植入式输液港与外周静脉置入中心静脉导管在化疗患者中长期随访效果观察

目的 观察比较植入式输液港(IVAP)与外周静脉置入中心静脉导管(PICC)应用于化疗患者的中长期效果,为血管通路的科学选择提供依据。 方法 选择2014年4月至2015年4月安徽医科大学第一附属医院272例化疗患者为研究对象,根据中心静脉置管方式不同分为IVAP组115例,PICC组157例,置管方式由患者意愿决定。分别对IVAP组和PICC组患者进行跟踪随访,直到导管取出或此项研究结束(2017年4月30日)止,比较两组患者一次性操作成功率、导管相关性并发症、舒适度。 结果 在一次性操作成功率、导管相关症状性血栓、导管相关性感染、堵管、疼痛方面,两组比较差异无统计学意义(P>0.05);IVAP组湿疹、异位、总体并发症发生率(0.87%,0.00%,10.43%)均低于PICC组(12.10%,8.28%,33.76%),差异有统计学意义(P<0.05)。IVAP组舒适度得分(6.97±0.97)分高于PICC组(5.98±0.58)分,差异有统计学意义(P<0.05)。 结论 IVAP与PICC均为安全的中心静脉置管方式。在减少并发症和提高患者舒适度方面IVAP优于PICC,临床实际应用时要全面综合评估患者,合理制定置管方案,科学选择血管通路。     

绝经后宫腔积脓的诊断与治疗

目的探讨绝经后女性宫腔积脓的诊断及治疗方法。方法对2000年1月～2007年12月年收治的21例宫腔积脓,对其发病特点,诊治方法加以分析总结。结果21例宫腔积脓有3例误诊为卵巢囊肿,2例误诊为盆腔脓肿（子宫外）,开腹手术治疗9例,＂经阴道宫颈扩张引流＋宫腔冲洗术＂治疗l2例,21例均痊愈出院。结论绝经后宫腔积脓发病隐匿,易误诊;经阴道超声检查对该病的诊断有重要价值;治疗应个体化,加强卫生宣教,提高自身免疫力等措施可防止该病发生。     

加强基层团组织建设促进青年的全面发展

秦皇岛市第一医院团委多年来在邓小平理论和“三个代表”重要思想的指导下，在院党委的领导和帮助下，积极有效的开展各项团员青年工作。取得了一定成绩。连续10年被共青团秦皇岛市委评为“五四”红旗团委，2003年又被共青团河北省委评为“五四”红旗团委和抗击非典优秀团委。     

敏感性分析在口腔医院临床科室运营管理中的应用

近年来,随着医改的深入,国家对医院运营管理提出了更高的要求,医院管理模式亟需向精细化管理转变。研究以2019年某口腔医院门诊科室为例,选取门诊人次、次均费用、变动成本、固定成本几个关键经济指标,测算各项指标变化对收益的影响程度,从而得出各经济指标的敏感系数。敏感性分析有助于口腔医院合理配置医疗资源,提升运营管理水平。在实际运用中,要考虑敏感性分析的局限性,充分分析医院自身所处政策、环境背景,为医院高质量发展奠定基础。     

无痛分娩150例临床分析

随着围生医学的发展和人们生活水平的提高，孕妇对分娩提出了更高的要求，分娩期间在保证母婴安全的同时，要求无痛苦。因此，减轻或消除分娩疼痛是产科临床亟待解决的重要课题。我院自2006年以来开展无痛分娩，取得了良好的效果，现报告如下。     

延期妊娠并发羊水过少对母婴的影响

羊水过少是产科常见并发症之一，随着围产医学的发展，延期妊娠并发羊水过少对母婴的不良影响日益受到重视，羊水过少容易发生胎儿窘迫与新生儿窒息，增加围生儿病死率。本文对26例延期妊娠并发羊水过少孕妇进行分析，探讨延期妊娠羊水过少正确的处理方法，降低围生儿病死率。现报道如下。     

无痛分娩150例临床分析

随着围产医学的发展和人们生活水平的提高，孕妇对分娩提出了更高的要求，分娩期间在保证母儿安全的同时要求无痛苦。因此，减轻或消除分娩疼痛是产科临床亟待解决的重要课题。我院自2006年以来开展无痛分娩，取得了良好的效果，现报告如下：     

冠状动脉慢血流现象的冠状动脉血流成像分析

目的 应用冠状动脉血流成像(CFI)无创性评估冠状动脉慢血流现象患者的冠状动脉血流速度变化.方法 冠状动脉无明显狭窄且心肌梗死溶栓试验(TIMI)提示慢血流现象患者21例,冠状动脉造影无明显狭窄且TIMI血流正常者9例作为对照组.采用校正的TIMI血流计帧法(CTFC)评价冠状动脉血流速度.常规超声心动图测量左室舒张末期内径、收缩末期内径、左室射血分数、E峰、A峰、E/A值.CFI测量冠状动脉前降支远端舒张期峰值血流速度(Vmax)、舒张期平均流速(Vmean)和血流速度时间积分(VTI).结果 慢血流组前降支CTFC为(45.37±8.62)帧,对照组为(15.94±4.66)帧,二者差异有统计学意义(t=-9.596,P=0.000).慢血流组与对照组常规超声心动图测值差异均无统计学意义.慢血流组前降支Vmax为(22.86±3.04)cm/s,Vmean为(17.62±2.89)cm/s,VTI为(8.49±2.01)cm;对照组前降支Vmax为(31.78±9.28)cm/s,Vmean为(23.67±7.60)cm/s,VTI为(10.91±4.47)cm,两组差异均有统计学意义(P＜0.05).对照组及慢血流组前降支CTFC与Vmax和Vmean呈负相关,对照组前降支CTFC与VTI呈负相关,慢血流组前降支CTFC与VTI无相关性.结论 冠状动脉慢血流现象患者冠状动脉前降支远端血流速度减慢,CFI能够反映冠状动脉造影TIMI血流的变化,但诊断冠状动脉慢血流现象有局限.

Abstract：

Objective To non-invasive assess coronary blood flow velocity changes of patients with slow coronary flow phenomenon (SCFP) by coronary blood flow imaging (CFI).Methods Twenty-one patients who had no significant coronary artery stenosis but had thrombolysis in myocardial infarction (TIMI) slow-flow phenomenon were the experimental group,nine patients who has no significant coronary stenosis and TIMI flow normal were the control group.Using corrected TIMI frame count(CTFC) assess velocity of coronary artery.The left ventricular end diastolic diameter,end systolic diameter,ejection fraction,E peak velocity,A peak velocity,E/A ratio were measured by conventional echocardiography.The distal anterior descending coronary artery diastolic peak flow velocity(Vmax),mean velocity(Vmean) and blood flow velocity time integral(VTI) were measured by CFI.Results The corrected TIMI frame count (CTFC) of left anterior descending artery blood flow in slow blood group was (45.37 ± 8.62)frame,that in control group was (15.94± 4.66)frame,the difference was statistically significant (t = -9.596,P =0.000).The conventional echocardiographic measurements of two groups were not significantly different.The left anterior descending artery Vmax was (22.86 ± 3.04)cm/s,Vmean was (17.62 ± 2.89)cm/s,VTIwas (8.49± 2.01)cm in the slow blood flow group,the left anterior descending artery Vmax was (31.78 ± 9.28) cm/s,Vmean was (23.67 ± 7.60) cm/s,VTI was (10.91 ± 4.47) cm in the control group.The difference was statistically significant.The left anterior descending artery CTFC with Vmax and Vmean was negative correlation in the control group and the slow blood flow group.The left anterior descending artery CTFC was negatively correlated with VTI in the control group,there was no correlation between left anterior descending artery CTFC and VTI in the slow blood flow group.Conclusions Coronary artery flow velocity in the left anterior descending artery was declined.CFI can reflect changes in coronary TIMI flow,but in the diagnosis of coronary slow flow phenomenon CFI has limitations.     

0.9%氯化钠注射液联合抗生素羊膜腔灌注治疗羊水过少及护理体会

我科室针对胎膜早破的发生诱因,对未足月胎膜早破并羊水减少的孕妇,采取0.9%氯化钠注射液联合抗生素行羊膜腔灌注治疗羊水过少,现报告如下。     

冠状动脉慢血流现象的冠状动脉血流成像分析

Objective To non-invasive assess coronary blood flow velocity changes of patients with slow coronary flow phenomenon (SCFP) by coronary blood flow imaging (CFI).Methods Twenty-one patients who had no significant coronary artery stenosis but had thrombolysis in myocardial infarction (TIMI) slow-flow phenomenon were the experimental group,nine patients who has no significant coronary stenosis and TIMI flow normal were the control group.Using corrected TIMI frame count(CTFC) assess velocity of coronary artery.The left ventricular end diastolic diameter,end systolic diameter,ejection fraction,E peak velocity,A peak velocity,E/A ratio were measured by conventional echocardiography.The distal anterior descending coronary artery diastolic peak flow velocity(Vmax),mean velocity(Vmean) and blood flow velocity time integral(VTI) were measured by CFI.Results The corrected TIMI frame count (CTFC) of left anterior descending artery blood flow in slow blood group was (45.37 ± 8.62)frame,that in control group was (15.94± 4.66)frame,the difference was statistically significant (t = -9.596,P =0.000).The conventional echocardiographic measurements of two groups were not significantly different.The left anterior descending artery Vmax was (22.86 ± 3.04)cm/s,Vmean was (17.62 ± 2.89)cm/s,VTIwas (8.49± 2.01)cm in the slow blood flow group,the left anterior descending artery Vmax was (31.78 ± 9.28) cm/s,Vmean was (23.67 ± 7.60) cm/s,VTI was (10.91 ± 4.47) cm in the control group.The difference was statistically significant.The left anterior descending artery CTFC with Vmax and Vmean was negative correlation in the control group and the slow blood flow group.The left anterior descending artery CTFC was negatively correlated with VTI in the control group,there was no correlation between left anterior descending artery CTFC and VTI in the slow blood flow group.Conclusions Coronary artery flow velocity in the left anterior descending artery was declined.CFI can reflect changes in coronary TIMI flow,but in the diagnosis of coronary slow flow phenomenon CFI has limitations.