癌症患者的心理特征及心理护理

我科2000年12月—2005年12月收治250例癌症患者,通过对其实施有效细致的心理护理,患者的生活质量得以提高,生存期有所延长。现将250例患者的心理护理体会总结如下。1临床资料本组250例癌症患者,男175例,女75例,年龄21岁~78岁,平均年龄50岁。其中食管癌占60%,胃癌占30%,乳腺癌占6%,肺癌占2%,肝癌占2%。     

老年患者开胸手术后呼吸道的护理

开胸手术后呼吸道护理是防止肺部并发症的关键。由于开胸手术后患者的肺活量减少，残气量增加，最大通气量明显减少，氧利用系数降低，膈肌活动幅度减少，肺顺应性降低，所以极易发生呼吸道并发症。我科自2003年1月－2007年1月，对73例老年患者实施胸科手术，男50例，女23例，年龄60－84岁，平均年龄66岁。施行全肺切除术7例，肺叶切除术54例，胸膜纤维板剥脱术12例。术后根据患者呼吸系统的症状，进行了吸氧、呼吸道湿化，协助排痰，保持呼吸道通畅等积极有效的护理措施，取得了较好的效果，报道如下。     

重新评估β受体阻滞剂在高血压方面的疗效：荟萃分析

最近发表的1篇荟萃分析中，研究者认为β受体阻滞剂不应该用于治疗高血压（CMAJ，2006，174：1737—1742）。基于老年人和年青人高血压的发病机制不同，该荟萃分析旨在阐明不同年龄人群β受体阻滞剂的疗效。研究首要终点是：全因卒中、心肌梗死和死亡。方法：该文汇总随机对照试验，评价β受体阻滞剂治疗高血压一线用药预防主要心血管事件发生的疗效。中老年患者（平均年龄≥60岁）与年青患者（平均年龄〈60岁）分开分析，采用随机效应模式汇总数据，结果：汇总21项高血压试验中145811名患者的数据，发现在安慰剂-对照试验中，β受体阻滞剂可以降低年青患者主要心血管事件的发生率[危险比（RR）=0．86，     

11例矽肺合并自发性气胸的护理体会

矽肺是因长期吸入二氧化硅粉尘引起的,以肺部弥漫性纤维化为主的全身性疾病。由于矽肺间质广泛纤维组织增生,最后在纤维团块周围肺组织出现代偿性肺气肿甚至形成肺大泡,当剧烈咳嗽或过度用力时,肺大泡破裂形成自发性气胸。因此,防治并发症在矽肺治疗和护理中有很重要的意义。我院自2003年7月至2005年9月收治矽肺合并自发性气胸11例,均为男性,年龄32～63岁,平均年龄40岁,以工人居多,文化程度低,Ⅱ期矽肺6例,Ⅲ期矽肺5例,双侧气胸并皮下气肿2例,双侧气胸5例,合并肺结核4例。1一般护理心理护理:对患者作好解释工作,情感支持,使患者产生信任和亲…     

胆心综合征误诊为急性冠状动脉综合征13例临床分析

本文将通辽市科尔沁区第一人民医院2001—2005年收治的胆心综合征误诊为急性冠状动脉综合征13例患者介绍如下，并分析其误诊原因。 1临床资料 1．1一般资料 13例患者中，男9例，女4例，年龄37～72岁，平均年龄58岁。13例患者均有不同程度胸闷、心悸、心前区不适，表现为心前区疼痛5例，伴上腹部痛2例，阵发性心悸、气短5例，发作性胸骨后压榨样疼痛3例，4例胸痛时伴有低热、恶心、呕吐。     

女“糖友”更年期来得更早

据英国《每日邮报》报道,哥伦比亚卡塔赫纳大学的研究团队发现：相比普通女性,2型糖尿病女性患者更年期来得早的可能性会增加3倍。这些患者更年期来临的平均年龄为48．5岁,而非患者更年期来临的平均年龄为50．1岁。这就意味着,     

优思弗联合舒肝宁注射液治疗重症淤胆性肝炎的效果分析

本研究选取我院收治的73例重症淤胆性肝炎患者进行临床研究,探讨其采用优思弗与舒肝宁注射液联合治疗的临床效果。 资料和方法 一、临床资料 选取开封市第二人民医院2010年7月至2013年1月收治的73例重症淤胆性肝炎患者的临床资料,其中男48例,女25例,年龄21-72岁,平均年龄42±3．5岁。病程1．3～4．6年,平均病程2．1±0．3年。其中感染 HBV 54例,HAV 9例, HCV 8例,HEV 2例。将其按照住院号尾号的奇偶分为治疗组36例和对照组37例,两组患者各临床资料采用统计学软件分析无统计学意义,具有可比性。     

Analysis of thirteen cases with hyperthyroidism-associated myocardial infarction

Background The close relationship between the thyrotoxic state and abnormalities in cardiac function,arrhythmias and congestive heart failure is well known to clinicians. Patients with hyperthyroidism-induced acute myocardial infarction(AMI) are unusual and almost all reported cases have been associated with coronary vasospasm. There is quite consistent evidence that hyperthyroidism is directly associated with the presence of a prothrombotic state. Methods The present article reports a 69-year-old female with hyperthyroidism who developed myocardial infarction(MI) and reviews AMI in hyperthyroidism cases reported in the literature. We conducted a comprehensive review of the English literature since 1990 to analyze data on MI in hyperthyroidism patients who had developed AMI. Results From 11 English articles, we identified 12 hyperthyroidism patients, plus our cases, with AMI. They consisted of 11 females and 2 males.Their mean age was 49 ± 14.4 years(range 28-71). Coronary angiography revealed normal coronary arteries in 6 patients, coronary spasm in 6 patients. Only our patient received percutaneous coronary intervention through coronary thrombus suction and other patients were treated mainly with medicine. Twelve patients had good prognosis and 1 patient died of cardiogenic shock. Conclusions Hyperthyroidism-induced AMI is rare.Coronary thrombus or spasm without coronary atherosclerotic stenosis should be considered. Different therapies should be chosen according to different types of coronary involvement.     

多发性错构瘤综合征的镜下发现

多发性错构瘤综合征（Cowden综合征）以侵及整个消化道的弥漫性错构瘤为主要特征,发生于胃肠道的多个部位且并不连续,息肉以错构瘤多见。在一项多中心的研究中,Coriat R等观察了10例Cowden综合征患者（年龄18～56岁,平均年龄为37岁）的镜下表现。结果发现,所有患者消化道的上下段均具有病变;9例患者具有弥漫性棘皮症;     

Dsteosynthesis with long volar locking plates for meta- physeal-diaphyseal fractures of the distal radius

Objective：Metaphyseal-diaphyseal fractures of the distal radius are a major treatment dilemma and orthopaedic surgeons have to pay due consideration to restoration of anatomy of distal radius together with rotation of the radial shaft and maintenance of radial bow and interosseous space.We performed this study to evaluate the clinic-radiological outcome of metaphyseal-diaphyseal fractures of the distal radius treated with long volar locking plates.Methods：This prospective study involved 27 patients （22 males and 5 females） with metaphyseal-diaphyseal fracture of the distal radius.Their mean age was （30.12±11.48） years （range 19-52 years） and the follow-up was 26.8 months （range 22-34 months）.All patients underwent open reduction and internal fixation with a long volar locking plate.According to AO/OTA classification,there were 7 type A3,13 type C2 and 7 type C3 fractures.Subjective assessment was done based on the disabilities of the arm,shoulder and hand （DASH） questionnaire.Functional evaluation was done by measuring grip strength and range of motion around the wrist and the radiological determinants included radial angle,radial length,volar angle and ulnar variance.The final assessment was done according to Gartland and Werley scoring system.Results：Postoperative radiological parameters were well maintained throughout the trial,and there was significant improvement in the functional parameters from 6 weeks to final follow-up.The average DASH scores improved from 37.5 at 6 weeks to 4.2 at final follow-up.Final assessment using Gartland and Werley scoring system revealed 66.67%（n=l8） excellent and 33.33% （n=9） good results.There was one case of superficial infection which responded to antibiotics and another carpel tunnel syndrome which was managed conservatively.Conclusion：Volar locking plate fixation for metaphyseal-diaphyseal fractures of distal radius is associated with excellent to good functional outcome,early rehabilitation and minimal complications.