二尖瓣置换术围术期血糖变化的研究

目的探讨二尖瓣置换术围术期血糖变化规律及护理要点。方法对78例二尖瓣置换术患者分别于手术前、切皮前、体外循环中、停机后、术后6 h和手术次日晨6个时点取桡动脉血测定血糖。结果切皮前血糖比手术前明显升高(P<0.01),体外循环开始后进一步上升,到停机后达最高峰,手术结束后血糖开始下降,但至术后次日晨仍保持在高于术前的水平(P<0.01),差异有极显著性意义。结论二尖瓣置换术中,病人血糖发生了明显变化,密切监测血糖浓度,预防高糖血症、低血糖反应,是ICU护理工作的重要内容。     

养肝活血汤对酒精性肝病大鼠的影响

目的:探讨养肝活血汤对酒精性肝病大鼠的影响.方法:将SD大鼠按照随机数字表法分为空白对照组、模型对照组、养肝活血汤组(12.8 g ? kg-1)、硫普罗宁钠组(60 mg ? kg-1).检测各组大鼠血清中天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、谷丙氨酸氨基转移酶(ala...     

中医药治疗糖尿病血瘀证研究进展

从辨证论治(脾肝肾论治、气阴亏虚论治)、中医药研究(单味药及提取物研究、复方研究等综述糖尿病血瘀证的中医药研究进展)。指出:糖尿病血瘀证的诊断,目前尚无统一标准,有必要确定一个较为统一诊断标准和疗效评定标准,建议采取循证医学原则进行大样本临床研究、选取公认、敏感的多个指标进行评定,重视中药通过改善糖尿病血瘀证对糖尿病慢性并发症的防治作用的研究。     

Effect of electroacupuncture on the bladder function in rats with bladder hyperactivity

目的：观察电针对排尿频率、骶髓背角血管活性肠肽（VIP）表达的影响,探讨针刺抑制大鼠左旋多巴诱发的膀胱机能亢进的神经生物学机制。方法：将48只SD雌性大鼠按随机数字表分成正常组6只,对照组14只,模型组14只,电针组14只。全部动物均施行膀胱插管术,正常组不做腹腔注射;对照组腹腔注射生理盐水;模型组和电针组动物腹腔内先后注射卡比多巴和左旋多巴;应用连续膀胱测压技术动态观察电针中膂俞对大鼠排尿频率的影响;应用免疫组织化学的方法,观察电针后骶髓背角的vIP动态变化,并用图像分析技术进行定量分析。结果：模型组在腹腔注射左旋多巴后排尿频率较处理前迅速增加（P〈0．05）,电针组在腹腔注射左旋多巴后15～75min时段排尿频率较处理前增加（P〈0．05）,75～105min时段排尿频率接近处理前水平。在腹腔注射左旋多巴后3h时电针组骶髓背角的VIP阳性纤维和终末比模型组、正常组显著增加（P〈0．05）。在腹腔注射左旋多巴后8h时模型组骶髓背角的VIP阳性纤维和终末较正常组显著增加（P〈0．05）,而电针组与正常组则无统计学差异。结论：电针可促进左旋多巴引起的膀胱机能亢进大鼠的躯体传入神经释放VIP,从而降低排尿频率。     

多普勒超声定量血流量准确性的实验研究

目的：本文探讨几种常用多普勒血流参数定量血流量的准确性。方法：在离体模型上准确模拟出不同的血流量,用频谱多普勒测量几种血流数（TAmean、TApeak和VTI）,分别计算每分血流量Q,并与实际血流量进行比较。结果：Q(TAmean）与实际血流量接近,测量比较准确（回收率RR＝98．0％）,其次是Q（TApeak)（RR＝91．6％）,而Q(VTI)准确性较差（RR＝159．9％）,高估实际血流量约60％;而各方法的变异系数无明显差别。结论：应用TAmean计算每分血流量较其它血流参数相对比较准确。     

Patient‐centred care – preanalytical factors demand attention: A questionnaire study of venous blood sampling and specimen handling

Objective. Most mistakes in laboratory medicine are the result of human error occurring before the blood sample reaches the laboratory. This survey of preanalytical procedures was designed to identify sources of error and potential targets for quality improvement strategies. Material and methods. The staff in a highly specialized surgical ward at a university hospital completed a questionnaire addressing the collection and handling of venous blood samples in plastic vacuum test‐tubes for general clinical chemistry testing. Results. The results suggest that venous blood sampling instructions are not always followed. When uncertain about how a sample should be collected, the majority of respondents rely on potentially poor sources of information, such as out‐of‐date printed instructions or the advice of a colleague, rather than consult up‐to‐date electronic instructions. Furthermore, they do not always report errors and the referrals are not always handled according to sampling instructions. The respondents were highly motivated, however, and had a strong interest in receiving further education in, and assuming increased responsibility for, venous blood sampling procedures in the ward. Conclusions. We believe that the introduction of standardized routines and regular staff training, combined with an exchange of the existing paper‐based referral management system with an electronic system for managing referrals, could increase safety in the preanalytical process, with positive effects on patient safety. Given the importance of venous blood samples in patient care, a more extensive study covering other hospital wards and primary health‐care centres is needed.     

溃疡性结肠炎伴不全肠梗阻并严重感染的诊治分析

【目的】探讨溃疡性结肠炎(UC)伴不全肠梗阻并发严重感染的诊治方法。【方法】回顾性分析本院近期收治的一例 UC 伴不全肠梗阻并发严重感染患者的临床资料,三次入住本院消化内科症状无明显改善后转入本科室治疗,拟逐步停用激素及免疫抑制剂后行探查手术,同时予以肠内外营养支持治疗,三个月后行腹腔镜结肠肝曲癌根治+左半结肠切除术。【结果】患者腹泻症状较术前明显缓解,未再诉腹痛、腹胀;体温恢复正常;肛瘘病情好转;术后病检结果为 UC 伴结肠肝曲癌变。【结论】UC 患者在使用激素、抗免疫治疗时出现不全肠梗阻应早期预防性给予抗感染治疗,避免出现爆发感染,疗效不佳时应尽早手术治疗;对于病程长的 UC 患者出现类似克隆恩病肠壁增厚不全肠梗阻时应早期手术,谨防癌变。     

品管圈对糖尿病患者健康促进的效果

目的：探讨品管圈对糖尿病患者健康促进的效果。方法成立品管圈糖尿病活动小组,对糖尿病患者进行持续的疾病控制管理,分析管理前后患者的自护能力与血糖、血脂及体质指数变化情况。结果经过QCC管理后患者的自护能力明显比入院时提高( P<0.01)。经过QCC活动小组管理后,患者出院6个月后的空腹血糖、餐后2 h血糖及血脂明显下降,患者平均体质指数也明显减轻,与入院时比较差异明显( P<0.01)。结论品管圈活动对糖尿病患者进行连续有效服务,不仅能达到实现自我管理的目的,更是治疗糖尿病、控制并发症的有效途径,值得临床进一步推广应用。     

Application of a portable microscopic cell counter for the counting of residual leukocytes in leukoreduced apheresis platelet concentrates in a hospital blood bank

While a portable microscopic cell counter has been evaluated to enumerate residual white blood cells (WBCs) in red blood cells and platelet concentrates at blood centers, it has not yet been assessed in a hospital blood bank. We investigated the performance of this device and evaluated its accuracy, along with its benefits in time management.Residual WBCs from each of 100 apheresis platelet specimens were measured manually using a Nageotte chamber, along with flow cytometry methods and an ADAM-rWBC automated instrument (NanoEnTek, Seoul, South Korea). The efficiency was calculated by measuring the time required for the analysis of one specimen ten times consecutively.Flow cytometry and the ADAM-rWBC were able to detect four sporadic cases that had residual WBCs exceeding 1/μL that were not detected by the manual method. Analysis time was the shortest with the ADAM-rWBC, followed by flow cytometry and the manual method.Our data suggest that hospital blood banks require quality control of residual WBCs; among the methods evaluated in this study, the portable microscopic cell counter offers the best time efficiency.