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目的 探讨富血小板血浆(PRP)联合关节镜治疗Ⅲ度半月板损伤患者的临床疗效,及其对膝关节功能恢复时间的影响。方法 选取2021年2月—2022年2月南方医科大学南方医院增城院区骨科收治的Ⅲ度半月板损伤患者45例,采用随机数字法分为观察组22例与对照组23例,对照组患者在关节镜下行半月板成形术,观察组在对照组基础上给予PRP治疗。观察两组患者术后恢复时间、治疗效果及并发症发生情况;比较两组治疗前和治疗后1、3、6个月膝关节功能、疼痛情况。结果 利用观察组患者自体全血制备的PRP,其血小板的回收率、红细胞留存率、白细胞留存率分别为(91.00±9.27)%、(0.29±0.12)%、(29.98±6.68)%,PRP制备质量稳定、可控。观察组联合PRP治疗术与关节镜手术治疗后恢复时间均短于对照组,观察组治疗有效率高于对照组(P<0.05)。经重复方差测量分析,两组美国特种外科医院膝关节评分系统(HSS)评分、西安大略大学和麦克马斯特大学骨关节炎指数(WOMAC)评分、视觉模拟疼痛评分法(VAS)交互(F交互=1.869、F交互=1.482、F交互=2.193)比较差异均有统计学意义(P<0.05);与对照组治疗后1、3、6个月比较,观察组HSS评分升高,WOMAC评分、VAS评分下降(P<0.05);观察组并发症总发生率4.55%低于对照组30.43%(χ2=5.156、P=0.023)。结论 对于Ⅲ度半月板损伤患者,采用PRP联合关节镜手术治疗可帮助患者消炎止痛、加快疗效、加快膝关节功能的恢复,缩短其恢复的时间,效果良好,且安全性较高。
Objective To investigate the clinical effect of platelet rich plasma(PRP)combined with arthroscopy treatment on patients with third degree meniscus injury,and its impact on the recovery time of knee joint function.Methods From February 2021 to February 2022,45 patients with III-degree meniscal injuries admitted to the Department of Orthopedics,Zengcheng district,Nanfang Hospital of Southern Medical University were selected and divided into an observation group of 22 cases and a control group of 23 cases using the random number method.Patients in the control group received menisplasty under arthroscopy,and the observation group was given PRP treatment on the basis of the control group.The postoperative recovery time,treatment effects and complications of the two groups of patients were observed;the knee joint function and pain of the two groups before treatment and 1,3,and 6 months after treatment were compared.Results The platelet recovery rate,red blood cell retention rate,and white blood cell retention rate of PRP prepared from the autologous whole blood of patients in the observation group were(91.00±9.27)%,(0.29±0.12)%,and(29.98±6.68)% respectively.The PRP preparation quality is stable and controllable.The recovery time after combined PRP treatment and arthroscopic surgery in the observation group was shorter than that in the control group,and the treatment effectiveness of the observation group was higher than that of the control group(P<0.05).After repeated measures of variance analysis,the comparison of American Hospital for Special Surgery(HSS)Knee Scoring System,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),and visual analogue pain scales(VAS)interacted(FInteraction=1.869,Finteraction=1.482,Finteraction=2.193),the differences were statistically significant(P<0.05).Compared with the control group 1,3,and 6 months after treatment,the HSS score of the observation group increased,and the WOMAC score,VAS score decreased(P<0.05);the total incidence of complications in the observation group was 4.55%,lower than that in the control group(30.43%,χ2=5.156,P=0.023).Conclusions For patients with III-degree meniscal injuries,PRP combined with arthroscopic surgery can help reduce inflammation and pain,speed up the curative effect,accelerate the recovery of knee joint function,and shorten the recovery time.It has good effects and is relatively safe.
论著
目的 探讨特发性间质性肺炎(IIPs)[非特发性肺间质性纤维化(IPF)型]合并弥漫性肺部出血综合征患者治疗方案以及应用价值。方法 报道1例IIPs(非IPF型)合并弥漫性肺部出血综合征患者的治疗经过以及结果,结合文献分析治疗IIPs(非IPF型)合并弥漫性肺部出血综合症临床应用价值。结果 该文报道 l 例特发性肺间质肺炎(非IPF型)伴弥漫性肺泡出血综合征的老年男性患者,合并呼吸、循环衰竭,启用静脉-静脉体外膜肺氧合(VV-ECMO)抢救并成功撤机,病情好转出院。结论 IIPs作为病因以及发病机制未明、临床表现多样的一类肺间质性疾病,需临床多学科协作,及早诊断、治疗,才能成功挽救患者。
Objective To explore the treatment plan and application value of idiopathic interstitial pneumonia(non IPF)complicated with diffuse alveolar hemorrhage syndrome.Methods A case of idiopathic interstitial pneumonia(non IPF)complicated with diffuse alveolar hemorrhage syndrome was reported.The clinical application value of treatment of idiopathic interstitial pneumonia(non IPF)complicated with diffuse alveolar hemorrhage syndrome was analyzed combined with the literature.Results A case of idiopathic interstitial pneumonia(non IPF type)with diffuse alveolar hemorrhage syndrome was reported in this paper. Combined with respiratory and circulatory failure,veno-venous extracorporeal membrane oxygenation was used to rescue and successfully wean,and the condition improved and discharged.Conclusions Through the curative effect evaluation of this patient,it is believed that idiopathic interstitial pneumonia,as a kind of pulmonary interstitial disease with unknown etiology and pathogenesis and diverse clinical manifestations,need clinical multidisciplinary cooperation,early diagnosis and treatment,in order to successfully save the patient.
论著
目的 分析恩格列净对2型心肾综合征(CRS)患者的治疗效果。方法 研究于2021年10月—2023年10月进行,随机抽取88例2型CRS患者,经计算机程序随机分成对照组(44例,给予常规治疗)、实验组(44例,在常规治疗的同时加用恩格列净),通过对比两组患者心、肾功能指标来评估疗效,并记录两组患者治疗过程中发生的不良反应。结果 治疗后,实验组LAD、LVED低于对照组,而LVEF高于对照组;实验组血清肌酐、尿酸等肾功能指标水平均低于对照组(均P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论 对于2型CRS患者,恩格列净可促进其心、肾功能的改善,且无过多不良反应,安全性理想,治疗效果可观,值得推广。
Objective To analyze the therapeutic effect of empagliflozin on patients with type 2 cardiorenal syndrome(CRS).Methods The study was conducted from October 2021 to October 2023,and 88 patients with type 2 CRS were randomly selected and divided into control group(44 cases,receiving conventional treatment)and experimental group(44 cases,receiving conventional treatment combined with englaglitzin)by computer program.The efficacy was evaluated by comparing cardiac and renal function indexes and adverse reactions.Results After treatment,the LAD and LVED of the experimental group were lower than those of the control group,while LVEF was higher than that of the control group.The levels of serum creatinine,uric acid and other renal function indexes in the experimental group were lower than those in the control group after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions For patients with type 2 CRS,empagliflozin can promote the improvement of cardiac and renal function without many side effects,with ideal safety and considerable therapeutic effect,which is worthy of promotion.
论著
目的 分析国产帕利哌酮缓释片治疗稳定期精神分裂症的疗效与安全性。方法 采用随机数字表法将驻马店市第二人民医院2021年10月—2023年10月收治的108例稳定期精神分裂症患者分为对照组(服用原研帕利哌酮缓释片)与观察组(服用国产帕利哌酮缓释片),每组各54例,以阳性与阴性症状量表(PANSS)评分变化为疗效衡量指标,以不良反应发生率及药物副反应量表(TESS)评分变化为安全性衡量指标。结果 治疗后,两组PANSS评分均比治疗前降低,组内不同时间点评分差异有统计学意义(t=22.147、4.513、3.431、21.369、3.927、3.601,P值分别为<0.001、<0.001、0.001、<0.001、<0.001、<0.001),但组间不同时间点评分比较差异无统计学意义(t=0.281、0.043、0.150,P=0.779、0.966、0.881);观察组不良反应发生率(14.81%)与对照组(12.96%)比较差异无统计学意义(χ2=0.090,P=0.765);两组TESS评分接近,不良反应皆轻微(t=0.185,P=0.856)。结论 国产帕利哌酮缓释片治疗稳定期精神分裂症患者可促进症状改善,且不良反应轻微,疗效及安全性与原研制剂相当。
Objective To analyze the efficacy and safety of domestic paliperidone sustained-release tablets in the treatment of stable schizophrenia.Methods A total of 108 patients with stable schizophrenia admitted to Zhumadian Second People's Hospital from October 2021 to October 2023 were divided into control group(taking the original paliperidone sustained-release tablet)and observation group(taking domestic paliperidone sustained-release tablet)by random number table method,with 54 cases in each group.The change of Positive and Negative Symptom Scale(PANSS)was used as the efficacy measure,and the change of incidence of adverse reactions and Treatment Emergent Symptom Scale(TESS) score was used as the safety measure.Results After treatment,PANSS scores in both groups were lower than before treatment,and the differences in scores at different time points in the groups were statistically significant(t=22.147,4.513,3.431,21.369,3.927,3.601,the P values were<0.001,<0.001,0.001,<0.001,<0.001,<0.001,respectively).However,there was no significant difference in scores at different time points between the groups(t=0.281,0.043,0.150,P=0.779,0.966,0.881).There was no significant difference in the incidence of adverse reactions between observation group(14.81%)and control group(12.96%)(χ2=0.090,P=0.765).TESS scores were similar between the two groups,and adverse reactions were mild(t=0.185,P=0.856).Conclusions The domestic paliperidone sustained-release tablets can improve the symptoms of stable schizophrenia patients,and the side effects are slight,and the efficacy and safety are comparable to the original agent.
论著
目的 对比输尿管硬镜、输尿管软镜钬激光碎石术在输尿管上段结石治疗中的应用价值。方法 分析于我院接受住院手术治疗的80例输尿管上段结石患者基本资料,按照入院顺序对患者进行分组治疗,对照组实施输尿管硬镜钬激光碎石术治疗,研究组实施输尿管软镜钬激光碎石术治疗,对比两组治疗相关数据及并发症发生率。结果 术后研究组患者PCT、CRP、IL-6、IL-10指标均较对照组理想(P<0.05);术后研究组患者生活质量评分高于对照组(P<0.05);研究组高热发生率低于对照组(P<0.05),其他并发症发生率无明显差异(P>0.05)。结论 相比输尿管硬镜,对输尿管上段结石患者实施输尿管软镜钬激光碎石术治疗能够显著改善手术指标和炎性因子指标,有利于提升患者术后生活质量,且安全性良好。
Objective To explore the value of ureteral rigid and ureteral flexible holmium laser lithotripsy in the treatment of upper ureteral stones.Methods The basic data of 80 patients with upper ureteral stones who underwent inpatient surgical treatment in our hospital were analysed,and the patients were divided into equal groups according to the order of admission.The control group was treated with holmium laser lithotripsy by rigid ureteroscopy,and the study group was treated with holmium laser lithotripsy by ureteroscopy,and the treatment-related data and the incidence of complications were compared between the two groups.Results PCT,CRP,IL-6,and IL-10 indices were closer to the standard range in patients in the study group after surgery(P<0.05);postoperative quality of life scores of the patients in the study group were higher compared with those in the control group(P<0.05);the incidence of hyperthermia was lower in the study group than in the control group(P<0.05),and there was no significant difference in the incidence of other complications(P>0.05).Conclusions Holmium laser lithotripsy with flexible ureteroscopy for patients with upper ureteral stones can significantly improve surgical indexes and inflammatory factor indexes,and is conducive to the improvement of postoperative quality of life and safety,and has the value of popularization.
论著
目的 针对精神分裂症患者接受喹硫平与帕利哌酮联合治疗对其代谢功能及血清因子的影响。方法 纳入2022年1月—2023年3月驻马店市第二人民医院收治的120例精神分裂症患者,根据住院号进行编号,并通过通过随机抽签方法分为两组,对照组60例应用单一喹硫平治疗,观察组60例应用喹硫平与帕利哌酮联合治疗,对比两组的治疗效果。结果 经治疗,观察组临床总疗效高于对照组(P<0.05);该组各项代谢功能指标均与对照组比较差异无统计学意义(P>0.05);该组各项血清因子测定该结果均高于对照组(P<0.05);该组各项精神症状评分均低于对照组(P<0.05);该组不良反应发生率与对照组比较差异无统计学意义(P>0.05)。结论 采用喹硫平与帕利哌酮联合的方式治疗精神分裂症患者,可以提升临床疗效,对患者各种精神症状及血清因子改善效果更好,虽然药物会对患者代谢功能产生一定的影响,但是联合用药与单独用药的影响情况无差异,未增加不良反应发生率,安全性良好。
Objective To evaluate the combination of quetiapine and paliperidone on metabolic function and serum factors in schizophrenia.Methods A total of 120 patients with schizophrenia admitted to Zhumadian Second People's Hospital from January 2022 to March 2023 were included,numbered according to the hospitalization number,and divided into two groups by random drawing method.Sixty patients in the control group were treated with quetiapine alone,and 60 patients in the observation group were treated with quetiapine combined with paliperidone,and the therapeutic effects of the two groups were compared.Results After treatment,the total clinical efficacy of the observation group was higher than that of the control group,P<0.05;the metabolic function indexes comparison were P> 0.05;the serum factor of observation group was higher,P<0.05;the scores of psychiatric symptoms in the group were all lower than the control group,P<0.05;the incidence of adverse reactions in the observation improve group was not different from the control group,P>0.05.Conclusions Using quetiapine and schizophrenia,can improve clinical curative effect,various mental symptoms and serum factors,although certain effect on patient metabolic function may occur,but did not significantly increase the incidence of adverse reactions,with high safety.
论著
目的 探讨护理目标执行理念护理在哮喘患儿治疗中的价值。方法 前瞻性选取泉州市妇幼保健院于2021年8月—2023年8月收治的100例支气管哮喘患儿,应用随机数字表法将其分为两组,每组均为50例。对照组采取常规护理,观察组在常规护理基础上给予护理目标执行理念护理。3个月后,对比两组家属对患儿的疾病管理能力、哮喘控制状况、生活质量。结果 护理后两组患儿家属相关家庭管理测量量表(FaMM)评分均升高,且观察组高于对照组(P<0.05);观察组患儿哮喘控制率高于对照组(P<0.05);护理后两组患儿情感、活动、症状相关标准儿童哮喘生活质量评分表(PAQLQ)评分均升高,且观察组高于对照组(P<0.05)。结论 护理目标执行理念护理可改善哮喘患儿家属对患儿疾病的管理能力,改善哮喘控制效果,提升患儿生活质量。
Objective To explore the value of nursing goal execution concept intervention in the treatment of children with asthma.Methods From August 2021 to August 2023,100 children with bronchial asthma admitted to Quanzhou Maternal and Child Health Hospital were Prospective selected.They were randomly divided into observation group and control group,with 50 cases in each group.The control group of children received routine care,while the observation group of children received intervention based on the nursing goals execution concept in addition to routine care.After 3 months of intervention,The disease management ability,compliance,asthma control and quality of life of the two groups were compared.Results Family-related FaMM scores were increased in all two groups after the intervention,and the observation group was higher than the control group(P<0.05).The asthma control rate of the children in the observation group was higher than that in the control group(P<0.05);after nursing,the PAQLQ score increased,and the observation group was higher than the control group(P<0.05).Conclusions Intervention based on the nursing goals execution concept can improve the management ability of family members of asthma patients towards their diseases,and enhance their quality of life,which is worthy of clinical application and promotion.
论著
目的 总结儿童嗜酸细胞性胃肠炎(EG)的临床表现、内镜检查和病理学特点、治疗和预后。方法 回顾性分析2019年1月—2022年12月滨州医学院附属医院儿科确诊的48例EG患儿临床资料,包括临床症状、实验室检查、影像学检查、内镜和病理学检查、治疗和随访情况。结果 48例患儿中,男26例(54.17%),女22例(45.83%),中位年龄7.8岁,20例(41.67%)患儿有过敏史或家族史,临床症状主要有腹痛(34例,70.83%)、腹泻(18例,37.5%)和腹胀(12例,25%)。外周血嗜酸性粒细胞(EOS)升高36例(75%),血清总IgE升高14例(29.17%)。48例行胃镜检查,最常见的表现是黏膜充血水肿(32例,66.67%)、点状红斑(28例,58.33%)和糜烂(22例,45.83%),28例行结肠镜检查,表现为黏膜充血水肿(18例,64.29%)、点状红斑(15例,53.57%)和结节样隆起(12例,42.86%)。黏膜组织病理表现为大量EOS浸润,主要累及十二指肠降部、胃窦和回肠末端。所有患儿均采用饮食干预的治疗,6例(12.5%)单纯饮食干预治疗后好转,16例(33.33%)孟鲁司特钠、酮替芬、奥美拉唑治疗后好转,26例(54.17%)联合泼尼松治疗后好转,随访10个月~3年,8例(16.67%)停药后复发,再次治疗后好转。结论 儿童EG临床症状和内镜表现多样化、缺乏特异性,内镜下黏膜组织病理检查有助于确诊。大多数患儿外周血EOS升高,饮食干预和糖皮质激素治疗效果显著,但存在复发的可能,需长期维持治疗和随访。
Objective To summarize the clinical manifestations,endoscopic and pathological features,treatment and prognosis of eosinophilic gastroenteritis(EG)in children.Methods A retrospective analysis was carried out on clinical data of 48 patients with EG diagnosed at the Department of Pediatrics of Binzhou Medical University Hospital from January 2019 to December 2022,including clinical symptoms,laboratory examination,imaging examination,endoscopic and pathological examination,treatment and follow-up.Results A total of 48 patients were included in the analysis,including 26 males(54.17%)and 22 females(45.83%),with the median age of 7.8 years(7 months to 13 years).Twenty patients(41.67%)had a history or family history of allergy.The most clinical symptoms were abdominal pain(34 cases,70.83%),diarrhea(18 cases,37.5%)and abdominal distension(12 cases,25%).Peripheral blood eosinophils(EOS)increased in 36 cases(75%),and the serum total IgE increased in 14 cases(29.17%).48 cases underwent gastroscopy,the most common manifestations were mucosal hyperemia and edema(32 cases,66.67%),punctate erythema(28 cases,58.33%)and erosion(22 cases,45.83%).Twenty-eight cases underwent colonoscopy,the manifestations were mucosal hyperemia and edema(18 cases,64.29%),spotted erythema(15 cases,53.57%)and nodular eminence(12 cases,42.86%).Mucosal histopathology showed a large number of EOS infiltration,mainly involving the descending duodenum,gastric antrum and terminal ileum.All children were treated with dietary intervention,6 cases(12.5%)were improved after simple diet intervention,16 cases(33.33%)were improved after treatment with montelukast,ketotifen,omeprazole,26 cases(54.17%)were improved after combined treatment with prednisone acetate.Followed up for 10 months to 3 years,8 cases(16.67%)relapsed after drug withdrawal and improved after retreatment.Conclusions The clinical symptoms and endoscopic manifestations of EG in children are diverse and lack of specificity,endoscopic mucosal histopathological examination is helpful for diagnosis.The EOS in peripheral blood of most children increased,diet intervention and glucocorticoid therapy are effective,but there is a possibility of recurrence,which need long-term maintenance treatment and follow-up.
专家述评
脊柱结核是脊柱感染性疾病中最为常见的类型。本文综述了脊柱结核外科治疗的现状及最新进展。在早期治疗阶段,规范化的抗结核药物治疗能够有效缓解疼痛,改善患者生活质量。但对于中后期,特别是椎旁脓肿较大,椎体骨质破坏较大而导致脊柱不稳定的患者,手术治疗往往是必要且必需的辅助手段,手术可以最大限度清除病变的椎间盘、椎体和脓肿,也应该最大限度保留健康的骨质。其主要原则包括病灶彻底清除、脊髓充分减压、脊柱稳定性重建等步骤。在手术治疗中,一期前路手术作为经典入路已经得到广泛应用,而单纯后路手术治疗也逐渐受到重视。近年来,随着微创手术技术的发展,其在脊柱结核治疗中的应用越来越广泛。微创手术的优势在于术中创伤更小、恢复更快,为患者带来了更好的治疗体验和临床效果。然而,对于手术的选择,临床医师需要综合考虑患者的个体差异性、临床表现及特征、影像学资料和手术适应证等多种因素,以确定最合适的治疗方案。只有充分考虑各种治疗手段的优劣,采取个性化、综合性的治疗方案,才能更好地提高患者的生活质量和治疗效果。
Spinal tuberculosis is the most common types of infectious diseases affecting the spine.This article reviews the current status and progress of surgical treatment for spinal tuberculosis.In the early and initial stages,standardized anti-tuberculosis drug therapy can effectively alleviate pain and improve patients' quality of life.However,for more complex cases in the middle and late stages,surgical treatment is needed,including thorough lesion clearance,adequate spinal cord decompression,and reconstruction of spinal stability.In surgical treatment,anterior approach surgery,as a classical method,has been widely applied,and posterior approach surgery alone has gradually gained attention.In recent years,with the development of minimally invasive surgical techniques,their application in the treatment of spinal tuberculosis has become increasingly widespread.The advantages of minimally invasive surgery lie in smaller intraoperative trauma and faster recovery,providing patients with better treatment experience and clinical outcomes.However,for the selection of surgery,clinicians need to consider multiple factors such as individual differences,clinical manifestations and characteristics,imaging data and surgical indications to determine the most suitable treatment plan.Only by fully considering the advantages and disadvantages of various treatment modalities and adopting personalized,comprehensive treatment plans can the quality of life and treatment outcomes of patients be effectively improved.
论著
目的 观察雌二醇片/雌二醇地屈孕酮片对早发性卵巢功能不全(POI)患者卵巢储备功能及血清免疫指标的影响。方法 选取2022年2月—2023年8月福建中医药大学附属第三人民医院妇科收治的早发性卵巢功能不全患者60例,按随机数字表法分为对照组和研究组,对照组(30例)予常规激素替代疗法,研究组(30例)予雌二醇片/雌二醇地屈孕酮片。比较两组血清抗缪勒管激素(AMH)、卵泡刺激素(FSH)、雌二醇(E2)、抗心磷脂抗体(ACA)、抗卵巢抗体(AOA)、抗β2糖蛋白1 IgM抗体(β2GP1-IgM)水平。结果 研究组治疗总有效率高于对照组,治疗后两组患者血清AMH、E2水平均升高,血清FSH、ACA、AOA和β2GP1-IgM水平均降低(均P<0.05),研究组临床疗效优于对照组,且不良反应发生率较低(P<0.05)。结论 雌二醇片/雌二醇地屈孕酮片可改善POI患者的卵巢储备功能,纠正机体自身免疫紊乱,其作用机制可能与免疫调节有关。
Objective To observe the effects of Complex Packing Estradiol Tablets/Estradiol and Dydrogesterone Tablets on ovarian reserve function and serum immune indicators in patients with premature ovarian insufficiency. Methods Sixty patients with early-onset ovarian insufficiency admitted to the gynecology department of the Third People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from February 2022 to August 2023 were selected and randomly divided into a control group(CG)and a study group(SG)using a random number table method.The CG(30 cases)received Complex Packing Estradiol Tablets/Estradiol and Dydrogesterone Tablets.while the SG(30 cases)received Femoston.Compare two groups of serum anti-Müllerian hormone(AMH),follicle stimulating hormone(FSH),estradiol(E2),anticardiolipin antibody(ACA),anti ovarian antibody(AOA),and anti β2 Glycoprotein 1 IgM antibody(β2GP1 IgM)level. Results The total effective rate of the SG was higher than that of the control group(P<0.05);Compared with before treatment,the serum levels of AMH and E2 increased in both groups of patients after treatment,while serum levels of FSH,ACA,AOA and β The level of 2GP1 IgM decreased(P<0.05),and the clinical efficacy of the SG was better than that of the CG,with a lower incidence of adverse reactions. Conclusions Complex Packing Estradiol Tablets/Estradiol and Dydrogesterone Tablets can regulate the levels of sex hormones in patients with premature ovarian insufficiency,improve ovarian reserve function,correct autoimmune disorders in the body,and its mechanism of action may be related to immune regulation.