论著
目的 探讨急性脑梗死采用丹红联合曲克芦丁脑蛋白水解物治疗的效果。方法 本文将2019年7月—2020年9月我院收治的88例急性脑梗死患者作为研究对象,应用简单数字表达法将患者随机分为两组,44例对照组和44例实验组,对照组患者应用丹红注射液治疗,实验组患者则在对照组基础上联合曲克芦丁脑蛋白水解物进行治疗,1个疗程后,统计分析用药后有效率、治疗前后NIHSS评分、血液流变学指标。结果 两组之间治疗后NIHSS评分、血液流变学指标相比,实验组较对照组低;用药后有效率相比,实验组较对照组高,P<0.05。结论 采用丹红注射液治疗急性脑梗死的基础上给予曲克芦丁脑蛋白水解物治疗可提升疗效,改善患者神经功能缺损状态与血液循环,改善患者预后,促进患者早日康复。
Objective To investigate the effect of Danhong combined with troxerutin brain protein hydrolysate in the treatment of acute cerebral infarction. Methods 88 patients with acute cerebral infarction in our hospital from July 2019 to September 2020 were randomly divided into two groups, 44 cases in the control group and 44 cases in the experimental group. The effective rate, NIHSS score and hemorheology indexes before and after treatment were statistically analyzed after one course of treatment. Results After treatment, NIHSS score and hemorheology indexes of the experimental group were lower than those of the control group; the effective rate of the experimental group was higher than that of the control group, P<0.05. Conclusion On the basis of Danhong injection in the treatment of acute cerebral infarction, troxerutin cerebroprotein hydrolysate can improve the curative effect, improve the neurological deficit and blood circulation, improve the prognosis of patients, and promote the early recovery of patients.
临床诊疗
目的 探讨湿化高流量鼻导管通气(HHFNC)联合枸橼酸咖啡因治疗早产儿呼吸暂停的临床疗效。方法 选取2016年1月—2017年12月我院收治的58例呼吸暂停的早产儿为研究对象,随机分为两组:HHFNC组和对照组,HHFNC组除采用枸橼酸咖啡因治疗方案外,联合HHFNC法进行治疗;对照组采取鼻导管吸氧联合枸橼酸咖啡因治疗。结果 HHFNC组较之对照组治疗早产儿呼吸暂停的总有效率更高,差异有统计学意义(P<0.05);HHFNC组较之对照组总用氧时间、无创辅助通气的时间减少,住院时间缩短,差异有统计学意义(P<0.05)。结论 湿化高流量鼻导管通气(HHFNC)联合枸橼酸咖啡因减少早产儿呼吸暂停的发生,改善早产儿呼吸状况。
临床诊疗
目的 观察牙周基础治疗联合口腔正畸对牙周炎患者炎症细胞因子的疗效分析。方法 以2017年4月—2018年5月于我院医院进行治疗的82例牙周炎患者为研究对象,按随机数字表法分为研究组(41例,给予牙周基础治疗联合口腔正畸)和对照组(41例,口腔正畸)。观察两组患者治疗后临床疗效,对比治疗前后两组患者牙周指数情况、血清炎症因子及咀嚼功能。结果 治疗1周后,研究组有效率高于对照组(97.56% vs 82.93%),组间比较(P<0.05)。治疗前,两组SBI、PLI、GI比较(P>0.05);治疗1周后,两组SBI、PLI、GI均低于治疗前,与对照组SBI、PLI、GI比较,研究组降低,组间比较(P<0.05)。治疗前,两组AL、PD比较(P>0.05);治疗1周后,两组AL、PD均低于治疗前,与对照组AL、PD比较,研究组降低,组间比较(P<0.05)。治疗前,两组TNF-α、IL-8及IL-6水平比较(P>0.05);治疗1周后,两组TNF-α、IL-8及IL-6水平均低于治疗前,与对照组TNF-α、IL-8及IL-6水平比较,研究组下降明显,组间比较(P<0.05)。治疗前,研究组及对照组的咀嚼功能分别为(51±2)分、(52±2)分,两组比较(P>0.05);治疗后1周,研究组及对照组的咀嚼功能分别为(85±4)分、(73±3)分,研究组咀嚼功能明显高于对照组,组间比较(P<0.05)。结论 牙周基础治疗联合口腔正畸治疗牙周炎患者效果确切,可降低炎症反应,值得临床推广应用。
临床诊疗
目的 探讨硝普钠联合多巴胺治疗心肌梗死后左心衰竭的疗效。方法 选取2018年11月—2019年11月我院收治的心肌梗死后左心衰竭患者148例,应用随机数字法分为两组,对照组应用多巴胺治疗,研究组应用硝普钠联合多巴胺治疗。比较2组治疗效果,心率、呼吸、收缩压及舒张压等心功能指标,头痛、视力模糊、肌肉颤搐等不良反应。结果 经过治疗后,比较2组治疗效果,经研究可知,研究组有效率为97.2%,对照组为87.8%,研究组疗效高于对照组,差异有统计学意义(P<0.05);治疗后,2组患者心脏功能指标均优于治疗前,且研究组心脏功能指标优于对照组,差异有统计学意义((P<0.05);经过治疗后,比较2组治疗效果,经研究可知,研究组不良反应为2.8%,对照组为10.8%,研究组不良反应低于对照组,差异有统计学意义(P<0.05)。结论 在治疗心肌梗死左心衰竭患者,通过使用硝普钠联合多巴胺治疗,治疗效果显著,能够有效改善患者的心率、呼吸等心功能指标,而且患者在用药后出现的不良反应少,提高了患者的生活质量,有助于早日康复出院,值得临床上大力推广应用。
临床诊疗
目的 评价经椎间孔镜术和显微镜下髓核摘除术治疗腰椎间盘突出症的临床疗效及优缺点,并探讨该术式的有效性、安全性,以期找到更优的手术治疗腰椎间盘突出症方法及临床应用价值。方法 通过回顾性分析我院2019年1月—2019年12月经椎间孔镜下髓核摘除术及显微镜下椎板开窗减压髓核摘除术患者,总随访251例,其中椎间孔组229例,显微镜组22例。采集数据包括病例数、性别、年龄、手术时间、出血量及切口感染情况,术前、术后的JOA评分、VAS评分、ODI功能指数、改良MacNab标准,并对数据进行统计学分析。结果 椎间孔组手术采用局麻下进行,显微镜组采用全麻下进行,其中椎间孔镜组有2例患者因术中腰部剧痛不能配合完成,余患者手术完成顺利。椎间孔镜组平均病程5个月,手术时间(96±10)min,术中出血量(25.8±10.6)mL,术前JOA评分、VAS评分、ODI功能指数依次为14.23±3.08、6.08±1.64、30.18±7.92,术后JOA评分、VAS评分、ODI功能指数分别是22.65±1.58、1.77±0.5、19.67±3.89,改良MacNab标准为优150例,良42例,可26例,差9例,总优良率84.6%。显微镜组平均病程8个月,手术时间(45±10)min,术中出血量(62±10.6)mL,术前JOA评分、VAS评分、ODI功能指数依次为15.13±2.06、6.85±1.27、29.42±7.47,术后JOA评分、VAS评分、ODI功能指数分别是23.25±1.31、1.98±0.53、20.12±4.03。椎间孔镜组改良MacNab标准为优150例,良42例,可26例,差9例,总优良率84.6%;显微镜组改良MacNab标准为优17例,良2例,可3例,差0例,总优良率86.4%;两组患者性别、年龄与术前JOA评分、VAS评分、ODI功能指数相关性无统计学意义;9例椎间孔镜术后患者因效果差择期行显微镜下开窗手术治疗。结论 经皮椎间孔镜手术及显微镜下开窗减压髓核摘除手术治疗腰椎间盘突出症疗效均可靠,能有效改善患者下肢放射痛等临床症状,提高患者的生活质量及减轻功能障碍,但椎间孔镜组更具有微创、出血量少、术后恢复快等优势。
论著
目的 分析AngioJet血栓抽吸联合髂静脉支架在下肢深静脉血栓合并髂静脉压迫的临床疗效。方法 2016年1月—2019年6月在揭阳市人民医院普外一科收治的首发髂股DVT并在AngioJet吸栓或联合导管溶栓后置入支架的患者,比较吸栓后直接支架置入和溶栓再分期支架置入的治疗效果。结果 本研究共纳入50例接受支架手术的DVT患者,其中治疗组29例,分期置入组21例。治疗组临床症状缓解率和住院时间优于对照组,差异有统计学意义(P<0.05),且出血风险更低。 而置入支架长度和直径无差异,治疗组的3个月、6个月和12个月的通畅率、静脉返流时间和 Villalta评分均无差异(P>0.05)。结论 AngioJet血栓清除后直接支架置入术是治疗合并髂静脉压迫的下肢深静脉血栓的有效方法,临床改善更快,住院时间显著缩短。
Objective To analyze the clinical effect of AngioJet thrombus aspiration combined with iliac vein stent in deep vein thrombosis of the lower extremity with iliac vein compression. Methods From January 2016 to June 2019, patients with first iliofemoral DVT and stent implantation after AngioJet thrombolysis or combined catheter thrombolysis were treated in the first department of general surgery, Jieyang People's Hospital. The therapeutic effects of direct stent implantation and stent implantation after thrombolysis were compared. Results A total of 50 patients with DVT who underwent stent surgery were included in this study, including 29 in the treatment group and 21 in the staging group. The clinical symptom relief rate and length of stay in the treatment group were better than those in the control group, the difference was statistically significant (P<0.05), and the risk of bleeding was lower. There was no significant difference in stent length and diameter. There were no significant differences in patency rate, venous reflux time, and Villalta score in the treatment group at 3 months, 6 months, and 12 months (P>0.05). Conclusion Direct stent placement after AngioJet thrombectomy is an effective method for treating deep venous thrombosis of lower limbs with iliac vein compression. The clinical improvement is faster and the length of hospital stay is significantly shortened.
论著
目的 分析高压氧治疗对面部填充术后血管并发症的疗效。方法 将62例面部填充剂注射后并发症患者根据高压氧介入时机分为A组和B组,A组在在常规治疗的基础上,48小时内进行高压氧治疗,B组在在常规治疗的基础上,48小时后进行高压氧治疗,在治疗结束后对两组患者进行疗效分析。结果 A组患者的治疗疗效较B组患者治疗疗效好,差异有统计学意义(P<0.05)。结论 高压氧治疗对面部填充剂注射后并发症疗效是肯定的,且高压氧介入时间越早效果越好。
Objective To analysie effect of hyperbaric oxygen therapy on vascular complications after facial filling. Methods 62 patients with complications after injection of facial filler according to the timing of hyperbaric oxygen intervention were divided into group A and group B.Group A was treated with hyperbaric oxygen within 48 hours on the basis of conventional treatment.Group B was treated with hyperbaric oxygen 48 hours later on the basis of conventional treatment to analysie the efficacy of the two groups of patients after the end of treatment. Results The efficacy of group A patients was better than that of group B, the difference was statistically significant P<0.05. Conclusion Hyperbaric oxygen therapy is effective in the treatment of complications after facial filler injection, and the earlier the hyperbaric oxygen intervention time is taken, the better the effect is.
论著
目的 探讨替罗非班联合丁苯酞应用于进展性脑梗死的疗效与安全性。方法 选取2016年1月—2018年1月广州医科大学附属第三医院神经内科收治的进展性脑梗死患者98例。对照组采用硫酸氢氯吡格雷加阿司匹林(双抗)治疗,观察组采用替罗非班(静脉治疗48 h)联合丁苯酞序贯双抗治疗。结果 替罗非班联合丁苯酞序贯双抗治疗组的神经功能缺损(NIHSS)评分、日常生活能力评定量表(Barthel指数)、改良 Rankin 量表评分优于对照组,血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)与凝血酶时间(TT)水平高于对照组,两组有差异。两组患者药物不良反应发生率无差异。结论 替罗非班联合丁苯酞序贯双抗治疗可明显改善进展性脑梗死的神经功能,为时间窗外的进展性脑梗死提供了治疗方法,疗效显著。
Objective To observe the effect and safety of triofiban combined with butylphthalide in treatment of progressive cerebral infarction. Methods A total of 98 patients with progressive cerebral infarction in the department of neurology from January 2016 to January 2018.The control group was treated with clopidogrel hydrogen sulfate plus aspirin(dual antiplatelet). The observer group was treated with Tirofiban(48 h intravenous treatment) combined with butylphthalide on the basis of the treatment of the control group. Results The score of National Institutes of Health Stroke、 Barthel Index and mRS in the triofiban combined with butylphthalide group were better than that of the control group. There were statistical differences between the two groups. PT,APTT and TT were higher than that in the control group .There was no significant difference in drug adverse reactions between the two groups. Conclusion Triofiban combined with butylphthalide may improve the neurologic function of progressive cerebral infarction and provide treatment for progressive cerebral infarction outside the time window.
临床诊疗
目的 探讨吗替麦考酚酯联合泼尼松治疗儿童紫癜性肾炎的临床疗效。方法 将2016年2月—2018年2月在广州开发区医院儿科和广州市第一人民医院儿科收治的36例紫癜性肾炎肾病综合征型患者根据治疗分为联合组和对照组,每组18例。联合组采用吗替麦考酚酯和泼尼松治疗,对照组采用泼尼松治疗。比较两组患儿治疗前后血肌酐(Scr)、总胆固醇(Chol)、24 h 尿蛋白定量、血白蛋白(ALB) 。结果 联合组治疗效果优于对照组,差异有统计学意义(Z=-2.461,P < 0.05) ; 联合组治疗后24 h尿蛋白定量下降,血肌酐(Scr)降低,总胆固醇(Chol)下降和血白蛋白(ALB)升高,两组实验室指标差异有统计学意义(P< 0.05) 。结论 吗替麦考酚酯联合泼尼松治疗紫癜性肾炎治疗效果明确,可以降低血肌酐和胆固醇,改善尿蛋白水平,提升血白蛋白浓度,治疗效果明显,能有效控制病情,在临床上值得推广应用。
论著
目的 分析远红外穴位敷贴辅助蒙脱石口服液治疗小儿腹泻的疗效。方法 选择2014年9月—2016年9月我院门诊收治的腹泻患儿190例,按照随机数字表法分为对照组(n=95)和观察组(n=95),对照组患儿给予蒙脱石散口服液,观察组患儿在对照组治疗基础上给予远红外穴位敷贴治疗,比较2组患儿治疗效果、大便次数恢复正常时间、大便性状恢复正常时间、平均治愈时间及不良反应。结果 观察组患儿治疗有效率94.74%高于对照组85.26%(P<0.05);观察组患儿大便次数恢复正常时间、大便性状恢复正常时间、平均治愈时间均较对照组少(P<0.05);观察组与对照组患儿均无明显不良反应发生。结论 远红外穴位敷贴辅助蒙脱石口服液治疗小儿腹泻疗效显著,安全性较高。
Objective To analyze the efficacy of far infrared acupoint application assisted montmorillonite oral liquid on infantile diarrhea. Methods 190 cases of children with diarrhea treated in outpatient clinic of our hospital from September 2014 to September 2016 were selected for the study and divided into control group (n=95) and observation group (n=95) according to the random number table method. The control group was given the montmorillonite powder oral liquid, and the observation group was treated with far infrared acupoint application on the basis of treatment in the control group. The treatment effect, the recovery normal time of defecation frequency, the recovery normal time of stool property, the average cure time and adverse reactions were compared between the two groups. Results The effective rate of the observation group was higher than that of the control group (94.74% vs. 85.26%) (P<0.05). The recovery normal time of defecation frequency, the recovery normal time of stool property, the average cure time in the observation group were less than those of the control group (P<0.05). There were no significant adverse reactions between the observation group and the control group. Conclusion Far infrared acupoint application assisted montmorillonite oral liquid may have a significant efficacy and high safety in the treatment of infantile diarrhea.