布地奈德联合沙丁胺醇治疗小儿支气管哮喘疗效分析

Objective To investigate the effect of Budesonide combined with Salbutamol in treatment of chil-dren with bronchial asthma.Methods 100 cases of children with asthma were randomly divided into conventional therapy group(Group A)50 cases and combined treatment group(Group B)50 cases;Conventional therapy was given to group B and Group A Was givend the conventional therapy puls Budesonide combined with salbutamol treatment,2 times a day.The course of treatment was 10d;The effect of clinical symptom score、clinical recovery and adverse reac-tions in two groups were observed.Results The total efficiency of 47 cases(94.O%) in group A were significantly higher than the B group 36 cases(72.0%)(P<0.05);The index of breathing diffculties、coushing、wheezing、wheezing sustain and sleep satisfaction after treatment were significantly decreased compared with before treatment in two groups(all P<0.01);The time of recovery of breath shortness、cough、asthma、wheezing and therapy hys in group A were less than group B(all P<0.05).Condusion Atomizing inhalation treatment of Bedesonide combined with Sallbutamol was effective to treat children with bronchial asthma.     

3种药物治疗妊娠中期外阴阴道假丝酵母菌病的疗效比较

Objective To observe the clinical therapeutic effect of the treatment on vulvovaginal candidiasis (VVC) in the mid trimester of pregnancy with three species of drug (Clotrimazole,Macmirorcomplex, Baofukang Shuan). Methods 83 women diagnosed with VVC in the mid trimester of pregnancy were divided into three groups: Group A with 30 cases, treated with Clotrimazole for twice; Group B with 28 cases, treated with Macmirorcomplex for 6 days; Group C with 25 cases, treated with Baofukang Shuan for 8 days. Observed the clinical effect, the microbes therapeutic effect and the adverse effect of the treatment with three species of drug. Results (1)The clinical cure rate of Group A was 86.67% and the fungal negative rate was 93.33%. The clinical cure rate of Group B was 57.14% and the fungal negative rate was 75%. The clinical cure rate of Group C was 60% and the fungal negative rate was 40%. There were no adverse effect to be found in the three groups. (2) The clinical cure rate and curative rate of Group A were significantly higher than those of Group B and Group C( P＜0,05 ),but there were no difference in Group B and Group C ( P＞ 0.05 ). The V VC scores of the three groups were significantly descended compared with those of pretherapy ( P＜ 0.01 ), but there were no difference of the curative rate about microbes therapeutic effect in the three groups ( P＞ 0.05 ).Conclusion The three drugs for VVC in pregnancy are all effective and no serious adverse effect. Clotrimazole has better clinical therapeutic effect than Macmirorcomplex and Baofukang Shuan.     

再谈痔瘘围手术期的镇痛治疗

For the sake of probing into perioperative analgesic therapies of hemorrhoids and fistulas, 80 patients with hemorrhoids or fistulas were randomly divided into two groups:the applied group (40 cases) and the controlled group (40 cases).The combines perioperative analgesia was used in the applied group and the conventional analgesia in the controlled group. The analgesic conditions of the two groups were prospectively evaluated and clinically observed. The result showed that the analgesic effect in the former was much better than that in the latter (P≤0.O1). It is concluded that the combined perioperative analgesic therapy should be used in the treatment of hemorrhoids and fistulas。     

缬沙坦联合贝那普利治疗慢性心力衰竭的疗效观察

Objective To observe the effect of valsartan combined with benazepril in treatment of patients with chronic heart failure. Methods 60 patients with heart failure of New York Heart Association (NYHA) class Ⅱ -Ⅳ and LVEF less than or equal 40% were selected and randomly divided into two groups. The patients in control group were given benazepril(10mg/d) alone,and the patients in treatment group were given valsartan(80mg/d) combined with benazepril(10mg/d). After 8 months therapy, the changes of the parameters of left ventriclular function and ventriclular dimension of the patients with chronic heart failure were compared before and after treatment. And the clinical efficacy was compared between two groups. Results The ventriclular dimension of the patients with chronic heart failure was decreased,and left ventriclular function was improved. The patients of the combination therapy group were improved especially after treatment. Conclusion Angiotensin-converting-enzyme(ACE) inhibitor could improve heart function of patients with chronic heart failure. Therapy of valsartan combined with benazepril was more effective.     

不同病程支气管哮喘儿童右心功能的变化

Objective To explore the cardiac function of right ventricles in children with various course of bronchial asthma. Methods The cardiac function was evaluated by using the Doppler echocardiography in 36 chil-dren with course > 1 year bronchial asthma in remission stage and 38 children with course ≤ 1 year bronchial asthma in remission stage. 40 healthy children were used as normal controls. After treatment, 10 children with course > 1 year were evaluated again. Results The injury of right ventricle systolic function was predominant in children with > 1 year bronchial asthma, The systolic function of right ventricle remained normal in children with ≤ 1 year bronchi-al asthma. Conclusion The cardiac function damage occurs in children with > 1 year bronchial asthma and will be recoveied by cure the astham. The Doppler echocardiography is noninvasive method for determination of cardiac func-tion.     

纤溶酶联合血塞通注射液治疗急性脑梗死临床研究

Objective To explore the total curative effects of Xuesaitong injection combined whth fibrinogenase on acute cerebral infarction(ACI). Methods One hundred and twelve patients with ACI were randomly and equally divided into two groups, 56 cases in the treatment group were treated with Xuesaitong injection combined Fibrinogenase, while 56 cases in the control group were treated with compound danshen injection, once a day for 15days. Results Coagulation indicators of the treatment group was obviously better than that of the control group(P ＜0.05 or P ＜ 0.01 ). The total effective rate (91.1% ) of the treatment group was obviously higher than that of the control group( 69.6% )( P＜ 0.05 ). The Neurological deficit scores of therapy group were significantly improved (P ＜ 0.05). There was no obvious adverse reaction. Conclusion Xuesaitong injection combined fibrinogenase are remarkablyeffective and safe in treating ACI.     

中西医结合治疗腰椎间盘突出症的临床研究

Objective To investigate the curative effect of western combined with traditional Chinese medicine in treatment of acute lumbar disc herniation.Methods 200 patients with lumbar disc herniation were randomly divided into western combined with traditional Chinese therapy group(group A) and western medicine group(group B) ,each group 100 cases.B group was conducted with the general anti - inflammatory, dehydration, nerve pain and nutritional therapy,and A group was given the traditional Chinese medicine treatment on the base of B group.After 3 weeks treatment, the curative effect, VAS score and hospital stay were observed.Results A total effective rate 90.0% in group A was higher than B group 73.0% ( x2 = 3.987 ,P < 0.05); The scores of VAS after treatment 4 weeks[(1.1 ±1.23、0.9 ±0.6)/point]were lower than before treatment[(8.6 ± 1.43,8.8 ± 1.382)/point]in two groups(t =2.301,2.335,all P<0.05) ;The scores of VAS after treatment 3d and 1 week in group A[(5.5 ±0.92) point,(2.7±1.14) point] were lower than group B[(8.2 ±0.59) point,(5.3 ±0.91) point] (t =2.405,2.435,all P<0.05);The hospital days(20.1 ±3.5)d in group A was significantly lower than group B(27.6 ±4.3)d( t = 2.314,P <0.05).Conclusion Western combined with traditional Chinese medicine had better clinical efficacy in teatrent of patients with acute lumbar disc hemiation.     

纤溶酶联合血塞通注射液治疗急性脑梗死临床研究

Objective To explore the total curative effects of Xuesaitong injection combined whth fibrinogenase on acute cerebral infarction(ACI). Methods One hundred and twelve patients with ACI were randomly and equally divided into two groups, 56 cases in the treatment group were treated with Xuesaitong injection combined Fibrinogenase, while 56 cases in the control group were treated with compound danshen injection, once a day for 15days. Results Coagulation indicators of the treatment group was obviously better than that of the control group(P ＜0.05 or P ＜ 0.01 ). The total effective rate (91.1% ) of the treatment group was obviously higher than that of the control group( 69.6% )( P＜ 0.05 ). The Neurological deficit scores of therapy group were significantly improved (P ＜ 0.05). There was no obvious adverse reaction. Conclusion Xuesaitong injection combined fibrinogenase are remarkablyeffective and safe in treating ACI.     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

Objective To observe the anesthetic effect of sevoflurane combined with propofol total general anaesthesia in children undergoing tracheal foreign body removal. Methods Sixty patients aged from 1 to 4 years admitted for tracheal foreign body removal were randomly divided into two groups : sevoflurane group (n = 30) and ketamine group (n = 30). In the sevoflurane group, anaesthesia was induced and maintained with inhalation of sevoflurane and propofol [1.5 mg/(kg · h)] was administered continuously for anesthesia maintenance by micro-pump during operation. The ketamine group were pre-medicated with ketamine 6 mg/kg i. m for sedation, then an-aesthesia was induced with midazolam 0.1 mg/kg and ketamine 1.5 mg/kg i. v and was maintained with intravenous bolus of ketamine. Systolic blood pressure(SBP), Diastolic blood pressure(DBP) ,heart rate(HR) and saturation of percutaneous oxygen(SPO2) were monitored in both groups before anaesthesia inducation (T0) , after anaesthesia inducation and before operation (T1), at the time point of bronchial endoscopy(T2) ,endoscope remoral (T3) ,con-sciousness recovery(T4). The operation condition was evaluated by surgeons, and the incidence of bronchial spasm, glossal drop, nausea and vomiting were recorded both during operation and after operation. Results The SBP and HR increased at the time point of bronchial endoscopy in two groups and decreased after anaesthesia inducation in aevoflurane group. The SPO2 increased in two group after anaesthesia inducation. Compared with ketamine group, the time of consciousness recovery was shorter markedly in sevoflurane group. The occurrence of postoperative glossal drop was higher in ketamine group. Conclusion Sevoflurane combined with propofol is safe and effective during general anaesthesia of children undergoing tracheal foreign body removal.     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

Objective To observe the anesthetic effect of sevoflurane combined with propofol total general anaesthesia in children undergoing tracheal foreign body removal. Methods Sixty patients aged from 1 to 4 years admitted for tracheal foreign body removal were randomly divided into two groups : sevoflurane group (n = 30) and ketamine group (n = 30). In the sevoflurane group, anaesthesia was induced and maintained with inhalation of sevoflurane and propofol [1.5 mg/(kg · h)] was administered continuously for anesthesia maintenance by micro-pump during operation. The ketamine group were pre-medicated with ketamine 6 mg/kg i. m for sedation, then an-aesthesia was induced with midazolam 0.1 mg/kg and ketamine 1.5 mg/kg i. v and was maintained with intravenous bolus of ketamine. Systolic blood pressure(SBP), Diastolic blood pressure(DBP) ,heart rate(HR) and saturation of percutaneous oxygen(SPO2) were monitored in both groups before anaesthesia inducation (T0) , after anaesthesia inducation and before operation (T1), at the time point of bronchial endoscopy(T2) ,endoscope remoral (T3) ,con-sciousness recovery(T4). The operation condition was evaluated by surgeons, and the incidence of bronchial spasm, glossal drop, nausea and vomiting were recorded both during operation and after operation. Results The SBP and HR increased at the time point of bronchial endoscopy in two groups and decreased after anaesthesia inducation in aevoflurane group. The SPO2 increased in two group after anaesthesia inducation. Compared with ketamine group, the time of consciousness recovery was shorter markedly in sevoflurane group. The occurrence of postoperative glossal drop was higher in ketamine group. Conclusion Sevoflurane combined with propofol is safe and effective during general anaesthesia of children undergoing tracheal foreign body removal.     

胸腺肽治疗重症肺炎合并脓毒血症的疗效研究

目的探讨胸腺肽治疗重症肺炎合并脓毒血症的疗效。方法收集2013年12月~2015年10月期间我院收治的重症肺炎合并脓毒血症患者共82例,随机分为观察组和对照组,每组41例,对照组给予常规治疗;观察组在给予常规治疗的基础上皮下注射胸腺肽治疗,两组患者均连续治疗5d。比较两组临床疗效、机械通气时间及ICU住院时间、IL-6、TNF-α、CD4~+、CD8~+、CD4~+/CD8~+。结果观察组临床治疗显效率(95.12%)明显高于对照组(80.48%),机械通气时间及ICU住院时间均少于对照组,差异有统计学意义(P0.05)。治疗后观察组和对照组IL-6、TNF-α、CD8~+水平与治疗前比较均出现明显降低,CD4~+、CD4~+/CD8~+与治疗前比较均出现明显升高,观察组IL-6、TNF-α、CD8~+水平低于对照组,CD4~+、CD4~+/CD8~+高于对照组,两组差异有统计学意义(P0.05)。结论胸腺肽治疗重症肺炎合并脓毒血症临床疗效较好,可使患者的临床症状得到明显改善,免疫功能明显提高,可作为一种治疗重症肺炎合并脓毒血症有效的方法在临床推广应用。     

输尿管镜联合尿道切开镜治疗9例尿道狭窄

目的探讨输尿管镜联合尿道切开镜治疗尿道狭窄的疗效。方法骶管麻醉下用F8/9.8输尿管镜检查尿道狭窄情况,直视下将导丝通过狭窄段尿道置入膀胱。如尿道狭窄段无小孔通道,可从膀胱造瘘管内注入美蓝液,再用力按压膀胱,同时观察闭锁远端有无蓝色液体渗出。改尿道切开镜循导丝的后尿道于12点处切割狭窄环,前尿道于6点方向切开,边切割边推进尿道镜,直至24F尿道内切开镜进入膀胱。术后常规留置F18～F22三腔气囊导尿管4～6周,运用抗生素治疗,拔管后定期行尿道扩张1～3月。结果本组患者手术均一次切开成功。本组手术时间35～83 min,平均46 min。术后住院5～8 d。留置导尿管拔出后l周内排尿通畅,19～21F尿道扩张器通过顺利。无尿失禁、尿外渗、继发性出血,尿道热等发生。结论输尿管镜直视下留置安全导丝,再行尿道切开镜治疗尿道狭窄可有效减少尿道穿孔或假道的发生,是一种并发症少、创伤小、住院时间短、恢复比较快的手术方法。     

类风湿关节炎合并肺间质纤维化的临床特征研究

目的 对类风湿关节炎合并肺间质纤维化患者的临床特征进行分析,为今后的临床诊治工作提供可靠的参考依据.方法 选取2010年1月-2013年3月我院收治的类风湿性关节炎患者102例,按照是否合并肺间质纤维化分成合并组和单纯组,而后对这两组的临床观察指标进行对比分析.结果 合并组患者的男性所占比例、吸烟者比例、患者年龄、发病年龄、抗环瓜氨酸抗体、类风湿因子、C反应蛋白水平以及骨破坏发生率均较单纯组高.结论 类风湿关节炎患者合并肺间质纤维化可能与诸多临床指标均存在较大的相关性,临床应给予关注,采取有效措施进行预防和治疗.     

洁尔阴治疗尖锐湿疣48例

本文就洁尔阴治疗本院门诊的尖锐湿疣患者48例总结分析如下：回资料与方法l．l临床资料近5年本院JI诊收治的尖锐湿疣86例,其中阴道发病48例（558％）;诊断依据：患者本人或性伙伴有不洁性生活史,肉眼检查阴道粘膜有大小不等的、淡红色赘生物,质较脆,易出血,形状有乳头状、菜花状、疣状。1．2治疗方法患者取卧位,自行将洁尔阴原液10～20ml用阴道冲洗器注入阴道深部,抬高臀部防止药液流出,保持约10分钟,然后起立,让药液流出,每天1～2次,1周为1个疗程。2结果用药2个疗程,治愈35例（729％）;部分病灶消失43例（89．6％）;无效5…     

髓系恶性肿瘤伴骨髓纤维化患者的预后研究

目的评估骨髓纤维化、骨髓增生异常综合征相关预后系统对我国急性髓系白血病(AML)、骨髓增生异常综合征(MDS)伴骨髓纤维化的预后效力,探讨AML/MDS伴骨髓纤维化预后因素。方法回顾性分析134例AML及MDS伴骨髓纤维化患者病例资料,采用PMF-IPSS、DIPSS、IPSS-Chinese、DIPSS-Chinese、MYSEC-PM、 MDS-IPSS、IPSS-R、WPSS对其进行预后分组及评估,并分析预后因素。结果 PMF-IPSS、DIPSS、IPSS-Chinese、DIPSS-Chinese、MYSEC-PM、 MDS-IPSS、IPSS-R、WPSS均不能对AML/MDS伴骨髓纤维化患者进行准确预后,在MDS-IPSS、WPSS基础上增加骨髓纤维化分级可改善其预后效力。有脾肿大(P=0.015)、有输血依赖(P=0.008)、纤维化分级≥2级(P<0.001)、CRP>5.0 mg/L(P=0.032)是AML/MDS伴骨髓纤维化的不良预后因素。结论目前缺乏AML/MDS伴骨髓纤维化的预后系统,脾肿大、输血依赖、纤维化分级及CRP与其预后相关,或许可为预后评估及治疗提供新的选择。     

新斯的明复合罗哌卡因术后硬膜外镇痛的临床效果

目的 探讨新斯的明复合罗哌卡因患者自控硬膜外镇痛(PCEA)效果.方法 60例择期行胆囊切除术的患者随机分为4组,每组15例.PCEA均用罗哌卡因178 mg,用生理盐水稀释到100 ml.A组加新斯的明2 mg,B组加新斯的明3 mg,C组加吗啡4 mg,D组加新斯的明2 mg和吗啡2 mg.记录术后6、12、24和48 h的VAS评分、循环变化及胃肠功能恢复时间.结果 A组术后48 h内各记录时点的VAS评分均比B、C、D 3组高.4组术后血压和心率变化与术前比较均无显著性差别;C组术后瘙痒的发生率(26.7%)明显高于其他3组.结论 罗哌卡因178 mg PCEA加新斯的明2 mg和吗啡2 mg的镇痛效应与单加吗啡4 mg相当,而副作用明显减轻.     

肺结核合并呼吸衰竭患者机械通气治疗的护理

目的对机械通气治疗肺结核合并呼吸衰竭患者的护理方法和效果进行分析和研究,探讨其优势和不足,总结经验,以更好的指导临床护理的进行。方法随机选择我院近3年采用机械通气治疗的70名肺结核合并呼吸衰竭患者,有针对性的对患者进行密切的护理,观察病情和护理效果,并加以总结。结果对机械通气治疗肺结核合并呼吸衰竭患者进行适当护理后,患者得到较好恢复,病情有所缓解,成功脱离呼吸机,同时有效减少其他并发症状的出现,具有较好的护理效果。结论适当的护理,能够使采用机械通气治疗的肺结核合并呼吸衰竭患者较快恢复,摆脱呼吸器帮助,病情得到有效缓解,有效率较高,同时,能有效减少并发症发生率,具有较高的临床使用价值和推广价值。     

射频消融房室结折近性心动过速55例临床分析

目的:房室结折返性心动过速(AVNRT)拟行射频消融(RFCA)治疗的患者,在术中密切注意各种操作细节,可降低Ⅲ度房室传导阻滞(AVB)的发生率,提高RFCA成功率.方法:选择自2000年6月至2006年1月共55例AVNRT拟行RFCA的患者,常规放置CS电极、HRA电极、HIS电极、RV电极,行心内电生理检查(EPS),确诊为AVNRT.消融导管经股静脉送至右房,采用影像与心内电图相结合确定靶点,在希氏束和冠状静脉窦口之间进行仔细标测,寻找小A大V,确定靶点图的标准为A/V为小于0.5,无H波,于窦性心律下行射频消融,功率为20 W-30 W,在放电过程中,严密监测,如有AV间期延长、快速交界心律(＞150 bpm)、消融电极向上移位等立即停止放电,重新标测;成功标志为:放电15秒内出现交界性心律,在该部位继续放电,直至交界性心律消失.消融的终点为:静滴异丙肾上腺素不能诱发原有的心动过速,无AH跳跃,无心房回波,消融成功.结果:55例AVNRTK患者均为慢径消融,成功率100%,无1例复发,其中2例在术中出现一过性I度AVB,立即停止放电,观察1-3 min均恢复正常房室传导,而另1例在术中出现Ⅲ度AVB,立即停止放电,但始终未恢复正常房室传导,成为永久性ⅢAVB.结论:在AVNRT的RFCA中,应严密监测,可降低Ⅲ度AVB发生率,提高RFCA成功率.