马齿苋乙醇提取物和水提取物对小鼠出血时间和耐缺氧存活时间的影响

[目的]探讨马齿苋乙醇提取物和水提取物对小鼠出血时间和耐缺氧作用的影响.[方法]采用小鼠断尾法测定小鼠的出血时间,应用常压耐缺氧法测定耐缺氧存活时间.[结果]马齿苋乙醇提取物和水提取物均延长小鼠出血时间;马齿苋乙醇提取物中、大剂量组和马齿苋水提取物大剂量组小鼠缺氧存活时间均明显延长.[结论]马齿苋乙醇提取物和水提取物均具有延长小鼠出血时间和耐缺氧存活时间的作用.     

Factors that affect early postoperative health-related quality of life in patients with gastrointestinal cancer: a three-center cohort study

[Purpose] In this study, we investigated the preoperative and early postoperative health-related quality of life in patients who underwent surgical treatment for gastrointestinal cancer and also the factors that affect postoperative health-related quality of life. [Participants and Methods] The study included 198 patients who underwent elective surgery for gastrointestinal cancer (129 males and 69 females, age: 65.4 ± 11.8 years). Health-related quality of life was evaluated using the Short-Form 36-Item Health Survey version 2 at the following time points: 1–2 days preoperatively (baseline) and 4 weeks postoperatively. [Results] Compared with baseline levels, physical functioning, bodily pain, vitality, as well as physical, social, and emotional role functioning significantly decreased 4 weeks postoperatively. In contrast, compared with baseline levels, mental health significantly improved 4 weeks postoperatively. Physical functioning and general health evaluated 4 weeks postoperatively were significantly associated with income, baseline health-related quality of life, and the 6-minute walk test. [Conclusion] It is important to consider baseline income and health-related quality of life and increase postoperative exercise capacity to improve health-related quality of life in patients who undergo surgical treatment for gastrointestinal cancer.     

扁桃体下极被膜保留的扁桃体切除术在儿童阻塞性睡眠呼吸暂停治疗中的应用

目的 观察扁桃体下极被膜保留的扁桃体切除术在儿童阻塞性睡眠呼吸暂停(OSA)中的可行性及优势。方法 将2018年8月—2019年12月行扁桃体下极被膜保留扁桃体切除术(91例)与2017年1月—2018年7月行传统扁桃体切除术(100例)治疗儿童OSA患者的临床资料进行回顾性对比分析。比较两组手术时间、术中出血、术后疼痛评分、术后并发症、随访1年的情况。结果 两组手术时间及术中出血无明显差异,下极被膜保留组术后第1天、第3天疼痛评分显著低于传统手术组(P＜0.05)。术后出血率传统手术组(7/100,7％)高于下极被膜保留组(2/91,2.19％)(P＜0.05)。术后随访1年,两组均未出现局部感染及再发扁桃体肥大情况。结论 扁桃体下极被膜保留的扁桃体切除术是儿童OSA的一种安全可行的手术方式,可以有效降低术后出血风险及术后疼痛。     

妇科止血灵片联合米非司酮治疗功能性子宫出血的Meta分析

目的 利用Meta分析方法对妇科止血灵片联合米非司酮治疗更年期功能性子宫出血的疗效和安全性进行评价分析。方法检索并选取1989—2020年国内、外公开发表的关于妇科止血灵片联合米非司酮治疗更年期功能性子宫出血的临床随机对照试验文献,筛选符合纳入标准的试验进行研究,采用Revman5.1软件统计并分析相关数据。结果 共有5项研究符合纳入标准。与对照组比较,妇科止血灵片联合米非司酮治疗更年期功能性子宫出血的神经功能缺损临床疗效比数比（OR）合并值为4.02(95%可信区间为2.09～7.73)。促黄体生成素水平的加权均数差（WMD）合并值为-1.90(95%可信区间为–2.35～-1.46)。卵泡刺激素水平的WMD合并值为-4.52(95%可信区间为-7.19～-1.85)。雌二醇水平的WMD合并值为–87.91(95%可信区间为-88.78～-87.03)。孕酮水平的WMD合并值为-3.97(95%可信区间为-5.71～-2.77)。用药安全风险OR合并值为0.89(95%可信区间为0.46～1.73)。结论 Meta分析结果显示,妇科止血灵片联合米非司酮治疗更年期功能性子宫出血安全、有...     

Isolated sigmoid varicose vein rupture and hemorrhage: A case report

Rationale:Ectopic varices are the collateral circulation of portal vein located anywhere in the gastrointestinal tract other than the esophageal and gastric regions. Rupture of these varices often results in life-threatening hemorrhage. Management guidelines for ectopic variceal bleeds are not yet standardized because cases are rare and treatment approaches described in the literature vary considerably.Patient concerns:A 53-year-old woman with a 20-year history of chronic hepatitis C cirrhosis came to our hospital for treatment due to intermittent black stools for 4 days. After admission, the patient developed hemorrhagic shock, with hemodynamic instability.Diagnosis:Postoperative histological examination confirmed the diagnosis of sigmoid varicose veins.Intervention:Emergency colonoscopy showed that a varicose vein mass in the sigmoid colon wall 30 cm from the anus was ruptured and bleeding. Percutaneous transhepatic inferior mesenteric venography revealed the presence of a varicose mass of sigmoid colon veins. After embolization of the sigmoid varicose veins with spring coils, angiography showed that the hemorheology of the distal varicose vein mass was slow but not completely blocked. Three days after embolization, the patient had hematochezia again. Splenectomy and sigmoid colon resection were performed immediately.Outcomes:Follow-up computed tomography showed no residual varices were observed after sigmoid colon resection.Lessons:Ectopic varices, which are rare sequelae of portal hypertension, need to be taken seriously because bleeding from these varices can be catastrophic. We report a case of isolated sigmoid variceal rupture and hemorrhage due to portal hypertension in cirrhosis. The patient experienced failure of endoscopic hemostasis and sigmoid colon venous coil embolization. She was eventually successfully brought to hemostasis by surgery.     

医护良好配合抢救急性腹部大出血

目的：探讨医护良好配合对抢救急性腹部大出血的意义。方法66例急性腹部大出血患者,急症行血管造影检查及血管内栓塞治疗。结果本组66例患者经积极介入诊疗,医护密切配合及优质护理,经1次选择性动脉造影获得明确诊断65例,诊断阳性率98．5％。明确诊断后,一次性栓塞治疗成功率98．5％。1例消化道出血患者,介入栓塞治疗4天后复发,经第二次选择性动脉造影及介入栓塞侧枝供血后成功止血,未出现相关并发症。结论急性腹部大出血的抢救成功与否及治疗效果好坏,不仅与术者技术有关,还与护理水平、医护配合密切相关。优质的护理,对保证介入手术顺利、成功,减少和防止并发症,缩短住院时间具有重要作用。     

危重病患儿胃肠功能衰竭的实验室检查及预后影响研究

目的 探讨危重病患儿伴胃肠功能衰竭的临床特征与实验室检查对预后的影响。方法 回顾性分析56例急性胃肠功能衰竭患儿的血乳酸和胃黏膜pH值实验室检查及对预后的影响。结果 危重病患儿血乳酸和胃黏膜pH值水平显著高于非危重病患儿（对照组）,差异有统计学意义（P均〈0.01）;危重期血乳酸和胃黏膜pH值水平高于恢复期（P均〈O.01）,恢复期与对照组比较无统计学差异（P〉0.05）;伴有胃肠功能障碍者血乳酸和胃黏膜pH值水平高于不伴有者和对照组（P均〈0.01）;多器官损害组血乳酸水平高于单器官损害组（P均〈0.01）;危重病组血乳酸和胃黏膜pH值水平呈正相关（r=0.442,P〈0.05）。结论 危重病并发胃肠功能衰竭预示病情凶险,早期发现危重病并发胃肠功能衰竭患儿,是积极治疗病因和改善预后与降低病死率的关键。     

卡前列甲醛栓防治剖宫产术后出血50例临床分析

目的 探讨研究卡前列甲醛栓在临床剖宫产术后出血患者防治中的应用.方法 选择本院妇产科2009年1月至2010年12月间收治的100例剖宫产患者的临床手术及护理情况进行回顾性分析,患者被随机分为两组并分别予以缩宫素与卡前列甲醛栓治疗,并对两组产后出血的防治效果进行对比.结果 研究组患者术后总出血量为(424±172)ml...