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151例老年患者心脏瓣膜置换术护理

目的:分析60 岁以上老年心脏瓣膜置换术围术期的护理特点。方法:2000 年1 月～2007 年2 月对我科收治的151 例老年心脏瓣膜病患者(60～72 岁)实施心瓣膜置换术,其中二尖瓣置换95 例,主动脉瓣置换19 例,二尖瓣和主动脉瓣双瓣置换术37 例,110 例置入机械瓣,41 例置入生物瓣。结果:本组死亡5 例占3.3%,4 例死于低心排综合征,1 例死于心室颤动,切口感染1 例,纵隔感染2 例,肺部感染5 例,均作相应处理痊愈出院。出院随访3～52 个月,每年236 人次,心功能恢复Ⅰ级82例,Ⅱ级46例。结论:手术技巧的提高和围术期针对老年人的生理特点,加强呼吸循环神经系统的监护对提高生存率,促进早日康复有十分重要的意义。

冠心病患者主动脉内球囊反搏植入术后并发脾梗死一例

Acinetobacter baumannii peritoneal dialysis-related peritonitis: a review of 10 cases

ObjectiveTo investigate the clinical characteristics, treatment and outcomes of patients with Acinetobacter baumannii peritoneal dialysis-related peritonitis.MethodsWe retrospectively analyzed the clinical data of patients with Acinetobacter baumannii peritoneal dialysis-related peritonitis in the First Affiliated Hospital of Airforce Military University from January 2011 to December 2018. The clinical baseline data, treatment process, microbiological data, antibiotic susceptibility test of the bacterial isolates and outcomes were analyzed.ResultsA total of 10 patients were enrolled, including 4 males and 6 females. The average age of all patients was (44.90±17.03) years, the average age of peritoneal dialysis was (21.70±17.06) months. Seven cases were infected for the first time, and 3 cases were reinfected. The infections were mainly caused by mechanical failure of catheter connection system (3 cases) or enterogenous infection (3 cases). The main symptoms were abdominal pain (10 cases), fever (7 cases) and diarrhea (3 cases). Empirical anti-infective treatment was given after admission, only 1 case was effective, and the treatment of the other 9 cases were adjusted according to the results of drug sensitivity. Acinetobacter baumannii was sensitive to cefoperazone, carbapenem (meropenem, imipenem), quinolones (ciprofloxacin, levofloxacin), aminoglycosides (gentamicin) and polymyxin. Only one case was resistant to ceftazidime. Among the 10 patients, 8 cases were cured (continued peritoneal dialysis), 1 case died, and 1 case dropped out from peritoneal dialysis to hemodialysis.ConclusionsAcinetobacter baumannii peritoneal dialysis-related peritonitis in this hospital is mainly caused by mechanical disturbance of catheter connection system or enterogenic infection. Appropriate measures, including aseptic standard operation, follow-up and effective anti-infective treatment, should be taken to decrease the incidence and mortality of Acinetobacter baumannii peritoneal dialysis-related peritonitis.

MammoSite Balloon Brachytherapy for Accelerated Partial Breast Irradiation Following Breast-conserving Surgery for Patients with Early Stage Breast Cancer: A Single Arm Meta-analysis

ObjectiveTo assess the cosmetic outcomes and adverse events of MammoSite balloon brachytherapy for Accelerated Partial Breast Irradiation following breast-conserving surgery for patients with early stage breast cancer. MethodsWe searched PubMed, EMbase, Chinese Biomedical Database, Chinese Studies Online, China Journal Full-text Database up to March 2016, to collect clinical trials about MammoSite balloon brachytherapy following breast-conserving surgery for early stage breast cancer. And meta-analyses were performed by OpenMeta and Stata softwares. ResultsTwenty trials involving 3 796 patients were enrolled. The single arm meta-analysis results showed that:the cosmetic results were rated as excellent to good in 93% (95%CI 0.91 to 0.96), and the 5-year incidence of ipsilateral breast tumor recurrence (IBTR) was 3% (95%CI 0.020 to 0.040). ConclusionTo carry out the conclusion above, we still need controlled trials, especially randomized controlled trials (RCTs) to prompt further verification.