派瑞松联合外耳道冲洗治疗真菌性外耳道炎的临床研究

目的探讨派瑞松联合外耳道冲洗治疗真菌性外耳道炎的方法及效果。方法随机选取本院2009年9月~2011年9月收治的80例真菌性外耳道炎患者分成两组,实验组42例,行派瑞松联合外耳道冲洗治疗;对照组38例,单纯行外耳道冲洗。随访10~15 d,比较两组患者治疗前后的病情积分、临床疗效和不良反应。结果随访期间两组内相比,治疗后患者的病情积分均低于治疗前（P〈0.05）;两组间相比,实验组患者的病情积分、临床疗效和不良反应发生率均优于对照组（P〈0.05）。结论应用派瑞松联合外耳道冲洗治疗真菌性外耳道炎,可显著减轻患者的病情恶化,避免不良反应,提高临床疗效。     

Reduction of surgical site infections by use of pulsatile lavage irrigation after prolonged intra-abdominal surgical procedures

Background

Surgical site infections cause significant postoperative morbidity and may be reduced by pressurized irrigation of high-risk laparotomy wounds before closure. This was a retrospective review (June 2007 to May 2008) from a surgical unit at a tertiary care center.

Methods

Patients undergoing laparotomy extending beyond 4 hours, when a standard wound management strategy was instituted by either simple irrigation or pressurized pulsatile lavage (<15 psi) with saline before closure, were included. The outcome measures were the surgical site infections and factors contributing to them.

Results

The median surgical time for the patients was 8 hours, with 34 wounds managed by simple irrigation and 42 wounds managed by pulse irrigation. Both groups had similar characteristics. Overall there were 15 (20%) surgical site infections. Significantly fewer infections occurred in the pulse irrigation group (10% vs 32%; P = .019). The use of a pulse irrigation device was the only factor associated with a reduction in wound infections (P = .019).

Conclusions

Surgical site infections appear to be reduced with pulsatile lavage irrigation of wounds before skin closure in patients undergoing prolonged intra-abdominal surgeries.     

卡介苗膀胱灌注治疗浅表性膀胱癌的临床观察

目的：探讨浅表性膀胱癌术后膀胱灌注卡介苗的临床效果。方法：对2001年至2006年确诊为浅表性膀胱癌的56例患者随机分成两组,在手术后2周第1组给以卡介苗60mg加生理盐水40m l膀胱灌注;第2组给以卡介苗100 mg加生理盐水40m l灌注。对不良反应以及治疗效果进行观察。结果：第1组2例在手术后6月出现血尿,经B超检查为肿瘤复发,无发热、尿痛、尿急、尿频等症状。第2组患者中有12例在灌注卡介苗后出现尿痛、尿急、尿频,1例发热,全部不良反应经对症处理于灌注后3d消失,在随访的2年内无复发病例。结论：采用卡介苗100 mg适当加大灌注液的量既可以达到减少肿瘤复发又可以减少不良反应。     

海水浸泡开放性颅脑损伤病原菌的种类及冲洗疗法研究

目的分析海水浸泡重型开放性颅脑损伤的病原菌种类分布,并探讨冲洗疗法的治疗作用。方法将制作36只兔自由落体颅脑损伤模型创面用海水浸泡30min,然后随机等分为3组,抗生素冲洗组和生理盐水冲洗组分别用广谱抗生素和生理盐水冲洗,对照组不冲洗。海水浸泡30min（冲洗前）和伤后24h分别取脑表面细菌进行培养,观察培养结果和实验兔1周内生存时间。结果抗生素冲洗组和对照组革兰阴性杆菌培养结果差异有统计学意义。对照组生存时间显著性短于抗生素冲洗组和生理盐水冲洗组。结论海水浸泡重型开放性颅脑损伤的病原菌为多科属种细菌,主要为革兰阴性杆菌,其次为葡萄球菌。广谱抗生素冲洗能降低海水浸泡重型开放性颅脑损伤兔的颅内感染率并延长生存时间。     

鼻腔手术后三氧化生理盐水鼻腔冲洗疗效观察

目的探讨鼻、鼻窦手术后不同种类局部药物冲洗时术腔恢复的近期疗效。方法将80例常见鼻、鼻窦手术包括鼻中隔矫正术（30例）,下鼻甲部分切除术（20例）,内窦镜鼻窦手术（30例）随机分为治疗组（术后滴鼻＋三氧化生理盐水鼻腔冲洗）和对照组（术后滴鼻＋生理盐水鼻腔冲洗）进行观察,随访2周～1个月。结果3种鼻、鼻窦手术后治疗组鼻腔黏膜形态和功能恢复时间较对照组提前,差异有非常显著性（P〈0．01）。结论术后鼻腔使用三氧化生理盐水冲洗能加快鼻腔黏膜恢复和症状改善。     

Simple provocative maneuvers in renal transplant scintigraphy for detecting urine leak

Urine leak in the early postoperative period following renal transplantation is a serious complication requiring early identification and aggressive intervention, which significantly reduces the morbidity and mortality. Renal transplant scintigraphy is a noninvasive method to evaluate the perfusion and function of a transplanted kidney and urinary drainage including urine leak. Here, we reported two cases in which the standard transplant renogram failed to demonstrate urine leak. The cases were referred for a diethylenetriaminepentaacetic acid renogram following the transplantation to evaluate the cause of symptoms or elevated serum creatinine level. In both the cases, urine leak was successfully detected following simple maneuvers such as diuretic administration or Foley catheter irrigation. Renal transplant scintigraphy is an effective and safe technique and the use of these simple maneuvers can enhance the diagnostic sensitivity of the transplant renogram in the detection of urine leak.     

污灌玉米中有机污染物对小鼠的遗传毒性及氧化损伤作用

[目的]研究污灌玉米中有机污染物对小鼠的遗传损伤及其氧化损伤机制。[方法]选取某污灌农田产出的玉米为研究对象,地下水灌溉的玉米为对照,采用超声振荡法提取玉米中的有机污染物,对小鼠灌胃法染毒（共分为5组,每组8只：试剂对照组、对照区低剂量组、对照区高剂量组、污灌区低剂量组、污灌区高剂量组）。每日染毒1次,染毒剂量：低剂量组相当于10g玉米干重／（kg·d）,高剂量组相当于60g玉米干重／（kg·d）。连续染毒2周后,进行单细胞凝胶电泳试验、微核试验并测定总超氧化物歧化酶（T—SOD）活力、谷胱甘肽过氧化物酶（GSH-Px）活力和丙二醛（MDA）含量。[结果]与试剂对照组比较,对照区各组的T-SOD活力均降低（P〈0．05）;污灌区拖尾率、拖尾长度及微核率均增高,且高于对照区（P〈0．05）;污灌区T—SOD和GSH-PX活力均降低（P〈0．05和P〈0．01）,且低于对照区（P〈0．05）。[结论]该污灌区玉米有机提取物中含有致小鼠遗传毒性及氧化损伤的有机污染物,其毒性强于对照区。