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Introducción: Como consecuencia del desarrollo del tratamiento médico de la úlcera péptica duodenal, el tratamiento quirúrgico ha disminuido notablemente. Objetivo: El objetivo del estudio es describir la progresión del tratamiento de la úlcera péptica duodenal. Material y Métodos: Estudio descriptivo, de corte, desde finales del siglo XIX hasta la actualidad. Se utilizó el método histórico-lógico y un análisis deductivo-inductivo de múltiples fuentes bibliográficas. Desarrollo: A pesar de ser la úlcera una entidad clínica reconocida desde la antigüedad, los cirujanos la consideraron causada por el ácido, y todos los esfuerzos fueron concentrados en eliminar el ácido por medio de una operación. A partir de 1881, se comenzaron a conocer las complicaciones. En la década de los años 30 del pasado siglo, se tratan las complicaciones y también la enfermedad. Desde 1940, además, se conserva el funcionamiento digestivo y aparecen las tres formas básicas de vagotomía. En la década de 1970, se desarrollaron novedosas técnicas quirúrgicas, la endoscopía, la radiología intervencionista y la cirugía mínimamente invasiva. Sin embargo, el tratamiento médico llegó con los poderosos supresores del ácido y el descubrimiento del Helicobacter pylori. Nuevamente la cirugía ha quedado relegada a tratar las úlceras refractarias y las complicadas. Conclusiones: El tratamiento médico, por medio de la terapia anti-Helicobacter asociada a potentes inhibidores de la secreción gástrica ha conseguido su curación; sin embargo, la cirugía todavía tiene un importante papel en el tratamiento de la úlcera refractaria o complicada(AU)
Introduction: Surgical treatment of duodenal peptic ulcer has notably decreased as a consequence of the development of medical treatment. Objective: The objective of this study is to describe the advances in the treatment of duodenal peptic ulcer. Material and Methods: A descriptive study was conducted from the end of the 19th century to the present. The historical-logical method and a deductive-inductive analysis of multiple bibliographic sources were used. Development: Despite ulcer has been recognized as a clinical entity since ancient times, surgeons considered that it is caused by acid; therefore, all efforts were concentrated on removing the acid through an operation. From 1881 on, complications began to be treated. In the decade of the 30s of the last century, complications and the disease were treated. Since 1940, the digestive function has also been preserved and the three basic forms of vagotomy appeared. In the 1970s, novel surgical techniques such as endoscopy, interventional radiology, and minimally invasive surgery were developed. However, powerful acid suppressants as well as the discovery of Helicobacter pylori were taken into consideration for medical treatment. Once again, surgery was relegated to the treatment of refractory ulcers and complicated ulcers. Conclusions: Medical treatment with anti-Helicobacter therapy associated with potent inhibitors of gastric acid secretion has managed its healing; however, surgery still plays an important role in the treatment of refractory or complicated ulcer(AU)
Subject(s)
Humans , Peptic Ulcer/therapy , Minimally Invasive Surgical Procedures , Gastric AcidABSTRACT
Objective To discuss the influence of preoperative family purge care for the quality of life of patients with long type of congenital Hirschsprung′s disease (HD) who had enterocolitis history in neonatal period. Preoperative family purge care, which can shorten the HD postoperative treatment, improve the quality of life. Methods A total of 40 cases of patients with long type of congenital HD who had enterocolitis history in neonatal period received 1-stage radical preoperative by family phone call. Nineteen cases from January 2010 to February 2013 were as normal group and 21 cases from March 2013 to April 2016 were as improved group. Routine family purge nursing care 3-6 months were used in both the groups, while the combined nursing care of expanding anus were used in the improved group in addition. Evaluated the effects of postoperative observation indicates: the first defecation time, length of hospital stay, time needed for expanding anus, patency rate of defecation and not patency rate in 9-12 days, need enema intervention to assist defecate rate after postoperative 1 year, the recurrence of enterocolitis at 1-3 years after operation. Results The first defecation time, length of hospital stay, time needed for expanding anus were (39.15±8.23) h, (7.89±0.82)d, (5.17±0.98) min in normal group, (23.79± 7.54) h, (7.10± 0.29) d, (3.15±0.73) min in improved group, and there were significant differences between two groups (t=6.13, 5.46, 15.54, all P0.05). Conclusions Patient with long type of congenital HD who had enterocolitis history in neonatal period neonatal period,received family enema and expanding anus in 3- 6 months before 1-stage radical preoperative can shorten the postoperative HD treatment, improve the quality of life.
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<p><b>OBJECTIVE</b>To in vivo dynamically observe the time-effect characteristic of local stimulating effect on acupoints after micro-invasion embedding, which could provide references for the interval period of micro-invasion embedding.</p><p><b>METHODS</b>With magnetic resonance imaging (MRI) technique, the local T2WI fat-suppression images and T2 Mapping 8-echo sequence images were collected at multiple time points from 8 healthy subjects who received embedding at left Sanyinjiao (SP 6).After the 8-echo sequence images were transformed into T2 Mapping images by using software FuncTool, the T2 average value of embedding area was measured, and the changes of local signal strength of T2WI fat-suppression images and T2 average value along with time after embedding at left Sanyinjiao (SP 6)were analyzed.</p><p><b>RESULTS</b>Compared before embedding, the signal strength of local T2WI fat-suppression images and the T2 average value began to increase 8 h after being embedded(<0.01); the signal strength of T2WI fat-suppression images and the T2 average value were significantly increased 3 d and 7 d after being embedded(all<0.01);the signal strength of local T2WI fat-suppression images and the T2 average value 14 d after being embedded were lower than those at previous 2 time points, but higher than those before embedding(both<0.01); 21 d, 28 d and 35 d after embedding, the signal strength of local T2WI fat-suppression images and the T2 average value were similar to those before treatment (all>0.05).</p><p><b>CONCLUSIONS</b>After micro-invasion embedding at Sanyinjiao (SP 6), the stimulation effect period on acupoint is approximately 21 days.When applying micro-invasion embedding under similar condition at acupoints which has similar structure as Sanyinjiao (SP 6), the interval period of embedding could consider 21 days as a reference.</p>
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Objective To reduce unreasonable use of antibiotics in acute suppurative tonsillitis cases. Methods Retrospective analyses of 1107 acute suppurative tonsillitis cases from the pediatric outpatient department were conducted.According to course of antibiotic treatment, these cases were divided into the group of full course of treatment and the group of insufficient course of treatment.According to the types of antibiotic, the subjects were di-vided into azithromycin group and non-azithromycin group.Three months after the onset of illness, the occurrence of complications and illness relapse between full course of treatment group and insufficient course group, azithromycin group and non-azithromycin group were analyzed.Meanwhile, the cases were divided into Chinese mainland group, Macao and Taiwan group, and foreign group according to their native places and nationalities.We compared the num-ber of cases used insufficient course in these three groups and analyzed their reasons.Results The relapse rate was significantly lower in the full course treatment group compared with insufficient course treatment group ( P<0.05 ) , and significantly higher in non-azithromycin group compared with azithromycin group ( P<0.05 ) .The occurrence rate of insufficient course treatment in the Chinese mainland group was obviously higher than the Macao group, Tai-wan group and foreign group (P<0.05).The main reasons for insufficient course of treatment were the insufficient patients′obedience and some doctors′poor understanding of the disease course.Conclusion A full course treatment with antibiotics on acute suppurative tonsillitis are strongly suggested.It may be of great significant to strengthen the awareness of reasonable use of antibiotics among the inland citizens.
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ObjectiveTo investigate the clinical efficacy of continual needle knife treatment for cervical spondylosis and whether it increases adverse reactions and the number of treatments.MethodNinety-two patients with cervical spondylosis were randomly allocated to a treatment group of 47 cases and a control group of 45 cases. The treatment group received continual needle knife therapy once every day and the control group, interrupted needle knifetherapy once 10 days.ResultThere were no statistically significant differences in the number of treatments, the total efficacy rate and postoperative adverse reactions between thetwo groups (P>0.05). There were statistically significant differences inthe treatment period and cure rate between the two groups (P<0.05). The treatment period was significantly shorter in the treatment group than in the control group(P<0.05). The cure rate was significantly higher in the treatment group than in the controlgroup(P<0.05).ConclusionContinual needle knife therapy cannot increase postoperative adverse reactions and the number of treatments. It can significantly shorten the treatment period, avoid another injury and increase the cure rate in the patients.
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Objective To investigate the efficacy and the course of desensitization treatment in bronchial asthma with positive specific IgE to dust mite in children. Methods A total of 105 children with bronchial asthma with positive specific IgE to dermatophagoides farinae allergens were randomized into the observation group and the control group. Children in the control group were treated to continue anti-asthma according to the routine of prevention and treatment children with asthma. Chinldren in the observation group were treated by dermatophagoides farinae drops in addition to the treatment of children in the control group. The recurrence of asthma was compared between two groups at 25 weeks post-treatment. At 25 weeks post-treatment , children in the observation group was randomly divided into the observation groupⅠand group Ⅱ. Children in the observation groupⅠreceived continuous treatment except for desensitization treatment. Children in the observation group II received the sublingual immunotherapy with dermatophagoides farinae drops (No.4) for 1 year in addition to the treatment in the observation groupⅠ. The recurrence of asthma was also compared between the two sub-groups. Results The rate and times of recurrence of asthma were lower in the observation group than those in the control group(P 0.05). Conclusion The recurrent rate and frequency of asthma could be reduced by the sublingual immunotherapy with dermatophagoides farinae drops in children with asthma of positive specific IgE to dust mite. The course of treatment may be half year long.
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Objective In recent years , SIT has gradually become the main way for the treatment of allergic rhinitis .To con-trast the clinical efficacy of specific immune therapy for one year and two years of allergic rhinitis and discuss the appropriate mainte -nance treatment time of subcutaneous immunotherapy with Dermatophagoides pteronyssinus . Methods Ninety-eight patients with al-lergic rhinitis to Dermatophagoides pteronyssinus were allocated to receive either treatment for one year (A group, n=46) or treatment for two years(B group, n=52).Nasal symptoms and medication scores of two groups were assessed to evaluate the clinical efficacy af -ter treatment respectively , and evaluate the quality of life of patients . Results There was no statistical significance in nasal symptom and medication scores between the two groups after one year treatment (7.00 ±1.08 vs 6.63 ±0.79, 1.50 ±0.51 vs 0.41 ±0.42, P>0.05).The quality of life in patients with decreased , but lack of statistical significance (345.00 ±31.89 vs 344.42 ±32.26, P>0.05).It presented statistical significance in nasal symptom and medication scores between the two groups after two years treatment (6.20 ±0.78 vs 4.29 ±0.64, 0.53 ±0.43 vs 0.21 ±0.34, P<0.05).The quality of life between patients also presented statistical significance (P<0.05). Conclusion Compared with A group, B group can significantly alleviate the symptoms of allergic rhinitis , so we think the optimal maintenance treatment time of specific immunotherapy for allergic rhinitis should be at least 2 years.