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Objective To explore the effect of preheating of substitution fluid on the incidence of hypothermia in patients with continuous renal replacement therapy (CRRT). Methods Use SPSS software to generate random Numbers, 98 cases were numbered in advance, and then randomly divided into control group and experimental group with 49 cases in each group. Control group based on the conventional way in the process of CRRT heating, experimental group preheating the substitution fluid to 37℃in constant temperature box on the basis of conventional heating. The CRRT parameters of the two groups, the hourly body temperature of the patients and the arteriovenous temperature of the blood filtration catheter were recorded,and the laboratory indicators related to hemolysis before and after treatment were compared between the two groups. Results In the control group, the incidence of hypothermia at 6h, 12h, 18h, 24h, 48h and 72h was 20.41% (10/49), 32.65% (16/49), 40.82% (20/49), 48.98%(24/49), 55.10%(27/49), 59.18%(29/49),while the incidence of hypothermia in the experimental group at 6h, 12h, 18h, 24h, 48h and 72h was 6.12% (3/49), 14.29% (7/49), 20.41% (10/49), 28.57% (14/49), 34.69% (17/49), 38.78% (19/49), the incidence of hypothermia between the two groups was statistically significant ( χ2=4.083-4.804, P<0.05). The difference of arteriovenous terminal temperature in the control group at 6h, 12h, 24h, 48h and 72h was (0.15±0.21), (0.16±0.12), (0.17±0.10), (0.15±0.12), (0.17±0.11)℃, while the difference of arteriovenous terminal temperature in the experimental group at 6h, 12h, 24h, 48h and 72h was (0.15±0.21), (0.16±0.12), (0.17±0.10), (0.15±0.12), (0.17±0.11)℃, there were statistically significant differences between the two groups (Z=2.524-3.458, P < 0.05). When the rate of substitution fluid was ＜1 000ml/h, the incidence of hypothermia in the control group was 3/10, the incidence of hypothermia in the experimental group was 4/6 ,there was no statistically significant difference in body temperature between the two groups (P > 0.05). While the substitution fluid rate in 1 000-3 000 ml/h, the incidence of hypothermia in the control group was 50.00% (12/24), the incidence of hypothermia in the experimental group was 19.05% (4/21) ,the incidence of hypothermia in the experimental group was significantly lower than that in the control group (χ2=4.683, P< 0.05), When the rate of substitution fluid was > 3000ml/h, the incidence of hypothermia in the control group was 93.33%(14/15), and that in the experimental group was 50.00% (11/22). The difference in the incidence of hypothermia between the two groups was statistically significant (P<0.05).There was no significant difference between the two groups in hemolysis related laboratory indicators before and after CRRT treatment (P > 0.05). Conclusions Preheating of substitution fluid can safely and effectively reduce the incidence of hypothermia in CRRT patients, and when the rate of substitution fluid was>1 000ml/h, the effect of preventing hypothermia is more significant.
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Objective@#To explore the effect of preheating of substitution fluid on the incidence of hypothermia in patients with continuous renal replacement therapy (CRRT).@*Methods@#Use SPSS software to generate random Numbers, 98 cases were numbered in advance, and then randomly divided into control group and experimental group with 49 cases in each group. Control group based on the conventional way in the process of CRRT heating, experimental group preheating the substitution fluid to 37℃ in constant temperature box on the basis of conventional heating. The CRRT parameters of the two groups, the hourly body temperature of the patients and the arteriovenous temperature of the blood filtration catheter were recorded, and the laboratory indicators related to hemolysis before and after treatment were compared between the two groups.@*Results@#In the control group, the incidence of hypothermia at 6h, 12h, 18h, 24h, 48h and 72h was 20.41% (10/49), 32.65%(16/49), 40.82%(20/49), 48.98%(24/49), 55.10%(27/49), 59.18%(29/49), while the incidence of hypothermia in the experimental group at 6h, 12h, 18h, 24h, 48h and 72h was 6.12% (3/49), 14.29% (7/49), 20.41% (10/49), 28.57% (14/49), 34.69% (17/49), 38.78% (19/49), the incidence of hypothermia between the two groups was statistically significant (χ2=4.083-4.804, P < 0.05). The difference of arteriovenous terminal temperature in the control group at 6h, 12h, 24h, 48h and 72h was (0.15±0.21), (0.16±0.12), (0.17±0.10), (0.15±0.12), (0.17±0.11)℃, while the difference of arteriovenous terminal temperature in the experimental group at 6h, 12h, 24h, 48h and 72h was (0.15±0.21), (0.16±0.12), (0.17±0.10), (0.15±0.12), (0.17±0.11)℃, there were statistically significant differences between the two groups (Z=2.524-3.458, P < 0.05). When the rate of substitution fluid was <1 000ml/h, the incidence of hypothermia in the control group was 3/10, the incidence of hypothermia in the experimental group was 4/6, there was no statistically significant difference in body temperature between the two groups (P > 0.05). While the substitution fluid rate in 1 000-3 000 ml/h, the incidence of hypothermia in the control group was 50.00% (12/24), the incidence of hypothermia in the experimental group was 19.05% (4/21), the incidence of hypothermia in the experimental group was significantly lower than that in the control group (χ2=4.683, P< 0.05), When the rate of substitution fluid was > 3000ml/h, the incidence of hypothermia in the control group was 93.33%(14/15), and that in the experimental group was 50.00%(11/22). The difference in the incidence of hypothermia between the two groups was statistically significant (P < 0.05).There was no significant difference between the two groups in hemolysis related laboratory indicators before and after CRRT treatment (P > 0.05).@*Conclusions@#Preheating of substitution fluid can safely and effectively reduce the incidence of hypothermia in CRRT patients, and when the rate of substitution fluid was > 1 000ml/h, the effect of preventing hypothermia is more significant.
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Objective To study the clinical efficacy of treatment of atrophic scars of facial hemangioma after isotopes radiotherapy with micro-plasma.Methods A total of 52 patients with atrophic scars were selected under micro-plasma treatment for 4 times,one time every six weeks.And their efficacies were evaluated by compared with single standard of that before and after the treatment.Results By means of rate of clinical index,the total effective rate of atrophic scars was 82.7％.The degree of improvement was as follows:cured in 53.8％,marked effective in 28.9％,effective in 17.3％ and no case ineffective.The total effective rate of hyperpigmentation was 90.3％,including cured in 59.6％,marked effective in 30.8％,effective in 9.6％ and no ineffective cases.Conclusions Micro-plasma is an effective therapy for atrophic scars of facial hemangioma after isotopes radiotherapy,which can significantly improve the depression degree of scars,eliminate the hyperpigmentation and improve the color of scars,but it only has adverse reactions of wound pain and postoperative wound erythema.
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Objective To describe and analyze the misdiagnosis and mistreatment status of pulmonary alveolar proteinosis (PAP), especially cases with combination of severe infection. Method The misdiagnosis and mistreatment of 84 PAP patients and 6 cases with combination of severe infection before admitting to PUMCH was analyzed retrospectively. Results 66.7%(56/84) had experienced misdiagnosis before admission. 32.1% (27/84) were misdiagnosed with idiopathic interstitial pneumonia (IIP) and 14.3% (12/84) with pulmonary tuberculosis. 88.1%(74/84) had received anti-infection treatment, 33.3%(28/84) received eortieosteroids, and 19.0%(16/84) received anti-tuberculosis treatment. The percentage of the pa-tients who had taken the bronchoscopic examination outside the PUMCH was 53.6%(45/84). The PAP pa-tients diagnosis was established through bronchoscopic examination (including BAL and TBLB) in 86.9% (73/84) patients. There were 6 patients who had severe infection when PAP established. All of these 6 cases had been misdiagnosed with IIP and received corticosteroids treatment, 2 of whom died. Conclusions The misdiagnosis and mistreatment happens commonly in PAP patients. The misuse of corticosteroids makes some PAP cases get the severe infection. The image feature and the examination of bronchoscopy, BAL and TBLB are the key point in avoiding misdiagnosis. The administration of corticosteroids in uncertain patients should be avoided.
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To present a case of systemic lupus erythematosus patient complicated by diffuse alveolar hemorrhage and severe immune deficiency. To improve the knowledgement of physicians about severe cases of SLE.
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Objective To evaluate the appearance of CT in patients with severe acute respiratory syndrome (SARS) in the recovery phase, and to study the correlation of CT findings with pulmonary function.Methods From June to August in 2003, 100 patient with confirmed SARS accepted examination in our hospital. Among them, 91 patients (39 men, 52 women, mean age 36.4 years, age range 19- 66 years) received CT examination and pulmonary function test on the same day. The interval between SARS onset and the examination ranged from 52 to 125 days (mean 87.4 days). CT appearances of pulmonary parenchymal abnormalities including distribution and extent of involvement were quantitatively analyzed, and four levels on CT scan including the aortic arch, the tracheal carina, the pulmonary venous confluence, and the dome of right diaphragm were selected to score the lesions. The correlation of CT scores with the results of pulmonary function tests was studied.Results Of the 91 cases, 47 patients had normal CT appearance in the recovery phase, whereas the other 44 patients still had parenchymal abnormalities, including residual ground-glass opacification and reticular shadow. CT visual score had correlation with DLco% ( r =-0.618, P