呼吸管道更换时间与呼吸机相关性肺炎发生的相关性分析

目的:通过对发生呼吸机相关性肺炎与呼吸管道更换时间之间的相关新分析,寻求最佳呼吸机管道更换时间,为机械通气患者寻求最佳的护理方法。方法:从我院2014年1月至2016年9月收治的患者中,选取机械通气患者40例,将其随机生成对照组和观察组,每组各20例,对对照组每7d更换一次呼吸机管道,对每2d更换一次呼吸机管道,每周对患者进行1次床边胸叶、2次痰液培养,两周后比较两组患者呼吸机相关性肺炎的发生几率。结果:经过研究表明,两组患者呼吸机相关性肺炎发生几率无显著差异(P>0.05)。结论:综合考虑患者的生理和心理以及护理成本,相较于每2d更换一次呼吸机管道而言,每7d更换一次呼吸机管道更为合适,值得临床推广。

呼吸机管道更换时间对COPD患者呼吸机相关性肺炎的影响的课题管理

本课题通过研究呼吸机管道更换时间对COPD患者呼吸机相关性肺炎的影响，探讨呼吸机管道定植菌定植规律，为减少VAP的发生提供依据。本课题实行课题组内和课题组外监督，同时每周进行讨论，保证课题按计划高质量地完成。科研课题获得我院2010年度科技进步优秀奖，并培养了1名硕士研究生，核心期刊发表论文3篇。通过本研究得出结论：COPD患者呼吸机管道更换时间以4d为宜。

呼吸机管道更换时间对 COPD 患者呼吸机相关性肺炎的影响

目的：探讨呼吸机管道更换时间与COPD患者呼吸机相关性肺炎（ VAP ）的相关性，总结呼吸机管道更换维护方法，抑制肺炎并发。方法选取2011年4月至2013年2月我院呼吸内科收治的COPD住院患者共90例，随机分为对照组1、对照组2、实验组各30例，管道更换频率分别为1 d／次、2 d／次、4 d／次，统计并发VAP例次与时间、死亡例次和病原菌检验结果。结果对照组1并发VAP 1次、2次、3次率与死亡率分别为63．33％、30．00％、6．67％和16．67％，对照组2为60．00％、33．33％和13．33％、13．33％，实验组为60．00％和13．33％、0．00％、13．33％，实验组与对照组1和对照组2并发1次VAP、死亡率差异不显著（P＞0．05），但多次并发VAP例数少于对照组1、对照组2，差异显著（P ＜0．05）；G－杆菌是VAP感染主要菌种，G＋球菌其次，不同例次VAP病原菌菌种差异不显著（ P＞0．05）；对照组1并发第1次VAP时间短于对照组2、实验组，实验组并发第2次VAP时间长于对照组1、对照组2，对照组2并发第3次VAP时间长于对照组1，差异显著（ P＜0．05）。结论呼吸机管道更换越频繁，并发多次VAP的概率越高，但并不影响并发1次VAP概率与死亡率，对照组1并发VAP的时间相对更短，因此出于抑制多次并发考虑，可适当延长初次更换时间，并发VAP后可延长气道更换时间。

Expressions and clinical significance of CD147 and CK19 in hepatocellular carcinoma

Objective: The aim of this study was to investigate the expressions of CD147 and CK19 in hepatocellular car- cinoma (HCC) and their clinical significance. Methods: The expressions of CD147 and CK19 were determined by tissue microarray and immunohistochemistry (IHC) in 272 cases of HCC and 81 cases of adjacent tumorous tissue. Results: The positive expression of CD147 in HCC and adjacent tumorous tissue was 73.53% (200/272) and 13.58% (11/81) with signifi- cant difference (P < 0.05). The positive expression of CK19 in HCC and adjacent tumorous tissue was 14.34% (39/272) and 0 (0/81) with significant difference (P < 0.05). The positive expression of CD147 were closely correlated to the histological grade, clinical stage, tumor-free survival, diameter of tumor and embolus of cancer in aqueduct or portal vein; but not to the patients' sex, age, liver cirrhosis, AFP level, infection of HBV, lymph node metastasis, number of tumor, invasion liver involucrum and the micro-satellites (P > 0.05). The expression of CK19 in HCC were closely correlate to the tumor-free survival, histological grade, diameter of tumor, liver cirrhosis, micro-satellites, lymph node metastasis and clinical stage; but not to patients' sex, age, number of tumor, invasion liver involucrum, AFP level, infection of HBV and embolus of cancer in aqueduct or portal vein (P > 0.05). Among the patients of positive expression of CD147, the median replacing time and overall survival were 13 and 24 months, lower than 48 and 60 months in the patients of negative expression (P < 0.05). Among the patients of positive expression of CK19, the median replacing time and overall survival were 7 and 13 months, lower than 31 and 42 months in the patients of negative expression (P < 0.05). The expression of CD147 had no correlation with the expression of CK19 (r = 0.061, P = 0.317). Conclusion: The positive of CD147 and CK19 closely correlate with the clinical prognosis of HCC, it may indicate poor prognosis of HCC.