放射性核素心肌灌注显像检查患者的护理

双探头带符合线路的SPECT可以准确评估负荷和静息状态下的心肌灌注血流情况,尤其是腺苷药物负荷试验对于无症状或不典型的心绞痛<'[1]>,其诊断符合率与运动试验相仿,但不增加心肌的耗氧量与负荷,特别适合于年老体弱、下肢残缺、周围血管或呼吸道疾患等患者,为冠心病的诊断、危险度的分层及其对预后的评价提供了可靠的依据.由于试验有可能导致心绞痛的发作,因此做好检查时的护理十分重要.笔者对放射性核素心肌灌注显像检查的护理要点进行总结,现报道如下.     

动脉瘤性蛛网膜下腔出血患者外周血白细胞计数与病情严重程度的相关性分析

目的比较动脉瘤性蛛网膜下腔出血(aSAH)患者白细胞总数(WBC)及分类计数在判断aSAH患者病情严重程度中的临床价值。方法 180例aSAH患者依病情严重程度按Hunt-Hess级分为高级别、低级别,按格拉斯哥昏迷评分(GCS)分为轻中型、重型。分析入院时WBC及分类与该两个临床分级的相关性。绘制受试者工作特征(ROC)曲线,评价WBC及分类计数鉴别病情严重的能力。结果分别与Hunt-Hess低级别和GCS轻中型相比,Hunt-Hess高级别和GCS重型的WBC、中性粒细胞绝对值、中性粒细胞百分比显著升高,淋巴细胞百分比则均降低,差异均有统计学意义(P0.05)。WBC、中性粒细胞绝对值与Hunt-Hess分级较强正相关(r=0.516,P=0.000;r=0.527,P=0.000),与GCS较强负相关(r=-0.508,P=0.000;r=-0.514,P=0.000),而中性粒细胞百分比、淋巴细胞百分比与该两个临床分级弱相关。ROC曲线分析显示判断病情严重程度的最佳指标为WBC和中性粒细胞绝对值;该二者判断Hunt-Hess高级别的截点值分别为12.21×10~9/L、10.14×10~9/L;判断GCS重型的截点值分别为15.10×10~9/L、13.55×10~9/L。结论 aSAH患者入院时WBC、中性粒细胞绝对值判断病情严重程度价值相当且最佳。临床量表联合WBC和中性粒细胞绝对值有助于更可靠地准确评估aSAH病情严重程度。     

非匹配负波对遗忘型轻度认知障碍诊断和预后的价值

目的 前瞻性探讨事件相关电位-非匹配负波(event-related potential mismatch negativity,ERP-MMN)在评估遗忘型轻度认知障碍(amnestic mild cognitive impairment,aMCI)患者的诊断和预后的价值.方法 181例研究对象分为aMCI组102例、对照组79名,所有研究对象均进行神经心理虽表、头颅影像学和MMN检奁,分析其峰潜伏期和波幅.随访1年,依据神经心理量表及临床表现等评估MMN在aMCI预后中的价值.结果 aMCI组MMN的峰潜伏期[(312.7±25.7)ms]较对照组[(285.1±28.8)ms]明显延长(t=6.81,P<0.01),波幅[(3.48±1.32)μV]较对照组[(4.66 ±1.12)μV]明显降低(t=-6.37,P<0.01).转化为阿尔茨海默病(AD)的aMCI亚组MMN的峰潜伏期[(332.2±24.1)ms]较未转化为AD的aMCI亚组[(307.5±24.0)ms]明显延长(t=2.75,P=0.007);转化的aMCI亚组MMN的神经心理量表检查和波幅较未转化的aMCI亚组差异无统计学意义.结论 MMN能辅助诊断aMCI并判断其预后,反映和监测aMCI患者认知功能状态的改变.     

非匹配负波对遗忘型轻度认知障碍诊断和预后的价值

Objective To evaluate the value of event-related potential mismatch negativity(ERP-MMN)for diagnosis and prognosis of amnestic mild cognitive impairment(aMCI).Methods 181 people were enrolled in this study,including 102 aMCI patients and 79 normal people and all of them underwent the clinical symptom and performance of neuropsychologieal measures and cranium imaging and examination of MMN.aMCI patients were judged to progress to Alzheimer's disease(AD)or not by clinical symptom and performance of neuropsychological measures during 1 year follow-up period.Through analysis of peak latency (PL)and amplitude(Amp),the value of MMN in diagnosis of aMCI and normal subjects was assessed,judging aMCI progress to AD or not.Results In contrast to normal control subjects(NC),PL of MMN in subjects of aMCl was significantly longer and Amp was significantly shorter,PL of MMN(312.7±25.7)ms vs(285.1±28.8)ms(t=6.81,P<0.01),Amp(3.5 ±1.3)μV vs(4.7±1.1)μV(t=-6.37,P<0.01).Moreover,PL of MMN in subjects of aMCl which would progress to AD was significantly longer than of subjects of aMCI which would not progress,(332.2±24.1)ms vs(307.5 ±24.0)ms(t=2.75,P=0.007).However.significantly difference was not observed in Amp of MMN and neuropsychological measures between subjects of aMCI would progress and not.Conclusions MMN can be used in auxiliary diagnosis and judging prognosis of aMCI.It is appropriate when is required to reflect and monitor periodic cognitive state of subjects of aMCI.     

继承与发展传统骨科 打造特色品牌专科--与时俱进的广州市正骨医院

广州市正骨医院（原名广州市越秀区正骨医院）是一家有51年历史,以中医骨伤为主的专科医院。几代正骨人以坚持不懈的求索奋斗打造了“正骨”金色品牌。     

铜仁地区1452例阴道分泌物检测结果分析

目的:了解妇科阴道疾病的病原体检出率,为临床预防和治疗提供参考。方法:对1452例门诊妇科患者阴道分泌物进行白带常规检查和细菌性阴道病的检测。结果:BV检出率为32.4%,假丝酵母菌检出率为23.7%,假丝酵母菌+BV检出率为12.9%滴虫+BV检出率为5.1%,滴虫检出率为3.45%。结论:BV的检出率高,在阴道分泌物检查时即使清洁度正常也要注意查找病原菌,并应注意混合感染。     

思密达保留灌肠联合口服锌制剂治疗小儿腹泻56例临床分析

目的探讨思密达保留灌肠联合口服锌制剂治疗小儿腹泻的临床应用价值。方法将112例小儿腹泻患儿随机分为观察组和对照组各56例,对照组给予常规治疗方法,观察组在对照组的基础上给予思密达保留灌肠联合口服锌制剂,比较两组疗效。结果观察组总有效率94.64%,对照组总有效率74.98%,两组比较有显著性差异(χ2=8.3913,P<0.01)。结论采用思密达保留灌肠联合口服锌制剂治疗小儿腹泻具有良好的临床疗效,值得临床推广。     

健康体检满意度问卷调查结果分析与质量控制

体检客户满意度是指体检者在医院接受体检服务过程中的满意程度,是体检者对其体检过程的直接体验和亲身体会,是了解体检医疗服务质量的重要信息来源。体检中心是21世纪的朝阳产业,健康体检作为一种新型健康消费方式,成为人们了解自身健康状况、早期发现疾病、早期治疗疾病及规范健     

依达拉奉治疗进展性脑梗死的疗效观察

目的 观察依达拉奉治疗进展性脑梗死的临床疗效.方法 80例进展性脑梗死患者分为治疗组和对照组,对照组静脉滴注丹红,口服阿司匹林、普伐他汀等药,治疗组加用依达拉奉.结果 依达拉奉治疗组治疗14 d后神经功能缺损评分及有效率显著优于对照组(P＜0.05).结论 依达拉奉治疗进展性脑梗死疗效确切.     

非匹配负波对遗忘型轻度认知障碍诊断和预后的价值

Objective To evaluate the value of event-related potential mismatch negativity(ERP-MMN)for diagnosis and prognosis of amnestic mild cognitive impairment(aMCI).Methods 181 people were enrolled in this study,including 102 aMCI patients and 79 normal people and all of them underwent the clinical symptom and performance of neuropsychologieal measures and cranium imaging and examination of MMN.aMCI patients were judged to progress to Alzheimer's disease(AD)or not by clinical symptom and performance of neuropsychological measures during 1 year follow-up period.Through analysis of peak latency (PL)and amplitude(Amp),the value of MMN in diagnosis of aMCI and normal subjects was assessed,judging aMCI progress to AD or not.Results In contrast to normal control subjects(NC),PL of MMN in subjects of aMCl was significantly longer and Amp was significantly shorter,PL of MMN(312.7±25.7)ms vs(285.1±28.8)ms(t=6.81,P<0.01),Amp(3.5 ±1.3)μV vs(4.7±1.1)μV(t=-6.37,P<0.01).Moreover,PL of MMN in subjects of aMCl which would progress to AD was significantly longer than of subjects of aMCI which would not progress,(332.2±24.1)ms vs(307.5 ±24.0)ms(t=2.75,P=0.007).However.significantly difference was not observed in Amp of MMN and neuropsychological measures between subjects of aMCI would progress and not.Conclusions MMN can be used in auxiliary diagnosis and judging prognosis of aMCI.It is appropriate when is required to reflect and monitor periodic cognitive state of subjects of aMCI.