无痛性心肌梗死的早期观察与护理

急性心肌梗死发病时常常可以出现压榨性胸闷，胸背痛或呼吸困难等。但由于各种原因上述症状可以部分或全缺，或者表现为心脏以外的症状或完全没有症状，只有靠典型的心肌酶检查及心电图改变才能作出诊断。这种无痛性心肌梗死的临床表现有别于其他类型的心肌梗死。因此早期观察和护理的重点也有所区别。     

睑板腺压榨法治疗睑板腺功能障碍的疗效分析

目的探讨改良睑板腺压榨法治疗睑板腺功能障碍的疗效。方法选取2016年1月至2017年1月四川大学华西医院接诊的240例睑板腺功能障碍患者为研究对象,按照随机号码表法将其分为改良组和传统组,改良组患者采取改良睑板腺压榨法治疗,传统组患者采取传统睑板腺压榨法治疗,比较两组患者疾病相关参数、总体治疗效果、眼结膜上皮损伤程度和眼表疾病指数(ocular surface disease index,OSDI)。结果治疗后,改良组患者泪膜破裂时间(break-up time of tearfilm,BUT)与基础泪液分泌试验(Schirmer I test,SIT)结果均显著高于传统组(均P <0.01),荧光素钠染色(fluorescein staining,FLS)、睑脂性状、睑脂排出难易程度、睑板腺评分和OSDI总分均显著低于传统组(均P <0.01),眼结膜上皮损伤程度显著轻于传统组(P <0.01)。结论相比于传统睑板腺压榨法,改良睑板腺压榨法治疗睑板腺功能障碍的并发症更少,对眼结膜上皮损伤更小,具有借鉴意义。     

谨防甲亢“伤”了心

32岁的陈先生是外企白领,工作繁忙。这天,他刚加完班,突感胸前心脏部位压榨性疼痛,而且面色苍白,伴有心慌,大汗淋漓。同事们见状,赶紧叫救护车把陈先生送到医院。急诊科的医生对陈先生的身体做了全面诊查,发现他的心肌缺血严重,这种情况在医学上叫＂不稳定型心绞痛＂,好发于有冠心病史的中老年人。     

严谨的药物选择是冠心病心绞痛治疗的基石

参照世界卫生组织“缺血性心脏病的命名及诊断标准”,心绞痛分为:劳累性心绞痛、自发性心绞痛和混合性心绞痛三类。心绞痛是冠状动脉供血不足,心肌急剧的、暂时缺血与缺氧所引起的以发作性胸痛或胸部不适为主要表现的临床综合征。其特点为前胸阵发性、压榨性疼痛,可伴有其他症状,疼痛主要位于胸骨后部,可放射至心前区与左上肢。心绞痛常在劳累或情绪激动时发生,每次发作持续3~5分钟,可数日一次,     

磁吻合技术实现下腔静脉吻合组织与电镜观察

目的 通过磁性压榨式吻合技术(MCA)实现腹腔大血管无缝线吻合的组织学与电镜观察,比较新型血管吻合器较传统手工缝合方法的优点.方法 杂种犬16条,随机分为MCA组与手工缝合组,统计两组下腔静脉(IVC)吻合时间,观察吻合即刻、吻合后4、12、24周两组犬IVC吻合口愈合情况;血管吻合口苏木素-伊红染色(HE)与Masson三色染色用于组织学分析;扫描电镜观察吻合口内皮细胞连续性和生长情况.结果 MCA组IVC吻合时间较手工缝合组明显缩短[(3.25±1.21) min比(13.23±2.34) min,P＜0.01].电镜观察:MCA组吻合口内膜光滑,内皮细胞排列整齐,形态规则,但手工缝合组吻合口因缝线牵拉导致管腔内凹凸不平,内膜不完整,吻合口内皮细胞排列紊乱,形态不规则;组织学检查:MCA组吻合口血管壁对位整齐,血管内膜覆盖吻合口,术后12周吻合口呈慢性炎性反应,少量淋巴细胞浸润,24周无明显炎性反应,但手工缝合血管吻合口有明显缝线异物残留与瘢痕形成.结论 MCA组较手工缝合组手术耗时少,血管壁各层衔接较好,内皮细胞层光滑,无明显增生,血管腔无异物残留,吻合口炎性反应轻微.MCA血管吻合技术实现IVC无缝线吻合效果可靠.     

一夜风流引起心脏病

面对梅毒性心脏病的诊断,周总感到疑惑不解,自己最近没有干过那种寻花问柳的事,怎么会染上梅毒?虽然20多岁出差住旅店时曾有过一次“艳遇”……     

川芎嗪对慢性压迫性损伤大鼠神经病理痛行为学的影响

目的探讨川芎嗪对慢性压迫性损伤（CCI）大鼠行为学的影响。方法建立大鼠坐骨神经CCI神经病理痛模型,取40只雄性大鼠随机分成4组,Ⅰ组为空白对照组,Ⅱ组为假手术组,Ⅲ组为CCI＋川芎嗪治疗组,Ⅲ组在术后第1天开始腹腔注射100 mg/kg川芎嗪注射液,Ⅳ组为CCI手术组。分别于术前（0 d）及术后1、3、5、7、91、1、14 d以von Frey细丝法和热辐射法测定机械缩足反射阈值（mechanical withdrawal threshold,MWT）和热缩足反射潜伏期（thermal withdrawal latency,TWL）,观察CCI大鼠神经病理痛的行为学变化。结果术后14 d,Ⅳ组和I、Ⅱ、Ⅲ组相比较,大鼠后爪的机械和热痛敏阈值明显降低（P〈0.01）;I、Ⅱ、Ⅲ组之间相比,大鼠后爪的机械和热痛敏阈值差异没有显著性（P〉0.05）。结论川芎嗪可以缓解CCI大鼠的慢性神经病理痛行为学表现。     

心肌梗死16例误诊分析

急性心肌梗死(AMI)为临床常见病,其病情凶险、病死率高,及时、正确的诊断与治疗对降低病死率,改善预后至关重要。典型心肌梗死表现为胸骨后压榨或紧缩性疼痛,结合心电     

鞘内注射JNK特异性抑制剂SP600125对CCI大鼠痛行为的影响

Objective To observe the effect of intrathecal administration of SP600125 on both MWT and TWL of rats after chronic constriction injury (CCI) of the sciatic nerve. Methods 40 male SD rats were randomized to deride into 5 groups (n=8). Rats in group SP5 received SP600125 5 μg after CCI; rats in group SP25 received SP600125 25 μg after CCI; rats in group SP50 received SP600125 50 μg after CCI; rats in group DMSO received 2% DMSO 10 μl after CCI; rats in group Naive received SP600125 50 μg without sciatic nerve injury. SP600125 was dissolved in 10 μl 2%DMSO solvent. On the 7th day after CCI, MWT and TWL were determined with yon Frey filaments and thermal radiation apparatus repectively after intrathecal administration of SP600125. Results Intrathecal administration certain dosage of SP600125 could attenuate the established mechanical allodynia and thermal hyperalgesia induced by CCI rather than normal rats. Conclusion Intrathecal administration certain dosage of SP600125 could attenuate the established mechanical allodynia and thermal hyperalgesia induced by CCI.     

鞘内注射JNK特异性抑制剂SP600125对CCI大鼠痛行为的影响

Objective To observe the effect of intrathecal administration of SP600125 on both MWT and TWL of rats after chronic constriction injury (CCI) of the sciatic nerve. Methods 40 male SD rats were randomized to deride into 5 groups (n=8). Rats in group SP5 received SP600125 5 μg after CCI; rats in group SP25 received SP600125 25 μg after CCI; rats in group SP50 received SP600125 50 μg after CCI; rats in group DMSO received 2% DMSO 10 μl after CCI; rats in group Naive received SP600125 50 μg without sciatic nerve injury. SP600125 was dissolved in 10 μl 2%DMSO solvent. On the 7th day after CCI, MWT and TWL were determined with yon Frey filaments and thermal radiation apparatus repectively after intrathecal administration of SP600125. Results Intrathecal administration certain dosage of SP600125 could attenuate the established mechanical allodynia and thermal hyperalgesia induced by CCI rather than normal rats. Conclusion Intrathecal administration certain dosage of SP600125 could attenuate the established mechanical allodynia and thermal hyperalgesia induced by CCI.