目的 总结对急腹症在病情判断方面的经验。方法 回顾性分析310例急腹症患者的临床资料。结果 即时确诊211例，经短暂观察确诊54例，经手术探查确诊32例，未明确诊断但经保守治疗痊愈好转6例，误诊、漏诊7例，总确诊率为95.8%。结论 急腹症的病情判断和动态观察是明确诊断和及时治疗的前提。只有勤于实践并掌握正确的方法才能提高分析判断能力。
目的 评价依托芬那酯凝胶治疗腱鞘炎在超声引导下微创术后肿痛的有效性和安全性。 方法 采用随机、对照的设计，将2011年5月－2012年7月，在四川省人民医院门诊接受腱鞘炎超声引导微创术后的患者157例，分为两组，治疗组（n=81）采用依托芬那酯凝胶外用，对照组（n=76）不使用外用药物。 结果 两组治疗后24 h及3 d的疼痛评分、压痛及关节功能缓解率与治疗前自身比较及组间比较，差别均有统计学意义（P＜0.05），7 d时治疗组临床总有效率为90.12%，对照组为89.47%，组间比较无统计学意义（P＞0.05），治疗组在使用应急药物上明显优于对照组。两组安全性评价比较差异无统计学意义（P＞0.05）。 结论 依托芬那酯凝胶能快速、有效、安全地缓解腱鞘炎超声引导微创术后局部肿胀疼痛的症状。
ObjectiveTo systematically review the effectiveness of breastfeeding duration and intensity in reducing the risk of overweight or obesity among offspring exposed to intrauterine hyperglycemia. MethodsThe PubMed, EMbase, Web of Science, CBM, WanFang Data, CNKI and VIP databases were electronically searched to collect observational studies on the associations of breastfeeding with the risk of overweight or obesity among offspring exposed to intrauterine hyperglycemia from inception to September 25th, 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Stata 16.0 software was used for the meta-analysis. ResultsA total of 12 657 participants from 13 observational studies were included. The results of meta-analysis showed that breastfeeding could reduce the risk of overweight or obesity among offspring exposed to intrauterine hyperglycemia (OR=0.67, 95%CI 0.53 to 0.84, P=0.001). Subgroup analysis revealed a protective effect of breastfeeding for both 1-6 months (OR=0.53, 95%CI 0.37 to 0.75, P<0.001) and ≥6 months (OR=0.56, 95%CI 0.46 to 0.69, P<0.001); however, breastfeeding shorter than one month was suggested to increase the risk of overweight or obesity (OR=2.15, 95%CI 1.41 to 3.27, P<0.001). ConclusionAvailable evidence suggests that breastfeeding for more than one month is effective in reducing the risk of overweight or obesity in offspring exposed to intrauterine hyperglycemia, and women with hyperglycemia should be encouraged to breastfeed their offspring for at least 1 month to achieve the effect. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo explore the nursing method to avoid rupture of intracranial aneurysm during induction of anesthesia. MethodWe retrospectively analyzed the nursing method for 428 patients with aneurysm during the induction of anesthesia between October 2012 and October 2013. According to the causes of rupture of intracranial aneurysm (anxiety, tension, excitement, sudden elevation of blood pressure, physical labor), we adopted nursing methods to avoid those causes, and implemented targeted nursing methods during induction of anesthesia. ResultsNo intracranial aneurysm rupture occurred in these 428 aneurysm patients during induction of anesthesia. Two patients' absolute value of systolic blood pressure was below 80 mm Hg (1 mm Hg=0.133 kPa) during induction of anesthesia, and the vital signs of other patients kept normal. The number of intraoperative rupture cases was 3. When discharged from hospital, there were 385 patients with good prognosis, 39 patients with bad prognosis, and 4 death cases. ConclusionsTargeted nursing method based on patients' particular situation during induction of anesthesia can effectively control patients' emotion, stabilize fluctuations in hemodynamic indexes, decrease the incidence of aneurysm rupture, improve surgery treatment effect of intracranial aneurysm clipping, decrease complications, and improve patients' prognosis.