有限病灶清除联合局部化疗治疗脊柱结核的临床应用研究

目的：评价有限病灶清除联合局部化疗治疗脊柱结核的疗效。方法选取行有限病灶清除联合局部化疗的患者92例，对术前后ESR、CRP、神经功能ASIA分级、矢状位脊柱后凸Cobb角数据进行统计学分析。结果术前与术后1个月、1年血沉、C-反应蛋白比较，差异均有显著统计学意义（P＜0.01）。术前与术后1年矢状位脊柱后凸Cobb角比较，差异无统计学意义。术后1年神经受损情况ASIA分级较术前显著改善（P<0.05）。结论有限病灶清除联合局部化疗是治疗脊柱结核的有效方法。     

克罗恩病排除性饮食的研究进展

<正>近年来,克罗恩病(Crohn’sdisease,CD)发病率在世界范围内不断增加,尽管在治疗方面取得了一定进展,但CD患者仍然面临疾病不断恶化造成的严重后果^[1]。环境因素特别是饮食因素在CD的发病机制中可能扮演重要的角色,因此可以采取饮食干预来治疗CD^[2]。     

部队老干部病房陪护人员对误吸认知情况调查

部队老干部病房住院患者以高龄老年人为主,老年人吞咽运动的时间明显比年轻者延长,误吸发生率较高。误吸常引起反复咳嗽、咳痰、咽喉部不适、夜间睡眠差等,造成患者生活质量明显下降,严重误吸可引发急性气道阻塞而导致患者死亡。住院老干部一般都由亲属陪护或专职陪护人员照顾起居饮食,提高陪护人员对误吸的认知程度可以显著降低住院老干部误吸的发生率。对此,我们调查了部分陪护人员对误吸的认知情况,并根据结果进行有针对性的健康教育。     

老年功能性消化不良的营养评估及护理干预对策

老年人随着年龄的不断增长,生理机能逐渐退化,使得营养不良发病率增高[1].功能性消化不良(functional dyspepsia,FD)是指存在被认为源自胃十二指肠区域的症状,且无任何可以解释这些症状的器质性、系统性或代谢性疾病[2],这些症状可能导致老年人饮食状况不佳,增加发生营养不良的危险.本研究应用微型营养评定法(mini nutritional assessment,MNA)评估老年FD患者的营养状况,并探讨可行的护理干预对策,以达到改善老年FD患者营养状况的目的.     

钴合金椎弓根螺钉植入修复脊柱结核重度后凸畸形：自身对照临床试验方案

BACKGROUND: There is evidence that internal fixation through an anterior or posterior approach for treatment of severe kyphotic deformity in spinal tuberculosis exhibits good curative effects. However, few prospective, long-term follow-up case control studies are reported.     

比较不同方式置入椎弓根钉内固定修复胸腰椎爆裂骨折的生物相容性

BACKGROUND: During the repair of thoracolumbar fracture, pedicle screw fixation is a commonly used treatment method. In the process of fixation, the different approaches can be used.  OBJECTIVE: To compare effect and biocompatibility of pedicle screw by percutaneous approach, posterior median approach, and intervertebral space approach for thoracolumbar fracture.  METHODS: 118 cases of thoracolumbar fracture were included after pedicle screw fixation. All patients were divided into three groups according to the approach: posterior median approach group (38 cases), intervertebral space approach group (40 cases) and percutaneous approach group (40 cases). After 12 months of follow-up, perioperative conditions, pain score, vertebral height of anterior border, kyphosis correction effect, adverse events and biological compatibility were compared among three groups. RESULTS AND CONCLUSION: (1) Operation time, intraoperative bleeding and time in bed after surgery were shorter or less in the percutaneous approach and intervertebral space approach groups than in the posterior median approach group. Postoperative drainage was better in percutaneous approach and intervertebral space approach groups than in the posterior median approach group (all P < 0.05). Except drainage in the percutaneous approach and intervertebral space approach groups, no significant difference in other indicators was found. (2) Patients received imaging examination at different time points. The percentage of anterior vertebral height and kyphosis were significantly improved immediately after treatment and in final follow-up (all P < 0.05). No significant difference was detected before treatment, immediately after treatment and in final follow-up. (3) Visual Analogue score was identical before treatment. Visual analogue score was lower in the percutaneous approach and intervertebral space approach groups than in the posterior median approach group at 24 hours and 3 days after treatment and in final follow-up (all P < 0.05). No significant difference was detectable at 24 hours and 3 days after treatment and in final follow-up between the percutaneous approach and intervertebral space approach groups. (4) No rejection or wound non-healing was seen at 12 months after treatment. Some patients suffered from mild low back pain, which was improved by active symptomatic treatment. (5) These findings suggest that intervertebral space approach percutaneous approach obtained satisfactory outcomes compared with posterior median approach for treatment of thoracolumbar spine fractures, and good biocompatibility was found.        

7例卵黄囊瘤病理组织形态特征

目的加强对卵黄囊瘸的病理组织形态学特征的认识,并讨论其诊断及鉴别诊断要点。方法回顾总结7例已确诊的卵黄囊瘤的常见形态特征。结果7例肿瘤由胚胎性瘤细胞组成,具疏松网状结构,同时伴有上皮样及卵黄囊样结构,基底膜样物质,嗜酸性小球为主要特征,也有个别是以血管上皮套结构为主或卵黄囊结构为主者。结论明确卵黄囊瘤形态特征,有利于诊断及鉴别诊断。     

病椎间固定在脊柱结核患者治疗中的应用价值

[目的]探讨病椎固定在脊柱结核患者治疗中的疗效.[方法]回顾性分析本院2009年1月到2014牟12月收治的脊柱结核患者84例,根据患者意愿分为两组.病椎间组:38例,固定在病变累及的单个神经单元中完成;超病椎间组:46例,采用长、短节段内固定,范围超出病灶外2个运动神经单元.比较两组患者的术中出血量、手术时间及术前、术后血沉(ESR)、C反应蛋白(CRP)、视觉模拟(VAS)评分及Frankel分级、Cobb角.[结果]病椎间组术中出血量及手术时间均优于超病椎间组,差异有统计学意义(P＜0.05);两组患者ESR、CRP术后6个月均降低至正常水平,组间比较差异无统计学意义(P＞0.05);病椎间组与超病椎间组末次随访时VAS评分较术前均下降,且低于超病椎间组,差异有统计学意义(P＜0.05);两组患者Frankel功能分级较术前均明显恢复;两组患者末次随访时Cobb角均小于术前Cobb角.但两组间术前、术后、末次随访、矫正度数及丢失度数比较差异无统计学意义.[结论]病椎固定治疗脊柱结核是安全、有效的,能有效保留与病椎相邻正常运动神经单元,并有术中出血少、手术时间短的优势,值得临床推广应用.     

内镜下黏膜切除术治疗80岁以上患者胃息肉的护理

<正>内镜下黏膜切除术是近年来逐渐开展起来的一项技术,用于消化道平坦型癌前病变和早期肿瘤的治疗。其主要原理是通过黏膜下注射使黏膜病变抬高,然后用圈套高频电流切除病变黏膜,达到根除黏膜层早期癌或癌前病变的目的[1]。2007年1月—2011年1月我院共完成80岁以上高龄患者胃息肉内镜下黏膜切除术36例,并实施了各种相关性的护理,     

恢复窦性心律有助于提高和保证持续性心房颤动射频消融效果的研究

目的:通过分析在射频消融术(消融)中运用不同方式恢复窦性心律(窦律)的临床随访效果,探讨恢复窦律对持续性心房颤功(房颤)消融治疗效果的影响.方法:60例持续性房颤患者接受以环肺静脉隔离为基础的消融治疗.其中5例患者接受2次消融后复发,2例患者接受3次消融.消融结束后房激不能终止者应用药物复律和(或)体外直流电复津.术后...