费森尤斯 4008B型血透机平衡腔故障的处理

通过观察费森尤斯4008B血透机一例温度报警现象,经过原理分析与检修,最终找出故障原因为平衡膜漏.     

血透室的综合管理与评价

应用血透技术治疗慢性肾衰已有半个世纪的历史。进入90年代，随着国外最先进血透设备的涌入，国内医院的血透工作更趋电子化、自动化、计算机化；在血透技术领域内，理、工、医、药等多学科得到综合运用。这种趋势推动着血透技术的精细深发展；也使医护技等各部门工作分工发生新变化；血透规模不断扩展。因此对血透室的管理提出新要求：如何充分发挥人的主观能动性；如何使医疗设备发挥最佳医疗效能；创造最佳经济、社会效益已成为血透室管理者及工作者十分关心并需深入探讨的课题。结合我科几年来的工作情况与同行谈谈体会：1．科学的制度…     

维生素D受体与佝偻病

1961年Prader等报道由常染色体显性遗传引起的维生素D(VitD)性佝偻病,症状和所见类似VitD缺乏性佝偻病,但不是VitD缺乏所引起,称为假性VitD缺乏性佝偻病。这样的患者虽摄取正     

增强型体外反搏联合中医辩证治疗不稳定性心绞痛疗效观察

目的观察增强型体外反搏(EECP)联合中医辨证(痰瘀闭阻)治疗冠心病不稳定性心绞痛(UA)的疗效。方法随机分为对照组、药物治疗组和反搏治疗组。对照组常规西药加EECP;药物治疗组常规西药加中药化痰活血、理气宽胸法治疗;反搏治疗组在常规西药加中药治疗基础上再加EECP。12天为一疗程,增强型体外反搏1小时/次,连续治疗3疗程。观察治疗前后心绞痛症状改善和心电图变化以及不良反应发生情况。结果所有治疗组心绞痛症状改善和心电图变化均有所改善,对照组、药物治疗组疗效相近,反搏治疗组疗效优于对照组、药物治疗组。结论增强型体外反搏联合中医治疗冠心病不稳定性心绞痛的疗效更高,各组均无不良事件发生。     

外周动静脉同步换血疗法治疗重度新生儿高胆红素血症的临床研究

目的探讨外周动静脉同步换血治疗重度新生儿高胆红素血症的疗效及相关并发症。方法回顾性分析30例行外周动静脉同步换血术治疗的重度高胆红素血症患儿,比较换血前后血清总胆红素、血常规、血糖、血气分析及血电解质等,分析换血相关并发症。结果 30例患儿经换血后,总胆红素水平下降显著(P<0.001);血常规中白细胞和血小板计数较换血前均有显著下降(均P<0.001),红细胞和血红蛋白较前升高;血电解质中血钾、血钙和血钠与换血前比较,差异无统计学意义(均P>0.05)。大部分换血不良反应是无症状、可治愈的。结论外周动静脉同步换血疗法治疗新生儿重症高胆红素血症,疗效好且安全。     

Superiority of Laparoscopy in the Peritoneal Dialysis Catheter Reset Surgery

Peritoneal dialysis catheter surgery has been used in clinical treatment for nearly 40 years, and open surgery under local anesthesia is the conventional method. However, catheter displacement after open surgery is still the thorny issue during our clinical practice. Then the reset surgery is often required to be taken again. Nowadays, laparoscopic peritoneal dialysis catheter draws our attention due to its advantages of accurate positioning, smaller incision, and less pain, and its clinical application has been limited. While laparoscopic surgery is recognized, there are few relevant studies on whether there is difference during the catheter reset process between the two surgical approaches. In this study, we mainly discussed the rate of secondary catheter migration, the incidence of complications after catheter reset for two surgical approaches and the hospital stay as well as the total clinical cost for the two surgical approaches. In this study, we retrospectively analyzed 25 cases of end-stage renal disease, who received catheterization for peritoneal dialysis and regular peritoneal dialysis in our hospital from March 2010 to December 2013, and had a medical history of catheter migration. We collected the relevant clinical data for all patients. Fifteen patients selected laparoscopic catheter reset, and 10 patients selected the traditional surgical method for catheter reset by themselves. For all patients enrolled, we analyzed the incidence of secondary catheter migration and postoperative complications, hospitalization time, and total cost for different methods of reset. Through the studies above, we found that laparoscopic peritoneal dialysis catheter surgery offered accurate catheter location and a small incision that was easy to heal. Besides, the incidence of postoperative complications for the laparoscopic surgery was lower than that for traditional surgical approach for catheter reset. The average hospitalization time for laparoscopic surgery was shorter than that for the traditional surgical approach. The total cost of laparoscopic surgery was more than that of the traditional surgery. Therefore, the rational application of a laparoscopic peritoneal dialysis catheter and reset surgery can increase the success rate of peritoneal dialysis, reduce the complications, shorten hospitalization time of patients, and thus enhance patient’s confidence to stick it out.     

络病理论在心血管疾病中的应用进展

目前,络病理论治疗心系疾病疗效显著,受到了学术界的重视。近年来,该应用已取得了一定的进展,尤其是在冠心病心绞痛、高血压、糖尿病心脏病这三个领域,但总体来说研究范围仍较为局限,临床实验研究较少。     

低剂量联合降压对原发性高血压合并代谢综合征患者的疗效观察

目的比较以氨氯地平为基础的两种联合降压方案对原发性高血压合并代谢综合征患者的疗效及不良反应。方法研究对象来源于中国高血压综合干预研究项目,本地区纳入的251例原发性高血压患者中符合代谢综合征的共102例。采用多中心、随机对照、盲终点评估临床试验方法,观察初始小剂量氨氯地平(2.5 mg/d)加复方阿米洛利组(含阿米洛利1.25 mg,氢氯噻嗪12.5 mg,A组,n=46)和小剂量氨氯地平(2.5 mg/d)加替米沙坦组(40 mg/d,B组,n=56)1年内的降压疗效和不良事件。结果治疗1年时,血压达标率B组高于A组,分别为89.3%和78.3%(P=0.002)。B组降压作用优于A组,1年时舒张压下降幅度分别为(13.1±7.4)mm Hg和(9.5±9.9)mm Hg(P=0.047)。结论低剂量氨氯地平联合替米沙坦能更安全有效地控制原发性高血压合并代谢综合征患者的血压。     

反渗水复用法对消除透析中热原反应效果的临床观察

复用导致热原反应和菌血症是透析器复用的最大弊端之一。因 1999年 3月受水源污染影响 ,我院及临近医院血透中心同时发生大量热原反应 ,于 1999年 5月停用软化水 ,改用反渗水复用透析器及管路。现将结果报告如下 :1　方法1.1　反渗水来源 :将原有瑞典金宝 CWP6 1型反渗机增加一个反渗膜 ,扩容为 CWP6 2型 ,由反渗机出端设分支供应复用机 ,冲洗压力调在 1kg/ cm2 ,出水电导率为 5 μs/ cm。1.2　复用消毒处理 :德国进口血仿膜透析器复用 2次～ 8次 ,常规冲洗 :正冲——反冲——反超。仍有残血的透析器注入3%双氧水作用 15 m in;仍有残余蛋…