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find Author "许树云" 6 results
  • 蜂毒主动免疫对预防蜂蜇伤严重毒效应的研究进展

    蜂蜇伤属于常见动物致伤病,伤后轻者可出现局部红肿热痛,部分患者中毒症状明显,甚至因感染或多脏器功能不全而死亡。目前国内对蜂蜇伤的治疗基本局限于对症治疗和支持治疗,很少采取主动免疫方式防患于未然。蜂毒液主动免疫即是将少量蜂毒提取液对高危人群进行注射,以使其获得主动免疫的方法,效果确切,安全性高,已成为国外防治蜂蜇伤严重中毒反应的最主要方法。现就蜂毒液主动免疫的应用机制、安全性、应用范围、使用方法等作一阐述。

    Release date:2016-09-08 09:12 Export PDF Favorites Scan
  • 有毒气体导致急性肺损伤的作用机制研究进展

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  • Value of Procalcitonin and C-reaction Protein in Predicting the Prognosis of Transferred Patients with Pneumonia Combined with Sepsis

    目的 探讨血清降钙素原(PCT)、C反应蛋白(CRP)与急性生理及慢性健康评分标准Ⅱ(APACHE Ⅱ)评分在转诊肺炎合并脓毒症患者诊断中的相关性,以寻找更为简洁、快速判断其病情严重程度的指标。 方法 2009年1月-2010年12月,选取178例转诊肺炎合并脓毒症患者并进行脓毒症分级,对其进行血清PCT和CRP测定,并与APACHE Ⅱ评分及预后进行相关性分析。 结果 严重脓毒症组及脓毒性休克组患者血清PCT、CRP水平与APACHE Ⅱ评分较全身炎症反应综合征组及脓毒症组高(P<0.05);30 d内死亡的患者其血清PCT、CRP水平及APACHEⅡ评分较存活组明显增高(P<0.05);转诊肺炎合并脓毒症患者血清PCT与APACHE Ⅱ评分呈正相关(r=0.683,P=0.023),与血清CRP水平呈较弱的正相关(r=0.272,P=0.037)。 结论 对转院肺炎合并脓毒症患者进行血清PCT和CRP测定,对病情评估具有一定临床价值,特别是PCT可作为对转诊肺炎合并脓毒症患者病情程度判断的重要指标,为早期干预及治疗提供依据,值得临床推广应用。

    Release date:2016-09-07 02:38 Export PDF Favorites Scan
  • 汶川大地震后1周内伤员特点分析(附1216例报道)

    目的:了解地震后1周内地震伤伤员的特点。方法:询问地震后1周内就诊的伤员性别、年龄、来诊时间和方式、进行伤情判断并应用损伤严重程度计分法(injury severity score,ISS)进行评分,统计入院率,抢救成功率。结果:受伤人员以7~18岁年龄段最多;平均每小时来院(7.90±11.75)人,震后53 h、54 h形成2个来诊高峰,每小时来院人数分别为70人、58人,地震36 h后夜班伤员来院明显减少,第3天来院人数最多,为328人;四肢伤员最多,为565例,占46%;地震后第2天来院的伤员ISS评分最高,为(10.24±5.79)分;急诊科停留时间平均为(97.47±12.56) min,入院率为57.81%,抢救成功率为99.8%。结论:地震发生后第2天来院的伤员最重,第3天来院人数最多,36 h后每天夜班伤员人数明显减少。

    Release date:2016-09-08 10:01 Export PDF Favorites Scan
  • Clinical Features of Patients with Bee Stings Anaphylaxis and the Related Risk Factors

    ObjectiveTo identify the clinical features of and risk factors for allergic reaction to bee stings in Sichuan. MethodWe retrospectively analyzed the clinical data of 387 patients with bee stings admitted to the Emergency Department of nine hospitals in Sichuan during January 1, 2010 to December 31, 2011, and evaluated the risk factors for bee sting anaphylaxis with logistic regression analysis, and explored the influence of anaphylaxis on death with Fisher exact probability method. ResultsAmong the 387 patients with bee stings, 41 (10.6%) had allergic reactions. The age in patients from the anaphylaxis group was significantly older than those in the non-anaphylaxis group (P<0.05). Logistic regression analysis showed that age was an independent risk factor for allergic reaction in patients with bee stings[OR=0.983, 95%CI (0.967, 0.999), P=0.042]. All the patients with allergic reactions were prescribed with systemic corticosteroids, and 16 were prescribed with antihistamine drugs, but no patients were prescribed with epinephrine. Among the 16 patients with systemic allergic reaction, 12 were given less than 1000 mL intravenous rehydration per 24 h, 2 were given 1000-3000 mL intravenous rehydration, and only 2 were given more than 3 000 mL intravenous rehydration. The mortality of allergic patients was significantly higher than that of the non-allergic group (9.8% vs 1.4%, P<0.05). ConclusionsThe mortality of anaphylaxis patients is significantly higher than that of the non-anaphylaxis group. Age is an independent risk factor for allergic reactions to bee stings. Treatment of bee stings related to severe allergic reaction needs to be further standardized.

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  • Feasibility of ultrasound-guided osteofascial chamber puncture manometry in assessing the pressure of osteofascial chamber in patients with venomous snake bites

    Objective To investigate the efficacy on clinical condition assessment and the safety of ultrasound-guided osteofascial chamber puncture manometry in evaluating the pressure of the osteofascial chamber in patients with venomous snake bites. Methods Patients with venomous snake bites admitted to the Department of Emergency Medicine of West China Hospital of Sichuan University between April 2021 and January 2023 were prospectively included, and their basic information, physiological indicators (heart rate, blood pressure), laboratory examination indicators, physical signs, treatment methods and prognosis were collected. The patients whose extremal pressure was measured by osteofascial chamber puncture under ultrasound guidance were selected as the manometry group. Patients who were bitten by venomous snakes at the same time without puncture pressure measurement were randomly selected as the control group at a ratio of 1∶1. The bleeding, infection, nerve injury, length of hospital stay and long-term prognosis of the two groups were compared to explore the safety of ultrasound-guided osteofascial chamber puncture manometry. The correlation between the pressure measured in the manometry group and creatine kinase (a representative index of acute poisoning severity score) was analyzed to explore the efficacy of ultrasound-guided osteofascial chamber puncture manometry in evaluating the disease. Results There was no significant difference between the manometry group and the control group in new or aggravated infection, bleeding, nerve injury (such as numbness and anesthesia), hospital treatment time, final detumescence time of the affected limb, or final adverse prognosis (P>0.05). There was a positive correlation between the measured pressure and creatine kinase (rs=0.286, P=0.002). Conclusions The higher pressure measured by ultrasound-guided osteofascial chamber puncture manometry is, the more serious the poisoning condition may be. In addition, ultrasound-guided osteofascial chamber puncture manometry does not prolong the hospital time of patients or the final swelling reduction time of the affected limb, and does not increase the incidence of bleeding, infection, nerve damage or eventual adverse prognosis events. It has clinical practicability and feasibility.

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