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    河北醫學

    河北醫學

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    Hebei Medicine
    本刊為綜合性醫學科技期刊，1997年已入編《中國學術期刊（光盤版》，1999年入編中國期刊網，主要報道全國各省市醫療、衛生、科研、管理的成果和進展以及新經驗。以全國衛生技術人員為主要對象。本刊辟有論著、實驗研究、經驗交流、中醫中藥、預防保健、調查報告、臨床護理、衛生及醫院管理、專家講座、文獻綜述、技術交流、病例報告等欄目。
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    • 國內刊號/CN：13-1199/R
      國際刊號/ISSN：1006-6233
    • 發行周期：月刊
      郵發代號：18-242
    • 主管單位：河北省衛生廳
      主辦單位：河北省醫學會
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    • 地址：河北省承德市雙橋區翠橋路河北醫學雜志社
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    河北醫學 >2023年第1期

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    • 摘要：目的:探討危重早產兒早期綜合干預對應激反應的影響.方法:對我院新生兒科2008年1月至2011年1月80例危重早產兒隨機分為干預組及對照組各40例,早期干預組在沒有出現應激反應前給予綜合性干預治療,對照組無干預措施,出現應激反應后給予對癥治療.結果:早期干預組出現應激反應與對照組有統計學差異(P＜0.01).結論:危重早產兒通過早期干預治療可以大大降低應激反應的發生,對提高危重早產兒搶救的成功率起到了關鍵作用.
    • 摘要：Objective: To explore the clinical effect of rehabilitation and nursing care in cervical spondylosis. Method: After the conventional treatment of rehabilitation and nursing care in the 580 cases with cervical spondylosis treated in our hospital from October 2011 to December 2011, observe the treatment effect. Result: 409 cases in 580 patients were cured ( 70. 5% ), 146 cases improved ( 25. 2% ), 25 patients were invalid! 4.3% ), the total effective rate was 95. 7 % . Conclusion: The rehabilitation and nursing care in cervical spondylosis is safe and effective, which is worthy to be applied.%目的:探討頸椎病康復護理的臨床療效.方法:對2011年10月至2011年12月來我院就診的580例頸椎病患者常規治療后進行康復護理,觀察治療效果.結果:580例患者中治愈409例(70.5%),好轉146例(25.2%),無效25例(4.3%),總有效率為95.7%.結論:頸椎病的康復護理安全有效,可以推廣應用.
    • 摘要：目的:探討有效的護理措施在白內障超聲乳化聯合人工晶體植入術中的作用.方法:對承德縣醫院近三年接受白內障超聲乳化聯合人工晶體植入術的615例患者,手術前后實施有效的護理措施,改善病房管理,分析對手術效果的影響.結果:615例白內障超聲乳化聯合人工晶體植入術患者手術順利進行,并發癥減少.結論:在白內障超聲乳化聯合人工晶體植入術手術前后給以有效的護理措施,加強病房管理,對保證手術的順利進行,提高手術成功率,減少并發癥發生起著重要作用.
    • 摘要：目的:實施優質護理服務,加強護士內涵建設的重要性,為患者提供"安全、有效、方便、滿意"的服務,讓病人滿意,讓家屬放心.方法:學習領會"優質護理服務示范工程"精神,根據血液凈化科護理工作特點,制訂優質護理服務工作方案及計劃,改革排班模式,實行責任制整體護理,提出堅持"以病人為中心"的指導思想,以病人的需求為起點,以病人的滿意為結果,推出"一心"、"二到位"、"三聲"、"四有"、"五清"的服務模式,加強基礎護理、專科護理、健康宣教、護患溝通和團隊意識,開展特色護理,建立激勵機制及便民措施,創建溫馨病房.結果:實施優質護理以來,護士的整體服務意識明顯增強,健康宣教知曉率普遍提高,患者滿意度顯著提高,由原來的92%提升到98.12%,護患關系進一步密切.結論:優質護理服務體系的構建與實踐夯實了基礎護理、保障了護理安全、增進了護患和諧,增強了護士的責任感,提高了血液凈化科的護理質量.
    • 摘要：現將承德市中心醫院自2010年至2011年診治68例帶狀皰疹患者臨床情況總結分析如下。1資料與方法收集我院2010年至2011年收治帶狀皰疹診斷病例的臨床診治病歷資料,對診治情況進行統計分析。
    • 摘要：Objective: Comparison of different blood sampling methods on blood routine examination result influence. Method: In our hospital from Jan. 2011 to Dec. 2011 , 120 cases of patients with routine inspection as the object of study, at the same time for peripheral blood, venous blood collection, comparison of two specimens collected from test results. Result: 120 patients venous blood and peripheral blood routine examination results in an outer peripheral blood MCH , RBC, Hb, Hct, MCV, MVHC, PLT level lower than venous blood, WBC level was higher than in the venous blood, the statistical results were statistically significant ( P<0.05 ). The reproducibility of experimental results of peripheral blood CV was significantly higher in venous blood ( P<0.01 ), with statistical significance. Conclusion: Venous blood test result is relatively stable, and more accurate numerical peripheral blood, blood routine examination should be the use of venous blood sampling.%目的:比較不同采血方法對血常規檢驗結果的影響.方法:選取我院自2011年1月至2011年12月收治的120例進行血常規檢驗患者作為研究對象,同期分別進行末梢血、靜脈血采集,比較兩種采集標本檢測結果.結果:120例患者靜脈血及末梢血血常規檢查結果除MCH一項外,末梢血RBC、Hb、Hct、MCV、MCHC、PLT水平均低于靜脈血,WBC水平高于靜脈血,統計結果均有統計學意義(P<0.05).重復性試驗結果比較中末梢血CV值明顯高于靜脈血(P<0.01),具有統計學意義.結論:靜脈采血檢驗結果較穩定,且數值較末梢血準確,血常規檢查時應使用靜脈采血.
    • 摘要：Objective: To analyze the clinical characters and effects in elderly diabetic patients with a-symptomatic cerebral infarction. Method: 40 elderly diabetic patients with asymptomatic cerebral infarction were treated in our hospital from Jan. 2009 to Jun. 2010 in observing group and 39 diabetic patients without asymptomatic cerebral infarction in control group. Head CT image characteristics biochemical indicators such as the TC ( total cholesterol ), TG ( triglyceride ), BMI ( body mass index ), HDL-c ( high density lipopro-tein ) and FIB ( fibrinogen ) and other indicators of the two groups were compared. Result: There's significant difference in multifocal cerebral infarction between the control group and observation group, so were TC, HDL-c, FIB, BIM. Conclusion: There are more multif ocal cerebral infarction in elderly diabetic patients with asymptomatic cerebral infarction, the elderly diabetic patients with high TG, TC, low HDL-c or obese patients are susceptible to get asymptomatic cerebral infarction.%目的:分析老年糖尿病患者合并無癥狀性腦梗死的臨床特點及療效.方法:將我院2009年1月至2010年6月收治的40例老年糖尿病合并無癥狀性腦梗死患者為觀察組,非糖尿病患者合并無癥狀性腦梗死患者39例為對照組,對比兩組患者頭顱CT圖像特點和血液生化指標如TC(總膽固醇)、TG(甘油三酯)、BMI(體重指數)、HDL-c(高密度脂蛋白)、FIB(纖維蛋白原)等指標.結果:對照組與觀察組之間多灶性腦梗死具有顯著性差異,TC、HDL-c、FIB、BIM的差異同樣也有顯著性.結論:老年糖尿病合并無癥狀性腦梗死多為多灶性腦梗死,老年糖尿病合并高TG、高TC、HDL-c降低或是肥胖的患者易患無癥狀性腦梗死.
    • 摘要：Objective: To investigate the clinical effect and significance of artificial femoral head replacement to intertrochanteric femoral fractures. Method: The retrospective analysis was used to analyze the clinical data of 101 old patients with intertrochanteric femoral fracture treated in our hospital from Jan. 2005 to Jan. 2010 and to obseve the clinical efficacy of artificial femoral head replacement and dynamic medullary screw ( DHS ) fixation, at last to do the statistical analysis. Result: The operation time, blood loss was significantly longer ( and more ) in the femoral head replacement group than that in the DHS group, which had significant difference ( P < 0. 05 ); The weight loading time on the floor of the femoral head replacement group was significantly earlier than that of the DHS group, which had statistical difference among two groups ( P<0. 01 ); The short-term effect of the femoral head replacement group was better than that of the DHS group, the harris hip scores of the femoral head replacement group were significantly higher than those of the DHS group, which had significant difference( P<0. 05 ), but they had almost the same long-term effect ( harris hip scores were of no significant difference after 6 months and 24 months ). Hemiarthroplasty group' s recent complication rate was 10.5% , which was significantly lower than DHS group ( 35.0% ), there was significant difference between the two groups ( P<0. 05 ). Conclusion: The artificial femoral head replacement therapy has good short-term curative effect, with rapid recovery of joint function short weight loading time and fewer complications, which is a better method to treat intertrochanteric fracture.%目的:探討人工股骨頭置換術治療高齡股骨粗隆間骨折的臨床療效及意義.方法:對我院2005年1月至2010年1月收治的101例高齡股骨粗隆間骨折患者的臨床資料進行回顧性分析,觀察人工股骨頭置換術及動力性髓螺釘(DHS)內固定術治療的臨床療效,并進行統計分析.結果:股骨頭置換組手術時間、術中出血量多于DHS組,組間比較有顯著差異(P＜0.05);下地負重時間較DHS組明顯提前,組間比較有顯著差異(P＜0.01);股骨頭置換組的近期療效較好,其術后1個月髖關節Harris評分明顯高于DHS組,組間比較有顯著差異(P＜0.05),但遠期療效相當(術后6個月、24個月髖關節Harris評分無顯著差異).股骨頭置換組的近期并發癥發生率為10.5%,明顯低于DHS組的35.0%,組間比較有顯著差異(P＜0.05).結論:人工股骨頭置換術治療高齡股骨粗隆間骨折具有近期療效好,關節功能恢復快,下地負重時間短,并發癥少等優點,是目前治療高齡股骨粗隆間骨折的一種較佳方案.
    • 摘要：Objective: To observe and evaluate the treatment effect of a—lipoic acid combined with bre-viscapine for diabetic peripheral neuropathy and adverse reactions. Method: 114 diabetic peripheral neuropathy patients were randomly divided into the observation group and the control group. The observation group were given breviscapine 40mg, a—lipoic acid 600mg forl5 days; The control group were given a—lipoic acid 600 mg for 15 d. Result: After treatment, both groups of patients with sensory symptoms and nerve conduction velocity all improved compared with before treatment ( P<0. 05 ). But compared with the control group, The efficiency of the observation group was better than that of the control group ( P<0. 05 ). Conclusion: The combined use of a-lipoic acid and breviscapine for diabetic peripheral neuropathy is ideal and no adverse reactions.%目的:觀察和評價α-硫辛酸聯合燈盞花素治療糖尿病周圍神經病變的效果及有無不良反應.方法:114例糖尿病性周圍神經病變患者隨機分為觀察組和對照組,觀察組每日給予燈盞花素40mg,α-硫辛酸600mg,治療15 d;對照組每日給予α-硫辛酸600 mg治療15 d.比較兩組患者治療前后神經傳導速度及感覺癥狀和總體治療效果.結果:治療后,兩組患者的感覺癥狀及神經傳導速度均較治療前有改善(P<0.05),是與對照組相比,觀察組改善優于對照組(P<0.05).結論:聯合使用α-硫辛酸和燈盞花素治療糖尿病合并周圍神經病變效果較為理想,無不良反應.
    • 摘要：Objective: To observe the clinical effect of immediate restoration of non-vascularized bone graft on mandibular defects. Method: Choosing 98 cases with mandibular defects treated in our hospital from March 2011 to October 2011 as the research object. According to the classification of HCL, mandibular defect is classified. Using the method of immediate restoration of non-vascularized bone graft on mandibular defects , analyzed and summarized the graft survival rate and postoperative complications occurred after the re-pair. Result: The graft survival rate was 89. 7% , with the highest survival rate of L clsaa mandibular defect. The postoperative overall complication rate was 31. 6% ,with the highest infection rate including H class mandibular defect, and L kind was the lowest. Conclusion: The method of immediate restoration of non-vascu-larized bone graft on mandibular defects is easy and effective to reconstruct and rehabilitate its form and function. It is most suitable for the defect of the class L.%目的:探討非血管化骨移植即刻修復下頜骨缺損的臨床治療效果.方法:本實驗選取在2011年3月至2011年10月份到我院進行治療的下頜骨缺損患者98例為研究對象,對下頜骨缺損按HCL分類法進行分類,采用非血管化骨移植法對不同類型的下頜骨缺損即刻修復,分析并總結修復后移植骨成活率及術后并發癥發生的情況.結果:移植骨成活率89.7%,其中L類下頜骨缺損成活率最高.術后總體并發癥發生率31.6%,其中H類下頜骨缺損感染率最高,L類下頜骨缺損感染率最低.結論:采用非血管化骨移植即刻修復下頜骨缺損是重建和恢復其外形和功能的簡單、有效、理想治療方法,該方法最適合于L類缺損者.
    • 摘要：Objective: To observe the clinical effect of endoscopic sinus auxiliary on malignant tumor. Method: Choosing 68 cases with malignant tumor treated in our hospital from Jul. 2008 to Sep. 2009, in which 38 patients were treated with routine endoscopy auxiliary sinus malignant tumor resection in the experimental group; while 30 cases were treated with nasal sinus auxiliary lens common malignant tumor resection in the control group. Conventional chemotherapy treatment were given after tumor resection, and made a statistical analysis of general information and clinical results between the two groups. Result: After 2 years" follow-up, 3 cases recurred and reoperated in the experimental group( 7. 89% ), 2 patients died within 2 years ( 5. 26% ), 2 years survival of 36 cases ( 94. 74% ). As for the control group, 9 patients recurred and reoperated ( 30% ) , 8 patients died within 2years ( 26. 67% ), 22 cases survived within 2 years ( 73. 33% ). Two groups of patients were followed up for material after statistics analysis, P < 0. 05 , which has statistical difference. Conclusion: The clinical effect of the treatment of endoscopic sinus auxiliary on malignant tumor is better than the treatment of nasal sinus auxiliary lens common malignant tumor, which has obvious difference. It is worth of clinical promotion.%目的:探討鼻內鏡輔助治療鼻竇惡性腫瘤的臨床效應.方法:選取2008年7月至2009年9月于我院治療的鼻竇惡性腫瘤患者68例,其中38例行內鏡輔助下鼻竇惡性腫瘤切除術,為實驗組;30例行普通鼻鏡輔助下鼻竇惡性腫瘤切除術,為對照組,腫瘤切除后均給予常規化療治療,將兩組患者的一般資料及臨床效果進行統計分析.結果:經過2年隨訪,實驗組復發并再次手術治療3例,占7.89%,2年內死亡2例,占5.26%,2年內生存36例,占94.74%;對照組復發并再次手術治療9例,占30%,2年內死亡8例,占26.67%,2年內生存22例,73.33%.兩組患者隨訪資料經統計學分析,均P＜0.05,差異具有統計學意義.結論:內窺鏡輔助下治療鼻竇惡性腫瘤的臨床療效明顯優于普通鼻鏡輔助治療效果,具有明顯差異,值得臨床推廣應用.
    • 摘要：目的:探討131I治療甲狀腺功能亢進合并肝功能損害的臨床療效,以及對機體免疫的影響.方法:40例診斷明確的患者采用131I治療,觀察記錄患者治療前后的癥狀和體征,以及比較甲狀腺功能(FT3、FT4、TSH)、肝功能(TBIL、AST、ALT、γ-GT、A LP)和機體免疫功能(IL-2、CXCL-10)的變化情況.結果:經過治療后,40例患者中顯效23例、有效11例和無效6例,總有效率85.00%;治療后,血清TBIL、AST、ALT、γ-GT及A LP IL-2、CXCL-10水平明顯下降,血清FT3和FT4水平顯著降低,而TSH顯著上升,與治療前比較,差異存在統計學意義(P＜0.05).結論:131I治療甲狀腺功能亢進合并肝功能損害具有較好的臨床效果,促進肝功能和免疫紊亂的恢復,值得臨床推廣應用.%Objective: To explore the I in treatment of hyperthyroidism complicated with liver function damage : a clinical efficacy, as well as the effect on immunity. Method: 40 cases of diagnosed patients treated with 13 I and observed records of patients before and after treatment, the symptoms and signs, as well as the comparison of thyroid function ( FT3 , FT4 , TSH ), liver function ( TBIL, AST, ALT, GT, A Y - LP ) and immune function ( IL-2, CXCL-10 ) changes. Result: After treatment, 23 cases in 40 patients, effective in 11 cases and 6 cases ineffective, the total effective rate was 85% ; after treatment, serum TBIL, AST, ALT, and A LP Y - GT IL-2, CXCL-10 levels were significantly decreased, serum FT3 and FT4 level decreased significantly, while TSH increased significantly, Companing before treatment, There's singmificant difference exists in control group ( P < 0. 05 ). Conclusion: I in treatment of hyperthyroidism complicated with liver function impairment has good clinical effect, promote the recovery of liver function and immune disorders, it is worthy of clinical application.
    • 摘要：目的:探討踝足矯形器對于兒童矯形生理學影響與治療效果.方法:選取2009年5月至2011年7月于我院治療的腦癱患兒67例,分為實驗組35例,對照組32例,對兩組患者矯形生理學影響及治療效果進行評價分析.結果:經4個月治療,實驗組在各個平面對運動和痙攣的控制情況均優于對照組,P＜0.05,差異具有統計學意義;實驗組GMFM評分為(141.83±22.55)分,對照組為(101.27±14.33)分,經統計學分析,實驗組與對照組治療后評分比較,P＜0.01,差異具有統計學意義.結論:兒童踝足矯形器能有效改善患者在各個平面上對運動和痙攣的控制情況,提高患者的臨床治療效果,改善患者生活質量,值得推廣.%Objective: To explore the prognostic value of the kinetic serum CA125 detection in patients with epithelial ovarian cancer. Method: The level of serum CA125 were examined in 42 patients with epithelial ovarian cancer primarily underwent operation in this hospital from Jan. 2003 to Dec. 2008 , calculated the serum CA125 half-life and the normalized time, analyzed the median survival time and the mean time of recurrence. Result: The median survival times of patients( n = 22 ) with CA125 half —life ≤20 days and those ( n = 20 )>20 days, were 38 months and 15 months ( P<0. 05 ). Further, patients with serum CA125 normalized time ≤ 8 weeks ( n = 23 ) experienced a median survival of 37 months, compared to only 23 months for those ( n= 19 )>8 weeks ( P<0. 05 ). Finally, the recurrent rate in patients with normalized time >8 weeks was higher than those ≤8 weeks. In contrast, the recurrent mean time was shorter than those ≤8 weeks. Conclusion: It is useful to predict treatment response and prognosis of epithelial ovarian cancer by serum CA125 decreased markers such as half-life and normalized time, the latter is more convenient. The increase of CA125 after treatment indicated recurrence.
    • 摘要：Objective: To explore the prognostic value of the kinetic serum CA125 detection in patients with epithelial ovarian cancer. Method: The level of serum CA125 were examined in 42 patients with epithelial ovarian cancer primarily underwent operation in this hospital from Jan. 2003 to Dec. 2008 , calculated the serum CA125 half-life and the normalized time, analyzed the median survival time and the mean time of recurrence. Result: The median survival times of patients( n = 22 ) with CA125 half 條ife =20 days and those ( n = 20 )>20 days, were 38 months and 15 months ( P<0. 05 ). Further, patients with serum CA125 normalized time = 8 weeks ( n = 23 ) experienced a median survival of 37 months, compared to only 23 months for those ( n= 19 )>8 weeks ( P<0. 05 ). Finally, the recurrent rate in patients with normalized time >8 weeks was higher than those =8 weeks. In contrast, the recurrent mean time was shorter than those =8 weeks. Conclusion: It is useful to predict treatment response and prognosis of epithelial ovarian cancer by serum CA125 decreased markers such as half-life and normalized time, the latter is more convenient. The increase of CA125 after treatment indicated recurrence.%目的:探討動態監測血清CA125在上皮性卵巢癌中的療效評估及預測復發的臨床價值.方法:采用回顧性分析方法,對2003年1月至2008年12月間在我科初治且資料完整的42例EOC患者進行血清CA125的檢測,計算CA125半衰期及轉陰時間,分析不同組生存期的差異及復發的情況.結果:CA125半衰期t 1/2≤20天組22例及 t 1/2＞20天組20例,中位生存時間分別為38月、23月,有顯著性差異(P＜0.05);CA125轉陰時間NT≤8周組23例及NT＞8周組19例,兩組中位生存時間分別為37月、24月,有顯著性差異(P＜0.05);NT＞8周組較NT≤8周組復發率高,且復發中位時間短,復發時血清CA125均大于正常值上線.結論:EOC患者術后CA125的下降速率指標(如半衰期、轉陰時間)均可判斷預后,但后者更簡便、直觀;術后CA125水平的升高可預測復發.
    • 摘要：目的:探討他克莫司聯合糖皮質激素治療成人特應性皮炎療效.方法:將本院近期門診收治的60例成人特應性皮炎患者隨機分兩組,對照組30例單行糖皮質激素治療,實驗組30例聯合他克莫司,對比兩組患者治療后的脫屑、紅斑、毛細血管擴張、皮膚萎縮、丘疹膿皰、色素沉著等皮損積分變化,并統計患者總有效率(顯效+有效).結果:兩組內比較,治療后第4周患者各項皮損積分均優于治療前 (P<0.05);而兩組間相比,實驗組患者的各項皮損積分明顯優于對照組 (P<0.05),且實驗組患者的總有效率為93.3%,明顯高于對照組的80.0%(p<0.05).結論:應用他克莫司聯合糖皮質激素早期治療成人特應性皮炎,可以顯著改善皮損積分變化,有效提高患者的預后.%Objective: To investigate the tacrolimus combined with corticosteroids in the treatment of a-dult atopic dermatitis in the method and curative effect. Method: the recent outpatient hospital treated 60 cases of adult patients with atopic dermatitis were randomly divided into 2 groups, 30 cases in the control group specific glucocorticoid treatment, the experimental group 30 cases combined with tacrolimus, compared two groups of patients after treatment of scaling, erythema, telangiectasia, papules , pustules, skin atrophy, pigmentation and other skin lesions integral change, and statistical total efficiency ( markedly + effective ). Result: of the two group, after fourth weeks of treatment on the patients with lesions integral are better than before treatment ( P < 0.05 ); and the two groups compared, the patients in experimental group the various lesions integral was significantly better than the control group ( P < 0.05 ), and the patients in the experimental group in the total efficiency was 93. 3% , significantly higher than that in control group. 80% ( P < 0.05 ). Conclusion:the application of tacrolimus combined with glucocorticoid early in adult patients with atopic dermatitis, can significantly improve skin lesions integral change, effectively improve the prognosis of the patients.
    • 摘要：Objective: To discuss the effect of low molecular weight heparin sodium on children with primary nephrotic syndrome. Method: Divided the 97 children with primary nephrotic syndrome who were treated in my hospital from Jan. 2009 to Oct. 2010 into two groups randomly. Patients in the control group received routine treatment, Therapeutic drugs includes prednisone, diuretics, lipid-lowering drugs, angioten-sin-converting enzyme inhibitor and so on. On the medical basis of the control group, the patients in the experimental group used the low molecular weight heparin sodium. Compared the treatment effect of the two groups, and anlyzed the urinary protein, f ibrinogen, albumin of the children. The results were processed u-sing statistics. Result: After the clinical treatment, 48 patients in the experimental group, 21 patients remitted completely, 16 patients remitted partly, the total efficiency was 77.08% ; Among the 49 patients in the control group, 9 patients remit completely, 16 patients remit partly, the total efficiency was 51. 02% , patients in the experimental group were better than the control group. According to the statistical analysis, P < 0. 05. The urinary protein and fibrinogen of the patients in the experimental group dropped, and the albumin rose. Compared with the control group, the difference was notable, P<0.05. Conclusion: In the treatment of the children with primary nephrotic syndrome, low molecular weight heparin has and better effect, which is worth promoting in clinical.%目的:探討采用低分子量肝素鈉對兒童原發性腎病綜合征的治療效果.方法:將我院2009年1月至2010年10月收治的97例兒童原發性腎病綜合征患者隨機分為兩組.對照組患者給予常規治療方法,治療藥物包括強的松、利尿劑、降脂藥物、血管緊張素轉換酶抑制劑等.實驗組患者在對照組患者用藥基礎上,使用低分子量肝素鈉治療.比較兩組患者的治療效果,并對患兒尿蛋白、血纖維蛋白原、血白蛋白進行分析.將結果使用統計學處理.結果:實驗組患者48例經過臨床治療后,患者完全緩解21例,部分緩解16例,總有效率為77.08%;對照組患者49例,完全緩解9例,部分緩解16例,總有效率為51.02%,實驗組患者療效明顯優于對照組,經統計學分析,P<0.05.觀察組患者的尿蛋白、血纖維蛋白下降,血清白蛋白上升,與對照組比較,差異顯著,P<0.05.結論:在治療兒童原發性腎病綜合征時,為患者提供低分子量肝素,效果更好,值得在臨床推廣使用.
    • 摘要：Objective: To investigate the clinical efficacy and safety of hormone replacement therapy in perimenopausal syndrome . Method: 80 cases of patients were randomly divided into the observation group and the control group ( n = 40 cases ), the observation group was treated with hormone replacement therapy, while the control group used oryzanol tablets, compared the clinical efficacy. Result: The patients in the observation group Kupperman score than the control group decreased more obviously ( P < 0.05 ); two groups of patients after treatment of the level of serum E2 increased, FSH and LH level decreased, but the observation group were more obvious changes in amplitude ( P < 0. 05 ); both of two groups after treatment of endo-metrial thickness were increased ( P < 0. 05 ) ,but the observation group was increased greatly ( P < 0. 05 ). Conclusion: low dose hormone replacement therapy in perimenopausal syndrome is safe and effective, but the clinical treatment should be good grasp of the indications and contraindications.%目的:探討激素替代治療圍絕經期綜合征的臨床療效和安全性.方法:80例患者采用隨機數字的方法分為觀察組和對照組各40例,觀察組采用激素替代治療,對照組采用谷維素治療,比較二者臨床療效.結果:觀察組患者Kupperman評分較對照組下降更明顯(P＜0.05);兩組患者治療后血清E2水平增加,FSH和LH水平下降,但是觀察組患者變化幅度更明顯(P＜0.05);兩組患者治療后子宮內膜厚度均增加(P＜0.05),但是觀察組患者增加幅度更大(P＜0.05).結論:小劑量激素替代治療圍絕經期綜合征安全有效,但臨床治療應把握好適應癥和禁忌癥.
    • 摘要：Objective: To indicate the value of examination of fundus before laser in situ keratomileusis. Method: 2760 myopic eyes ( 1380 patients ) treated with laser in situ keratomileusis in our hospital from Nov. 2005 to Nov. 2008 were collected in this study to accept examination of fundus. Result: 800 eyes( 403 patients ) had different extent of retinopathy, accounting for 30 percents of examined eyes. Conclusion: Examination of fundus before laser in situ keratomileusis ensures achieving satisfied vision and provides envi-dence for early treating and preventing other complication of fundus.%目的:探討LASIK術前眼底檢查的意義.方法:收集2005年11月至2008年11月來我院準分子治療中心的LASIK術患者1380例2760只眼,對術前LASIK行散瞳后眼底檢查并作詳細眼底記錄.結果:發現800眼底有不同程度的視網膜病變,占總檢查眼數的30%.結論:LASIK術前擴瞳后眼底檢查是必不可少的,是術后患者達到理想視力的重要保障,并為患者眼底疾病的及早防治提供有力依據.
    • 摘要：Objective: To evaluate the prevention of genital warts recurrence with BCG-PSN. Method: 178 patients by double-blind, randomly divided into control group ( n = 89 ) and the observation group ( n = 89 ), for 4 weeks of treatment, control group, only get rid of the wart using C02 laser ablation, the treatment group on the basis of the control group, after intramuscular injection of BCG-PSN. Result: After 6 months follow-up, In the control group, the cure rate was 52. 81% , the overall recurrence rate was 26. 97% ; the observation group to 88. 76% cure rate, the overall recurrence rate was 6. 74% . The efficacy of the observation group was obvioussly superior to the control group , P <0. 05 , statistically significant difference. Conclusion: The high efficacy of BCG-PSN treatment of genital warts, no significant side effects, is an ideal method of treatment genital warts, is worthy of clinical application.%目的:評價斯奇康預防尖銳濕疣復發的臨床療效.方法:將178例患者按雙盲、隨機原則分為對照組(n=89)和觀察組(n=89),對照組僅采用CO2激光燒灼祛除疣體,觀察組在對照組的基礎上,術后肌肉注射斯奇康注射液,4周為一療程.結果:治療結束隨訪觀察6個月后,對照組的治愈率為52.81%,總復發率為26.97%;而觀察組的治愈率為88.76%,總復發率僅為6.74%.觀察組的療效明顯優于對照組,P<0.05,差異具有統計學意義.結論:應用斯奇康治療尖銳濕疣療效高,無明顯副作用,是尖銳濕疣理想的治療方法,值得臨床推廣應用.
    • 摘要：Objective: To observe the clinical application of laparoscopic in gynecology. Method: 200 gynecological patients who were treated from Jul. 2009 to Jul. 2011 in our hospital were selected and divided into two groups randomly. 120 patients in the observation group were treated with laparoscopic surgery, and 80 patients were treated with routine open surgery. Compared the operative time, blood loss, postoperative intestinal function recovery time, postoperative fever rate and hospitalization days between the two groups. Result: The difference of the operative time between the two groups was not obvious, The blood loss, postoperative intestinal function recovery time, postoperative fever rate and hospitalization days were compared with the control group, which has statistically significant, P<0.01. Conclusion: Laparoscopic surgery combines diagnosis, treatment, minimally invasive integration. It can improve the drawbacks of traditional surgery, to reduce the suffering of patients, and is worthy of extensive promotion and application in gynecological clinical treatment.%目的:觀察腹腔鏡在婦科疾病中的臨床應用效果.方法:選自我院2009年7月至2011年7月收治的200例婦科患者,隨機分為兩組,觀察組120例行腹腔鏡手術治療,對照組80例行常規開腹手術治療,對比兩組手術時間、術中出血量、術后腸功能恢復時間、術后發熱率和住院天數.結果:觀察組和對照組的手術時間相差不明顯,但觀察組的術中出血量、術后腸功能恢復時間、術后發熱率和住院天數與對照組相比,均具有顯著性差異,P＜0.01.結論:腹腔鏡手術集診斷、治療、微創一體化,可改善傳統手術的弊端,減少患者的痛苦,值得在婦科臨床治療中廣泛推廣和應用.
    • 摘要：目的:探討女性早發急性心肌梗死對近期預后的危險因素.方法:回顧性分析我院114例急性心肌梗死患者的臨床資料,對疑似相關危險因素進行統計分析.結果:女性早發急性心梗患者糖尿病、吸煙、飲酒的比例、近期心血管事件發生率顯著低于男性早發心梗患者,體內TG水平升高比例高于男性早發心梗患者,差異具有顯著性;同時糖尿病、吸煙、飲酒、早發心梗家族史、近期心血管事件發生率、體內TG水平升高等比例均顯著高于女性非早發心梗患者,LDL-C升高的比例則顯著降低.結論:高血壓、糖尿病、吸煙、飲酒、血脂異常、早發心梗家族史等因素是女性早發心梗的危險因素,嚴重影響患者預后.
    • 摘要：臍帶是連接胎兒和胎盤的條索狀組織,一端連于胎兒腹壁臍輪,另一端附于胎盤胎兒面,附著在胎盤的中央或偏心性附著。臍帶是胎兒和母體之間營養物質供應和代謝產物排出的重要通道[1]。臍帶附著異常包括球拍狀胎盤（邊緣性入口）和臍帶帆狀附著。產前通過彩色多普勒超聲檢查,觀察胎盤臍帶入口,如發現異常,能為臨床及時提供有價值信息。
    • 摘要：目的:分析旬陽地區孕產婦妊娠期康復保健教育對產后影響的相關關系.方法:對198例孕婦的臨床資料進行回顧性分析與總結.結果:73.84%的產婦產后堅持純母乳喂養,陰道分娩產物的母乳喂養率相對剖宮產者要高.剖宮產者惡露延長發生率為9.44%,陰道分娩產婦為6.95%,兩者差異有顯著性意義.月經復潮率也存在顯著差異.結論:旬陽地區孕產婦妊娠期康復保健教育對產后有重要的影響,建議增強對產婦妊娠期康復保健教育.
    • 摘要：1病例摘要孕婦,30歲。孕2產1,孕24周來我院行常規產前超聲檢查。曾于孕兩個月時于外院行超聲檢查,超聲所見為：F1、F2胎兒頂臀長符合停經周數,均見胎心搏動;F3胎兒頂臀長明顯小于孕周,未見明顯胎心搏動及血流信號閃動。超聲提示：宮內早孕三胎,其一胎死宮內。孕5個月時再次行產前超聲檢查。
    • 摘要：目的:探討大腸息肉的各種病理類型與癌變相關因素.方法:選擇2002年1月至2011年12月在本院腸鏡檢查檢出大腸息肉患者1578例,回顧性研究大腸息肉的發病年齡、部位、大小、形態、病理類型與癌變因素.結果:大腸息肉檢出率為22.72%,癌變率5.64%;不同年齡檢出率有統計學差異(X2=8.250,P=0.016),中年患者檢出率高;大腸息肉在直腸(32.00%)乙狀結腸檢出(35.80%)最常見,息肉直徑≤1cm較常見(78.90%),在直徑1cm-2cm的息肉中腺瘤性息肉占比最高(70.12%),形態研究發現無分葉狀息肉較常見(80.04%);癌變因素研究發現老年患者(X2=10.070 P=0.002)、發生部位在直腸及乙狀結腸(X2=0.843 P=0.016)、息肉直徑>2cm(X2=114.173 P<0.001),分葉狀息肉(X2=16.66 P<0.001)、三種腺瘤性息肉(X2=71.14 P<0.001)較其它因素癌變率顯著增加.結論:大腸息肉的發病與年齡性別密切相關;不同病理類型的大腸息肉臨床特點明顯不同;直腸和乙狀結腸、分葉、腺瘤性、直徑>2.0cm的息肉是發生癌變的高危因素;對大腸息肉須及時治療,定期隨訪,減少大腸癌的發生.%Objective: To investigate the various pathological types of colorectal polyps and carcinogene-sis-related factors. Method: 1578 cases of colorectal polyps detected by colonoscopy in our hospital from January 2002 to December 2011 , reviewing the incidence of colorectal polyps, age, location, size, shape, and the pathological type of carcinogenesis factors. Result: Colon polyp detection rate was 22.72% , carci-nogenesis rate was 5. 64% ; A significant difference of different age groups are detected ( X = 8. 250, P = 0.016 ), with a high detection of middle-aged patients. Colorectal polyps occurred in common in the rectum (32.00% ) and sigmoid colon ( 35. 80% ), with polyp diameter ≤ lcm ( 78. 90% ). Adenomatous polyps was the highest proportion in the diameter of lcm—2cm polyps ( 70. 12% ). Morphological studies found non— lobulated polyps were more common ( 80. 04% ). It was found in carcinogenesis factors that elderly patients ( X2= 10.070 P = 0.002 ), occurrence in the rectum and sigmoid colon ( X2 = 0. 843 P = 0. 016 ), polyp diameter> 2cm ( X2 = 114. 173, P <0. 001 ), lobulated polyps ( X2 = 16.66, P <0. 001 ), adenomatous polyposis coli (X = 71. 14 p = <0.001) increased carcinogenesis rate significantly compared with other factors. Conclusion: The incidence of colorectal polyps are closely related to the age and sex; Different pathological types of colorectal polyps had significantly different clinical features ; Occurrence in the rectum and sigmoid colon, non - lobulated, adenomatous polyposis coli diameter > 2.0cm are risk factors of carcinogenesis ; Colorectal polyps is timely to treat, regular follow-up and therefore reducing the incidence of colorectal cancer.
    • 摘要：Objective: To investigate the effect of noninvasive ventilator in the treatment of type 2 respiratory failures in chronic obstructive pulmonary disease. Method:64 patients were divided in two groups, One group were treated with noninvasive ventilator, the other with routine treatment. Compared heart rate, respiratory rate and blood gas analysis in the two groups. Result: More obvious improvement of heart rate, respiratory rate and blood gas analysis were observed in noninvasive ventilator treatment group than the routine treatment group, There's significant difference ( P<0.05 ). Conclusion: Noninvasive ventilator is effective in the treatment of type 2 respiratory failures in chronic obstructive pulmonary disease. It rapidly relieves symptoms, improves PaO2 and reduces PaCO2- Shortens hospitalization time.%目的:探討鼻(面)罩無創呼吸機在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的療效.方法:入選病例64例,分為常規治療組和呼吸機治療組,兩組患者心率,呼吸頻率,血氣分析比較.結果:呼吸機治療組患者心率,呼吸頻率,血氣分析的改善優于常規治療組,差異有統計學意義(P< 0.05).結論:無創呼吸機治療COPD合并Ⅱ型呼吸衰竭療效肯定,緩解患者的臨床癥狀更快;使PaO2,SaO2和降低PaCO2提高更明顯;而縮短住院時間.
    • 摘要：Objective: To analyse the clinical features of chronic cor pulmonale complicating arrhythmi-a. Method: 158 cases patients treated in our hospital with chronic cor pulmonale, including arrhythmia group of 97 patients, non - arrhythmia group of 61 patients, They were griven conventional treatment, observed the type of arrhythmia and two groups were compared the incidence of concurrent symptoms. Result: The most common type of chronic cor pulmonale complicating arrhythmia is mainly sinus tachycardia ( 42. 27% ) and atrial premature beats ( 32.99% ); Pulmonary infection, heart failure, hypoxia, electrolyte imbalance were 100% , 44. 33% , 60. 82% , 73. 20% in arrhythmia group and 85. 25% ,18. 03% , 36. 07% , 52.46% in non-arrhythmia group. There's significant difference, P<0.01. Conclusion: Chronic cor pulmonale complicating arrhythmia occurs with age , infection, hypoxia, electrolyte imbalance , heart failure and other factors, timely appropriate treatment can effectively reduce the mortality.%目的:分析慢性肺源性心臟病并發心律失常的臨床特征.方法:將我院治療的慢性肺心病患者158例,其中心律失常組97例,非心律失常組61例,給予常規治療,觀察心律失常的類型,比較兩組并發癥狀發生情況.結果:肺源性心臟病并發心律失常最常見的類型主要為竇性心動過速(42.27%)及房性早搏(32.99%);心律失常組并發肺部感染、心力衰竭、缺氧、電解質紊亂分別為100%、44.33%、60.82%、73.20%,與非心律失常組85.25%、18.03%、36.07%、52.46%比較,有統計學差異,P<0.01.結論:肺源性心臟病并發心律失常的發生與年齡、感染、缺氧、電解質紊亂、心力衰竭等因素有關,及時給予相應的治療能夠有效地降低病死率.
    • 摘要：目的:討論多巴胺速尿硝酸甘油合劑治療風濕性心臟病伴心力衰竭的臨床療效.方法:隨機選取2010年1月至2010年10月入我院住院治療的風濕性心臟病伴心力衰竭癥患者48例為研究對象,將所有患者分為觀察組(多巴胺速尿硝酸甘油組)和對照組(單純基礎治療組),每組患者24例,并進行觀察和統計比較兩組患者治療后的心功能等其它臨床癥狀情況.結果:觀察組在心腎功能改善、呼吸和睡眠等方面的臨床效果明顯高于對照組,P＜0.05,有顯著性差異.結論:采取基礎治療聯合多巴胺、速尿、硝酸甘油合劑法用于治療風濕性心臟病伴心力衰竭是一種科學有效的治療手段,值得在臨床中推廣和使用.
    • 摘要：目的:探討超聲檢查在子宮肌瘤與子宮腺肌病的診斷鑒別中的臨床價值.方法:選擇我院2009年2月至2011年8月收治的子宮肌瘤患者與子宮腺肌病患者各50例,手術前醫師對100例患者進行二維及彩色多普勒超聲檢查,并分別對其二維聲像圖及彩色多譜勒血流顯像進行觀察分析.結果:50例子宮肌瘤患者中有7例超聲診斷顯示二維超聲顯示結構異常,50例子宮腺肌病患者中有9例顯示二維超聲顯示結構異常.子宮腺肌病組與子宮肌瘤組的病灶血流阻力指數、病灶血流搏動指數具有顯著區別,子宮腺肌病患者的病灶血流阻力指數、病灶血流搏動指數明顯高于子宮肌瘤患者.結論:二維及彩色多普勒超聲檢查子宮肌瘤與子宮腺肌病的診斷結果確切,在鑒別診斷中具有臨床價值,值得推廣應用.
    • 摘要：目的:探討導致胎兒窘迫的主要病因、臨床診斷及處理對策;方法:回顧性分析我院自2009年1月至2011年6月收治的167例發生胎兒窘迫患者的臨床資料,分析窘迫原因,總結診治經驗;結果:臍帶異常是造成胎兒窘迫及新生兒窒息的最主要因素,發生胎兒窘迫時多會出現羊水異常(84.4%),胎兒窘迫后造成新生兒窒息者80例,發生率為47.9%,全部胎兒窘迫得到解除,新生兒窒息全部復蘇成功.結論:早期針對性病因防治是預防胎兒窘迫的重要措施,胎兒窘迫引產后,做好新生兒窒息復蘇準備,可有效提高新生兒生存率.

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