目的:探讨超长时间心肺复苏成功的不同病因影响因素及远期预后.方法:选取我院超长时间心肺复苏患者74例,观察不同病因患者的自主循环恢复率、24h存活率和存活出院率.结果:74例超长时间心肺复苏患者自主循环恢复率39.19％,24h存活率22.97％,存活出院率12.16％,其中心脑血管疾病、电击伤、麻醉患者成功率较高,恶性肿瘤晚期、慢性肾功衰竭、多器官衰竭等患者成功率较低.结论:对于心脑血管疾病、电击伤、麻醉等患者,超长时间心肺复苏是十分必要的,建议常规进行,使更多的心搏骤停患者受益.对于恶性肿瘤晚期、慢性肾功衰竭、多器官衰竭等患者可以根据患者家属要求或者器官衰竭程度选择合适的抢救时间.

危重患者易发生应激性溃疡,部分患者会并发大出血,出现大出血后一般会有明显的临床表现,如胃管有血、柏油样便、呕血、贫血等.非典型(无明显临床表现)的溃疡大出血罕见,我院于2012年8月收治1例,现报道如下: 1 病例简介 患者,男,55岁,因"外伤致上胸部以下感觉运动障碍3+h"2012年8月14日人院.入院时患者神清语弱,精神差,颈部压痛,颈活动障碍,双上肢感觉减退,肌张力低下,肌力2～3级,能自主活动,双侧胸部乳头平面以下感觉运动障碍,双下肢感觉、运动、反射消失.CT示颅内未见确切异常,C6双侧下关节突、C7双侧上关节突骨折,T6骨折,肺气肿,纵膈挫伤待排,肺挫伤.完善术前准备后于2012年8月22日在全麻下行经颈后路单侧椎板切开椎管扩容减压椎管成形、颈6、7自体植骨融合术,术毕回骨科进行相应治疗,一般情况较好,术后当日开始进食.

目的：观察乌司他丁对脓毒性休克的治疗效果.方法：将90例脓毒性休克患者随机分为治疗组(46例)和对照组(44例),两组患者入院后均集束化治疗脓毒性休克,治疗组入院当天至第5天静脉滴注乌司他丁20万Uq8h,对照组未使用乌司他丁,观察2组患者病情稳定所需时间, MODS发生率,ICU住院时间及病死率.结果：治疗组病情稳定所需时间、MODS发生率、ICU住院时间及病死率均低于对照组,差异有显著性(P<0.05).结论：脓毒性休克在集束化治疗基础上使用乌司他丁可改善预后.

Objective To observe the clinical effect of septic shock treated with early goal-directed therapy.Methods 160 patients with septic shock were randomly divided into two groups,in which 80 patients were treated with early goal-directed therapy(treatment group),and 58 patients with conventional treatment(control group).After treatment,the change of CVP,MAP,SCVO2,serum lactic acid,MODS incidence,28 days case-fatality rate were compared in the two groups of patients. Results In the two groups of patients,the disease before treatment was not statistically different(P>0.05).And there was statistically difference in the change of CVP,MAP,SCVO2,serum lactic acid,MODS incidence,28 days case-fatality rate after 6 and 24 hours treatment with early goal-directed therapy in the treatment group(P<0.05).Conclusion The treatment with early goal-directed therapy can significantly improve the survival and prognosis of patients with septic shock.

目的:集束化治疗感染性休克的临床效果观察.方法:选择120例感染性休克患者随机分为两组,62例患者实施集束化治疗(治疗组),58例患者实施常规治疗(对照组),观察两组患者治疗后CVP、MAP、SCVO2变化、血清乳酸含量、MODS发生率、28天病死率.结果:两组患者入选时的病情无统计学差异(P＞0.05).治疗组治疗后6h及24小时的CVP、MAP、SCVO2、乳酸值变化、MODS发生率、28天住院病死率与对照组比较均有统计学差异(P＜0.05).结论:集束化治疗能较显著的改善感染性体克患者的生存和预后情况

Objective To explore Dexmedetomidine clinical curative effect In the ICU in sedation。Methods 120 cases in treatment group shall be Dexmedetomidine for sedation,120 cases of control group was composed of hebron shall be Midazolam,compared between the two groups Ramsay score sedation situation,daily,wake up,the length of time the ICU.Results The treatment group Ramsay score in 2,4 points is occupied 97. 6%,the control group Ramsay score in 2,4 points to 72%(P0.05),the treatment group and control group in daily awaken 100% daily wake up 62%(P 0.05),the treatment group average the length of time the ICU about 5.9 days,and the control group average the length of time the ICU about 8.3 days(P0.05).Conclusion Dexmedetomidine in ICU in sedation more can control,and can reduce the length of time the ICU,clinical use is promotion.

objective Explore type B natriuretic peptide(BNP)test joint CVP determination of heart failure patients in the diagnosis of the clinical significance.Methods In 248 cases with difficulty breathing for symptoms of heart failure patients suspected BNP and CVP determination,according to the history,clinical presentation,assistant examination and to respond to treatment,and other comprehensive judgment to make clinical diagnosis,more BNP joint CVP determination and pure BNP determination result and clinical diagnosis of the relationship between the two.The exhaust is heart failure diagnosis is a good index,and promote the use of clinical.Results BNP and CVP is more clinical significance for heart failure diagnosis,BNP quartile value 1800ng/L and CV>12 cmH2O diagnosis of heart failure positie predictie alue 99.5%,and simple quartile BNP 1800ng/L,with increased CVP,heart failure diagnosis of the positie predictie alue 89.7%(P<0.05);BNP<100ng/L and CVP is not high,heart failure negatie predictie alue 100%,eliminate heart failure;Pure BNP<100ng/L,heart failure negatie predictie alue 90.9%(P<0.05),BNP joint CVP determination and pure in heart failure diagnosis of BNP determination are significantly different.Conclusion BNP and CVP more help to determine the rapid diagnosis early or the exclusion of heart failure,heart failure diagnosis is the better index,and promote the use of clinical

Objective To observe the curative effect of postoperative pain relief with indometacin and furazolidone suppositories in haemorrhoids.Methods 598 patients with haemorrhoids after operation were randomly divided into two groups,the treatment group(300 patients) and the control group(298 patients).In the treatment group,patients were given two pieces of indometacin and furazolidone suppositories immediately after operation and also two pieces after cacation,and in the control group,no suppositories were used.Then the pain degree in the two groups was compared.ResultsAnd there was statistically difference in pain degree after operation in the two groups (P0.05). Conclusion The indometacin and furazolidone suppositories can truly relieve pain after operation in haemorrhoids,and it’s cheap and easy to use,so it’s worthy for being widely used in clinic

目的:探讨初治肺结核患者使用左氧氟沙星(LVFX)对诊断和治疗的影响.方法:2009~2011年宜宾市翠屏区 CDC 和宜宾市二医院就诊的初治肺结核患者(以下简称患者)当中,通过病史询问及查阅患者门诊及住院病历,回顾和现况调查 LVFX 的使用情况.统计使用 LVFX的患者人数及百分比,调查处方医生对患者使用 LVFX 的原因.将患者是否有 LVFX 用药史分为两组,比较分析两组患者从初次就诊到确诊为肺结核所需的时间有无差别,以及治疗6月后两组患者 X 胸片病灶吸收效果.结果:共调查患者262例,其中明确有使用 LVFX 的患者112例(42.8%),未使用116(44.3%)例,无法查明用药史34(12.9%)例.调查使用 LVFX 的原因,确诊前以误诊为肺炎治疗和诊断性抗炎治疗为主,确诊后以抗结核和治疗肺结核合并细菌感染治疗为主.以是否有 LVFX 用药史将患者分为2组,比较两者确诊时间以及治疗6月末 X 线胸片病灶吸收无差异.结论:初治肺结核患者 LVFX 的不规范使用使诊断延误,初治方案加用 LVFX 对肺部病灶吸收无明显效果,而且增加初治肺结核患者对氟喹诺酮类药物耐药的风险

"复苏"主要是指"心肺复苏"(CPR),但是,心肺复苏成功的关键不仅是自主呼吸和心跳的恢复,更重要的是中枢神经系统功能的恢复,故将"心肺复苏"扩展为"心肺脑复苏"(CPCR),心肺复苏(CPR)是临床医学最困难、最代表水平、最具有挑战意义的问题之一.如何提高CPR的成功率,一直为临床医务人员所关注.复苏后出现的多器官功能不全综合征(MODS)即复苏后综合征(P RM)在临床工作中越来越常见.本研究回顾分析48例患者的临床特点,并探讨有效的抢救治疗措施.

患者,女,72岁.直肠脱垂70年.自2岁起,排便时脱出,便后能自行回纳,成年后由于长期劳作及生育8个子女,直肠脱垂加重,但因经济困难一直未治疗.

1999-2001年,我院将吗啡注入腰……