摘要:目的:探討新生兒銅綠假單胞菌肺炎的臨床特點及藥敏特點,為合理治療提供依據。方法:對我院新生兒科2006年8月到2008年7月收治新生兒肺炎痰標本進行培養分離鑒定,選擇培養結果為銅綠假單胞菌者做藥敏及臨床分析。結果:銅綠假單胞菌對碳青霉烯類,如:亞胺培南,美洛培南敏感率達100%,對近幾年在新生兒較少用的或不用的氨基糖甙類,環丙沙星敏感率為85%～100%,而對常用的氨芐西林+舒巴坦不敏感,對頭孢他啶敏感率gt;70%,臨床根據藥敏結果選擇敏感抗生素治療,療效滿意。結論:近年新生兒銅綠假單胞菌肺炎有上升趨勢,病死率極高,故應根據藥敏試驗結果選擇敏感抗生素,以控制疾病發展,降低病死率。
Objective To explore the technique and clinicaleffects of internal fixation of complicated distal femoral fractures using the supporting steel of AO femoral condyles.Methods From October 2001 to February 2004, 23 cases of complicated distal femoral fractures were treated with open reduction and internal fixation using the supporting steel of AO femoral condyles. Of 23 cases, there were 19 males and 4 females, aged 27-55 years. The locations were the right side in 10 cases and the left side in 13 cases. Fracture caused by traffic accident in 16 and by fall in 7, including 14 closed fracture and 9 open fracture, 21 fresh fracture and 2 old fracture. Accordingto AO classification, 6 cases were classified as type A extra-articular fracture and 17 cases as type C intra-articular fracture. The X-ay films before operation showed comminuted fracture of femoral intercondyles and femoral supracondyles. All cases received scientific and rational rehabilitative treatment postoperatively. Results The postoperative follow-up ranged from 6months to 20 months, 23 cases achieved fracture healing with an average healing period of 10.3 months (from 7 months to 16 months). According to the criteria of Kolmert and Wulff, the results were excellent in 16 cases, good in 4 cases, fair in 2 case andpoor in 1 case. The excellenct and good rate was 86.9%.Conclusion Internal fixation with the supporting steel of AO femoral condyles for treatment of complicated distal femoral fractures has advantages of reasonable design, convenient operation, firm fixation and reliable clinical outcome .
目的:分析探討終末期慢性腎衰竭(CRF)并急性左心衰的發病機制及救治措施。方法:對36例各種原因所致的終末期CRF患者并急性左心衰采用藥物控制血壓,降低外周血管阻力,減輕心臟后負荷及采用血液透析等方法,減輕心臟前負荷,控制心衰。結果:36例患者2286次來院救治并發急性左心衰1144次,搶救成功1138次,成功率99.5%。結論:終末期CRF并急性左心衰據發病機理不同,給予不同處理,關鍵是盡快控制血壓,脫水,降低外周血管阻力和控制血容量,降低心輸出量。