中药配合激素辨证治疗肾病综合征的体会

介绍了激素治疗肾病综合征的不同阶段,中医证型的演变及辨证施治,并从药理研究角度揭示了中药发挥疗效的机理,证明激素治疗肾综过程中配合中医辨证施治,能最大限度的发挥治疗作用,减少激素副作用,提高疗效。     

优化复苏集束化策略对脓毒性休克预后的影响

目的 探讨优化复苏集束化策略对急诊脓毒性休克患者预后的影响.方法 将经急诊重症监护室(ICU)收住的脓毒性休克患者65例用数字表法随机分为治疗组(采用优化复苏集束化策略)32例和对照组(采用拯救脓毒症运动经典方法)33例.观察和比较两组患者器官衰竭评分系统(SOFA)评分的变化及血管活性药物使用时间、机械通气时间、ICU住院时间和28 d病死率.结果 治疗组人选后3d、7 d SOFA评分分别为(9.1±2.5)分、(8.2±2.8)分,均低于对照组同期的(10.1 ±3.3)分、(9.5±3.1)分(=4.52、3.99,均P＜0.05);治疗组28 d病死率为28.1％,低于对照组的48.5％(x2=12.84,P＜0.05).结论 早期应用优化复苏集束化策略可以明显改善急诊脓毒性休克患者的预后.     

糖尿病患者的心理护理

<正>目前,我国2型糖尿病患者已近4千万人。而且糖尿病发病率也在逐年激增,从1980年的0.8%,到1995年的2.9%,再到2000年超过3.5%,糖尿病已经成为一种日益严重的公共健康问题。糖尿病是慢性内分泌代谢性疾病,从它的发病机制来看,情、志创伤是其中重要一环,所以调和情志是糖尿病康复的重要内容。对糖     

护理干预对首次血液透析直接穿刺患者舒适度的影响

2005年4月～2007年5月，我们对78例首次直接穿刺透析的患者除行常规护理外，给予针对性的护理干预，取得满意效果。现报告如下。     

口腔癌手术患者医院感染现状及危险因素分析

目的 调查口腔癌手术患者医院感染现状,探讨医院感染危险因素,为医院感染防控提供科学依据.方法 前瞻性目标监测调查2019年1月-2020年12月山东省某三甲医院口腔颌面外科的口腔癌患者,分析口腔癌手术患者医院感染的发生率及危险因素.结果 本研究纳入394例口腔癌手术患者,发生医院感染58例,医院感染率为14.72％;总...     

外科重症监护病房内栓塞症的诊断与治疗--附4例报告及文献复习

目的 分析外科重症监护病房（surgical intensive care unit,SICU）内常见栓塞症（脂肪栓塞和羊水栓塞）的临床表现,探讨其诊断和治疗方法。方法 对我院2002年SICU确诊的4例栓塞症患者的临床资料进行回顾性分析。结果 4例患者中,男1例,女3例,年龄23～36岁,1例为左上肢、双下肢长骨骨折致脂肪栓塞,1例为左股骨骨析致脂肪栓塞,1例为剖宫产术中发生羊水栓塞、1例为催产素引产失败后发生羊水栓基。4例患者均不同程度出现意识改乏、呼吸衰竭、贫血、血小板减少,除1例病情较重死亡,其余均痊愈出院。结论 SICU内患者病情复杂,对长骨骨折及高危产妇,要警惕栓塞症的发生,如果早期诊断,及时治疗,预后良好。     

多指标协同应用在危重症合并血小板减少患者诊断DIC中的作用

Objective To observe critical patients with thrombocytopenia,and exam their coagulation function,so as to diagnose disseminated intravascular coagulation(DIC)in the early stage.Methods Totally 56 critical patients complicated with thrombocytopenia were enrolled in the investigation;complete set of DIC tests were performed.A total of 26 cases were diagnosed as DIC according to the criteria from the International Society of Thrombosis Haemostasis(ISTH).The sensitivity,specificity,accuracy,likelihood ratio,predictive value of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fg),antithrombin Ⅲ and bleeding signs(including petechia and ecchymosia)were calculated by applying fourfold table.Results The specificity of PT prolongation and Fg reduction was 87.0%;the sensitivity of ATⅢ decrease,and each of PT prolongation,Fg reduction,and bleeding(including petechia and ecchymosis)were as high as 96.0%.Conclusion Multi-markers based on thrombocytopenia are likely to improve sensitivity and specificity of DIC diagnosis.     

多指标协同应用在危重症合并血小板减少患者诊断DIC中的作用

Objective To observe critical patients with thrombocytopenia,and exam their coagulation function,so as to diagnose disseminated intravascular coagulation(DIC)in the early stage.Methods Totally 56 critical patients complicated with thrombocytopenia were enrolled in the investigation;complete set of DIC tests were performed.A total of 26 cases were diagnosed as DIC according to the criteria from the International Society of Thrombosis Haemostasis(ISTH).The sensitivity,specificity,accuracy,likelihood ratio,predictive value of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fg),antithrombin Ⅲ and bleeding signs(including petechia and ecchymosia)were calculated by applying fourfold table.Results The specificity of PT prolongation and Fg reduction was 87.0%;the sensitivity of ATⅢ decrease,and each of PT prolongation,Fg reduction,and bleeding(including petechia and ecchymosis)were as high as 96.0%.Conclusion Multi-markers based on thrombocytopenia are likely to improve sensitivity and specificity of DIC diagnosis.     

慢性乙型肝炎重叠急性戊型肝炎的临床特点

目的:观察慢性乙型肝炎重叠急性戊型肝炎(慢乙肝加戊肝)的临床特点.方法:比较慢乙肝加戊肝(20例)与单纯急性戊肝(20例)的临床表现与肝功能.结果:慢乙肝加戊肝后黄疸的发生率、白蛋白/球蛋白倒置、凝血酶原时间延长、前白蛋白显著下降等均较单纯急性戊肝组显著(P＜0.05～P＜0.005).结论:慢性乙肝重叠感染急性戊肝后肝功能损害严重、病死率高、预后差.     

B型利钠肽治疗充血性心力衰竭随机对照试验的分析

目的:了解B型利钠肽(BNP)治疗对心衰患者血流动力学的效应及其安全性和耐受性。方法:以充血性心衰为主题词,B-typenatriureticpeptide和nesiritide分别为文本词,对Medline数据库检索临床随机对照试验(RCT),对各试验的方法学和结果等进行评价。结果:8个临床随机对照试验被纳入,结果是BNP的人工合成制剂nesiritide使肺毛细血管楔压(PCWP)平均降低4.06mmHg,95%CI[-4.79,-3.33],P<0.00001,心脏指数(CI)增加0.08L/min·m2,95%CI[0.02,0.15],P=0.01,低血压发生率增加,RR=3.36[2.15,5.26],P=0.01,心动过缓发生高于对照,RR=4.99[1.70,14.60],P=0.003,而室性心律失常两组相似。结论:BNP能有效改善心衰患者血流动力学,改善近期预后,呈剂依赖;明显降低严重心衰患者且危险因素≥4个患者的远期死亡率;Nesiritide治疗虽存在低血压等诸多副作用,但一般患者均能耐受。