似颞下颌关节紊乱病张口受限9例临床分析

目的:探讨似颞下颌关节紊乱病的张口受限临床特点。方法:对颞下颌关节外科门诊经治的9例患者诊治情况做回顾性分析。结果:非颞下颌关节紊乱病张口受限,最常见为两大类疾病。一类是发病部位隐蔽的关节周围组织的肿瘤。二类是上颌智齿阻生。结论:由于颌面部深在组织间隙的病变位于关节周围位置隐蔽,有很多症状体征常类似颞下颌关节紊乱病(TMD),尤其是张口受限,这些临床特征可以错误的导向TMD的诊断而误诊。在临床症状持续存在或治疗后加重时应高度重视,及时做X片检查、CT检查,以利于早期诊断正确治疗。     

复方氟米松乳膏联合硅油乳膏封包治疗慢性局限性湿疹疗效观察

目的观察复方氟米松乳膏联合硅油乳膏封包治疗慢性局限性湿疹的临床效果。方法 100例局限性湿疹患者随机分成两组,分别给予复方氟米松乳膏联合硅油乳膏封包治疗和常规药物封包治疗。根据保护指数评定疗效,于2周后观察、比较显效率。结果试验组显效率为84.00%,对照组为66.00%,两组差异有统计学意义(P<0.05)。结论复方氟米松乳膏联合硅油乳膏封包治疗局限性湿疹疗效确切,安全性好,治疗简单方便,易于被患者所接受,值得临床应用。     

Z成形术矫治局限性倒睫的临床应用

①目的 探讨Z成形术矫治上、下睑倒睫的临床效果.②方法 在倒睫相应的睑缘灰线设计一水平方向切口线,长度略长于倒睫范围,在相应的眼睑皮肤处设计一水平方向切口线,长度与灰线切口相同,两线分别作为Z字上、下两臂,其间距视倒睫范围和轻重而定,在两线间做一斜线,作为Z字中轴,两夹角大小可不完全一致.按设计线切开形成两舌形皮瓣,相互交叉换位,将带有睫毛的皮瓣移向远离睑缘方向,无睫毛的皮瓣移至睑缘处.③结果 本组41例患者(44眼),术后随诊6～12个月,倒睫矫治良好无复发,眼睑外形满意,瘢痕无外露,41例均无复发.④结论 Z成形术矫治局限性倒睫创伤小,操作简单,临床效果良好.     

癌症病人家属对限制陪护心理反应的调查分析

目的 探讨癌症病人家属对限制陪护的心理反应及相关原因。方法 参考国外危急重病人家属需要量表，对我院100名癌症病人家属进行调查。结果 病人家属对探视制度的看法与健康教育、病情转归、医护质量有关。结论 护士必须重视健康教育，充分认识病人家属的需要，及时提供各种反馈信息，帮助家属应对其危机状态。同时，要求医院设定相关配套服务措施，缓解、维护病人家属的身心健康。     

导管头皮针与钢针头皮针临床效果对比研究

目的:通过一次性使用导管头皮针与钢针头皮针临床效果对比研究,找出其差异性,为导管头皮针推广应用提出客观依据。方法:将临床80例患者随机分为实验组和对照组,实验组采用一次性使用导管头皮针输液,对照组采用一次性使用钢针头皮针输液。观察两组输液过程中刺破血管率、液体渗漏率、活动受限情况。结果:输液过程中刺破血管率实验组为0,对照组为22.5%;液体渗漏率实验组为0,对照组为22.5%;活动受限率实验组为0,对照组为100%,两组比较差异均有统计学意义(P<0.05)。结论:一次性使用导管头皮针在输液过程中能降低刺破血管率和液体渗漏率,活动不受限,临床效果优于钢针头皮针,值得推广。     

Limitation ou arrêt de thérapeutiques actives en situations d’urgence. Le point de vue des anesthésistes réanimateurs

Objectives

One objective is to state more accurately the difficulties met by the anaesthesiologists in an emergency context in case of withholding or withdrawing life sustaining therapies.

Study design and participants

A questionnaire addressed to anaesthesiologists of nine hospitals in the extreme West part of France.

Materials and methods

The questionnaires were sent and returned by mail in order to guarantee confidentiality.

Results

The participation rate was 40% with 172 questionnaires analysed. Ninety-eight per cent of the anaesthesiologists have already participated in a withholding or withdrawing life sustaining treatments, and in an emergency context in 92% of the cases. In that last case, criteria related to the severity of the clinic presentation and to the short-term death probability influence the decision made to interrupt life-sustaining therapies. For 93% of anaesthesiologists, the decision should be collegial, but 50% of them had already made such a decision alone. The withdrawal of ventilatory support was the most difficult decision to make. Withdrawing mechanical ventilation or extubating appeared impossible for 23.4 and 50% of the anaesthesiologists respectively. Providing comfort care to the patients with end of life decision was essential for 100% of the anaesthesiologists, but 11% of them used and considered analgesic and sedation after withholding or withdrawing life sustaining treatments as euthanasia. The complaint possibility worried 57% of the anaesthesiologists and influenced the writing of the process or giving information to the families respectively for 65 and 75%. The righting of the medical files could be improved for 92% of the anaesthesiologists.

Conclusion

The decision of withholding and withdrawing life sustaining treatments in an emergency context is based on the conviction of short-term death probability. Withholding and withdrawing life sustaining treatments is a decision made according to the principles of collegiality and necessary comfort cares, but the procedure can still be improved, especially in the redaction of the medical file and the ethical and juridical control of these extreme situations.     

不同炮制方法对泽泻中泽泻醇B23-乙酸酯的影响

文章分析了当前对“临床思维”概念的狭义理解及其局限性 ,提出了广义的“临床思维”概念并分析了形成广义“临床思维”的必要性。     

中成药质量标准局限性探讨

本文通过系统查阅中成药标准的相关文献,广视角、多层面地进行中成药标准局限性的分析,同时结合我国近年来中药严重不良反应/事件进行实证分析。旨在探讨当前中成药质量标准存在的局限性。以达到提高对中成药标准的局限性在企业道德缺失的市场环境下产生巨大危害的认识,强化中成药质量再评价措施,提高中成药质量,减少药害事件的发生,保障患者用药安全的目的。