急性重症胰腺炎并发腹腔间隔室综合征的诊治

重症胰腺炎并发腹腔间隔室综合征是急性胰腺的一种特殊并发症，其病情极其复杂且凶险，死亡率高。到目前为止，很多临床医生对其认识不足，有必要加以探讨。本文就该病的发病机制、病理生理变化、临床特征以及诊断、治疗方面相关问题加以论述。     

应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.     

生活方式及心理因素对体外受精-胚胎移植的影响

越来越多的证据表明相同治疗条件下,不孕夫妇的生活方式对体外受精-胚胎移植的成功有重要影响,但其具体作用机制有待进一步研究.体外受精-胚胎移植治疗过程中,不孕夫妇的负性心理影响治疗的成功率,心理干预可有效地提高妊娠率.目前,有关心理因素影响体外受精-胚胎移植成功率的作用机制及更为有效的心理干预措施仍在研究中.     

心肺复苏早期应用氨茶碱与传统方法的比较研究

目的探讨心肺复苏(CPR)早期应用氨茶碱的临床意义.方法将100例心脏骤停(CA)患者,随机分成观察组(肾上腺素+氨茶碱组)、对照组(肾上腺素组),对照组按照传统CPR方法,静脉注射肾上腺素;观察组在传统方法的基础上早期加用氨茶碱静注.对两组在6h、24h存活率及正常出院方面进行统计学分析. 结果①两组在性别、年龄、疾病构成方面无统计学差异(P＞0.05);②两组在肾上腺素剂量、开始使用时间、直流电除颤等方面比较无统计学差异(P＞0.05);③观察组6h存活率与对照组比较有显著性差异(P＜0.05);两组24h存活率无统计学差异,但在正常出院方面观察组略优于对照组.结论①早期使用氨茶碱可提高6h存活率,正常出院略优于单使用肾上腺素组(对照组);②早期使用氨茶碱可能对最终生存率有益.     

应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.     

纳洛酮与地塞米松治疗肾综合征出血热原发性休克的研究

目的　研究纳洛酮和地塞米松治疗肾综合征出血热 (HFRS)原发性休克的疗效。方法　将 110例原发性休克患者随机分为治疗组与对照组。治疗组 5 6例予以纳洛酮 0 .8～ 1.2mg、静脉缓慢注射 ,之后 1.2～ 1.6mg加入 2 5 0ml液体中滴注 ,每分钟 2 0～ 3 0滴 ;地塞米松 2 0mg、静脉注射。对照组 5 4例予以阿拉明 2 0～ 3 0mg与多巴胺 40～ 60mg加入2 5 0ml液体中滴入 ,每分钟 15～ 3 0滴。结果　治疗后 1h休克纠正率治疗组与对照组分别为 89 2 9% ( 5 0 /5 6)和 68.5 2 %( 3 7/5 4) ,P <0 0 0 5 ;越过少尿期率分别为 14 .2 9% ( 8/5 6)与 3 .70 % ( 2 /5 4) ,P <0 0 5 ;肾功能恢复正常天数分别为 12 .96±1.76天和 14 .75± 1.92天 ,P <0 0 0 1;病死率分别为 3 .5 7% ( 2 /5 6)和 12 .96% ( 7/5 4) ,P <0 0 5。结论　纳洛酮与地塞米松治疗HFRS原发性休克疗效明显优于阿拉明与多巴胺     

调Q倍频Nd：YAG激光治疗太田痣的副反应及相关因素的探讨

观察调Q倍频Nd：YAG激光治疗太田痣的副反应及其相关因素。方法回顾性分析750例患者经调Q倍频Nd：YAG激光治疗后的副反应及其与治疗次数、治疗能量的关系。结果750例接受治疗的患者中发生副反应者76例(10．1％)，其中暂时性色素沉着55例(7.3％)，暂时性色素减退18例(2.4％)，永久性色素减退1例(0.1％)，萎缩性瘢痕2例(0.3％)。出现副反应与治疗次数无关，与治疗能量有关。结论副反应的出现与激光治疗本身没有特异性关系，随治疗能量的增加副反应发生率上升。调Q倍频Nd：YAG激光治疗太田痣无连续激光治疗后所致的增生性瘢痕、持续性色素沉着等副反应，用于治疗太田痣是安全的。     

盐酸氮芥联合中药治疗肾病综合征并急性肾衰竭

肾病综合征 (NS)尤其有中重度水肿患者合并特发性急性肾衰竭 (ARF)临床较为常见 ,属于危重病人 ,其治疗较为棘手而困难 ,但如果治疗得当和及时 ,肾衰竭多可逆转。近年来我们对肾病综合征合并特发性急性肾衰竭采用盐酸氮芥联合中药治疗 ,取得满意的效果 ,且疗效快 ,现报道如下。资料与方法1　临床资料　 (1)纳入标准 :①符合肾病综合征诊断即尿蛋白 >3.5 g/ 2 4h ,血浆白蛋白 <30 g/L ;②符合急性肾衰竭诊断标准[1] 。 (2 )排除标准 :明显低血容量、感染及肾毒性药物等诱因引起的ARF。2 3例中男 19例 ,女 4例 ;年龄 17岁～ 5 8岁 ,平均(2…     

100例鼻咽癌患者心理社会因素配对调查与多变量分析

为探讨心理社会因素对恶性肿瘤的影响规律，本文按多因素１：１病例－配对对照设计法，对１００例鼻咽癌及其配对对照了临床流行病学调查。资料经ＱＵＩＣＫ ＢＡＳＩＣ语言支持下完成了配对Ｌｏｇｉｓｔｉｃ回归分析。在α＝０．１０的水准，分别有Ｘ１，Ｘ２，Ｘ３，Ｘ４，Ｘ６，Ｘ１０，及Ｘ１１共７个入选的变量最终进入了方程：Ｌｏｇｉｔ Ｐ＝ａｉ＋０．２８８Ｘ１＋０．５６０Ｘ２－１．０１５Ｘ３－１．６９５Ｘ４＋０．９