锁骨下动脉损伤及创伤性假性动脉瘤手术方法探讨

目的探讨锁骨下动脉损伤及创伤性动脉瘤的外科治疗方略。方法1991—2005年对2例锁骨下动脉损伤，6例锁骨下假性动脉瘤根据病变的部位、程度及受伤时间、累及范围等选择手术入路，采用血管缝扎、血管壁修补、血管吻合、血管移植、辅助体外循环及球囊止血技术实施手术。结果6例痊愈，1例动静脉狭窄，1例动脉闭塞伴臂丛损伤。平均失血800mL。结论锁骨下动脉损伤及假性动脉瘤手术复杂，术前对病变进行仔细评估，选择合理的切口及手术方法是减少并发症的关键。     

局部热敷对静脉输液的作用及对比分析

静脉输液是临床治疗最常见的基础技术操作，穿刺的成功与疼痛的轻重是病人和护士关注的焦点，在寒冷的季节，由于末端血管收缩，为静脉输液带来一定的难度，本研究根据热疗的原理，用于静脉输液中，取得了很好的疗效，现报告如下；     

论河北省卫生系统办公自动化管理系统

系统采用基于TCP/IP协议的国际互联网为基础,采用B/S结构,客户端采用IE浏览器,服务器端采用WINDOW2000的IIS作为服务器。其主要功能:工作督办、工作信息、电子邮件、收文、发文、图书管理、档案管理、车辆管理、日程管理、待办事宜、电子论坛、考勤管理等。     

重症肌无力胸腺切除术后呼吸道管理与并发症的防治

目的 探讨重症肌无力胸腺切除术后呼吸道管理与并发症的防治.方法 32例ICU收治的重症肌无力胸腺切除术后的患者,根据危象预测积分,分为普通组(积分＜12分,n=21)和高危组 (积分＞12分,n=11),对两组患者术后呼吸机支持时间、拔管前后肌力恢复情况、自主呼吸情况、动脉血气分析情况以及两组患者术后体温、胸片和痰培养结果进行统计分析.结果 高危组患者术后呼吸支持时间(18 ～ 30 h,平均26 h)大于普通组患者(4 ～ 28 h,平均14 h),两组有显著性差异(P＜0.01),同时术后发热、胸片渗出影以及阳性痰培养结果的发生率也高于普通组.结论 术后给予高危患者严密的监测和充分的呼吸支持,有助于降低重症肌无力危象的发生率和死亡率,同时应充分重视气道护理和感染的防治.     

低脉压与晚期慢性心衰患者利钠肽和死亡率升高独立相关

目的:脉压(PP)升高一贯用来预测有心血管疾病危险患者和轻度慢性心衰(CH F)患者的心血管疾病发生率和死亡率增高。相反,PP降低与急性失代偿性心衰患者死亡率升高相关。然而,尚不清楚PP对于晚期CH F患者的预测价值。方法和结果:采用Cox比例风险回归分析研究了1901例N YH A III或IV级CH F患者(平均年龄65岁,平均射血分数26%)的资料,经校正其他危险因素后,分析PP对死亡率的影响。检测了1个亚组患者的利钠肽水平。多元Cox回归分析表明,PP降低与死亡率增高相关(每增加10m m H g的H R为0.91,95%CI0.93～0.99),这一相关性独立于平均…     

Cognitive impairment of acute onset in the Consortium to Investigate Vascular Impairment of Cognition (CIVIC) study: occurrence, correlates, and outcomes.

OBJECTIVE: Having demonstrated that dementia of acute onset represents a distinct syndrome with distinct outcomes, the authors investigated whether similar attributes describe cognitive impairment of acute onset (CIAO). METHODS: The authors conducted a secondary analysis of the Consortium to Investigate Vascular Impairment of Cognition study. RESULTS: Ninety patients met our criteria for CIAO. Compared with cognitive impairment of gradual onset, CIAO was associated with vascular features (odds ratio [OR]: 12.3, 95% confidence interval [CI]: 3.2-47.9), dementias other than Alzheimer disease (OR: 6.5, 95% CI: 2.1-20.8), and decreased survival (hazard ratio: 2.8, 95% CI: 1.6-4.6). CONCLUSIONS: Patients with CIAO are clinically identifiable and have distinct outcomes.     

超声诊断异位妊娠249例临床分析

目的为了提高对异位妊娠的诊断技术。方法选择在我院经手术病理证实的异位妊娠249例住院患者行2DB超和CDFI的声像图特征进行分析。结果2D超声声像图特征在249例异位妊娠中内膜增厚223例，厚度为4—8mm／2；宫内假环状孕囊28例，大小为4．12mm；宫外探及孕囊178例，大小为8-48mm；盆腔混合性包块28例，大小为40．80mm：伴有黄体囊肿的123例，存活宫外孕3例，可显示原始心管搏动；CDFI声像图特征为宫外孕急性破裂的患者显示肿块及周围组织的彩色血流信号增多，动脉频谱血流速度增快，RI降低。结论超声检查对妇产科急诊有显著性作用，可直接指导临床明确诊断，选定治疗方案。     

桡骨颈骨折经皮撬拨复位的远期疗效

用经皮撬拨复位治疗桡骨颈骨折56例,其中复位良好46例,较好6例和不良4例;经3年7个月平均随访,复位良好和较好的44例中,后期疗效良好32例,较好11例和一般1例。骨折解剖复位、撬拨复位的手术损伤轻和石膏固定时间较短是后期疗效满意的关键。成人桡骨颈骨折伴肘内侧副韧带严重损伤比儿童多见,但儿童桡骨颈骨折严重倾斜移位和完全移位比成人多见,后期疗效更满意。     

Relationship among dosages of aminophylline, plasma levels of theophylline and variation of pulmonary arterial pressure]

The relationship among the dosages of aminophylline, plasma levels of theophylline and variations of mean pulmonary arterial pressure (mPAP) in 72 patients with COPD was investigated. The results showed that after a different loading dosage of aminophylline (6 mg/kg, 5 mg/kg and 4 mg/kg) was administered by intravenous injection, mPAP in the 6 mg/kg group was decreased more significantly (P less than 0.01) than that in the 4 mg/kg group. In the 6 mg/kg group, the decreased mPAP period sustained for 120 min, which was longer than that in the other 2 groups. The plasma levels of theophylline in the 6 mg/kg group of patients 30 to 120 min after loading dose injected were 115.54-79.04 mumol/L, which were higher than that in the others. Within the 120 min period of observation after the drug was administered no patients in any of these groups showed severe untoward effects. According to the results of this experiment, we suggest that the 6 mg/kg as a loading dose should be advised for the treatment of pulmonary hypertension in COPD. The optimum time to give the maintenance dosage should be set within 2 h after the loading dose. It is necessary to monitor the plasma levels of theophylline while aminophylline is administered, so that optimal therapeutic effects could be achieved without side effects.