非确定性人工气道湿化法降低脑卒中舌后坠患者肺部感染的效果研究

目的探讨脑卒中舌后坠患者非确定性人工气道(口咽通气道下)湿化的方法及临床应用效果。方法选择应用口咽通气道的脑卒中舌后坠呼吸困难患者60例,随机分为观察组和对照组各30例,观察组采取经口咽通气道内径孔道持续湿化法;对照组应用五官科喉头喷雾器间歇湿化法。观察两组患者痰液湿化效果、吸痰次数、痰痂的形成、气道黏膜损伤以及肺部感染情况。结果湿化第3、7天观察组痰液湿化效果满意率优于对照组、肺部感染率低于对照组,差异有统计学意义(P0.05);湿化第7天观察组痰痂的形成、气道黏膜的损伤低于对照组,差异有统计学意义(P0.05);湿化第3、7天观察组吸痰次数明显低于对照组,差异有明显统计学意义(P0.01)。结论脑卒中舌后坠患者采用非确定性人工气道持续湿化法,湿化效果满意,可减少吸痰次数、痰痂的形成以及气道黏膜的损伤,有效降低患者肺部感染的发生率。     

烧伤病房肠杆菌科细菌耐药性及其危险因素分析

Objective To study the risk factors of infection of extended-spectrum beta-lactamases (ESBL) -producing strains and drug resistance of Enterobacteriaceae that infected burn patients. Methods A retrospective study was performed on clinical information of 92 patients with Enterobacteriaceae infection in our burn unit from January 2001 to December 2008. The distribution and drug resistance of Enterobacteriaceae , and the detection rate, drug resistance of ESBL-producing strains, and its risk factors of nosocomial infection were analyzed. Data were processed with Chi-square test. Results One hundred and nine strains of Enterobacteriaceae were isolated, with 38 (34.9%) strains of Enterobacter cloacae , 25 (22.9%) strains of Escherichia coli , 22 (20. 2%) strains of Klebsiella pneumoniae , 13 (11.9%) strains of Proteus mirabilis , and 11 (10. 1%) other strains of Enterobacteriaceae . Enterobacteriaceae were moderately or highly resistant to antibiotics except imipenem, resistance rate of which was less than 8. 0%. ESBL-producing strains accounted for 44. 0% in Escherichia coli , and 77. 3% in Klebsiella pneumoniae . Drug-resistance rate of ESBL-producing strains to antibiotics was obviously higher than that of non ESBL-producing strains. Length of hospital stay longer than 20 days, and use of the third-generation cephalosporin longer than 5 days, quinolone antibiotics longer than 7 days, and topical antibiotics longer than 5 days were the risk factors of nosocomial infection caused by ESBL-producing strains, comparing with non ESBL-producing strains, the difference was statistically significant (with χ2 value respectively 5.491 , 4.441, 15. 186, 4. 938 , P values all below 0. 05) . Conclusions Enterobacteriaceae strains in burn unit of our hospital are highly drug resistant, with high lactamase-producing rates, calling for intense monitor to control the risk factors that predispose the infection of ESBL-producing strains in order to lower the infection rate.     

醒脑静注射液联合黛力新治疗慢性主观性头晕的临床研究

目的:研究醒脑静注射液联合抗焦虑药物黛力新治疗慢性主观性头晕(chronic subjective dizziness,CSD)的疗效.方法:将81例CSD患者随机分为2组,联合组:醒脑静联合黛力新治疗41例;对照组:黛力新治疗组40例.联合组给予醒脑静注射液20 ml 静脉输液,每日一次;黛力新片, 一片口服,一天两次;对照组:黛力新片, 一片口服,一天两次;共14天.于治疗第3、7,14天评定2组疗效,采用眩晕残障程度评定量表(DHI)、和汉密尔顿抑郁量表、焦虑量表,评价治疗前后的症状变化,并对比分析.结果:2组患者的眩晕残障程度评定量表评分得分均显著下降了(P<0.05),焦虑、抑郁量表得分也有不同程度下降(P<0.05),但联合组患者下降更加显著(P<0.05).结论:醒脑静联合黛力新治疗慢性主观性头晕疗效确切,起效快,可以更明显改善患者头晕情况、减轻焦虑,有协同治疗作用 .     

烧伤病房肠杆菌科细菌耐药性及其危险因素分析

目的 了解烧伤患者感染肠杆菌科细菌的耐药性及产超广谱β内酰胺酶(ESBL)菌感染的危险因素.方法 对2001年1月-2008年12月笔者医院烧伤病房细菌培养结果为肠杆菌科细菌的92例患者进行回顾性分析.分析其病原菌分布情况、耐药情况、产ESBL菌株检出率和耐药性,以及产ESBL菌引发医院感染的因素.数据行χ2检验.结果 共分离109株肠杆菌科细菌,其中阴沟肠杆菌38株占34.9%,大肠埃希菌25株占22.9%,肺炎克雷伯菌22株占20.2%,奇异变形杆菌13株占11.9%,其他肠杆菌科细菌11株占10.1%.常见肠杆菌科细菌除对亚胺培南的耐药率低于8.0%外,对其余抗菌药物均为中高度耐药.大肠埃希菌和肺炎克雷伯菌的ESBL检出率分别为44.0%、77.3%.产ESBL菌株对大多数抗菌药物的耐药率高于未产ESBL菌.单因素分析可见,患者住院时间大于20 d、第三代头孢菌素使用时间大于5 d、喹诺酮类药物使用时间大于7 d、外用抗菌药物使用时间大于5 d是产ESBL菌引发医院感染的危险因素,与未产ESBL菌比较,差异有统计学意义(χ2值分别为5.491、4.441、15.186、4.938,P值均小于0.05).结论 笔者单位烧伤病房肠杆菌科细菌耐药情况严重,产酶率高,应加强监测,控制引起产ESBL菌感染的危险因素,减少其感染发生率.     

烧伤病区葡萄球菌耐药性与抗菌药物相关性调查

感染是引起烧伤患者死亡的主要原因之一,而葡萄球菌是烧伤患者感染最常见的细菌[1].为此,我们对本院2001年1月-2008年12月收治住院的烧伤患者葡萄球菌耐药性,以及不同种类抗菌药物限定日剂量(DDD)的变化情况与葡萄球菌耐药率之间的关系进行了相关性调查.     

70例重症胸外伤治疗的临床分析

目的探讨重症胸部外伤的临床特点及救治方法。方法 2010年2月至2012年6月,本院收治重症胸外伤患者70例,对70例患者的病例资料进行分析总结。治疗方法采用胸腔闭式引流、胸部护板固定、剖胸探查、肋骨骨折复位、损伤脏器修补、胸腔穿刺等,同时加以呼吸机辅助。结果本组重症胸外伤70例,治愈63例,治愈率90%,死亡7例,病死率10%。死于呼吸窘迫综合征2例,心功能衰竭1例,失血性休克3例,多器官功能衰竭死亡1例。结论早期诊断、早期治疗、正确手术时机、及时处理并发症是治疗重症胸外伤成功的关键。     

集束化护理干预对预防妇科手术患者深静脉血栓形成的效果

目的 探讨集束化护理干预在妇科手术后预防下肢深静脉血栓形成的效果。方法 选择 2021 年 7 月至 2022 年 6 月妇科癌 症手术患者共 94 例为研究对象。以随机数字表法将患者分为对照组和观察组,每组各 47 例。对照组进行常规手术护理,观察 组实施集束化护理。比较两组的凝血指标、下肢状况和患者满意度。结果 与对照组比较,观察组与对照组相比,凝血酶原时 间、凝血酶时间、活化部分凝血活酶时间均明显延长,观察组纤维蛋白水平、D-二聚体显著下降（P<0.05）。观察组股静脉、 腘静脉和胫后静脉血流速度均高于对照组（P<0.05）。观察组下肢肿胀、疼痛、静脉血栓程度均低于对照组,护理满意度高于 对照组（P<0.05）。结论 对妇科癌症手术病人实施集束化护理,能够促进患者下肢血液循环,减轻下肢肿胀,改善凝血状况, 预防深静脉血栓。     

应用心理护理对急诊骨外伤患者的治疗结果影响分析

目的 本文旨在探索对急诊骨外伤患者采用临床心理护理进行治疗效果的影响.方法 本文随机选取自2009年7月~2011年7月这一时期来本院就诊的100例成年的骨外伤患者,研究组采用临床心理护理,对照组进行日常护理,最后分析比较两组患者在心理状态、护理满意程度、患者平均住院天数、健康知识评分、住院费用等方面指标.结果 本研究结果显示研究组患者在焦虑、抑郁得分都比对照组低,且两组间的差异具有统计学差异(P<0.05),但是患者对护理程度的满意度以及健康知识评分都比对照组高,而患者手术后并发症的发生率,患者平均住院天数以及住院费用都低于对照组,差异具有显著性(P<0.05).结论 研究结果显示加强急诊骨外伤患者的临床心理护理,能使患者更有效的克服心理障碍减少焦虑,并能让患者积极的配合医生进行治疗,从而树立患者康复的信心,从而有利于提高急诊骨外伤患者的治疗效果.     

烧伤病房肠杆菌科细菌耐药性及其危险因素分析

Objective To study the risk factors of infection of extended-spectrum beta-lactamases (ESBL) -producing strains and drug resistance of Enterobacteriaceae that infected burn patients. Methods A retrospective study was performed on clinical information of 92 patients with Enterobacteriaceae infection in our burn unit from January 2001 to December 2008. The distribution and drug resistance of Enterobacteriaceae , and the detection rate, drug resistance of ESBL-producing strains, and its risk factors of nosocomial infection were analyzed. Data were processed with Chi-square test. Results One hundred and nine strains of Enterobacteriaceae were isolated, with 38 (34.9%) strains of Enterobacter cloacae , 25 (22.9%) strains of Escherichia coli , 22 (20. 2%) strains of Klebsiella pneumoniae , 13 (11.9%) strains of Proteus mirabilis , and 11 (10. 1%) other strains of Enterobacteriaceae . Enterobacteriaceae were moderately or highly resistant to antibiotics except imipenem, resistance rate of which was less than 8. 0%. ESBL-producing strains accounted for 44. 0% in Escherichia coli , and 77. 3% in Klebsiella pneumoniae . Drug-resistance rate of ESBL-producing strains to antibiotics was obviously higher than that of non ESBL-producing strains. Length of hospital stay longer than 20 days, and use of the third-generation cephalosporin longer than 5 days, quinolone antibiotics longer than 7 days, and topical antibiotics longer than 5 days were the risk factors of nosocomial infection caused by ESBL-producing strains, comparing with non ESBL-producing strains, the difference was statistically significant (with χ2 value respectively 5.491 , 4.441, 15. 186, 4. 938 , P values all below 0. 05) . Conclusions Enterobacteriaceae strains in burn unit of our hospital are highly drug resistant, with high lactamase-producing rates, calling for intense monitor to control the risk factors that predispose the infection of ESBL-producing strains in order to lower the infection rate.     

儿童重症肺炎支原体肺炎的临床特征及相关危险因素分析

目的探讨儿童重症肺炎支原体肺炎(SMPP)的临床特征及其危险因素, 为临床早期识别SMPP提供指导依据。方法回顾性分析2019年1月至2021年12月在安徽省儿童医院呼吸科住院的263例肺炎支原体肺炎患儿的临床资料, 根据病情严重程度将其分为重症组(88例)和轻症组(175例), 比较两组患儿一般情况、临床表现、实验室检查、影像学特征和支气管镜下表现的差异, 进行统计学分析。结果两组患儿的性别、发病季节差异无统计学意义(P>0.05)。重症组年龄大于轻症组(P<0.05), 按照年龄分组, 其中婴幼儿组SMPP发生率(14.10%)低于学龄前组(45.00%)及学龄组(37.65%)(P<0.05), 而学龄前组与学龄组比较, 差异无统计学意义(P>0.05)。重症组发热程度、肺外并发症的比例高于轻症组, 热程、住院时间、大环内酯类药物使用时间长于轻症组(P均<0.05)。两组患儿白细胞计数/淋巴细胞计数、C-反应蛋白(CRP)、前白蛋白、谷丙转氨酶、乳酸脱氢酶(LDH)、免疫球蛋白G、免疫球蛋白A、降钙素原、红细胞沉降率(ESR)、D-二聚体、肺泡灌洗液...