氟哌利多预防硬膜外麻醉中寒战反应的临床效果

目的 观察氟哌利多预防硬膜外麻醉中寒战的效果.方法 选择60例拟在硬膜外麻醉下行上,下腹部、下肢或产科手术的成年患者,随机分为3组(每组20例):氟哌利多组(A组),曲马多(D组)、和对照组(C组).于硬膜外注药前30min,A组肌注氟哌利多5mg,D组肌注曲马多1.5 mg/kg;C组肌注生理盐水2ml.观察麻醉手术过程中寒战的发生率、寒战的严重程度及寒战发生前后的体温变化.结果 寒战发生率在A组为5%,D组和C组分别为25%和35%;D组与C组相比,有显著性差异(P<0.05).D组嗜睡发生率较高,但无统计学意义.结论 氟哌利多有助于预防硬膜外麻醉中的寒战反应.     

曲马多复合氟哌利多用于控制剖宫产术中寒战

目的观察曲马多复合氟哌利多抑制剖宫产硬膜外麻醉期间寒战的效果。方法选择剖宫产术中发生寒战产妇60例，随机分为A组（曲马多复合氟哌利多组）30例，静脉分别注射氟哌利多2．5mg与曲马多1mg／kg；B组（曲马多组）30例，静脉注射曲马多1mg／kg。观察寒战消失情况及副作用。结果A组和B组寒战减弱至消失的时间相一致，但A组副作用明显少于B组（P〈0．01）。结论曲马多复合氟哌利多治疗剖宫产术中寒战明显优于单纯使用曲马多。     

曲马多与芬太尼治疗硬膜外麻醉期间寒战的对比观察

目的：观察曲马多辅用氟哌利多与芬太尼辅用氟哌利多治疗硬膜外麻醉期间寒战的效果。方法：选择ASAⅠ—Ⅱ级,择期手术,在硬膜外麻醉期间出现末战者60例,随机分成2组,芬太尼加氟哌利多组（A组）和曲马多加氟哌利多组（B组）,每组30例。当寒战出现持续2min不消失时,A组静脉缓注芬太尼1．5μg／kg加氟哌利多0．05mg／kg,B组静脉缓注曲马多1．5mg／kg加氟哌利多0．05mg／kg。观察注药后2min、5min和10min寒战级别变化,副作用及MAP、SPO2、HR和RR的改变。结果：注药后2min寒战消失者A组18例,占60％;B组27例,占90％,两组同时点比较P〈0．05,差异有显著性。A组注药后SPO2稍有下降,两组比较无统计学差异。结论：曲马多辅用氟哌利多治疗硬膜外麻醉期间寒战优于芬太尼辅用氟哌利多。     

曲马多治疗剖宫产术硬膜外麻醉期间寒战50例效果观察

目的:观察曲马多、曲马多加氟哌利多在剖宫产术硬膜外麻醉期间治疗寒战的效果及对产妇呼吸循环系统及新生儿Apgar评分的影响。方法:选择ASAI-II级剖宫产手术患者150例随机分为对照组、曲马多组(A组)和曲马多加氟哌利多组(B组),每组50例。A组静脉缓注曲马多1.0mg/kg,B组静脉缓注曲马多1.0mg/kg及氟哌利多0.05mg/kg,对照组不予用药。胎儿娩出后。记录用药前后1、3、5、10、30m in的平均动脉压(MAP)、氧饱和度(SPO2)、心率(HR)和呼吸(RR)的变化及副反应同时记录胎儿娩出1、5m in Apgar评分。结果:两组注药后与注药前比较差异有统计学意义(P<0.05),B组用药3m in后与A组同时点比较差异有统计学意义(P<0.01)。两组静脉注药前后MAP、SPO2、HR和RR均无明显改变(P>0.05),A组出现恶心者比率较B组高;新生儿1、5m in Apgar评分各组间差异无统计学意义(P>0.05)。结论:曲马多用于剖宫产术硬膜外麻醉期间治疗寒战是安全有效的,在曲马多的基础上辅用氟哌利多能达到更好的效果。     

术中应用小剂量曲马多加氟哌利多对硬腰联合麻醉后不良反应的临床研究

目的探讨小剂量曲马多加氟哌利多对临床硬腰联合麻醉后出现的低血压、恶心、呕吐及寒战等不良反应的预防及治疗作用。方法将90例硬腰联合麻醉下行腹部和下肢手术的患者随机分为A、B组和对照组各30例。A组在麻醉穿刺成功手术开始前静注曲马多1mg/kg;B组在麻醉穿刺成功手术开始前静注曲马多1mg/kg,间隔10min后加静注氟哌利多0.1mg/kg;对照组单纯静注生理盐水,注射时间及ml数同A、B组。记录麻醉开始后3h内低血压、恶心、呕吐及寒战等不良反应的发生情况。结果 A、B组不良反应发生率明显低于对照组;A组明显低于B组(P0.05)。结论曲马多合并氟哌利多对预防麻醉后相关不良反应安全有效。     

曲马多氟哌利多复合液静脉硬膜外联用防治硬膜外麻醉寒战

目的　观察曲马多、氟哌利多复合液静脉硬膜外联用防治硬膜外麻醉寒战的效果。方法　选择ASAⅠ～Ⅱ级择期手术患者 ,在硬膜外麻醉期间出现寒战者 60例 ,随机分为两组 ,静脉组 (V组 )和静脉硬膜外组 (VE组 )各 3 0例。V组和VE组均静脉缓注曲马多 1.0mg/kg加氟哌利多 0 .0 5mg/kg ,VE组在静脉用药 2 0分钟后硬膜外注入曲马多 0 .5mg/kg加氟哌利多 0 .0 2 5mg/kg(加 0 .9%盐水至 10ml) ,V组用相同药量静脉注射。记录两组阻滞平面、血压 (BP)和心率 (HR) ,观察病人寒战发生情况。结果　用药后 12小时内V组寒战发生率为 3 0 .0 % ( 9/3 0 ) ,VE组则为 6.7% ( 2 /3 0 ) ,两组比较具有显著性差异 (P <0 .0 5 )。结论　曲马多、氟哌利多复合液静脉硬膜外联用 ,可减少硬膜外麻醉术中寒战和术后寒战再发生。     

曲马多复合氟哌利多不同途径治疗硬膜外麻醉期间寒战的临床观察

目的：观察曲马多复合氟哌利多不同途径治疗硬膜外麻醉期间出现寒战的临床效果。方法：选择ASAⅠ～Ⅱ级择期手术患者，在硬膜外麻醉期间出现寒战者60例，按给药途径随机分为3组(每组20例)：硬膜外 静脉组(Ⅰ组)，单纯硬膜外组(Ⅱ组)，单纯静脉组(Ⅲ组)。Ⅰ组静脉注入曲马多1mg／kg 氟哌利多0．025mg／kg，并同时从硬膜外导管注入曲马多1mg／kg 氟哌利多0．025mg／kg；Ⅱ组从硬膜外导管注入曲马多2mg／kg 氟哌利多0．05mg／kg；Ⅲ组静脉注入曲马多2mg／kg 氟哌利多0．05mg／kg，记录各组用药后寒战消失时间、不良反应、寒战复发例数和MAP、HR及SpO2变化。结果:Ⅰ组、Ⅲ组3min内寒战停止例数明显多于Ⅱ组，10min后3组寒战停止例数无明显差异；Ⅱ组、Ⅲ组寒战复发例数多于Ⅰ组，但无统计学差异；Ⅲ组并发恶心例数明显多于Ⅰ组和Ⅱ组，舒适例数Ⅲ组最少；Ⅲ组用药后MAP、SpO2下降明显于Ⅰ组、Ⅱ组。结论：曲马多复合氟哌利多是一种治疗硬膜外麻醉期间寒战的有效方法，且硬膜外和静脉同时分量给药效果最佳。     

哌氟合剂及曲马多伍用氟哌利多治疗硬膜外麻醉期间寒战效果的体会

目的 观察哌氟合剂及曲马多伍用氟哌利多治疗硬膜外麻醉期间寒战的临床效果.方法 随机选择在硬膜外麻醉下手术期间出现寒战者60例,分为两组:A组(n=30)给予哌替啶0.5 mg/kg,氟哌利多0.05mg/kg;B组(n=30)给予曲马多1.0mg/kg,氟哌利多O.05mg/kg.当寒战发生时静脉分别给予哌氟合剂或曲马多伍用氟哌利多.结果 A组和B组注药后药物的起效速度及效果比较差异均无统计学意义(P＞0.05),但A组的HR、SpO2用药前后差异有统计学意义(P＜0.05),而B组的HR、SpO2用药前后差异无统计学意义(P＞0.05).结论 曲马多伍用氟哌利多治疗硬膜外麻醉期问寒战的效果优于哌氟合剂.     

地塞米松预防术后平衡镇痛引起恶心呕吐的观察

目的:研究地塞米松联合氟哌利多预防曲马多和芬太尼术后静脉平衡镇痛中所致的恶心呕吐.方法:130例ASAⅠ-Ⅱ级的普外和妇产科手术病人随机分为2组,观察组曲马多500mg 芬太尼1mg 氟哌利多 2.5mg 地塞米松10mg;对照组曲马多500mg 芬太尼1mg 氟哌利多2.5mg.观察术后24小时病人恶心呕吐的发生率.结果:观察组恶心发生率4.61%(3/65),呕吐发生率为0;对照组恶心发生率10.77%(7/65),呕吐发生率为 6.15%(4/65).结论:两药联合应用时产生协同又相加的作用,使镇吐作用增强,抗恶心呕吐的效果更加显著.     

阿扎司琼预防小儿斜视矫正术后恶心呕吐的效果观察

目的:观察阿扎司琼预防小儿斜视矫正术后恶心呕吐的效果。方法:选择4~10岁择期手术的患儿75例随机分为A组(对照组,n=25)手术结束前,静脉注射生理盐水2m l;B组(氟哌利多组,n=25)手术结束前静脉注射氟哌利多0.075m g/kg。C组(阿扎司琼组,n=25)手术结束前静脉注射阿扎司琼0.2m g/kg。记录每组患儿24h恶心呕吐发生率。结果:术后24h内恶心呕吐发生率C组小于B组(P<0.05),而B组小于A组(P<0.05)。结论:本研究表明阿扎司琼能安全有效地预防小儿斜视矫正术后恶心呕吐的发生。     

Value of D-Dimers in patients with acute aortic dissection

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.     

Research of combined liver-kidney transplantation model in rats

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

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…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.