肛泰软膏治疗内痔湿热下注型随机双盲双模拟平行对照临床研究

目的客观评价肛泰软膏治疗痔疮的临床疗效及其安全性.方法观察内痔患者43例,其中治疗组(用肛泰软膏)24例,对照组(用肛泰贴脐片)19例.采用随机双盲双模拟平行对照的方法给药并观察疗效.结果治疗组显效率为70.83%,总有效率为95.83%,且无明显不良反应;与对照组疗效比较无显著性差异(P＞0.05).结论肛泰软膏适用于中医辨证属湿热下注型的内痔和以内痔为主要症状的混合痔,对痔出血、肛门下坠、肿痛、局部不适症状改善较为明显.     

Providing evidence‐based information to patients in general practice and pharmacies: what is the acceptability,usefulness and impact on drug use?

Background A common and often integral method of delivering patient information is the use of patient guides. However, the acceptability, utility and impact of evidence‐based therapeutic guides on physicians, pharmacists and patients have not been well evaluated. Methods This study was a prospective evaluation of 53 general practitioners' offices and 30 community pharmacies from three locations in Canada. Evidence‐based guides were provided to 1176 patients who presented to either a general practitioner or a community pharmacist and were interested in receiving information about sore throat, heartburn, or osteoporosis ( http://www.ti.ubc.ca/canadadrugguide ). The acceptability, utility and impact of the guides were assessed via structured patient telephone interviews, structured health professional interviews, and patient chart audits. Results Eighty to 90% of patients reported that the guides were ‘very easy’ to understand. Fifty six per cent/47%/38% (sore throat/heartburn/osteoporosis) of patients rated the guides as ‘very’ or ‘extremely’ useful. Seventy‐two per cent/67%/58% of respondents reported that the information helped them make decisions about their treatment. Ninety eight per cent of physicians and 92% of pharmacists reported that the guides helped their patients understand the issues involved in their treatment. None of the analyses showed any significant differences in prescribing of medications between the intervention and control groups. Interpretations Patients found these evidence‐based guides to be useful, easy to understand, and that they helped them in their understanding of treatment options and the decision‐making process. Physicians and pharmacists reported that the guides helped their patients understand the issues involved in their treatment. Further research is required to determine the degree to which providing evidence‐based guides to patients can impact on prescribing and patient outcomes.     

转移因子咽部注射治疗慢性咽喉炎

应用转移因子咽部注射治疗慢性咽喉炎患者１０５例，经过一年的随访观察，证实疗效显著。转移因子治疗组总有效率（９８％）明显高于对照组（５７％）。该疗法简便、安全，治疗期间未见明显不良反应。     

In Ear Surgeries Intravenous Dexamethasone Preoperatively Decreases Post Operative Sore Throat After Endotracheal Intubation in Adult Patients: A Prospective Randomized Control Study

Sore throat is commonly seen after general anaesthesia with endotracheal intubation. It is distressing for the patient as it delays return to work, increases morbidity and bad memories of the surgical period with disturbances in sleep. This double-blinded prospective randomized study was done to know the efficacy of intravenous dexamethasone in decreasing the incidence of postoperative sore throat at 1, 6 and 24 h after tracheal extubation. 60 patients aged 18–50 years scheduled for ear surgeries under general anesthesia with endotracheal intubation, were randomly allocated into two groups A and B. The patients received either intravenous 0.2 mg/kg diluted till 4 ml dexamethasone (group A, n = 30) or 4 ml normal saline (group B, n = 30) prior to induction. Endotracheal intubation was done to secure the airway. Follow up for the incidence of sore throat was done at 1, 6 and 24 h post-extubation. At 1 h, 6 h and 24 h after extubating the patient, the incidence of sore throat in the control group was significantly less in dexamethasone group compared to the control group (p < 0.039, 0.024, 0.032) respectively. Prophylactic intravenous dexamethasone in a dose of 0.2 mg/kg can reduce the incidence of postoperative sore throat after extubation with minimal side effects.     

两种升高腰桥侧卧位在泌尿外科手术中的应用效果观察

目的探讨泌尿外科手术中安全、舒适的侧卧位摆置方法,以降低因手术体位引起的并发症。方法在泌尿外科手术病人中,选取124例为实验组,199例为对照组,实验组采取改良体位,对照组采取传统体位,比较两组病人的皮肤受压情况。结果实验组无1例出现皮肤压疮现象,而对照组5例出现皮肤潮红,2例出现水泡,两组皮肤情况比较,经统计学分析,P<0.05,差异有统计学意义。结论腰桥区床垫的厚度及升桥的高度是局部皮肤出现压疮的高危因素;在传统健侧侧卧位升高腰桥位的摆置方法的基础上,改良升高腰桥侧卧体位可减轻局部皮肤压力,防止局部皮肤压疮的发生。     

压疮的伤口评估及局部治疗的临床研究进展

主要从压疮的伤口评估和局部治疗方面提出许多新的概念、新的方法，并就压疮伤口评估及压疮湿性疗法、负压疗法等的临床应用进展进行介绍。     

“碱性成纤维细胞生长因子”治疗褥疮、烧伤的临床观察

应用bFGF治疗褥疮及烧伤,bFGF对轻度、中度褥疮及烧伤疗效很好,对重度褥疮亦有明显疗效。bFGF使创面干燥,结痂快,肌肉等软组织生长良好,bFGF高效、简便、无毒、无副作用,值得临床应用。     

以降低手术患者压疮发生率为主题的品管圈实施步骤探讨

目的探讨品管圈在降低手术患者压疮发生率中的作用及实施方法。方法以手术压疮防护为主题,运用现场调查、数据统计、脑力激荡、评估打分等方法围绕主题实施品管圈的各项步骤,并将改进前、后的各项数据进行对比。结果手术患者压疮发生率由改善前的5.29%降至1.12%,手术压疮评估失误率由改进前的3.85%降至改进后的0.37%,差异均有统计学意义(均P0.01);无形成果确认中圈员在解决问题的能力、责任心、沟通协调、自信心、团队凝聚力、积极性、幸福感、品管手法等8项内容的自评中改进后的评分均高于改进前。结论品管圈的实施,规范了手术压疮风险的评估、告知以及应采取的护理措施,提高了手术压疮防护的护理质量。     

Prevalence and significance of methicillin-resistant Staphylococcus aureus in patients with cystic fibrosis

Recent reports indicate that methicillin-resistant Staphylococcus aureus (MRSA) may be emerging as a significant pediatric nosocomial pathogen. Children with cystic fibrosis (CF) pulmonary disease are subject to many of the risk factors for MRSA colonization and/or infection. We retrospectively investigated the prevalence and significance of MRSA from sputum and throat cultures in 452 patients with CF followed during 1986. No MRSA had been isolated during 1984 or 1985. Although S. aureus was isolated from 212 patients (47%) in 1986, only 14 (3%) showed MRSA. The MRSA strains had 11 different antimicrobial susceptibility patterns. Neither age, clinical condition, nor recent prior hospitalization correlated with MRSA acquisition. Acquisition did not appear to directly affect the course of the pulmonary disease in these patients even though no patient received any treatment for their MRSA. The prevalence of MRSA is low, although patients with CF are subject to many risk factors. MRSA appears to be mainly community-acquired and to represent colonization rather than infection. However, the potential for nosocomial MRSA infection is present, and vigilance is required in monitoring any changes in frequency of isolation or infection with these organisms.     

氢化可的松与丙帕他莫对全麻气管插管术后咽喉痛的影响

目的 探讨氢化可的松与丙帕他莫合用对全麻气管插管术后咽喉痛（POST）的影响.方法 纳入气管插管全麻手术患者200例,年龄18 ～ 65岁,ASA Ⅰ或Ⅱ级.依手术时间先后随机分成A、B、C、D四组,每组各50例,A组为对照组,B、C、D为实验组,分别实施：A组气管插管后生理盐水20ml静注;B组氢化可的松50mg＋生理盐水20ml静推;C组丙帕他莫2.0加入生理盐水100ml中静滴（15min内滴完）;D组同时合用B组和C组药.四组均记录拔管后的1、6、12、24小时POST的发生率和严重程度.结果 四组拔管后12小时POST发生率达高峰.B组达40％、C组36％与D组22％发生率均低于A组66％ （P＜0.05）,且D组明显低于B组和C组（P＜0.05）,各组未见与注射药物相关的不良反应.结论 氢化可的松与丙帕他莫合用能有效降低POST的发生率及严重程度,且安全性高.