目的 比较一次性包皮切割缝合器与传统包皮环切术和套扎环包皮环切术的临床应用效果。方法 对我院2016年7月—2016年12月内门诊收治的包皮过长和包茎患者,采用不同手术方法治疗,其手术时间、术中疼痛评分(VAS评分)、术后水肿、疼痛持续时间、以及外观满意度等方面进行对比。结果 在手术时间和外观满意度方面一次性包皮切割缝合器明显优于传统包皮环切术;在术中疼痛评分(VAS评分)、疼痛持续时间和术后水肿方面一次性包皮切割缝合器明显优于套扎环包皮环切术。结论 一次性包皮切割缝合器与两种传统常规手术比较,手术更加简单、方便且安全,术后外观满意度高,值得临床推广。

Objective To compare the effects of circumcision between using a novel disposable suture device and traditional or plastibell procedure. Methods The patients from July 2016 to December 2016 that underwent different ways of circumcision were documented. The operation time, VAS score, postoperative edema, the duration of the pain and appearance of satisfaction were collected and analyzed. Results The suture device group had shorter operation time, better appearance of satisfaction than that of traditional group (P<0.05). Besides, the suture device group had lesser VAS score, shorter duration of the pain and less postoperative edema (P<0.05). Conclusion Compared to traditional or plastibell procedure, a novel disposable suture device circumcision represents convenient, efficient and minimal invasive. It is worth promoting clinically.

目的 探究一次性带冲洗球囊胃管的临床应用。方法 收集来我院进行腹部外科手术的患者共200例,随机分为研究组与对照组,每组100例,其中研究组患者采用一次性带球囊胃管治疗,对照组则应用传统胃管进行治疗。观察对比2组患者进行引流的通畅情况、治愈时间、胃管滑脱及胃管相关并发症等情况。结果 研究组患者的一次置管成功率高于对照组(P＜0.05),置管停顿率和自行拔管率均低于对照组(P＜0.05);研究组低于对照组(P＜0.05);研究组患者的不良反应发生率低于对照组(P＜0.05),差异均有统计学意义。结论 一次性带冲洗球囊胃管治疗可持续冲洗胃腔及灌注药物,保证引流通畅,明显提高胃肠减压效果,促进胃黏膜的炎症水肿、糜烂出血等病症的修复愈合,并且能够提高置管效果,减少置管时间,同时避免不良反应的发生,值得临床进一步推广。

Objective To investigate the clinical value of disposable balloon catheter with irrigation. Methods In our hospital for abdominal surgery patients with a total of 200 cases were randomly divided into study group and control group, 100 cases in each group. The study group was treated by disposable balloon intubation, the control group used conventional gastric tube. Observation and comparison of two groups were taken with drainage patency, cure time, gastric tube slippage and gastric tube related complications. Results The study group of patients with a success rate of catheterization was higher than that of the control group (P<0.05), catheter pause rate and self extubation rate were lower than that of the control group (P<0.05); the study group was significantly lower than that of the control group (P<0.05); the adverse reaction of patients in the study group was significantly lower than that of the control group (P<0.05), the differences were statistically significant. Conclusion Disposable flushing balloon intubation treatment of gastric cavity perfusion and sustainable irrigation, to ensure smooth drainage, may improve the effect of gastrointestinal decompression, promote the repair of gastric mucosal inflammation and edema, erosion, bleeding and other symptoms and improve the effect of catheterization, reduce the intubation time, and avoid the occurrence of adverse reactions. It is worthy of further promotion.

目的 探讨在急诊冠心病快速心律失常患者中应用胺碘酮治疗的临床效果。方法 选取在我院接受治疗的164例冠心病快速心律失常患者进行研究,采用随机数字表法将其随机分为对照组和研究组,每组82例。对照组给予利多卡因治疗,研究组给予胺碘酮治疗,比较两组患者的临床治疗效果及不良反应发生情况,同时比较研究组中不同类型心律失常患者的治疗效果。结果 研究组患者治疗总有效率为89.0%,对照组为64.6%,两组比较均有差异(P＜0.05);采用胺碘酮治疗的研究组患者中,室性早搏患者的治疗总有效率最高,其次为阵发性房颤、持续性房颤、阵发性室性心动过速、室性心动过速,其中室性早搏和阵发性房颤治疗总有效率高于心动过速(P＜0.05)。结论 胺碘酮治疗急诊冠心病快速心律失常在适应症和禁忌症的严格掌握和心率、血压的密切监测的前提下效果更为确切,可作为首选药物应用。

目的 对比双腔耐高压PICC和股静脉置管在IV级心力衰竭患者中的应用效果。方法 选取我院 2016年1月—12月收治的端坐位IV级心力衰竭患者61例,按照便利抽样的方法将其随机分成研究组31例和对照组30例。研究组患者行耐高压PICC置管,对照组患者行双腔中心股静脉置管,观察2组患者的一次性置管成功率、导管头端位置、并发症发生率、留置导管天数和患者满意度等相关临床指标。结果 研究组患者的一次插管成功率为 93.55%(29例),高于对照组的83.33%(25例)(P<0.05);研究组患者的并发症发生率低于对照组(P<0.05)。结论 对IV级心力衰竭患者在端坐位下予以耐高压PICC 插管进行治疗,能提高一次置管成功率,降低并发症发生率,提高患者满意度,可作为患者抢救时的首选静脉通道。

Objective To compare the effect of dual chamber high pressure PICC (peripherally inserted central catheter) and femoral vein CVC(central venous catheter)catheterization in patients with IV class heart failure. Methods From January to December 2016, 61 patients with congestive heart failure in the sitting position were selected from our hospital. According to the convenient sampling method, they were randomly divided into the study group (31 cases) and the control group(n=30). The study group were treated with high pressure PICC tube, the control group underwent femoral vein catheterization. Two groups of patients with the success rate of catheterization, catheter tip location, complications, indwelling catheter days and related clinical indicators of patient satisfaction were observed. Results The successful rate of intubation in the study group was 93.55% (29 cases), higher than that of the control group (25 cases)(P<0.05), and the incidence of complications in the study group was lower than that of the control group(P<0.05)(83.33%). Conclusion Treatment for patients with heart failure IV be in sitting position under high pressure PICC intubation, may improve the success rate of catheterization, reduce the incidence of complications, improve patient satisfaction, and be the first choice when the rescue of patients with venous channel.

目的 探讨活性臭氧水在失禁性皮肤炎中的应用效果。方法 将123例失禁性皮肤炎患者按入院时间分为对照组、银离子组、实验组各41例,分别给患者使用氧化锌软膏、银离子敷料和活性臭氧水进行治疗,治疗后对治疗效果、愈合时间以及患者对疗效的满意度进行评估。结果 治疗后银离子组、实验组有效率达100%,实验组、银离子组患者愈合时间比较接近,与对照组比较差异有统计学意义(P＜0.05);治疗后实验组的满意度为100%,银离子组为90.24%,对照组为60.98%。结果显示实验组更优于银离子组,且与对照组比较差异有统计学意义(P＜0.01)。结论 利用活性臭氧水治疗失禁性皮肤炎不仅能有效地提高创面的愈合能力,缩短愈合时间,而且方便、安全、高效、成本低。

Objective To investigate the efficacy of ozone water in the treatment of incontinence dermatitis. Methods 23 cases of incontinence dermatitis were divided into control group, silver ion group and experimental group respectively. Each group consists of 41 cases. The patients were treated with Zinc oxide ointment in control group, ionic silver dressing in silver ion group and activity of ozone water treatment in experimental group. Healing time and curative effect, as well as satisfaction assessment of patients after treatment were studied. Results It showed that both silver ion group and experimental group achieved an effective rate of 100%. The healing time of experimental group and silver ion group were relatively similar, while that of control group is significant differentt (P<0.05). Satisfaction assessment showed that the experimental group after treatment was 100%, while silver ion group was 90.24% and 60.98% in the control group. Results showed that experimental group is better than that of silver ion group, and both groups were statistically significant different to control group (P<0.01). Conclusion The use of ozone water in the treatment of incontinence dermatitis can not only effectively improve the wound healing ability, shorten the healing time, but also is convenient, safe and low cost.

目的 研究多排螺旋CT低剂量扫描在浸润型肺结核化疗期间复查的应用价值。方法 选取100例浸润型肺结核化疗期病人为研究对象,对选取100例患者行常规剂量胸部CT扫描后再行低剂量扫描。比较常规剂量组和低剂量组CT扫描的图像质量及疗效评估。结果 两组扫描肺窗图像质量比较无统计学差异(P＞0.05);两组肺窗薄层多平面重建图像质量比较无统计学差异(P＞0.05); 两组软组织窗图像质量有统计学意义(P< 0.05)。观察组ED、DLP和CTDIvol等指标低于对照组(P＜0. 01),即观察组受检者CT扫描辐射剂量低于对照组(P＜0.01)。结论 多排螺旋CT低剂量胸部扫描用于浸润型肺结核的复查,可以获得与常规剂量接近的肺窗图像质量,满足肺结核病灶的分析评估,并可有效减少胸部CT扫描中的辐射剂量;既能满足肺结核复查的疗效评估,又提高了肺结核CT复查的安全性,还有效节约检查成本。

Objective To study the application of low-dose scan of multidetector row CT(MDCT)in the chemotherapy of infiltrative tuberculosis. Methods 100 patients with infiltrative pulmonary tuberculosis who were under treatment were selected. All patients accepted conventional-dose and low-dose scan of MDCT. The image quality and treatment effect of two groups were compared. Results The image quality on lung window of two groups did not differ significantly(P＞0.05). The image quality on lung window with multiplanar reconstruction of two groups also did not differ significantly(P＞0.05). The image quality on soft-tissue window differed significantly (P<0.05). The ED, DLP and CTDIvol of the low-dose group were significantly lower than those of the conventional-dose group. Conclusion For MDCT follow-up examination of patients with infiltrative tuberculosis, the image quality on lung window with low dose is similar to the image quality with conventional dose. It may effectively reduce the exposure dose of CT examination. This cost-effective modality not may can meet the curative effect evaluation of TB, but also can improve the security of the follow-up examination of patients.

目的 比较不同浓度罗哌卡因横纹肌阻滞应用于剖宫产术后镇痛的临床效果。方法 选取2015年3月—2016年3月于我院剖宫产的孕妇300例,随机分为A组、B组、C组,每组100例,A组产妇给予质量浓度为1.5 g/L的罗哌卡因1.5 mg/kg,B组产妇给予质量浓度为2 g/L的罗哌卡因1.5 mg/kg,C组产妇给予质量浓度为2.5 g/L的罗哌卡因1.5 mg/kg,同时给予所有产妇镇痛泵辅助镇痛。记录观察所有产妇术后6 h、12 h、24 h、36 h、48 h的疼痛视觉模拟评分(VAS)、镇痛泵按压次数、产妇对镇痛效果的满意程度以及腹横肌平面阻滞(TAP)不良反应发生情况。结果 B、C组产妇的VAS评分均低于A组产妇(P＜0.05),24 h后C组产妇的VAS评分低于B组产妇(P＜0.05);与B、C组产妇相比,A组产妇的镇痛泵按压次数更多,镇痛效果满意度较低(P＜0.05),同时B组产妇的镇痛泵按压次数多于C组产妇(P＜0.05);3组产妇均未出现术后不良反应。结论 使用质量浓度为2.5 g/L的罗哌卡因横纹肌阻滞进行剖宫产术后镇痛,效果显著、安全性较高,临床中可推广使用。

Objective To compare the clinical effects of different concentrations of ropivacaine for postoperative analgesia after cesarean section. Methods 300 cases of pregnant women undergoing cesarean section in our hospital from March 2015 to March 2016 were selected and were randomly divided into group A, group B and group C with 100 cases in each group. The patients in group A were given 0.15% ropivacaine 1.5 mg/kg, 0.20% ropivacaine 1.5 mg/kg in group B and 0.25% ropivacaine 1.5 mg/kg in group C, and at the same time all the pregnant women were given analgesic pump assisting analgesia. The pain visual analogue scales (VAS) of the pregnant women were recorded at 6 hours, 12 hours, 24 hours and 36 hours after cesarean section and the number of times of analgesia pressing pump were also recorded. The satisfaction degree of analgesic effect and the TAP occurrence of adverse reactions of the patients were also recorded. Results The VAS scores of group B and group C were lower than that of group A(P<0.05). 24 hours after cesarean section, the VAS score of group C was lower than that of group B (P<0.05). Compared with group B and C, the number of times of analgesia pressing pump in group A were more but the analgesic effect of satisfaction was lower (P<0.05), and at the same time the number of times of analgesia pressing pump in group B were more than those in group C (P<0.05). No adverse reactions were found in the three groups. Conclusion The treatment of using of 0.25% of ropivacaine for muscle block for postoperative analgesia after cesarean section is effective and safe, which may be widely used in clinical practice.

目的 前瞻性探讨三维增强磁共振血管成像(3D CE-MRA)技术在显示骶前区血管的可行性。方法 选取40例因盆腔病变常规行MRI检查的成年患者,采用ACHIEVA 3.0T双源磁共振扫描仪对患者盆腔骶前区血管行DCE-MRA扫描,利用后处理工作站采用最大密度投影(MIP)及容积再现重组(VR)进行血管重建成像以最佳显示骶前区动脉及静脉,主要观察骶前区血管的影像学解剖。结果 40例骶正中动脉均显示清晰,成功率为100%;骶正中动脉均开口于腹主动脉分叉后上方,沿骶骨前面走行至尾骨尖,管径平均为(1.42±0.06)mm(1.30 mm～1.50 mm);骶前区静脉显示率为75%(30/40),可见骶前区静脉呈阶梯状分布。结论 应用3D CE-MRA可以清晰显示部分骶前区血管,可为骶前区手术提供个体局部影像学解剖信息。

Objective To explore the feasibility of three-dimensional enhanced magnetic resonance angiography (3D CE-MRA) in the presacral blood vessels. Methods 40 adult patients with pelvic lesions were examined by ACHIEVA 3.0T dual-source magnetic resonance scanner. DCE-MRA was used to scan the pelvic sacral anterior vessel. The maximal density projection (MIP) and the post volume reproducibility (VR) were reconstructed for optimal reconstruction of the anterior sacral arteries and veins, primarily to observe the anatomy of the anterior sacral vessels. Results 40 cases of sacral median artery were clear, the success rate was 100%; the sacral median arteries open in the abdominal aorta bifurcation after the top along the sacrum to the coccyx tip, the average diameter of (1.42±0.06) mm (1.30 mm-1.50 mm); the rate of the presacral venous display was 75% (30/40), showing that the anterior sacral vein was ladder-like distribution. Conclusion The application of 3D CE-MRA can clearly show some presacral blood vessels, which may provide individual local anatomical information for sacral precancerous surgery.

目的 探讨红外线照射联合中药穴位贴敷在骨外科术后护理工作中的应用。方法 选择2014年2月—2015年6月我院收治的120例骨外科手术治疗患者,随机分为对照组与观察组,每组各60例;两组患者均给予饮食、心理、排便训练等常规护理,观察组在常规护理基础上给予中药穴位贴敷联合红外线照射综合护理,比较两组患者术后自主排便功能恢复情况,采用汉密尔顿抑郁量表(HAMD)与汉密尔顿焦虑量表(HAMA)评估患者干预前后心理状态,于术后不同时间采用视觉模拟评分法(VAS)对患者的疼痛情况进行评定,记录患者住院时间及下肢深静脉血栓发生情况。结果 术后观察组自主排便恢复情况(88.3%)高于对照组(73.3%)(χ²=4.357,P＜0.05),观察组自主排便恢复时间低于对照组(t=5.422,P＜0.05);术后5、30 d两组患者HAMD和HAMA评分均性降低(P＜0.05),观察组低于对照组(P＜0.05);术后5、10、20 d观察组患者疼痛评分比对照组降低(P＜0.05);观察组患者住院时间少于对照组(P＜0.05),观察组下肢深静脉栓发生率1.7%低于对照组6.7%,但无统计学意义(P＞0.05)。结论 红外线照射联合中药穴位贴敷可改善骨外科手术术后患者自主排便功能,降低患者心理压力,促进手术后恢复。

目的 探讨心理干预联合补佳乐在绝经后妇女宫内节育器(IUD)取出术中的临床效果。方法 选取2012年10月—2015年9月在本站施行IUD取出术的绝经后妇女200例,随机分为观察组和对照组各100例,对照组在手术前给予口服补佳乐1 mg 每日1次 连服7天,第8天施行取出术,观察组在对照组的基础上配合心理干预,观察两组在手术过程中的疼痛程度、宫颈松弛度、心理紧张度的差异。结果 IUD取出术中疼痛程度,观察组:0级 53%,1级40.0%, 2级7.0%,3级0%;对照组:0级14.0%,1级27.00%,2级44.0%,3级15.0%。观察组患者IUD取出术中成功率、满意度分别为87%、96%,与对照组比较,两者差异均有统计学意义(P<0.05)。结论 心理干预联合补佳乐应用于绝经后IUD取出术,可有效改善生殖器的施术条件,减少受术者痛苦,安全、有效,效果满意。