【摘要】 目的 探討在重癥監護病房（intonsive cane tmit，ICU）行選擇性消化道脫污染（selective digestive decontamination，SDD）的臨床實用價值。 方法 選取2007年1月—2010年1月危重癥患者376例，隨機分為兩組，對照組予常規口腔護理治療，治療組予選擇性消化道脫污染治療，比較兩組患者病情療效的參數。 結果 治療組院內獲得性肺炎發生率為18.4%、院內獲得性肺炎發生時間（7.2±3.2）d、人工氣道（氣管插管/切開）保留天數（10.5±3.8）d、機械通氣天數（8.4±3.1）d、入住ICU天數（14.7±4.8）d、病死率11.6%；對照組院內獲得性肺炎發生率為30.1%、院內獲得性肺炎發生時間（5.6±3.6）d、人工氣道（氣管插管/切開）保留天數（12.5±4.6）d、機械通氣天數（10.2±4.2）d、入住ICU天數（17.2±6.2）d、病死率19.4%；兩組比較差異均有統計學意義（Plt;0.05）。 結論 在ICU內行選擇性消化道脫污染可有效控制院內獲得性肺炎，改善患者病情，減少住院天數，降低病死率。【Abstract】 Objective To discuss the clinical value of selective digestive decontamination in the intensive care unit (ICU). Methods From January 2007 to January 2010, 376 critically ill patients were randomly divided into two groups. Patients in the control group received conventional oral cavity nursing treatment, and those in the treatment group underwent the selective digestive decontamination. Then, we compared the curative effect parameters of these two kinds of procedures for the two groups of patients. Results For patients in the treatment group, the rate of hospital-acquired pneumonia (HAP) was 18.4%, the occurring time of HAP was (7.2±3.2) days, the time of retaining artificial gas channel (trachea cannula / incision) was (10.5±3.8) days, the time of mechanical ventilation was (8.4±3.1) days, ICU stay time was (14.7±4.8) days, and the mortality rate was 11.6%. For the control group, the correspondent parameters were respectively 30.1%, (5.6±3.6) days, (12.5±4.6) days, (10.2±4.2) days, (17.2±6.2) days, and 19.4%. The differences of these parameters between the two groups were significant (Plt;0.05). Conclusion For patients in the ICU, the selective digestive decontamination can effectively control the occurrence of HAP, improve patient conditions, reduce hospitalization time, and decrease mortality rate.
【摘要】 目的 探討甘油三酯（triglyceride，TG）和總膽固醇（total cholesterol，TC）試劑對血清總膽汁酸（total bile acid，TBA）檢測結果的影響及解決辦法。 方法 2008年1月-2009年10月采用魅力2000全自動生化分析儀，首先單獨檢測20份血清標本的TBA 含量。然后分別檢測TC和TG后進行TBA含量檢測。最后設定特殊檢測程序和清洗程序后再按TC→TBA，TG→TBA順序進行TBA含量檢測。 結果 單獨檢測20份血清標本的TBA結果均值為7.2 μmol/L;按TC→TBA，TG→TBA順序檢測結果均值分別為13.5 μmol/L和14.3 μmol/L，單獨和組合測量方法測定TBA結果有統計學意義（Plt;0.05）。設定特殊檢測程序和清洗程序后按TC→TBA，TG→TBA順序檢測結果均值分別為7.4 μmol/L和7.5 μmol/L，與單獨測量TBA結果相比，無統計學意義。 結論 TG和TC試劑對TBA檢測產生干擾的原因是試劑成分中含有濃度較高的TBA，在魅力2000全自動生化分析儀上，設定特殊檢測程序和清洗程序，能有效消除TG、TC試劑對TBA檢測的影響。【Abstract】 Objective To explore the influence and procedure improvement strategies of triglyceride (TG) and cholesterol reagent on the result of serum total bile acid (TBA) test. Methods The study was carried out between January 2008 to October 2009. The charming 2000 automatic biochemical analyzer was used. First, TBA content of 20 serum samples was independently tested. Then TBA was detected after the detection of TG and total cholesterol (TC) concentration. Finally, TBA test was conducted with special testing procedures and cleaning procedures of TC→TBA and TG→TBA method. Results The average concentrate of TBA of 20 serum samples was 7.2 μmol/L, while the average concentrates of TBA tested by TC→TBA and TG→TBA methods were 13.5 μmol/L and 14.3 μmol/L, respectively. With special testing procedures and cleaning procedures of TC→TBA and TG→TBA tests, the average concentrates of TBA were 7.4 μmol/L and 7.5 μmol/L, respectively. Conclusion High concentration of TBA in triglyceride and cholesterol reagents contributes substantially to the interference in serum total bile acids detection. With the charming 2000 automatic biochemical analyzer, special testing procedures and cleaning procedures are able to effectively eliminate the interference of triglycerides and cholesterol reagents from TBA detection.
