目的 探讨妈富隆用于治疗围绝经期功血的临床效果。方法 选择年龄40~53岁的出现围绝经期功血的育龄妇女100例。采用盲选法随机分为观察组和对照组,每组各50例。观察组诊刮后第5天开始口服妈富隆,开始每次服1片,每8 h服1次,血止后每3天递减1/3剂量,至维持量1片/天,共计21天,停药后撤退性出血的第5天开始服下周期的药;对照组诊刮后第15天开始口服醋酸甲羟孕酮片,10 mg/天,连服10 天停药后撤退性出血的第15天开始服下周期的药;两组各连服3个周期。结果 观察组服药后阴道流血控制时间和完全止血时间明显短于对照组,在治疗效果方面,观察组总有效率90%,对照组48%,观察组疗效优于对照组。结论 妈富隆治疗围绝经期功血的效果优于孕激素后半周期治疗围绝经期功血的效果,临床上值得推广。

Objective To investigate the clinical effect of Marvelonon perimenopausal dysfunctional uterine bleeding. Methods Select the age 40-53 year old appearance ofperimenopausal dysfunctional uterine bleeding of 100 women of childbearing age. The blind were randomly divided into the observation group and the control groupmethod, 50 cases in each group. The observation group and curettage fifth days after the start of Marvelon, begin to take 1 tablets eachtime, every 8 h 1 times, after the cessation of blood every 3 days and decreasing 1/3 dose,to maintain the volume of 1 pieces of/d, a total of 21 days, fifth days after stopping drug withdrawal bleedingbegan to take periodic drug; control group and curettagefifteenth days after the start of oral medroxyprogesterone acetate tablets, 10 mg/d, and even served fifteenth daysafter withdrawal of 10d. withdrawal bleeding began to takeperiodic drug; two of each suit 3 cycle group. Results The observation group after taking the vaginal bleedingcontrol time and complete hemostasis time significantly shorter than the control group, in treatment effect, total effective rate of observation group 90%, contrast group48%, observation group was significantly better than the control group. Conclusion Conclusion Marvelon on perimenopausal dysfunctional uterine bleeding effect is better than the second half cycleof progesterone treatment of perimenopausal dysfunctional uterine bleeding effect, is worth popularizingin clinic.

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 观察肌内效贴联合物理治疗急性踝关节扭伤的临床疗效。方法 将52例急性踝关节扭伤患者随机均分为肌内效贴联合物理治疗组(观察组)和常规物理治疗组(对照组),分别于治疗前及治疗后第5、10天时观察患部肿胀程度和VAS评分及踝关节kofoed评分。结果 治疗后第5、10天时两组肿胀程度和VAS评分较治疗前好转(P＜0.05),kofoed评分较治疗前升高(P＜0.05)。观察组在肿胀改善、VAS评分及kofoed评分方面均优于对照组(P＜0.05)。结论 肌内效贴联合物理治疗改善急性踝关节伤患者临床症状,改善踝关节功能,临床疗效优于单纯物理治疗。

Objective The purpose of this pilot study was to investigate the effectiveness of kinesio taping combined with conventional physiotherapy for acute ankle sprain patients. Methods 52 acute ankle sprain patients were randomly divided into kinesio taping combined with conventional physiotherapy group(observation group) and the conventional physiotherapy group(control group),and to observe the changes of the affected part of swelling and the visual analogue scale(VAS)and the extent of the ankle joint function recovery situation at the fifth day and the tenth day respectively. Results Two groups suffering from swelling part and the VAS was improved after the treatment at the fifth day and the tenth day (P<0.05), and the ankle kofoed scores were increased too (P<0.05). The observation group in improving the swelling, VAS and kofoed score were significantly better than the control group (P< 0.05). Conclusion Kinesio taping combined with conventional physiotherapy can be a more effective therapeutic technique for treating acute ankle sprain.

目的 观察保留括约肌挂线法和瘘管切除术治疗复杂性肛瘘的临床效果。方法 选择2010年10月—2013年10月期间收治的复杂性肛瘘患者共122例,并随机均分为A、B两组。其中A组采用保留括约肌挂线法,B组采用瘘管切除术,比较两组患者的近远期治愈率、愈合时间以及后遗症的发生情况。结果 两组患者分别采用保留括约肌挂线法和瘘管切除治疗后均达到治愈标准,近期治愈率及复发率两组间无统计学差异。术后情况,A组愈合时间为(20.74±5.62)天,B组为(19.19±6.84)天,P>0.05,组间无统计学差异,但A组中后遗症的发生率为3.28%,B组中的后遗症发生率为37.70%,χ²=14.182,P<0.05,A组中后遗症的发生率明显低于B组。结论 保留括约肌挂线法与瘘管切除术均能很好地治疗肛瘘,其中保留括约肌挂线法在保存肛门正常生理功能,减少术后后遗症发生等方面较后者有优势,值得临床推广。

Objective To observe the effect of sphincter preservation seton applied in complex anal fistulas treatment. Methods 122 cases of patients with complex anal fistulas treated from October 2010 to 2013 were selected and divided into A and B group randomly and equally. And sphincter preservation seton was applied in A group, while fistula resection applied in B group. The cure rate of short and long term, healing time and occurrence of sequel were compared. Results Standard cure was got in both groups, and there were no statistically significant difference between the cure rates and recurrence rates of short term in the 2 groups. Healing time in A group was (20.74±5.62) days, and (19.19±6.84) days in B group (P>0.05), and no statistically significant difference was between the 2 groups. Occurrence of sequel was 3.28% in A group, while 37.70% in B group, (χ²=14.182, P<0.05), and the occurrence of sequel in A group was much lower than that in B group. Conclusion Complex anal fistulas could be treated well by both sphincter preservation seton and fistula resection, and normal physiological function of anus could be better retained by sphincter preservation seton, and the superiority of reduction of postoperative sequelae was apparent by former surgical. It was worthy of clinical use.

目的 探讨经皮穴位电刺激对脑卒中偏瘫患者上肢运动功能的影响。方法 37例脑卒中患者随机分为TAES组(n=19)和安慰刺激组(n=18)。两组常规治疗相同。TAES组采用KD-2A型经皮神经电刺激治疗仪治疗,刺激部位选择患侧上肢的4个穴位(肩髃、曲池、外关、合谷),频率100 Hz,脉宽0.2 ms,强度以患者最大耐受强度为限;每天治疗1次,每次60 min,连续3周共15次;安慰刺激组接受治疗的部位、时间和疗程与TAES组相同,但每次治疗时没有电流输出。治疗前、治疗第2周、治疗第3周分别用上肢Fugl-Meyer评分和改良Barthel指数评分(MBI)评定上肢运动功能及日常生活活动能力。结果 治疗前,两组患者间的一般情况、FMA-UE 评分和MBI评分的比较差异无统计学意义(P>0.05)。经过治疗,两组患者的FMA-UE和MBI评分与治疗前比较均有改善(P<0.05);TAES组FMA-UE和MBI评分的改善较安慰刺激组明显(P<0.05)。结论 TAES治疗能够提高脑卒中患者上肢运动功能,提高生活自理能力。

Objective To investigate the effect of transcutaneous accupoint electrical stimulation (TAES) in enhancing upper limb function in subjects with stroke. Methods 37 subjects with first stroke were randomly assigned into 2 groups:TAES group(n=19) and placebo stimulation group(n=18). All subjects received the same standard rehabilitation. In the TAES group, Model KD-2A stimulator was applied with 0.2 ms pulses, at 100 Hz within the subject's tolerance level on the 4 acupuncture points (LI15, L I11, LI4, and SJ5) in the affected upper limb for 60 min, 5 days a week for 3 weeks; The time and the course of treatment of the placebo stimulation group were as well as the TAES group's, but no current output for each treatment. All subjects in the 2 groups received standard rehabilitation program. Measurements including Fugl-Meyer motor assessment (FMA-UE) and modified Barthel index(MBI) on affected side were recorded before treatment after 2 and 3 weeks' treatments. Results After 3 weeks treatments,the function scores on affected side of the two groups were improved significantly(P<0.05). And function scores of the TAES group were significantly improved than those of the placebo group (P<0.05). Conclusion Transcutaneous accupoint electrical stimulation significantly may improve the recovery of upper limb function.

目的 观察并评估内毒素性急性肺损伤大鼠吸入一氧化氮后外周血中内皮祖细胞和炎症介质的变化情况。方法 90只SPF级健康大鼠分为3组,A组为正常对照组(n=30),B组为急性肺损伤组(ALI)(n=30), C组为一氧化氮(NO)组(n=30)。分别计算各组外周血内皮祖细胞(Endothelial progenitor cells,EPCs) 数量,同时监测肺组织中白细胞介素-10(Interleukin-10,IL-10)水平和髓过氧化物酶(Myeloperoxidase,MPO)活性。结果 我们成功建立了大鼠的ALI肺损伤模型, C组EPCs数量、MPO活性上升幅度均小于B组、而IL-10上升水平均高于B组,差异有统计学意义(P<0.05)。结论 大鼠吸入一氧化氮可减轻内毒素所致急性肺损伤程度,其机制可能与外周血中内皮祖细胞数量及MPO水平下降和IL-10水平上升有关。

Objective To investigate the effect of nitric oxide(NO) inhalation in endotoxin-induced acute lung injury mice. Methods Ninety SPF mice were randomly assigned to the normal group(group A), ALI group(group B)and ALI+NO group(group C). The number of endothelial progenitor cells was counted and the level of Interleukin-10(IL-10) and myeloperoxidase (MPO) were measured. Results Endotoxin administration resulted in pulmonary edema. The pulmonedema was lightened and the level of MPO were decreased by the inhalation of nitric oxide while the level of IL-10 increased. Conclusion NO inhalation can mitigate acute lung injure. The decline of EPCs and MPO and the increase of IL-10 may be one of the mechanism.

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 探讨农村地区糖尿病患者在镇卫生院—村卫生站一体化管理模式下的效果。方法 于2013年10月—2014年9月对花山镇26个村1267名糖尿病患者实行镇卫生院—乡村卫生站一体化管理,镇卫生院定期组织医疗队到村卫生站健康宣教、义诊、体检,村卫生站乡医为本村糖尿病患者开展跟踪随访、血糖监测、用药及饮食运动指导。一年后比较患者的规范管理率、血糖控制率。结果 实施管理后农村糖尿病患者的规范管理率和血糖控制达标率均有提高,尤以血糖控制达标率为明显。结论 对农村社区糖尿病患者实施镇卫生院—村卫生站一体化管理能更好地跟踪监测患者血糖水平,增强患者防病意识,有效提高农村社区糖尿病患者血糖控制率。

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。