上消化道出血急救护理

上消化道出血是急诊科常见的急症之一,急性大出血可危及生命,迅速正确有效的治疗是急救的关键。而恰当的护理又是抢救成功的重要环节,我院自2004年1月～2005年1月共收治54例上消化道出血患者,现将护理体会介绍如下。1 临床资料本组54例,其中男34例,女20例,年龄20～86岁。其中2例为胃癌出血,6例肝硬化胃底静脉曲张破裂出血,46例为消化性溃疡及急性胃黏膜病变引起的出血,出血量估计:大出血12例,中等量出血27例,小出血12例,休克3例。2 抢救及护理要点2.1 迅速止血,快速扩容:患者入院后均迅速建立静脉通道,必要时双管输液,快速补充血容量,静脉应用制酸药及     

卡托普利对自发性高血压大鼠血管平滑肌细胞增殖及癌基因和抑癌基因的影响

目的：观察卡托普利（CaP）对自发性高血压大鼠（SHR）血管平滑肌细胞（VSMC）增殖的作用及对原癌基因及抑癌基因的影响。方法：氚-胸腺嘧啶核苷（3H－TdR）参入，电镜，原位来交及Northernblot杂交。结果：CaP在降低SHR血压同时，能减少VSMC的线粒体，粗面内质网及3H－TdR参入量（P<0.01），并能逆转c－fos，c－myc，c－sis原癌基因mRNA表达增强（P<0.05或0.01），p53抑癌基因mRNA表达减弱（P＜0．01）。结论：Cap能抑制SHR的VSMC增殖，与癌基因调控的分子生物学机制有关。     

鼻腔真性纤维瘤1例

<正> 患者,女,53岁。因右鼻阻塞10余年来诊,于1990年2月18日住院。10年前始出现右侧鼻塞,流涕,有时鼻涕带血,未引起注意。鼻塞进行性加重,近2年右鼻腔完全阻塞,且可见肿物填塞。1年前在某医院以鼻息肉手术治疗,未能将肿物摘除。查体:全身无特异。右鼻侧隆起,右鼻腔见灰白色肿物充填,表面光滑,无分泌物,触之质韧、不易出血,根蒂看不清。右侧鼻后孔可见同样肿物,未突出鼻咽部。查血WBC4.8×10~9/L,N0.76,L0.24;E.S.R8mm/h。X线摄片示:右鼻腔有软组织阴影,鼻中隔被推向左侧,右上颌窦内壁有破坏,窦腔未见异常。颅底X线摄片未见异常。入院后取活检,诊为右鼻腔血管纤维瘤,于     

来比林退热疗效观察

作者于 2 0 0 0 - 0 5～ 0 9月对 6 0例患儿伴有发热的病例采用来比林退热进行临床观察 ,现将结果报告如下。1　材料与方法1.1　本文 30例患儿中 ,男性 19例 ,女性 11例 ,年龄最小为 7个月 ,最大为 13岁 ,平均年龄为 4 .2± 2 .6岁 ,急性发热患儿原发疾患中 ,以支气管肺炎最多     

门奇静脉完全断流术56例分析

我院自1980年2月至1987年2月间,行门奇静脉完全断流术治疗门脉高压症91例,其中合并上消化道出血者56例,经随访获得满意效果,报道如下。临床资料性别:男45例,女11例。年龄:最大76岁,最小10岁,平均43岁。出血量与次数:大量呕血者11例,中量出血者9例,小量出血36例。出血1次者39例,2次出血者16例,3次出血者1例。病史:有典型病史者49例,无任何病因者7例。脾大及亢进:除15例脾脏不大外,余例均有脾大     

爆炸冲击伤现场急救和后送过程中的护理

20世纪90年代以来的几次高科技条件下的局部战争表明．随着军事高科技的发展。作战形式的改变，战伤救治的环境、观念、策略以及模式都发生了巨大变化。对军事医学和护理学面临严峻的挑战。其中爆炸冲击伤的现场急救及后送显得尤为关键。台军在“汉光”演习而举办的装备展示中，有一件很少为外界所知的新武器，即所谓的台军“小原子弹”一燃料空气弹，也是改变阿富汗战局的秘密武器。燃料空气弹的出现是常规弹药的重大变革。     

放射线联合p53基因及内皮抑素治疗小鼠前列腺癌皮下移植瘤

Objective To test the hypothesis that p53 gene therapy combined with endostatin can enhance tumor response to radiation therapy of RM-1 mouse xenograft prostate cancer and to investigate its mechanism. Methods A mouse prostate cancer model was established. Then mice with xenograft tumor were randomly divided into group A (control), B (radiation), C (radiation and rAdp53), D (radiation and rh-endostatin) and E (radiation and rAdp53 and rh-endostatin). On day 1, rAdp53 was injected intra-tumorously with 1 × 1010 vp per animal to group C and E. From day 1 to 14, rh-endostatin was given 15 mg/kg intraperitoneally daily to group D and E. On day 4 single fraction of 15 Gy was given to tumors in groups B, C, D and E. Normal saline was injected intra-tumorously or intraperitoneaUy accordingly as control. No treatment was done to group A. Tumor volume was measured daily. Samples were collected on Days 5, 10 and 15. Ki67, CD31, p53 and VEGF were detected by means of immunohistochemistry. Results (1) Radiation alone, radiation combined with intra-tumorous injection of Adp53 and/or intraperitoneal injection of rh-endostatin resulted in tumor growth arrest of RM-1 cells in vivo (P = 0.000). Radiation combined with both rAdp53 and rh-endostatin was the most effective treatment (P < 0.05). (2) All the four treatment groups had a decreased expression of mutant type P53 (P = 0.000). The expression of Ki67 in groups B and C were equal (P 0.05) and increasing (P = 0.000), respectively. Group D had a up-down-up curve (P < 0.05), but group E had a up-down one. On day 5 the expresion of VEGF in group E was the lowest (P < 0.05). An increased expression of MVD compared with the control was shown, and MVD in groups C, D and E were always higher than that in the control (P < 0.05). Conclusions The limitation of radiotherapy could be overcome by combination with beth p53 gene therapy and endostatin on the growth of mouse prostate cancer cell. Radiation, rAdp53 and endostatin have their own role but they can be interacted with each other.     

血栓通治疗老年早期糖尿病肾病疗效观察

对老年早期糖尿病肾病患者,采用血栓通治疗,并与对照组比较.结果治疗组与对照组比较,血液流变学各项参数水平指标、尿白蛋白排泄率及肾功能指标均有显著性差异(P＜0.05).结论血栓通是治疗老年早期糖尿病肾病较好药物.     

益心汤治疗慢性心力衰竭临床观察

心力衰竭(chronic heart failure,CHF)是心脏病的终末阶段,死亡率及致残率均较高,是严重危害人类健康的疾病,单纯西药治疗复发率高。2001-08—2004-10,笔者在常规治疗基础上加用益心汤治疗慢性心力衰竭30例,并与常规治疗30例对照观察,现报告如下。1资料与方法1.1一般资料全部60     

慢性咳嗽的治疗

慢性咳嗽病因复杂，明确病因是治疗成功的关键。多数慢性咳嗽与感染无关，无需使用抗菌药物。咳嗽原因不明或不能除外感染时，慎用糖皮质激素。