国产封堵器治疗并发重度肺动脉高压的动脉导管未闭

目的评价国产封堵器治疗并发重度肺动脉高压动脉导管未闭（PDA）的可行性及近期效果。方法采用经导管国产封堵器堵闭并发重度肺动脉高压PDA 9例,术后进行经胸超声心动图、X线及心电图复查随访。结果9例均封堵成功;2例术后残余分流,在30 d随访中完全消失;血流动力学及心功能在术后和随访期间均有显著改善。全部病例均无严重并发症。结论应用国产封堵器治疗并发重度肺动脉高压PDA,安全可行,近期效果好。     

老年男性慢性阻塞性肺疾病与骨质疏松的关系

目的探索老年男性慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者骨密度(bone mineral density,BMD)水平及骨质疏松(osteoporosis,OP)发生率,进而探讨COPD与OP可能存在的联系。方法选取2013年1月至2017年9月期间入我院的60周岁以上共94名老年男性作为研究对象,并分为COPD组52名和对照组42名,利用双能X线骨密度仪测量不同部位的骨密度T值(腰椎TL2-4、股骨颈TNeck、髋部TTotal);肺通气功能仪测量肺通气指标值(FEV1%、FEV1/FVC%、VC%、MVV%)。计量资料采用独立样本t检验或曼-惠特尼U检验,计数资料采用χ2检验,多因素分析采用二分类Logistic回归分析。结果老年男性COPD患者的骨密度指标值(TNeck、TTotal)及肺通气各项指标值(FEV1%、FEV1/FVC%、VC%、MVV%)均显著低于对照组,差异具有统计学意义。老年男性COPD组与对照组的骨质疏松、骨量减少和骨量正常构成比分别为21.2%、55.8%、23.1%和9.5%、42.9%、47.6%,差异具有统计学意义。老年男性COPD的影响因素包括身高、体重、BMI指数、TNeck及FEV1/FVC%。结论老年男性COPD患者的股骨颈及髋部BMD显著低于对照组、骨质疏松的发生率显著高于对照组;老年男性患者股骨颈BMD值越高,COPD发生的风险越低。     

微创置管引流在7例爆发性胰腺炎腹腔间室综合征患者中的应用

目的 探讨微创置管引流在暴发性胰腺炎并间室综合征的应用.方法 对7例爆发性胰腺炎腹腔室隔综合征患者在入院3-48h内即行微创置管引流,并做好置管中的监护,置管后的观察及综合性护理.结果 6例患者在微创置管引流24～48h内心肺肾及腹腔压力指标有明显改善,肠道功能恢复在72h后开始改善.1例患者在微创置管引流7d时开腹减压手术.结论 爆发性胰腺炎腹腔间室综合征的治疗护理应遵循个体化,早期微创置管引流能缓解腹腔高压等.微创置管后认真观察其引流液的色泽、性质和量,并保持其引流通畅;加强心肺肾多脏器功能的监护.     

甲巯咪唑致粒细胞减少及肝损害1例分析

1病例资料患者,女,46岁,主诉“咳嗽、咳痰6+天,加重伴心累、气紧2+天”。既往无食物药物过敏史,“甲亢”病史3余年,未予重视及治疗。半月前感心悸不适,当地卫生院诊断为甲状腺功能亢进症,给予甲疏咪醴片(北京市燕京药业,批号:170108)25 mg,po,bid治疗半个月,后因受凉出现咽痛,偶有咳嗽,咳白色黏痰,伴畏寒、发热,自行加用“感冒药”3 d,具体药物不详,症状无好转。2017年9月6日来我院就诊。体检:P 152次/min,R 30次/min,BP 132/85 mmHg,听诊双肺可闻及大量湿啰音,心律不齐。     

留空气注射法在控制性超排卵治疗中的应用

目的探讨留空气注射法在控制性超排卵治疗中的应用价值。方法将需实施体外受精-胚胎移植(IVF-ET)治疗的患者随机分为实验组和对照组,分别采用留空气注射法与传统肌肉注射法实施治疗,对两组患者一个周期超排卵药物的用药量、药物费用、注射皮下血肿和疼痛情况进行比较。结果实验组患者一个周期用药量、费用支出与对照组比较,t=10.236,P<0.01,差异有显著性意义;实验组与对照组患者均未出现明显的皮下气肿;实验组患者注射后各种程度疼痛的发生率与对照组比较,χ2=14.197,P=0.007<0.01,差异也有显著性意义。结论留空气注射法明显减少了患者超排卵药物的用量,也相应地减轻了患者的经济负担,相对安全,明显降低了患者的疼痛。     

人工鼻与加热湿化在护理用时中的对比研究

Objective To compare the difference of impact on the nursing time consuming between two types of artificial airway humidification, which means HME (heal and mositure exchanger) and HH (heated humidifier).Methods Use HME as experimental group and HH as control group, evaluate the effect of these two types of artificial airway humidification from sputum viscosity, formation of sputum callus, airway spasm and humidification accident, account, and analyze the data by statistic method. Results HME was much better than HH on effect of humidification. The experiment group spent (6.67±1.01 ) min on time consuming for nursing and the control group spent (26.27±1.75) min, the difference between two types of humidification was significant (P ＜ 0. 01) . By the way, HME was much better than HH on the frequency of sputum suction bedclothes replacement (P＜0.05).Conclusions The advantage of HME is decreasing the nursing manpower investment, through saving the time consuming for nursing, relieving strength of nurse work and improving efficacy of artificial airway management.     

人工鼻与加热湿化在护理用时中的对比研究

Objective To compare the difference of impact on the nursing time consuming between two types of artificial airway humidification, which means HME (heal and mositure exchanger) and HH (heated humidifier).Methods Use HME as experimental group and HH as control group, evaluate the effect of these two types of artificial airway humidification from sputum viscosity, formation of sputum callus, airway spasm and humidification accident, account, and analyze the data by statistic method. Results HME was much better than HH on effect of humidification. The experiment group spent (6.67±1.01 ) min on time consuming for nursing and the control group spent (26.27±1.75) min, the difference between two types of humidification was significant (P ＜ 0. 01) . By the way, HME was much better than HH on the frequency of sputum suction bedclothes replacement (P＜0.05).Conclusions The advantage of HME is decreasing the nursing manpower investment, through saving the time consuming for nursing, relieving strength of nurse work and improving efficacy of artificial airway management.     

重型破伤风继发呼吸道感染的相关因素及护理

破伤风是一种历史久远的梭状芽孢杆菌感染，梭状芽孢杆菌在自然界分布甚广，在灰尘、土壤、人和动物的粪便中均可发现，但其必须通过破损的皮肤或黏膜并在缺氧的环境下生长繁殖后才会致病。破伤风杆菌一旦致病，便是一种严重的急性特异性感染性疾病，发病越早，症状越重，病死率越高。临床上分为轻、中和重3型，重型破伤风潜伏期〈7d，3d内出现明显的临床症状，病死率为30％-50％C31。     

痛风误诊1例

痛风以往在我国认为比较少见,但是,近年来随着人民生活水平和饮食结构改变,呈逐年上升趋势。此病多见中老年男性,男女比例为20:1。当中老年男性突然出现足