目的:通过对高胆红素血症新生儿换血前后血生化、甲状腺功能变化的检测,探讨其原因。方法:分别对17例高胆红素血症新生儿换血前后血常规、电解质、血糖及甲状腺功能等指标进行检测。结果:本组血清总胆红素和间接胆红素换血前、后有明显下降。换血后血电解质血钾降低,血钠、血钙升高,血糖暂时性升高,但在24 h内自行恢复至正常。可有贫血,白细胞及血小板明显下降,甲状腺功能变化没有显著性意义(Pgt;0.05),无明显并发症发生。结论:换血后可出现低钾、高钙、高钠、高血糖、低白细胞和血小板血症的发生,应预防感染、出血和电解质紊乱的发生。
目的:探讨莫西沙星注射液应用在中重度急性腹腔感染治疗中的临床疗效与安全性。方法:共纳入31 例患者,随机分为罗氏芬加甲硝唑治疗组(对照),罗氏芬2 g,每日1次,甲硝唑0.5 g,每日2次;莫西沙星治疗组,莫西沙星400mg,每日1次,均为静脉滴注,疗程为7~14 天。结果:两组的痊愈率分别为80 ％和81.25 ％,有效率分别为86.67 ％和87.5 ％,细菌清除率分别为91.67%与90%。组间比较差异均无统计学意义。两组的不良反应发生分别为2／15和 1／16,主要表现为局部刺激及转氨酶升高等。结论:莫西沙星注射液治疗中重度腹腔细菌感染疗效确切,安全性好。
ObjectiveTo explore the effect of lidocaine on postoperative pain management after throat surgery. MethodsSixty patients undergoing throat surgery between June 2011 and May 2013 were randomly divided into trial group and control group, with 30 in each group. Patients in the trial group accepted lidocaine for pain management, while the control group used dicaine. Pain management effect was observed and compared between the two groups. ResultsThe pain scores of patients at hour 0.5, 2.0, 6.0, and 24.0 after surgery were 2.7±0.8, 2.2±0.9, 1.7±0.8, and 1.5±0.3 in the trial group, and 4.7±1.1, 4.2±0.8, 3.4±0.7, and 2.9±0.5 in the control group, and the differences were significant (P<0.05). Postoperative incidences 6.7% in the trial group, and 30.0% in the control group, and the difference was also significant (P<0.05). ConclusionLidocaine can reduce the pain of patients in postoperative pain management after throat surgery, with such advantages as long-time functioning, no toxic side effect, and obvious effect, which is worth promoting.
ObjectiveTo explore the levels of serum leptin,TNF-α,IL-8 and hypersensitivity C-reactive protein (hs-CRP) in stable COPD patients with different body mass index (BMI). Methods30 healthy controls with BMI 18.5 to 23.9 kg/m2 and 105 patients with stable COPD were recruited in the study. The serum levels of leptin,TNF-α,and IL-8 were determined by radioimmunoassay and hs-CRP level was determined by versatile biochemical automatic analyzer. The COPD patients were divided into a low BMI group (BMI<18.5 kg/m2,n=32),a normal BMI group (BMI 18.5-23.9 kg/m2,n=48),and a high BMI group (BMI≥23.9 kg/m2,n=25). ResultsSerum leptin level in the COPD patients was significantly reduced compared with the control subjects (P<0.05). Serum leptin levels were reduced in the low BMI and the high BMI groups compare with the normal BMI group [(7.89±3.16)ng/L and (10.52±5.98)ng/L vs. (13.04±5.73) ng/L,P<0.01 or P<0.05]. Leptin level in the low BMI group was lower than that in the high BMI group (P<0.05). Serum TNF-α levels were significantly increased in the low BMI group compared with the normal BMI and high BMI groups [(229.39±89.57)μg/L vs. (180.06±74.24) μg/L and (189.46±82.41) μg/L,P<0.01]. Serum TNF-α level in the COPD patients was significantly increased compared with the control subjects [(192.37±83.65) μg/L vs. (178.59±60.38) μg/L,P<0.05]. The IL-8 levels were not significant different among three BMI groups with COPD. The hs-CRP level in the high BMI group was higher than that in the low BMI and normal BMI groups (P<0.05). ConclusionLeptin and TNF-α may be involved in weight-loss of COPD malnutritional patients.
Objective To explore the effect of smoking on pulmonary function parameters of male patients with chronic obstructive pulmonary disease (COPD) and to analyze the correlation between smoking and pulmonary function parameters. Methods From January 2014 to October 2015, the pulmonary function parameters of 223 male outpatients or hospitalized patients with COPD in the Department of Respiratory Medicine were retrospectively analyzed by using SPSS 17.0 software. The patients were randomly divided into smoking group (n=98), smoking cessation group (n=82) and non-smoking group (n=43). Results Various degrees of damage or abnormality of lung capacity, ventilatory function, gas exchange function and airway resistance (Raw) existed in the patients with COPD. Compared with smoking cessation group and non-smoking group, residual volume/ total lung capacity (RV/TLC) and Raw were significantly higher (P< 0.05), maximum ventilatory volume, ventilation reserve percent, forced vital capacity, the percent of first second forced expiratory volume compared its predicted value (FEV1%pred), maximum mid-expiratory flow (MMEF), forced expiratory flow 50%, forced expiratory flow 75% and diffusing capacity of carbon monoxide were significantly lower (P<0.05) in the smoking group. There was a negative relationship between MMEF, FEV1%pred and smoking index (r=–0.352, –0.381, P<0.05), and a positive relationship between Raw, RV/TLC and smoking index (r=0.403, 0.378, P<0.05). Conclusions Most of the male COPD patients smoke or used to smoke. Smoking leads to ventilation and gas exchange function decrease, small airway limitation aggravation, airway resistance and emphysema degree increase in COPD patients. Smoking index has a negative relationship with MMEF, FEV1%pred and a positive relationship with Raw and RV/TLC.
目的 了解新生儿患者多重耐药菌社区感染的特点和定植情况，采取预防控制措施，防止在院内传播。 方法 对2011年9月－2012年8月所有新入院新生儿患者共801例进行耐甲氧西林金黄色葡萄球菌（MRSA）、耐万古霉素肠球菌（VRE）和产超广谱β内酰胺酶（ESBL）菌入院筛查，了解多重耐药菌社区感染的特点和定植情况。并将801例新生儿患者（观察组）医院感染发生率与2010年9月－2011年8月同期801 例新生儿患者（对照组）医院感染发生率进行比较。 结果 观察组发现MRSA和产ESBL菌共321例，检出率为40.1%。其中包括单纯MRSA 45例，占14.1%；产ESBL菌238例，占74.1%；MRSA+产ESBL菌38例，占11.8%。观察组医院感染发生率为2.0%，多重耐药菌医院感染构成比为12.5%；对照组医院感染发生率为5.1%，多重耐药菌医院感染构成比为53.6%；两组医院感染发生率和多重耐药菌医院感染构成比差异均有统计学意义（P＜0.01）。 结论 新生儿患者多重耐药菌定植情况严重，应引起高度重视，加强管理可防止在医院传播，减少医院感染发生。