目的 研究胰激肽原酶在早期糖尿病足患者治疗中的应用效果.方法 选取2018年1—9月收治的64例早期糖尿病足患者,采用均衡分组法分为参照组和研究组,各32例.参照组采用前列地尔治疗,研究组采用胰激肽原酶治疗.治疗4周后观察效果,包括治疗总有效率、不良反应发生情况及治疗前后踝肱指数、足背动脉流速指标变化.结果 研究组治疗总有效率96.88％,参照组治疗总有效率65.63％,对比差异有统计学意义(P<0.05).研究组不良反应发生率3.13％,参照组不良反应发生率3.13％,对比无统计学意义(P>0.05).治疗后,研究组踝肱指数、足背动脉流速指标高于参照组和治疗前,对比差异有统计学意义(P<0.05).结论 胰激肽原酶在早期糖尿病足患者治疗中的效果显著,可有效改善踝肱指数、足背动脉流速指标,且安全性及可行性均处于较高水平,值得临床推广.

目的 评价血栓通在急性深静脉血栓形成(DVT)患者治疗中的应用价值.方法 选取该院在2017年1月—2019年1月期间收治的90例急性DVT患者,按数字随机表法分为对照组(n=45)、观察组(n=45),对照组患者采取溶栓、抗凝治疗,观察组患者在对照组基础上采取血栓通治疗;比较两组患者治疗效果.结果 观察组治疗后凝血功能、血液流变学较对照组改善明显,胫骨腿围及髌骨腿围差值低于对照组,差异有统计学意义(P<0.05).结论 对急性深静脉血栓形成患者采取血栓通治疗,可改善患者凝血功能,临床价值高.

目的 探讨局部溶栓联合抗凝对DVT的治疗效果.方法 任意选取82例于2015年9月—2017年9月间入住该院的DVT患者为研究对象,根据治疗手段均分为对照组和观察组.对照组用抗凝方案,予以观察组患者局部溶栓联合抗凝疗法,进行两组疾病治疗效果的对比.结果 观察组疼痛缓解时间为(6.5±1.2)d、肢体肿胀缓解时间为(7.0±1.5)d,静脉扩张缓释时间为(7.6±1.8)d,皮肤潮红缓解时间为(6.0±0.7)d,与对照组相比,数据间差异有统计学意义(P<0.05);观察组患者生活质量评分为(232.0±3.6)分,明显高于对照组的(199.9±3.5)分,存在统计学层面的数据,差异有统计学意义(P<0.05);对照组和观察组患者的并发症发生率分别为22.0％和4.8％,所得数据间差异有统计学意义(P<0.05).结论 联合应用局部溶栓联合抗凝方案,可获得明显的治疗效果,值得在深入探讨的基础上展开广泛应用.

Objective To investigate the treatment methods and therapeutic effect of hepatitis B cirrhosis in patients with cirrhosis.Methods Selected 72 cases with hepatitis B cirrhosisfrom November 2012 to February 2014 in our hospital to research and analysis, according to the patients' treatment to were divided into the observation group and the control group, each group had 36 cases, the control group use routine treatment with lamivudine, observation group uses ordinary routine treatment and grace entecavir,two groups of 48 weeks of treatment effect were compared and analyzed.ResultsAfter treatment, observation group with hepatitis B virus gene conversion rate was higher than the control group. The results were statistically signiifcant, the observation group and the control group of hepatitis Bantigen seroconversion rate comparison was no significant difference,P>0.05, The adverse reactions of the two groups were not statistically different,P>0.05. ConclusionLost decompensated hepatitis B cirrhosis patients received en for the therapeutic effect of entecavir than lamivudine outstanding, the patients of hepatitis B virus gene replication can be restricted, with the progression of the disease under control, liver function damage is improved.

ObjectiveTo study clinical effect of the Pegasys and ribavirin for combination therapy of HCV .Methods Selected 197 cases of hepatitis C patients from January 2009 to June 2012 in our hospital. The control group using conventional treatment. The treatment group receiving Pegasys and ribavirin for combination therapy,and RNA and alanine aminotransferase(ALT)levels of two groups of patients were analyzed.Results After treatment,clinical indicators was better in treatment patients than in the control group,the difference there were significant (χ2=4.60,P<0.05). After 48 weeks of treatment and 24 weeks after discontinuation,complete responses number of cases of two groups,the difference was not statistically significant(P>0.05).Conclusion HCV patients receiving Pegasys and ribavirin for combination therapy with excellent clinical results.

目的 研究分析乙型肝炎后肝硬化患者接受核苷类抗病毒药物治疗的临床效果.方法 选取2011年7月～2013年7月我院接收的163例失代偿期乙肝后肝硬化患者进行分析,将患者分组为A、B、C三组,A组使用拉米夫定(LAM)治疗、B组使用阿德福韦酯(ADV)治疗、C组使用恩替卡韦(ETV)治疗,对三组患者治疗12个月后的血清生化指标和病毒载量情况进行对比分析.结果 三组患者的乙型肝炎病毒(HBV) DNA载量、ALT指标、Child-Pugh评分等均有较大幅度的降低,治疗前后据有统计学差异性,C组患者的病毒DNA载量和HBeAg转阴率要比A组和B组优秀,结果存在统计学差异性.结论 乙型肝炎后肝硬化患者接受核苷类抗病毒药物后,其体内的HBV病毒DNA载量有所下降,患者的HBeAg转阴率有所提升,临床中未出现严重不良反应情况,使用恩替卡韦的治疗效果好.

目的：观察两种截骨矫形术式治疗强直性脊柱炎胸腰椎后凸畸形围手术期并发症，研究原因、预防措施。方法总结收治的100例实施强直性脊柱炎胸腰椎后凸畸形截骨矫形治疗患者的临床资料。因截骨术式的不同将100例患者分为1组（多节段经关节突“V”形截骨，36例）、2组（单节段经椎弓根椎体截骨，64例）。观察两组围手术期并发症。结果术中气管套管脱落2例，术中螺钉松动1例，硬脊膜破裂4例，神经并发症2例，胃肠道并发症5例。2组：术中气管套管脱落1例，术中螺钉松动3例，术中截骨端脱位2例，硬脊膜破裂1例，术中大出血4例，神经并发症4例，胃肠道并发症6例，后凸过度纠正1例。结论因截骨方法的差异导致两种手术的围手术期并发症构成具有一定程度的不同，因此临床中应该采取相关预防处理措施以降低并发症发生率。

Objective Explore the locking compression plate and bone graft in the treatment of non Union of clavicular fractures treatment. MethodsRandom retrospectively of 100 cases of nonUnion of clavicular fractures were divided into two groups and the control group, each group of 50 cases. Observer group row locking compression plate and bone graft in the treatment and control groups treated with conventional methods, comparative clinical efficacy.ResultsObserve group average fracture healing time, shoulder joint function recovery was signiifcantly better than the control group, the difference was statistically significant (P<0.05). Conclusion Locking compression plate and bone graft in the treatment of nonUnion of clavicular fractures result is good, can significantly relieve symptoms, improve the quality of life.

目的:观察踝关节骨折采用手术治疗与手法复位治疗的临床应用价值.方法:随机将96例踝关节骨折患者分为两组,每组48例.观察组行手法复位治疗,对照组行手术治疗,比较两组治疗效果.结果:观察组与对照组优良率差异无显著性意义(P>0.05).结论:采用手术与手法复位治疗踝关节骨折在临床疗效方面无明显差异,临床中应该根据患者具体情况选择相应治疗措施.

Objective Exploration of different ifxed program ifbula fracture treatment outcome. Thinking to develop new treatments. Methods Collected 200 cases of fibular fracture patients since January 2015 to our hospital orthopedic clinic by clinic program were randomly divided into two groups, each group of 100 patients. Statistical analysis of patients discharged after recovery and postoperative functional recovery effect is the result of two types of treatment programs. Results Patient discharge time of the experimental group was significantly earlier than in the control group; the experimental group fracture healing time and complications rates and other indicators of comparison with the control group (P < 0.05), the difference was significant. Conclusion By open reduction and internal ifxation of the ifbula fracture treatment programs for diagnosis and treatment have better healing effect.

Objective Investigate treatment of thoracolumbar transpedicular bone fracture treatment.Methods Random 100 cases of thoracolumbar burst fractures were divided into two groups, each group of 50 case .Damaged vertebral body posterior pedicle screw ifxation in the observation group then transpedicular bone in control group only damaged vertebral body posterior pedicle screw fixation. After 3 months, the vertebral height reduction rates were observed, fracture healing and other indicators.ResultsAfter 3 months, the vertebral height reduction rates in the observation group, the damaged segment vertebral Cobb angle was significantly better than the control group (P<0.05), 40 cases of fracture healing in the observation group (80%), NonUnion of fracture in 10 cases (20%), 24 cases of fracture healing in the control group (48%), 26 cases of fracture nonUnion (52%), Two sets of fracture healing rate difference was signiifcant (P<0.05); No statistically signiifcant difference in incidence of complications in the two groups (P>0.05).Conclusion Treatment of thoracolumbar transpedicular bone fractures signiifcantly, heal faster and the prognosis is good, worthy of promotion.

Objective To study interferon combined with ribavirin on liver fibrosis indexes in patients with decompensated hepatitis C cirrhosis. Methods According to the December 2009 to December 2013 in our hospital of 32 cases of patients with hepatitis C cirrhosis of research and analysis. These patients were grouped into control group and treatment group,the treatment group using interferon and ribavirin for combination therapy,the control group using conventional liver protective treatment,the two groups before treatment, after 12 weeks,24 weeks of treatment of liver function indexes were recorded and analyzed. Results The control group and treatment group in 24 weeks after the treatment of serum liver fibrosis four indicators compared to the results of the treatment group was low,the difference was statistically significant(P < 0.05). Conclusion Having good effect with the use of interferon and ribavirin in hepatitis C cirrhosis patients.

骨盆骨折的非手术治疗即保守治疗,是治疗骨盆骨折的主要方法,尤其是在传统治疗观念中,非手术疗法有广泛的适应证,普遍认为该疗法多能取得预期的疗效,达到治疗的既定目标,且操作简单,易于基层医疗机构和院前抢救时应用,相应的费用也较少.

开放性骨盆骨折又称为致命性骨盆骨折,据报道此类损伤的死亡率近50%,明显高于闭合性骨盆骨折的死亡率(10%～ 15%).开放性骨盆骨折是指与外界相通(包括与直肠、尿道或阴道相通)的骨盆骨折,由于尿道或胃肠道内容物而造成的骨折污染很常见.软组织损伤严重常伴有明显的骨盆环畸形,并伴有难以控制的大出血,因此对诊断明确的骨盆骨折应首先注意气道、呼吸和循环方面的急救,然后再考虑骨盆骨折的治疗.

Objective: To evaluate the long-term efficacy and safety of lamivudine(LAM) combined with thymosinα1(Tα1) in the treatment of the patients with chronic hepatitis B(CHB). Methods: 72 CHB patients aged 18 to 56 years (HBV-DNA and HBeAg,positive) were randomly divided by 1:1 proportion into two groups: 36 patients were given LAM alone(dose,100mg a day, orally,at least for one year)(i.e.LAM group); 36 patients LAM(usage dosage, the same as LAM group) plus Tα1(starting dose during the first 4 days of half a year cycle, 1.6mg a day, subcutaneously; after that,1.6mg,twice a week)(i.e.LAM + Tα1 group). Results: At one year, HBeAg seroconversion rate in LAM + Tα1 group was 44.4%(16/36), which was significantly higher than that in LAM group(5.6%,2/36)(P0.01). Through one-year follow-up after treatment, 58.3%(21/36) of ALT recovery rate in LAM + Tα1 group was obviously higher than that in LAM group(16.7%,6/36). Conclusion: The curative effect of LAM + Tα1 group, in the treatment of CHB, is superior to that of LAM group, which has little side effects.

食道静脉曲张破裂大出血是门静脉高压常见并发症,病情凶险,死亡率高[1],硬化剂注射、三腔管压迫止血以及静脉滴注垂体后叶素等治疗虽然有效,但副作用也较多.

苦参素为植物提取药,其有效成份为氧化苦参碱,近年来已在各传染病专科医院普遍用于治疗慢性病毒性肝炎,具有降酶、抗病毒、抗肝纤维化等作用[1].我们采用苦参素胶囊治疗慢性乙型肝炎,以观察其抗病毒的效果,结果报告如下.