胰岛素抵抗综合征的护理进展

体温是临床医护人员采集病史和资料过程中最重要的客观指标之一，其准确性和精确性直接影响到疾病的诊断和治疗。近年来，有关体温的测量及其与临床的研究日渐增多，现将其测量方法与临床疾病的关系等进行综述，现介绍如下。     

Influence of moderate hypothermia on cerebral oxygenation in pigs with intracranial hypertension

BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them. OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia. DESIGN: A randomized controlled trial. SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University. MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5–5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100 micro-injection pump (Carnegie Company, Sweden). METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ① Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3–]. ② Rectal temperature was monitored with mercurial thermometer. ③ Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④ Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCO2), HCO3– and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34 ℃ using ice bags, and the body temperature was maintained at 33–35 ℃ for 2 hours. The changes of the parameters were observed continuously, and the pigs in the normothermia group were not treated with cooling. MAIN OUTCOME MEASURES: ① MAP, ICP, rectal temperature, CCP; Indexes of cerebral oxygenation detected with Neurotrend-typed multiparameter monitoring system; ② Results of blood gases analysis in the moderate hypothermia group. RESULTS: All the 20 pigs were involved in the analysis of results. ① MAP, ICP, rectal temperature, CCP and indexes of cerebral oxygenation: In the moderate hypothermia group, the ICP after cooling was obviously lower than that before cooling [(3.31±1.19), (5.33±0.95) kPa, P < 0.05], CCP was higher, brain tissue PCO2 [(12.03±1.73), (10.59±2.01) kPa, P < 0.05], and brain tissue pH value was higher [(7.03±1.63), (9.40±1.30) kPa, P < 0.05], whereas the brain temperature was decreased as compared with that before cooling [(34.9±0.3), (37.2±0.2) ℃, P < 0.05]. ② Results of blood gases analysis in the moderate hypothermia group: There were no significant differences in the parameters of peripheral arterial blood gases analysis before and after cooling in the moderate hypothermia group (P > 0.05) CONCLUSION: Moderate hypothermia will not impair the cerebral oxygenation, and it can reduce brain tissue CO2 and decrease brain tissue acidosis.     

儿童龋病的就医导向

由于龋病在儿童中流行甚为严重，儿童龋病的危害性较大，而多数家长对乳牙龋病的危害认识不足及患龋后的就医导向不知所措，医务人员在龋病诊治中如何掌握儿童的心理变化特征与如何指向，这都是摆在我们口腔医务工作者与妇幼保健人员面前亟待解决的重要问题。     

图们市2006年大骨节病现患调查结果

为了摸清图们市大骨节病病情现状，掌握10年来病情变化规律，为今后防治提供科学依据，经省地病办和省卫生厅批准，于2006年3～4月在全市范围内，以病区为重点进行了大骨节病现患调查。     

肾元胶囊对早期糖尿病肾病治疗作用的临床观察

糖尿病肾病（diabetic nephropathy，DN）是糖尿病的主要微血管并发症之一，也是导致慢性肾衰竭的常见原因。其发生首先以微血管的血流动力学变化为起点，继而发生以毛细血管基底膜增厚和系膜基质扩展为特征的肾小球硬化。据欧、美、日本的统计资料表明，目前DN已跃升为终末期肾病（ESRD）的首位原因，占35％左右。近年来，我院应用肾元胶囊对早期糖尿病肾病治疗取得了一定的疗效，现总结报告如下。     

给青光眼患者选眼药

青光眼是眼球内压力升高，造成视觉神经细胞缺血性损伤所致。造成眼压升高的原因是循环于眼前房中的房水淤积所引起。房水的生成和排除在正常情况下维持着一种平衡状态，如果房水生成过多或排除受阻，就会滞留在眼球内，使眼压升高。过大的压力强加在眼后部视网膜的血管上，影响血液流通，致使视神经出现病理性变化，损伤视力，造成失明。     

老年人测量腹股沟温度40例分析

我们2003—05-2003—08及2004—03-2004—05分别对40例随机抽取的已康复老年人进行了口温、腋温、腹股沟温的自身对照测量，现报告如下。     

哮喘急性发作院前急救的综合护理

支气管哮喘表现为反复发作的喘息、呼吸困难、胸闷、咳嗽,多数患者可自行缓解或经治疗后缓解.但哮喘的急性发作起病急,病情变化快、复杂.     

加温措施对腹腔镜卵巢囊肿切除患者体温的影响（附60例报告）

腹腔镜卵巢囊肿切除术是微创外科手术，具有切口小、痛苦小、出血少、愈合快等优点，腹腔镜手术极易发生低体温。手术过程中由于麻醉、身体暴露、输入冷液体、腹腔冲洗液、CO2气体等因素作用，病人普遍存在体温下降现象。而术后低体温与患者术后多种并发症的发生有关，对机体多个系统产生影响，从而影响患者的术后康复。因此，保持患者术中正常体温非常重要，笔者选取60例2008年1月～2009年10月在我院进行腹腔镜卵巢囊肿切除术患者，