癌症患者与抑郁症

癌症患者与抑郁症山西医学院第二附属医院（０３０００１）原天岗，白克俊，成学恭，赵秀英太原精神病院梁爱生山西省肿瘤医院原韶铃，邢守正我们对省肿瘤医院１９９１年１０～１２月间住院的２００例癌症患者进行了较系统的调查。以期对癌症患者的心理咨询及必要的抗抑郁治疗提供科学依据。对象和方法对象：本组２００例男１６３例，女３７例，年龄１２～７３岁。病种：肺癌６７例，食管癌５０例，贲门癌２０例，胃癌１０例、淋巴瘤７例，血癌７例，其２１４种共３９例。方法：汉米顿抑郁量表（ＨＡＭＤ），采用１７项版本［１］。由副主任医师负责评定。先学习，统一标准，进行一致性检验，一致性达９５％以上，而后正式评定。抑郁自评量表（ＳＤＳ）［２］，共２０项，分４级评分，宣读指导语后由患者自己评定，对文盲逐条念让其听懂后自己评定，由工作人员代填，５０分以上为抑郁症。简式个性问卷［３］，共２０项，工作人员根据病人的回答填写，以测试个性之内外向和神经质水平。病情调查表（自制）：内容包括一般人口学资料。既往精神病史，遗传史（肿瘤和精神病），诊断、治疗、是否知道患癌症及其含义，检查（验）资料、精神检查，抗癌药物的使用，精神卫生干预等。由研究者根据病历及检查病人     

122例急性戊型肝炎重叠感染患者的肝功能及临床特点分析

目的 比较分析单纯急性戊型肝炎与重叠感染患者的肝功能指标和临床特点.方法 以40例单纯急性戊型肝炎为对照,回顾性分析了122例重叠感染戊型肝炎患者的肝功能指标、临床资料.结果 单纯戊肝组、甲戊重叠感染组、乙戊重叠感染组,三组之间ALT、AST、TBIL、DBIL差异均无统计学意义(P0.05),急性戊肝组与乙戊重叠感染组,甲戊重叠感染组与乙戊重叠感染组的白蛋白、球蛋白有统计学差异(P<0.01);甲戊重叠感染、乙戊重叠感染与单纯戊肝相比较临床合并症多、并发症重.结论 戊型肝炎重叠感染,特别是乙戊重叠感染患者,要加强临床监测,提高早期预防并发症的意识,以降低病死率.     

122例急性戊型肝炎重叠感染患者的肝功能及临床特点分析

目的 比较分析单纯急性戊型肝炎与重叠感染患者的肝功能指标和临床特点.方法 以40例单纯急性戊型肝炎为对照,回顾性分析了122例重叠感染戊型肝炎患者的肝功能指标、临床资料.结果 单纯戊肝组、甲戊重叠感染组、乙戊重叠感染组,三组之间ALT、AST、TBIL、DBIL差异均无统计学意义(P0.05),急性戊肝组与乙戊重叠感染组,甲戊重叠感染组与乙戊重叠感染组的白蛋白、球蛋白有统计学差异(P<0.01);甲戊重叠感染、乙戊重叠感染与单纯戊肝相比较临床合并症多、并发症重.结论 戊型肝炎重叠感染,特别是乙戊重叠感染患者,要加强临床监测,提高早期预防并发症的意识,以降低病死率.     

11例人流漏吸继续妊娠的临床分析

<正> 本文收集了人流后继续妊娠1l例,作一简要分析并作讨论。 1.临床资料 11例均为门诊病人,其中本院漏吸4例、7例来自外院,年龄20—36岁,平均27岁。 1·1 人流后求诊时间 1月内就诊4例,1—2月就诊5例,2—3月就诊2例。     

浅谈对糖尿病性脑梗死患者进行综合治疗及护理的方法

目的：探讨对糖尿病性脑梗死患者进行综合治疗及护理的方法。方法：对2012年1月～2013年8月期间我院收治的90例糖尿病性脑梗死患者的临床资料进行回顾性研究。我们将这90例患者随机分为观察组和对照组，每组各有45例患者。我们对两组患者均进行综合治疗，在此基础上，我们对观察组的患者进行综合护理，对对照组的患者进行常规护理。治疗结束后，比较两组患者的治疗效果及护理效果。结果：在治疗后，观察组患者的神经功能缺损的恢复程度明显好于对照组的患者，其治疗效果、血糖控制情况及患者对护理满意度均优于对照组的患者，二者相比差异有显著性（P＜0.05）。结论：对于患有糖尿病性脑梗死的患者，我们应先对其进行扩血管、抗凝、脱水等综合治疗，在此基础上，尽早采取综合护理措施，以降低其血糖水平。另外，对于处在糖尿病急性期的患者，我们要严密监测其血糖水平，同时纠正其高血压、脂代谢紊乱等症状，以减轻其病情及脑缺血对其身体的损害，进而改善其预后。     

获得性免疫缺陷综合征患者胃黏膜组织人类免疫缺陷病毒感染分析

Objective To investigate the distribution and amount of human immunodeficiency virus (HIV) infection in gastric mucosa from untreated acquired immune deficiency syndrome (AIDS) patients and highly active antiretroviral therapy (HAART) treated patients.Methods Thirty-five AIDS patients (14 untreated patients and 21 patients receiving HAART) and 10 HIV-1 seronegative patients with gastrointestinal symptoms were enrolled and examined by upper endoscopy.The labeled HIV-1 double-stranded cDNA probe was a PCR product corresponding to the LTR and gag gene of the HIV-1 genome.HIV in gastric mucosal tissues from AIDS patients was detected using in situ hybridization (ISH) and compared with that in peripheral blood mononuclear cells (PBMC).Results ① No obvious character was found in gastrointestinal symptoms,endoscopy examination and pathology results of AIDS patients.② The expression of HIV gene was mainly detected in the gastric mucosal mononuclear cell (MMC).Other cells were also observed with HIV expression including mucosal epithelial cells,gland epithelial cells and interstitial cells.③There was no difference in HIV expression between sinus ventriculi and gastric body.④ HIV gene expression from AIDS patients was (1.97±3.25)% in gastric mucosa,no difference in HIV gene expression between two groups (P＞0.05).⑤ HIV gene expression in PBMC smear from AIDS patients was (12.38 ± 9.17)%.HIV expreesion in PBMC from patients who had received HAART for 1-4 years were markedly lower than that from patients who had not received HAART (P＜0.05).Conclusions The gastric mueosa is one of HIV infected sites.The potential effect of HAART on the decrease of HIV infected cells in gastric mucosa was unsatisfactory.     

获得性免疫缺陷综合征患者胃黏膜组织人类免疫缺陷病毒感染分析

Objective To investigate the distribution and amount of human immunodeficiency virus (HIV) infection in gastric mucosa from untreated acquired immune deficiency syndrome (AIDS) patients and highly active antiretroviral therapy (HAART) treated patients.Methods Thirty-five AIDS patients (14 untreated patients and 21 patients receiving HAART) and 10 HIV-1 seronegative patients with gastrointestinal symptoms were enrolled and examined by upper endoscopy.The labeled HIV-1 double-stranded cDNA probe was a PCR product corresponding to the LTR and gag gene of the HIV-1 genome.HIV in gastric mucosal tissues from AIDS patients was detected using in situ hybridization (ISH) and compared with that in peripheral blood mononuclear cells (PBMC).Results ① No obvious character was found in gastrointestinal symptoms,endoscopy examination and pathology results of AIDS patients.② The expression of HIV gene was mainly detected in the gastric mucosal mononuclear cell (MMC).Other cells were also observed with HIV expression including mucosal epithelial cells,gland epithelial cells and interstitial cells.③There was no difference in HIV expression between sinus ventriculi and gastric body.④ HIV gene expression from AIDS patients was (1.97±3.25)% in gastric mucosa,no difference in HIV gene expression between two groups (P＞0.05).⑤ HIV gene expression in PBMC smear from AIDS patients was (12.38 ± 9.17)%.HIV expreesion in PBMC from patients who had received HAART for 1-4 years were markedly lower than that from patients who had not received HAART (P＜0.05).Conclusions The gastric mueosa is one of HIV infected sites.The potential effect of HAART on the decrease of HIV infected cells in gastric mucosa was unsatisfactory.     

恶性肿瘤患者临终抢救阶段心理护理

2000年1月~2005年1月,我们共参与了60例恶性肿瘤患者的临终抢救,针对其中出现的心理问题进行护理,效果满意。现将护理体会报告如下。1临床资料1·1一般资料本组男38例,女22例,7~85岁,平均48岁。农民12例,工人19例,知识分子22例,商人7例;信佛教5例,基督教4例。1·2患者及家属心理状况评估1·2·1恶性肿瘤患者临终抢救时期的心理特征美国医学博士KUBLER ROSS把癌症患者从获知病情到临终时心理反应分为5个阶段:否认期、愤怒期、祈求期、抑郁期、接受期。在临终抢救阶段,患者神志尚清并已意识到死亡可能随时来临,心理状态大多是恐惧、无助、…     

110例慢性子宫内膜炎的临床治疗结果分析

目的根据我院近期治疗的110例慢性子宫内膜炎患者的治疗体会,对比慢性子宫内膜炎的不同治疗方式,完善临床治疗方法。方法依据我院2012年9月至2013年9月间收治疗的110例慢性子宫内膜炎患者,以其临床治疗资料为研究对象,其中40例使用常规性子宫内膜炎治疗方式。记为组A,另70例使用人工周期抗感染联合阴道洗液方式治疗,记为组B。使用同样的护理方式,治疗时间最长为6个月。结果组A:患者痊愈率为42.50%,治疗总有效率为70.00%,治疗无效率为27.50%。组B:患者痊愈率为91.43%,治疗总有效率为100.00%,治疗无效率为0.00%。对比两组治疗结果具有显著统计学差异性(P<0.05)。结论人工周期抗感染联合阴道洗液的治疗方式具有临床实际应用效果,较单纯性使用抗生素效果更理想,并且治疗针对性更强,不良反应小,几乎无不良反应,治疗方法简单易控制,可作为临床慢性子宫内膜炎常规性治疗方式。