喜炎平注射液联合头孢呋辛钠治疗小儿肺炎的临床效果

目的：探讨喜炎平注射液联合头孢呋辛钠治疗小儿肺炎的疗效。方法：选取本院2013年1月-2014年7月收治的80例小儿肺炎患者作为研究对象,按照随机数字列表法将其分为研究组和对照组,每组40例。对照组单纯采用头孢呋辛钠进行治疗,研究组在对照组的治疗基础上联合喜炎平注射液进行治疗,7 d为一疗程。治疗1个疗程后,观察比较两组患儿的临床疗效、临床症状消失时间、住院天数及并发症发生情况。结果：经1个疗程的治疗后,研究组的治疗总有效率97.5%明显高于对照组的80.0%,且患儿发热症状、咳嗽及胸部湿啰音等临床症状消失时间及住院天数均明显短于对照组,差异均有统计学意义（P<0.05）。而两组患儿的并发症发生率比较差异无统计学意义（P>0.05）。结论：对小儿肺炎患者采用喜炎平注射液联合头孢呋辛钠进行治疗具有良好的临床疗效,患儿的症状消退时间和住院时间短,且不会增加并发症的发生率,值得在临床上进一步推广。     

胆石症胆道感染并发心包积脓7例分析

本院26年中胆石症、胆道感染并发心包积脓7例。其中6例死亡,作者指出,凡胆石症并感染的患者出现心肺症状和体征,应警惕本并发症的发生。A型超声和X线检查对诊断有重要帮助。一旦确诊应及时行心包穿刺抽脓或心包造口引流;及时有效地处理胆道原发病灶是预防和减少本并发症的根本措施。     

头颈部放射线损伤25例临床分析

目的 :探讨预防、诊治放射治疗所致头颈部肿瘤患者的放射线损害。方法 :回顾分析头颈癌 2 5例放疗后发生并发症患者的临床资料。结果 :男 2 1例 ,女 4例 ,18～ 6 8岁 ,原发头颈肿瘤分别为 :鼻咽癌 2 1例 ,硬腭癌 1例 ,喉癌 1例 ,食道癌 1例 ,腮腺混合瘤 1例 ;放射线损害 30例次 :局部骨髓炎伴瘘管 5例次、神经损伤 2例次、上腔静脉综合征 1例次、鼻咽闭锁 1例次、腭瘘 2例次、颌面颈淋巴回流障碍 2例次、放疗诱发第二原发癌 9例次、局部溃疡大出血 4例次、颞颌关节强直 4例次。经保守治疗、手术及综合治疗 ,死亡 10例 ,其中 5例死于放疗所致的并发症 ,5例死于第二原发癌 ,生存期 3～ 4 3年 ,健在 15例 ,存活 7～ 37年。结论 :放疗对机体产生的各种损害多为不可逆 ,且随时间的推移逐渐累积和显现 ;严格掌握放疗指征 ,杜绝不必要的放疗 ;精确设计放射野和剂量 ,采用高能放射源及立体定向技术等能预防放射线损伤 ,综合治疗对放射线损伤有效     

综合性护理干预对肝硬化合并上消化道出血治疗效果的影响

目的 探讨综合性护理干预对肝硬化合并上消化道出血治疗效果的影响.方法 选择我院2010年1月～2013年1月间收治的肝硬化合并上消化道出血患者60例,根据护理方法随机分为干预组和对照组,各30例,对照组予以常规对症护理,干预组实施综合性护理干预,比较两组的疗效、止血时间、住院时间、并发症及护理满意度.结果 干预组患者治疗有效率达90.0％,对照组有效率达73.3％,两组差异存在显著性（P＜0.05）.干预组患者的止血时间、住院时间短于对照组,组间比较差异存在显著性（P＜0.05）.干预组治疗期间并发症发生率达10％,对照组并发症发生率达36.7％,组间比较差异存在显著性（P＜0.05）.干预组的护理满意度达96.7％,明显高于对照组,组间比较差异存在显著性（P＜0.05）.结论 对肝硬化合并上消化道出血患者在积极有效治疗的同时实施综合性的护理干预措施,可以明显提高疗效,缩短住院时间,减少并发症发生,提高护理满意度.     

Diagnosing Periprosthetic Joint Infection: a Scoping Review

Purpose of ReviewThe goal of this review is to provide an up to date understanding of the utility and limitations of the current tests utilized in the diagnosis of periprosthetic joint infection (PJI) in total knee and hip arthroplasty.Recent FindingsDespite the growth in literature surrounding PJI diagnosis, there remains challenges in establishing a diagnosis of PJI. A combination of clinical, serum, and synovial tests and microbiologic and histologic examinations can yield a diagnosis in the majority of cases. Novel molecular and imaging studies may be beneficial for indeterminant cases. A number of emerging diagnostic tests have been proposed and may be incorporated into diagnostic algorithms in the future. Recently proposed stepwise diagnostic algorithms have shown high sensitivity and specificity.SummaryThe diagnosis of PJI remains challenging due to a lack of tests that can definitively rule out infection. Diagnosis and investigations should occur in a stepwise fashion. There has been a plethora of new diagnostic tests introduced in attempts to improve the accuracy of diagnostic algorithms. The definition and algorithms for the diagnoses of PJI will continue to evolve as new techniques and tests are introduced.     

Diagnostic endoscopic ultrasonography: Assessment of safety and prevention of complications

Endoscopic ultrasonography (EUS) has gained wide acceptance as an important, minimally invasive diagnostic tool in gastroenterology, pulmonology, visceral surgery and oncology. This review focuses on data regarding risks and complications of non-interventional diagnostic EUS and EUS-guided fine-needle biopsy (EUS-FNB). Measures to improve the safety of EUS und EUS-FNB will be discussed. Due to the specific mechanical properties of echoendoscopes in EUS, there is a low but noteworthy risk of perforation. To minimize this risk, endoscopists should be familiar with the specific features of their equipment and their patients’ specific anatomical situations (e.g., tumor stenosis, diverticula). Most diagnostic EUS complications occur during EUS-FNB. Pain, acute pancreatitis, infection and bleeding are the primary adverse effects, occurring in 1% to 2% of patients. Only a few cases of needle tract seeding and peritoneal dissemination have been reported. The mortality associated with EUS and EUS-FNB is 0.02%. The risks associated with EUS-FNB are affected by endoscopist experience and target lesion. EUS-FNB of cystic lesions is associated with an increased risk of infection and hemorrhage. Peri-interventional antibiotics are recommended to prevent cyst infection. Adequate education and training, as well consideration of contraindications, are essential to minimize the risks of EUS and EUS-FNB. Restricting EUS-FNB only to patients in whom the cytopathological results may be expected to change the course of management is the best way of reducing the number of complications.     

Complications of muscle injuries

Muscle injuries can be classified into strain injuries and contusions. Depending on the type of injury, different complications may occur, which in turn can be divided into early, intermediate and delayed complications. A prompt diagnosis of complications allows early treatment and permits to avoid harmful sequelae. Imaging studies, ultrasonography in particular, allow (recognizing) the assessment of complications whenever clinically suspected. In this article the most frequent complications of muscle injuries are presented.     

针刺治疗肝癌肝动脉化疗栓塞后综合征的疗效观察

目的 :探讨针刺法治疗肝癌肝动脉化疗栓塞后综合征的临床疗效。方法 :采用针刺内关、足三里等穴位治疗肝癌肝动脉化疗栓塞后综合征 36例 ,设西药恩丹西酮等为对照组 ,观察两组的临床疗效。结果 :治疗组有效率为 97 2 % ,对照组有效率为 95 2 % ,两组有效率之间差异无显著性意义 (P >0 .0 5 ) ;但两组临床显效率之间差异有显著性意义 (P <0 .0 5 )。结论 :治疗组临床显效率优于对照组 ,且见效快 ,无毒副作用