Search

14例孤立性蝶窦真菌病的诊断及手术治疗

目的 总结对孤立性蝶窦真菌病的诊断及治疗效果。 方法 回顾性分析2005年7月-2009年7月14例孤立性蝶窦真菌病患者资料，总结临床表现、影像学特征及治疗效果。 结果 14例孤立性蝶窦真菌病患者中，最主要的临床症状为头痛、回涕带血及眼部症状。鼻部CT有利于了解病变范围，主要表现为不均匀的软组织密度影。患者均行鼻窦内窥镜下蝶窦开放术。手术安全，出血少。 结论 孤立性蝶窦真菌病临床表现无特异性，CT检查有利于早期诊断，确诊需病理学检查，可通过鼻内窥镜手术治愈。

仿真人模拟教学在妇产科护理实践教学中的应用

摘要:妇产科护理学是一门专业性、操作性、实用性很强的临床专业课程,在医学教育中有着重要地位。而对女性患者,常常涉及到其隐私部分给实践课示教、临床见习带来诸多困难。本文对仿真人模拟教学应用于妇产科护理实践课教学方法及效果进行了介绍及分析,对培养学生的临床实践操作能力及综合分析能力,提高教学质量具有积极意义。

Psychological Status, Quality of Life and Related Psychological Intervention in Patients with Gynecological Malignancies

目的　探讨心理干预措施对改善妇科恶性肿瘤患者的生命质量的作用及有效性。 方法　对2008年11月－2010年11月收治的87例妇科恶性肿瘤患者，随机分为试验组与对照组，试验组43例，实施心理干预及常规治疗；对照组44例，采取常规治疗；并对两组患者入院后及出院前生存质量、心理状况以问卷调查方式进行资料收集，用以比较、评价心理干预对改善妇科恶性肿瘤患者生命质量的作用及效果。 结果　妇科恶性肿瘤患者抑郁发生率为56.3%（49/87），焦虑发生率为62.1%（54/87）； 心理干预后两组患者组间各指标比较，试验组患者的总体健康状况、生存质量、角色功能、情绪功能、认知功能得分比对照组增高（P＜0.05）；试验组患者疲倦、恶心呕吐、失眠、食欲下降、便秘症状、抑郁、焦虑得分比对照组得分下降（P＜0.05）。 结论 心理干预可改变妇科肿瘤患者的负性心理倾向，缓解抑郁、焦虑等情绪，减轻化疗药物所引起的系列副作用，能有效提高其生活质量。

银杏叶注射液联合甲钴胺治疗糖尿病周围神经病变

目的 观察银杏叶注射液联合甲钴铵治疗糖尿病周围神经病变（DPN）临床疗效。 方法 选择2007年9月-2009年10月收治的DPN患者75例，随机分为观察组和对照组，两组均给予甲钴胺口服，观察组在此治疗基础上加用银杏叶注射液。 结果 治疗1个疗程后，观察组疗效优于对照组，两组比较总有效率有统计学意义（Plt;0.05）；观察组治疗后与治疗前比较，有统计学意义（Plt;0.05），对照组无差异 （Pgt;0.05）。两组治疗后神经传导速度比较，观察组优于对照组，有统计学意义（Plt;0.05）。 结论 在有效控制血糖基础上，银杏叶注射液联合甲钴胺治疗糖尿病周围神经病变是一种有效的方法，建议临床推广。

老年血液透析患者低血压的护理

急性缺血性脑卒中使用rtPA静脉溶栓的观察与护理

婴幼儿检查前水合氯醛灌肠效果影响因素分析

【摘要】　目的　总结婴幼儿检查前应用水合氯醛灌肠镇静效果的影响因素及对策。　方法　2008年11月－2010年11月对450例进行MRI、CT、多导心电图等检查前的患儿应用10％水合氯醛灌肠。　结果　308例（68.4％）在20 min内进入睡眠，85例（18.9％）患儿能在20～30 min内进入睡眠镇静，57例（12.7%）无效。　结论　水合氯醛保留灌肠的效果受时间、体位等诸多因素影响，采取必要的措施就能提高灌肠的有效率。

EFFECTIVENESS OF DIFFERENT BONE GRAFT FUSION WAYS IN TREATING THORACOLUMBAR BURST FRACTURES

Objective To assess the effectivness of different bone graft fusion ways in the treatment of thoracolumbar burst fractures. Methods Between June 2000 and June 2009, 126 cases of thoracolumbar burst fractures were treated by onestageposterior short segment internal fixation combined with bone graft fusion. All patients had acute spine and spinal injuryat the levels of T11-L2, who were with different degrees of neural function injury (below Frankel grade D). The patients were randomly divided into 3 groups and were treated respectively by centrum combined with interbody bone graft fusion (group A), posterolateral bone graft fusion (group B), and ring bone graft fusion (group C) combined with posterior short segment pedicle instrumentation. The changes of the Cobb angle, correction loss of Cobb angle, bone fusion rate, internal fixation failure rate, Oswestry Disabil ity Index (ODI), and Frankel grade of the fracture vertebral were observed after operation to evaluate the effectiveness of different bone graft fusion ways. Results All 126 cases were followed up 24-32 months (mean, 28 months). The operation time and bleeding volume in group C were significantly larger than those in groups A and B (P lt; 0.05), but no significant difference was found between groups A and B (P gt; 0.05). At 2 years after operation and last follow-up, the Cobb angle and correction loss in group B were significantly larger than those in groups A and C (P lt; 0.05), but there was no significant difference between groups A and C (P gt; 0.05). At last follow-up, the bone fusion rate and internal fixation failure rate were 100% and 0 in group A, 78.6% and 21.4% in group B, and 97.5% and 0 in group C; there were significant differences between group B and groups A, C (P lt; 0.05), but no significant difference was found between groups A and C (P gt; 0.05). ODI and Frankel grade were obviously improved after operation, showing significant differences between preoperation and last follow-up (P lt; 0.05) in 3 groups, between group B and groups A, C (P lt; 0.05), but no significant difference was found between groups A and C (P gt; 0.05). Conclusion The centrum combined with interbody bone graft fusion is best in 3 bone graft fusion ways because of its optimum bone fusion and according with human body biomechanics mechanism. Back outboard bone graft fusion may not a appropriate bone fusion way because of its high internal fixation failure rate and not according with human body biomechanics mechanism. The ring bone graft fusion may not be an indispensable bone fusion way because of its common bone fusion ratio and lower cost-performance ratio.

Risk factors of central line-associated bloodstream infection

Objective To investigate the risk factors of central line-associated bloodstream infection (CLABSI) and provide clinical guidance for reducing the incidence of CLABSI. Methods The clinical data of patients with central venous catheter catheterization in Sichuan Provincial People’s Hospital between January 2018 and December 2021 were retrospectively collected. According to whether CLABSI occurred, the patients were divided into CLABSI group and non-CLABSI group. The data of patients were analyzed and the risk factors of CLABIS were discussed. Results A total of 43 987 patients were included. Among them, there were 63 cases in the CLABSI group and 43924 cases in the non-CLABSI group. The incidence of CLABSI was 0.18/1 000 catheter days. Multivariate logistic regression analysis showed that admission to intensive care unit (ICU) [odds ratio (OR)=74.054, 95% confidence interval (CI) (22.661, 242.005), P<0.001], hemodialysis [OR=4.531, 95%CI (1.899, 10.809), P=0.001] and indwelling catheter days [OR=1.017, 95%CI (1.005, 1.029), P=0.005] were independent risk factors for CLABSI. A total of 63 strains of pathogenic bacteria were isolated from the 63 patients with CLABSI. Among them, 28 strains of Gram-positive bacteria, 25 strains of Gram-negative bacteria and 10 strains of Candida. Conclusions Admission to ICU, hemodialysis and long-term indwelling catheter are independent risk factors for CLABSI. The prevention and control measures of CLABSI should be strictly implemented for such patients to reduce the risk of infection.

Treatment of Severe Abdominal Cavity Infection Compl icating Respiration-Circulation Dysfunction with Ulinastatin and Growth Hormone

【摘要】　目的　探讨严重腹腔感染合并呼吸循环功能障碍的有效治疗方法。方法　选择2004 年10 月至2006 年5 月期间我院ICU 收治的严重腹腔感染合并呼吸循环功能障碍患者42 例,其中治疗组( n = 22) 应用乌司他丁和生长激素联合治疗方案,对照组( n = 20) 应用常规治疗。比较2 组病例的临床病死率,并对2 组病例的ICU 住院时间及呼吸支持时间、循环支持时间的差异进行分析。结果　治疗组与对照组的临床病死率(22. 7 % vs35. 0 %) 差异无统计学意义( Pgt; 0. 05) ,而治疗组较对照组ICU 住院时间〔(12. 1 ±4. 2) d vs (18. 8 ±3. 6) d〕、呼吸支持时间〔(10. 1 ±3. 1) d vs (15. 4 ±4. 4) d〕及循环支持时间〔(5. 6 ±1. 8) d vs (11. 3 ±2. 1) d〕明显减少( P lt;0. 05) 。结论　乌司他丁和生长激素联合使用可以改善严重腹腔感染合并呼吸循环功能障碍的治疗效果。