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1.
目的:探讨性别对结核病患者顺式阿曲库铵药效学参数的影响。方法择期行全身麻醉手术80例,结核病( T组)及非结核病( N组)患者40例,两组依性别不同分为结核病男性组( TM组)、女性组( TF组)及非结核病男性组( NM组)、女性组( NF组),每组20例。所有患者入室后予静脉输注咪达唑仑0.1 mg/kg、芬太尼4μg/kg,靶控输注丙泊酚1~4μg/mL,患者意识消失后采用4个成串刺激进行肌松监测,静脉注射顺式阿曲库铵0.15 mg/kg,当第1个肌颤搐反应( T1)下降至最低值并连续重复3次以上时行气管插管,记录起效时间、T1最大抑制程度、临床作用时间、恢复指数、药理作用时间及气管插管条件和麻醉诱导前(t0)、给予肌松药后5 min(t1)、15 min(t2)、30 min(t3)、45 min(t4)、1 h(t5)时的平均动脉压和心率。结果与男性相比,T组女性起效时间较短,临床作用时间及药理作用时间较长( P<0.01);与N组相比,T组患者顺式阿曲库铵临床作用时间及药理作用时间较短,但组间差异无统计学意义( P>0.05)。结论结核病患者顺式阿曲库铵单次静脉注射时女性较男性更敏感,表现为起效时间较短,临床作用时间及药理作用时间较长。  相似文献   

2.
目的测定结核病患者维库溴铵的药效学参数。方法将40例择期行全身麻醉手术的患者按疾病的不同分为结核病(T)组及非结核病(N)组,每组20例。2组均静脉输注咪达唑仑0.1mg·kg-1、芬太尼4μg·kg-1,靶控输注丙泊酚1~4μg·mL-1,等患者意识消失后采用4个成串刺激(TOF)进行肌松监测,静脉注射维库溴铵0.1mg·kg-1,注药时间5s。当第一个肌颤搐反应(T1)下降至最低值并连续重复3次以上时行气管插管,记录起效时间、T1最大抑制程度、临床作用时间、恢复指数、药理作用时间、气管插管条件及麻醉诱导前(t0)、给予肌松药后5min(t1)、15min(t2)、30min(t3)、45min(t4)、1h(t5)时的平均动脉压(MAP)和心率(HR)的变化。结果 2组麻醉诱导后各时间段的MAP及HR较t0均有不同程度下降(均P<0.05);2组麻醉诱导前及麻醉诱导后各时间点的MAP及HR比较差异均无统计学意义(均P>0.05)。T组维库溴铵临床作用时间较N组明显缩短(P<0.05);2组T1最大抑制程度、起效时间、恢复指数及药理作用时间比较差异均无统计学意义(均P>0.05)。肌松监测过程中所有患者均未发生体动,也未见皮疹、低血压、气道峰压升高等不良反应,气管插管均一次成功。结论结核病患者维库溴铵单次静脉注射时T1最大抑制程度、起效时间、恢复指数及药理作用时间与一般患者相似,但其临床作用时间较短。  相似文献   

3.
目的:测定不同性别结核病患者维库溴铵的药效学参数。方法择期行全身麻醉手术80例,结核病( T组)及非结核病( N组)患者各40例,两组依性别不同分为结核病男性组、女性组及非结核病男性组、女性组,每组20例。所有患者入室后予静脉注射咪达唑仑0.1 mg/kg、芬太尼4μg/kg,靶控输注丙泊酚1~4μg/mL,意识消失后采用4个成串刺激进行肌松监测,静脉推注维库溴铵0.1 mg/kg,当第1个肌颤搐反应( T1)下降至最低值并连续重复3次以上时行气管插管,记录各组起效时间、T1最大抑制程度、临床作用时间、恢复指数、药理作用时间及气管插管条件和麻醉诱导前(t0)、给予肌松药后5 min(t1)、15 min(t2)、30 min(t3)、45 min(t4)、1 h(t5)时的平均动脉压和心率。结果 T组患者维库溴铵临床作用时间较N组缩短(P<0.05),但男女比较差异无统计学意义(P>0.05),N组女性临床作用时间较男性长(P<0.05);各亚组间T1最大抑制、起效时间、恢复指数及药理作用时间比较差异无统计学意义( P>0.05)。结论结核病患者围术期使用维库溴铵时可不考虑性别因素对阻滞时效的影响。  相似文献   

4.
许斌兵  叶茂  柏林 《上海医学》2012,35(2):111-114
目的研究全凭静脉麻醉下儿童单次气管插管剂量国产顺式阿曲库铵的肌肉松弛效应,以及性别差异的影响。方法气管插管全凭静脉麻醉下行择期颜面部手术的2~8岁患儿52例,男、女各26例。全凭静脉麻醉,单次静脉注射3×95%的有效药物剂量(ED95,0.15mg/kg)国产顺式阿曲库铵,观察气管插管条件,采用肌肉松弛监测仪对尺神经进行连续4个成串刺激(TOF),观察拇内收肌的加速度变化。记录起效时间、最大效应持续时间、临床作用时间、恢复指数、体内作用时间及TOF比值(第4个肌颤搐反应高度与第1个肌颤搐反应高度的比值)恢复到70%的时间(TOFR0.7)。结果全部患儿气管插管条件评估分级均为Ⅰ级。男女患儿间起效时间、最大抑制持续时间、临床作用时间、恢复指数、体内作用时间及TOFR0.7的差异均无统计学意义(P值均>0.05)。结论 3×ED95顺式阿曲库铵应用于患儿可获得满意的气管插管条件,且男女患儿间单次气管插管剂量肌肉松弛效应无明显差异。  相似文献   

5.
目的 采用单次注射法探讨舒芬太尼对全麻病人顺式阿曲库铵起效时间的影响. 方法 ASA I~II级择期全麻手术患者60例,随机分为 2组;单纯丙泊酚(A组),丙泊酚复合舒芬太尼(B组).A组麻醉诱导采用丙泊酚 2mg/kg;B组麻醉诱导采用丙泊酚2 mg/kg,舒芬太尼1ug/kg.A组和B组诱导时静注顺式阿曲库铵 0.15 mg/kg,待肌松抑制达到最大(T1=0)行气管插管,通过记录刺激尺神经时拇指内收肌的收缩加速度诱导期采用单个刺激(频率0.1Hz,持续0.2ms)监测肌松起效时间 (顺式阿曲库铵注药毕至肌颤搐抑制100%的时间).结果 顺式阿曲库铵起效时间在二组之间无显著差异P >0.05).结论 舒芬太尼并不影响全麻患者顺式阿曲库铵起效时间.  相似文献   

6.
顺式阿曲库铵、维库溴铵在妇科腹腔镜手术中的应用比较   总被引:1,自引:0,他引:1  
刘朝文  刘春  赵娜  邓莉  李有长 《重庆医学》2009,38(24):3067-3069
目的 观察单次静脉注射国产顺式阿曲库铵、维库溴铵在短小妇科腹腔镜手术中药效学的差异.方法 ASAⅠ~Ⅱ级择期短小(手术时间小于60min)妇科腹腔镜手术患者60例,随机分成顺式阿曲库铵组(A组,n=30)和维库溴铵组(V组,n=30).采用TOF-Guard加速度仪对尺神经行连续4个成串刺激(TOF)监测拇内收肌肌颤搐反应;气管内插管全凭静脉麻醉,静脉注射咪达唑仑0.03 mg/kg,芬太尼3.0μg/kg,异丙酚2.5 mg/kg,以及 A、V组分别静脉注射0.1 mg/kg(2倍ED95)国产顺式阿曲库铵和维库溴铵进行麻醉诱导,靶控输注(TCI)异丙酚3.0~3.5μg/mL和瑞芬太尼4.0~5.0ng/mL维持麻醉;评价气管插管条件,监测麻醉诱导期间血液动力学,记录手术时间, 起效时间(肌松药注毕至T1达最大抑制的时间),无反应期(T1消失到T1再出现的时间),T1从最大抑制程度恢复至25%、75%、95%的时间,恢复指数(T1恢复从25%至75%的时间),TOF比值(T4/T1)(TOFR)恢复至70%的时间,以及残余肌松拮抗情况;观察不良反应. 结果 A、V组手术时间、气管插管条件评级、血液动力学变化差异无统计学意义(P>0.05).与A组相比, V组起效时间较短,无反应期长,T1从最大抑制程度恢复至25%、75%、95%的时间较长,以及残余肌松需拮抗的比例较高,差异有统计学意义(P<0.05);两组间恢复指数、TOF比值(T4/T1)(TOFR)差异无统计学意义(P>0.05).A、V组均无不良反应发生.结论单次静脉注射顺式阿曲库铵与维库溴铵用于短小妇科腹腔镜手术,前者临床肌松作用更短,术毕患者苏醒快、拔管早,更有利于手术麻醉转台.  相似文献   

7.
目的 探讨不同的给药方式和性别对顺式阿曲库铵药效学的影响.方法 选择60例ASA I~II级择期手术的患者,根据性别和给药方式分成4组(每组15例):女性靶控输注(TCI)组、女性间断单次静脉注射组、男性TCI组以及男性间断单次静脉注射组.用TOF-Watch肌松监测仪以间隔12s连续监测4个成串刺激尺神经后拇内收肌的收缩反应.并记录顺式阿曲库铵插管剂量和单位时间用量、肌松起效时间 (从开始给药到T1/TC达5%的时间)以及肌松自主恢复时间(最后一次给药或者停止输注T1/TC 恢复到75%的时间).结果 TCI时顺式阿曲库铵插管剂量(0.11±0.04)mg/kg小于间断单次静注(0.15±0.00)mg/kg,P<0.01;单位时间的用药剂量也小于单次注射(P<0.01);但起效时间显著延长(P<0.01).TCI时自主恢复时间明显缩短(P<0.01).与男性相比,女性患者的肌松需要量显著减少,而肌松起效时间缩短,但肌松恢复时间不受影响.结论 TCI时顺式阿曲库铵的用量少,肌松恢复快.女性患者对顺式阿曲库铵比男性敏感,起效快.表明女性患者肌松需要减小剂量.  相似文献   

8.
目的 探讨顺式阿曲库铵和罗库溴铵分别用于全麻诱导气管插管的效果.方法 将124例行全麻气管插管腹部手术的患者随机分为顺式阿曲库铵组和罗库溴铵组,各62例,经静脉注入咪达唑仑0.1 mg/kg,芬太尼3 μg/kg进行麻醉诱导,待患者意识和睫毛反射消失后,顺式阿曲库铵组给予顺式阿曲库铵0.15 mg/kg,罗库溴铵组给予罗库溴铵0.6 mg/kg后行气管插管,比较气管插管的总有效率及两组患者诱导前、插管后1、5 min时平均动脉压(MAP)、脉搏氧饱和度(SpO2)、心率(HR)的变化,记录全麻诱导的起效时间、作用时间、恢复指数及组胺释放情况.结果 罗库溴铵组气管插管总有效率为95.2%,与顺式阿曲库铵组(88.6%)比较差异有统计学意义(x2=1.74,P<0.05);两组患者插管后1 min的MAP、HR明显上升(P<0.05),5 min后与诱导前无明显差异;罗库溴铵组的起效时间和作用时间较短,恢复指数也明显低于顺式阿曲库铵组,差异有统计学意义(P<0.05).结论 罗库溴铵用于全麻气管插管术的起效时间短,恢复迅速,是临床上较理想的肌松药.  相似文献   

9.
目的:研究国产顺式苯磺酸阿曲库铵(Cisatracurium)在国人中的临床药效及对肝肾功能的影响.方法:择期手术成人患者30例,美国麻醉师协会分级(ASA)Ⅰ~Ⅲ级,单次注射顺式苯磺酸阿曲库铵0.15mg/kg诱导麻醉.观察心率、血压和全身皮肤情况以及连续4个成串刺激(TOF)的变化,当每串刺激的第一个肌颤抽(T1)达到最大抑制时行气管插管的情况.记录拇收肌诱发颤搐反应的抑制时程和恢复过程,术后24h测定肝肾功能.肌肉松弛效应观察指标包括:T4/T1抑制和恢复25%、75%、100%的时间.结果:所有患者在抑制达到100%时,完成气管插管,插管条件达到1级28例(93.3%),2级2例(6.7%).所有患者无皮肤潮红和支气管痉挛的表现.麻醉诱导后心率,血压比诱导前显著下降(P<0.05).术后肝、肾功能与术前比较无差异.顺式苯磺酸阿曲库铵起效时间为(4.46±0.91)min,25%恢复时间为(42.02±6.73)min,100%恢复时间为(64.69±9.47)min,25%~75%恢复指数为(11.59±3.11)min.结论:麻诱导时用3倍ED95(95%有效药物剂量)顺式苯磺酸阿曲库铵可提供满意的插管状态;对血压、心率、肝、肾功能无明显影响;肌松恢复迅速.  相似文献   

10.
目的探讨不同体重指数对顺苯磺酸阿曲库铵药效学的影响。方法全身麻醉择期手术患者40例,ASAⅠ~Ⅲ级,按体重指数的不同分为四组:偏瘦组(Ⅰ组),BMI18.5 kg/m2;正常体重组(Ⅱ组),BMI 18.6~24.9 kg/m2;超重组(Ⅲ组),BMI 25.0~30.0 kg/m2;肥胖组(Ⅳ组),BMI≥30.0 kg/m2。四组均按实际体重分别给予0.15 mg/kg(3 ED95)顺苯磺酸阿曲库铵。使用加速度肌松监测仪(TOF-Watch誖SX)行TOF监测拇内收肌肉阻滞(NMB)程度。麻醉采用全凭静脉麻醉诱导及维持。当T1达最大抑制值(T1降至最低值并重复3次以上不变时)时进行气管插管。记录起效时间(从肌松药注毕至T1达到最大抑制值的时间)、临床作用时间(注药结束到T1恢复至25%的时间)、药理作用时间(注药结束到T1恢复至90%的时间)、恢复指数(T1从25%恢复到75%的时间)和气管插管条件评级。结果体重指数与3倍ED95顺苯磺酸阿曲库铵的临床作用时间呈线性相关,回归方程为Y=1.531X+8.479(R2=0.628,P0.01);BMI与3倍ED95顺苯磺酸阿曲库铵药理作用时间呈线性相关,回归方程为Y=1.954X+15.049(R2=0.585,P0.01)。4组患者的临床作用时间和药理作用时间差异有统计学意义(P0.05),而起效时间、恢复指数和插管条件差异均无统计学意义(P0.05)。结论顺苯磺酸阿曲库铵按实际体重3倍ED95给药,随着患者的体重指数增高,其临床作用时间和药理作用时间亦随之延长,体重指数是影响该药恢复时间的重要因素之一。  相似文献   

11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

12.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

13.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

14.
FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…  相似文献   

15.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

16.
Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P<0.01);the MAP decreased(P<0.01)and the HR increased drastically(P<0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

19.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

20.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

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