【摘要】 目的 探讨感觉统合训练及神经发育疗法对脑性瘫痪患儿智能发育的影响。方法 对2006年7月—2008年6月脑性瘫痪患儿100例,随机分成治疗组和对照组,治疗组50例,男26例,女24例,年龄8个月～5.8岁,平均2.7岁。对照组50例,男27例,女23例,年龄9个月～5.8岁,平均年龄2.7岁。两组均采用神经发育疗法,治疗组加用感觉统合训练,1次/d,30 min/次,每周5次,3个月1疗程,连续治疗2个疗程；治疗前后进行Gesell量表测试,观察患儿智能发育改善情况。结果 治疗组显效24例,有效25例,无效1例；对照组显效8例,有效39例,无效3例,两组比较有统计学意义(Plt;0.05),Gesell测试5项评分,两组治疗前无差异(Pgt;0.05),治疗后差异有统计学意义(Plt;0.05)。结论 感觉统合训练可提高脑性瘫痪患儿的智能发育,是减少小儿残疾的一个重要途径。
【摘要】 目的 分析国内布地奈德、地塞米松吸入治疗小儿急性喉炎的疗效。 方法 系统检索中国生物医学文献数字库（CBM）、中国期刊全文数据库（CNKI）、维普、万方数据库，检索时间为各个数据库建库至2010年7月。纳入布地奈德对比地塞米松吸入治疗小儿急性喉炎的随机对照试验（randomized controlled trial，RCT），对纳入研究进行质量评价和Meta分析。 结果 共纳入11个RCT，分析结果提示两组声嘶、犬吠样咳嗽、呼吸困难、喉喘鸣症状消失时间差异均存在统计学意义，其MD及95%CI分为:-0.88 （-1.10，-0.65），-1.43 （-2.01，-0.84），-0.48 （-0.63，-0.32），-0.59 （-0.78，-0.41）。 结论 基于当前国内证据，布地奈德改善小儿急性喉炎梗阻症状疗效优于地塞米松吸入治疗。【Abstract】 Objective To evaluate the effectiveness of budesonide versus dexamethasone for the treatment of acute laryngitis in children of china. Methods Literatures in CBM, CNKI, VIP, WanFang databases were searched from the time of establishment of these databases till July 2010. Randomized controlled trials (RCT) of budesonide versus dexamethasone for the treatment of acute laryngitis in children were gathered, and quality was evaluated and meta-analysis was carried out. Results Eleven RCTs were identified, and meta-analysis indicated that there were significant differences between the two groups in the disappearing time of hoarseness, barking cough, dyspnea and laryngeal stridor. The MD values and their 95% CI were respectively -0.88 (-1.10, -0.65), -1.43 (-2.01, -0.84), -0.48 (-0.63, -0.32), and -0.59 (-0.78, -0.41). Conclusion Based on current evidence in China, budesonide is better than dexamethasone for the improvement of acute laryngitis in children.
目的 研究脑电双频指数（BIS）在小儿麻醉中的应用，为BIS在小儿临床麻醉上的广泛应用及提高小儿麻醉的安全性提供依据。 方法 2011年1月－3月拟行腹部外科手术的患儿60例，男39例，女21例；年龄1～4岁，美国麻醉医师协会分级Ⅰ～Ⅱ级，随机分为两组，每组各30例。S组：七氟醚、瑞芬太尼和维库溴铵维持麻醉；P组：丙泊酚、瑞芬太尼和维库溴铵维持麻醉。采用BIS监测麻醉深度，将BIS控制在50 ± 5，记录麻醉诱导前到手术探查期间不同时点的血流动力学参数及苏醒、拔管时间。 结果 手术过程中P组血压及心率明显低于麻醉前水平（P＜0.05）。S组苏醒迅速、完全，苏醒时间与P组比较差异有统计学意义（P＜0.05）。S组的血流动力学稳定性优于P组，苏醒时间、拔管时间相对较短。麻醉诱导前两组的BIS值均为97 ± 1，意识消失时的BIS值为71 ± 2。BIS值为50 ± 5时，结果显示手术过程中（T4、T5、T6、T7）两组的心率、血压都很平稳。 结论 BIS作为小儿麻醉镇静深度的监测指标有临床意义。
For treatment of pediatric inguinal hernia, we fabricated a device, i.e. so called "filling type pediatric hernia sac", which treats the problem from the abdominal cavity, through the abdominal and is a self-adaptive closer, using synthetic material. The device includes filling rack, self-adaptive umbrella support bar, bottom piece, outside pulling line and device fixing lines. The filling rack is composed of 2 concentric circles of 3.0 cm diameter with peripherally fixed together and can be pulled into the shapes of a ball or an olive. The supporting bar is structured of 3 pieces with 0.5 cm wide, 4.0 cm long, cross-fixed on top of the filling rack. The bottom piece is in a circular structure with a diameter of 3.0 cm, and it is connected to the filling rack bottom. Adjust positioning stay outside the fixed on the top of the device are connected at one end, and the other end free through filling the top frame connected with the bottom slice of central fixation. By using this device, we treated 37 pediatric inguinal hernia cases with 38 side-inguinal hernia successfully. The mean duration of post-operation follow-ups was 14.6±5.89 months, without hernia recurrence, obvious scar and hard sections of inguinal region. This device could provide a convenient, safe and effective plugging technology for children's pediatric hernia.
ObjectiveTo investigate the clinical characteristics, diagnosis and management of postoperative chylothorax after congenital cardiac surgery in infants and children. MethodsWe retrospectively analyzed clinical data of 79 postoperative patients with chylothorax after congenital cardiac surgery in Guangdong General Hospital between January 2006 and December 2013.There were 54 males and 25 females at age ranged 8 days to 14 years. ResultsThe prevalence of postoperative chylothorax was 0.6% (79/12 067). A total of 75 (94.9%) patients were cured. And 71 patients (89.9%) were cured by conservative treatment. While 4(5.1%) patients received operative treatment, including 3 patients undergoing ligation of thoracic duct, 1 patient undergoing lymphatic ablation. There were 4 (5.1%) patients failed to treat, including 1(1.3%) abandoned, 3 (mortality of 3.8%) deaths in hospital for low cardiac output syndrome, cardiac arrest and severe anastomotic stenosis after transposition of conducting arteries(TGA), tetralogy of Fallot(TOF) and total anomalous pulmonary venous connection(TAPVC) operation respectively. Hospitalization time ranged 10 to 108 (39.3±19.4) d. There was no recurrence of chylothorax within 6 months to 8 years of following-up. ConclusionThe key to prevention of chylothorax is to improve the surgical technology. Conservative management of chylothorax will be successful in most cases, but surgical treatment ought to be considered if the conservative management is unsuccessful.