目的 探究低分子量肝素在维持性血液透析治疗中的疗效及安全性。方法 资料随机选取2013年6月—2014年6月本院收治的140例维持性血液透析患者,按照随机数字表法分为研究组与对照组,每组70例。血液透析时对照组采用普通肝素抗凝,研究组采用低分子量肝素抗凝,分析两组治疗效果和安全性。结果 两组透析器与透析管道凝血等级0、1、2级患者比较均无差异(P＞0.05),透析后15 min~4 h研究组APTT、TT水平均低于对照组(P＜0.05);研究组穿刺点压迫止血时间短于对照组(P＜0.05,P＜0.01),透析后两组不良反应发生率比较无差异(P＞0.05)。结论 维持性血液透析治疗应用低分子量肝素抗凝疗效确切,可减少透析器及透析管道凝血现象的发生,提高血液透析的安全性及质量。

目的 研究探讨小儿支气管肺炎应用穿心莲内酯磺化物雾化吸入治疗的临床疗效及安全性。方法 选取2012年7月—2014年6月我院收治并确诊的128例小儿支气管肺炎患儿为研究对象,将所有患儿随机分为对照组和观察组各64例。两组患儿均给予常规退热,消炎、镇咳、平喘、抗病毒感染等治疗,对照组患儿在常规治疗基础上采用红霉素、青霉素和头孢等药物治疗,观察组患儿在常规治疗基础上采用喜炎平注射液雾化吸入治疗,观察两组患儿治疗后退烧时间、肺部啰音消失时间、咳嗽消失时间、临床总有效率以及住院天数。结果 治疗后观察组患儿的各症状消失时间以及住院天数均短于对照组患儿,差异有统计学意义(P<0.05)。观察组患儿总有效率为96.88%高于对照组的85.94%,两组差异有统计学意义(P<0.05)。结论 采用喜炎平注射液雾化吸入治疗小儿支气管肺炎有效果,能效缓解患儿的临床症状,值得大力推广。

Objective To Study and investigate the curative effect and security using nebulizer inhalation of Andrographolide Sulfonate to children's bronchopneumonia. Methods From July,2012 to June, 2014, we chose 128 children who had been diagnosed as bronchopneumonia by our hospital as our research subjects, and divided them into the contrast group and the observation group randomly with 64 children each. The both groups were all treated by using the methods of Antipyretic,anti-inflammatory,antitussive,antiasthmatic,anti-viral infection, treated by using erythromycin, penicillin and cefotaxime in the contrast group,treated the observation group by using Xiyanpin injection by nebulizer inhalation, of cause these two treatment were all on the basis of the conventional treatment. After treatment, we recorded the exact time of when the fever was gone, the disappearing time of pulmonary rales and their cough, the total effective rate and the time of being in hospital of the two groups. Results The time of all the observation group's symptom disappearing and being in hospital was obviously shorter than that of the contrast group after treatment. The difference between both groups was statistically significant(P<0.05). The total effective rate for the observation group was 96.88%, and it's higher than the contrast groups',which was 85.94%. The difference was statistically significant(P<0.05)too. Conclusion Using Xiyanpin injection by nebulizer inhalation for children's bronchopneumonia could effectively relieve the children's clinical symptom. It is worth popularizing for its good clinic medical value.

目的 通过分析6例阴茎折断患者术后主要护理的要点,以提高阴茎折断患者术后的护理水平。方法 回顾性分析阴茎折断患者术后护理。对6例术后患者进行心理辅导,病情观察,正确体位的摆放,出院指导等护理干预。结果 6例患者在明确诊断后均急诊行阴茎血肿清除加白膜修补术,其中1例另外行尿道修补术。住院时间10~15天,平均9天,住院期间伤口愈合良好,无出现术后并发症。术后随访2~12个月,平均8个月。5例患者阴茎外观正常,性生活满意,无阴茎弯曲、痛性勃起、尿道狭窄等并发症。1例阴茎外观有轻度弯曲,但不影响性生活。结论 目前阴茎折断治疗的方法主要是手术治疗,护理人员帮助患者消除手术顾虑保持良好心态积极面对手术是手术成功的关键, 重视术后局部的护理以及病情观察,预防并发症的发生;指导患者积极进行功能锻炼和配合治疗,促进患者恢复。

Objective To summarize the experience of nursing intervention in diagnosis and treatment of penile fracture, and to improve the level of nursing of penile fracture. Methods The clinical data of 6 cases with penile fracture were retrospectively analyzed, the nursing intervention mode and significance in diagnosis and treatment were evaluated. 6 patients have emergency surgery after the diagnosis, and one patient urethra accepted surgical repair. Results The hospitalized period varied from 10 to15 days(average 9 days), and the patients were followed up for 2~12 months(average 8 months). 5 patients showed a very good outcome without complications, such as the penile deviation, pain, ED and urethral stricture, and 1 patient with penile deviation did not impede sexual activity. Conclusion Prompt surgical intervention of penile fracture showed a satisfied long-term outcome and get better therapeutic effects. Nursing intervention is important to improve the success rate of surgical, and targeted nursing after surgical can reduce complications.

目的 探讨血浆D-二聚体及纤维蛋白原在社区获得性肺炎患者严重程度评估的应用价值。方法 收集110例社区获得性肺炎患者的临床资料,根据CURB-65评分标准对患者进行分组,分别测定患者血浆D-二聚体及纤维蛋白原水平,比较其在不同分组间的差异及通过ROC曲线了解其在重症社区获得性肺炎诊断中的价值。结果 不同CURB-65分组间D-二聚体、纤维蛋白原水平比较差异有统计学意义(P<0.05),重症肺炎组D-二聚体、纤维蛋白原水平明显高于非重症肺炎组(P<0.05)。ROC曲线显示入院D-二聚体、纤维蛋白原水平诊断重症肺炎曲线下面积(AUC)分别为0.815、0.777。结论 血浆D-二聚体及纤维蛋白原可以有效评估社区获得性肺炎患者病情的严重程度,其是诊断重症肺炎的一个良好指标。

Objective To evaluate the prediction and evaluation of plasma D-dimer and fibrinogen levels upon the severity of community acquired pneumonia(CAP). Methods Clinical variables of 180 patients with CAP were evaluated and divided into different groups by CURB65.Plasma D-dimer and fibrinogen were measured to compare their levels among different groups and evaluate the prediction in the diagnosis of the severe CAP by ROC curve. Results The mean D-dimer and fibrinogen level were different significantly among different CURB65 groups. D-dimer and fibrinogen level of severe CAP were significantly higher than non-serious pnrumonia group. The area under the curve of the D-dimer, fibrinogen in the diagnosis of severe pneumonia were 0.815, 0.777. Conclusion Plasma D-dimer and fibrinogen can effectively evaluate the severity of illness in patients with community acquired pneumonia and they could be useful for assessment of the severity of CAP.

目的 观察等离子消融髓核成形术联合神经阻滞治疗椎间盘源性腰痛的临床疗效。方法 将183例椎间盘源性腰痛患者随机分为对照组91例、治疗组92例,分别予综合疗法联合神经阻滞治疗、等离子消融髓核成形术联合神经阻滞治疗,观察两组患者治疗前后目测类比疼痛(Visual Analog Scale VAS)评分、改良Stauffer-Coventry评定系统术后日常活动及满意率等指标。结果 治疗组VAS评分和日常活动及满意率均优于对照组(P<0.05或P<0.001)。结论 等离子消融髓核成形术联合神经阻滞治疗椎间盘源性腰痛疗效显著,值得临床推广。

Objective To observe the effect of percutaneous low-temperature disk plasma ablation (PLDA) and nerve block(NB) on discogenic low back pain. Methods 183 patients were randomly divided into two groups: the control group (n=91) and the treatment group (n=92). Corresponding methods were used to treat everyone, to observe two groups VAS before and after the treatment, daily activities and satisfaction rate of improved Stauffer Coventry evaluation system etc. Results The VAS, daily activities and satisfaction rate of the treat group were distinctly more than that's of the control group (P<0.05 or P<0.001). Conclusion PLDA and NB has the therapeutic effects on the discogenic low back pain patients which is worth promoting.

目的 探讨生理情况下高龄肝脏与低龄肝脏的区别,寻找可以区分高龄肝脏与低龄肝脏的指标。方法 取6周龄SD大鼠和9月龄以上退役SD大鼠各5只,采用超声弹性成像检测肝脏硬度、全自动生化检测仪检测血清学指标、H&E染色观察肝脏形态结构、Sirius Red染色及Masson染色检测胶原纤维的沉积、免疫组化SP法检测TGF-β1、p16^INK4a、SMP-30蛋白的表达。结果 高龄组和低龄组之间血清学指标、胶原纤维沉积及TGF-β蛋白、p16^INK4a蛋白的表达无差异;超声弹性成像检测低龄组Vs值为(1.21±0.09)m/s,高龄组为(1.32±0.05)m/s(P=0.033);SMP-30蛋白低龄组IOD值为138244.988±51286.257,高龄组为116240.170±35017.936(P=0.007)。结论 高龄大鼠与低龄大鼠肝脏的硬度及SMP-30蛋白的表达存在差异,随着年龄的增加肝脏硬度增大,SMP-30蛋白表达下降。肝脏硬度与SMP-30蛋白可作为区分高龄肝脏与低龄肝脏的指标。

Objective To investigate the differences between elderly and younger liver. Methods In accordance with the age of the SD rats into two groups: younger group (Group Y, 6 weeks, n=5) and elderly group (Group O, 40 weeks or more, n=5). Data were compared by using ultrasound elasticity imaging to detect liver stiffness, automatic biochemical detector to gauge serum indexes, H&E staining to observe the liver morphological structure, Sirius Red staining and Masson staining to assay the collagen fibers deposition, Immunohistochemistry to identify the expression of TGF-β₁, p16^INK4a and SMP-30 protein. Results Serum indexes, collagen deposition, TGF-β₁ and p16^INK4a protein expression were no statistically significant difference between two groups. The Vs value was (1.21±0.09) m/s in Group Y and (1.32±0.05) m/s in Group O (P=0.033). and the IOD value of SMP-30 protein between Group Y and Group O were 138244.988±51286.257 and 116240.170±35017.936 (P=0.007). Conclusion The degree of liver stiffnessnd and SMP-30 protein in elderly and younger liver are different.Increased the degree of liver stiffness and decreased the expression of SMP-30 protein in the elderly SD rats. Liver stiffness and SMP-30 protein could be used as indicators to distinguish between elderly and younger liver.

目的 探讨优质护理对于提高白内障手术患者术后恢复的影响。方法 选取本院自2014年1月—2014年6月收治的56例实施白内障手术的患者,将患者平均分配为对照组和实验组,对照组实行常规护理服务,观察组实施优质护理服务,建立完善的护理人员工作机制,提高护理人员素质;加强对患者的健康教育和心理护理,及时给患者进行检查。统计两组患者的治疗效果,分析优质护理服务的效果。结果 在术后接受优质护理服务的实验组患者的恢复效果好于对照组患者,术后的不良事件发生率较对照组低,患者的疼痛程度低,二组数据差异具有统计学意义。结论 给白内障术后的患者以优质护理服务能提高护理质量,缩短患者恢复时间,提高患者恢复效果。

目的 通过对比观察常规西药和当归芍药散加减治疗哺乳期子宫上环术后子宫异常出血的临床效果,探讨其安全有效的治疗方法。方法 选取在哺乳期行子宫上环术的妇女96例,随机分为两组,西药组采用常规西药治疗,中药组采用当归芍药散加减方剂治疗。观察术前、术后及治疗后月经量的变化,并对实验结果进行分析和评价。结果 所有96例患者在行子宫上环术后均出现月经量较术前增多(P<0.05),在经过药物治疗后,所有患者月经量较治疗前减少(P<0.05),并治疗后月经量与术前月经量相比波动较小,差异无统计学意义(P>0.05)。中药组与西药组比较,治疗后月经量稍增多,差异无统计学意义(P>0.05)。西药组有5例患者出现头痛、头晕、恶心、呕吐等不适,对症处理或减量后好转,中药组无不良反应病例。结论 西药及中药治疗哺乳期子宫上环术后子宫异常出血效果相当,当归芍药散加减方剂副作用小,具有较高的可靠性和安全性,值得借鉴与推广。

目的 分析经直肠彩超引导下不同前列腺穿刺方式的阳性率及其相关因素,探讨安全的穿刺方案。方法 回顾性分析接受经直肠彩超引导下前列腺穿刺的701例患者临床资料,所有患者均接受系统性13点穿刺活检,并假设13点穿刺中减少前列腺中线3个穿刺点为10点穿刺术式,加之标准的6点穿刺术式。比较上述穿刺术式的阳性率,分析T-PSA、前列腺体积、PSA体积密度(PSAD)、有无前列腺结节对穿刺阳性率的影响。结果 随前列腺穿刺针数的增加,活检阳性率增高。同一穿刺方式,不同T-PSA组间、不同前列腺体积组、不同PSAD组阳性率有差异。T-PSA>100 ng/mL时,三种穿刺方式的阳性率无差异;T-PSA<100 ng/mL时,6点穿刺法阳性率较低,而10点穿刺、13点穿刺阳性率无差异。前列腺体积>80 mL时,不同穿刺法阳性率有差异。PSAD<0.5 ng/mL²时,10点、13点穿刺阳性率无差异。结论 前列腺穿刺活检阳性率随穿刺针数增多而增加,可根据PSA水平、前列腺体积、PSAD选择个体化穿刺方案。

目的 研究探讨适合基层医院开展白内障复明手术的手术方式。方法 随机抽取我院2010年4月—2014年4月收治的白内障患者1560例为研究对象。所有患者的患眼有2460只。并将其随机分成观察组和对照组,每组患者患眼分别有1230只。对照组采用大切口(巩膜隧道)有缝线白内障(囊外)摘除并人工晶状体植入手术,观察组患者采用小切口(巩膜隧道) 无缝线白内障(囊外)摘除并人工晶状体植入手术治疗的方法,并对两组的疗效进行分析。观察患者手术后的视力、术中以及术后并发症、住院费用等。结果 治疗结果显示,观察组患者的视力术后7天在0.4以上的患者占有89.7%,对照组患者视力在0.4以上的患者占有87.3%。差异无统计学意义(P＞0.05)。手术时间对照组长于观察组,手术费用对照组略高于观察组,差异有统计学意义(P<0.05)。两组在术中后囊膜破裂的发生率、前房型人工晶体植入的比例、上袢缝合固定后房型人工晶体植入比例比较,差异有统计学意义(P<0.05),观察组上述情况少于对照组。结论 在基层医院进行白内障复明活动,采用小切口(巩膜隧道) 无缝线白内障(囊外)摘除并人工晶状体植入手术治疗的方法疗效可靠,并发症少,手术时间短,住院总费用较低,有利于我们在资金、设备有限的情况下在限定的时间内完成较多的白内障复明手术。因此,在基层医院开展的白内障扶贫复明活动中小切口白内障(囊外)摘除并人工晶状体植入手术方法值得推广。