鼻内镜下手术治疗慢性鼻窦炎临床疗效分析

目的观察鼻内窥镜下手术治疗慢性鼻窦炎的临床效果,提高临床治疗水平。方法选取我院自2011年3月~2012年8月收治的100例慢性鼻窦炎患者作为研究对象,将其随机分为两组。50例对照组患者采用传统的Wigand术式治疗,而50例治疗组患者在全麻下行鼻内窥镜手术,对于合并鼻中隔偏曲的患者两组均同时行鼻中隔矫正术。结果 50例治疗组患者经过上述治疗之后,治愈43例(86%),好转6例(12%),无效1例(2%),总有效率98%,而50例对照组患者,治愈33例(66%),好转5例(10%),无效12例(24%),总有效率76%,具有显著差异,P<0.01。结论鼻内镜下手术治疗慢性鼻窦炎较为安全,临床疗效好,没有不良反应及并发症,值得临床推广应用。     

鼻内镜下治疗慢性鼻窦炎的临床疗效

目的探讨鼻内镜下治疗慢性鼻窦炎患者的临床疗效。方法对我院2012年1月至2013年12月收治采用鼻内镜手术治疗的160例慢性鼻窦炎患者进行回顾分析,并与同期收治采用传统手术的160例患者进行对比。结果观察组患者手术时间、出血量明显优于对照组（P〈0.05）,两组患者住院时间比较差异无统计学意义（P〉0.05）。观察组总有效率为96.2%,对照组总有效率为76.2%（P〈0.05）。结论鼻内镜下手术创伤小,患者身体恢复快,是治疗慢性鼻窦炎的有效方法。     

鼻内镜手术治疗慢性鼻窦炎的围术期护理

目的探讨鼻内镜手术治疗慢性鼻窦炎的围术期护理措施和疗效。方法选择我院治疗的100例慢性鼻窦炎患者的临床资料,所有患者都采用鼻内镜手术治疗,在术前、术中、术后的护理中总结分析所有患者的临床疗效。结果护理后总有效率是90%(90/100),患者在手术后症状较轻微,患者当中有7例出血情况出现,鼻窦粘连状况2例,眼眶血肿状况1例,都未出现术后并发症。结论加强慢性鼻窦炎患者鼻内镜手术治疗的围术期护理,可提高鼻内镜手术成功的疗效,降低发生并发症的可能性。     

鼻内镜手术治疗慢性鼻窦炎鼻息肉临床疗效

近几年,功能性鼻内镜外科(FESS)理论进入我国,鼻内镜下进行鼻窦炎、鼻息肉手术己取代了传统和常规的鼻息肉手术。鼻内镜手术可清除鼻腔、窦口鼻道复合体,能有效保证鼻窦腔气流通畅,是手术治疗慢性鼻窦炎和鼻息肉的新途径,有着广阔的前景[1]。笔者收集我院2009年5月至2013年1月住院治疗的128例病例,采取鼻内镜的手术方法,坚持术后随访,临床疗效较满意。1资料与方法 1.1一般资料本组收集我院2009年5月至2013     

功能性内镜鼻窦手术治疗慢性鼻窦炎临床疗效分析

目的就功能性内镜鼻窦手术治疗慢性鼻窦炎临床疗效进行分析。方法选取我院在2011年11月～2013年11月收治的63例慢性鼻窦炎患者,取仰卧位,对双侧鼻腔进行彻底检查,面部用4%洗必泰头来进行常规消毒,本组患者全部采用Messerklinger术式。结果本组63例患者行Messerklinger术式,成功率为100.0%,无1例手术失败;术后行随访观察,总有效率为95.2%;术后并发率为4.8%。结论功能性内镜鼻窦手术治疗慢性鼻窦炎,疗程短,副反应轻,疗效比较显著,术后无严重的并发症和不良反应,值得在临床上大量应用。     

中药在慢性鼻窦炎鼻内镜术后的应用进展

随着鼻内镜鼻窦手术的不断发展,慢性鼻窦炎的诊治水平有了明显的提高,但这并不意味着慢性鼻窦炎的彻底根治,内窥镜鼻窦手术的目的是改变鼻腔内的异常结构、改善鼻腔的通气引流,为鼻腔鼻窦黏膜的炎症的良性转归创造必要的条件,顾之燕等认为鼻腔鼻窦黏膜的炎症,特别是慢性炎症的良性转归需要经过长期的综合治疗实现。鼻腔黏膜在内窥镜鼻窦手术以后发生了新生病变,如黏膜水肿、囊泡形成、息肉再生等,以及鼻腔内分泌物较多,鼻涕倒流等情况。慢性鼻窦炎     

鼻内镜手术治疗慢性鼻窦炎患者115例护理分析

临床实践中,鼻内镜手术作为一种比较常规的鼻窦炎手术治疗方法,具有治疗效果显著的特征,且复发率低。本文主要就鼻内镜手术治疗慢性鼻窦炎患者115例患者的情况,对手术前和手术后的护理措施进行了分析和探讨。     

鼻内镜下手术治疗鼻窦炎效果观察

鼻窦炎以鼻内镜手术治疗为主,术后需要定期清除患者分泌物及鼻腔内痂皮,有利于患者术腔愈合,如果窦内有霉菌团块,则会出现反复的溢脓,黏膜水肿,窦口再次堵塞或者闭合,甚至可能伴有骨质破坏,必须重新开放,彻底清理窦内霉菌团块,还要注意保护窦腔黏膜;给予常规应用抗生素预防患者术腔感染,鼻腔填塞物取出后,每日以生理盐水冲洗鼻腔患处,内镜下清理患者鼻腔水肿组织、术腔粘连等,确保患者鼻腔通气顺畅;对于病变范围较大并且明显骨质破坏的患者,给予口服抗真菌药物治疗。有利于控制疾病复发和感染扩散,促进术腔患处愈合和上皮化。     

鼻内窥镜下治疗慢性鼻窦炎的临床分析

目的探讨鼻内窥镜下手术治疗慢性鼻窦炎的方法及临床疗效。方法对2009年2月～2011年6月我院收入的56例慢性鼻窦炎患者进行鼻内窥镜手术治疗,记录并做回顾性分析。结果 56例患者中治愈36例,好转18例,无效2例。结论鼻内窥镜手术治疗慢性鼻窦炎鼻息肉疗效确切,手术并发症少、复发率低、出血少、创伤小,最大限度保留了鼻黏膜的功能,值得临床应用推广。     

经鼻内镜行鼻窦炎手术或鼻息肉摘除术的围术期护理措施

目的探讨经鼻内镜行鼻窦炎手术或鼻息肉摘除术的围术期护理方法。方法选取我院耳鼻喉科在2012年1月至2014年1月收治的鼻窦炎、鼻息肉患者共80例,将其随机分为两组,对照组患者给予常规护理,观察组患者给予整个围术期护理,并比较两组护理效果。结果观察组并发症发生率(2.5%)明显小于对照组(15.0%),观察组(97.5%)护理满意度明显高于对照组(82.5%),差异均有统计学意义(P<0.05)。结论对行鼻内镜手术的鼻窦炎和鼻息肉患者加强围术期护理可明显降低并发症发生率,提高患者护理满意度。     

Budget impact analysis of bioabsorbable drug-eluting sinus implants following endoscopic sinus surgery

Objective: Propel is a bioabsorbable drug-eluting sinus implant inserted following an endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). The objective of this study was to estimate the budget impact of incorporating Propel post-ESS for CRS patients from a self-insured employer or third-party payer perspective.

Methods: An Excel-based budget impact model was developed. Estimates of the prevalence of CRS, rates of ESS, and effectiveness outcomes, along with direct and indirect costs from CRS were obtained from published literature. A total population of 1.5 million members was hypothesized for the analysis. All cost data were adjusted to October 2015 US dollars using the Medical Care Component of the Consumer Price Index. The cost and clinical/economic characteristics of Propel were compared to other treatments commonly used to minimize post-operative complications. The primary outcome was the incremental budget impact reported using per-member-per-month (PMPM) costs. Scenario-based, probabilistic, and one-way sensitivity analyses were performed to gauge the robustness of the results and identify the parameters with the most influence on the results.

Results: For a US self-insured employer or a commercial health plan of 1.5 million members, the incremental PMPM impact of incorporating Propel was estimated to range from ?Objective: Propel is a bioabsorbable drug-eluting sinus implant inserted following an endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). The objective of this study was to estimate the budget impact of incorporating Propel post-ESS for CRS patients from a self-insured employer or third-party payer perspective.

Methods: An Excel-based budget impact model was developed. Estimates of the prevalence of CRS, rates of ESS, and effectiveness outcomes, along with direct and indirect costs from CRS were obtained from published literature. A total population of 1.5 million members was hypothesized for the analysis. All cost data were adjusted to October 2015 US dollars using the Medical Care Component of the Consumer Price Index. The cost and clinical/economic characteristics of Propel were compared to other treatments commonly used to minimize post-operative complications. The primary outcome was the incremental budget impact reported using per-member-per-month (PMPM) costs. Scenario-based, probabilistic, and one-way sensitivity analyses were performed to gauge the robustness of the results and identify the parameters with the most influence on the results.

Results: For a US self-insured employer or a commercial health plan of 1.5 million members, the incremental PMPM impact of incorporating Propel was estimated to range from ?$0.003 to $0.036, respectively, for all members in the health plan. Sensitivity analyses identified the cost of Propel, probability of polyposis recurrence requiring medical intervention, probability of adhesion formation requiring surgical intervention, and the treatment costs for polyposis as the primary parameters influencing the results.

Conclusion: This study has demonstrated the use of Propel following ESS procedures has a negligible impact on the budget of a US self-insured employer or payer. The upfront cost of Propel was offset by savings associated with reduced probability for polyp recurrence, adhesion formation, and their subsequent treatment.     

慢性支气管炎患者的临床护理

目的：探讨慢性支气管炎患者的临床护理。方法回顾性分析2012年8月至2014年8月河南省永城市人民医院收治的120例慢性支气管炎患者的护理方法及治疗措施。结果经相应的治疗和护理后,115例患者咳嗽、咳痰及喘息症状得到明显缓解,3例患者还存在不同程度的喘息和轻微咳嗽,2例发生感染,给予抗感染治疗后痊愈。结论护理措施对慢性支气管炎的康复有重要意义。     

结肠息肉切除术后并发出血的内镜治疗

目的探讨内镜治疗结肠息肉切除术后并发出血患者的临床疗效。方法选取2007年6月至2014年6月在我院接受结肠息肉切除术治疗的16例术后并发出血患者,均采用急诊结肠镜检查,同时在内镜下进行止血治疗。结果本组16例患者经急诊结肠镜检查的同时在内镜下均得到成功止血。结论内镜治疗结肠息肉切除术后并发出血的效果良好,可有效止血。     

Disease-related expenditures and revision rates in chronic rhinosinusitis patients after endoscopic sinus surgery

Aims: The objective of this study was to quantify the treatment costs and revision surgery rates in chronic rhinosinusitis (CRS) patients, with and without nasal polyposis (CRSwNP and CRSsNP), who require treatment with endoscopic sinus surgery (ESS). The additive contributions of nasal polyposis (NP) and revision surgery to 1-year costs were a primary focus.

Materials and methods: Adults (aged 18–64 years) undergoing ESS for CRS in 2012–2015 were identified within the Blue Health Intelligence database and used to estimate revision rates. Patients with ±1 year of enrollment around the index ESS were used to estimate 1-year healthcare expenditures. Revision ESS rates were evaluated via Kaplan-Meier and Cox regression models. Disease-related healthcare and pharmacy expenditures were modeled with generalized linear regression to assess the impact of baseline patient characteristics.

Results: A total of 86,052 patients underwent ESS for CRS (43.5?±?12.4 years; 49.3% male), and a sub-set of 23,542 patients were available for 1-year healthcare expenditure analysis (44.0?±?12.1 years; 50.0% male). Revision ESS rates within 1 year were 3.5% in the CRSwNP cohort and 1.6% in the CRSsNP cohort. NP, deviated septum, gender, and region were statistically significant predictors of revision surgery. Mean 1-year treatment expenditures, including the index ESS, were $8,824 for CRSsNP and $11,166 for CRSwNP patients without revision ESS. CRSwNP doubled the risk of revision surgery in the first year after ESS compared with CRSsNP and cost 24% more in the absence of a second procedure. Revision ESS within the first year increased mean 1-year expenditures by $11,150 and $13,139 for CRSsNP and CRSwNP, respectively.

Limitations: The primary limitation was the limited length of follow-up available for estimating revision ESS rates.

Conclusions: In a large commercially insured US population, disease-related expenditures for patients having ESS for CRS are substantial, as are the additive impacts of NP and revision surgery.     

硫唑嘌呤联合小剂量曲安西龙治疗老年慢性免疫性血小板减少症的疗效观察

目的探讨硫唑嘌呤联合小剂量曲安西龙治疗老年慢性免疫性血小板减少症(CITP)的疗效,并观察其不良反应。方法 56例非重症的老年CITP患者,随机分为治疗组及对照组,治疗组给予口服硫唑嘌呤1.5mg/kg/d及曲安西龙片20mg/d治疗,对照组仅口服强的松1mg/kg/d治疗。结果治疗6个月后,治疗组总有效率(79.3%)高于对照组(51.9%),治疗组血小板均值高于对照组。结论硫唑嘌呤联合小剂量曲安西龙治疗老年性CITP有效率高,毒副作用少。     

微创小切口手术治疗单纯性阑尾炎患者的临床疗效

目的：探讨微创小切口手术治疗单纯性阑尾炎患者的临床疗效。方法选取2010年1月至2014年1月南京中医药大学附属常州市中医院普外科收治的单纯性阑尾炎患者资料150例,按随机数字表法将其分为观察组与对照组,各75例。观察组患者行微创小切口手术治疗,对照组患者行常规阑尾切除手术治疗,比较两组患者的手术指标、并发症发生情况及治疗效果。结果观察组患者手术时间、术后排气时间以及住院时间均明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义（均P＜0.05）;观察组患者术后发生感染、皮下积液、肠梗阻发生率均明显低于对照组,差异有统计学意义（P＜0.05）;观察组患者治疗优良率为94.7%,明显优于对照组的85.3%,差异有统计学意义（P＜0.05）。结论采用微创小切口手术治疗单纯性阑尾炎效果明显、经济实惠。     

保乳手术治疗早期老年乳腺癌的临床价值

目的探讨保乳手术治疗早期老年乳腺癌的临床价值。方法将我院近期收治的早期老年乳腺癌患者150例,随机分为治疗组和对照组,各75例,治疗组患者进行保乳手术,对照组患者进行传统手术,对比分析两组患者经过手术后临床疗效,以及生活质量等。结果治疗组患者的手术中出血量、拔引流管时间、总的引流量及术后并发症显著优于对照组患者(P<0.05),同时治疗组患者经手术治疗后其生活质量高于对照组患者(P<0.05)。结论相比于传统的手术保乳手术具有手术后恢复时间短、并发症少及患者生活质量高等方面的优势,在临床治疗上可以进行大力推广。     

中药内服配合敷脐治疗慢性结肠炎患者的临床疗效

目的：探讨中药内服配合敷脐治疗慢性结肠炎患者的临床疗效。方法选取2014年1月至2015年1月在辽阳市中医医院肛肠科接受治疗的114例慢性结肠炎患者,按随机数字表法将其分为试验组与对照组,各57例,试验组患者采用中药内服配合敷脐治疗,对照组患者应用糖皮质激素、免疫抑制剂药物治疗。比较两组患者的临床效果。结果试验组患者总有效率为94.7%,明显高于对照组的84.2%,差异有统计学意义（P＜0.05）。结论中药内服配合敷脐用于慢性结肠炎的疗效确切,有助于肠道功能的恢复。     

妇科千金胶囊联合左氧氟沙星治疗慢性宫颈炎患者的临床疗效

目的探讨妇科千金胶囊联合左氧氟沙星治疗慢性宫颈炎患者的临床疗效。方法选取2019年11月至2020年11月朝阳市中心医院收治的60例慢性宫颈炎患者作为研究对象,按治疗方案不同分为对照组与观察组,每组30例。对照组单纯应用左氧氟沙星治疗,观察组在对照组基础上联合妇科千金胶囊治疗,比较两组的治疗效果。结果观察组治疗有效率为93.3%,高于对照组的76.7%,差异有统计学意义(P<0.05);治疗前,两组超敏C反应蛋白、白细胞介素-2、白细胞介素-10水平比较差异无统计学意义(P>0.05);治疗后,观察组超敏C反应蛋白、白细胞介素-2、白细胞介素-10低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为6.7%,低于对照组的16.7%,差异有统计学意义(P<0.05);观察组白带增多、外阴瘙痒、腰骶不适症状缓解时间短于对照组(P<0.05)。结论左氧氟沙星联合妇科千金胶囊治疗慢性宫颈炎,可以有效降低炎症介质水平,提高患者治疗及预后效果,且安全性较高,对促进患者康复具有重要意义。