1例脊髓空洞症侧脑室延髓池内分流术的护理

1 病例介绍病人,男,34岁,左下肢步态不稳10年,加重伴酸麻、隐痛1年,于2004年4月入院.入院时精神欠佳,生活不能完全自理,左上肢肱二腱、肱三腱反射和下肢膝反射亢进,右上肢肱二腱、肱三腱反射减弱,右前臂及手部触觉消失,左下肢膝关节以下触觉、位置觉、浅感觉消失.MRI示脊髓空洞症.术前检查未发现手术禁忌证,行全身麻醉下环枕畸形减压、侧脑室延髓池内分流术.手术顺利,术中输红细胞悬液400 mL,放置皮下引流管1根,术后恢复好,无并发症发生,病人生活上基本自理,出院随访1年,情况良好.……     

对我院护士继续教育学分未达标的原因分析及对策

应用继续医学教育管理系统对我院2004年度护士学分进行审核,从继续教育管理、参加人员的认识水平、工学矛盾对学习的影响等方面分析34名护士学分未达标的原因,制定并加强政策宣传,提高认识水平;完善规章制度,加大管理力度;对上网学习者提供指导,避免错误操作;拓宽学习渠道,缓解工学矛盾等管理措施,以提高护士继续教育学分达标率.     

长期输精管结扎术后附睾的超声表现

目的:探讨长期输精管结扎术后附睾的超声表现。方法:选择输精管结扎术后10～31年且有临床症状的患者64例(结扎组)。同时选择同期被临床诊断为附睾疾病而无结扎史的患者60例作为对照组。用高频超声观察附睾头、体、尾部的形态,厚度及内部回声;用彩色多普勒血流图或能量图观察附睾的血流状况。结果:结扎组附睾体部增厚、尾部增厚、头体尾均增厚及附睾管扩张的发生率分别为64.1%、78.1%、42.2%、54.7%,均显著高于对照组的15.0%、51.7%、8.3%、8.3%(P<0.01),而结扎组附睾的高血供发生率15.6%显著低于对照组的61.7%(P<0.01)。结论:长期输精管结扎术后附睾的主要超声表现是附睾增厚、附睾管扩张,但附睾血流多为无血供或低血供状况。     

介入治疗下肢深静脉血栓的临床应用

目的 探讨介入治疗下肢深静脉血栓(deep venous thrombosis,DVT)的效果. 方法 38例DVT均行深静脉置管接触性溶栓,12例联合血管球囊扩张及血管内支架置入术.按我院疗效观察标准:治愈,造影检查示血栓完全溶解,静脉壁光滑;显效,静脉回流通畅,静脉内有附壁血栓,管腔内径≥2/3;有效,静脉内仍有血栓残留,管腔内径＜2/3;无效,造影检查示静脉回流不通畅. 结果 治愈22例,显效14例,有效2例.治疗中无严重并发症发生.34例随访3～24个月,其中3～6个月7例,7～12个月12例,13～24个月15例,血栓复发2例,经再次深静脉置管接触性溶栓治疗后部分再通. 结论 介入治疗DVT操作简便,安全有效.     

CT导向下经皮射频消融术治疗肾上腺恶性肿瘤

目的对29例肾上腺肿瘤患者行射频消融（RFA）治疗，研究其近期局部治疗效果、不良反应和副作用。方法肾上腺肿瘤患者共29例，病灶总数31个，其中直径≤2．0cm的病灶共5个，2．1-4．0cm者18个，4．1-6．0cm者5个，≥6．1cm者3个，经RFA治疗1个月后行螺旋CT双期增强扫描评价肿瘤治疗效果。结果上述病灶经消融治疗后达到完全坏死者分别为5个、18个、3个、2个。患者无严重并发症出现。结论RFA治疗安全可靠，副作用小，是治疗肾上腺恶性肿瘤的有效方法之一。     

多疗程治疗的癌症病人入院时的焦虑状态调查

[目的]了解恶性肿瘤病人反复多次入院治疗时的心理状态,通过护理干预帮助病人更快投入治疗情境.[方法]通过焦虑自评量表(SAS)进行心理测验,随机将病人分为对照组和实验组,针对结果分别进行相应护理,1周后复查.[结果]实验组和对照组护理后的SAS评分差异显著.[结论]癌症病人多疗程入院的病人焦虑状况严重,实施焦虑的支持护理及心理辅助,可较好地促进病人进入治疗角色,减少弃治轻生的发生.     

Bone growth patterns in Chinese children and adolescents: a 6-year follow-up study provides evidence for sexual dimorphism and tracking

Summary We prospectively examined bone growth patterns in 894 children aged 6–17 years at the baseline visit, with a 6-year follow-up. Results show bone “tracking” over a six-year interval and sexual dimorphism of bone attained levels and timing of peak bone growth. Our findings underscore childhood and adolescence as critical periods for building bone and developing gender differences. Introduction Bone growth patterns were prospectively examined in 894 Chinese children (496 males), aged 6–17 yrs, from a population-based twin cohort. Whole-body bone area (BA), bone mineral content (BMC), and bone mineral density (BMD) were measured by DEXA at baseline and a 6-yr follow-up. Methods Graphic smoothing plots and generalized estimating equations were used to model bone attained levels, growth, and “tracking”. Results Attained levels of BMC and BA increased curvilinearly with age. Male attained levels were higher than females after age ∼15 yr, but BMD was lower between 13–17 yrs (Tanner stage I to IV). In both genders, peak BMC and BMD growth lagged ∼2 yrs behind peak BA growth, which lagged 2 yrs behind peak height growth. Peak bone growth occurred 1–3 yrs later in males. Over the 6-yr follow-up, all bone measurements “tracked”, but “shifting” across ranks also occurred, and baseline tertile ranking influenced bone growth. Females with early menarche had higher attained levels than females with late menarche at age 12–13 yrs. Conclusion Our findings confirm and expand previous studies on peak bone growth conducted in Caucasian cohorts, particularly sexually dimorphic and maturational effects. The significant “tracking” of bone measurements in this 6-yr follow-up study underscores the importance that osteoporosis prevention should begin in childhood and adolescence. Fengxiu Ouyang and Binyan Wang contributed equally to this article. Source(s) of support: This study is supported in part by grant R01 HD049059, R01 HL0864619 and R01 AR045651 from the National Institute of Health and by the Food Allergy Project.     

PHS 应用在腹股沟马鞍疝无张力修补术11例分析

目的 探讨PHS在腹股沟马鞍疝无张力修补术中的治疗效果和手术经验.方法 对11例使用PHS行无张力修补术的腹股沟马鞍疝患者进行分析.结果 在局麻下完成手术,手术时间25～60 min,全组留院观察24～72 h,无阴囊积液、切口感染、血肿及其它与手术有关的并发症.随访6个月～30个月,无复发,无异物感.结论 PHS修补牢靠,对于腹股沟马鞍疝的手术治疗更有针对性.重视手术的技巧是手术成功的关键.