结肠癌致急性肠梗阻的外科诊疗体会

<正>急性肠梗阻是结肠癌的一个常见的临床表现,一般属于结肠癌的中晚期症状。由于结肠癌早期的临床表现不典型,对疾病认识的局限性等因素,部分患者常常以急性肠梗阻为首发症状来院就诊,给临床诊断和手术等造成了困难,同时也给治疗效果和恢复带来了一些不利影响。现将本院8间年收治结肠癌致急性肠梗阻病例的诊断和外科治疗体会分析如下。     

全国多中心类风湿关节炎患者门诊用药费用的调查

Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.     

食管胃底静脉曲张破裂出血急诊行贲门周围血管离断术的护理

门静脉高压症并发食管胃底静脉曲张破裂出血是外科治疗的难题,若抢救不及时常可危及生命,病死率高达40%～50%[1].而贲门周围血管离断术是紧急手术止血时首选的断流术式[2],通过脾切除加贲门周围血管离断阻断门奇静脉间的反常血流,以达到止血的目的.1999年1月以来,我们护理了75例贲门周围血管离断术的患者,报告如下.     

炎琥宁联合依巴斯汀片治疗急性湿疹疗效观察

目的:观察炎琥宁联合依巴斯汀片治疗急性湿疹的有效性。方法:将102例湿疹患者随机分为治疗组52例和对照组50例。治疗组采用炎琥宁静脉滴注联合依巴斯汀片口服治疗,外用硼酸水湿敷及0.05%地塞米松涂搽;对照组采用依巴斯汀片口服治疗,外用硼酸水湿敷及复方地塞米松涂搽。两组分别于治疗1周及2月后按湿疹面积及严重度指数(EASI)评分标准评价临床疗效。结果:治疗组临床疗效总有效率为92.4%,对照组为76%,治疗组总有效率明显优于对照组(P<0.05)。结论:炎琥宁联合依巴斯汀片治疗急性湿疹疗效确切,复发率降低。     

护理程序在婴幼儿高热惊厥急救中的应用

高热惊厥是发作突然,病情紧急是其特点,为了提高急症护理水平和抢救速度,培养护理人员的现代急救意识,使抢救程序化,我们运用护理程序[1],以评估、准备、实施及效果评价为主线,将其基本步骤与高热惊厥的急救相结合,制订了小儿高热惊厥急救护理程序,成功地救治了52例高热惊厥患儿,现报道如下.     

淋球菌对5种抗菌药物敏感性的监测分析

目的观察淋球菌对抗菌药物的耐药情况,指导临床合理用药。方法采用琼脂稀释法对淋球菌进行青霉素、四环素、环丙沙星、头孢曲松、大观霉素的敏感性测定。结果耐青霉素、四环素、环丙沙星的菌株分别占96.77%,94.62%,77.41%,同时耐2种及以上抗菌药物的多重耐药率为97.84%,未发现耐大观霉素、头孢曲松的菌株。结论头孢曲松、大观霉素可以作为重庆地区治疗淋病的首选药物。     

迪银片结合肤光粉药浴治疗寻常型银屑病临床观察

2001年以来我们用自制肤光粉与迪银片联合治疗寻常型银屑病96例，取得了满意的疗效，现报告如下。