目的 了解老年2型糖尿病動脈僵硬度與踝臂指數（ABI）對評價外周動脈硬化的價值。 方法 2010年1月－3月，應用超聲、回聲跟蹤技術和動脈硬化檢測儀檢測80例老年2型糖尿病患者（觀察組）和40例正常老年人（對照組）的頸總動脈內中膜厚度（IMT）、僵硬系數（β）、脈搏波傳導速度（PWVβ）、ABI及動脈斑塊情況。 結果 與對照組比較，觀察組患者的IMT增厚、β增高、PWVβ增快、ABI降低及動脈斑塊發生率增多，差異均具有統計學意義（P＜0.001）。 結論 老年2型糖尿病可導致IMT增厚、動脈僵硬度增高、PWVβ增快、ABI降低及更易發生動脈粥樣硬化斑塊，這些參數可以預測外周動脈粥樣硬化的程度，利用彩色多普勒超聲診斷儀和動脈硬化檢測儀可以較容易得到這些參數，是評價外周動脈粥樣硬化病變一種簡便、易行，有臨床實際意義的方法和手段。
【摘要】 目的 探討阿托伐他汀強化降脂治療和左旋氨氯地平聯用對高血壓患者血壓的影響。 方法 選擇2009年1月-2010年11月住院及門診原發性高血壓合并高脂血癥患者196例，均給予左旋氨氯地平和阿托伐他汀治療8周后，復查血脂，從其中選擇血脂正常者120例，隨機分為對照組（單用左旋氨氯地平組）和治療組（繼續左旋氨氯地平聯用阿托伐他汀），繼續治療20周后的血壓情況。 結果 兩組治療20周后，治療組收縮壓和舒張壓均較對照組下降明顯，組間差異有統計學意義（Plt;0.01），治療組優于對照組。 結論 高血壓合并高脂血癥患者，使用左旋氨氯地平降壓和阿托伐他汀降脂治療時，在血脂降至正常后，繼續同時左旋氨氯地平降壓和阿托伐他汀強化降脂治療，降壓效果優于單用左旋氨氯地平。【Abstract】 Objective To investigate the effects of levamlodipine combined with atorvastatin on blood pressure in patients with primary hypertension. Methods Between January 2009 and November 2010, 196 patients with hypertension and hyperlipidemia in the outpatient and inpatient departments of our hospital were given levamlodipine and atorvastatin for 8 weeks, after which 120 patients with normal blood lipid were chosen and randomly divided into the control group (treated only by levamlodipine) and the treatment group (treated by levamlodipine combined with atorvastatin). After 20 weeks of the treatment, we observed their blood pressure. Results After twenty weeks of treatment, the diastolic and systolic pressure was significantly lower in the treatment group than that in the control group (Plt;0.01). Conclusion For patients with hypertension and hyperlipidemia who have undergone the treatment by levamlodipine and atorvastatin, after their blood lipid level decreases to normal, the continuous enhanced treatment by the two drugs has a better efficacy compared with the therapy of single levamlodipine in decreasing the blood lipid.
Objective To explore the application methods and values of using health failure mode and effect analysis (HFMEA) to prevent surgical site infection (SSI) in patients undergoing bone fracture and craniotomy surgery with class Ⅰ incision. Methods Patients undergoing bone fracture and craniotomy surgery with class Ⅰ incision at the Chengdu Pidu District People’s Hospital between January 2020 to December 2021 were selected. Based on whether receiving HFMEA-based risk management or not, the patients were divided into conventional group and intervention group. The compliance rates with infection control measures, changes in risk priority numbers (RPN) at various stages (1 month and 10 months after intervention) of HFMEA implementation, and the incidence of SSI between the conventional group and the intervention group were compared. Results A total of 884 surgeries were included. Among them, there were 399 cases in the conventional group and 485 cases in the intervention group; 16 cases SSI occurred. A total of 7 SSI prevention and control measures had been formulated. Except for proper surgical attire (P＞0.05), there were statistically significant differences in the compliance rate of the other prevention and control measures between the two groups of patients (P＜0.05). In the intervention group, the RPN values of pre-operative, intra-operative, and post-operative risk factors at the 10th month after intervention were all lower than those at the 1st month after intervention (P<0.05). Except for the incidence of SSI during craniotomy surgery (6.1% vs. 1.8%, P=0.375), there were statistically significant differences in the total SSI incidence (3.3% vs. 0.6%) and bone fracture surgery SSI incidence (2.7% vs. 0.5%) between the conventional group and the intervention group (P>0.05). Conclusion Applying HFMEA-based risk management techniques to prospectively identify, assess, analyze, manage and track the risk of SSI in bone fracture and craniotomy surgery with class Ⅰ incision can effectively enhance the adherence of preventive measures and reduce the incidence rate of SSI.