探讨无痛消化内镜热极治疗胃肠息肉的临床效果

目的分析无痛消化内镜热极治疗胃肠息肉的临床效果。方法选取我院收治的胃肠息肉患者90例为研究对象,随机分为两组,各45例。对照组采取消化内镜下高频电刀治疗,观察组采取无痛消化内镜热极治疗,比较分析两组临床疗效与患者满意度。结果观察组总有效率为97.78%,高于对照组的82.22%(P<0.05);观察组总满意率为100.00%,高于对照组的86.67%(P<0.05)。结论无痛消化内镜热极治疗胃肠息肉,临床效果好,能有效提高患者满意度,有临床推广价值。

内镜下无痛热极治疗胃肠息肉的临床研究

目的研究热极治疗胃肠息肉术中、术后消除患者腹痛的措施；观察内镜下热极治疗胃肠息肉的临床效果。方法常规术前准备，行胃镜或结肠镜检查，息肉清除前3min内，实验组（64例）通过内镜活检孔喷洒2％利多卡因5ml局麻息肉组织，对照组（62例）喷洒0．9％生理盐水5ml至息肉组织。热极探头通过内镜活检孔，对准息肉组织通电，治疗温度根据息肉大小调至200℃-250℃，直接对病灶“顶、贴、压、滑、扫”，并借助内镜同步进退和转动热极探头等措施，将息肉清除。结果126例患者（167枚）直径≤2cm的息肉一次清除率达到100％，且无出血、穿孔并发症。实验组（64例）有1例腹痛，无痛率98．44％，对照组（62例）有9例腹痛，无痛率85．48％，P〈0．05。结论喷洒2％利多卡因局麻息肉组织后治疗，达到了无痛治疗目的，内镜下热极治疗胃肠息肉效果肯定。该方法安全可靠，疗效好，无不良反应，操作简便，值得推广。

就两个“归去来”的解释问题再答叶晨晖同志

(一)叶晨晖同志最初一次说:“《归去来辞》中所表现的是归隐的乐趣和欣喜。该文的序中说‘因事顺心’,是思想斗争获得胜利才写这篇辞的。” (《广西师范学院学报》哲学社会科学版一九八一年第三期第八十页) 请看陶渊明《归去来辞》中说“倚南窗以寄傲”。它的意思是指做官的人向南坐,我回家了,也仍然倚南窗以寄托我的傲慢,看不起他们那些趋炎附势的人。陶渊明这种话是“快乐”的,“欣喜”的呢,还是“痛恨”的呢?我认为这是陶渊明极痛恨的话。

Therapeutic observation on herbal cake-partitioned moxibustion for dysmenorrhea due to deficiency cold

Objective:To observe the clinical efficacy of herbal cake-partitioned moxibustion for dysmenorrhea due to deficiency cold.Methods:A total of 70 patients with dysmenorrhea who met the inclusion criteria were randomized into a mild moxibustion group and a herbal cake-partitioned moxibustion group by the random number table,with 35 cases in each group.Shenque(CV 8),Zhongji(CV 3)and bilateral Zigong(EX-CA 1)were selected for both groups.The treatment continued for 3 menstrual cycles.The visual analog scale(VAS)and COX menstrual symptom scale(CMSS)were scored in both groups before treatment,after treatment and at the end of the 3rd menstrual cycle after treatment.The clinical efficacy was evaluated at the end of the 3rd menstrual cycle after treatment.Results:After treatment,the clinical efficacy of the herbal cake-partitioned moxibustion group had the tendency to be superior to that of the mild moxibustion group,while there was no statistically significant difference in the overall efficacy between the two groups(P>0.05).The VAS and CMSS scores after treatment and at the follow-up were significantly lower than those before treatment in both groups(all P<0.05).At the follow-up,the VAS scores in both groups had no significant intra-group differences from those after treatment(both P>0.05).The CMSS scores in both groups were significantly lower than those after treatment(both P<0.05).The VAS scores at the follow-up of both groups had no statistical differences from those after treatment(both P>0.05).After treatment,the CMSS score in the herbal cake-partitioned moxibustion group was significantly lower than that in the mild moxibustion group(P<0.05).At the follow-up,there were no statistical differences in the CMSS score between the two groups(P>0.05).Conclusion:The herbal cake-partitioned moxibustion has the same therapeutic efficacy for dysmenorrhea as the mild moxibustion;the two moxibustion methods can significantly improve the concomitant symptoms of dysmenorrhea,and the herbal cake-partitioned moxibustion is little better.