低剂量等渗造影剂碘克沙醇脑部CTA分支血管强化差异分析

目的:探讨低剂量脑部CTA各级分支血管强化程度差异.方法:对16例应用碘克沙醇的患者行脑部CTA检查,在CT窗宽、窗位和容积再现阈值均固定的条件下,由2名医师分别对各级血管CT值进行测量,并对比2组测量结果间的一致性;对同一医师所测不同血管的CT值进行比较.结果:2名医师所测量的颈内动脉、基底动脉和大脑中动脉CT值分别为:(436.12±82.47)、(354.67±61.56)、(353.63±65.79)HU及(429.18±81.04)、(361.46±72.91)、(357.88±64.20)HU,两两比较Kappa值分别为0.756、0.654和0.718,表明2名医师所测2组结果间一致性较好;同一医师所测颈内动脉与基底动脉之间和颈内动脉与大脑中动脉之间强化程度的差异均有统计学意义(P＜0.05);而基底动脉与大脑中动脉之间差异无统计学意义(P＞0.05).结论:2名医师脑部CTA的CT值测量的一致性较好;不同分级血管之间(颈内动脉与基底动脉之间和颈内动脉与大脑中动脉之间)强化程度有差异性,同级别的血管(基底动脉与大脑中动脉)之间强化程度无差异.     

输卵管阻塞性不孕症宫腹腔镜术后应用欣可聆插管通液效果观察

[目的]观察输卵管阻塞性不孕症宫腹腔镜联合术后,用欣可聆注射液进行彩色超声引导下宫腔镜输卵管插管通液的临床效果。[方法]选择宫腹腔镜术后至少一侧输卵管通畅的不孕症患者160例,按入院先后依次编入观察组和对照组,每组80例,观察组术后第1次月经干净后3~7 d应用欣可聆注射液,行彩色超声引导下宫腔镜输卵管插管通液;对照组不给予任何药物,采取期待疗法。比较两组术后1年妊娠情况。术后1年未妊娠者,于月经干净后3~7 d行子宫输卵管碘佛醇造影检查,观察比较两组输卵管通畅情况。[结果]术后1年,观察组正常宫内妊娠率为68.75%高于对照组的51.25%,差异有统计学意义(χ2=5.104,P=0.024);两组异位妊娠率比较,差异无统计学意义(P0.05);观察组未妊娠者输卵管双侧通畅率为40.9%,显著高于对照组的14.2%(P0.05);双侧不通发生率为9.1%,非常显著低于对照组的42.8%(P0.01);两组总通畅率比较,差异无统计学意义(P0.05)。[结论]输卵管阻塞性不孕症宫腹腔镜联合术后第1次月经干净后3~7 d,用欣可聆注射液行彩色超声引导下宫腔镜输卵管插管通液,可以降低盆腔的再次粘连,维持输卵管的通畅,提高妊娠率,可以作为宫腹腔镜术后的后续治疗方法,值得临床推广应用。     

依达拉奉联合血塞通对急性脑梗死的疗效研究

目的探讨依达拉奉联合血塞通治疗急性脑梗死的疗效。方法选择2008年1月至2012年12月我院收治的92例急性脑梗死患者作为观察对象,随机分为试验组（45例）和对照组（47例）。对照组给予血塞通治疗,试验组给予依达拉奉联合血塞通治疗。观察两组患者在临床疗效及神经功能损伤方面的差异。结果试验组治疗总有效率为86．7％．明显高于对照组的63．8％,差异具有统计学意义（P〈0．05）;治疗后,两组神经功能缺损评分均显著降低,且试验组较对照组降低更为明显,差异均具有显著性（均P〈0．05）。结论依达拉奉联合血塞通治疗急性脑梗死患者,能够显著增加其临床有效率,促进神经功能的恢复,提高患者的生活及生存质量,同时不良反应少、安全性高．值得临床选择。     

输液设备的质量控制和检测方法

根据输液设备质量检测规范,利用FULK测量设备分别对输液泵和注射泵的外观、流量、阻塞报警压力阈值、监测与报警系统进行检测,并对各个参数的检测方法与标准做了详细介绍,为医学工程人员进行输液设备的质控工作提供参考。     

Platelet rich plasma versus laser therapy in lateral epicondylitis of elbow

Background:

Platelet rich plasma (PRP) extract has shown to be a general stimulation for repair and currently used widely in various sports injury. A prospective observational study was done to assess the efficacy of autologous PRP injection in lateral epicondylitis of elbow, and compare the result with low level laser therapy.

Materials and Methods:

The trial was conducted at a tertiary care center for a period of 2 years. Eighty-one patients with chronic lateral epicondylitis were divided into two groups. PRP group (n = 39) and laser therapy group (n = 42). The primary analysis included Nirschl pain score, local tenderness, pain on wrist extension, grip strength, elbow swelling were clinically assessed at different interval of followup (minimum followup: 52 weeks) and; clinical and functional outcome evaluated at final followup. The statistical analysis were done.

Results:

The mean Nirschl pain score decreased significantly from baseline in PRP when compared with low level laser therapy (P ≤ 0.05).

Conclusions:

Treatment of patients with chronic lateral epicondylitis with PRP extract reduced pain and significantly increased function, exceeding the effect of low level laser therapy on long term followup. Low-level laser therapy is better in the short term period, but on long term followup injection PRP therapy is better than laser therapy in lateral epicondylitis.     

Microwave coagulation therapy and drug injection to treat splenic injury

Background

The present study compares the efficacy of 915- and 2450-MHz contrast-enhanced ultrasound (CEUS)–guided percutaneous microwave coagulation with that of CEUS-guided thrombin injection for the treatment of trauma-induced spleen hemorrhage.

Materials and methods

In a canine splenic artery hemorrhage model with two levels of arterial diameter (A, <1 mm and B, between 1 and 2 mm), hemostatic therapy was performed using 915- and 2450-MHz microwaves and drug injection. Therapy efficacy was measured by comparing bleeding rate, hemostatic time, bleeding index, bleeding volume, and pathology.

Results

The most efficient technique was CEUS-guided 915-MHz percutaneous microwave coagulation therapy in terms of action time and total blood loss. The success rate of the 915-MHz microwave group was higher than that of the 2450-MHz microwave and the drug injection groups (except A level, P < 0.05). Hemostatic time, bleeding index, and bleeding volume were significantly less in the 915-MHz microwave group than those in the 2450-MHz microwave and drug injection groups (P < 0.05). Obvious degeneration and necrosis of parenchyma and large intravascular thrombosis were observed in the cavity of larger vessels in the 915-MHz microwave group, but pathologic changes of light injury could be seen in the other groups.

Conclusions

The present study provides evidence that microwave coagulation therapy is more efficient than thrombin injection for the treatment of splenic hemorrhage. Furthermore, treatment with 915-MHz microwaves stops bleeding more rapidly and generates a wider cauterization zone than does treatment with 2450-MHz microwaves.     

柚皮苷硬膜外腔注射对髓核致坐骨神经痛大鼠的疼痛行为影响

目的研究柚皮苷硬膜外腔注射对致坐骨神经痛大鼠的疼痛行为学的影响。方法选择雄性SD大鼠28只,制作髓核致坐骨神经痛大鼠模型。随机分为4组,每组7只大鼠。术后第3天开始注药治疗,柚皮苷组每日硬膜外腔注入柚皮苷注射液50μl,地塞米松组每日硬膜外腔注入地塞米松注射液50μl,生理盐水组每日硬膜外腔注入生理盐水50μl,未注药组硬膜外腔无药物注入处理。检测大鼠术前,术后及给药后1、3、7、14d的疼痛行为指标（50％机械性刺激缩足阈值和热刺激缩足反应潜伏期）。结果4组大鼠在术后均对机械刺激产生明显的痛觉过敏,与术前比较差异有显著性（P〈0.05）;柚皮苷组与地塞米松组在提高疼痛行为学指标的作用方面差异无显著性（P〉0.05）。结论硬膜外腔注射柚皮苷可有效改善髓核致坐骨神经痛大鼠的疼痛反应。     

马来酸桂哌齐特治疗急性脑梗死的疗效及对血液流变学的影响

目的：观察马来酸桂哌齐特注射液治疗急性脑梗死的临床效果及对血液流变学的影响。方法选择2009-12-2012-12我院内科收治的急性脑梗死患者133例,随机分为治疗组68例和对照组65例。2组均给予常规基础治疗,治疗组在对照组基础上应用马来酸桂哌齐特注射液320 mg加入500 mL 0.9％氯化钠注射液中静滴,1次/d ,共应用14 d ,治疗前后采用改良爱丁堡-斯堪的那维亚量表（SSS ）与日常生活能力（ADL ）量表对2组患者的疗效进行评定。对比治疗前后2组患者血液流变学指标变化。结果治疗7 d、14 d后治疗组SSS评分、ADL评分与对照组比较差异有统计学意义（ P＜0.05）。治疗组治疗前后SSS评分、ADL评分比较差异有统计学意义（ P＜0.05）。2组治疗后总有效率比较差异有统计学意义（ P＜0.05）。治疗组治疗后血液流变学指标均较治疗前有显著改善（ P＜0.05）。结论马来酸桂哌齐特注射液治疗急性脑梗死安全有效,且能显著改善患者的血液流变学指标。     

前列地尔联合黄芪治疗慢性肾功能衰竭的临床观察

目的探讨前列地尔联合黄芪治疗慢性肾功能衰竭的临床疗效,延缓病情进展。方法选择符合标准的患者80例,采用随机数字表分为观察组和对照组各40例,观察组在常规治疗的基础上加用前列地尔和黄芪,对照组仅加用黄芪,比较二者临床疗效以及治疗前后内生肌酐清除率（Ccr）、血肌酐（Scr）、血尿素氮（BUN）和24h尿蛋白定量（24h—Upro）的水平。结果观察组患者治疗总有效率为80．00％,明显高于对照组的65．00％,差异有统计学意义（P〈0．05）。两组患者治疗前BUN、SCr、Ccr及24h—Upro比较,差异无统计学意义（P〉0．05）;两组患者治疗结束BUN、SCr及24h—Upro较治疗前明显下降,Ccr较治疗前明显升高,差异有统计学意义（P〈．05）;但是观察组各项指标改善程度明显优于对照组,差异存在显著性（P〈0．05）。两组患者治疗期间均未发现明显药物不良反应。结论前列地尔联合黄芪治疗慢性肾功能衰竭可显著改善患者的肾功能,有效延缓病情进展,延迟进入维持性血液透析。     

舒血宁注射液联合叶酸片治疗冠心病心绞痛的临床疗效观察

目的：研究舒血宁注射液联合叶酸片治疗冠心病心绞痛的临床效率。方法选取2010年7月-2012年8月我院收治的冠心病心绞痛患者70例,随机分为研究组和对照组,每组35例,研究组给予舒血宁注射液联合叶酸片进行治疗,对照组给予常规硝酸甘油,比较两组临床疗效和心电图改善疗效。结果研究组总有效率显著高于对照组,两组比较差异具有统计学意义（P＜0.05）;研究组心电图改善总有效率显著高于对照组,两组比较差异具有统计学意义（P＜0.05）。结论舒血宁注射液联合叶酸片治疗冠心病心绞痛具有较好疗效,能改善微循环,缓解心绞痛。