胸水抽取方法的改进

胸水抽取方法的改进周志远徐春雷冷瑞芝张守文１９９５～１９９６年，笔者对１０例大量胸腔积液患者共２３次采用改良的胸水抽取方法，同时配合静脉途径用药，治疗效果良好。现予报道。１临床资料１０例均为结核性胸膜炎大量胸腔积液，影响呼吸功能。男性７例，女性３例；...     

血肿腔穿刺加大剂量尿激酶注入治疗高血压脑出血35例

目的探讨高血压脑出血不同手术方式的疗效。方法对我科4年来用血肿腔穿刺加大剂量尿激酶注入治疗高血压脑出血病人的临床特点及疗效进行回顾性分析。结果35例患者均随访6个月,死亡7例,死亡率为20%,全愈16例,无1例再出血,生存质量明显改善。结论大剂量尿激酶使用安全可靠,大大提高手术疗效。     

肠易激综合症的临床治疗观察

目的 探讨培菲康联合舒丽启能治疗肠易激综合症的临床意义。方法 将肠易激综合征患者107例随即分成A，B两组，A组给予培菲康（420mg tid）及舒丽启能（200mg tid），B组仅给予舒丽启能（200mg tid），疗程4周，观察两组临床疗效。结果 A组缓解率为88．9％，B组为66．0％（P〈0．01）。结论 培菲康联合舒丽启能治疗肠易激综合症有明确的临床意义。     

血小板表达TLR4调节LPS刺激血小板释放细胞因子的作用

Objective To affirm the expression of Toll like receptor 4 (TLR4) on the surface membrane of platelet and to explore the immunomodulatory factors[(interlukine-8(IL-8),β-thromboglobulin(β-TG), soluble CD40 ligand(sCD40L)] released by platelets after platelets stimulated by TLR4 ligand.Methods TLR4 expressed on the platelet was detected by flow cytometry. Monoclonal anti-human FcγRⅡantibody(Ⅳ.3)-treated human platelets were cultured with LPS in the presence or absence of blocking monoclonal antibody to human TLR4. The release of IL-8, β-TG, sCD40L were measured by specific enzymelinked immunosorbent assay. Results Human platelets could express functional TLR4. The detection rate of TLR4 on platelets were decreased after LPS involvement(P<0.01). It was noted that sCD40L and β-TG were present in large concentration in the release of platelets stimulated by TLR4 ligand but the release of IL-8 was independent of platelet activation after TLR4 engagement. The concentration of sCD40L and β-TG had no statistical difference between 1-5 μg/ml LPS. The effects of LPS on the modulation of secretory factors were attenuated by preincubation of platelets with an anti-TLR4 monoclonal antibody. Conclusion The TLR4 on platelet could recognize and link LPS, induce the release of sCD40L, β-TG by platelet, but could not influence IL-8.     

颞肌下小骨窗治疗基底节区高血压脑出血

目的探讨基底节区高血压性脑出血颞肌下小骨窗减压的手术方法、操作技巧和临床效果,进一步总结该方法在临床上的微侵袭理念。方法回顾性总结分析了采用颞肌下小骨窗减压手术治疗35例基底节区高血压性脑出血病例。结果术后24 h内35例手术患者均复查头颅CT明确颅内基底节区血肿清除效果,其中28例颅内血肿清除率>90%,4例颅内血肿清除率<70%,3例颅内再出血,出血量不多,没有再次行手术治疗。术后存活34例,死亡1例,死亡原因为颅内再出血伴肺部感染。存活者随访6个月~1年不等,根据GOS五级划分,Ⅰ级:恢复良好,患者可正常生活22例;Ⅱ级:中度残废,有功能障碍,但可独立生活7例;Ⅲ级:重度残废,清醒,但生活不能自理3例;Ⅳ级:植物生存1例;Ⅴ级:死亡1例。结论颞肌下小骨窗减压手术治疗基底节区高血压性脑出血效果令人满意,具有操作简单、创伤小、止血彻底、血肿清除率高、再出血几率小、神经功能恢复好等优点。     

血小板表达TLR4调节LPS刺激血小板释放细胞因子的作用

Objective To affirm the expression of Toll like receptor 4 (TLR4) on the surface membrane of platelet and to explore the immunomodulatory factors[(interlukine-8(IL-8),β-thromboglobulin(β-TG), soluble CD40 ligand(sCD40L)] released by platelets after platelets stimulated by TLR4 ligand.Methods TLR4 expressed on the platelet was detected by flow cytometry. Monoclonal anti-human FcγRⅡantibody(Ⅳ.3)-treated human platelets were cultured with LPS in the presence or absence of blocking monoclonal antibody to human TLR4. The release of IL-8, β-TG, sCD40L were measured by specific enzymelinked immunosorbent assay. Results Human platelets could express functional TLR4. The detection rate of TLR4 on platelets were decreased after LPS involvement(P<0.01). It was noted that sCD40L and β-TG were present in large concentration in the release of platelets stimulated by TLR4 ligand but the release of IL-8 was independent of platelet activation after TLR4 engagement. The concentration of sCD40L and β-TG had no statistical difference between 1-5 μg/ml LPS. The effects of LPS on the modulation of secretory factors were attenuated by preincubation of platelets with an anti-TLR4 monoclonal antibody. Conclusion The TLR4 on platelet could recognize and link LPS, induce the release of sCD40L, β-TG by platelet, but could not influence IL-8.     

抽脓注药治疗肛管直肠周围脓肿20例

抽脓注药治疗肛管直肠周围脓肿２０例周志远徐春雷冷瑞芝张敬东王桂林张明早１９８６年３月以来，我科对中小型肛管直肠周围脓肿，采用局部抽脓后注入抗生素治疗２０例，临床疗效良好，兹作报道。１临床资料１．１一般资料男８例，女１２例；年龄８～７６岁，平均４０．６...     

妇产康复治疗仪治疗宫缩痛50例护理效果观察

目的:探讨通过产后康复仪治疗缓解产后宫缩痛的疗效。方法:随机抽取100例住院产妇,治疗组50例采用SRL800A型妇产康复治疗仪缓解宫缩痛,对照组50例住院产妇仅作常规处理,观察两组产后宫缩痛差异情况。结果:治疗组产后宫缩痛明显少于对照组(P<0.05)。结论:使用妇产康复治疗仪缓解产后宫缩痛不仅无创伤,疗效性确定,而且又不增加产妇的用药风险,是值得推荐治疗的措施。     

脂必泰对肝功能不全患者的调脂作用

在调脂治疗的各类药物中,他汀类药物因其强有力的降低低密度脂蛋白,同时具有抗氧化、抗炎、调节血管内皮功能、抑制血栓形成等重要的非降脂调节功能,成为临床上治疗高胆固醇血症及PCI术后血管内皮保护的首选药物.由于他汀类药主要作用部位在肝脏,多数他汀类药被肝脏细胞色素P450酶代谢,其肝毒性发生率为0.5％～2.0％,约1％患者的转氨酶会超出正常上限的3倍[1-2],他汀治疗与血清丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)水平升高之间存在相关性[3].因此,临床上对合并肝损害的高脂血症患者,我们更希望寻找一种既安全又有效的治疗手段.     

大骨瓣减压术治疗重型颅脑损伤(附45例报告)

目的 探讨大骨瓣开颅术治疗重型颅脑损伤的效果.方法 应用外伤大骨瓣开颅术治疗重型颅脑损伤患者45例.结果 本组患者恢复良好29例,中残8例,重残3例,植物生存2例,死亡3例.结论 运用大骨瓣开颅术治疗额颞部重型颅脑损伤,能彻底清除幕上颅内血肿和坏死脑组织,充分减压,提高抢救成活率,减低病死率和病残率,提高患者的生存质量...