目的 探讨本中心引起儿童泌尿系统感染的常见病原菌的分布以及耐药情况,为临床合理选用抗菌药物提供参考。方法 回顾性分析本医疗中心2012年1月—2013年12月2463例泌尿系统感染患儿中段尿标本培养及药敏检测结果。结果 2463例患儿中段尿标本共培养病原菌479株,阳性率为19.45%。其中革兰阴性杆菌309株(64.51%),革兰阳性球菌138株(28.81%),真菌32株(6.68%,主要为白假丝酵母菌)。分离率前7位的病原菌依次为大肠埃希菌(36.53%)、肺炎克雷伯菌(12.73%)、粪肠球菌(D群)(12.32%)、屎肠球菌(D群)(10.23%)、真菌(6.68%)、铜绿假单胞菌(5.22%)、奇异变形菌(3.13%),革兰氏阴性杆菌以大肠埃希菌和肺炎克雷伯菌为主,其中产超广谱β‐内酰胺酶菌株125株,比例高达71.42%;革兰阳性球菌以肠球菌(D群)为主,金黄色葡萄球菌检出率为2.30%,其中耐甲氧西林株占27.27%。结论 大肠埃希菌仍为儿童泌尿系统感染的主要病原菌,且存在多重耐药菌感染情况,革兰氏阳性球菌有增多的趋势;明确病原菌种类及药敏结果,对临床合理应用抗菌药物治疗儿童泌尿系统感染有重要意义。

Objective To research the distribution of common pathogenic bacteria and drug resistance of urinary tract infection in the hospital for providing reference of antimicrobial drugs for clinical reference. Methods Pathogenic bacteria isolated from the germiculture positive specimens of midstream urine and the antimicrobial susceptibility test results from Jan 2012 to Dec 2013 in our hospital were retrospective summarized. Results 479 strains pathogenic bacteria were isolated from 2463 urine samples totally. The positive rate was 17.3％, with 309 strains of gram-negative bacilli (64.51％),138 strains of gram-positive coccus(28.81％),32 strains of fungi(6.68％).The top 7 isolation of pathogens were strains of escherichia coli(36.53％),strains of klebsiella pneumoniae(12.73％),strains of enterococcus faecalis D group(12.32％),strains of enterococcus faecium D group(10.23％),strains of fungi(6.68％),strains of pseudomonas aeruginosa(5.22％),strains of staphylococcus epidermidis(3.13％).125 strains of klebsiella pneumoniae produced ESBL were detected out with the rates of up to 71.42%. The strains of gram-negative bacteria were based on enterococcus faecalis (D group),yet staphylococcus aureus methicillin resistant strains accounted for 27.27%. Conclusion Escherichia coli is the main pathogenic bacteria of child urinary tract infection and the multidrug resistance of the pathogenic bacteria is in a very serious situation. And gram-positive cocci is going to be increasing. It is necessary to make clear pathogens and drug sensitivity results, which is important to guide clinic make use of antibacterial agents exactly to cure infection of urinary system in children.

目的 研究比较低流量异氟烷与七氟烷麻醉在小儿腹腔镜手术中的麻醉效果。方法 选取在我院进行腹腔镜手术治疗的小儿患者120例作为研究对象,随机分为异氟烷和七氟烷两组,每组各60例,分别采用低流量异氟烷和七氟烷进行麻醉,比较两组患儿的相关麻醉参数,以及入睡、苏醒、拔管时间和不良反应情况。结果 两组患儿的不同时期脉搏氧饱和度、心率、呼气末二氧化碳浓度比较无差异(P＞0.05);七氟烷组患儿的不同时期的平均动脉压具有较强的稳定性,而异氟烷组患儿在诱导期间、手术过程中平均动脉压降低,差异有统计学意义(P＜0.05)。结论 在小儿腹腔镜手术过程,采用低流量七氟烷进行麻醉,可以使手术过程中血流动力学更加稳定,缩短术后拔管时间,减少术后不良反应发生,更易满足小儿腹腔镜手术的麻醉要求。

Objective To investigate efficacy between low flow isoflurane and sevoflurane in pediatric laparoscopic surgery. Methods 120 cases of children underwent laparoscopic surgery in our hospital were randomly divided into two groups. 60 patients in isoflurane group were given low-flow isoflurane anesthesia; 60 patients in sevoflurane group were given low-flow isoflurane anesthesia. Heart rate (HR), mean arterial blood pressure (MAP), pulse oxygen saturation (SpO₂), end-tidal partial pressure of carbon dioxide (EtCO₂) at different period, sleep and awakening time, extubation time, and adverse reactions of two groups were observed. Results Heart rate (HR), pulse oxygen saturation (SpO₂), end-tidal partial pressure of carbon dioxide (EtCO₂) of two groups at different period had no significantly difference (P>0.05). Mean arterial blood pressure (MAP) of two groups at different period had significantly difference (P<0.05). The sleep time and recovery time of two groups had no significant difference (P>0.05). The extubation time of sevoflurane was significantly lower than isoflurane group (P<0.05). The adverse reaction rate of sevoflurane was significantly lower than isoflurane group (P<0.05). Conclusion Low flow isoflurane and sevoflurane can be used in pediatric laparoscopic surgery, and the efficacy of sevoflurane is better.

       目的   探讨中医药治疗小儿腺样体肥大（AH）的研究现状、研究热点及趋势，为本领域研究者提供借鉴。方法   检索中国知网（CNKI）数据库从2005年1月1日至2024年1月31日中医药治疗小儿腺样体肥大的相关文献。运用Excel 2019分析其发文量，运用CiteSpace 6.2.R6软件分析其作者、机构、关键词。结果   共纳入文献395篇，年发文量整体呈现波动上升的趋势；发文量最多的作者为姜之炎；发文量最多的研究机构为山东中医药大学。初步形成了以姜之炎、俞景茂、阎兆君为核心的研究团队；研究机构以中医类院校及其附属医院为主。高频关键词提示当前研究热点前三位为中医药治疗方法、临床疗效。结论  AH领域研究内容主要以内治法、外治法、作用机制为主；研究热点逐渐从临床研究转向作用机制等实验研究；应用“数据挖掘”“网络药理学”等计算机技术研究AH会成为趋势。

       Objective  To explore the research status，research hotspots，and trends of traditional Chinese medicine in the treatment of adenoid hypertrophy in children，to provide a reference for researchers in this field．Methods  The relevant literature on the treatment of adenoid hypertrophy in children with traditional Chinese medicine was searched in the CNKI database from January 1，2005，to January 31，2024．Excel 2019 was applied to analyze the number of published papers，and CiteSpace 6.2.R6 software was applied to analyze its authors，institutions，and keywords．Results  A total of 395 papers were included，and the annual number of papers showed a fluctuating upward trend．The author with the largest number of papers was JIANG Zhiyan．Shandong University of Traditional Chinese Medicine was the research institution with the largest number of papers．The core  research teams including JIANG Zhiyan，YU Jingmao，and YAN Zhaojun were initially formed．The  research institutions were mainly Chinese medicine colleges and their affiliated hospitals．High-frequency keywords suggest that the current top three research hotspots were traditional Chinese medicine treatment methods，clinical efficacy．Conclusions  The research content in this field is mainly based on internal treatment，external treatment，and mechanism．The focus has gradually shifted from clinical research to experimental research such as mechanism．The application of computer technologies such as “data mining” and “network pharmacology” for this disease will become a trend．