目的 了解老年2型糖尿病动脉僵硬度与踝臂指数（ABI）对评价外周动脉硬化的价值。 方法 2010年1月－3月，应用超声、回声跟踪技术和动脉硬化检测仪检测80例老年2型糖尿病患者（观察组）和40例正常老年人（对照组）的颈总动脉内中膜厚度（IMT）、僵硬系数（β）、脉搏波传导速度（PWVβ）、ABI及动脉斑块情况。 结果 与对照组比较，观察组患者的IMT增厚、β增高、PWVβ增快、ABI降低及动脉斑块发生率增多，差异均具有统计学意义（P＜0.001）。 结论 老年2型糖尿病可导致IMT增厚、动脉僵硬度增高、PWVβ增快、ABI降低及更易发生动脉粥样硬化斑块，这些参数可以预测外周动脉粥样硬化的程度，利用彩色多普勒超声诊断仪和动脉硬化检测仪可以较容易得到这些参数，是评价外周动脉粥样硬化病变一种简便、易行，有临床实际意义的方法和手段。
【摘要】 目的 探讨阿托伐他汀强化降脂治疗和左旋氨氯地平联用对高血压患者血压的影响。 方法 选择2009年1月-2010年11月住院及门诊原发性高血压合并高脂血症患者196例，均给予左旋氨氯地平和阿托伐他汀治疗8周后，复查血脂，从其中选择血脂正常者120例，随机分为对照组（单用左旋氨氯地平组）和治疗组（继续左旋氨氯地平联用阿托伐他汀），继续治疗20周后的血压情况。 结果 两组治疗20周后，治疗组收缩压和舒张压均较对照组下降明显，组间差异有统计学意义（Plt;0.01），治疗组优于对照组。 结论 高血压合并高脂血症患者，使用左旋氨氯地平降压和阿托伐他汀降脂治疗时，在血脂降至正常后，继续同时左旋氨氯地平降压和阿托伐他汀强化降脂治疗，降压效果优于单用左旋氨氯地平。【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.