雷尼替丁防治急性脑血管病应激性溃疡出血60例疗效观察

急性脑血管病（AVCD）并发应激性溃疡出血临床上相当常见，病死率高。故对该病的预防十分重要。2001年至2004年我们应用雷尼替丁预防ACVD并发应激性溃疡出血，取得了良好效果。     

急性心肌梗塞患者溶栓治疗前后QT离散度的变化及临床意义

选择行静脉溶栓治疗的急性心肌梗塞(AMI)患者37例,根据治疗结果分为梗塞相关动脉再通组与未通组,观察了两组溶栓治疗前及溶栓后6小时的QT离散度(OTd)。结果显示,两组溶栓治疗前QTd均明显增大,但无显著性差异(P>0.05);未通组治疗前后QTd无显著差异(P>0.05),再通组治疗后较治疗前明显缩小(P<0.001),与未通组治疗后比较差异有显著性(P<0.001),提示成功的溶栓可明显缩小局部心肌复极差异性,降低室性心律失常发生率;测量溶栓治疗前后QTd变化可以判断溶栓疗效。     

磁共振DWI在诊断急性脑梗死中的临床应用

目的 探讨磁共振弥散加权成像(DWI)在急性脑梗死诊断中的价值.方法 对72例急性脑梗死患者MRI各序列的影像学表现进行对比分析.结果 72例患者中共检出梗塞病灶104个,陈旧性病灶26个,超急性、急性梗塞病灶78个,急性、超急性病灶中,T2WI显示出梗塞灶53个,阳性率67.9%.DWI显示出病灶78个阳性率100%.陈旧性病灶26个呈长T1、长T2信号,DWI上呈等、低信号.结论 DWI对急性梗塞病变应用价值高,较常规MRI中T2WI序列敏感.     

抗心磷脂抗体与脑梗死关系的研究

目的 探讨抗心磷脂抗体(anti-eardiolipin antibodies,ACA)与脑梗死的关系.方法 应用酶联免疫吸附实验(ELISA)检测150例脑梗死患者发病后3d内血清ACA阳性率,并与进展性脑梗死组、脑出血组及正常对照组比较.结果 进展性脑梗死组ACA阳性率(60.8%)高于腩梗死组(48%),差异有统计学意义(P<0.05).脑梗死组ACA阳性率(48%)明显高于脑出血组(21.8%)、正常对照组(17.2%),差异有显著统计学意义(P<0.01).脑出血组ACA阳性率(21.8%)虽高于正常对照组,但差异无统计学意义(P>0.05).进一步分析脑梗死组及进展性脑梗死组中年龄<50岁患者的ACA阳性率(59%)高于年龄>50岁患者(46%),差异有统计学意义(P<0.05).结论 脑梗死患者急性期ACA阳性率高,尤其是年龄<50岁者,提示ACA的升高与脑梗死的形成关系密切,对于脑梗死疾病的发生及预后可能具有预测意义,从而对临床早期干预起一定的指导作用.

Abstract：

Objective To study the relationship between anti-cardiolipin antibodys(ACA)and cerebral infarction (CI).Methods The positive rate of serum ACA were detemined by enzyme linked immunosorbent assay(ELISA)in 150 patients with CI at thirth day after the onset of the disease.The results were compared with progression CI group,intracerebral hemorrhage(ICH)group and nomal control group.Results The positive rate of ACA in progression CI group (60.8%)was higher than CI group(48%)(P<0.05).The positive rate of ACA in CI group(48%)wag significantly higher than ICH(21.8%)and nomal control group(17.2%)(P<0.01).The positive rate of ACA in ICH group was higher than nomal control group,but there wa8 no statistical significance(P>0.05).The patients with CI and progression CI under 50 years old had hisher positive rate of ACA than the patients over 50 years old(P<0.01).Conclusions High positive rate of ACA appeares at acute phase of CI and in the patients under 50 years old.There is close relationship between anti-eardiolipin antibodys and cerebral infarction.It would forecast with disease and it,s prognosis and would guide to the early intervention.     

癫痫患者治疗依从性与疗效的关系及影响因素分析

目的 调查癫痫患者的治疗依从性与疗效的关系及影响因素,探讨提高治疗依从性的对策.方法 利用自行设计的问卷对2006年～2008年间在我院门诊就诊的已确诊的癫痫患者102例进行回顾性问卷调查.根据癫痫患者发作频率的变化分成恶化、无效、有效、显效、控制组.对各组治疗依从性进行判定.并分析比较其影响因素.结果 癫痫患者的治疗依从性与疗效直接相关,治疗依从性良好的患者疗效好(P<0.05),反之依从性差疗效也差.文化程度高,经济条件好,有医疗保险保障的癫痫患者,尤其城市居民和儿童治疗依从性较好,结论癫痫疾病的转归受多种因素影响,其中依从性起关键作用.应采取综合措施提高患者治疗依从性,从而改善患者的疗效和预后.

Abstract：

Objective To investigate the compliance and pertaining factors of patients with epilepsy, and to improve the treatment of compliance. Methods The patients with epilepsy ( 102 cases) were retrospectively surveyed by self-designed questionnaire during 2006 ～2008. According to the frequency changing of seizures, the patients were divided into aggravate group 、ineffective group、and effective group、excellent group、the control group. We determined the compliance of the groups, and analyzed the pertaining factors. Results The treatment compliance and effect is directly related in people with epilepsy, good treatment compliance in people with epilepsy has good effect(P <0. 05) ,On the contrary,the bad compliance also has bad effect. Patients with epilepsy in the high level of education, economic condition, medical insurance protection , especially for urban residents and children got better treatment compliance. Conclusions The prognosis of the epilepsy was affected by a number of factors, in which compliance play a critical role. Comprehensive measures should be taken to improve the treatment compliance of patients with epilepsy, to improve their efficacy and prognosis.     

奋乃静和吡罗昔康过量致多脏器功能障碍综合征1例

患者，女，37岁，一次同时口服奋乃静40片(4mg/片)和吡罗昔康16片(20mg/片)F4，饮低度白酒约50ml，卧热炕。2h后被发现时已呼之不应，周身汗出，阵发抽搐，高热，T：41.0℃。村卫生员肌注安痛定2ml后速来院，急诊给予地塞米松5mg和安定10mg肌注。     

班布特罗治疗老年慢性支气管哮喘40例临床分析

班布特罗是长效支气管扩张剂，文献报道它有改善哮喘患者肺功能的作用。故我科应用盐酸班布特罗观察治疗老年哮喘，取得满意疗效。     

持续质量改进对新生儿皮肤脓疱疮感染率的影响

目的：探讨实施护理干预措施持续质量改进（Continuous Quality Improvement ,CQI）对新生儿皮肤脓疱疮发生的影响。方法分析2011年山东大学附属省立医院产科86例新生儿发生皮肤脓疱疮感染的特点,根据分析结果制定并实施护理防控干预措施CQI ,前瞻性监测2012年、2013年产科出生的4282例和4430例新生儿发生皮肤脓疱疮感染率情况。结果实施CQI后,新生儿皮肤脓疱疮感染率从2011年的2．36％降低到2012年的0．59％和2013年的0．66％,2011年与2012年、2013年比较,新生儿皮肤脓疱疮感染率差异均有统计学意义（ P ＜0．01）;2012年和2013年新生儿皮肤脓疱疮感染率差异无统计学意义（ P ＞0．05）。结论实施护理干预措施CQI ,可有效减少院内新生儿脓疱疮的发生,值得应用和推广。