湿润暴露疗法与手术疗法治疗手背部深Ⅱ度烧伤的疗效观察

目的：比较湿润暴露疗法(MEBT)与手术植皮疗法对手背部深Ⅱ度烧伤的治疗效果。方法：对1998-2003年期间收治的75例106只手背部深Ⅱ度烧伤患者随机分为两组，其中53只采用湿润暴露疗法，全程应用湿润烧伤膏治疗(A组)；另53只采用早期削切痂，整张植皮术或后期肉芽创面邮票植皮术治疗(B组)，观察分析两组的治疗效果。结果：A组在愈合后手背部皮肤的色泽，柔软度及弹性均优于B组，疼痛发生率，瘢痕发生率及功能障碍出现率明显低于B组，组间存在显著差异。结论：湿润暴露疗法治疗手背部深Ⅱ度烧伤疗效明显优于手术植皮疗法。     

ICU病员家属的沟通技巧

目的：加强ICU医务人员与病员家属进行有效沟通，减少医疗纠纷，方法：对120例病员家属进行问卷调查，分型，并针对不同类型进行沟通。结果：提高了病员及家属的满意度，减少了医疗纠纷的发生，结论：在ICU病房加强医护人员与病员家属的沟通，对于促进护患，医患合作，减少医疗纠纷的发生，促进病员早日康复，具有重要意义。     

氧自由基清除剂对大鼠急性肺损伤预防作用的实验研究

目的：大鼠尾静脉注射油酸造成急性肺损伤模型，观察氧自由基清除剂对肺组织脂质过氧化物和花生四烯酸代谢产物血栓素A2(TXA2)、前列环素(PGI2)的变化。方法：放射免疫分析方法及紫外分光光度仪分别测定TXB2、PGI2及脂质过氧化物(LPO)。结果：模型组肺组织、LPO和花生四烯酸代谢产物TXB2、6—K—PGFLα显著升高，P＜0．01；肺组织内大量PMN扣押，血管内皮、基底膜受损及肺池水肿等。氧自由基清除则可显著降低LPO产生，纠正PGI2/TXA2失衡，P＜0．01，减轻肺部病理学病变。结论：氧自由基清除剂通过抑制氧自由基反应和改善PGI2/TXA2平衡而对急性肺损伤有预防保护作用。     

血液透析中应用抗凝剂的探讨

目的 探讨伴有活动性出血及透析中抗凝剂的应用。方法 采用低分子肝素(LMWH)透析开始时一次性注入或普通肝素(UFH)常规应用,观察不同患者各项出、凝血指标并进行了对比分析。结果 LMWH组各项出、凝血指标在透析期间及透析之后无明显改变,透析前后血脂无显著性差异(P>0.05);与UFH组比较,穿刺点压迫止血时间明显缩短;透析器及血路管复用容易。结论LMWH是维持性血液透析较为理想的抗凝剂。     

五酯胶囊防治抗结核药物肝损害的临床观察

目的　观察五酯胶囊对抗结核药物所致肝损害的防治效果。方法 初治肺结核179例,给予2HRZS(E)/4～10HR抗结核治疗,治疗组96例,全程加服五酯胶囊;对照组83例,全程加服葡醛内酯。结果 治疗组出现肝损害7例(7.3%),其中HBsAg阳性患者出现肝损害5例(11.4%);对照组出现肝损害32例(38.6%),其中HBsAg阳性患者出现肝损害20例(52.6%)。两组差异显著(P<0.01)。HBsAg、HBeAg阳性患者在抗结核治疗中肝功能更容易受损害。结论 五酯胶囊在防治抗结核药物所致肝损害的发生是有效的,尤其是HBsAg阳性的结核病患者。     

重症肾衰急诊血液透析与腹膜透析的疗效观察

目的:通过观察分析重症肾衰患者在初次透析时,选择血透、腹透的疗效、利弊,为更好地选择透析方案提供指导。方法:对从1998年至2001年我科收住的25例重症肾衰患者急诊透析疗效,按年龄、疾病分层分析。结果:血透与腹透疗效相似。但血透心血管并发症明显高于腹透,腹透并发高血糖及营养不良高于血透组。结论:对有高血压III级、冠心病、房颤、室早者易早期进行腹膜透析;对有营养不良、高血糖未控制的患者易早进行血液透析。     

B超检查胸部病变的评价——与X线对照分析(附270例报告)

自1987年1月至1991年10月,对270例胸部病变进行了B超检查,其中胸壁病变10例,胸膜病变36例,肺内病变130例,纵隔病变81例及一侧胸腔大部或全部呈暗影者13例。本文与X线诊断进行对比分析,讨论了B超诊断胸部病变的价值及其限度。本组270例中,125例进行了B超引导下活检,诊断准确率为97.5％,活检后少量气胸者2例(1.6％)。     

肝动脉插管化疗加栓塞术治疗中晚期肝癌

15例无手术指征的中晚期肝癌患者,经肝动脉插管灌注化疗加栓塞治疗效果观察。临床症状明显改善者占80％,瘤体缩小占73％。灌注加栓塞治疗较单纯灌注好。多次灌注栓塞治疗较一次好,患者的生存期延长,部分病人可获得二期手术切除的机会。     

Influence of Trimebutine on Inflammation- and Stress-induced Hyperalgesia to Rectal Distension in Rats

The effects of trimebutine and its major metabolite, N-desmethyltrimebutine on inflammation- and stress-induced rectal hyperalgesia have been evaluated in rats fitted with electrodes implanted in the longitudinal striated muscle of the abdomen. Intermittent rectal distension was performed before and 3 days after induction of rectal inflammation by local infusion of trinitrobenzenesulphonic acid (in ethanol). Stress consisted of 2 h partial restraint and rectal distension was performed before and 30min after the end of the partial restraint session. The animals were treated intraperitoneally with trimebutine or desmethyltrimebutine (5, 10 or 20mgkg^?1) or vehicle 15min before rectal distension. Naloxone (1mgkg^?1) or saline was injected subcutaneously before trimebutine and desmethyltrimebutine. Before treatment trimebutine at the highest dose (20 mgkg^?1) reduced the abdominal response to rectal distension for the highest volume of distension (1·6mL) whereas desmethyltrimebutine was inactive. After rectocolitis the abdominal response to rectal distension was enhanced and trimebutine at 5mgkg^?1 reduced and at 10mgkg^?1 suppressed inflammation-induced hyperalgesia, an effect reversed by naloxone. Desmethyltrimebutine was inactive. Stress-induced hypersensitivity was attenuated or suppressed, or both, by trimebutine and desmethyltrimebutine at doses of 5, 10 or 20mgkg^?1; greater efficacy was observed for desmethyltrimebutine and the effects were not reversed by naloxone. It was concluded that trimebutine and desmethyltrimebutine are active against inflammation- and stress-induced rectal hyperalgesia but act differently. The effect of trimebutine on inflammation-induced hyperalgesia is mediated through opioid receptors.     

X线B超与纤维胃镜对胃癌的诊断价值探讨

本文作者分别用纤维胃镜、B超和X线观察了48例胃癌患者的胃粘膜、胃壁受累等变化。结果发现,用纤维胃镜诊断胃癌的检出率为95.8％,用B超,79.1％;用X线检出率为87.5％。三种方法结合检出率达100％。结论:三种方法联用可免漏诊。