丙种球蛋白治疗小儿重症病毒性脑炎临床观察

目的 探讨大剂量丙种球蛋白对小儿重症病毒性脑炎的治疗效果.方法 将临床确诊的72例重症病毒性脑炎患儿按随机数字表法分为治疗组和对照组,每组36例.两组均采用抗病毒和对症支持的综合治疗,治疗组在综合治疗的基础上静脉滴注丙种球蛋白1.0g/(kg·d),连用2d.观察两组热退时间、头痛和呕吐消失时间、意识精神状态恢复时间、惊厥停止时间及住院时间,并比较疗效.结果 治疗组热退时间、头痛和呕吐消失时间、意识精神状态恢复时间、惊厥停止时间及住院时间均明显短于对照组[(7±2)d比(12±3)d、(3±2)d比(6±2)d、(7±4)d比(11±3)d、(5±3)d比(9±2)d、(13±3)d比(21±3)d],差异有统计学意义(P＜0.05).治疗组总有效率明显高于对照组[91.7％(33/36)比72.2％(26/36)],差异有统计学意义(P＜0.05).治疗组无一例因静脉滴注丙种球蛋白而出现不良反应.结论 静脉滴注大剂量丙种球蛋白能够显著改善重症病毒性脑炎患儿的临床症状和体征,提高总有效率.     

儿童复杂性尿道狭窄的治疗

目的 探讨儿童复杂性尿道狭窄手术方法的选择及成功的关键。方法 25例复杂性尿道狭窄采用不同的手术方法治疗30次，其中采用口腔粘膜管状重建尿道3例。口腔粘膜补片尿道成形3例；经耻骨径路尿道端端吻合11例，膀胱壁瓣尿道成形2例；经会阴径路尿道端端吻合8例；双阴唇带蒂皮瓣Ⅰ期尿道成形2例；带蒂包皮内板Ⅰ期尿道成形1例。结果 术后随访2-36个月。平均18.5个月。一次手术后排尿通畅20例。术后效果不佳5例。经再次手术后排尿通畅4例。结论 儿童尿道狭窄手术方法的选择应根据尿道狭窄段的长短，位置选择合适的术式；口腔粘膜具有取材方便。创伤小，有较强的抗感染力的优点，是一种较好的尿道替代物。     

腰麻伍用微量吗啡的术后镇痛效果

腰麻为操作简单、麻醉效果确切、适用于下腹与下肢手术的一种麻醉方法，但对术后镇痛有些不便。我们自2002年2月至12月对择期下肢手术患者在单次腰麻过程中伍用吗啡0.1mg，得到满意的麻醉效果和术后镇痛效果，现总结报告如下。     

儿童后尿道狭窄手术径路的应用评价

目的 评价儿童后尿道狭窄各种手术径路的应用,提高儿童后尿道狭窄的治疗效果。方法 对24例儿单后尿道狭窄患者的手术径路进行回顾性分析。结果 19例(79.2％)手术治愈。采用单纯经会阴径路5例中治愈3例(60％);经会阴耻骨下缘径路10例中治愈9例(90％);经耻骨联合会阴径路9例中治愈7例(77.8％)。结论 儿童后尿道狭窄的各种手术径路均存在一定的优缺点。经会阴耻骨下缘径路具有操作方便,创伤小,并发症少,且不破坏骨盆稳定性等优点,尤其适合于儿童。     

女性尿道憩室26例临床分析

尿道憩室是女性较为常见的尿道疾病之一，是女性反复尿路感染的重要原因。由于部位隐蔽，临床表现多样，极易误诊。我院1994年5月—2004年10月共收治26例，治疗后均痊愈。     

超长段尿道狭窄术后勃起功能的评估

Objective To investigate the effect of substitutive reconstruction of long urethral stricture on male erectile function. Methods From January 2007 to January 2009, 23 patients with anterior or posterior long urethral stricture were accepted for a variety of onlay substitutive procedures, including lingual mucosa, perputial skin, and mid-scrotal skin. During the follow-up, data from the International Index of Erectile Function-5 (ⅡEF-5) questionnaire and the Quality of Life (QOL) questionnaire as well as maximal flow rate were recorded. All data were compared with those obtained before surgery. Results Significant improvement in QOL (1.22 ± 1.40, 1.82 ± 1. 17,2.07± 0.46) and maximal flow rate (22.46± 4.65, 23.81 ± 6.22, 21.52 ±7.44 ) could be observed 3, 6 and 12 months after surgery compared with those before surgery (5. 22 ± 0. 75, 3. 93 ± 3. 62)(P＜0.01). No significant differences in the responses to the ⅡEF-5 questionnaire were observed among all patients during the follow-up (P＞0. 05). At the 3, 6 and 12 months after procedure,scores of ⅡEF-5 in patients with anterior urethral stricture ( 17.79 ± 6.42, 16. 57 ± 4. 78, 16.01 ±3.85) were significantly higher than those with posterior urethral stricture (11.67 ± 2.59, 12.35 ±1.83,13. 19±1.67, P＜0.05). In patients with posterior urethral stricture, the multiple linear regression showed that age, time interval of injury and length of stricture were related to the ⅡEF-5score (P＜0.05). Conclusions Substitutive reconstruction for treating the long urethral stricture has little effect on male erectile function. But the location of stricture, especially extended to posterior urethra, may have impact on the erectile function.     

超长段尿道狭窄术后勃起功能的评估

Objective To investigate the effect of substitutive reconstruction of long urethral stricture on male erectile function. Methods From January 2007 to January 2009, 23 patients with anterior or posterior long urethral stricture were accepted for a variety of onlay substitutive procedures, including lingual mucosa, perputial skin, and mid-scrotal skin. During the follow-up, data from the International Index of Erectile Function-5 (ⅡEF-5) questionnaire and the Quality of Life (QOL) questionnaire as well as maximal flow rate were recorded. All data were compared with those obtained before surgery. Results Significant improvement in QOL (1.22 ± 1.40, 1.82 ± 1. 17,2.07± 0.46) and maximal flow rate (22.46± 4.65, 23.81 ± 6.22, 21.52 ±7.44 ) could be observed 3, 6 and 12 months after surgery compared with those before surgery (5. 22 ± 0. 75, 3. 93 ± 3. 62)(P＜0.01). No significant differences in the responses to the ⅡEF-5 questionnaire were observed among all patients during the follow-up (P＞0. 05). At the 3, 6 and 12 months after procedure,scores of ⅡEF-5 in patients with anterior urethral stricture ( 17.79 ± 6.42, 16. 57 ± 4. 78, 16.01 ±3.85) were significantly higher than those with posterior urethral stricture (11.67 ± 2.59, 12.35 ±1.83,13. 19±1.67, P＜0.05). In patients with posterior urethral stricture, the multiple linear regression showed that age, time interval of injury and length of stricture were related to the ⅡEF-5score (P＜0.05). Conclusions Substitutive reconstruction for treating the long urethral stricture has little effect on male erectile function. But the location of stricture, especially extended to posterior urethra, may have impact on the erectile function.     

擅长诊治牛皮癣的医生推介

北京杨雪琴教授治好了我父亲的关节型牛皮癣 我们是来自河南的求医者.我父亲患关节型牛皮癣已经近10年了.他全身上下的大小关节处均有厚厚的一层皮癣,且手、腕及足等小关节经常出现红肿疼痛的症状,右手已经发生了肌肉萎缩.数年来,我父亲去过很多家医院,也接受过很多种疗法进行治疗,然而疗效一直不甚理想.由于当时我们家的经济状况不太好,还要每月拿出一笔钱供我和弟弟上大学,因此,我父亲主动放弃了治疗.     

驻洛部队干休所部分老干部用药情况调查及分析

为了深入了解老干部合理用药情况,我们对驻洛部队干休所部分老干部2010年5月-2010年12月期间用药情况进行了调查. 1 临床资料 1.1一般情况:例中,男186例,女3例;年龄76-99岁,平均83.7岁. 1.2方法:采用巡防、走访、座谈,查阅门诊登记、出院通知单等方法,调查老干部住院期间与门诊就诊、体检以及在所休养期间的用药情况.     

后尿道狭窄的诊断和治疗——2O年经验总结

吻合术142例次;经会阴加阴茎海绵体中隔切开86例次;经会阴加耻骨下缘切除196例次;经耻骨劈开联合会阴径路后尿道端端吻合术68例次.426例随访3～120个月,平均32个月.其中302例排尿通畅,无需尿道扩张;12例分别行尿道扩张2～6次后排尿稳定;32例行直视下尿道内切开术后排尿通畅;53例经过再次或3次后尿道端端吻合术获得治愈.总手术治愈率为93.7%(399/426). 结论 根据后尿道狭窄或闭锁患者的病情选择合适的影像学诊断方法和合理有效的手术径路和手术技巧,有助于提高后尿道狭窄的诊治水平.