慢性泪囊炎患者应用鼻内镜下鼻腔泪囊造口术的临床效果及对安全性的影响

目的探讨慢性泪囊炎患者应用鼻内镜下鼻腔泪囊造口术的临床效果及安全性。方法选取2018年1月至2019年12月因慢性泪囊炎于本院接受治疗的46例患者为研究对象,随机分为研究组与对照组,各23例。对照组接受泪囊鼻腔造口治疗,研究组取鼻内镜下鼻腔泪囊造口术治疗,比较两组临床效果、手术指标以及并发症发生情况。结果研究组治疗总有效率高于对照组(P<0.05);研究组术中出血量少于对照组,手术及住院时间均短于对照组(P<0.05);研究组并发症总发生率低于对照组(P<0.05)。结论慢性泪囊炎患者采用鼻内镜下鼻腔泪囊造口术治疗效果显著,并发症较少,安全性较高,值得临床推广应用。     

心脏瓣膜置换术后患者的出院准备度现状及其影响因素分析

目的:调查心脏瓣膜置换术后患者的出院准备度现状,并分析其影响因素。方法:于2018年9月至2019年3月用一般资料、出院准备度量表、出院指导质量量表对139例瓣膜置换术后患者进行调查。结果:心脏瓣膜置换术后患者的出院准备度总分为(89.51±8.53)分,与出院指导质量呈正相关;多元回归分析显示,主要照顾者、婚姻状况、工作状态、服药种类、出院指导质量为出院准备度影响因素。结论:心脏瓣膜置换术后患者的出院准备度有待提高,患者感知的个人状态得分不理想;护士应鼓励患者配合进行早期康复,强化出院指导,采取有效措施提供康复信息,满足患者及其家属需求,提高出院准备度。     

Cleaning,Shaping, and Disinfecting Abilities of 2 Instrument Systems as Evaluated by a Correlative Micro–computed Tomographic and Histobacteriologic Approach

IntroductionThis study assessed the cleaning, shaping, and disinfection abilities of 2 instrumentation systems in molar root canals using a novel correlative analytical approach.MethodsThe root canals from extracted mandibular and maxillary molars with apical periodontitis were pair matched according to anatomic similarities as determined by micro–computed tomographic analysis and prepared with either XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland) (n = 16) or Reciproc Blue (VDW, Munich, Germany) (n = 16) instruments and 2.5% sodium hypochlorite irrigation. Pre- and postpreparation micro–computed tomographic scans were used to identify and calculate the unprepared surface areas (shaping), which were histobacteriologically evaluated for the presence of residual bacteria (disinfection) and pulp tissue remnants (cleaning) in each canal third.ResultsUnprepared canal surface areas for XP-endo Shaper and Reciproc Blue in the full canal length were approximately 26% and 19% (P < .05), respectively (30% and 23% in the apical part of the canal, P > .05). Preparation with Reciproc Blue resulted in 37.5% canals free of bacteria in all sections examined and 56% in the apical sections only. XP-endo Shaper resulted in 44% canals free of bacteria in all sections, and 56% in the apical part of the canal only. Pulp tissue remnants were not observed in 31% (all canal sections) and 50% (apical canal sections) of specimens from both instrument systems. No significant differences were observed between instruments when comparing the amount of pulp tissue remnants and the number of cases negative for bacteria and tissue remnants (P > .05).ConclusionsAlthough the Reciproc Blue instrument had superior shaping ability in comparison with XP-endo Shaper, both systems performed similarly in cleaning and disinfecting root canals. Irregular canals and difficult-to-reach areas were not thoroughly cleaned and disinfected by any of the tested systems.     

经鼻导管高流量吸氧与经鼻气道正压通气在重症毛细支气管炎呼吸支持中的应用价值比较

目的：比较经鼻导管高流量吸氧（HFNC）与经鼻气道正压通气（nCPAP）在重症毛细支气管炎呼吸支持中的应用价值，为临床治疗方案的选择提供参考。方法：选取2016年12月至2018年12月我院儿科收治的重症毛细支气管炎患儿90例，采用随机数字表法分为观察组和对照组各45例。两组患儿入院后均给予常规综合治疗以保证呼吸道通畅，在此基础上观察组采用HFNC治疗，对照组采用nCPAP治疗，比较两组患儿治疗前和治疗24 h后呼吸频率、经皮血氧饱和度（TcSO2）、呼吸窘迫评分体系（CSS）评分、动脉血氧分压（PaO2）等呼吸相关指标及治疗前后临床症状体征改善情况。结果：两组患儿治疗24 h后呼吸频率、CSS评分均降低，且观察组降低程度更大，TcSO2、PaO2于治疗24 h后升高，观察组升高幅度较对照组明显；治疗后两组患儿咳嗽及肺部湿啰音、肺部炎症情况均改善，观察组症状体征消失时间早于对照组，差异均有统计学意义（P<0.05）。结论：重症毛细支气管炎患儿采用HFNC治疗可明显改善通气功能和临床症状，治疗效果优于nCPAP治疗，可扩大样本量进一步观察。     

经鼻高流量氧气湿化治疗老年慢性阻塞性肺疾病急性加重合并呼吸衰竭的可行性研究

ObjectiveTo investigate the feasibility of transnasal heated humidified high flow nasal cannula oxygen therapy (HFNC) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure in elderly patients. MethodsA total of 176 elderly patients with AECOPD complicated with respiratory failure who were hospitalized at Peking University Shougang Hospital from December 2016 to January 2022 were enrolled, including 82 patients in an HFNC group and 94 patients in an NPPV group. After treatment, pulse oxygen saturation (SPO₂), arterial partial pressure of carbon dioxide (PaCO₂), oxygenation index (OI), respiratory rate (RR), heart rate (HR), mean arterial pressure (MAP), comfort score, discharge rate, rate of endotracheal intubation, rate of transfer to intensive care unit (ICU), and mortality were compared between the two groups. The independent sample t-test was used for comparison between the two groups. Statistical data are expressed in percentage or number of cases and the χ² test was used for their comparisons. ResultsThe SPO₂ values at 30 min, 1 h, and 6 h were significantly higher in the HFNC group than in the NPPV group (t=-2.049,-2.618, and -3.314, P=0.043, 0.010, and 0.001, respectively). SPO₂ before discharge was significantly lower than that of the NPPV group (t=2.162, P=0.033), but OI at each time point and before discharge had no statistical significance (P＞0.05). MAP at 6 h was significantly higher in the HFNC group than in the NPPV group (t=-2.209, P=0.029), but within the normal range. HRs at 2 h and 3 h in the HFNC group were significantly higher than those of the NPPV group (t=-2.199 and -2.336, P=0.030 and 0.021, respectively). There were no significant differences in RR, HR, or MAP between the two groups at other time points and before discharge (P＞0.05). There was no significant difference in PaCO2 between the two groups (P＞0.05). Comfort score in the HFNC group was significantly higher than that of the NPPV group (t=-46.807, P＜0.001). There were no significant differences in discharge rate, ICU transfer rate, endotracheal intubation rate, and mortality between the two groups (P＞0.05). ConclusionHFNC is as effective as NPPV in treating elderly patients with AECOPD complicated with type Ⅰ or mild type Ⅱ respiratory failure, and HFNC is more comfortable than NPPV.     

浅谈口腔医学硕士研究生科研作图能力的培养

科研作图是展示研究数据的主要形式,也是科研素养的重要体现。口腔医学硕士研究生是接触科学研究的第一站,然而目前的研究生教育环节对科研作图能力缺乏系统性培养,许多研究生在科研作图中存在许多不规范的问题,本文针对这一问题进行初步探讨。本文分析比较了常用作图工具Microsoft Excel、Origin和Graphpad Prism的特点;以学校口腔医学硕士的培养过程为参考,分析目前硕士研究生科研作图方面存在的主要问题及应对策略。发现不同作图软件具有不同的风格特点,当前硕士研究生作图存在风格不统一、拼图不规范、图注不规范等问题,应当根据自身需求合理选择作图工具,提升作图能力。科研作图是科研能力的重要方面,应当加强口腔医学硕士研究生作图能力的培养。