2490名中老年干部钙化性主动脉瓣病的患病情况及超声心动图分析

本文分析了在2490名中老年干部中经超声心动图诊断的104例钙化性主动脉瓣病的超声心动图表现。发现其患病率随年龄增长成倍数递增,男性多于女性。该病不仅可以引起众所周知的AS,也可引起AI,以无冠瓣受累最多。轻—中度CAS及CAI尚不足以引起心脏解剖结构的明显改变,左室收缩功能也保持正常,但舒张功能却发生障碍。     

突发公共事件紧急医疗救援体系运行模式探讨

建立健全四川省突发公共事件紧急医疗救援指挥体系，建立省、市（州）紧急医疗救援中心及急救网络，制定紧急医疗救援预案，加强应急救援队伍建设及培训和演练，重视应急医疗救援设备装备和救援物资储备，与当地政府、公安、消防、军队等密切配合，能很好地完成交发公共事件的紧急医疗紧急救援。     

个体化肺结节三维重建模拟手术在胸腔镜肺段切除中的应用

目的探讨个体化肺结节三维重建模拟手术在胸腔镜肺段切除中的应用价值。方法 2018年12月～2019年12月接受手术治疗的肺结节病人60例,随机分为三维重建模拟手术组和非三维重建模拟手术组,每组各30例。比较两组围手术期相关指标的差异。结果两组均顺利完成胸腔镜下肺段切除术;三维重建模拟手术组术前与术中吻合率分别为:结节部位100%,靶段血管96.67%,靶段支气管96.42%;三维重建模拟手术组的手术时间、术中出血量、引流管留置时间、术后总引流量以及术后住院时间均低于非三维重建模拟手术组,差异有统计学意义(P0.05),两组术中清扫淋巴结个数与术后并发症发生率比较,差异无统计学意义(P0.05)。结论肺结节基于三维重建个体化胸腔镜解剖性肺段切除术安全有效,较常规手术更具临床应用价值。     

主动适应医改立于不败之地

城镇职工基本医疗保险这种新的保障体制是我们必须面对的课题。去年我市正式推出和贯彻落实国务院颁发的医改配套文件 ,我院也作为首批参加当地省、市城镇职工基本医疗保险制度试点的三甲医院之一。在贯彻落实医改政策过程中 ,院领导班子召开了全院动员大会 ,认真组织全院学习了医保相关政策 ,强调关键是要主动适应医疗制度改革 ,通过在全院统一思想 ,深化内部改革 ,坚持优质服务 ,以病人为中心的各项工作落到了实处。1　以门急诊为窗口 ,提供方便快捷的服务方式我院地处市区 ,工伤、交通事故及市内、外来院的就诊人员流动量大 ,因而门急诊…     

T2～T3期食管癌根治术后辅助化疗对远期生存的影响

目的研究T2～T3期食管癌根治术后辅助化疗对患者的生存率及影响预后因素的分析。方法 1998年6月至2005年6月间进行根治性手术的T2～T3期食管癌患者140例,分成辅助化疗实验组78例和对照组62例,实验组于术后3～4周开始辅助化疗,每3周1次,共4次,所有患者全部随访,选择5个可能影响预后的因素进行Cox回归分析。结果术后辅助化疗可延长中晚期食管癌根治术后的远期生存。经过Cox比例风险模型分析,年龄、性别、部位等不影响患者的预后,但淋巴结转移和术后辅助化疗是影响T2～T3期食管癌根治术后的生存的主要因素。结论术后辅助化疗和淋巴结转移是影响T2～T3期食管癌切除术后预后的主要因素,为提高远期生存,应常规进行术后辅助化疗和区域淋巴结清扫。     

静脉注射6%羟乙基淀粉130/0.4和呋塞米治疗急性胰腺炎的初步研究

目的观察静脉输注6%羟乙基淀粉130/0.4（万汶）和静脉推注呋塞米（速尿）对急性胰腺炎转归的影响。方法入院当天即给予患者万汶静脉输注（成人通常为1000～2000ml）,同时静脉推注呋塞米,力求作到出入量基本平衡;入院第2天开始逐渐减少万汶用量。结果48例急性胰腺炎患者（Ranson评分≥3分者35%,Balthazar CT评分≥D或E者48%）,胰腺局部并发症和全身并发症仅为6%和4%,胰腺手术率为4%,1个月病死率为2%。结论静脉输注万汶和静脉推注呋塞米可改善急性胰腺炎的转归。     

中国内地首例输入性甲型H1N1流感病例诊断处置流程分析

Objective The patient started from St. Louis (U. S.), and reached Chengdu (China) after 3 days of flight(St. Louis- Tokyo- Beijing - Chengdu). The patient felt unwell, so he and the two relatives took a taxi to the Emergency Center of Sichuan Provincial People' s Hospital for treatment. The epidemiological survey showed that, the patient had been living in the University of Missouri in the United States, no pigs died locally, there were no markets for the living pigs, farmers markets, farms, and slaughterhouses, and he hadn't contact with pigs. But 4 days before the onset, he closely contacted with a schoolmate, who had cold symptoms. The pa-tient had never been to virus laboratory 7 days before the onset. Clinical examinations showed that, the patient had a fever (37.8 ～ 38.8℃), WBC 7.9×10-9 L-1, N 5.475 × 10-9 L-1, L 19.5% ;the chest X-ray shewed that texture increased and the heart shadow augmented on both lungs; the result of throat swab culture was negative. The result of virus nucleic aeid detected by Sichnan Provincial Center for Disease Control showed H1N1 influenza virus, suspected. Sichuan Province Health organization organized experts on the prevention and control of H1N1 influenza for consultation, and the patient was diagnosed as the first suspected H1N1 influenza case in mainland China based on the epidemiological investigation, symptoms and signs of the patient, the results of laboratory ex-amination, and the result of virus test. Confirmed by the experts from Chinese center for disease control and pre-vention and The Ministry of Health of the People's Republic of China, the patient was diagnosed as the first H1N1 influenza case in mainland China.     

中国内地首例输入性甲型H1N1流感病例诊断处置流程分析

Objective The patient started from St. Louis (U. S.), and reached Chengdu (China) after 3 days of flight(St. Louis- Tokyo- Beijing - Chengdu). The patient felt unwell, so he and the two relatives took a taxi to the Emergency Center of Sichuan Provincial People' s Hospital for treatment. The epidemiological survey showed that, the patient had been living in the University of Missouri in the United States, no pigs died locally, there were no markets for the living pigs, farmers markets, farms, and slaughterhouses, and he hadn't contact with pigs. But 4 days before the onset, he closely contacted with a schoolmate, who had cold symptoms. The pa-tient had never been to virus laboratory 7 days before the onset. Clinical examinations showed that, the patient had a fever (37.8 ～ 38.8℃), WBC 7.9×10-9 L-1, N 5.475 × 10-9 L-1, L 19.5% ;the chest X-ray shewed that texture increased and the heart shadow augmented on both lungs; the result of throat swab culture was negative. The result of virus nucleic aeid detected by Sichnan Provincial Center for Disease Control showed H1N1 influenza virus, suspected. Sichuan Province Health organization organized experts on the prevention and control of H1N1 influenza for consultation, and the patient was diagnosed as the first suspected H1N1 influenza case in mainland China based on the epidemiological investigation, symptoms and signs of the patient, the results of laboratory ex-amination, and the result of virus test. Confirmed by the experts from Chinese center for disease control and pre-vention and The Ministry of Health of the People's Republic of China, the patient was diagnosed as the first H1N1 influenza case in mainland China.     

肛管直肠损伤的诊断和治疗

目的：探讨肛管直肠损伤的诊断和治疗。方法：回顾性分析近10年来收治的48例肛管直肠损伤患者的病历资料。直肠损伤41例，肛管损伤7例。合并伤33例(68．8％)。结果：全组均行手术治疗，单纯修补加局部引流14例，修补加结肠造口28例，单纯粪便转流加引流6例。45例治愈，3例(6．3％)死亡。16例(33．3％)术后发生并发症。结论：早期诊断，合理应用转流、引流、冲洗三项措施，控制感染和积极处理合并伤是提高治愈率、降低病死率的关键。     

地震伤并发挤压综合征的救治分析

目的 探讨地震后发生挤压综合征的危险因素和治疗措施.方法在325例地震伤患者中,有35例并发挤压综合征,按其性别、年龄、伤后就诊时间、治疗过程及预后进行比较分析.结果 获救时间、诊治延误及年龄均是挤压综合征发生的高危因素.35例地震伤并发挤压综合征患者均行彻底切开减压,6例痊愈,2例遗留功能障碍,27例截肢.结论 对地震伤后挤压综合征伤情高度重视和准确判断,早期诊断,及时充分减压,是对地震伤并发挤压综合征最主要的预防与治疗措施.