新生儿咽下综合征洗胃治疗69例

呕吐是新生儿时期最常见的症状之一，引起呕吐的原因很多，正常情况下，胎儿在宫内可吞入少量羊水，对胎儿的胃粘膜并无刺激。但在分娩过程中，胎儿如吞入羊水量过多，或吞入被胎粪污染或被感染的羊水，均可刺激新生儿的胃粘膜，导致胃酸及粘液分泌亢进引起呕吐称为咽下综合征，约占新生儿呕吐的1／5，呕吐内容为白色粘液或黄色絮状物，严重时呕吐咖啡样液，不发烧，无感染迹象。     

98例新生儿咽下综合征的护理

呕吐是新生儿时期最常见的症状之一 ,引起呕吐的原因很多 ,正常情况下 ,胎儿在宫内可吞入少量羊水 ,对胎儿的胃粘膜并无刺激。但在分娩过程中 ,胎儿如吞入羊水过多 ,或吞入被胎粪污染或被感染的羊水 ,或含较多母血的羊水均可刺激新生儿的胃粘膜 ,导致胃酸及粘液分泌亢进而引起呕吐称咽下综合征[1] 。其临床主要表现为出生后未开奶前就有呕吐 ,开奶后呕吐加剧。呕吐内容为白色粘液或黄色絮状物 ,严重时呕吐咖啡样液。 1998年 5月～ 1999年 11月我科共分娩新生儿 2 0 33例 ,其中新生儿咽下综合征有 98例 ,现将其护理体会总结如下。1　临床资料…     

洗胃防治新生儿咽下综合征125例对比观察

呕吐是新生儿时期最常见的症状之一。正常情况下．胎儿在官内可吞入少量羊水，对胎儿的胃黏膜并无刺激。但在分娩过程中如吞入羊水量过多，或吞入被胎粪污染的羊水可刺激新生儿的胃黏膜，导致胃酸及黏液分泌亢进而引起呕吐称咽下综合征。其发生率约占新生儿呕吐的1/6。通常可采用洗胃、保持呼吸道通畅、氧疗、保暖、禁食及喂养等护理干预，使     

新生儿咽下综合征的护理体会

新生儿咽下综合征是胎儿在分娩过程中，吞入羊水过多或吞人被胎粪污染或已被感染的羊水，或含较多母血的羊水，刺激胃黏膜，导致胃酸及黏液分泌亢进而引起呕吐，呕吐次数、呕吐量均不等，生后未进食即开始呕吐，进食后呕吐加重，呕吐物为白色黏液、黄绿色絮状物或有咖啡色血丝。咽下综合征在新生儿期并不少见，经过积极治疗及精心护理，患儿的呕吐症状减轻或消失，大多会治愈出院。现将护理体会总结如下。     

洗胃在新生儿咽下综合征中的应用研究进展

新生儿咽下综合征是指在胎儿娩出过程中,如吞入羊水量过多,或吞入被胎粪污染或已被感染的羊水,或含较多母血的羊水,均可刺激新生儿胃黏膜,导致胃酸及粘液分泌亢进而引起以呕吐为主要表现的综合征[1].洗胃是预防新生儿咽下综合症的有效途径,但是由于新生儿的解剖特点,传统洗胃尚不够完善,近年来大量医务工作者从事洗胃的研究,阐述出不少具有临床应用价值的改进方法,现综述如下.     

早期吸除呼吸道及胃内羊水预防新生儿窒息的护理

分娩过程中胎儿如吸入羊水或吞入羊水量过多，以及吞入被胎粪污染的羊水可刺激新生儿的胃粘膜，导致胃酸及粘液分泌亢进而引起呕吐和窒息，2007年我科用新生儿吸引管给经剖宫产出生5分钟内的新生儿吸净口鼻、咽喉及胃内羊水和粘液来预防呕吐及窒息，效果显著，报告如下。     

早期吸除胃内羊水预防新生儿咽下综合征的观察

胎儿在母体内生活在羊水中,分娩过程中如吞入羊水量过多,或吞入被胎粪污染的羊水可刺激新生儿的胃粘膜,导致胃酸及黏液及分泌亢进引起呕吐,2002年,笔者用新生儿吸引管给出身5min内的新生儿吸净胃内及咽喉部的羊水和黏液来防御呕吐,效果显著,报告如下.     

新生儿呕吐的护理体会

新生儿由于分娩时吸入过多羊水或吞入被胎粪污染的羊水,刺激新生儿胃粘膜导致胃酸及粘液分泌亢进引起反射性恶心呕吐。呕吐前常无恶心反射,故呕吐物常从口鼻喷出,如不注意可吸入气道导致窒息。所以新生儿呕吐的预防及护理是至关重要的。     

洗胃对新生儿咽下综合征的效果观察

新生儿咽下综合征是指胎儿在娩出过程中吞入羊水量过多,或吞入被胎粪污染的羊水,刺激新生儿胃黏膜,导致胃酸及黏液分泌亢进而引起以呕吐为主要表现的综合征。其发病率约占新生儿呕吐的1/6。以前按常规处理方法为暂禁食,待呕吐停止2 d后开始正常喂哺,这种治疗新生儿呕吐因处理方法比较被动,可致新生儿水电解质及酸碱平稳紊乱,由于喂奶困难,易发生新生儿低血糖,另一方面,也会给新生儿母亲身心带来负面影响,导致乳汁分泌不足,在临床工作中我们采用对新生儿咽下综合征的患儿用温盐水洗胃的方法,洗胃后胃管内注入0.02 m g/kg普瑞博思后拔掉胃管,…     

94例新生儿洗胃的观察及护理体会

目的 由于分娩时吸入过多的羊水,或吞入被胎粪污染的羊水,刺激新生儿的胃粘膜,导致胃酸及粘液分泌亢进即咽下综合征,引起反射性恶心、呕吐,严重的出现呛咳 [2],如护理不当易造成吸入性肺炎、窒息,为保证新生儿的及时喂养及预防并发症的发生,需进行及时的洗胃.     

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.     

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…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

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.