目的 探究质控预警系统在重症患儿连续性血液净化治疗的应用效果。方法 随机选取于2020年1月—2021年12月在我院进行连续性血液净化治疗的共80例重症患儿作为本次研究对象,将80例患儿随机分成研究组和对照组,对照组进行常规护理,研究组则在常规护理的基础上行预警系统质量控制,对比2组患儿连续性血液净化治疗时长及报警频次、2组患儿在不同治疗时间段内滤器凝血发生率、2组非计划下机发生情况及2组患儿家属的护理满意度。结果 研究组平均报警频次为(8.60±3.35),低于对照组(16.52±7.41)的报警频次。而研究组的治疗时长(32.54±6.73 h)较对照组(21.38±5.61 h)延长,研究组患儿在进行连续性血液净化治疗的过程中,在8小时至24小时之间及大于24小时滤器的凝血发生率低于对照组,研究组和对照组护理满意度分别为92.50%和75.00%,对比差异显著。结论 在对重症患儿进行连续性血液净化治疗过程中应用质控预警系统具有较高的临床使用价值,不仅可以有效降低报警频次及滤器凝血发生率,而且对延长治疗时间有显著的促进作用,值得在今后的治疗过程中大力推广。

Objective To explore the application effect of quality control early warning system in continuous blood purification treatment of critically ill children.Methods A total of 80 critically ill children who underwent continuous blood purification treatment in our hospital from January 2020 to December 2021 were randomly selected as the research object, and were randomly divided into observation group and control group.The control group received routine nursing,and the observation group received early warning system quality control on the basis of routine nursing.The duration and alarm frequency of continuous blood purification treatment,the incidence of filter coagulation in different treatment periods,the occurrence of unplanned quitting and nursing satisfaction of the two groups were compared.Results The average alarm frequency of the observation group was (8.60±3.35),which was significantly lower than that of the control group (16.52±7.41).However,the treatment duration of the observation group (32.54±6.73 h) was significantly longer than that of the control group (21.38±5.61 h).During continuous blood purification treatment,the incidence of blood coagulation in the observation group was lower than that of the control group,and the nursing satisfaction of the observation group and the control group were 92.50% and 75.00% respectively,with significant differences.Conclusions The application of quality control early warning system in the continuous blood purification treatment of critically ill children has a high clinical value,which can not only effectively reduce the alarm frequency and the incidence of filter coagulation,but also significantly prolong the treatment time,and it is worth promoting in the future treatment process.

目的 分析闽西南地区在院炎症性肠病患者流行病学资料,从而加强对炎症性肠病的认识。方法 回顾性研究炎症性肠病患者临床特点及用药情况。结果 纳入317例炎症性肠病,克罗恩病占212例,男女之比 2.07:1,溃疡性结肠炎占105例,男女比例1.84:1。克罗恩病患者确诊平均年龄29岁,以患A2型为主,溃疡性结肠炎者确诊平均年龄44岁。女性B2型比例明显高于男性。溃疡性结肠炎患者的病变部位主要为E3型(44.8%)。结论 炎症性肠病患者临床表现多样。克罗恩病确诊年龄主要是A2型, L3型是主要病变部位分型,B2型是疾病行为主要分型。E3型是溃疡性结肠炎患者的主要病变部位。克罗恩病多以免疫抑制剂和生物制剂治疗,糖皮质激素和5-ASA类制剂是轻中度的UC患者主要治疗措施。生物制剂、糖皮质激素治疗多用于重度UC患者。

Objective To analyze the epidemiological data of inflammatory bowel disease (IBD)patients in southwest Fujian Province, so as to improve the understanding of IBD. Methods To retrospectively study the clinical characteristics and medication of inflammatory bowel disease patients. Results A total of 317 IBD patients were included.Crohn's disease accounted for 212 cases, with a male-to-female ratio of 2.07:1, and ulcerative colitis accounted for 105 cases, with a male-to-female ratio of 1.84:1.Patients with Crohn's disease were diagnosed at an average age of 29, mainly with type A2, while patients with ulcerative colitis were diagnosed at an average age of 44. The proportion of female with type B2 was significantly higher than that of male.The lesions of ulcerative colitis patients were mainly type E3 (44.8%).Conclusions Patients with IBD had diverse clinical manifestations.The age of diagnosis of Crohn's disease was mainly type A2, type L3 was the main lesion, type B2 was the main disease classification.Crohn's disease was mainly treated with immunosuppressive and biological therapy. Glucocorticoids and 5-ASA were the main treatment for patients with mild-to-moderate ulcerative colitis. Biological agents and glucocorticoid therapy were mostly used in severe patients.

目的 探究合并下胫腓联合韧带损伤的踝关节骨折患者实施手术固定治疗的临床价值。方法 遴选2018年1月—2020年12月70例合并下胫腓作者联合韧带损伤的踝关节骨折患者,根据随机数字表法分2组,开展石膏外固定治疗35例(记对照组),开展手术内固定治疗35例(记观察组),评估2组治疗优良率、治疗康复情况、踝关节功能(Kofoed评分)以及日常生活能力(ADL评分)、术后并发症率。结果 观察组治疗优良率94.29%相较对照组77.14%更高(P＜0.05);观察组康复速率更快,二次手术率更低(P＜0.05);术前2组Kofoed评分、ADL评分比较,均无统计学差异(P＞0.05),术后观察组Kofoed评分、ADL评分较对照组更高(P＜0.05);观察组术后并发症率低于对照组(P＜0.05)。结论 对合并下胫腓联合韧带损伤的踝关节骨折患者开展实施手术内固定治疗,对骨折早期愈合及修复韧带损伤具有显著价值,降低二次手术率及控制术后并发风险,促进关节功能早日恢复,实现理想的临床疗效。

Objective To explore the clinical value of surgical fixation in patients with ankle fracture with lower tibiofibular syndesmosis injury.Methods A total of 70 patients with ankle fracture and lower tibiofibular syndesmosis injury from January 2018 to December 2020 were selected and divided into two groups according to the random number table method.Thirty-five cases were treated with external plaster fixation (control group) and 35 cases were treated with internal surgical fixation (observation group).The treatment and rehabilitation outcomes,ankle function (Kofoed score) and ability of daily living (ADL score),postoperative complication incidence rate of the two groups were evaluated.Results The effective rates of treatment were 94.29% and 77.14% in observation group and control group (P＜0.05).The observation group has a faster recovery rate and a lower rate of secondary operations (P＜0.05).There were no significant difference in Kofoed score and ADL score between the two groups before operation (P>0.05).After operation,the Kofoed score and ADL score in the observation group were significantly higher than those in the control group (P<0.05). The postoperative complication incidence in the observation group was significantly lower than that in the control group (P<0.05).Conclusions The implementation of internal surgical fixation in patients with ankle fracture and lower tibiofibular syndesmosis injury had significant value for early fracture healing and ligament injury repair,reduced the secondary operation rate and controlling the postoperative complication risk,promoted the early recovery of joint function and achieved ideal clinical effect.

目的 观察聚乙二醇化重组人粒细胞刺激因子(PEG-rhG-CSF)与重组人粒细胞刺激因子(rhG-CSF)在造血干细胞移植后促进造血恢复的疗效对比。方法 回顾分析2016年1月—2020年12月以来在深圳市第二人民医院血液科进行造血干细胞移植的恶性血液疾病患者共 100例,随机分为2组,分别在造血干细胞回输后给与聚乙二醇化重组人粒细胞刺激因子与重组人粒细胞刺激因子。结果 PEG-rhG-CSF组与rhG-CSF组中性粒细胞植入时间分别为(18.7±3.4)天、(18.0±3.1)天,P=0.281,无统计学差异。粒细胞缺乏伴发热在PEG-rhG-CSF组与rhG-CSF组分别发生26例、29例,发生率分别为53.06%、56.86%,P=0.89,无差异。用药次数分别为2.6次(2~5次)、18.1次(11~31次),P<0.05,差异有统计学意义。不良反应主要为骨痛、肌肉疼痛。结论 PEG-rhG-CSF组与rhG-CSF组结果相似,PEG-rhG-CSF具有用药次数少的优势。

Objective The efficacy of pegylated recombinant human granulocyte stimulating factor (PEG-rhG-CSF) and recombinant human granulocyte stimulating factor(rhG-CSF) in promoting hematopoiesis recovery after hematopoietic stem cell transplantation.Methods The data of 100 patients with malignant blood diseases who underwent hematopoietic stem cell transplantation in the Hematology Department of Shenzhen Second People's Hospital from January 2016 to December 2020 were retrospectively analyzed.They were randomly assigned to two groups,which accepted PEG-rhG-CSF and rhG-CSF respectively after hematopoietic stem cell transfusion.Results The time of neutrophil implantation in PEG-rhG-CSF group and rhG-CSF group were (18.7±3.4) days and (18.0±3.1) days respectively,P=0.281,showing no statistical difference.There were 26 cases of neutropenia with fever in PEG-rhG-CSF group and 29 cases in rhG-CSF group,with incidence of 53.06% and 56.86% (P=0.89),showing no statistical difference.The times of medication were 2.6 times (2-5 times) and 18.1 times (11-31 times),P<0.05,with significant statistical difference.The main adverse reactions were bone pain and muscle pain.Conclusions The outcomes of PEG-rhG-CSF group and rhG-CSF group were similar,PEG-rhG-CSF had the advantage of fewer times of medication.

目的 探讨便携式内窥镜视频系统辅助鼻咽喉检查治疗效果。方法 2019年1月1日—2019年12月31日,选取本院眼耳鼻颌面外科院内住院查房、门急诊中实施的168例患者作为研究对象,采用随机法对纳入患者进行分组,各分为84例。实验组采用自主研制的便携式内窥镜视频系统,对照组采用传统的喉镜腔镜系统。比较两组患者检查治疗效果、医务人员使用过程中的满意度和患者检查治疗过程中的满意度并进行效果评价。结果 两组患者鼻咽喉镜腔镜系统检查治疗时间比较,实验组时间为13.4 min;对照组时间为22.9 min;患者对鼻咽喉镜腔镜系统检查治疗的满意度比较主要从检查治疗效果、检查治疗体验效果进行评价,实验组满意度91.67%,对照组满意度86.91%,两组比较差异有统计学意义(χ²=4.695,P=0.030);医务人员对两组鼻咽喉镜腔镜系统检查治疗使用的满意度评价主要从性能参数、检查治疗使用效果等方面进行评价,性能参数主要包括便携性、图像质量、操作方法、运营成本等方面,实验组满意度92%,对照组满意度77%,两组比较差异有统计学意义(χ²=6.834,P=0.009)。结论 便携式内窥镜视频系统操作简单、使用方便,不仅能够满足患者的诊疗需要并减少患者的诊疗时间,而且能够满足医务人员使用过程中的便携性,能够提高医疗质量,非常适合临床使用。

Objective To investigate the therapeutic effect of portable endoscopic video system assisted nasopharynx examination. Methods From January 1, 2019 to December 31, 2019, 168 patients in the department of ophthalmology, otorhino-maxillofacial surgery in our hospital were selected as the research objects. The patients were randomly divided into 84 cases. The experimental group used the self-developed portable endoscope video system, while the control group used the traditional laryngoscope system. The treatment effect, satisfaction of medical staff and satisfaction of patients in the process of examination and treatment were compared between the two groups, and the effect was evaluated. Results Compared to the treatment time of nasopharynx and laryngoscope system between the two groups, the experimental group time was 13.4 min; the control group time was 22.9 min; the patients' satisfaction with nasopharyngoscope system examination and treatment was mainly evaluated from the examination and treatment effect, the experimental group satisfaction was 91.67%, while the control group was 86.91%, the difference was statistically significant (χ²=4.695, P=0.030); medical staffs' satisfaction evaluation on the use of nasopharynx and laryngoscope system in the two groups was mainly evaluated from the performance parameters, examination and treatment effect, and the performance parameters mainly included portability, image quality, operation methods, operating costs and other aspects. The satisfaction of the experimental group was 92%, and that of the control group was 77%. The difference between the two groups was statistically significant (χ²=6.834, P=0.009). Conclusion The portable endoscopic video system is easy to operate use. It can not only meet the needs of patients and reduce the diagnosis and treatment time of patients, but also meet the portability of medical staffs in the process of using, and can improve the quality of medical treatment, which is very suitable for clinical use.

目的 探究宫腔镜结合避孕药治疗子宫内膜息肉的临床疗效与对其安全性的分析。方法 随机选取2016年2月—2017年12月内160例子宫内膜息肉患者,分为对照组(80例,宫腔镜治疗)和观察组(80例,宫腔镜结合屈螺酮炔雌醇片治疗),对比两组临床疗效及不良反应的差异性。结果 与对照组相比,观察组患者月经改善效果更佳,其复发率更低,差异有统计学意义(P＜0.05);在不良反应的对比中,观察组结果与对照组结果相比较,不存在较大差异(P>0.05)。结论 宫腔镜结合避孕药治疗子宫内膜息肉取得了一定的临床疗效,不良反应并不显著,可推广运用。

Objective To explore the clinical efficacy and safety of hysteroscopy combined with contraceptives in the treatment of endometrial polyps. Methods From February 2016 to December 2017, 160 patients with endometrial polyps were randomly selected and divided into control group (80 cases treated by hysteroscopy) and observation group (80 cases treated by hysteroscopy combined with drospirenone and ethinyl estradiol tablets). The differences of clinical efficacy and adverse reactions between the two groups were compared. Results Compared with the control group, the observation group had better menstruation improvement effect and lower recurrence rate. The difference was statistically significant (P<0.05). In the comparison of adverse reactions, there was no significant difference between the observation group and the control group (P>0.05). Conclusion Hysteroscopy combined with contraceptives has achieved certain clinical efficacy in the treatment of endometrial polyps, and the adverse reactions are not significant, which can be popularized and applied.

目的 探讨应用三管引流法在防治直肠癌前切除术后吻合口漏中的疗效。方法 选取在我科2018年4月—2020年3月接受腹腔镜或者开腹直肠癌前切除术患者186例,将患者随机分为两组,研究组(三管引流法)96例,对照组(常规引流法)90例,进行对比研究。比较两组患者术后吻合口漏及恢复情况。结果 研究组患者吻合口漏发生率、非计划手术率、回肠造口率低于对照组(P＜0.05),吻合口漏患者中,研究组体温恢复正常时间、C反应蛋白(CRP)恢复正常时间及住院时间均少于对照组,差异均有统计学意义(P＜0.05)。结论 应用三管引流法,可预防直肠癌前切除术后吻合口漏,通过非手术治疗避免非计划二次手术,缩短吻合口漏患者恢复时间,显示更好的临床疗效。

Objective To explore and evaluate the clinical application value of three-tube drainage for the treatment of anastomotic leakage after low anterior resection for rectal cancer. Methods We retrospectively analyzed a total of 186 rectal cancer patients after low anterior resection for rectal cancer in our hospital from April 2018 to March 2020. According to the difference of prevention to anastomotic leakage, these patients were divided into two groups randomly that 90 cases used conventional drainage as control group, and 96 cases used three-tube drainage as study group. Postoperative recovery and anastomotic leakage were compared between these two groups. Results The rate of anastomotic leakage, ileostomy and unplanned reoperation of study group were lower than those of control group (P＜0.05).The times returned to normal of body temperature and C-reactive protein (CRP), the average length of stay in hospital of study group were shorter than those of control group respectively (P＜0.05). Conclusion The application of three-tube drainage may prevent anastomotic leakage and unplanned reoperation after low anterior resection for rectal cancer and shorten postoperative recovery time, to reveal better clinical effects.

目的 探讨¹³¹I联合甘氨双唑钠治疗分化型甲状腺癌(differentiated thyroid carcinoma,DTC)骨转移的临床疗效。方法 以我院96例DTC骨转移患者为研究对象,随机分为对照组和观察组各48例,对照组仅予¹³¹I治疗,观察组予¹³¹I联合甘氨双唑钠治疗,比较两组的临床疗效、转移灶清除效果及不良反应。结果 根据骨痛评价标准,观察组的有效率(71.00%)高于对照组(48.00%)(P＜0.05)。根据血清甲状腺球蛋白(thyroglobulin,Tg)评价标准,观察组的有效率(77.00%)高于对照组(58.00%)(P＜0.05)。根据病灶影像学评价标准,观察组的有效率(48.00%)高于对照组(27.00%)(P＜0.05)。两组不良反应发生率差异无统计学意义(P＞0.05)。结论 ¹³¹I联合甘氨双唑钠可提高DTC骨转移患者临床疗效,具有临床推广意义。

Objective To explore the clinical effect of ¹³¹I combined with sodium glycididazole in the treatment of differentiated thyroid cancer (DTC) with bone metastasis. Methods Ninty-six patients with DTC bone metastasis were randomly divided into the control group and the observation group, forty-eight patients in each group. The control group was treated with ¹³¹I only, while the observation group was treated with ¹³¹I combined with glycididazole sodium. The clinical effect, metastasis clearance effect and adverse reactions of the two groups were compared. Results The effective rate of the observation group (71.00%) was higher than that of the control group (48.00%) (P<0.05) according to the evaluation criteria of bone pain. The effective rate of the observation group (77.00%) was higher than that of the control group (58.00%) (P<0.05) according to the evaluation criteria of serum thyroglobulin (Tg). The effective rate of the observation group (48.00%) was higher than that of the control group (27.00%) (P<0.05) according to the imaging evaluation criteria. There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The combination of ¹³¹I and sodium glycidazole can improve the clinical effect of patients with DTC bone metastasis, which has clinical significance for promotion.

目的 探讨双靶点微创联合尼莫地平治疗丘脑出血破入脑室患者的安全性及对NIHSS评分的影响。方法 选择2017年1月—2020年1月期间本院收治的54例丘脑出血破入脑室患者作为研究资料,随机分组各27例,对照组行单纯侧脑室体外引流术治疗,观察组行立体定向下侧脑室联合丘脑血肿双靶点微创穿刺引流术治疗,均实施尼莫地平治疗,观察两组手术并发症,测定治疗不同阶段患者NIHSS评分、ADL评分、神经损伤指标、创伤应激指标变化。结果 并发症率比较,观察组7.41%低于对照组29.63%,P＜0.05;治疗后,观察组NSE、NGF、β-EP、Cor均降低,且低于对照组,P＜0.05;治疗后,观察组NIHSSL评分降低且低于对照组,ADL评分升高且高于对照组,P＜0.05。结论 针对丘脑出血破入脑室患者采取立体定向下侧脑室联合丘脑血肿双靶点微创穿刺引流术及尼莫地平治疗可进一步改善神经功能及生活质量,且手术安全性高,创伤应激恢复改善,神经损伤恢复快,并发症少,值得推广。

Objective To investigate the safety of double target minimally invasive surgery combined with nimodipine in the treatment of patients with thalamic hemorrhage breaking into ventricle and its influence on NIHSS score. Methods From January 2017 to January 2020, 54 patients with thalamic hemorrhage ruptured into ventricles in our hospital were selected as the research data, and they were randomly divided into 27 cases in each group. The control group was treated with external drainage of lateral ventricle alone, and the observation group was treated with stereotactic double target minimally invasive puncture and drainage of hypothalamic hematoma. The changes of NIHSS score, ADL score, nerve injury index and trauma stress index in different stages of treatment were determined. Results The complication rate of the observation group was 7.41%, lower than that of the control group 29.63%, P<0.05; after treatment, NSE, NGF, β-EP, Cor in the observation group were decreased, and lower than those in the control group, P<0.05; after treatment, NIHSSL score of the observation group was decreased, lower than that of the control group, ADL score was increased and higher than that of the control group, P<0.05. Conclusion For patients with thalamic hemorrhage breaking into ventricles, stereotactic double target minimally invasive puncture drainage combined with thalamic hematoma and nimodipine treatment may further improve the neurological function and patients’ quality of life, and the operation safety is high, the recovery of traumatic stress is improved, the recovery of nerve injury is quick, and the complications are less, which is worthy of promotion.

目的 探讨艾滋病继发真菌感染患者病情的临床特点与治疗措施。方法 选取2019年4月—2020年4月我院收治的艾滋病继发真菌感染患者90例,对所有患者的病情特点进行分析,并及时采取有效地治疗措施。分析患者真菌感染部位、病情临床特点、治疗效果。结果 患者真菌感染部位中,排在前三位的为口腔、肺、食道,占比为44.4%(40/90)、30.0%(27/90)、23.3%(21/90);90例患者中,感染真菌排在前三位的为白色念珠菌、马尔尼菲青霉菌、新型隐球菌,占比为36.7%(33/90)、24.4%(22/90)、16.7%(15/90);90例患者中,显效32例(35.5%)、有效46例(51.1%)、无效12例(13.4%),有效率为86.6%(78/90)。结论 艾滋病继发真菌感染患者中,感染的主要部位主要为口腔、肺、食道,其中感染的真菌主要有白色念珠菌、马尔尼菲青霉菌、新型隐球菌。对患者及时进行有效地抗逆转录病毒治疗可以降低患者死亡率,提高治疗效果。

Objective To explore the clinical characteristics and treatments of AIDS secondary fungal infection. Methods A total of 90 patients with secondary fungal infection of AIDS admitted to our hospital from April 2019 to April 2020 were selected, and the characteristics of all patients were analyzed, and effective treatment measures were taken in time. The sites of fungal infection, clinical characteristics and therapeutic effects were analyzed. Results The top three fungal infection sites were oral cavity, lung and esophagus, accounting for 44.4% (40/90), 30.0% (27/90) and 23.3% (21/90). Among the 90 patients, candida albicans, penicillium marneffei and cryptococcusneoforme ranked the top three, accounting for 36.7% (33/90), 24.4% (22/90) and 16.7% (15/90). Of the 90 patients, 32 had obvious effects (35.5%), 46 had effective effects (51.1%) and 12 had no effects (13.4%), and the effective rate was 86.6% (78/90). Conclusion In the patients with secondary fungal infection of AIDS, the main sites of infection were oral cavity, lung and esophagus, in which the main infected fungi were candida albicans, penicillium marneffei and cryptococcus neofordii. Timely and effective antiretroviral therapy can reduce the mortality and improve the treatment effect.