Objective To observe the clinical effect of lactase on rotavirus enteritis in infants and young children. Methods From January 2015 to May 2017,a total of 120 infants and young children with rotavirus enteritis were selected in the Department of Pediatrics,Naval Authority Clinics,and they were divided into A group,B group and C group according to random number table,each of 40 cases.Based on conventional treatment,patients in A group kept customary diet,patients in B group received free-lactose milk powder for 2 weeks,while patients in C group kept customary diet and received lactase for 2 weeks.Clinical effect,diarrhea frequency before treatment and 4 days after treatment,and diarrhea stopping time were compared in the three groups,compliance and incidence of adverse reactions was observed in C group.Results Clinical effect in B group and C group was statistically significantly better than that in A group,respectively(P<0.05),while no statistically significant differences of clinical effect was found between B group and C group(P>0.05).No statistically significant differences of diarrhea frequency was found in the three groups before treatment(P>0.05);4 days after treatment,diarrhea frequency in B group and C group were statistically significantly less than that in A group,respectively(P<0.05),while no statistically significant differences of diarrhea frequency was found between B group and C group(P>0.05).Diarrhea stopping time in B group and C group was statistically significantly shorter than that in A group,respectively(P<0.05),while no statistically significant differences of diarrhea stopping time was found between B group and C group(P>0.05).The compliance was good in C group, no one occurred any obvious adverse reactions.Conclusion Lactase has similar clinical effect with free-lactose milk powder in treating infants and young children with rotavirus enteritis,can effectively relieve the lactose intolerance without change the customary diet,and the compliance is good.

目的 探讨每搏量变异度(stroke volume variation,SVV)和脉搏压变异度(pulse pressure variation,PPV)在小儿腹腔镜手术中预测液体的准确性及阈值变化.方法 选择拟在全麻下行小儿腹腔镜的手术患儿40例,全麻后连续监测HR、MAP、每搏量(stroke volume,Sv)、每搏量指数(stroke volume index,SVI)、SVV、PPV等血流动力学指标,手术开始后进行气腹操作,待血流动力学稳定后进行容量负荷试验,分别于麻醉后气腹前(T0)、气腹后(T1)和补液试验结束后即刻(T2)记录上述血流动力学指标数值,然后以输液前后每搏量指数的差值(△SVI)将患者分为2组,即有反应组(R组,△SVI≥10％)和无反应组(NR组,△SVI＜10％),绘制SVV和PPV判断扩容效应的ROC曲线,确定患儿在腹腔镜手术中应用SVV和PPV预测容量状况的准确性、诊断阈值.结果 与T0时刻比较,T1时刻HR、MAP、SVV、PVV等血流动力学参数均无明显变化(P＞0.05).与T1时刻相比较,T2时刻SVV、PVV均明显减小,差异有统计学意义(P＜0.05),而SV、SVI、CO、CI明显增大(P＜0.05),其他血流动力学指标,HR、MAP变化差异无统计学意义(P＞0.05).SVV和PPV判断扩容有效的ROC曲线下面积分别为0.822和0.916,SVV的诊断阈值为14.5％,灵敏度为80.2％,特异度为85.7％;PPV的诊断阈值为15.0％,灵敏度为88.5％,特异度为93.5％.结论 SVV和PPV均可用于预测小儿在腹腔镜气腹状态下的容量状况,PPV的准确性略高于SVV,但两者的诊断阈值较正常情况下成年患者均升高.

目的:探讨针对性康复训练对慢性肩袖损伤的疗效.方法:选取2015年9至2017年9月诊治的符合纳入标准的慢性肩袖损伤患者138例,随机分成对照组和观察组,每组69例.对照组采用超短波治疗、口服抗炎止痛药物及肩关节松动技术,观察组在对照组治疗基础上增加针对性康复训练,包括肩袖损伤肌群激活、肩胛骨运动控制和肩关节肌肉强化稳定训练.4周后两组患者采用美国加州大学(UniversityofCalifornia–LosAngeles'UCLA)肩袖损伤专业评分系统进行各项分值比较及疗效评价.结果:两组患者治疗后在疼痛、肩关节功能、主动前屈力量及主动前屈活动度分值较治疗前均有显著提高,而两组在治疗后比较,观察组各项分值明显高于对照组(P<0.05);观察组总有效率(94.2％)明显优于对照组(69.6％),具有显著差异(P<0.05).结论:采用针对性康复训练治疗慢性肩袖损伤,能有效的促进肩关节功能的恢复,同时对稳定肩关节具有积极意义,值得临床推广应用.

目的：探讨丙酸氟替卡松鼻喷雾剂在改善儿童过敏性鼻炎症状以及控制哮喘反复发作方面的临床价值。方法选取儿童过敏性鼻炎合并哮喘患儿162例，采用数字随机法分为2组，81例患儿实施常规治疗（口服氯雷他定、经口吸入糖皮质激素）为对照组，81例患儿联用丙酸氟替卡松鼻喷雾剂为观察组，疗程均为12周。在治疗不同时段（0周、2周、4周、8周、12周）评定过敏性鼻炎症状评分、哮喘控制测试评分及测定峰值呼气流速。比较2组治疗效果、不良反应情况。结果治疗2周、4周、8周、12周时，观察组过敏性鼻炎症状评分均明显低于对照组，哮喘控制测试评分均明显高于对照组，峰值呼气流速均明显大于对照组。观察组总有效率明显高于对照组，不良反应发生率明显低于对照组。结论丙酸氟替卡松鼻喷雾剂是治疗儿童过敏性鼻炎合并哮喘的有效药物，可明显改善患儿的临床病症，可显著提高疾病治愈率，不良反应少且安全性高，值得临床推广使用。

目的 探讨高频超声在诊断儿童甲状腺肿瘤中的临床应用价值.方法 选取51例儿童甲状腺肿瘤患者,均接受高频超声检查,分析超声检查和病理诊断结果的差异.结果 超声诊断准确率为92.2％,良恶性准确率分别为97.0％与83.3％.良性肿瘤与恶性肿瘤在边界清晰度、形态规则度、有无微钙化、内部回声高低、有无颈部淋巴结肿大以及Ⅲ型肿块血流方面均存在明显差异(P＜0.05).联合指标评估比较中,形态不规则联合Ⅲ型血流表现的特异度和敏感度最佳.结论 针对儿童甲状腺肿瘤患者开展高频超声检查能够有效发现结节,并能够依据不同表现判定肿瘤的性质,可作为儿童甲状腺肿瘤的首选诊断方法.

目的:观察消旋卡多曲联合甘草锌治疗婴幼儿急性水样腹泻的临床疗效。方法:选择急性水样腹泻婴幼儿96例,随机分为观察组49例和对照组47例。对照组在退热、补液等常规治疗基础上,给予十六角蒙脱石加金双歧治疗,观察组加用消旋卡多曲及甘草锌治疗,对比两组临床疗效。结果:(1)两组治疗后第2天、第3天便次及平均止泻时间比较,差异显著(P<0.05)。(2)观察组显效40例,有效7例,无效2例,总有效率95.9%;对照组显效29例,有效10例,无效8例,总有效率83.0%。两组总有效率比较,差异显著(P<0.05)。(3)观察组治疗期间仅出现恶心2例、便秘1例,未发现皮疹、腹痛、白细胞减少等不良反应。结论:消旋卡多曲及甘草锌是婴幼儿急性水样腹泻有效且安全的治疗药物。

目的:调查了解某部婴幼儿缺铁性贫血(IDA)患病情况。方法:选择6个月～3岁婴幼儿1026例,重点对IDA患病情况及相关影响因素进行调查分析。结果:共发现婴幼儿IDA 62例,总患病率为6.0%。其中,轻度58例,占93.5%;中度4例,占6.5%;无重度病例。IDA影响因素:喂养不当(未及时添加富含铁辅食)30例;母亲妊娠期轻度贫血未坚持补铁治疗11例;多胎或早产、低体重儿8例;明显偏食8例;近期患腹泻病或呼吸道感染5例。结论:婴幼儿缺铁性贫血发病率偏高,应定期进行体检筛查,针对相关影响因素进行及时干预。

我国小儿腹泻病原构成比中,轮状病毒感染约占40%(欧美国家50%左右)[1-2].2004年11月～2006年2月,我们应用免疫球蛋白口服液治疗小儿轮状病毒肠炎43例,疗效满意.现报告如下.