奥美拉唑三联疗法根除幽门螺杆菌临床观察

幽门螺杆菌 (ｈｅｌｉｃｏｂａｃｔｅｒｐｇｌｏｒｉ,Ｈｐ)感染与消化性溃疡的发病密切相关 ,根除Ｈｐ后溃疡愈合率提高 ,复发率显著降低。为探讨一种高效、相对价廉的根除方案 ,我们应用奥美拉唑三联疗法治疗Ｈｐ感染的消化性溃疡 ,同时对疗程 1周和 2周的Ｈｐ根除率、溃疡愈合率进行前瞻性、随机性对比研究 ,并对此三联疗法根除Ｈｐ的方案进行卫生经济学分析。1　资料与方法1 1　一般资料　本组 83例为我院 1996年 6月至 1999年 6月门诊或住院消化性溃疡病人 ,并符合以下条件 :①胃镜诊断为活动性十二指肠溃疡或胃溃疡 ,溃疡最大径≥ 5ｍ…     

循证护理方案应用于缺血缺氧性脑病新生儿的效果

目的 探讨缺血缺氧性脑病（HIE）新生儿应用循证护理,对其神经、体格发育的影响。方法 回顾性分析2018年6月至2020年6月厦门市妇幼保健院收治的116例HIE新生儿的临床资料。根据护理方法的不同将所有患儿分为对照组和观察组,各58例。对照组实施常规护理,观察组在常规护理的基础上加用循证护理。比较2组患儿的神经行为、应激反应指标、体格发育水平及智能发育商（DQ）。结果 干预1个月后,2组的血浆皮质醇、促肾上腺皮质激素释放激素和D-乳酸水平均较干预前降低（P均<0.05）,且观察组均较对照组更低（P均<0.05）。干预1个月后,2组的新生儿行为神经测定（NBNA）各项评分均较干预前升高（P均<0.05）,且观察组均较对照组更高（P均<0.05）。干预1个月后,2组的身长、体重和头围均大于干预前（P均<0.05）,且观察组均大于对照组（P均<0.05）。观察组在6月龄和12月龄的各能区DQ评分均高于对照组（P均<0.05）。结论 循证护理能提高HIE新生儿的神经、体格和智能发育,并改善患儿预后。     

普萘洛尔治疗婴幼儿血管瘤的研究进展

目的:综述普萘洛尔治疗婴幼儿血管瘤的研究进展。方法:通过查阅相关文献资料,对普萘洛尔治疗婴幼儿血管瘤的药理作用、作用机制及安全用药等问题进行归纳总结、分析评述。结果与结论:普萘洛尔对婴幼儿血管瘤的治疗作用确切,但其作用机制尚未完全明确;普萘洛尔治疗婴幼儿血管瘤时的安全用药问题不容忽视,改变普萘洛尔的给药方式或者寻找其他种类的β受体阻滞药用于治疗婴幼儿血管瘤可能更具优势。     

临床护理路径在慢性肾衰竭病人健康教育中的应用效果

临床护理路径(CNP)是指导护理工作、实施健康教育的有效工具,是依据标准护理计划,为某一类特殊病人设定的住院护理图,能够帮助护理人员判别病人预后[1],目前已用于各临床专科护理领域的健康教育[2].我科50例住院慢性肾衰竭病人采用CNP进行健康教育,并与传统的方法为对照,取得了良好效果,现介绍如下.     

吻合器痔上粘膜环切术治疗重度痔26例体会

目的 探讨吻合器痔上粘膜环切术(PPH)的手术方法 及疗效.方法 分析PPH手术治疗26例Ⅲ、Ⅳ度内痔患者的临床资料.结果 手术平均时间25 min,术后平均住院时间4d,术后当日需用止痛剂10例,轻微疼痛6例,无疼痛10例,无出血、无直肠阴道瘘及感染病例.随访6～15个月,24例痔团完全回缩,2例有残留皮赘,无复发病例.结论 PPH手术治疗重度痔安全有效,具有手术时间短、术后疼痛轻、住院时间短、病人术后痛苦小、无肛门狭窄和大便失禁等优点,术后恢复快,复发率低,精细控便功能不受影响.     

乳腺癌前哨淋巴结探测的临床应用研究

乳腺癌的手术治疗已有100多年的历史,起初人们认为乳腺癌是局部疾病,因而手术占据着治疗的主导地位,且手术范围越做越大.近年来,随着对乳腺癌生物学行为的深入了解,乳腺癌综合治疗水平不断提高,同时由于现代医学模式的转变,对乳腺癌本身的认识和治疗上的观念也有了很大变化.目前普遍认为清除阴性淋巴结对预后毫无益处[1].按传统观念施行根治术清扫腋窝淋巴结(axillary lymph node dissection,ALND)会带来一些严重的并发症:同侧上肢疼痛、上举困难、淋巴水肿、肢体麻木等,Aitken等[2]报告为10%～60%,徐宏等[3]报告上肢肿胀发生率为7.9%,而前哨淋巴结活检可以减少或避免这些并发症[4].因此,乳腺癌病人手术方式选择的原则是在治疗效果相同的前提下,采用最简单、损伤少、副作用小、并发症少的方式.乳腺癌前哨淋巴结活检(sentinellymph node biopsy,SLNB)技术是乳腺外科领域的一个极具意义的进展,也是当前乳腺外科研究领域的一个热点[5,6].     

中药提取物促进睡眠作用研究进展

失眠是指无法入睡或无法保持睡眠状态,导致睡眠不足。迄今大量研究显示,许多中药提取物具有促进睡眠作用,能显著改善睡眠质量,且与西药可产生协同作用。笔者现将近5年的相关文献综述如下。     

羌活化学成分研究Ⅲ羌活石油醚提取部分化学成分的分离鉴定

经硅胶柱层析,制备薄板层析分离,化学分析和光谱鉴定,从羌活的石油醚提取部分分离并鉴定了β-谷甾醇、油酸、亚油酸、哥伦比亚甙元、娠烯醇酮和阿魏酸6种化学成分。娠烯醇酮为首次从本属植物中分离鉴定。     

白血病患者造血干细胞移植前单次全身照射的预后分析

Objective To analyze the prognostic factors of patients with leukemia treated with single fraction total body irradiation (SFTBI) followed by hernatopoietic stem cell transplantation (HSCT).Methods From January 2001 to September 2008, 102 patients received HSCT. The differences of the survival rate, relapse rate and incidence of interstitial pneumonia (IP) between groups regarding different genders, ages, pathological types, transplantation methods and TBI parameters were compared and the factors related with the survival rate, relapse rate and incidence of IP were analyzed. Results The followup time ranged from 15 to 1482 days (median, 406 days). The follow-up rate was 95.1%. 86 and 55patients were followed up more than one year and three years. The 1-and 3-year survival rates were 59.0%and 44.0%. In univariate analysis, the 3-year survival rate was signifcantly different between the groups with and without relapse before transplantation (20% vs. 55%, χ2 = 6.33, P = 0. 012), allogeneictranplantation versus autologous tranplantation (39% vs. 68%, χ2 = 8.06, P = 0.005), grade 3 or more acute graft versus host disease (aGVHD) and grade 0 -2 aGVHD (0% vs. 54%, χ2 = 7.52, P = 0.006),with and without relapse after transplantation (19% vs. 58%, χ2 = 10.13, P =0.001), with and without IP (23% vs. 58%, χ2 =8.35, P=0.004). Multivariate analysis showed that grade 3 or more aGVHD was the only statistically significant prognostic factors (χ2 = 12. 74 ,P =0. 000). The l-and 3-year relapse rateswere 30. 0% and 50. 0%. The incidence of relapse was obviously higher in the group with relapse before transplantation than that without (47% vs. 16%, χ2 =7. 32, P=0. 007). Multivariate analysis showed thatrelapse before transplantation was a significant factor predicting relapse after transplantation (χ2 = 9. 39,P =0. 020). The cumulative incidence of IP was 35.0%. The incidence of IP was different between groups with dose homogeneity > 3% and ≤ 3% (27% vs. 4%, χ2 = 5. 21, P = 0. 023), with and without acute parotitis (34% vs. 3%, χ2 = 14. 15, P= 0.000), allogeneic transplantation group and autologous transplantation group (31% vs. 8%, χ2= 7.70, P= 0.006). Multivariate analysis showed that transplantation methods, acute parotitis and dose homogeneity were statistically significant factors in predictingIP (χ2 = 10. 08 , 10. 08 and 7.69 , P = 0. 002 , 0. 002 and 0. 010 , respectively) . Conclusions Patients who develop grade 3 or higher aGVHD have poor prognosis. Dose homogeneity influences the incidence of IP. Patients undergoing allogeneic transplantation are apt to have IP. Acute parotitis is related with IP and might be a predictor.