老年自发性食管破裂术后护理特点

加强对老年自发性食管破裂术后护理和并发症的预防，做好心理护理，即可使多数患者术后恢复良好，也是保证手术成功，确保老年自发性食管破裂术后护理顺利康复的关键。     

体外循环中意外并发症分析

本文报道该院近16年来在体外循环直视下行心内手术820例,其中发生意外并发症30例。本文重点分析讨论了意外并发症发生的主要原因,并提出了相应的预防及治疗措施。     

基质金属蛋白酶-9和白介素-18在冠心病及糖尿病大血管并发症中的作用

目的探讨基质金属蛋白酶-9(MMP-9)和白介素-18(IL-18)在冠心病及糖尿病大血管并发症中所起的作用。方法选择住院患者181例,分为冠心病组(n=50)、冠心病+糖尿病组(n=50)、糖尿病组(n=50),并设对照组(n=31)。冠心病组、冠心病+糖尿病组随访急性冠脉综合征(ACS)的发生情况,并检测IL-18、MMP-9含量;糖尿病组随访颈部血管内-中膜厚度(IMT),分别于6个月、12个月采血检测IL-18、MMP-9含量。结果 ACS发生后血清IL-18、MMP-9水平显著升高;MMP-9是ACS的独立危险因素(OR=5.19,P=0.014,95%CI 1.396¹9.298),IL-18与ACS的发生关系不明显;MMP-9浓度变化与IMT增量呈正相关(r=0.472,P=0.011,95%CI 0.00819.298),IL-18与ACS的发生关系不明显;MMP-9浓度变化与IMT增量呈正相关(r=0.472,P=0.011,95%CI 0.008⁰.095)。结论 MMP-9参与ACS及糖尿病大血管并发症的发病过程,其含量变化对ACS、糖尿病大血管并发症有一定的预测价值。     

Report on 220 cases of endoscopic septoplasty with submucous resection

Objective To explore the efficiency of endoscopic septoplasty with submucous resection for the treatment of 220 patients with deviated nasal septum and report our experience in this field. Methods From May 2006 to May 2010, 220 patients with deviated nasal septum were treated by endoscopic septoplasty with submucous resection to decompress the stress points, resect the deviated parts and implant the reshaped bone of nasal septum, while retaining the normal structure of nasal septum with minimally invasive technique. Results Satisfactory effects were achieved in all the 220 patients, showing centered septal structure and disappeared symptoms such as nasal obstruction, headache and nasal hemorrhage, but no complications including perforation of nasal septum, depressed nasal bridge and septal chalasia and flaring. Conclusion Rhino-endoscopic septoplasty with submucous resection can substantially retain the original structure of nasal septum and thus is proven to be a desirable operation with multiple advantages including minimal invasiveness, quicker healing and fewer complications.     

2型糖尿病患者血浆内皮素水平及影响因素的探讨

我们用ＲＩＡ法测定了９０例２型糖尿病患者血浆中内皮素（ＥｎｄｏｔｈｅｌｉｎＥＴ）水平,观察了ＥＴ与糖代谢、脂代谢及糖尿病病程、血压、糖尿病慢性并发症的关系,以便了解ＥＴ在糖尿病慢性并发症中的作用,从而探讨糖尿病慢性并发症的发生机制。结果发现无合并症２型糖尿病组ＥＴ水平与正常对照组无显著性差异（Ｐ＞０．０５）,有合并症Ⅱ型糖尿病组ＥＴ水平显著高于无合并症２型糖尿病组及正常对照组（Ｐ＜０．００１）。长病程、高血压、高胆固醇血症及糖尿病肾病是导致２型糖尿病患者血浆ＥＴ升高的主要因素,而ＥＴ升高又进一步加重糖尿病血管功能异常,从而加重糖尿病的慢性并发症。