高龄患者围手术期急性肺损害的护理体会

目的总结我院高龄患者围手术期急性肺损害的护理经验。方法通过呼吸管理、气道护理观察等,对腹部外科术后出现急性肺损害危重患者采用中西医结合的方法综合治疗护理。结果患者均取得良好疗效,患者顺利度过危险期。结论临床密切观察,科学护理,对腹部外科术后出现急性肺损害危重患者采用中西医结合的方法综合治疗,疗效显著,安全度过围手术期。     

贫血、肝脾肿大

２０００年３月２９日,我院血液科收治１例因贫血、肝脾肿大住院患者。骨髓多部位多次穿刺均干抽,诊断不清,后经骨髓活检确诊。此为疑难少见病例,故提请西安市医学会组织第四军医大学西京医院、唐都医院,西安交通大学第一、第二医院,陕西省妇幼保健院,西安市中心医院,西安市第一人民医院及西安市儿童医院进行讨论,现将讨论情况总结报告如下。 病历摘要 患男,１２／１２岁。因面色苍白 ２月,发热３ｄ于２０００年３月 ２９日入院。２月前患儿无明显诱因出现面色苍白、乏力、食欲减退、消瘦,未引起家长重视。 ３ｄ前因受凉发热,…     

亚标准剂量静脉注射丙种球蛋白合并达那唑治疗特发性血小板减少性紫癜的观察

目的 :观察亚标准剂量静脉注射丙种球蛋白 (SUB- HD- IVIG)合并使用达那唑治疗重症特发性血小板减少性紫癜近期疗效。方法 :用 SUB- HD- IVIG(0 .3· kg- 1 · d- 1 ,共用 5 d)合并使用达那唑 (0 .6 g/ d)治疗初治重症 ITP并与 HD- IVIG治疗初治重症 ITP进行比较。结果 :与治疗前相比 ,治疗开始 6 d及以后两组血小板数明显上升 ,P<0 .0 1。治疗开始后 SU B- HD- IVIG组不同时间点血小板数的上升与 HD- IVIG组血小板数的上升之间的差异在统计学上无显著意义。治疗开始后出血消失的时间也相似。结论 :SU B- HD- IVIG合并口服达那唑是治疗特发性血小板减少性紫癜的一种有效方法。它既可减少患者经济费用 ,又能获得可靠疗效 ,但其远期疗效有待进一步观察。     

α-酸性糖蛋白在类风湿关节炎患者中的临床意义

目的研究α1-酸性糖蛋白在类风湿关节炎患者中的临床意义.方法应用速率散射比浊法测定72例类风湿关节炎患者(其中活动期43例,非活动期29例)血清α1-酸性糖蛋白.结果 72例类风湿关节炎患者α1-酸性糖蛋白的含量为(1247.4±386.5)mg/L,43例活动期类风湿关节炎患者为(1582.7±516.6)mg/L,29例非活动期类风湿关节炎患者为(831.4±306.5)mg/L,30例正常对照组AAG的水平为(436.5±278.3)mg/L,类风湿关节炎患者血清α1-酸性糖蛋白的水平高于正常对照组(P＜0.01).活动期类风湿关节炎血清α1-酸性糖蛋白高于非活动性类风湿关节炎(P＜0.01).结论α1-酸性糖蛋白检测对类风湿关节炎的活动期评价有一定的临床价值.     

泪道内镜下治疗泪道阻塞性疾病的初步观察

Objective To evaluate the therapeutic efficacy of lacrimal endoscope treatment for lacrimal passage obstruction, and to compare the effectiveness of endoscopically controlled laser surgery and micro-drill surgery for lacrimal passage obstruction. Methods It was a prospective random controlled trial. Eighty nine patients (104 eyes) with lacrimal passage obstruction, including presaccal canalicular obstruction (PSCO) and nasolacrimal duct obstruction (NLDO), were collected from September 2006 to December 2006 in Department of Ophthalmology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology. Patients were examined by endoscopy of the lacrimal drainage system under local anesthesia to detect the obstruction and changes of lacrimal mucous membrane. The obstructions were treated with laser or microdrill. Irrigation was performed to prove the recanalization of the lacrimal passage followed by injected ointment with 0.3% tobramycin and 0.1% dexamethasone into the lacrimal passage. All patients were followed up after the operation for 9-12 months. The difference between the laser and the microdrill treatment was observed. Chi-square test was used to evaluate the curative effect and complications differences between these two groups. Results The obstruction scene in the lacrimal passage of 89 patients could be observed effectively. All obstructions (104/104 eyes) were eliminated after the operation. Through the follow-up, the cure rate reached 78.85% (82/104 eyes). The cure rate of PSCO group and NLDO group, reached 77.78% (42/54 eyes) and 80.00% (40/50 eyes), respectively (χ2=0.077,P=0.782). The cure rate of laser group and micro-drill group, was 80.43% (37/46 eyes) and 77.59% (45/58 eyes), respectively (χ2=0.125,P=0.724). The cure rate of laser treatment was 89.66% (26/29 eyes) in the PSCO group and 64.71% (11/17 eyes) in the NLDO group (P=0.040). The cure rate of micro-drill treatment was 64.00% (16/25 eyes) in the PSCO group and 87.88% (29/33 eyes) in the NLDO group (χ2=4.664,P=0.031). Hemorrhage and palpebral edema occurred in 10.87% (5/46 eyes) and 4.35% (2/46 eyes) after laser treatment, respectively. Percentage of hemorrhage and palpebral edema after the micro-drill treatment was 55.17% (32/58 eyes) (compared to the laser group, χ2=21.969,P=0.000) and 6.90% (4/58 eyes) (compared to the laser group, χ2=0.017 ,P=0.896). Conclusions Lacrimal passage obstruction can be observed and treated directly through the endoscopy of lacrimal drainage system. Choosing an appropriate surgical procedure according to the locations of the obstruction can be helpful for improving the effectiveness of the operation.     

真菌性角膜溃疡致病菌种类及其药物敏感性分析

目的探讨真菌性角膜溃疡致病菌的种类的变迁及其对临床常用抗真菌药物的敏感性。方法对拟诊为真菌性角膜溃疡的412例患者培养出的215株致病性真菌进行调查分析,并将所分离的菌株分别做眼科常用抗真菌药物的敏感试验。结果412例标本中,涂片镜检可见菌丝和孢子者有201例,阳性率为48.8%;培养出致病性真菌215株,阳性率为52.2%,主要致病性真菌依次为镰刀菌属(48.3%),曲霉属(32.1%)和弯孢霉属(14.9%)。对抗真菌药物克霉唑、两性霉素B、酮康唑和氟康唑的敏感性分别为59.5%、43.7%、21.4%和11.2%。结论真菌性角膜溃疡主要致病性真菌为镰刀菌属,215株真菌对克霉唑有较高敏感性。     

胰岛素—胰酶联产工艺研究初报

<正> 鉴于胰脏是产生多种生化物质的宝库,是世界上属于匮乏的资源之一。因而综合利用胰脏的研究、生产已经成为生化制药产业中的新的必然趋势。又因为胰岛素和胰酶是以胰脏为原料。需求量最大的两个大宗产品,所以,我们围绕这两个产品,设计和改革生产工艺,得到了胰岛素和胰酶两个合格的生化产品。初报如下:     

中医健康教育路径在优质护理活动中的应用研究

目的：探讨中医健康教育路径在优质护理活动中的应用。方法将76例中风患者按照住院时间分为对照组39例,观察组37例,用Barthel指数评分量表、患者健康教育达标率、患者满意度比较两组宣教效果。结果经比较观察组患者Barthel指数评分量表、健康教育达标率、满意度明显高于对照组,有统计学意义（P＜0.05）。结论中医健康教育路径的实施对提高患者生活自理能力恢复和患者满意度有明显促进作用。