探讨密盖息联合钙剂治疗骨质疏松骨痛的应用效果

目的:探究密盖息联合钙剂治疗骨质疏松骨痛的应用效果。方法:抽选我院接收的骨质疏松骨痛患者110例作为研究对象,入选时间为2018年3月~2019年5月,依照单双号分组方式分为两组,即研究组与参照组,每组55例。参照组给予钙尔奇D治疗,研究组在参照组基础上给予密盖息治疗,比较组间治疗前后在休息与运动时疼痛程度。结果:研究组与参照组治疗前,休息时与运动时疼痛评分无显著差异P>0.05,治疗后,组间疼痛评分均有所下降,研究组治疗后休息时与运动时评分分别为(1.85±0.12)分、(2.03±0.24)分,参照组治疗后休息时与运动时评分分别为(3.01±0.14)分、(3.76±0.29)分,研究组显著低于参照组,P<0.05,差异存在统计学意义。结论:将密盖息联合钙剂运用于骨质疏松骨痛治疗,可有效缓解患者骨疼痛,提升其生活质量,值得临床推广。     

卵巢子宫内膜异位囊肿粘连程度及相关因素分析

Objective To investigate the relationship between degree of endometrioma adhesions and clinical feature, surgical treatment and postoperative recurrence. Methods From Jan 2003 to Mar 2008, 662 patients with endometrioma undergoing laparoscopic ovarian endometrioma excision in Peking Union Medical College Hospital were studied retrospectively. All patients were classified into four groups according to the extent of adhesions: 31 cases in none adhesions group, 123 cases in mild adhesions group (filmy thickness, avascular, easily separated adhesions), 310 cases in moderate adhesions group (less than a half of ovary was adjacent to dense thickness adhesions which was difficult to separate, or above a half of ovary were adjacent to filmy thickness adhesions) and 198 cases in severe adhesions group (above a half of ovary was adjacent to dense thickness, well vascularized adhesions which was difficult to separate, and always involved the other pelvic organs, observed angiogenesis). The comparison of degree, characteristics, period of pain, lab test, surgical management and postoperative recurrence was performed among those above groups. In the mean time, risk factors and multinomial logistic regression were analyzed. Results (1)Clinical characteristics: The incidence of patients with dysmenorrhea, dyspareunia, straining feeling in anus, chronic pelvic pain and the level of CA125 (>35 kU/L) was remarkably higher in moderate-to-severe adhesion groups than in none-to-mild adhesions groups (P=0.000, 0.000, 0.001, 0.006 and 0.000, respectively). Infertility rate were significantly higher in severe adhesions group(15.7%,31/198) than none adhesions group(3.2%,1/31), mild adhesions group(11.4%,14/123) and moderate adhesions group(9.7%,30/310, OR=1.728, P<0.05).(2)Operating time and blood loss: Operating time of each groups was as followed: (37±15) min in none adhesions group, (42±19) min in mild adhesions group, (50±20) min in moderate adhesions group and (63±22) min in severe adhesion group. Blood loss was (23±12) ml in none adhesion group, (31±27) ml in mild adhesion group, (40±32) ml in moderate adhesion group and (70±67) ml in severe adhesions group. Thicker adhesions result in longer operation time and more blood loss. (3)Combined with other disease: The ratio of patients who combined with adenomyosis or deeply infiltrating endometriosis in moderate-to-severer adhesion groups was higher than patients in none-to-mild adhesions groups (OR=3.466, P=0.000). (4) Postoperative recurrence: It was categorized into recurrence of pain and cyst. Moderate-to-severe adhesions was related to higher recurrence rate of pain (OR=1.685,P=0.046), but was irrelevant to recurrence of cyst. Conclusion The more extent of endometrioma adhesions was related to severer pelvic pain symptoms, longer operating time and more blood loss. Postoperative pain recurrence rate was observed in moderate-to-severe adhesion group. Extent of adhesions was irrelevant to cyst recurrence.     

《风湿性关节炎--一个值得磋商的病名》商榷

拜读“风湿性关节炎———一个值得磋商的病名”(中华风湿病学杂志 ,2 0 0 3,7:6 0 )一文 ,颇有同感。不知有多少关节痛的病人被误诊为“风湿性关节炎”而遭误治 !对“天气变化十分敏感”的关节炎不是风湿热的特征性表现的观点 ,亦非常赞同 ,但对“与天气变化较密切的关节炎多是骨关节炎”这一观点 ,说点粗浅看法。临床上 ,我们发现大量关节痛病人多有长居寒冷地、冷库工人、长期驾驶摩托车等受风寒史 ,每次关节痛发作与天气变化 (主要是阴冷下雨 )有密切关系 ,临床检查关节红肿不明显 ,实验室和影像学检查缺乏特异性改变 ,而且发病年龄作者…     

吉非罗齐中有机溶剂残留量的顶空毛细管GC测定

建立了顶空毛细管GC法测定吉非罗齐中甲酸乙酯、THF和甲基环己烷3种有机溶剂的残留量。采用HP-1毛细管柱，溶剂DMA，内标乙酸乙酯。平均同收率分别为99．8％、100．3％、100．0％，RSD分别为0．71％、1．51％和1．76％。     

骶管阻滞治疗慢性盆腔痛的镇痛价值

目的探讨骶管阻滞治疗对慢性盆腔痛镇痛的应用价值。方法将76例慢性盆腔痛患者分为两组，治疗组39例采用骶管阻滞治疗，对照组37例用芬必得治疗。结果治疗组患者疼痛明显缓解，且起效快、完全缓解及缓解持续时间长，与对照组比较差异有统计学意义（P〈0．01）。治疗组总有效率为97．4％，对照组总有效率为81．1％，治疗组疗效优于对照组（P〈0．05）；不良反应发生率治疗组5．1％，明显低于对照组的27％（P〈0．01）。结论骶管阻滞镇痛疗效优于芬必得，且无明显副作用，可作为临床治疗慢性盆腔痛一种新的治疗途径。     

综合治疗椎动脉型颈椎病60例

椎动脉型颈椎病主要表现为颈项强痛,偏头痛、眩晕、耳鸣、记忆力减退、视物模糊、猝倒,治疗以非手术的方法为主。笔者自2000~2003年对60例椎动脉型颈椎病患者进行综合治疗效果满意,现报道如下。1临床资料60例中,男24例,女36例;年龄最大64岁,最小28岁,平均46岁;病程最长8年,最短     

430例急性心肌梗死患者无痛性与有痛性的临床观察与护理

资料与方法 本组急性心肌梗死（AMI）430例，系1995年10月～2005年10月本院收住病人。随机选出有痛性350例，占81．39％，符合1979年世界卫生组织所定的AMI诊断标准；无痛性80例，占18．60％，发病特点是缺乏AMI早期的心前区胸骨后典型的疼痛，仅表现胃部一般性疼痛、恶心、呕吐者16例，头晕、晕厥者23例，颈肩、前臂、手指酸胀麻木者12例，嗜睡或烦躁者9例，下肢及腰部麻木疼痛者6例，貌似脑梗死的AMI14例，表现为短暂意识丧失、偏瘫和不同程度的意识障碍等。     

特殊污染穿刺针的清洗

特殊污染的胸、腹穿包,骨穿包,腰穿包等,必须经压力蒸汽灭菌后方可清洗。但在灭菌过程中,经过真空、高温、干燥,使血污中蛋白质凝固、干结在穿刺针管腔内、针座处,不易清洗。本院供应室穿刺针采用两种不同清洗方法清洗后,随机抽样,监测残留血污,有显著性差异,现报告如下。1方法随机抽取非一次性使用接触血污的特殊污染的各种穿刺针100支分两组,每组50支,分别采用不同的手工清洗法即A组为常规清洗;B组为改进方法清洗。A组清洗方法:①穿刺针用清水浸泡30 m in,用2000mg/L有效氯浸泡20 m in。②用清水反复冲洗3遍以上,再用洗涤灵浸泡5 m in,…     

中药包热敷治疗跟病症30例

跟痛症是门诊一种常见病。一般分为跟下痛和跟后痛及跟骨病3个类型。因为本病具有自感症状与检查结果不相符的情况，故临床上易披忽视或单纯以封闭治疗。但该病影响人们的生活质量。且易反复，因此急需一种简单有效的治疗方法。经过临床实践。应用中药包热敷对该病的治疗效果肯定，现报道如下。