撑起生命的一片蓝天--记怀化市第一人民医院神经内科的护士姐妹们

1 以人为本,维系生命之舟 湖南省怀化市第一人民医院六病室,是神经和呼吸内科,工作在这里的护士共有15位,年纪为18～40岁,平均年龄28岁,收治的多为脑卒中、慢性阻塞性肺病等重症患者。据统计,平均每年诊治的重危病人就达2800人次,常年护理任务紧张、繁忙。可是不论再忙、再累、再脏,护理组的15位姐妹,用以病人为护理中心的护理信念,本着严谨、求实、奉献精神,为病人提供优质、安全、耐心、细致的服务。在实际工作中,为病     

Rotigotine in the Treatment of Primary Restless Legs Syndrome:A Meta-analysis of Randomized Placebo-controlled Trials

The aim of this study was to summarize the efficacy and tolerability of rotigotine in the treatment of primary restless legs syndrome(RLS). Pub Med, EMBASE, and Cochrane Central Register of Controlled Trials(CENTRAL) were searched for English-language randomized controlled trials(RCTs) that assessed the effectiveness of rotigotine for RLS. The pooled mean change from baseline in International RLS(IRLS) Study Group Rating Scalescore and relative risk(RR) of response based on the Clinical Global Impression-Improvement(CGI-I) scale score were applied to evaluate the outcomes. The pooled proportions of adverse events(AEs) were also estimated. Six RCTs were included. The meta-analysis showed a favorable effectiveness of rotigotine versus placebo on RLS [mean change on IRLS score: mean difference(MD)=–4.80; 95% confidence interval(CI): –5.90 to –3.70; P<0.00001 and RR of response on CGI-I was 2.19; 95% CI: 1.86 to 2.58, P<0.00001]. The most common AEs were application site reactions, nausea, headache and fatigue. In general, rotigotine was well-tolerated in patients with primary RLS. Based on the findings from the meta-analysis, rotigotine was more significantly efficacious in the treatment of RLS than placebo. Nevertheless, long-term studies and more evidence of comparisons of rotigotine with other dopamine agonists are needed.     

复方樟柳碱颞浅动脉旁皮下注射治疗外伤性视神经病变的效果与护理

【目的】探讨复方樟柳碱颞浅动脉旁皮下注射治疗外伤性视神经病变的效果与护理体会。【方法】对31例(31只眼)外伤性视神经病变患者分别采用复方樟柳碱2mL患侧颞浅动脉旁皮下注射作为治疗组,每日1次,每疗程14d,2~4疗程。另对40例(40只眼)患者使用皮质类固醇(地塞米松)及血管扩张剂静脉注射治疗作为对照组。评价其治疗效果并总结护理体会。【结果】治疗组的总有效率为83.87%,高于对照组的62.50%,无明显影响治疗的不良反应。【结论】复方樟柳碱颞浅动脉旁皮下注射注射治疗外伤性视神经病变疗效显著,治疗方便。周到的心理护理与精细操作对保证治疗的成功、降低不良反应的发生有重要意义。     

男性不育症的治疗

由于最近的生殖辅助技术 (ａｓｓｉｓｔｅｄｒｅｐｒｏｄｕｃｔｉｖｅｔｅｃｈｎｏｌｏｇｙ,ＡＲＴ)的进步 ,使已处于绝望的妊娠变得有了希望。正因这一良好的疗效 ,使采用体外受精的妊娠也显得一般化了。ＡＲＴ是指人工授精 (ｉｎｔｒａｕｔｅｒｉｎｅｉｎｓｅｍｉｎａｔｉｏｎ ,ＩＵＩ)、体外受精胚移植法 (ｉｎｖｉｔｒｏｆｅｒｔｉｌｉｚａ ｔｉｏｎ -ｅｍｂｒｙｏｔｒａｎｓｆｅｒ,ＩＶＦ -ＥＴ)即细胞质内精子注入法 (ｉｎｔｒａｃｙｔｏｐｌａｓｍｉｃｓｐｅｒｍｉｎｊｅｃｔｉｏｎ ,ＩＣＳＩ) ,其中ＩＣＳＩ法即使有效精子数极少也…     

生物医学论文结构式摘要

目前,绝大部分生物医学期刊和其它科技期刊发表的论著和部分综述文章附有摘要,科技论文冠以摘要出现于本世纪60年代早期的《加拿大医学会     

怀化市第一人民医院

湖南省怀化市第一人民医院是一所集医疗、教学、科研于一体的大型综合性三级甲等医院，全院占地面积255亩，业务用房面积6.86万平方米。现有职工1020人，年门诊量34万人次，年出院病人2万次。     

体外循环下小儿肌部室间隔缺损的镶嵌治疗

目的 探讨镶嵌模式(hybrid procedure)治疗小儿肌部室间隔缺损(Mvsd)的手术方法及临床应用.方法 2006年1月至2010年6月,在体外循环心内直视手术下采用手术及封堵相结合的镶嵌技术矫治小儿Mvsd 45例,其中男20例,女25例;年龄52天～12岁;体重3～32 kg.7例为单个Mvsd,38例为多发性VSD.同时合并大血管错位(D-TGA)1例、法洛四联症(TOF)2例、肺动脉狭窄(PS)3例、动脉导管未闭(PDA)6例、房间隔缺损(ASD)6例、主动脉缩窄1例.均在心脏停跳后直视下将导引钢丝经三尖瓣孔自心脏右室面穿过VSD至左室面,直视下置入导引器,然后送入封堵器,完成Mvsd封堵.多发性VSD 38例,予自体心包片修补膜周部等较大的VSD,心内其他畸形同期完成矫治.结果 42例置入单枚封堵器(直径4～10 mm)、3例置入双枚封堵器(直径4～7 mm).手术经过顺利,术前左室射血分数(EF)均在正常范围,术后1天小于8月龄组EF均值低于正常,大于8月龄组EF正常,两者差异有统计学意义.术后常规每天给予5 mg/kg肠溶阿司匹林3～6个月.术后随访超声检查示封堵器位置无偏移,无残余分流,无二尖瓣、主动脉瓣反流、Ⅲ度传导阻滞及新发心律失常等.术后因重症感染放弃治疗1例,无远期死亡病例.结论 体外循环下镶嵌技术治疗小儿 Mvsd明显降低了围手术期并发症及病死率,简化了手术过程,降低了手术风险,是一种安全、有效的方法.

Abstract：

Objective To summarize the technique and clinical experience of hybrid procedure under cardiopulmonary bypass (CPB) in children with muscular ventricular septal defect (mVSD). Methods From January 2006 to June 2010, 45 cases of mVSD underwent hybrid procedure with CPB. mVSDs were closed with devices under direct vision in 45 cases. Of them, there were 20 males and 25 females. They ranged from 52 days to 12 years [mean (2.05 ±2.48) year] in age and from 3 to 30 kg [(11.93 ±7.70)kg] in body weight. Preoperatively, most of children were highly susceptible to respiratory tract infections. The hybrid approach was used in all patients with CPB under the guidance of transesophageal echocardiography (TEE). The diameter of mVSDs ranged from 2 to 7 mm under TEE. Of 45 cases, 40 patients had increased rates of pulmonary blood flow. 29 patients had left axis deviation and 12 cases had sinus arrhythmia on electrocardiography (ECG). 19 had other congenital heart lesions, including transposition of great arteries in 1 case, tetralogy of Fallot in 2, pulmonary artery stenosis in 3, patent ductus arteriosus in 6, atrial septal defects in 6) and aorta coactation in 1. The quantity of VSDs were from 1 to 7 (single, in 7; two, in 24 case; three, in 8 case; four, in 5 case and seven, in lease. 37 patients were combined with pulmonary hypertension in our cohort. 38 patients with another large VSD and 19 with other congenital heart lesions were required surgical repair at sometime. Results The hybrid procedures were undertaken in all 45 cases of this cohort. All cases were successful and no deaths occurred during operation. A total of 48 devices were implanted in 45 patients, including single devices in 42 cases (device size ranged from 4 to 10 mm) and two devices in 3 cases (device size ranged from 4 -7 mm). The average time on CPB was (58.28 ±20.70) min , while aortic crossclamp time was(34. 94 ± 14.75) min. In addition, the time on mechanical ventilation postoperatively ranged from 2 hours to 6 days. Compared to the older children, 20 infante aged less than 8 monhad a significant difference in cardiac function in the early postoperative period. One infant was given up treatment because of serious infection. Anather cases recovered with the use of supportive treatment, such as using vasoactive agents, digoxin, inhaling nitric oxide, diuresis, and so on. The enteric-coated aspirin was given at dose of 5 mg ? kg -1. day -1 for a period of 3 to 6 months as usual postoperatively. All patients attended follow-up at 1 week, 1 month, 3 months, 6 months, 1 year and 2 years post-procedure. No major complications were encountered during this period. All cases were no instance of migration of any of the devices, residual shunt, aortic regurgitation, atrioventricular valve dysfunction, Ⅲo atrial-ventricular conduction block, new arrhythmia, and so on. There are no death in long-term follow-up. Conclusion Hybrid procedure is safe and effective for the closure of congenital heart defects in children.     

艾灸联合穴位贴敷治疗儿童腹型过敏性紫癜的效果观察

目的观察艾灸联合穴位贴敷治疗儿童腹型过敏性紫癜的疗效。方法选取2016年1至10月儿科患儿60例,随机分为对照组和观察组,每组各30例,两组患儿均给予常规输液治疗,观察组在常规治疗的基础上给予中医特色疗法:艾灸和穴位贴敷,疗程均为1周,比较两组总体疗效,腹痛缓解的时间及便血消失的时间。结果观察组总有效率为100%,对照组总有效率为76.7%,两组相比差异有统计学意义(P0.05)。观察组皮疹消退时间、腹痛缓解时间及便血消失时间均低于对照组,差异有统计学意义(P0.05)。结论艾灸联合穴位贴敷治疗儿童腹型过敏性紫癜可以明显缩短患儿皮疹消退、腹痛缓解及便血消失时间,且无不不良反应发生,安全可靠,值得临床推广。     

慢性乙肝患者与慢性乙肝病毒携带者血清抗HBc-IgM(+)检测分析

目的探讨血清抗HBc-IgM（＋）在CHB与ASC中分布情况及CHB的血清抗HBc-IgM（＋）与HBVD-NA的关系,为乙肝防治提供依据。方法对91例CHB与118例ASC进行ALT、AST,HBv-M及HBVDNA检测,同时进行血清抗HBc-IgM检测,探讨血清抗HBc-IgM（＋）在CHB与ASC中的分布情况,并与HBVDNA检验结果做相关分析。结果53例HBeAg（＋）的CHB血清抗HBc-IgM（＋）者30例（56.6%）,38例HBeAg（-）的CHB血清抗HBc-IgM（＋）者21例（55.3%）;37例HBeAg（＋）的ASC血清抗HBc-IgM（＋）者7例（18.9%）,81例HBeAg（-）的ASC血清抗HBc-IgM（＋）者6例（7.4%）。91例CHB血清抗HBc-IgM（＋）总检出51例（56.0%）,118例ASC血清抗HBc-IgM（＋）总检出13例（11.0%）。30例血清抗HBc-IgM（＋）、HBeAg（＋）的CHB检出HBVDNA阳性29例（96.7%）,21例血清抗HBc-IgM（＋）、HBeAg（-）的CHB检出HBVDNA阳性15例（71.4%）。结论血清抗HBc-IgM（＋）在CHB与ASC中有不同的分布,在CHB中血清抗HBc-IgM（＋）检出与HB-VDNA阳性检出有高度相关性。     

基层医院专科病房的创建和护理管理

我院是一所地级市属三级甲等医院,为了促进学科的建设和发展,较快地形成专科的优势和特色,近3年来先后创建了神经内、外科病房和肝胆外科病房,我们掌握短、快、稳的原则,促使新专科病房在短期内开科收住病人,医疗和护理工作快速步入正轨,护理质量稳步上升,跨入模式病房的行列,现将我们的实践体会总结如下: