重度烧伤患者休克期血浆B型钠尿肽含量变化及意义

Objective To study the plasma content of B-type natriuretic peptide (BNP) in patients with severe burn during shock stage and probe its clinical significance. Methods Forty-two patients aged 18-60 years, with total burn surface area ≥30%TBSA or full-thickness burn area ≥10% TBSA, hospital-ized within 4 hours after burn, were divided into A group (with total burn surface area 30% -50% TBSA or full-thickness burn area 10% -20% TBSA, n = 21 ), and B group (with total burn surface area 50% TB-SA or full-thickness burn area > 20% TBSA, n = 21 ). Twenty patients admitted during the same time for plastic surgery were enrolled as control group. The plasma levels of BNP, creatine kinase (CK), CK-MB, troponin I (Tnl) of all patients were determined on admission. The levels of BNP, Tnl and fluid resuscita-tion volume were examined at 8, 16, 24, 48 post burn hour (PBH) in A and B groups. Analysis of correla-tion between BNP and fluid resuscitation volume was performed. Results On admission: BNP level in A group (68±19 ng/L) and B group (99±38 ng/L) , respectively, was increased as compared with that in control group (17±7 ng/L, P <0.01 ). Tnl level in A group (2.13±0.67 μg/L) and B group (2.98± 0.58μg/L), respectively, was increased as compared with that in control group (0.12 ± 0.03 μg/L, P < 0.01). There was no obvious difference in CK, CK-MB levels among A, B, and control groups ( P > 0.05). BNP levels in A, B groups continuously rose during 8 - 48 PBH, and they were positively correlated with fluid resuscitation volume. TnI level peaked at 24 PBH, and decreased at 48 PBH. Conclusions The plasma level of BNP is sensitive to reflect changes in myocardial ischemia and hypoxia as a rise in level of TnI in shock stage of severe burn, and it was positively correlated with fluid resuscitation volume. BNP can be used to guide fluid resuscitation during shock stage.     

表现为剧烈周围神经痛的肢体深部肿瘤(附2例报告)

近来,我们所遇2例多年神经痛患者,经B超及MRI检查确诊肿瘤所致,手术后治愈,现报告如下。 例1,王××,女,33岁。患者自发性左下肢内侧烧灼样疼痛5年,开始时疼痛间断发作,通过针灸、理疗尚能缓解,后来含服二氢埃托啡、肌注强痛定、患肢利多卡因封闭均收效甚微。入院前疼痛呈持续性、伴阵发性加剧,如刀割电击、曾先后在省内外数家医院检查,均未能确诊。查体:左大腿上内侧压痛明显;按之疼痛     

现代监护仪的最新应用技术

本文简述了现代监护仪的网络功能,临床信息整合,多任务处理,多功能测量,模块化设计等功能.     

自拟鱼败合剂灌肠治疗盆腔炎的研究

目的 探讨中药清热解毒、活血化瘀、排脓止痛配方对盆腔炎的治疗作用。方法 本研究用自拟方鱼败合剂对170例慢性盆腔炎进行自拟灌肠治疗观察，并以同期82例用抗生素类药物治疗作为对照。结果 治疗组有效率93．2％，对照组有效率80．5％，两组差异有显著性。结论 鱼败合剂自拟灌肠治疗盆腔炎，疗效明显，使用方便，吸收快，副作用小，不需要治疗费，治疗不受时间限制，病人乐意接受，有一定的临床观察推广价值。     

经皮附睾穿刺取精精子冷冻复苏后卵细胞胞质内单精子注射治疗无精子症的初步研究

目的:回顾性分析27例无精子症患者经皮附睾穿刺取精术(PESA)所获精子冷冻复苏后行卵细胞胞质内单精子注射(ICSI)治疗后的效果及妊娠结局。方法:将诊断性附睾穿刺以及PESA治疗周期ICSI后所剩余活精子以常规方法加以冷冻,将复苏后找到了足量活精子并行ICSI的病例归为冻精组,而采用新鲜PESA活精子ICSI的病例则归为对照组。比较冻精组与对照组的受精率、种植率、临床妊娠率,同时分析两组间的妊娠并发症、新生儿出生及畸形等情况。结果:冻精组15个周期、对照组100个周期分别注射MⅡ期成熟卵子163、1 157个,受精率冻精组显著高于对照组(84.05%vs73.29%,P<0.05),种植率、临床妊娠率则两组间差异无显著性(23.07%vs15.73%;53.33%vs37.00%,P>0.05),新生儿出生体重差异亦无显著性(P>0.05)。冻精组共妊娠8例,已分娩5例,继续妊娠3例。对照组妊娠37例,已分娩30例,1例死胎;继续妊娠3例;流产4例。两组均未出现重大的妊娠并发症及新生儿畸形。结论:采用PESA冷冻精子ICSI是治疗男性无精子症的一种经济、有效、安全的方法;但PESA冻精复苏率有待于进一步提高。     

脊髓型颈椎病患者体液免疫变化及意义

目的通过脊髓型颈椎病(CSM)血清免疫球蛋白含量与JOA评分的相关性研究,探讨了体液免疫在CSM发病机制中的作用。方法用散射比浊法检测30例CSM患者血清的IgGI、gAI、gM和补体C3含量;并对30例CSM患者进行JOA评分,同时检测正常对照组20例血清的IgGI、gA、IgM和补体C3含量。结果CSM组患者血清IgG含量明显高于正常对照组(P<0.01);CSM患者在以JOA评分为基准分组中:重、中度组(0～12分)和轻度组(13～17分),两组间血清IgG含量在两组中有差异(P<0.05)。结论脊髓型颈椎病(CSM)患者体液免疫可能参与CSM发病及影响到CSM患者JOA评分高低及临床症状的轻重。     

重症烧伤患者休克期乳酸清除率的观察

近年来,血乳酸在评价危重患者近期病死率及预后方面的作用已得到证实,但局限性也逐渐显露.为早期进行针对性治疗、降低病死率,乳酸的早期清除率检测日益受到重视 [1].本文旨在评估重症烧伤患者休克期乳酸清除率与预后的关系,探讨烧伤休克的监测.     

触诊判定乳腺癌腋淋巴结转移的临床价值

乳腺癌主要转移到腋淋巴结。在我院的临床实践中发现，有时可触及的肿大腋淋巴结经病理检查并非淋巴结转移，而触诊阴性时却可见腋淋巴结转移，偶可见严重的腋淋巴结转移。本文总结我院15年的临床经验，对触诊判定乳腺癌腋淋巴结转移的临床价值作一讨论。     

盐酸西布曲明治疗单纯性肥胖的多中心、随机双盲、安慰剂对照研究

据《中华预防医学杂志》2001年9月35卷第5期报道 上海第二医科大学附属瑞金医院赵咏桔等组织4家医院对国产盐酸西布曲明胶囊(曲美)治疗单纯性肥胖进行多中心、随机双盲、安慰剂平行对照的临床研究,旨在评价国产盐酸西布曲明胶囊的有效性和安全性。选择年