ObjectiveTo investigate the effect of acoustic earplugs combined with sedative drugs on improving the success rate of MRI examinations in children with epilepsy, and to provide an effective clinical evidence for MRI examination in children with epilepsy for the future.MethodsSeventy-four children with epilepsy who came to the Second Affiliated Hospital of Guangzhou Medical University, between July 2016 and February 2018 were included in this research. To test the effectiveness of acoustic earplugs on children with epilepsy in improving MRI success rates, participants were divided into two groups randomly. The control group only took the drug and withont using the acoustic earplugs. The observation group used both the drug and acoustic earplugs. The comparing the success rate of MRI examination between the two groups.ResultsThe observed group (with the acoustic earplugs) showed a success rate of 97.29% (36/37), the control group (without the acoustic earplugs) showed a success rate of 18.91% (7/37). The success rate of the observed group was higher than the control group (P<0.05) significantly.ConclusionsThe use of acoustic earplugs combined with sedative drugs is effective in improving the success rate of MRI examination in children with epilepsy and can be widely used in clinical practice.
Objective We studied the change of psychological behavior and quality of life in children with epilepsy, to explore the treatment strategy to improve their psychological behavior and quality of life. Methods Collected forty children with epilepsy from Hebei General Hospital during March 2015 to October 2015 and 40 normal children in this study. "Epilepsy patients quality of life scale", "Daily life ability scale" and "Sense of uncertainty in hospitalized patients disease scale" test were performed to the participants. The difference of daily psychological behavior ability, sense of uncertainty in illness and quality of life between the two groups were analyzed. Results The epilepsy children’s daily life ability and the quality of life are lower than normal children (P<0.05), the disease uncertainty is higher than normal children (P<0.05). Conclusion The epilepsy children had serious psychological and behavior disorders and lower life quality. Some medical intervention should be taken to alleviate the psychological burden, improve the ability of daily life, reduce the uncertainty in illness, and comprehensively improve the quality of life of children with epilepsy.
目的:通过对地震伤患儿家属心理状态的分析及心里疏导,探讨地震伤患儿家属心理干预的方法.方法:对我科2008年5月12日后收治的116例地震伤患儿家属的心理状态进行分析,并给与相应的心理干预。结果:116例地震伤患儿及家属心态良好,积极配合救治和护理,无心理障碍引起的过激反应,护理满意度达99%。结论:对患儿家属积极有效地进行心理疏导,不仅可以减轻其心理压力,还可以缩短与患儿及家属间的距离,有助于医护人员对患儿进行诊疗与护理,促使患儿早日康复。
Objective To determine the extent of off-label drug use in Pediatric Wards of West China Second University Hospital in 2010 and analyze its risk factors, so as to provide baseline data for getting acquainted with the extent of off-label drug use in pediatrics in China, and for making policies of off-label drug use. Methods The proportionate stratified random sampling was conducted to select medical advice and discharge medication for hospitalized children in Pediatric Wards in 2010. According to drug instructions, the off-label drug use of prescriptions of all selected children was analyzed in the following aspects, the category of off-label drug use, age, category of drugs and wards. In addition, a logistic regression was done that modeled the odds of receiving an off-label prescription as a function of the following possible risk factors: age, sex and the rank of doctors. Results The total 749 children were selected, and 14 374 prescriptions involving 385 drugs were analyzed. The rate of off-label drug use was 98.00%, 78.96% and 88.05% in children, prescriptions and drug categories, respectively. The main categories of off-label drug use were no pediatric information (29.41%), indication (18.35%), dosage (17.61%) and dosage range (±20%) (13.52%). The top 2 age groups of off-label drug use were adolescents (83.56%) and children (80.58%). The top 4 drugs of off-label use were those for alimentary tract and metabolism (82.28%), anti-infectives for systemic use (75.06%), blood and blood forming organs (79.27%) and respiratory (58.27%). The top 2 wards of off-label drug use were Pediatric Hematology (88.27%) and Neonates (79.12%). In hospital, children, adolescents and male patients had higher risk factors of off-label drug use, and doctors with senior rank prescribed more off-label prescriptions than those with intermediate rank. Conclusion The off-label drug use in Pediatric Wards is common in West China Second University Hospital. On the one hand, drug instructions lack the pediatric information, and, on the other hand, it’s badly in need of developing relevant legislations, regulations or guidelines to regulate off-label drug use, in order to avoid doctor’s professional risks and ensure the safety of pediatric drug use.
Objective To investigated the influence of the CYP2C9 polymorphism on lipid profile and blood concentration in epileptic children with VPA. Methods This study collected the information of healthy children and epilepsy children who were treated with VPA in the First Affiliated Hospital of Putian University during June, 2018 to March, 2021. The serum lipids of 184 cases were collected and compared between epilepsy group before and after treatment with VPA with the control group. The polymorphism of CYP2C9 gene in children with epilepsy was detected, and lipid and VPA concentration were compared after classification. Results There was no significant difference in lipid between the control group and the epilepsy group before treatment (P>0.05); The TC, HDL, LDL, TC/HDL, LDL/HDL were statistically different in VPA treatment group from the control group (P<0.05), and there were statistical differences in TG, LDL, TC/HDL, LDL/HDL between the trial group before the initiation and VPA treatment (P<0.05); There is no correlation between VPA blood concentration and lipid (P>0.05). VPA concentration, TC, HDL, LDL, TC/HDL and LDL/HDL in CYP2C9 wild-type were statistically different from heterozygous mutant. Conculsions CYP2C9 polymorphism and long-term use of VPA caused the changes in serum lipid levels in epilepsy children.
目的 研究七氟醚诱导气管插管减轻短期内行两次手术的脑性瘫痪患儿术前焦虑的效果。 方法 2009年12月－2011年7月选择需要短期内行两次全身麻醉（全麻）手术的痉挛性脑性瘫痪患儿60例，美国麻醉医师协会（ASA）Ⅰ～Ⅱ级。随机分为A组常规麻醉诱导气管插管（30例）和B组七氟醚诱导气管插管（30例）；分别在一期及二期手术术前访视时（M1、M3）、入手术室时（M2、M4）对两组患儿进行改良耶鲁围术期焦虑量表评估；并分别在一期及二期手术麻醉诱导期（N1、N2）对两组患儿进行诱导期合作度量表的标准评定。 结果 同组一期、二期手术比较，A组患儿二期手术术前焦虑更明显（P＜0.05），二期入手术室时焦虑更明显（P＜0.05），二期手术合作度更差（P＜0.05）；B组患儿两次手术术前焦虑无明显变化（P＞0.05），一期入手术室时焦虑明显（P＜0.05），一期手术合作度较差（P＜0.05）。两组之间，一期手术两组患儿焦虑情况无明显区别（P＞0.05），二期手术A组比B组的患儿焦虑更明显（P＜0.05），两次手术B组都比A组的患儿合作度更好（P＜0.05）。 结论 七氟醚麻醉诱导气管插管能够有效减轻短期内需要进行两次手术的痉挛性脑性瘫痪患儿的术前焦虑，提高患儿二期手术的合作度，提供良好的手术麻醉条件，保证患儿的围术期安全。
【摘要】 目的 探讨重组人凝血因子Ⅷ制剂小剂量短程预防性输注能否有效减少中重度血友病A患儿关节出血问题。 方法 对2008年11月-2009年4月期间就诊的13例年龄3~11岁的中重度血友病A患儿，均在为期2个月内接受重组人凝血因子Ⅷ 2次/周、间隔3 d、每次7.5~10.0 U/kg的静脉预防性输注，记录治疗前2个月与治疗2个月时关节出血次数，以及同一关节反复发生出血的情况。 结果 治疗前关节出血的发生次数为（3.77±2.13）次，治疗后关节出血的发生次数为（0.46±0.87）次，治疗前后比较，差异有统计学意义（Plt;0.01）；治疗前靶关节出血的发生率为35.7％，治疗后靶关节出血的发生率为0.0%，治疗前后比较，差异有统计学意义（Plt;0.01）。患儿治疗成本约510~680元/（kg?2个月）。 结论 重组人凝血因子Ⅷ制剂小剂量短疗程预防性输注能有效减少中重度血友病A患儿关节出血次数，同时可有效减少靶关节出血的发生率，从而在一定程度上保护关节的功能。治疗费用相对可接受。【Abstract】 Objective To evaluate the efficacy of low-dose short-course infusion of recombinant human factor Ⅷ concentration in treating joint bleeding in children with severe and moderate hemophilia A. Methods Thirteen children aged 3 to 11 years old with severe or moderate hemophilia A were included in the present study from November 2008 to April 2009. For children in the treatment group, they were treated with low-dose short-course infusion of recombinant human factor Ⅷ concentration with a dose of 7.5-10.0 U/kg twice weekly as secondary prophylaxis for two months. The incidence of joint bleeding 2 months before treatment (control group) and during the 2 months of treatment (treatment group) was observed. Moreover, the incidence of their target joint bleeding was measured in both groups. Results Children in the control group had (3.77±2.13) joint bleedings while children in the treatment group had (0.46±0.87) joint bleedings, which was obviously lower than those in the control group (Plt;0.01). Meanwhile, the incidence of target joint bleeding in the treatment group was 0%, which was obviously lower than that in the control group (35.7%) (Plt;0.01). In the treatment group, the costs of treatment were about RMB 510-680 yuan/kg every 2 months. Conclusions Treatment with low-dose short-course infusion of recombinant human factor Ⅷ concentration can effectively decrease joint bleeding in children with severe and moderate hemophilia A, and can effectively decrease the incidence of target joint bleeding. Therefore, this method may play an important role in protection of the joint function in those patients at an acceptable cost.
【摘要】 目的 总结腹腔镜对小儿美克尔憩室的临床诊断和应用价值。 方法 2005年4月-2009年12月，将41例行美克尔憩室切除术患儿随机分为两孔法腹腔镜手术组和传统手术组，就手术治疗、术后并发症、术后效果等临床资料进行对比分析。 结果 腹腔镜手术组患儿手术时间、术中出血量、下床活动时间、住院时间等均优于传统手术组；术后并发症发生例数均明显少于传统手术组。 结论 腹腔镜对患儿美克尔憩室的诊断和治疗具有明显优越性，可作为小儿美克尔憩室治疗的首选方式。【Abstract】 Objective To investigate the diagnostic and applicative value of laparoscopy for Meckel’s diverticulum in children. Methods The clinical data of 41 children with Meckel’s diverticulum who underwent resection between April 2005 to December 2009 were retrospectively analyzed. The patients were divided into tow-port laparoscopy-assisted resection group (group A,19 patients) and traditional resection group (group B, 22 patients). The intra-operative accidental injury, postoperative complications, postoperative general condition and prognosis were evaluated via randomized contrast analysis. Results The time of operation, amount of bleeding, recover intestinal peristalsis,out-of-bed activities time and the average days in hospital in group A were less than those in group B. The postoperative complications occurred in one and eight patients in group A and B respectively. Conclusion Laparoscopy had obvious superiority for the children’s Meckel’ s diverticulum in diagnosis and treatment,which should be the best choice.