感染性心内膜炎65例外科治疗

目的:探讨感染性心内膜炎 (IE)手术治疗的适应证 ,减少病人的早期及晚期病死率。方法 :6 5例 IE病人经静脉滴注大剂量抗生素 1～ 2周感染未能控制 ,于感染活动期施行主动脉瓣置换术 2 5例 ,二尖瓣置换术 2 3例 ,三尖瓣修复成形术 3例 ,肺动脉瓣成形术 2例 ,室间隔缺损修补术 11例 ,法乐氏四联症矫正术 1例。结果 :本组无手术死亡及术后早期死亡。随访 3～ 6个月均无心内膜炎复发 ,心功能恢复至 ～ 级。结论:当 IE无法控制 ,尤其是出现无法控制的心力衰竭时 ,尽早手术可以提高治愈率。     

椎体后凸成形术与椎体成形术治疗骨质疏松性椎体压缩骨折的对比研究

随着微创脊柱外科的发展,更多的骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)患者接受了经皮椎体成形术与经皮椎体后凸成形术的治疗.     

提高毛发移植的覆盖率

目的探讨显微外科技术自体毛发移植的特点和方法,提高毛发移植成活的覆盖率。方法在较低温度(20°C)环境下,采用边切边缝方法取耳后或枕后毛发,在显微镜下分离成保留周围少量脂肪组织的毛囊族或单株,按需要移植部位不同进行不同的毛囊族或单株并套插的显微外科技术移植共31例。结果31例移植毛发后随访21例,随访时间6~38个月,移植后的毛发能基本覆盖无毛发区的皮肤和瘢痕,移植覆盖率较原来的移植方法提高33%,且外形自然,效果稳定。结论显微外科技术自体毛囊族状(微株小株)或单株移植,具有操作快、损伤小、低温保湿等特点,能较好地保留毛囊周围少量脂肪,在孔与孔的皮肤间隙内再用毛发移植针植入单株毛坯的“套插”移植,更有助于增加毛发覆盖率。     

肾功能损伤分级系统在成人心脏术后的应用

Objective The aim of this study was to evaluate of adilty of two acute renal failure-specific scoring systenms (the classification by Bellome et al and the AKIN criteria) for predicting hospital mortality after cardiac surgery in adult patients. Methods Between October 1 st 2006 to Decemjber 31 st 2006, 509 adult patients who ungerwent coronary artery bypass grafting (CABG) and/ or valve operation were enrolled in this study. The medical data collection included gender, age, types of operation, perioperative he- modynamic parameters, urine output, biochemical parameters and outcome. Renal function was assessed daily according to the classi- ficatinn by Bellomo and the AKIN criteria, respectively. As references, Acure Physiology and Chronic Health Evaluation(APACHE) Ⅱ and Sepsis-related Organ Failure Assessment (SOFA) score were also calculated. Resuits Three hundred and forty-one patients were male (67.0%), and 168 were female (33.0%), mean age was (56.2±12.0) years old. Tnree hundred and nine patieats un- derwent CABG, 182 underwent valve operation and 18 underwent CABG plus valve operation, Mean duration of ventilation support was (20.4±17.7) houra, and the ICU stay was (1.4±1.0) days. Postoperative hospital stay was (13.8±9.1) days. According to the classification by Bellomo., the highest in-hospital mortality was 52.9% in ARFS group. Mahiplicatinn of in-hospital morality rate was abserved (X2 for trend, P<0.01) in 0.4% (non-ARF), 1.2% (stage 1), 12.0% (stal～ 2) and 32.4% (stage 3) of pa- tients based on the AKIN criteria. By applying the area under the receiver operating characteristic ourve, the classification by Bellomo and the AKIN criteria had good discriminative power. Furthering, multivariate logistic regression analysis verified that the Odds Ratio of the AKIN criteria was 5.478 (P =0.028, 95% Confidence Interval 1.027- 24.856), after adjusting for gender and age. Con- clusion Analytical data confinned good discriminative power of both the AKIN criteria and the classification by Bellomo for predicting hospital mortality of adult postoperative patient with ARF.     

柴米夫妻变奏曲

早6点．两岁的儿子醒了就开始哭。妻打着哈欠，抱怨着爬起来给孩子把尿。孩子把尿盆踢翻了，妻边训斥．边抓起一个靠枕向我扔来：“还躺得下去啊，你？”我懊恼地掀开被子，起来给孩子穿衣．叠被铺床．刷牙洗脸，然后在兜里塞两个饼，推自行车去上班，出门喊一声：“我走啦!”里面若有若无传来一声“嗯!”日复一日．天天如此。     

上消化道造影检查受检者所受剂量的研究

上消化道造影检查受检者所受剂量的研究贾明轩，戴铁成，刘玉珠，刘焕芹，冷仁利我国上消化道造影检查是消化道造影检查中最常见的Ｘ射线检查，大约占整个消化道造影检查的７０％。由于这种检查过程透视时间较长，受检者接受的剂量较大，并已成为全民剂量负担的中要来源之...     

生活饮用水中的石棉及其危害

生活饮用水中的石棉及其危害李宇飞１任峰玲１综述许长安２审校石棉为一种天然矿物，由于它的特殊性能，在工业上应用非常广泛。随着石棉使用量的日益增多，也就带来了相应的环境污染。石棉除了污染空气环境外，对水体也造成了污染，特别是石棉对生活饮用水的污染及由此所...     

动脉硬化闭塞症480例临床治疗体会

目的：总结静脉注射前列腺素E1（PGE1）结合中医中药治疗动脉硬化闭塞症（ASO）的治疗体会，方法：回顾分析480例临床资料，选用静脉注PGE1并根据不同的临床证型选用不同的中医药物；同时动态观察60例ASO治疗前后血浆内皮素（ET）、一氧化氮（NO）水平，并分析同临床治疗疗效的关系。结果：232例临床治愈（48．33％），216例显疗效（45．00％），12例进行（2．5％），20例治疗无效（4．17％），15例截肢（3．12％）；血浆ET、NO随病情好转和治愈逐渐趋于正常水平。结论：静脉应用PGE1并根据不同的临床证型选用不同的中医药物具有较好的ASO治疗效果，并可通过动态观察ET、NO水平判断治疗疗效。     

小儿弓形虫致脑损伤26例临床分析

小儿弓形虫致脑损伤２６例临床分析边海峰弓形虫感染是一种人畜共患疾病，具有广泛流行的特点。人体感染弓形虫后可累及多个组织器官，中枢神经系统也容易受累。我科于１９９５年１０月～１９９７年１月先后收治了经聚合酶链反应（ＰＣＲ）检测确诊为弓形虫感染患儿５０例...