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41.
BACKGROUND & AIMS: Feeding intolerance because of functional gastrointestinal dysmotility and parenteral nutrition-associated cholestasis (PNAC) are common problems in preterm, very-low-birth-weight (VLBW) infants. This double-blind, randomized, placebo-controlled study aimed to assess the effectiveness of "high-dose" oral erythromycin as a prokinetic agent in decreasing the incidence of PNAC. Two secondary end points, including the time to achieve full enteral feeding and the duration of parenteral nutrition, were also evaluated. METHODS: Infants consecutively admitted to the neonatal unit were randomized to receive erythromycin (12.5 mg/kg/dose every 6 hours for 14 days) or an equivalent volume of normal saline (placebo) if they attained less than half the total daily fluid intake (<75 mL/kg/day) as milk feeds on day 14 of life. RESULTS: Of 182 VLBW infants enrolled, 91 received erythromycin. The incidence of PNAC was significantly lower in erythromycin-treated infants (18/91) compared with placebo infants (37/91; P = .003). Treated infants achieved full enteral nutrition significantly earlier (mean, 10.1; SE, 1.7 days; P < .001), and the duration of parenteral nutrition was also significantly decreased by 10 days (P < .001). Importantly, fewer infants receiving erythromycin had 2 or more episodes of septicemia (n = 4) compared with placebo patients (n = 13, P = .03). No serious adverse effect was associated with erythromycin treatment. CONCLUSIONS: High-dose oral erythromycin can be considered as a rescue measure for VLBW infants who fail to establish adequate enteral nutrition and in whom anatomically obstructive pathologies of the gastrointestinal tract have been excluded. 相似文献
42.
玉米须(Corn Silkor Stigma Maydis)是一种物美价廉的药物,其"味甘、淡,性微温",玉米须含有多种有效化学成分,具有降糖、降压、降脂,抗菌,利胆、排石,止血,抗肿瘤,提高免疫力等药理作用,目前应用于临床治疗多种疾病。现仅就玉米须在肝胆疾病方面应用作综合讨论。 相似文献
43.
目的:探讨中医外治技术联合快速康复外科(ERAS)理念促进肝胆外科患者康复的临床疗效。方法:选择于2018 年8 月—2020 年10 月在我科行腹腔镜手术的患者308 例,随机分为外治组156 例,对照组152 例。对照组行腹腔镜手术+ERAS 理念,外治组在前者基础上加用中医外治技术,比较两组患者在术后肠鸣音恢复、肛门首次排气及排便时间、疼痛评分、住院天数、相关并发症等方面的差异。结果:外治组术后肠鸣音恢复、肛门首次排气排便时间均短于对照组(P <0.05),术后疼痛评分低于对照组(P <0.05),行肝脏手术及胰腺手术患者的住院时间均短于对照组(P <0.05)。但两组相关并发症发生率差异无统计学意义(P <0.05)。结论:中医外治技术联合ERAS 理念在肝胆外科围手术期的应用能减轻术后患者的疼痛,促进胃肠道功能的恢复,缩短住院时间,值得临床推广应用。 相似文献
44.
王国三老师是当代著名中医学家岳美中先生的得意门生,学识渊博,德高技精,在临床工作中积累了丰富的用药经验,对肝胆疾病的治疗更是有其独特的心得体会,临床效果显著。为了更好继承和发扬名老中医的学术思想,我们通过临床观察、跟师学习等方式对其治疗肝胆病的学术经验进行总结。 相似文献
45.
《Indian journal of medical microbiology》2015,33(3):427-429
We receive around 60 cases of hepatic abscess in a year. The commonest diagnosis reached at the time of discharge is amoebic liver abscess. The diagnosis of amoebic liver abscess is mostly presumptive and thus the patients are usually given a mixed treatment with injection ceftriaxone and tablet metronidazole. Here we report three cases of hepatic abscess diagnosed recently, where ascariasis was the probable etiology. Ascariasis may be a much commoner cause of hepatic abscesses in this region than we think. 相似文献
46.
Raed Al-Rajabi Sukeshi Patel Norma S. Ketchum Nicole A. Jaime Ting-Wei Lu Brad H. Pollock Devalingam Mahalingam 《Journal of gastrointestinal oncology.》2015,6(3):259-267
Background
Sorafenib is the only FDA-approved systemic therapy for advanced hepatocellular carcinoma (HCC). In clinical practice, dose reductions are often required, although there are limited efficacy data related to dose modifications. Given the prevalence of HCC in South Texas, we assessed the efficacy and safety of sorafenib therapy in relation to dose and Child Pugh (CP) score.Methods
A retrospective analysis was done of advanced HCC patients, starting sorafenib at 400 mg twice daily, or at physician discretion at 400 mg daily, with the goal of titrating to twice daily. Overall survival (OS) and progression-free survival (PFS) were assessed.Results
Among 107 patients, median OS (mOS) was 10.2 months; median PFS (mPFS) was 5.2 months. mOS for sorafenib 400 mg/day was 6.6 vs. 800 mg/day was 12.8 months [hazard ratio (HR), 0.59; P=0.04]; mPFS was 3.5 vs. 5.9 months, respectively (HR, 0.66; P=0.07). For Child Pugh A class (CP-A) patients, mOS was 15.8 months for 400 mg/day vs. 12.8 months for 800 mg/day (HR, 1.48; P=0.35); mPFS was 9.0 vs. 5.9 months, respectively (HR, 1.23; P=0.56). For Child Pugh B class (CP-B) patients, mOS was 5.0 months for 400 mg/day vs. 11.2 months for 800 mg/day (HR, 0.33; P=0.002); mPFS was 2.1 vs. 5.6 months, respectively (HR, 0.41; P=0.006). No differences in adverse events (AEs) were observed in CP-A vs. CP-B.Conclusions
Patients with CP-A or CP-B advanced HCC should be offered sorafenib at 400 mg twice daily with optimal management of AEs in order to improve survival. 相似文献47.
目的 探讨肝胆外科手术后切口感染的多因素分析及治疗对策.方法 选择医院从2005年5月-2011年8月收治的554例肝胆外科手术患者,通过回顾性调查分析,分析发生手术切口感染的相关因素.结果 554例肝胆外科手术患学中,发生切口感染66例,感染率为11.9%;患者年龄、手术时间、手术切口类型对切口感染率存在差异;年龄>60岁患者感染率显著高于<60岁患者,说明老年患者术后切口感染率高;Ⅰ类切口感染率为6.2%,明显低于Ⅱ、Ⅲ类切口的16.0%、23.7%;并且手术时间越长,发生切口感染的概率越高;因而预防肝胆外科术后切口感染,应从患者自身因素及手术操作两方面进行.结论 外科医师一定要加强无菌观念,加强无菌环境及手卫生依从性、尽量缩短手术时间、完善感染管理制度、控制探视人员流量,以最大限度减少手术切口感染的发生率. 相似文献
48.
49.
Shahid A Khan I Jane Cox Gavin Hamilton Howard C Thomas Simon D Taylor-Robinson 《Liver international》2005,25(2):273-281
Nuclear magnetic resonance (NMR) spectroscopy is a non-invasive technique, which allows the study of cellular biochemistry and metabolism. It is a diverse research tool, widely used by biochemists to investigate pathophysiological processes in vitro and, more recently, by physicians to determine disease abnormalities in vivo. This article reviews the basics of the NMR phenomenon and summarises previous research on the hepatobiliary system using both laboratory-based and clinical methodologies. The role of proton and phosphorus-31 ((31)P) NMR spectroscopy in the study of malignant and non-malignant liver disease and studies of bile composition are discussed. In vivo techniques (magnetic resonance spectroscopy, MRS) can be performed as an adjunct to standard MR examination of the liver. Although still primarily a research tool, the in vivo technique provides non-invasive biochemical information on disease severity and holds promise in its use to gauge response to treatment regimens. 相似文献
50.
目的:探讨间歇性肿瘤减灭术在晚期卵巢上皮性癌治疗中的临床价值。方法:将我院收治的68例卵巢上皮性癌患者随机分为观察组和对照组,观察组采用间歇性肿瘤减灭术治疗,对照组采用辅助化疗治疗,对比两组患者的治疗前后的临床特征及术后生存状况。结果:观察组的手术时间、住院时间、术中出血量明显优于对照组,术后3年生存率和5年生存率明显高于对照组。结论:间歇性肿瘤细胞减灭术提高卵巢上皮性癌的治疗效果,延长患者生命,具有较高的临床应用价值。 相似文献