目的:分析老年胃食管反流病(gastroesoph-ageal reflux disease,GERD)患者临床症状,并观察疗效.方法:随机选取2006-01/2008-01我院消化内科门诊符合GERD诊断的患者2000例,将患者分为2组,老年组1000例(≥60岁)和非老年组1000例(<60岁)...目的:分析老年胃食管反流病(gastroesoph-ageal reflux disease,GERD)患者临床症状,并观察疗效.方法:随机选取2006-01/2008-01我院消化内科门诊符合GERD诊断的患者2000例,将患者分为2组,老年组1000例(≥60岁)和非老年组1000例(<60岁).比较2组患者各种症状的发生率以及综合治疗前后RDQ量表评分变化.结果:GERD患者老年组食道外症状的发生率明显高于非老年组(P<0.01),综合治疗后与治疗前比较RDQ量表评分均数明显下降(老年组:8.52±4.32 vs 16.67±4.56,P<0.01;非老年组:7.23±5.56 vs 17.56±6.65,P<0.01),2组综合治疗均有明显疗效.结论:老年GERD患者应注意鉴别诊断及多系统综合治疗,才能达到全面康复的疗效.展开更多
Background:Hard-to-heal wounds are often compromised by the presence of biofilm.This presents an infection risk,yet traditional antimicrobial wound care products and systemic antibiotics are often used despite the unc...Background:Hard-to-heal wounds are often compromised by the presence of biofilm.This presents an infection risk,yet traditional antimicrobial wound care products and systemic antibiotics are often used despite the uncertainty of therapeutic success and wound progression.The aim of this study was to investigate the clinical impact of a next-generation anti-biofilm Hydrofiber wound dressing(AQUACEL Ag+Extra[AQAg+E])in hard-to-heal wounds that had previously been treated unsuccessfully with traditional silver-,iodine-or polyhexamethylene biguanide(PHMB)-containing dressings and products and/or systemic antibiotics.Methods:Clinical case study evaluations of the anti-biofilm dressing were conducted,where deteriorating or stagnant wounds were selected by clinicians and primary dressings were replaced by the anti-biofilm dressing for up to 4 weeks,or as deemed clinically appropriate,with monitoring via case report forms.The data was stratified for cases where traditional silver-,iodine-or PHMBcontaining products,or systemic antibiotics,had been used prior to the introduction of the antibiofilm dressing.Results:Sixty-five cases were identified for inclusion,wounds ranging in duration from 1 week to 20 years(median:12 months).In 47(72%)cases the wounds were stagnant,while 15(23%)were deteriorating;3 wounds were not recorded.After an average of 4.2 weeks of management with the anti-biofilm dressing(range:1–11 weeks),in 11(17%)cases the wounds had healed(i.e.complete wound closure),40(62%)wounds improved,9(14%)wounds remained the same and 5(8%)wounds deteriorated.Conclusions:The introduction of this anti-biofilm dressing into protocols of care that had previously involved wound management with traditional antimicrobial products and/or antibiotics was shown to facilitate improvements in the healing status of most of these hard-to-heal wounds.Dressings containing proven anti-biofilm technology,in combination with antimicrobial silver and exudate management technology,appear to be an effective alternative to traditional antimicrobial products and antibiotics in the cases presented here.The use of antimicrobial wound dressings that contain anti-biofilm technology may have a key role to play in more effective wound management and antibiotic stewardship.展开更多
文摘目的:分析老年胃食管反流病(gastroesoph-ageal reflux disease,GERD)患者临床症状,并观察疗效.方法:随机选取2006-01/2008-01我院消化内科门诊符合GERD诊断的患者2000例,将患者分为2组,老年组1000例(≥60岁)和非老年组1000例(<60岁).比较2组患者各种症状的发生率以及综合治疗前后RDQ量表评分变化.结果:GERD患者老年组食道外症状的发生率明显高于非老年组(P<0.01),综合治疗后与治疗前比较RDQ量表评分均数明显下降(老年组:8.52±4.32 vs 16.67±4.56,P<0.01;非老年组:7.23±5.56 vs 17.56±6.65,P<0.01),2组综合治疗均有明显疗效.结论:老年GERD患者应注意鉴别诊断及多系统综合治疗,才能达到全面康复的疗效.
文摘Background:Hard-to-heal wounds are often compromised by the presence of biofilm.This presents an infection risk,yet traditional antimicrobial wound care products and systemic antibiotics are often used despite the uncertainty of therapeutic success and wound progression.The aim of this study was to investigate the clinical impact of a next-generation anti-biofilm Hydrofiber wound dressing(AQUACEL Ag+Extra[AQAg+E])in hard-to-heal wounds that had previously been treated unsuccessfully with traditional silver-,iodine-or polyhexamethylene biguanide(PHMB)-containing dressings and products and/or systemic antibiotics.Methods:Clinical case study evaluations of the anti-biofilm dressing were conducted,where deteriorating or stagnant wounds were selected by clinicians and primary dressings were replaced by the anti-biofilm dressing for up to 4 weeks,or as deemed clinically appropriate,with monitoring via case report forms.The data was stratified for cases where traditional silver-,iodine-or PHMBcontaining products,or systemic antibiotics,had been used prior to the introduction of the antibiofilm dressing.Results:Sixty-five cases were identified for inclusion,wounds ranging in duration from 1 week to 20 years(median:12 months).In 47(72%)cases the wounds were stagnant,while 15(23%)were deteriorating;3 wounds were not recorded.After an average of 4.2 weeks of management with the anti-biofilm dressing(range:1–11 weeks),in 11(17%)cases the wounds had healed(i.e.complete wound closure),40(62%)wounds improved,9(14%)wounds remained the same and 5(8%)wounds deteriorated.Conclusions:The introduction of this anti-biofilm dressing into protocols of care that had previously involved wound management with traditional antimicrobial products and/or antibiotics was shown to facilitate improvements in the healing status of most of these hard-to-heal wounds.Dressings containing proven anti-biofilm technology,in combination with antimicrobial silver and exudate management technology,appear to be an effective alternative to traditional antimicrobial products and antibiotics in the cases presented here.The use of antimicrobial wound dressings that contain anti-biofilm technology may have a key role to play in more effective wound management and antibiotic stewardship.