引线硅胶管植入术治疗单纯泪小点狭窄或闭锁的疗效观察

目的:观察引线硅胶管植入术治疗单纯泪小点狭窄或闭锁的临床疗效。方法:单纯泪小点狭窄或闭锁患者42例72眼,按照年龄分成60岁以上及以下两组。局部麻醉下行引线硅胶管植入术,术后给予局部消炎抗感染治疗。术后冲洗泪道1次/wk,共4次,1～3mo后拔管,计算治愈率,并行卡方检验。结果:所有患者术中均成功植入引线硅胶管。平均观察14mo。治愈59眼(82%),好转8眼(11%),无效5眼(7%)。60岁以上组治愈率、有效率均较60岁以下组低。结论:引线硅胶管植入术治疗单纯泪小点狭窄或闭锁,操作简便、创伤小、效果好、值得临床推广。     

Use of Gamma-Irradiated Cornea to Plug Sclerostomy Site During Tube Shunt Revision

Tube shunt implantation is a common procedure for control of intraocular pressure (IOP). However, tube revision and repositioning must sometimes be performed, and this involves removing the tube from its sclerostomy site. This site is prone to leaking and this may cause postoperative hypotony. We describe a novel and cosmetically acceptable technique of plugging and covering the sclerostomy site with gamma-irradiated corneal tissue.     

脂质水胶敷料结合对口引流治疗糖尿病足的疗效

目的:观察脂质水胶敷料结合对口引流技术在糖尿病足溃疡患者换药治疗中的应用效果。方法:选取2017年1月至2018年1月该院住院及门诊糖尿病足溃疡需要换药的患者150例作为研究对象,采用随机数字表法分为对照组和观察组各75例。对照组采用常规换药方法,观察组采用脂质水胶敷料对口引流换药方法。对比分析两组的治疗时间、治疗效果...     

硝苯地平控释片体内外相关性溶出方法研究

目的 开发相应的能区分和反映参比制剂与自研制剂之间释放差异的溶出方法,使自研制剂与参比制剂体外释放达到最大程度的匹配,从而为生物等效性试验提供体内外更具相关性的研究。方法 采用美国药典(USP)溶出2法(桨法)作为质量控制方法;另采用流池法作为溶出区分性方法,评估不同实验参数下的溶出结果。结果 优化并确立方法为开环系统,流速3.0 mL·min^-1,加1/2勺玻璃珠。该方法可以有效区分处方和生产工艺变化对产品溶出的影响。以此法为基础所得到的体外溶出速率和溶出度与体内药动学研究结果一致。结论 本研究所开发的流池法适合作为硝苯地平控释片的溶出区分性方法,并具备一定的体内体外相关性。     

单孔局麻胸腔镜滑石粉胸膜粘连术治疗气胸

目的评价在单孔局麻气管镜下喷洒滑石粉治疗重症气胸安全性和临床效果。方法回顾分析江西省胸科医院2009年7月至2011年7月,经单孔局麻气管镜下喷洒滑石粉治疗重症气胸20例。临床资料:其中男17例,女3例,患者持续漏气7d以上,或反复发作,肺功能差或者合并哮喘等基础疾病不能耐受手术。采用冲洗器和引流管制成的简易装置向胸腔内喷洒5g医用滑石粉,气管镜下观察到滑石粉在胸膜腔内均匀分布,置28F胸管引流直至无漏气,术后复查胸片观察肺复张情况。结果20例患者中17例治愈,13例胸痛,9例发热,3例皮下气肿,3例持续漏气,拔管中位时间为5d(3d-8d),在随访期间(18-42个月)[中位时间36个月]无复发。无重大并发症发生。结论单孔局麻支气管镜下喷洒滑石粉治疗重症气胸是一项安全、有效、费用低廉的治疗方法,不仅可以治疗这类气胸,还可以预防气胸复发。     

普通B超探头引导下PTCD治疗恶性阻塞性黄疸的临床体会

目的探讨普通B超探头引导下经皮肝穿刺胆道置管引流(PTCD)治疗恶性阻塞性黄疸中的临床体会。方法回顾分析B超探头引导PTCD术治疗恶性肿瘤所致的阻塞性黄疸患者68例,按B超探头不同分为:研究组,普通凸阵B超探头,36例;对照组,专用穿刺探头,32例。比较两组术后的穿刺成功率、置管成功率、血清总胆红素水平、胆汁引流量的差别。结果两组术后的指标未见差别,穿刺成功率(P=0.067)、置管成功率(P=0.075)、血清总胆红素水平(P=0.124)、胆汁引流量(P=0.227)。结论普通B超探头引导下行PTCD术治疗恶性阻塞性黄疸临床疗效与应用专用穿刺探头无差别。     

抗返流引流袋在卧床老年患者中的应用

目的观察抗返流引流袋在长期卧床患者中的应用。方法将96例长期卧床的需留置导尿管的老年患者分为两组,一组为使用一次性尿袋每天更换1次（对照组）,另一组为抗返流引流袋每7天更换1次（观察组）,在相同天数下或拔除尿管前用无菌注射器按无菌原则抽吸法采集两组患者的尿液进行细菌培养。结果对照组的细菌阳性率较高,观察组的细菌阳性率较低,差异有统计学意义（P〈0．05）。结论留置导尿管患者使用一次性引流袋每天更换增加了感染机会,用抗返流引流袋每7天更换一次,不仅节省了护士的工作量、护理时间,还减少医院用于废弃物品的处理费用,减少环境污染。     

改良式单孔锥颅置管引流术治疗慢性硬膜下血肿疗效分析

目的：探讨改良式单孔锥颅置管引流术治疗慢性硬膜下血肿的临床疗效。方法选取2011年1月至2013年1月于我院就诊的慢性硬膜下血肿患者共100例,按照入院编号,将患者随机分为两组,观察组和对照组各50例。对照组患者给予常规的钻孔手术治疗,观察组给予患者改良式单孔锥颅置管引流术治疗,观察患者接受治疗后的临床效果。结果观察组50例患者在接受具有针对性和科学性护理之后,其中痊愈患者30例（60.0%）,好转20例（40.0%）,总有效率为100%;对照组患者中痊愈患者26例（52.0%）,好转18（36.0%）,无效6例（12.0%）,总有效率为88.0%。观察组患者治疗总有效率和痊愈率要明显高于对照组患者,组间治疗效果差异有统计学意义（P＜0.05）。结论临床上在治疗慢性硬膜下血肿症时,可以采用改良式单孔锥颅置管引流术治疗方法,能有效改善患者治疗效果,提高预后质量,获得非常理想的治疗效果。     

负压封闭引流在严重多发伤创面治疗中的作用

目的 探讨负压封闭引流在严重多发伤创面治疗中的作用.方法 1998年6月～2007年7月对64例严重多发伤组织器官修复手术后头、腰骶部及腹腔脏器创面采用负压封闭引流治疗(VS).结果 VS治疗时间5～24天,平均为11.5天.创面或创腔全部治愈,直接通过VS治愈创面或创腔24例,采用游离皮瓣修复13例,局部皮瓣转位修复9例,植皮覆盖12例,Ⅱ期缝合6例.结论 VS能消除感染,充分引流和刺激创面肉芽组织快速生长,促进创面愈合,在严重多发伤创面治疗中发挥重要作用.但应合理掌握VS的应用指征,严格掌握VS的技术方法.     

Transperineal pelvic drainage combined with lateral position to promote perineal wound healing after abdominoperineal resection: A prospective cohort trial

Background:For the rectal cancer <5 cm from anal margin, extralevator abdominoperineal resection (eAPR) has been accepted widely by surgeons. However, the rate of perineal infection following up eAPR is approximately 70%. We did the study with the aim of evaluating the effect and safety of transperineal pelvic drainage combined with lateral position (TPDLP) on perineal wound in patients undergoing eAPR.Methods:Patients were randomly assigned to N-TPDLP group (standard arm) or TPDLP group (intervention arm). In the standard arm, surgery was completed after abdominal drainage tube was placed in pelvic. Comparatively, an additional transperineal wound drainage tube was applied in the experimental arm. Postoperatively, patients of both 2 groups were informed not to sit to reduce perineal compression until the perineal wound healed. But lateral position was demanded in the intervention arm. The primary endpoint was the rate of uncomplicated perineal wound healing defined as a Southampton wound score of <2 at 30 days postoperatively. Patients were followed for 6 months.Results:In total, 60 patients were randomly assigned to standard arm (n = 31) and intervention arm (n = 29). The mean perineal wound healing time was 34.2 (standard deviation [SD] 10.9) days in TPDLP arm, which significantly differ from 56.4 (SD 34.1) in N-TPDLP arm (P = .001). At 30 days postoperatively, 3 (10%) of 29 patients undergoing TPDLP were classified into grade 4 according to Southampton wound score, however, 16 (52%) of 31 patients were classified into grade 4 in control arm, and significantly difference was observed between randomization groups (P = .001). What''s more, perineal wound pain was assessed at 30 days postoperatively, and it is discovered that the pain degree of patients in control arm was significantly more severe than the interventive arm (P = .015).Conclusion:In the present study, we found that TPDLP generated a favorable prognosis for perineal wounds with acceptable side-effects.