无痛分娩180例临床观察

分娩疼痛是大部分女性一生中遇到的最剧烈的疼痛,可对产妇的心理造成不良影响,越来越多的孕妇对分娩提出了更高要求,除了确保母婴安全,还要求无痛分娩。无痛分娩能明显减轻疼痛,提高孕妇对分娩的满意率。但无痛分娩是否对母婴造成不良影响,目前仍存在分歧。     

小切口骨折块螺钉固定在髓内钉中的运用

目的:介绍髓内钉在治疗股骨或胫骨骨折时辅以小切口螺钉固定分离骨折块的方法。方法:对11例胫骨骨折及7例股骨骨折行髓内钉固定的同时辅以小切口螺钉固定分离骨块,术后根据骨折稳定情况在康复师的指导下进行积极的功能锻练。结果:术后随访10～18个月,骨折均获得愈合,患肢功能恢复正常。结论:髓内钉治疗长骨骨折时辅以小切口骨折块螺钉固定可在基层医院推广使用。     

胃食管反流病的研究进展

胃食管反流病(GERD)是指胃内容物反流入食管,引起不适症状和(或)并发症的一种疾病。根据内镜和病理结果可将GERD分为三类:(1)反流性食管炎(RE):有反流症状兼有食管黏膜破损者;(2)非糜烂性食管反流病(NERD):有反流症状但内镜下未见食管破损者;(3)Barrett食管(BE):食管黏膜上皮被胃柱状上皮所替代。GERD为常见的慢性疾病,易反复发作,严重影响患者的生活质量,造成沉重的经济和社会负担。本文就该病的发病机制、诊断及治疗进展做一简要综述。     

1例鲁登巴赫综合征患者的护理体会

<正>鲁登巴赫综合征(lutembacher’s syndrome)[1]系房间隔缺损并二尖瓣狭窄的一组心脏病,临床较少见,其发生率占二尖瓣狭窄的0.6%~0.7%,占继发孔房间隔缺损的4%,女性多见。     

穴位埋线对功能性便秘患者自主排便次数和生活质量的影响

目的评价穴位埋线对功能性便秘患者自主排便次数及生活质量的影响。方法将90例功能性便秘患者随机分为治疗组和对照组,每组45例。治疗组予穴位埋线治疗,对照组予针刺治疗,取相同穴位。治疗后观察周完全自主排便次数(CSBMs)≥4次患者所占百分比和治疗后CSBMs较治疗前增加2次及以上的患者所占百分比以及两组患者周平均CSBMs,便秘患者生活质量量表(PAC-QOL),并观察不良反应。结果治疗组CSBMs≥4的百分比和周平均CSBMs增加2次及以上的百分比均明显高于对照组(P0.05);治疗期间治疗组周平均CSBMs(4.12±1.07)较对照组(3.36±0.99)明显增多(P0.05)。两组治疗后PAC-QOL评分均较治疗前下降(P0.05),且观察组低于对照组(P0.05)。结论穴位埋线治疗功能性便秘可以有效提高患者自主排便次数,提高患者的生活质量。     

肝硬化门脉高压性胃病132例

1999年5月至2002年11月,共收治经胃镜、腹部B超、CT等检查确诊为肝硬化门脉高压性胃病(PHG)患者132例,现将临床资料总结报道如下。     

口腔恶性肿瘤化疗后粘膜感染的防治

口腔鳞癌是口腔颌面部最常见的恶性肿瘤。手术切除肿瘤加化疗,是临床常用的治疗方法之一,但一些患者在化疗过程中常并发口腔溃疡及感染,为了加强对此类患者的口腔护理和治疗,我们从1983年～1996年对收治的41例口腔鳞癌手术加化疗患者,使用甲硝唑和四氢叶酸配制的混合漱口?..     

系统性红斑狼疮合并可逆性后部脑病综合征1例

This case report concerns a 22-year-old woman who had been diagnosed with systemic lupus erythematosus (SLE). She had intermittent fever, butterfly erythema, photosensitivity, oral ulcers, and multiple arthralgia in the past seven years, but she did not adhere to regular treatments. The edema of the lower extremities and face aggravated in the recent two weeks, so she was admitted to our Department of Rheumatology and Clinical Immunology. Meanwhile, we found she had severe hypertension, the maximal blood pressure was 170/120 mmHg. The patient had high SLE disease activity (the disease activity index score was as high as 23) with blood involvement, acute renal insufficiency, multiple serous effusion and rash. After one week treatments of intravenous methylprednisolone 80 mg daily and other drugs, her conditions made some extent improvement. However, she suffered sudden epileptic attacks. No positive neuro-pathological signs were found, and the blood pressure was up to 190/130 mmHg before the onset of the seizures. Her cerebrospinal fluid (CSF) pressure was 330 mmH₂O, the CSF protein level was normal value, and the white blood cell count was 0 cell/mm ³, with no signs of infection. Cranial MRI showed vasogenic edema at bilateral parietal, occipito-parietal regions, and centrum ovale. We prescribed drugs of decreasing intracranial pressure, intravenous drugs of decreasing blood pressure and midazolam for sedation, without corticosteroid impulse therapy. She recovered consciousness in the next day, without epilepsy recurrence. We eventually diagnosed it as posterior reversible encephalopathy syndrome (PRES), according to the history, laboratory results, imaging featuresand clinical outcome. PRES is a disorder of reversible subcortical vasogenic brain edema in patients with acute neurological symptoms (eg, seizures, encephalopathy, headache, and visual disturbances).PRES is mainly caused by blood pressure changes or endothelial injury, which lead to breakdown of the blood-brain barrier and subsequent brain edema. Most patients have a favourable prognosis.SLE complicated with PRES is not rare, especially in patients with disease activity, hypertension, lupus nephritis and/or renal insufficiency, and use of cytotoxic drugs, early recognition and appropriate treatment remain important. Brainstem involvement, intracranial hemorrhage, renal insufficiency and high disease activity of lupus are risk factors for poor prognosis.