 9 years of maintenance treatment (17%) was significantly less than that after 5 years without active anti-ulcer therapy (80%), P = 0.0001. The proportion of patients who remained free from ulcer haemorrhage during maintenance treatment was: 99.1% at 1 year and 98.1% at 5 and 9 years (95% C.I. 96.7-99.6%). The risk of haemorrhage was significantly greater in patients who were not receiving active treatment (12.4% at 5 years) than in patients receiving maintenance treatment (less than 2% at 9 years), P = 0.0001 (log-rank test). Patients who had originally presented with haemorrhage had an increased risk of further ulcer bleeding compared with patients who presented with pain (P = 0.0013). A significantly greater proportion of patients with NSAID-associated duodenal ulcers remained free from ulcer recurrence during maintenance treatment compared with patients suffering from 'idiopathic' ulcers (P = 0.0238), although there was no difference between the two groups in respect of haemorrhage during maintenance treatment. Conclusions. (a) Continuous maintenance treatment with ranitidine for up to nine years successfully prevents ulcer recurrence in more than 80% of patients with duodenal ulcer disease. (b) Young age increases the risk of ulcer recurrence during maintenance treatment with ranitidine. Ulcers associated with NSAID-intake at the time of diagnosis have a lesser risk of recurrence during maintenance treatment. (c) The risk of haemorrhage in patients with ulcer disease receiving maintenance treatment with ranitidine for nine years was less than 2% compared with greater than 12% in untreated patients observed for 5 years.(ABSTRACT TRUNCATED AT 400 WORDS)     

蒙脱石治疗消化性溃疡50例

目的 :评价蒙脱石治疗消化性溃疡的临床疗效与安全性。方法 :蒙脱石组 (5 0例 )患胃溃疡 18例和十二指肠球部溃疡 32例 [男性 35例 ,女性 15例 ,年龄 (5 0±s 11)a],用蒙脱石散剂 3g ,tid ,疗程 4wk。胶态次枸橼酸铋组 (30例 )患胃溃疡 12例和十二指肠球部溃疡 18例 [男性 2 0例 ,女性 10例 ,年龄(48± 13)a],用胶态次枸橼酸铋胶囊 110mg ,tid ,疗程 4wk。结果 :蒙脱石组消化性溃疡愈合率为80 % ,总有效率为 90 % ,胶态次枸橼酸铋组消化性溃疡愈合率为 6 0 % ,总有效率为 77% ;2组愈合率、总有效率相比 ,差异无显著意义 (P >0 .0 5 ) ,2组疗效的比较差异亦无显著意义 (P >0 .0 5 )。 2组不良反应均轻 ,分别为 4 %和 3% (P >0 .0 5 )。结论 :蒙脱石治疗消化性溃疡有较好疗效 ,且不良反应少而轻微 ,是一种安全有效的药物     

肝硬化病人消化性溃疡和门脉高压性胃病的发生及特点

目的 研究肝硬化病人消化性溃疡和门脉高压性胃病的发生及临床特点。方法 以1990年1月－1999年4月间在我院住院的496例病人为研究对象作胃镜检查。结果 肝硬化消化性溃疡的发生率为14．92％，门脉高压性胃病的发生率为43．75％；在childA级、B级、C级肝功能病人之间消化性溃疡和门脉高压性胃病的发生率差异无显著意义（P＞0．05）；有门脉高压性胃病和食道静脉曲张者消化性溃疡的发生率明显高于无门脉高压性胃病和食道静脉曲张者（P＜0．01）。肝硬化病人消化性溃疡82．43％无症状。结论 门静脉高压可能是肝硬化病人消化性溃疡发生率增高的重要致病因素，肝硬化病人消化性溃疡绝大多数无症状。     

醋氨己酸锌治疗肝硬化合并消化性溃疡

目的 :观察醋氨己酸锌对肝硬化合并消化性溃疡的疗效。方法 :肝硬化合并十二指肠溃疡 36例和合并胃溃疡 30例 ,随机分为醋氨己酸锌组 (醋氨己锌 0 .3g ,po ,tid ,其中胃溃疡 12例、十二指肠溃疡 12例 )、法莫替丁组 (法莫替丁 2 0mg ,po ,bid ,其中胃溃汤 9例、十二指肠溃疡 10例 )、联合用药组 (醋氨己酸锌 0 .3g ,po ,tid ,法莫替丁 2 0mg ,po ,bid ,其中胃溃疡 9例、十二指肠溃疡 14例 ) ,共3组。治疗胃溃疡疗程 6wk ,十二指肠溃疡疗程为4wk ,疗程结束后 ,用内窥镜观察溃疡愈合情况。结果 :醋氨己酸锌组肝硬化合并胃溃疡和十二肠溃疡的愈合率分别为 5 8% ,6 6 % ,法莫替丁组分别为5 6 % ,70 % ,联合用药组分别为 78% ,79% ,3组比较差异无显著意义 ,P >0 .0 5。结论 :醋氨己酸锌治疗肝硬化合并消化性溃疡的疗效与其他 2组相似 ,但其安全性好     

Loss of predictive value of gastric ulcer symptoms in a randomized treatment trial

Analysis of clinical data obtained in a double-blind randomized study, which compared liquid antacid (neutralizing capacity 120 mmol per day) with 1 g cimetidine in the treatment of 125 patients with gastric ulcer, revealed that, before starting treatment, 71% of the patients complained of epigastric pain, approximately 50% of bloating, and approximately 30% of nausea, heartburn, constipation or vomiting. Epigastric pain before treatment was significantly more frequent in patients with large ulcers (P less than 0.05) and in patients with ulcers unhealed after 4 weeks of therapy (P less than 0.05). This finding was the result of a highly significant correlation between diurnal epigastric pain and ulcer size and delayed healing (P less than 0.005). Nocturnal pain did not correlate with prognosis. In contrast to this correlation between pain before therapy and healing, the disappearance of epigastric pain with therapy did not signify ulcer healing. Only 14 (38%) of the 37 patients with healed ulcer were free from pain after the 4 weeks of therapy, whereas 25 (49%) of the 52 patients with persistent ulcers had no pain at this time. Placebo pain tablets relieved ulcer pain effectively in more than 85% of the patients, irrespective of whether the ulcer was healing or not. The other symptoms (bloating, nausea, heartburn, constipation or vomiting) were also alleviated by 4 weeks of therapy but no correlation was found with ulcer size or prognosis. The loss of the prognostic significance of ulcer pain is probably due to a complex interaction of the trial schedule on the patient's level of consciousness.(ABSTRACT TRUNCATED AT 250 WORDS)