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目的:探讨感染性心内膜炎(IE)的病因,致病微生物的变迁及抗生素的选择。方法:对1995年5月~2003年8月间住院的30例IE患者的临床资料进行回顾性分析。结果:风湿性心脏瓣膜病为其主要的基础心脏病变。链球菌在致病微生物中依然居首位,但凝固酶阴性葡萄球菌(CNS)等其它菌种逐渐增多,且对青霉素耐药发生率高,为临床诊治造成困难。结论:对于IE患者应尽可能早期明确诊断,早期选用有效的抗生素。CNS在IE的致病微生物中的地位有待进一步提高。 相似文献
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目的 探讨延续性护理在心脏瓣膜置换术患者中的应用效果.方法 选取2017年1月—2019年1月在四川省德阳市人民医院接受心脏瓣膜置换术治疗的80例瓣膜性心脏病患者作为研究对象,随机分为观察组和对照组各40例.出院后对照组不进行主动护理,观察组采用延续性护理,对两组患者干预前后服药依从性、生活质量及心功能进行比较分析.结果 出院时两组服药依从性、生活质量及心功能比较差异无统计学意义(P>0.05),出院后6个月观察组服药依从性、生活质量及心功能均优于对照组,差异有统计学意义(P<0.05).结论 延续性护理应用于心脏瓣膜置换术出院患者中可提高患者服药依从性,提升患者生活质量及心功能恢复,值得临床借鉴推广. 相似文献
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目的研究血液凝固性在全髋关节置换术前、后的改变以及术后服用利伐沙班对其影响。方法随机选择2011年在我科行全髋关节置换术的患者66例。所有患者术后第1天开始口服利伐沙班,并分别于术前、术后第1天、术后第4天行血栓弹力图(thromboelastography,TEG)检查。比较各阶段TEG重要指标的差异。结果全髋关节置换术后TEG各指标中凝血反应时间(r)、血细胞凝集块形成时间(k)、凝血时间(r+k)值短于术前,血细胞凝集块形成速率(α)、最大振幅(ma)、凝血指数(CI)值高于术前,差异有统计学意义;术后服用利伐沙班后TEG各指标中r、r+k时间长于服药前,差异有统计学意义;k、α、ma、CI无显著变化,差异无统计学意义。结论全髋关节置换术可明显增加患者的血液凝固性,而增加血栓风险;术后短期口服利伐沙班可降低血液凝固性。 相似文献
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ObjectiveTo ascertain antimicrobial susceptibility profile of Proteus mirabilis (P. mirabilis) from clinical urine specimens at a university hospital in the spate of its recorded increasing resistance patterns.MethodsThe study was retrospective in nature. Data generated from urine cultures of patients at University of Calabar Teaching Hospital for a period of five years (2004–2009) were compiled. Relevant information obtained were age and gender of patients, organisms recovered and their antibiotic susceptibility patterns. P. mirabilis was identified using standard laboratory procedures.ResultsP. mirabilis showed the highest resistance against ampicillin, cloxacillin, amoxicillin, tetracycline, co-trimoxazole, erythromycin and chloramphenicol (100%–37.2%) while colistin, ofloxacin, ciprofloxacin, ceftriaxone, nalidixic acid and nitrofurantoin recorded the highest activity (59.1%–96.9%) with no drug recording 100% activity. The resistance of the nosocomial isolates of the organism were significantly higher than the community acquired isolates against that of the common antibiotics in use (P<0.05).ConclusionsExtreme caution should be exercised in antibiotic administration in hospital setting and the potential benefits adequately assessed while control of nosocomial infections be given a priority so as to limit the spread of resistant bacteria. 相似文献
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A Körber EN Schmid J Buer J Klode D Schadendorf J Dissemond 《Journal of the European Academy of Dermatology and Venereology》2010,24(9):1017-1025
Background In nearly every chronic wound different bacteria species can be detected. Nevertheless, the presence of such microorganisms is not necessarily obligatory associated with a delayed wound healing. But from this initially unproblematic colonization an infection up to a sepsis can arise in some patients. The aim of our clinical investigation was to analyse the spectrum of microbial colonization of patients with a chronic leg ulcer in our specialized dermatological outpatient wound clinic, and to compare them with the results of comparable data already collected 5 years ago. Objectives In our retrospective investigation the results of bacteriological swabs were documented in 100 patients with a total of 107 chronic leg ulcers. All patients visited the specialized wound outpatient clinic, Department of Dermatology, University of Essen in Germany. Methods A total of 60 patients were female, 40 were male. The mean age was 65 years. Altogether a total of 191 bacterial isolates and 25 different bacterial species could be identified. Results The most often detected species were Staphylococcus aureus (n = 60), Pseudomonas aeruginosa (n = 36) as well as Proteus mirabilis (n = 17). In 10 patients (10%) we identified a colonization with methicillin resistant S. aureus (MRSA). Merely in 6 patients the taken swabs were sterile. Five years ago a comparable investigation was already carried out in our wound outpatient clinic. At that time we could detect in particular more frequent MRSA (21.5% vs. 10%) and rarely P. aeruginosa (24.1% vs. 33.6%). Conclusion The results of our investigation demonstrate the current spectrum of the bacterial colonization in patients with chronic leg ulcers in a university dermatological wound centre in comparison to the last 5 years. In our institution we were able to demonstrate a shift of the detected bacterial species from gram‐positive in direction to gram‐negative germs. Beside the already known problems with MRSA, in future therapeutic strategies in patients with chronic leg ulcers the increasing amount of gram‐negative bacteria and especially of P. aeruginosa should considered. 相似文献
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The evaluation of flap growth and long‐term results of pediatric mandible reconstructions using free fibular flaps
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Gökhan Temiz M.D. Ufuk Bilkay M.D. Yiğit Özer Tiftikçioğlu M.D. Candan Tevfik Mezili M.D. Ecmel Songür M.D. 《Microsurgery》2015,35(4):253-261
Currently, the free fibular flap is well accepted as the first choice for mandibular reconstruction. Achieving functional results in pediatric patients requires a different approach than that employed for mature patients. Because the pediatric craniofacial skeleton continues to grow, reconstruction is more challenging, and the long‐term results can be different from those of adult patients. In this study, we sought to measure flap growth objectively in our series. Ten pediatric patients who underwent reconstruction with free fibular flaps were retrospectively reviewed. Flap growth was evaluated by comparing the intraoperative photographs with photographs of the control panoramic mandibular radiographs taken using photo‐anthropometric techniques. The measurements were converted to proportionality indices (PI), and these indices were compared. Subsequent complications and functional results were also evaluated. The mean patient age was 11.8 years, and the mean follow up was 57.7 months. The mean preoperative PI value was 10.74 ± 2.47. The mean postoperative PI value was 12.52 ± 2.34. The mean difference between the preoperative and postoperative PI values was ?1.78±0.53. These photo‐anthropometric data clearly illustrated the growth of the fibular flaps (P = 0.001). None of these patients exhibited nonunion of the fractures; however, one patient experienced a delayed union, one had chronic temporomandibular joint pain, and one had chronic temporomandibular joint luxation. In two patients, the inter‐incisive measurements were below the third percentile, and two additional patients had grade 2 eating abilities, which can be regarded as poor. All of the patients had symmetric mandibular contours. Free fibular flaps continue to grow in pediatric patients. This flap is a “workhorse” flap in children because it adapts to the craniofacial skeleton via its ability to grow, and this ability results in subsequent good cosmetic and functional results. © 2014 Wiley Periodicals, Inc. Microsurgery 35:253–261, 2015. 相似文献
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目的 对比分析单纯后路内固定+一期经腰椎间孔病椎间病灶清除(TLIF)与经典的前后联合手术在布氏杆菌性脊柱炎患者中的临床疗效及安全性。 方法 对我院2015年1月至2017年12月收治的93例布病性脊柱炎患者的临床资料进行分析。按手术方式分为观察组(45例)和对照组(48例)。对两组患者的基础数据、临床指标、术前术后各项指标水平以及术后并发症、植骨治愈情况。 结果 观察组与对照组基础数据比较,差异无统计学意义(P>0.05)。观察组患者的手术时间、住院天数、术中出血量及术后下床时间均明显低于对照组(P<0.01)。两组患者术后3个月的ODI、VAS、CRP、ESR及Cobb角均明显低于术前(P<0.05);术后3个月,观察组患者的ODI、VAS、CRP、ESR及Cobb角均明显低于对照组(P<0.05)。观察组术后并发症发生率(4.4%)明显低于对照组(25.0%)(Χ2=7.674,P<0.01)。 结论 TLIF治疗布氏杆菌性脊柱炎患者的临床疗效突出,安全性较好,更有利于患者术后身体的恢复。 相似文献