人工流产与药物流产用于终止早孕的临床优劣势比较分析

目的进一步比较人工流产与药物流产用于终止早孕的临床优劣势。方法根据实施治疗的方式不同,将204例要求终止早孕的患者分为人工流产组和药物流产组各102例。人工流产组实施电动负压吸宫术;药物流产组予以米非司酮联合米索前列醇口服。比较2组临床疗效及阴道出血时间、出血量。结果人工流产组完全流产率为98.04%,高于药物流产组的84.31%,且整体阴道出血量优于药物流产组;药物流产组整体阴道出血时间优于人工流产组,差异均有统计学意义(P<0.05)。结论人工流产与药物流产2种方式的优劣势都十分明显,在临床实践的过程中要注意根据患者的实际情况进行合理的选择,从而降低患者的痛苦。     

中药膏剂对钳刮术患者术后阴道流血的作用

目的 观察中药膏剂贴敷于相关穴位对行人工流产钳刮术患者术后阴道流血的改善情况。方法 将来我院妇科行人工流产钳刮术的患者分为对照组87例和观察组82例，对照组患者按照常规人工流产钳刮术后护理方式护理；观察组同时采用中药（包括当归、川芎、三七、炮姜）制作的膏药贴敷于相关穴位（包括神阙、气海、中极穴位），观察两组患者术后不同时间阴道流血量和流血持续时间。结果 与对照组相比，观察组患者术后1h、2h及6h阴道流血量和术后阴道流血持续时间均减少（P〈0．05）。结论 采用此中药膏剂贴敷于相关穴位能减少人工流产钳刮术患者术后出血量和出血时间，促进患者术后康复。     

The Endocrinologic Changes in Critically Ill Chronic Obstructive Pulmonary Disease Patients

ABSTRACT

Background: Alterations in the neuroendocrine system occur during critical illness. Chronic obstructive pulmonary disease (COPD) itself causes hormonal changes. The aim of this study was to determine neu roendocrine hormones of COPD patients with acute respiratory failure and to investigate the relationship between hormonal changes, mortality, and morbidity.Methods: We enrolled 21 patients (13 F/8 M) with COPD exacerbation requiring artificial airway support. Blood samples were collected on admission to the ICU, and on the day of hospital discharge. Eighteen healthy people were included as controls. Results: Female patients had lower luteinizing hormone (LH), follicle stimulating hormone (FSH), and free triiodothyronine (fT3), and higher prolactin (PRL) levels than controls on admission to the ICU (FSH: 70.3 vs. 29.3 mlU/mL; LH: 26.6 vs. 6.8 mlU/mL; fT3: 2.9 vs. 2.0 pg/mL; PRL: 12.4 vs. 21.3 ng/mL). Male patients had low testosterone and TSH and high PRL but only changes in TSH and PRL reached statistical significance (testosterone: 3.5 vs. 1.5 ng/mL, TSH: 1.1 vs. 0.5 ulU/mL, PRL: 9.7 vs. 14.2 ng/mL). Female patients had lower fT3 than males (fT3_female: 2.7 vs. fT3_male: 2.0 pg/mL). On follow-up, significantly elevated FSH and fT3 and decreased estradiol concentrations were documented among recovered women (FSH: 28.4 vs. 46.6 mlU/mL, fT3,: 2.0 vs. 2.6 pg/mL, E₂: 27.7 vs. 19.0 pg/mL). Patients had high C-reactive protein levels and acute physiologic and chronic health evaluation II scores. Mortality rate was 9.5% and a negative correlation between E₂ and duration of noninvasive mechanical ventilation and length of hospital stay was found in male patients. Conclusion: Men and women with acute respiratory failure in the presence of COPD develop significant changes in the neuroendocrine axis. Hormonal suppression vanishes with disease improvement.     

Pulmonary Ultrasound and Diaphragmatic Shortening Fraction Combined Analysis for Extubation-Failure-Prediction in Critical Care Patients

Introduction

Invasive respiratory support is a cornerstone of Critical Care Medicine, however, protocols for withdrawal of mechanical ventilation are still far from perfect. Failure to extubation occurs in up to 20% of patients, despite a successful spontaneous breathing trial (SBT).

人工肝支持系统治疗肝衰竭术后并发下肢深静脉血栓形成的处理策略

目的明确人工肝支持系统(ALSS)治疗肝衰竭(LF)病人术后并发下肢深静脉血栓形成的处理策略。方法回顾性分析2019年1月至2021年9月安徽医科大学第一附属医院收治的经ALSS治疗的肝衰竭病人216例，选择有临床症状并经彩