重型颅脑创伤的救治体会

2004年7月-2006年7月，我科共收治重型颅脑创伤患者61例，对其救治的情况进行回顾性分析，报告如下。     

咳嗽少痰为临床表现的肺炎型肺癌1例并文献复习

肺炎型肺癌是一种特殊类型的肺癌, 影像学与肺炎较难鉴别。浸润性肺腺癌为肺炎型肺癌常见病理亚型, 临床常以咳大量泡沫痰为主要表现。本文报道1例于2020年2月21日入青岛大学附属威海市中心医院, 以咳嗽、少痰为临床表现的患者抗感染治疗后病情进展, 最终病理证实为浸润性肺腺癌, 复习相关文献, 以期对临床工作提供帮助。     

垂体生长激素瘤并发糖尿病酮症酸中毒误诊1例

垂体瘤系良性腺瘤，临床较常见，约10万人中即有1例，由于其临床表现多样化，易引起误诊。现将我们收治的1例垂体瘤患者及误诊情况报道如下。     

慢性阻塞性肺疾病急性加重期血浆磷脂、C反应蛋白及纤维蛋白原含量的变化

目的 观察慢性阻塞性肺疾病急性加重期(AECOPD)患者血浆磷脂(PLs)、超敏C反应蛋白(hs-CRP)及血浆纤维蛋白原(Fbg)含量的变化及评估AECOPD的灵敏度.方法 收集2010年5月至2013年6月住院的65例AECOPD患者纳入本研究.60例年龄＞60岁的健康体检者作为对照组.观察治疗前后上述指标的变化,并与对照组进行比较.血浆PLs测定采用层析技术结合改良的无机磷定量方法.hs-CRP的测定采用免疫透射比浊法.结果 65例AECOPD患者治疗前血清hs-CRP水平(10.15±6.22) mg/L显著高于对照组(3.69±1.02) mg/L(P ＜0.01)及治疗后(6.36±5.72) mg/L(P＜0.05).治疗后血清hs-CRP水平高于对照组(P＜0.05).AECOPD患者治疗前Fbg水平(5.50±1.44) g/L显著高于对照组(2.96±0.87)g/L(P＜0.01)及治疗后(4.03±1.25) g/L(P＜0.01).治疗后Fbg水平仍高于对照组(P＜0.05).血PLs、hs-CRP和Fbg含量评估AECOPD的灵敏度分别为96.9％、76.9％和80.0％.PLs水平的灵敏度与hs-CRP及Fbg相比差异均有统计学意义(P＜0.01).结论 AECOPD患者血PLs、hs-CRP及Fbg含量均显著升高,血浆PLs水平对诊断及评估AECOPD有很高的灵敏度,有望成为AECOPD新的血浆生物标记物.     

乌司他丁治疗慢性阻塞性肺疾病急性加重期的临床疗效

Objective To discuss the effect of ulinastatin on chronic obstructive pulmonary disease with acute exacerbation and part of the mechanism. Methods Seventy-two cases consistent with the diagnostic criteria were randomly divided into ulinastatin statin therapy group and control group (36 cases each group),two groups both received conventional treatment,the treatment group on this basis was added ulinastatin with 200 000 U,intravenous injection, three times a day. Results In the treatment group the total effective rate was 86.11%, significantly better than in the control group 69.44% (P<0.05), its improvement in APACHE Ⅱ score,blood gas analysis and reduction in CRP,TNF-α,IL-8 was superior to the control group. The treatment group was significantly shorter than the control group in mechanical ventilation and ICU stay time (P<0.05). Conclusions Conventional therapy as basis plus ulinastatin has better clinical efficacy,for whose chronic obstructive pulmonary disease with acute exacerbation mechanism may lie in the inhibition of inflammatory mediators and cytokines release, reducing inflammation, relaxing smooth muscle,improving the patient's ventilatory function and blood rheotogy.     

中心静脉导管相关性败血症病原菌的临床分析

目的:探讨中心静脉导管相关性败血症(CRS)病人病原菌的分布特点及耐药情况.方法:对69例CRS病人的静脉导管尖端进行培养和药敏试验.结果:CRS常见的致病菌依次为真菌(41.1%),革兰阳性球菌(35.6%),革兰阴性杆菌(23.3%).非白念珠菌已成为主要的致病真菌(19/30株),革兰阳性球菌以表皮葡萄球菌为主,而且多数对苯唑西林耐药,革兰阴性杆菌常为多重耐药菌株.结论:CRS病原菌以念珠菌和革兰阳性球菌为主.减少中心静脉导管的应用并缩短留置时间,是有效预防CRS的措施.     

乌司他丁治疗慢性阻塞性肺疾病急性加重期的临床疗效

Objective To discuss the effect of ulinastatin on chronic obstructive pulmonary disease with acute exacerbation and part of the mechanism. Methods Seventy-two cases consistent with the diagnostic criteria were randomly divided into ulinastatin statin therapy group and control group (36 cases each group),two groups both received conventional treatment,the treatment group on this basis was added ulinastatin with 200 000 U,intravenous injection, three times a day. Results In the treatment group the total effective rate was 86.11%, significantly better than in the control group 69.44% (P<0.05), its improvement in APACHE Ⅱ score,blood gas analysis and reduction in CRP,TNF-α,IL-8 was superior to the control group. The treatment group was significantly shorter than the control group in mechanical ventilation and ICU stay time (P<0.05). Conclusions Conventional therapy as basis plus ulinastatin has better clinical efficacy,for whose chronic obstructive pulmonary disease with acute exacerbation mechanism may lie in the inhibition of inflammatory mediators and cytokines release, reducing inflammation, relaxing smooth muscle,improving the patient's ventilatory function and blood rheotogy.     

乌司他丁治疗慢性阻塞性肺疾病急性加重期的临床疗效

Objective To discuss the effect of ulinastatin on chronic obstructive pulmonary disease with acute exacerbation and part of the mechanism. Methods Seventy-two cases consistent with the diagnostic criteria were randomly divided into ulinastatin statin therapy group and control group (36 cases each group),two groups both received conventional treatment,the treatment group on this basis was added ulinastatin with 200 000 U,intravenous injection, three times a day. Results In the treatment group the total effective rate was 86.11%, significantly better than in the control group 69.44% (P<0.05), its improvement in APACHE Ⅱ score,blood gas analysis and reduction in CRP,TNF-α,IL-8 was superior to the control group. The treatment group was significantly shorter than the control group in mechanical ventilation and ICU stay time (P<0.05). Conclusions Conventional therapy as basis plus ulinastatin has better clinical efficacy,for whose chronic obstructive pulmonary disease with acute exacerbation mechanism may lie in the inhibition of inflammatory mediators and cytokines release, reducing inflammation, relaxing smooth muscle,improving the patient's ventilatory function and blood rheotogy.     

乌司他丁治疗慢性阻塞性肺疾病急性加重期的临床疗效

Objective To discuss the effect of ulinastatin on chronic obstructive pulmonary disease with acute exacerbation and part of the mechanism. Methods Seventy-two cases consistent with the diagnostic criteria were randomly divided into ulinastatin statin therapy group and control group (36 cases each group),two groups both received conventional treatment,the treatment group on this basis was added ulinastatin with 200 000 U,intravenous injection, three times a day. Results In the treatment group the total effective rate was 86.11%, significantly better than in the control group 69.44% (P<0.05), its improvement in APACHE Ⅱ score,blood gas analysis and reduction in CRP,TNF-α,IL-8 was superior to the control group. The treatment group was significantly shorter than the control group in mechanical ventilation and ICU stay time (P<0.05). Conclusions Conventional therapy as basis plus ulinastatin has better clinical efficacy,for whose chronic obstructive pulmonary disease with acute exacerbation mechanism may lie in the inhibition of inflammatory mediators and cytokines release, reducing inflammation, relaxing smooth muscle,improving the patient's ventilatory function and blood rheotogy.     

乌司他丁治疗慢性阻塞性肺疾病急性加重期的临床疗效

Objective To discuss the effect of ulinastatin on chronic obstructive pulmonary disease with acute exacerbation and part of the mechanism. Methods Seventy-two cases consistent with the diagnostic criteria were randomly divided into ulinastatin statin therapy group and control group (36 cases each group),two groups both received conventional treatment,the treatment group on this basis was added ulinastatin with 200 000 U,intravenous injection, three times a day. Results In the treatment group the total effective rate was 86.11%, significantly better than in the control group 69.44% (P<0.05), its improvement in APACHE Ⅱ score,blood gas analysis and reduction in CRP,TNF-α,IL-8 was superior to the control group. The treatment group was significantly shorter than the control group in mechanical ventilation and ICU stay time (P<0.05). Conclusions Conventional therapy as basis plus ulinastatin has better clinical efficacy,for whose chronic obstructive pulmonary disease with acute exacerbation mechanism may lie in the inhibition of inflammatory mediators and cytokines release, reducing inflammation, relaxing smooth muscle,improving the patient's ventilatory function and blood rheotogy.