培菲康治疗73例婴幼儿腹泻疗效观察

培菲康治疗７３例婴幼儿腹泻疗效观察浙江绍兴市第五人民医院绍兴３１２０００吴琴琴本文观察了７３例诊断为婴幼儿腹泻的病例。其中感染性腹泻４６例,非感染性腹泻１３例,其诊断标准参照《实用儿科杂志》１９９２年第五期《中国腹泻病诊断方案标准》一文。全部病例除一...     

酪酸梭菌活菌散联合抗菌药治疗小儿急性细菌感染性腹泻临床疗效观察

目的观察和评价酪酸梭菌活菌散（商品名：宝乐安）联合抗菌药治疗小儿急性细菌感染性腹泻临床疗效。方法将60例急性细菌感染性腹泻患儿随机分为观察组和对照组,观察组30例,对照组30例,2组均给予口服抗菌药及对症支持治疗。其中观察组在服用抗菌药2h后服用酪酸梭菌活菌散,0.5g/次,3次/d;对照组只给予抗菌药及对症支持治疗,不用酪酸梭菌活菌散。对2组总有效率及体温、大便恢复正常时间进行统计分析。结果观察组总有效率为96.7%,对照组总有效率为83.3%,2组相比差异具有非常显著性（P〈0.01）;观察组体温、大便恢复正常时间均显著短于对照组（P〈0.01）。结论酪酸梭菌活菌散联合抗菌药治疗小儿急性细菌感染性腹泻的疗效,优于单用抗菌药,值得临床推广应用。     

布拉酵母菌在成人感染性腹泻治疗中的作用研究

目的评价布拉酵母菌在感染性腹泻治疗中的作用及影响因素。方法收集浙江省龙游县人民医院自2010年5月至2012年10月共36例感染性腹泻病例,其中18例患者治疗应用左氧氟沙星联合布拉酵母菌,对照组18例患者单用左氧氟沙星,观察患者症状的改善状况和治愈疗程的差异。结果左氧氟沙星联合布拉酵母菌治疗患者大便次数在疗程第2~4天较单用左氧氟沙星患者明显缩短,两组比较差异有统计学意义（P 〈 0. 05）;联合治疗组平均止泻时间为（3. 85±1. 74） d,单用左氧氟沙星治疗组的平均止泻时间为（4. 89 ± 1. 67）d,两组比较差异有统计学意义〈0. 05）。结论感染性腹泻患者联合应用布拉酵母菌,有助于平衡肠道菌群,及早康复。     

丽珠肠乐胶囊同庆大霉素治疗急性腹泻的疗效对比观察

目的比较丽珠肠乐胶囊同庆大霉素治疗急性腹泻的临床疗效.方法治疗组口服丽珠肠乐胶囊2粒,每日3次,疗程5 d;对照组口服庆大霉素片8万单位,每日3次 ,疗程 5 d.结果 治疗组与对照组临床总有效率分别为 91.93%和79.31% ,χ2=3.92,P＜0.05,差异有显著性.结论丽珠肠乐胶囊治疗急性腹泻比庆大霉素更有效.     

马来酸曲美布汀联合参苓白术散治疗腹泻型肠易激综合征及对血浆生长抑素、神经肽Y水平影响

目的:观察马来酸曲美布汀联合参苓白术散治疗腹泻型肠易激综合征的临床疗效及对血浆生长抑素(SS)、神经肽Y(NPY)水平的影响.方法:将86例腹泻型肠易激综合征患者随机分为对照组和观察组,每组各43例.对照组采用西药马来酸曲美布汀进行治疗,观察组在此基础上,加用中药复方参苓白术散,治疗周期均为6周,治疗结束后评价疗效,并对治疗前后两组患者血浆SS、NPY水平进行比较.结果:观察组临床总有效率为88.37％,显著高于对照组的60.47％(P＜0.05),观察组患者治疗前后血浆SS、NPY水平差异显著,具有统计学意义(P＜0.05).结论:马来酸曲美布汀联合参苓白术散治疗腹泻型肠易激综合征的临床疗效确切,并能调节患者体内异常变化的血浆SS、NPY水平.     

低渗ORS在小儿急性腹泻中的临床疗效分析

目的 探讨低渗口服补液盐治疗小儿急性腹泻的临床效果.方法 将120例急性腹泻患儿随机分为观察组和对照组,观察组采用低渗口服补液盐治疗,对照组采用标准口服补液盐治疗,比较两组患儿急性腹泻症状的缓解情况和治疗效果.结果 观察组总有效率为90.0%,无效率为10.0%;对照组总有效率为76.67%,无效率为23.33%;两组总有效率、无效率比较差异显著(均P<0.05);观察组治疗3天内大便次数、呕吐次数显著少于对照组(P<0.05),腹泻症状缓解的时间也显著短于对照组(P<0.05).结论 低渗口服补液盐治疗小儿急性腹泻的疗效较好,安全性较高,值得临床上推广应用.     

应用促菌生治疗急性腹泻疗效观察

本文选择一种活菌制剂—促菌生,用于治疗急性腹泻,同时与抗生素疗法对此观察,以评价促菌生的临床疗效。在所选择的222例急性腹泻病人中,促菌生治疗了72例,有效率97.2％;氨苄青霉素治疗了76例,有效率89.5％;度大霉素治疗了74例,有效率89.2％。经统计学处理,有显著性差异P<0.05。资料显示,促菌生治疗急性腹泻,临床疗效优于氯苄青霉素和庆大霉素,是一种有前途的治疗手段。     

成人急性感染性腹泻治疗新进展

成人急性感染性腹泻与儿童感染性腹泻在发病率、严重程度、预后等方面有所不同,其治疗以补液、止泻为主,必要时使用抗微生物药物。近年来,成人急性感染性腹泻在补液治疗和益生菌、新止泻药物应用等方面更新了一些新的循证医学证据,在进一步确保现有药物安全性的同时促进了腹泻治疗思路与手段的发展。     

中西医结合治疗急性上消化道出血的疗效观察

目的 研究中西医结合治疗急性上消化道出血的临床效果.方法 选择2010年12月~2012年3月在我院接受治疗的急性上消化道出血患者94例,随机分成对照组和观察组各47例,对照组给予常规治疗及静脉滴注止血敏、奥美拉唑;观察组在对照组治疗的基础上加用中药经胃管注入治疗,治疗1周后比较分析两组的临床效果.结果 观察组总有效率为93.6%(44/47),显著高于对照组的80.9%(38/47),差异有统计学意义(P<0.05).结论 急性上消化道出血采用中西医结合治疗能有效缓解患者症状、促进预后、改善患者生活质量.     

微生态制剂防治儿童感染性腹泻的有效性评价CSCD

目的对微生态制剂防治儿童感染性腹泻的有效性和安全性进行分析研究。方法选取2017年3月到2018年3月间我院收治的132例感染性腹泻患儿为研究对象,依据随机数字表法分为对照组(n=66)与观察组(n=66)。对照组患儿施以常规药物防治,观察组患儿应用益生菌进行防治。对两组患儿的治疗效果、腹泻持续时间、治疗后病情、血常规与肝功能情况进行比较分析。结果观察组患儿治疗总有效率(96.97%)明显高于对照组(86.36%)。观察组患儿腹泻持续时间为(2.41±1.08)d,明显少于对照组的(3.67±1.89)d。观察组患儿治疗3 d后腹泻频率≤2次/d的发生率为24.24%,低于对照组的60.61%。观察组患儿治疗后脱水发生率为3.03%,低于对照组的22.73%。观察组患儿血常规与肝功能水平明显高于对照组,差异均有统计学意义(P<0.05)。结论在儿童感染性腹泻中应用微生态制剂有助于提高治疗效果,缩短腹泻持续时间,促进大便恢复正常,且具有较高的安全性,可有效促进患儿康复。     

微生态制剂辅助治疗溃疡性结肠炎的疗效与安全性研究

目的观察微生态制剂(思连康)辅助治疗活动期溃疡性结肠炎(UC)的疗效和安全性,并进一步探讨微生态制剂对肠黏膜局部细胞因子的影响。方法活动期UC患者86例,随机分为2组,对照组(40例)口服美沙拉嗪,同时用琥珀酸氢化考的松及庆大霉素、蒙脱石散保留灌肠,重度患者加静脉用激素。治疗组(46例)在上述治疗基础上,口服思连康1.5 g,每天3次。治疗6个月后评价2组疗效,主要症状和结肠镜变化情况,免疫组化法检测患者肠黏膜局部细胞因子IL-10、IL-6和IL-18的变化。结果治疗后2组临床表现均有明显好转,且治疗组优于对照组,2组比较差异有统计学意义(P<0.05)。2组治疗后结肠镜表现均有明显改善,治疗组优于对照组;疾病活动指数(DAI)降低(P<0.05),降低幅度治疗组优于对照组(P<0.05)。所有患者均未见明显的不良反应。免疫组化结果显示治疗后肠黏膜细胞因子IL-10的水平升高,治疗组优于对照组,IL-6和IL-18均有降低,IL-6下降治疗组优于对照组,而IL-18的降低2组间差异无统计学意义。结论微生态制剂口服辅助治疗UC疗效明显,并能降低UC的复发,且无不良反应。其机制可能与上调局部肠黏膜抗炎性细胞因子,下调炎性细胞因子有关。     

Hypertrophic osteoarthropathy in cystic fibrosis.

Seven adult patients with cystic fibrosis who had radiological evidence of hypertrophic osteoarthropathy were reviewed. In five of the patients symptoms were particularly pronounced at times of acute infective exacerbations; appropriate treatment of the infective episodes resulted in reduction or resolution of the bone pain and joint effusions. Despite this symptomatic relief periosteal changes persisted radiologically and their chronic nature was indicated by changes in the midshafts of long bones. Four of the seven patients had transient gynaecomastia or mastalgia related to infective exacerbations. It is hypothesised that a neuroendocrine mechanism--namely, release of vasoactive intestinal polypeptide--might account for the osteoarthropathy.     

L-NAME、G-CSF对急性胆道感染大鼠生存率和肺脏影响

目的 :了解大鼠在急性胆道感染时应用 L- NAME、G- csf后 ,其肺脏和生存率的影响。方法 :72只 SD大鼠随机分为 4组 ,即 :假手术组、急性胆道感染组、L- NAME处理组、G- csf处理组。采用胆总管注入大肠埃希菌 0 .2 m l(菌型 :2 5 92 2 ,浓度 4× 10 9CFU/ ml) ,双重结扎制成胆总管的急性胆道感染模型 ,观察肺组织光镜下的一般结构。 72只 SD大鼠随机分为 4组 ,分组方法如上 ,观察每组大鼠在 2 4、48、72 h的存活率。结果 :G- csf处理组与急性胆道感染组比较 ,肺脏病理损害减轻 (P<0 .0 5 ) ,存活率则显著增高 ((P<0 .0 1或 P<0 .0 5 )。L- NAME处理组肺脏病理改变有加重趋势。结论 :外源性细胞因子 L- NAME及 G- csf可影响感染中某些炎性介质的分泌和释放 ,L - NAME加重脏器损害 ,G- csf可减轻脏器损害 ,提高存活率。     

Gentamicin level in the prostate and its pharmacokinetics in patients with benign prostatic hypertrophy]

The study involved 15 male patients with periurethral prostatic adenoma without complete anuresis. The patients were given 80 mg of gentamicin intramuscularly one day before surgery and 80 mg in a one-hour infusion immediately before an operation. Gentamicin blood concentrations were measured. Pharmacokinetic parameters were calculated and dosage schemes for each patient basing on the antibiotic blood levels. Gentamicin levels in removed adenomas were also determined. Adenomas weighed between 18.0 and 45.8 grams while gentamicin concentration ranged from 1.31 to 3.8 micrograms/mL. It was found that gentamicin concentration in adenomas depend upon their weight. Moreover, pharmacokinetic parameters of this antibiotic exert negligible effect on its levels in adenoma.     

依达拉奉联合尤瑞克林治疗急性脑梗塞的疗效观察

目的:观察依达拉奉联合尤瑞克林治疗急性脑梗塞的疗效及安全性。方法:将84例急性脑梗塞患者随机分为2组,对照组予依达拉奉30 mg加入生理盐水100 mL静脉滴注,每日两次。观察组在上述基础上另予尤瑞克林0.15 PNA加入生理盐水250mL中静脉滴注,每天一次。两组疗程均为2周。观察两组患者的神经功能缺损评分、疗效与不良反应。结果:两组患者神经功能缺损评分均较治疗前明显改善(P<0.01),观察组评分明显低于对照组(P<0.01)。观察组临床总有效率达97.6%,明显高于对照组的57.1%(P<0.01)。两组不良反应发生率无统计学差异。结论:达拉奉联合尤瑞克林治疗急性脑梗塞临床疗效好,安全性高。     

Survival of Haemophilus equigenitalis in different antibiotic-containing semen extenders.

The ability of Haemophilus equigenitalis, the causal agent of contagious equine metritis 1977, to survive in various antibiotic-containing semen extenders was studied at different environmental temperatures. Gentamicin sulphate was found to be markedly superior to ampicillin or a combination of sodium benzyl penicillin and polymyxin B sulphate, Semen treated with the former antibiotic was either sterile at cultural examination or else yielded appreciably fewer colonies of H. equigenitalis than the untreated semen control. Ampicillin had no observable effect on the survival of this organism. Gentamicin was most effective when semen-extender mixtures were held at room temperature rather than at 37 or 4 degrees C. No detrimental effects on sperm motility were observed following the use of the different antibiotic-containing semen extenders in the presence or absence of H. equigenitalis.     

Clinical and X-ray features of pneumonia in drug addicts

The authors observed 68 drug addict in-patients, who received treatment for the pneumonia at the Primorski Regional Clinical Hospital and Vladivostok Municipal Clinical Hospital No. 1. The article details the specific features of the pneumonia of these in-patients. It was distinguished the 3 groups of hospital patients with the following characteristic features: patients with the respiratory distress syndrome of the adults; patients with the primary infective endocarditis mainly with the damage of respiratory (right) heart; patients with non-specific pneumonia. The peculiarities of the clinical process with the X-Ray pictures of the disease were also presented. The article identifies the acute beginning of the disease; the strongly pronounced intoxication syndrome; the usual cases of the late going to hospital of those patients; the extensiveness of the damage; the occurrence of the following complications at the early stage: pulmonary destruction, exudative pleurisy, empyema; the long period of the disease process; the development of the extensive pulmonary fibrosis. It was identified the 33.7% lethality for these groups of in-patients, while the average lethality of the in patients treated for pneumonia was 3.3% for the same period of time. The complicated pneumonia process of young patients with the infective endocarditis with damages of respiratory (right) hearts let us suppose their drug addiction.     

HV-CBP对急性重症胰腺炎患者机体免疫功能的影响

目的:探讨连续性高容量血液净化(HV-CBP)对急性重症胰腺炎患者免疫功能的影响及其临床效果。方法:选取我院消化科收治的急性重症胰腺炎患者220例,根据治疗方案不同分为对照组及试验组。对照组给予常规治疗,实验组在常规治疗基础上应用HV-CBP治疗。观察并比较两组患者治疗前后血清淀粉酶、脂肪酶、CRP、TNF-α及T淋巴细胞亚群的变化情况。结果:试验组体温、腹痛、黄疸症状恢复时间及住院天数均较对照组明显缩短(P0.05);治疗后试验组血清淀粉、脂肪酶、CRP、TNF-α水平明显低于对照组,而CD4+/CD8+比率明显高于对照组,差异均具有统计学意义(P0.05)。结论:HV-CBP对急性重症胰腺炎患者的临床症状、炎性刺激、病情进展及免疫功能具有良好的改善作用。     

马方综合征并发感染性心内膜炎的外科治疗体会

目的：探讨马方综合征并发感染性心内膜炎的外科治疗的体会。方法：回顾性分析2009年7月至2012年12月我院30例马方综合征并发感染性心内膜炎患者,男19例,女11例,年龄23.58（41．6±15．2）岁,所有患者均进行了抗生素治疗和心瓣膜置换或成形术,其中对患者进行经典Bent,all手术12例,纽扣法Bentall手术18例,比较分析手术治疗马方综合征并发感染性心内膜炎疗效。结果：手术时间276．742（405．0±125．0）min,体外循环时间115—319（159．0±43．0）rain,机械通气辅助时间1～12（2．4±2．0）d．住院时间10．60（28．5±11．0）d,术后出现并发症有7例,经二期手术治愈有5例,2例抢救无效死亡,并发症发生率为23.3％,死亡率为6．7％。结论：对于马方综合征并发感染性心内膜炎患者,正确把握手术的时机和抗感染药物治疗剂量,积极采取外科手术治疗是最佳的治疗方法。     

Comparative evaluation of treatment with low-dose aspirin plus dipyridamol versus aspirin only in patients with acute ischaemic stroke

ABSTRACT: BACKGROUND: Previous studies have suggested that pre-stroke treatment with low-dose aspirin (A) couldreduce the severity of acute ischaemic stroke, but less is known on the effect of pre-stroketreatment with a combination of aspirin and dipyridamole (A + D) and post-stroke effects ofthese drugs. The aim of the present study was to evaluate the effect of this drug combinationon acute and long-term prognosis of ischaemic stroke. METHODS: Patients without atrial fibrillation admitted to the stroke unit with acute ischaemic stroke (n =554) or TIA (n = 108) were studied during acute hospital care and up to 12 months afterdischarge from hospital. RESULTS: Prior to acute stroke 62 patients were treated with A + D while 247 patients were treated withA only. No beneficial effects of the combination A + D compared to A only were noted onstroke severity and/or acute in-hospital mortality. However, survival analysis by Coxproportionalhazard model demonstrated lower 12-months all-cause mortality in patientsdischarged with A + D (n = 275) compared with patients on A only (HR, 0.52; CI, 0.32-0.86;p = 0.011; n = 262) after adjusting for age, baseline NIHSS, previous stroke, previousmyocardial infarction and type 2 diabetes. We also noted a tendency towards lower all-causemortality at 3 months with use of A + D, but this was not statistically significant (p = 0.12). CONCLUSIONS: Pre-stroke treatment with a combination of low-dose A + D does not reduce the severity ofacute stroke, nor does it reduce the acute in-hospital mortality. However, treatment with A +D at discharge from hospital is seemingly associated with lower long-term mortalitycompared with A only, contrary to the results from previous randomised studies. However,our results must be interpreted with extreme caution considering the non-randomised studydesign.