布鲁杆菌病性脊椎炎健康教育护理路径对临床疗效的影响

目的探讨布鲁杆菌病性脊椎炎健康教育护理路径对临床疗效的影响。方法行手术治疗布鲁杆菌病性脊椎炎患者39例,随机分为2组,常规性护理19例为对照组(A组),预见性护理干预20例为干预组(B组),干预组实施康教育护理路径,包括超前镇痛护理计划、用药依从性护理教育及日常活动能力护理教育,术后1、3、6个月随访且临床评价。结果随着时间推移,同一时间点B组VAS评分、用药依从性及Oswestry功能障碍指数与A组相比差异有统计学意义(P0.05);临床疗效评价显示,特别在早期B组优良率明显高于A组,且同一时间点B组与A组比较差异有统计学意义(P0.05)。结论实施布鲁杆菌病性脊椎炎健康教育护理路径可以显著提高临床疗效。     

RADIOGRAPHIC AND COMPUTED TOMOGRAPHIC CHANGES AND CLINICAL PRESENTATION OF SPIROCERCOSIS IN THE DOG

A retrospective study of 39 dogs with spirocercosis is described, emphasizing radiographic and computed tomographic aspects and clinical presentation. Dogs were classified as complicated or uncomplicated, both clinically and radiographically. Besides the expected upper gastrointestinal signs, a high incidence of respiratory (77%) and locomotor (23%) complications were present. All dogs had thoracic radiographs. Esophageal masses were radiographically classified as typical or atypical according to their location. Twenty-seven dogs had a typical caudal esophageal mass. Six dogs had a mass atypically located in the hilar region. These masses were smaller and more difficult to visualize radiographically. The remaining 6 dogs did not have a radiographically detectable esophageal mass. Radiology as an initial diagnostic tool was effective in detecting and localizing the mass and to detect early respiratory abnormalities such as pleuritis, mediastinitis, pneumonia, and bronchial displacement. Endoscopy was the modality of choice to confirm antemortem esophageal masses. In dogs where the mass filled the whole esophageal lumen, endoscopy failed to give essential information necessary for surgical excision of neoplastic masses, such as the extent of esophageal wall attachment. Caudal esophageal sphincter involvement was difficult to determine endoscopically with large caudal esophageal masses. Computed tomography was performed on 3 dogs and did not address the latter problems completely, but was found to be a sensitive tool to detect focal aortic mineralization and early spondylitis, both typical for the disease, and essential in the diagnosis of non- or extramural esophageal abnormalities.     

南蛇藤合剂治疗强直性脊柱炎的时效性研究

目的 对比研究南蛇藤合剂与柳氮磺吡啶治疗强直性脊柱炎（ankylosing spondylitis,AS）的时效性。方法 80例AS患者按1：1比例随机分为南蛇藤合剂（NST）组和柳氮磺吡啶（sulfasalazine,SASP）组,分别服用南蛇藤合剂和SASP,疗程12周,分别在治疗前和治疗后1 w、2 w、4 w、8 w、12 w记录患者症状、体征、AS活动指数（BASDAI）、Bath 强直性脊柱炎功能指数（BASFI）、红细胞沉降率（ESR）、C反应蛋白（CRP）等。结果 NST组总有效率89.74%较SASP组总有效率81.08%高（P<0.05）。两组在12 w末均能明显控制患者腰痛晨僵时间、扩胸度、指地距离、Schober试验、BASDAI、BASFI、中医证侯评分、ESR、CRP,但南蛇藤组在第1 w末即能改善上述除BASDAI、BASFI外的所有指标,与治疗前相比差异有统计学意义（P<0.05）,在第2 w末能明显改善上述所有指标,与治疗前比差异有统计学意义（P<0.01）。两组在治疗后1 w、2 w、4 w、8 w、12 w组间相比,NST组明显优于SASP组（P<0.05）。结论 南蛇藤合剂起效快,作用持久,疗效优于柳氮磺吡啶。     

强直性脊柱炎患者中IL-23 R基因rs7517847多态性分析

目的：研究IL-23R基因rs7517847位点的单核苷酸多态性与强直性脊柱炎易感性的关系.方法采用PCR-RFLP方法对100例强直性脊柱炎患者进行IL-23R基因多态性检测,并与35例健康者对照分析.结果 rs7517847位点各基因型频率和等位基因频率在AS组与对照组之间的分布差异均具有统计学意义（P〈0.05）;并在假设遗传方式下,rs7517847位点的纯合突变GG基因型与（ TG＋TT）基因型比较,其频率分布差异在AS组与对照组之间也具有统计学意义（P〈0.05）.结论 IL-23R基因rs7517847位点的多态性与吉林地区人群AS易感性有关;携带G等位基因且为GG基因型的个体患AS的危险性增大,这可能是患AS的易感因素之一.     

锝[^99Tc]亚甲基二磷酸盐治疗强直性脊柱炎的疗效观察

目的:观察锝[99Tc]亚甲基二磷酸盐(99Tc-MDP)注射液治疗强直性脊柱炎(ankylosing spondylitis,AS)的疗效。方法:AS患者64例,分为2组:锝[99Tc]亚甲基二磷酸盐治疗组(观察组)40例,静脉注射99Tc-MDPAB剂2~4个疗程;对照组24例,应用非甾体抗炎药和甲氨喋呤治疗。观察治疗前后临床症状和实验室指标及副作用。结果:治疗2个疗程后,观察组患者临床症状和实验室指标均有明显改善,尤其是改善晨僵和关节活动度方面疗效明显,且无明显副作用,总有效率为85%,高于对照组(P<0.01),取得效果的时间明显缩短。结论:用99Tc-MDP治疗强直性脊柱炎疗效显著,起效快,无明显副作用,使用安全。