关键词： 复方阿嗪米特   莫沙必利   老年胃肠疾病相关性消化不良  

摘要： 目的 探究复方阿嗪米特＋莫沙必利联合方案在老年胃肠疾病相关性消化不良治疗中的应用效果。方法 将2016年4月-2017年4月本院收治的116例老年胃肠疾病相关性消化不良患者随机分为观察组与对照组,每组58例。观察组纳入阿嗪米特＋莫沙必利联合方案治疗患者,对照组纳入单用莫沙必利方案治疗患者,均治疗28 d。记录2组治疗前后消化不良症状总积分,依据治疗后症状积分缓解率评估临床疗效,计算2组不良反应发生率并行组间比较。结果 治疗前,2组消化不良症状总积分比较差异无统计学意义,2组消化不良症状总积分在有效疗程结束后均有不同程度降低,观察组降幅显著优于对照组（P〈0.05）。观察组治疗有效率为87.9%显著高于对照组60.3%（P〈0.05）。结论 复方阿嗪米特联合莫沙必利是治疗老年胃肠疾病相关性消化不良的有效方案,联合用药显著改善患者消化不良症状,提高患者生活质量,临床应用反馈良好,安全性可靠。

关键词： 五水头孢唑林钠   中药熏蒸   老年肛肠疾病   术后切口感染  

摘要： 目的探讨五水头孢唑林钠配合中药熏蒸治疗老年肛肠疾病术后切口感染患者的临床疗效与安全性。方法将2014年1月至2015年12月接受手术治疗且发生术后切口感染的122例老年患者依据随机数字表分为对照组与观察组,每组61例。对照组单独应用五水头孢唑林钠进行治疗,观察组在对照组的基础上联合中药熏蒸予以治疗,对比2组研究对象治疗后的临床疗效与安全性。结果观察组有效率为98.36%;对照组有效率为88.52%,2组差异有统计学意义(P<0.05);对照组水肿消失时间、渗出物消失时间、疼痛消失时间及切口愈合时间均明显长于观察组(P<0.05);观察组与对照组患者治疗后的疼痛评分均明显下降,但观察组患者的疼痛评分明显低于对照组患者(P<0.05);观察组不良反应发生率明显低于对照组(P<0.05)。结论五水头孢唑林钠配合中药熏蒸应用于老年肛肠疾病术后切口感染患者中,可取得良好临床疗效,缩短恢复时间,安全性较高,值得临床上推广应用。

关键词： 幽门螺杆菌分型   免疫印迹法   胃炎   胃溃疡   十二指肠溃疡  

摘要： 目的探讨幽门螺杆菌分型检测在胃肠疾病中的临床意义。方法选取247例经胃镜及病理检查证实且经快速尿素酶检测结合组织HE染色进行病理学检验为Hp感染患者的血清标本,采用免疫印迹法对Hp的特异性抗体细胞毒素相关蛋白(CagA)、尿素酶(UreC)、空泡毒素(VacA)进行血清学分型检测。结果 247例确诊Hp感染患者用免疫印迹法进行血清学分型检测,阳性标本244例,符合率为98.8%。在244例标本中,慢性浅表性性胃炎(CSG)、慢性萎缩性胃炎(CAG)、胃溃疡(GU)、十二指肠溃疡(DU)组中的HpⅠ型感染率都明显高于Ⅱ型,消化性溃疡患者HpⅠ型感染率明显高于慢性胃炎患者,差异均有统计学意义(P<0.05)。HpⅠ型感染率与年龄无明显相关性。HpⅠ型感染者中,以CagA+VacA抗体阳性为主,检出率为77.7%。结论幽门螺杆菌分型检测对于胃肠疾病的判断有临床指导意义。

关键词： 肛肠疾病   术后患者   疼痛管理   成效  

摘要： 目的研究肛肠疾病术后患者疼痛管理的临床效果。方法采用计算机表法将2015年3月—2016年3月期间该院收治的72例肛肠疾病术后患者随机分为两组,参照组(n=36)与实验组(n=36),参照组患者术后予以常规止痛干预,实验组患者术后予以疼痛管理干预,对比观察经不同止痛干预后两组肛肠疾病术后患者的临床效果。结果实验组肛肠疾病术后患者创面疼痛评分(0.44±0.21)分、止痛剂使用后止痛时间(12.25±2.54)h、管理满意度100.00%显著优于参照组患者创面疼痛评分(0.98±0.18)分、止痛剂使用后止痛时间(20.21±3.54)h、管理满意度75.00%,组间数据差异有统计学意义(P<0.05)。结论将疼痛管理应用在急诊中肛肠疾病术后患者管理中效果显著,可以缓解疼痛,提升患者对医院的满意度,值得借鉴与应用。

关键词： 原位再生医疗技术   肛肠疾病   术后   创面   疗效  

摘要： 目的探讨原位再生医疗技术治疗肛肠疾病术后创面疼痛的临床疗效。方法将2015年1月—2016年12月清镇市中医院普外科收治的161例肛肠疾病患者随机分为试验组(82例)与对照组(79例),试验组患者术后创面应用湿润烧伤膏治疗,对照组患者术后创面应用马应龙麝香痔疮膏治疗,对比观察两组患者的创面疼痛情况及住院时间。结果试验组患者住院时间为(6.11±2.13)d,使用盐酸哌替啶止痛者(即严重疼痛者)4例,使用盐酸曲马多止痛者(即重度疼痛者)6例,使用氯诺昔康止痛者(即中度疼痛者)16例,未使用镇痛药物者(即无疼痛或轻度疼痛者)56例;对照组患者住院时间为(8.36±2.26)d,使用盐酸哌替啶止痛者(即严重疼痛者)54例,使用盐酸曲马多止痛者(即重度疼痛者)16例,使用氯诺昔康止痛者(即中度疼痛者)9例,未使用镇痛药物者(即无疼痛或轻度疼痛者)0例。两组患者住院时间及镇痛药物使用情况对比,P均<0.01,差异具有统计学意义。结论原位再生医疗技术治疗肛肠疾病术后创面,可有效缓解术后创面疼痛,促进创面愈合,缩短患者住院时间,值得临床推广应用。

关键词： 胃气理论   手术前后   治疗方法   应用体现  

摘要： 中医顾护胃气理论是防病治病、摄生调养的重要原则。纵观胃肠手术术前、术后调治方法 ,扶正气,养胃气的治疗思路贯穿始终。本文主要从术前调治、术后治理方面简单探讨临床上中医学"胃气"理论在胃肠道手术患者治疗过程中的应用体现。

关键词： Abdomen   Bowel   Children   Inflammatory bowel disease   Pain   Ultrasound  

摘要： Ultrasound (US) is a versatile imaging study for the evaluation of the bowel in children. US imaging of the bowel can be used as the initial examination or in follow-up for many common pediatric diseases. In this article, we highlight our bowel US technique and describe how US can depict the features of a select group of bowel pathologies relevant to pediatric practice.

关键词： Vitamin D   Inflammatory Bowel Disease   Disease activity  

摘要： Many patients with inflammatory bowel disease (IBD) are vitamin D deficient. The purpose of our study was to identify risk factors for vitamin D deficiency in IBD and to assess the impact of vitamin D repletion on disease activity and quality of life (QOL). Patients with at least one 25-OH vitamin D level measured between 2004 and 2011 were included. Patients with a level < 30 ng/ml at baseline were followed until the time of repletion. QOL and disease activity scores were measured at baseline and repletion. A total of 255 patients were identified. 33, 29, and 39% had a vitamin D level of >= 30, 20-29, and < 20 ng/ml, respectively. When adjusting for disease type and duration, gender, smoking, and race, non-Caucasians had 5.3 (2.3-12.3) and UC patients had a 0.59 (0.33-1.03) odds of having a vitamin D < 30 ng/ml. Women were 1.7 times more likely to have a 25-OH vitamin D level < 20 ng/ml than men. 55 patients underwent repletion. In CD patients, the HBI and SIBDQ prior to repletion was 5.5 +/- 4.9 and 44.3 +/- 16.4, respectively;these improved to 3.6 +/- 3.4 and 48.6 +/- 14.2 after repletion (p = 0.0154 and p = 0.0684). In this tertiary care IBD cohort, the majority of patients have low vitamin D levels. Non-Caucasian race and female gender are associated with low vitamin D. UC was associated with lower risk of vitamin D insufficiency. In CD, vitamin D repletion is associated with decreased disease activity and increased QOL.

关键词： Calprotectin   lactoferrin   inflammatory bowel disease   primary care   paediatrics   point-of-care test  

摘要： Background. Faecal calprotectin is considered to be a valid test for ruling out inflammatory bowel disease (IBD) in children with chronic gastrointestinal symptoms in specialist care. In contrast, faecal lactoferrin has higher specificity. The recent availability of both as point-of-care tests (POCTs) makes them attractive for use in primary care. Objective. To evaluate the test characteristics of calprotectin and lactoferrin POCTs for diagnosing IBD in symptomatic children. Methods. We defined two prospective cohorts of children with chronic gastrointestinal symptoms: (i) children presenting to primary care (primary care cohort);(ii) children referred for specialist care (referred cohort). Baseline POCT results were compared with the outcome of either endoscopic assessment or 12 months follow-up. Clinicians were blinded to the POCT results. Results. In the primary care cohort, none of the 114 children had IBD, and the calprotectin and lactoferrin POCTs had specificities of 0.95 (0.89-0.98) and 0.98 (0.93-0.99), respectively. In the referred cohort, 17 of the 90 children had IBD: the sensitivity of POCT calprotectin and POCT lactoferrin were both 0.94 (0.72-0.99);and the specificity was 0.93 (0.84-0.97) and 0.99 (0.92-1.00), respectively. The POCT calprotectin could reduce the referral rate by 76% and POCT lactoferrin by 81%, while missing one child with IBD (6%). Conclusion. A diagnostic test strategy in primary care using a simple POCT calprotectin or lactoferrin has the potential to reduce the need for referral for further diagnostic work-up in specialist care, with a low risk of missing a child with IBD.

关键词： Medical Home   Inflammatory Bowel Diseases   Intestinal Diseases