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无创呼吸机治疗慢性阻塞性肺疾病合并重症呼吸衰竭的护理

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中文科技期刊数据库（全文版）医药卫生 2024年第3期 158-161页

作者：郑博曲阳县中医医院河北保定073100

研究无创呼吸机治疗慢性阻塞性肺疾病合并重症呼吸衰竭的护理效果。方法以医院收治96例慢性阻塞性肺疾病合并重症呼吸衰竭患者随机分组,分别给予常规护理(n=48)、综合护理(n=48)。结果护理后肺功能及血气指标观察组改善效果更佳(P<0.0... 详细信息

研究无创呼吸机治疗慢性阻塞性肺疾病合并重症呼吸衰竭的护理效果。方法以医院收治96例慢性阻塞性肺疾病合并重症呼吸衰竭患者随机分组,分别给予常规护理(n=48)、综合护理(n=48)。结果护理后肺功能及血气指标观察组改善效果更佳(Papache II评分观察组均更低(P<0.05)。结论对患者给予综合护理干预,可有效稳定血气指标,改善肺功能,降低并发症发生率,缓解病情,对改善预后有积极作用,值得推广。

关键词：慢性阻塞性肺疾病重症呼吸衰竭无创呼吸机综合护理 apache II评分

急性肾损伤患者连续性肾脏替代治疗并发高钾血症危险因素分析

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中国现代医药杂志 2024年第5期26卷 22-25页

作者：于洋邹润牡丹江医学院附属第二医院重症医学科黑龙江牡丹江157000

目的探讨与分析急性肾损伤(AKI)患者连续性肾脏替代治疗(CRRT)并发高钾血症的危险因素。方法选择2019年9月~2022年8月在我院进行CRRT的AKI患者88例作为研究对象,所有患者在CRRT后1个月检测血钾水平,判定高钾血症发生情况,调查并记录所... 详细信息

目的探讨与分析急性肾损伤(AKI)患者连续性肾脏替代治疗(CRRT)并发高钾血症的危险因素。方法选择2019年9月~2022年8月在我院进行CRRT的AKI患者88例作为研究对象,所有患者在CRRT后1个月检测血钾水平,判定高钾血症发生情况,调查并记录所有患者的一般资料、CRRT资料、CRRT前1天相关指标并进行危险因素分析。结果88例患者均完成CRRT,未出现死亡情况,CRRT后1个月内发生高钾血症8例(高钾血症组),未发生高钾血症80例(非高钾血症组)。两组的性别、尿液pH值对比差异无统计学意义(P>0.05),高钾血症组的年龄、CRRT前1天的血清肌酐(Scr)、总胆红素含量显著高于非高钾血症组,apacheⅡ评分低于非高钾血症组,AKI分期与非高钾血症对比差异有统计学意义(PapacheⅡ评分、AKI分期是导致高钾血症发生的独立危险因素(PapacheⅡ评分、AKI分期均与高钾血症的发生有关,应积极预防并加强管理干预。

关键词：急性肾损伤高钾血症肌酐血钾 apache Ⅱ评分 AKI 分期

apache: The Definitive Guide 2nd ed.

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Clinical characteristics of critical patients with pandemic influenza A(H1N1) virus infection in Chengdu,China

丛书名： A nutshell handbook

1999年

作者： Ben Laurie Peter Laurie

ISBN: (纸本)9781565925281

The freeware apache web server runs on about half of the world's existing web sites, and it is rapidly increasing in popularity. apache: The Definitive Guide, written and reviewed by key members of the apache Group, is the only complete guide on the market today that describes how to obtain, set up, and secure the apache software.apache was originally based on code and ideas found in the most popular HTTP server of the time: NCSA httpd 1.3 (early 1995). It has since evolved into a far superior system that can rival (and probably surpass) almost any other Unix-based HTTP server in terms of functionality, efficiency, and speed. The new version now includes support for Win32 systems. This new second edition of apache: The Definitive Guide fully describes Windows support and all the other apache 1.3 features. Contents include:The history of the apache Group Obtaining and compiling the server Configuring and running apache on Unix and Windows, including such topics as directory structures, virtual hosts, and CGI programming The apache 1.3 Module API apache security A complete list of configuration directives With apache: The Definitive Guide, web administrators new to apache can get up to speed more quickly than ever before by working through the tutorial demo. Experienced administrators and CGI programmers, and web administrators moving from Unix to Windows, will find the reference sections indispensable. apache: The Definitive Guide is the definitive documentation for the world's most popular web server. Includes CD-ROM with apache manuals and demo sites discussed in the book

关键词： guide definitive apache

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2012年第1期13卷 49-55页

作者： Li-hui DENG1,2,Yi-lan ZENG3,Ping FENG1,Ya-ling LIU3,Li-chun WANG1,2,Yun BAI3,Hong TANG1,2(1Center of Infectious Diseases,West China Hospital of Sichuan University,Chengdu 610041,China)(2Division of Infectious Diseases,State Key Laboratory of Biotherapy,Sichuan University,Chengdu 610041,China)(3Chengdu Infectious Disease Hospital,Chengdu 610041,China) Center of Infectious Diseases West China Hospital of Sichuan University Chengdu 610041 China.

Objective:The critical illness of pandemic influenza A(H1N1) virus infection may be associated with relatively poor outcomes.The objective of this study is to describe clinical features and factors associated with the deaths of critical patients.Methods:Medical records of 26 critical patients with H1N1 infection admitted from Sept.1 to Dec.31,2009,were retrospectively reviewed.Diagnosis was established by real-time reverse transcriptase-polymerase chain reaction(RT-PCR) assay.Results:The mean age of the patients was(40.4±18.4) years and 73.1% of them were male.Clinical manifestations included fever,cough,and sputum production.The laboratory findings included leukocytosis,lymphopenia,C-reaction protein,and lactic dehydrogenase elevation.In this series,17 subjects survived and 9 died.The parameters between the deaths and survivors were compared,which included acute physiology and chronic health evaluation II(apache II) scores(23.8±10.1 vs.14.3±6.6,Papache II,SOFA,and MODS scores,which may be associated with an increased risk of death and complex clinical courses.

关键词：危重病人病毒感染临床特点 A型流感 apache 肾功能衰竭成都

Impact of disease severity on gastric residual volume in critical patients

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World Journal of Gastroenterology 2011年第15期17卷 2007-2012页

作者： Chien-Wei Hsu Shu-Fen Sun David Lin Lee Shoa-Lin Lin Kam-Fai Wong Hsiu-Hua Huang Hung-Ju Li Department of Medicine School of Medicine National YangMing University Taipei Taiwan China Intensive Care Unit Department of Medicine Kaohsiung Veterans General Hospital Kaohsiung City 813 Taiwan China Department of Physical Medicine and Rehabilitation Kaohsiung Veterans General Hospital Kaohsiung City 813 Taiwan China Institute of Statistics National University of Kaohsiung Kaohsiung City 813 Taiwan China Department of Nutrition Kaohsiung Veterans General Hospital Kaohsiung City 813 Taiwan China

AIM: To investigate whether illness severity has an impact on gastric residual volume (GRV) in medical critically ill patients. METHODS: Medical intensive care unit (ICU) patients requiring nasogastric feeding were enrolled. Sequential Organ Failure Assessment (SOFA) score was assessed immediately preceding the start of the study. Acute Physiology and Chronic Health Evaluation (apache) Ⅱ scores were recorded on the first, fourth, seventh, and fourteenth day of the study period. GRV was measured every 4 h during enteral feeding. The relationship be-tween mean daily GRV and SOFA scores and the correlation between mean daily GRV and mean apache Ⅱ score of all patients were evaluated and compared. RESULTS: Of the 61 patients, 43 patients were survivors and 18 patients were non-survivors. The mean daily GRV increased as SOFA scores increased (P apache Ⅱ scores of all patients correlated with mean daily GRV (P = 0.011, Pearson correlation) during the study period. Patients with decreasing GRV in the first 2 d had better survival than patients without decreasing GRV (P = 0.017, log rank test). CONCLUSION: GRV is higher in more severely ill medical ICU patients. Patients with decreasing GRV had lower ICU mortality than patients without decreasing GRV.

关键词：严重程度危重病人残留量疾病 apache 健康评估胃 ICU

Predictors of the outcomes of acute-on-chronic hepatitis B liver failure

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World Journal of Gastroenterology 2012年第36期18卷 5078-5083页

作者： Hsiu-Lung Fan Po-Sheng Yang Hui-Wei Chen Teng-Wei Chen De-Chuan Chan Chi-Hong Chu Jyh-Cherng Yu Shih-Ming Kuo Chung-Bao Hsieh Division of General Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical Center Division of General Surgery Department of SurgeryMackay Memorial Hospital School of Medicine University of PittsburghPittsburghPA 15261United States Division of Pediatric Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical Center

AIM:To identify the risk factors in predicting the outcome of acute-on-chronic hepatitis B liver failure patients.METHODS:We retrospectively divided 113 patients with acute-on-chronic liver failure-hepatitis B virus(ACLF-HBV) and without concurrent hepatitis C or D virus infection and hepatocellular carcinoma into two groups according to their outcomes after anti-HBV therapy.Their demographic,clinical,and biochemical data on the day of diagnosis and after the first week of treatment were analyzed using the Mann-Whitney U test,Fisher's exact test,and a multiple logistic regression analysis.RESULTS:The study included 113 patients(87 men and 26 women) with a mean age of 49.84 years.Fiftytwo patients survived,and 61 patients died.Liver failure(85.2%),sepsis(34.4%),and multiple organ failure(39.3%) were the main causes of death.Multivariate analyses showed that Acute Physiology and Chronic Health Evaluation(apache) Ⅱ scores ≥ 12 [odds ratio(OR) = 7.160,95% CI:2.834-18.092,P apache Ⅱ scores on the day of diagnosis and MELD scores after the first week of anti-HBV therapy are feasible predictors of outcome in ACLFHBV patients.

关键词：慢性乙型肝炎肝功能衰竭预测因子急性 Logistic回归分析 Fisher精确检验 apache 乙肝病毒

Protective effect of periplaneta americana extract on intestinal mucosal barrier function in patients with sepsis

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Journal of Traditional Chinese Medicine 2013年第1期33卷 70-73页

作者： Hongwei Zhang Liyou Wei Zhenyu Zhang Shuzheng Liu Gang Zhao Jing Zhang Yanling Hu The Department of Intensive Care Unit The second Hospital of Tangshan The Department of Orthopaedics The second Hospital of Tangshan The Department of Intensive Care Unit People's Hospital of Tangshan

OBJECTIVE: To investigate the effect of the periplaneta americana extract on the intestinal mucosal barrier and prognostic implications in patients with sepsis. METHODS: Sixty and six patients with sepsis were assigned randomly to treatment group (32 cases) and control group (32 cases). The extractfrom periplaneta americana plus conventional medication for sepsis was administered to the treatment group, while the control group only received conventional treatment. The gastrointestinal function scores and acute physiology and chronic health evaluation II (apacheⅡ) scores of all subjects were documented at baseline, at days 1, 3 and 7 after treatment respectively and their blood endotoxin was tested at the same time points as well.The incidence of death was recorded for both groups throughout the trial. RESULTS: At days 3 and 7 after treatment, gastroin-testinal function score, apache II, and endotoxin level in treatment group wasbetter than that in control group and the difference between them was significant (both P 0.05). CONCLUSION: The extract of periplaneta americana had protective effect on intestinal mucosal barrier and could improve the condition and prognosis in patients with sepsis.

关键词：屏障功能美洲大蠊保护作用提取物肠黏膜脓毒症患者 apache

Continuous regional arterial infusion and laparotomic decompression for severe acute pancreatitis with abdominal compartment syndrome

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World Journal of Gastroenterology 2011年第44期17卷 4911-4916页

作者： Zhi-Gang Deng Jian-Yin Zhou Zhen-Yu Yin You-Yuan Peng Fu-Qiang Wang Xiao-Min Wang Department of Hepatobiliary Surgery Xiamen University Zhongshan Hospital Xiamen 361004 Fujian Province China

AIM:To evaluate the therapeutic effects of abdominal decompression plus continuous regional arterial infusion(CRAI) via a drug delivery system(DDS) in severe acute pancreatitis(SAP) patients with abdominal compartment syndrome(ACS).METHODS:We presented our recent experience in 8 patients with SAP.The patients developed clinical ACS,which required abdominal decompression.During the operation,a DDS was inserted into the peripancreatic artery(the catheter was inserted from the right gastroepiploic artery until it reached the junction between the pancreaticoduodenal and gastroduodenal artery).Through this DDS,a protease inhibitor,antibiotics and octreotide were infused continuously.The duration of the regional artery infusion ranged from 8 to 41 d.The outcomes and the changes in the apache Ⅱ score,computed tomography(CT) severity index and intraabdominal pressure(IAP) of the patients were retrospectively evaluated.RESULTS:Eight patients with an initial apache Ⅱ score of 18.9(range,13-27) and a Balthazar CT severity index of 9.1(range,7-10) developed severe local and systemic complications.These patients underwent subsequent surgical decompression and CRAI therapy because of intra-abdominal hypertension(IAH).After a mean interval of 131.9 ± 72.3 d hospitalization,7 patients recovered with decreased apache Ⅱ scores,CT severity indexes and IAP.The mean apache Ⅱ score was 5.4(range,4-8),the CT severity index was 2.3(range,1-3),and IAP decreased to 7.7 mmHg(range,6-11 mmHg) 60 d after operation.One patient died of multiple organ failure 1 wk after surgery.CONCLUSION:CRAI and laparotomic decompression might be a therapeutic option for SAP patients with ACS.

关键词：重症急性胰腺炎综合征动脉减压灌注腔室连续区 apache

Serum inter-cellular adhesion molecule 1 is an early marker of diagnosis and prediction of severe acute pancreatitis

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World Journal of Gastroenterology 2012年第20期18卷 2554-2560页

作者： Hai-Hang Zhu Lin-Lin Jiang Department of Gastroenterology Northern Jiangsu HospitalCollege of Clinical Medical MedicineYangzhou UniversityYangzhou 225001Jiangsu ProvinceChina

AIM:To determine if serum inter-cellular adhesion molecule 1(ICAM-1)is an early marker of the diagnosis and prediction of severe acute pancreatitis(SAP) within 24 h of onset of pain,and to compare the sensitivity,specificity and prognostic value of this test with those of acute physiology and chronic health evaluation(apache)Ⅱscore and interleukin-6(IL-6). METHODS:Patients with acute pancreatitis(AP)were divided into two groups according to the Ranson's criteria:mild acute pancreatitis(MAP)group and SAP group.Serum ICAM-1,apacheⅡand IL-6 levels were detected in all the patients.The sensitivity,specificity and prognostic value of the ICAM-1,apacheⅡscore and IL-6 were evaluated. RESULTS:The ICAM-1 level in 36 patients with SAP within 24 h of onset of pain was increased and was significantly higher than that in the 50 patients with MAP and the 15 healthy volunteers(Papache-Ⅱscoring system(0.770)and superior to IL-6(0.508)in distinguishing SAP from MAP. CONCLUSION:ICAM-1 test is a simple,rapid and reliable method in clinical practice.It is an early marker of diagnosis and prediction of SAP within the first 24 h after onset of pain or on admission.As it has a relatively low NPV and does not allow it to be a stand-alone test for the diagnosis of AP,other conventional diagnostic tests are required.

关键词：细胞间粘附分子-1 重症急性胰腺炎早期诊断预测指标血清 ICAM-1 apache 白细胞介素-6