【摘要】 目的 探讨在基层医院建立脑卒中单元模式的临床意义。 方法 将2006年1-3月和2007年同期共381例脑卒中患者分为脑卒中单元组和普通病房组。脑卒中单元组按照脑卒中单元模式进行治疗，普通病房组按照传统方法治疗，分别于治疗前、治疗后7、15、30 d时，对比分析两组患者神经功能缺损及疗效。 结果 脑卒中单元组和普通病房组治疗后，随时间两组的神经功能缺损评分（NIHSS）均逐渐降低，两组在治疗后15、30 d时差异有统计学意义（P=0.007），脑卒中单元组家属满意度明显高于普通病房组（P=0.002）。 结论 在基层医院脑卒中单元模式对脑卒中患者的治疗效果明显优于传统治疗。【Abstract】 Objective To investigate the clinical significance of setting up stroke unit model in basic hospital. Methods Three hundreds and eighty-one stroke patients were randomly divided into stroke unit group (n=186) and general ward group (n=189). The stroke unit group patients were treated with the stroke unit model designed by ourselves, while the control group patients were treated with traditional method, The clinical efficacy was compared before treatment, seven days, 15 days and 30 days after treatment. Results Improvement in neurological score was significantly better among patients treated in the SU than in the GW. NIHSS scores gradually reduce in the both groups after treatment, which were significantly lower than those in the control group on 15 days and 30 days after treatment(P=0.007,0.004). The satisfactory of relatives in the stroke unit group was better than that in the general ward group(P=0.002). Conclusion The efficacy of treatment with stroke unit model was better than that of treatment with traditional method in the stroke patients.
ObjectiveTo evaluate the therapic efficacy for severe acute pancreatitis (SAP) during different periods. MethodsAccording to internalized standard, 234 patients with SAP admitted to this hospital from January 1986 to October 2009 were included, which were divided into two stages based on the time of admitting to this hospital. The first stage named prior operation group was from January 1986 to August 1998 (n=117), the second stage named individual treatment group was from September 1998 to October 2009 (n=117). There was comparability in demography and clinic between two groups. The prior operation group primarily underwent laparotomy and medication, and the individual treatment group underwent multiple combined therapies. These indexes were compared between two groups: hospital stay, cure rate, and mortality; the incidences of pancreatic pseudocyst, pancreatic and peripancreatic abscess, pancreatic encephalopathy, cardiac insufficiency, acute renal failure (ARF), acute respiratory distress syndrome (ARDS), and shock. The efficacies for early treatment, ascites, biliary pancreatitis, and pancreatic and peripancreatic complications were compared two groups by stratified analysis. ResultsCompared with the prior operation group, the hospital stay was shorter (Plt;0.05), cure rate was higher (Plt;0.001), and mortality was lower in the individual treatment group (Plt;0.001). During the treatments, the incidences of pancreatic pseudocyst, pancreatic and peripancreatic abscess, pancreatic encephalopathy, cardiac insufficiency, ARF, ARDS, and shock in the individual treatment group were lower than those in the prior operation group (Plt;0.05). According to the stratified analysis, the efficacies for early treatment, ascites, biliary pancreatitis, and pancreatic and peripancreatic complications in the individual treatment group were better than those in the prior operation group (Plt;0.001). ConclusionIn recent years, the change of therapeutic mode significantly improves the treatment efficacy for SAP.
Surgery is an accepted standard in the treatment of adenocarcinoma of esophagogastric junction (AEG), but the efficacy of surgery alone for locally advanced AEG is limited. In-depth studies concerning combined therapy for AEG have been carried out worldwide, including neoadjuvant chemotherapy (nCT), neoadjuvant chemoradiotherapy (nCRT), perioperative chemotherapy (pCT), postoperative chemoradiotherapy, etc. Significantly, the contribution of nCRT and pCT to improving the prognosis of locally advanced AEG patients has been shed light on. Compared with that, multimodality treatment for AEG patients is not well established in China. An attempt was thus made to take an overview of the evidence-based research advance regarding integrated therapy of AEG.