专利产品推介

“BORN-BE无创脑水肿动态监护仪 项目名称:BORN-BE无创脑水肿动态监护仪 产品简介:BORN-BE无创脑水肿动态监护仪是一种全新的、填补目前临床脑水肿无创监护空白的系列医疗仪器。该仪器能够无创、床旁、连续、动态显示脑水肿变化状况,作为CT、MRI等设备对脑水肿病人救治的补充,是一种实用的、在临床应用中能够发挥作用的数字医疗仪器。 产品用途:     

脑出血后脑水肿扩大的相关危险因素分析

目的探讨脑出血后脑水肿扩大的危险因素,为脑出血后脑水肿扩大的预防和治疗提供参考。方法对60例脑出血后脑水肿患者的临床资料进行回顾性分析,对脑出血后脑水肿扩大的相关危险因素进行Logistic回归分析,筛选脑出血后脑水肿扩大的相关危险因素。结果单因素分析结果显示,发病至首次CT时间、入院时GCS评分、血肿形态、入院后24h内使用降压药与脑出血后脑水肿扩大有关,而脑出血后脑水肿扩大与性别、年龄、高血压史、糖尿病史、高脂血症、卒中史、吸烟史、饮酒史、首次血肿体积、血肿破入脑室、入院后24h内使用脱水剂等因素无明显相关性（P〉0.05）;多因素Logistic回归法分析表明,发病至首次CT时间和血肿形态是脑出血后脑水肿扩大的危险因素。结论发病至首次CT时间和血肿形态是脑出血后脑水肿扩大的危险因素,对这些危险因素加以重点评估和合理控制,可以控制脑出血后脑水肿扩大的发生。     

小儿脑水肿的治疗

脑水肿是指脑组织含水量增加所导致的脑脊液容积增大,是儿科临床较常见的并发症和致死原因之一,故将其主要治疗手段介绍如下。一、脑水肿的分类根据脑水肿的病理生理改变,将脑水肿分为3型,各型的发病机理不同夕治法亦有差别。 (1)血管源性脑水肿:临床最常见,主要见于脑外伤、脑肿瘤、颅内感染、窒息等,如何     

脑水肿的治疗研究进展

脑水肿是神经内外科许多疾病伴发的最常见的病症,是脑对各种损害普遍存在的反应.如果脑水肿治疗理想,将会显著降低脑血管病、脑外伤、脑瘤和颅内感染等许多疾病伴发的最常见的直接致死的凶险病症--脑水肿的病死率、致残率,许多疾患的预后将会明显改善,脑水肿的进展程度对原发病的预后起决定性作用.脑科专家一致认为:谁掌握了脑水肿的治疗方法,谁就掌握了神经科学的金钥匙.     

糖皮质激素受体与脑水肿

脑水肿是临床上常见并较严重的一种并发症。它意味着脑组织水份的增多,同时伴有脑体积及重量的增加。脑水肿的分类一、血管源性脑水肿:这是最常见的一种脑水肿。因颅内肿瘤,炎症及颅脑损伤引起的脑水肿通常归于此类。系由于脑毛细血管内皮细胞通透性增加所致,主要发生于白质。     

中毒性脑水肿的氧疗法

脑组织缺氧往往是造成脑水肿的直接原因。而脑水肿与脑缺氧相互影响,互相促进。血氧降低和二氧化碳分压升高能加剧脑水肿,使颅内压更加升高、颅内压升高时颅内血循环障碍导致脑缺血、缺氧更加严重,形成恶性循环。此时若采用氧疗法,增加血氧含量,则能有力的阻止上述循环。在某些毒物中毒所引起的脑水肿,采用氧疗法是有效的病因学治疗措施。如一氧化碳中毒引起的脑水肿,采用氧疗法能促进碳氧血红蛋白解离,加速一氧化碳排出,能有效控制脑水肿病变的继续发展。因此,氧疗法是消除脑水肿的重要措施之一。     

脑水肿时的输液问题

各种病因所致的脑水肿可引起水、电解质平衡紊乱,水、电解质平衡紊乱又可反过来加剧脑水肿。适当限制液体入量对预防和治疗脑水肿虽是有益的。但过于限制液体入量或输入过量脱水剂易导致失水、低血压、休克、电解质紊乱等,从而使病情恶化,这也是不容忽视的。所以临床上正确掌握脑水肿时的水、电解质平衡问题是非常重要的。脑水肿时的输液,其原则是既     

急性脑外伤及脑缺血脑水肿防治研究

脑水肿是一种组织病理学反应,由于脑是一种细胞密集型器官,细胞外间隙很少,仅及脑容积之5%,故脑水肿以细胞内水肿为主.近年来,各家致力于脑外伤、脑缺血后细胞分子水平的研究,对脑水肿机理有了更深一步的认识,提出了防治脑水肿的一些新观点,有利于指导今后临床实践.     

脑水肿的治疗研究进展

脑水肿是神经内外科许多疾病伴发的最常见的病症，是脑对各种损害普遍存在的反应。如果脑水肿治疗理想。将会显著降低脑血管病、脑外伤、脑瘤和颅内感染等许多疾病伴发的最常见的直接致死的凶险病症——脑水肿的病死率、致残率，许多疾患的预后将会明显改善，脑水肿的进展程度对原发病的预后起决定性作用。脑科专家一致认为：谁掌握了脑水肿的治疗方法，谁就掌握了神经科学的金钥匙。     

传染病并发脑水肿的临床表现——附13例尸解分析

近年来传染病并发脑水肿已引起人们的更多注意。目前可以认为几乎所有急性传染病都有并发脑水肿的可能,在疾病的极期,脑水肿往往是急性致死的重要原因,又因为脑水肿的临床表现常易与各种传染性疾病,尤其是易与中枢神经系统的传染性疾患的临床表现相混淆。因此,正确处理传染病并发脑水肿就显得     

Can knowledge protect against acute mountain sickness?

BACKGROUND: Studies show that the well-prepared traveller is less likely to suffer travel related illness. This study is designed to examine trekkers' knowledge of altitude sickness in an attempt to see whether knowledge can protect against acute mountain sickness (AMS) and high altitude pulmonary or cerebral oedema (HAPE/HACE). METHODS: A convenience sample of 130 trekkers were interviewed in the Solu Khumbu region of Nepal. They were asked what action they would take firstly if they developed symptoms of AMS, and secondly, symptoms of HAPE/HACE whilst ascending. Options were to continue up, stay at the same altitude, descend or ask their guide. RESULTS: With symptoms of moderate to severe AMS, 37 trekkers (28 per cent) indicated they would continue their ascent while 113 (72 per cent) would not. Those individuals who proposed continued ascent were significantly more likely to be suffering from symptoms of AMS (p = 0.025) and had ascended significantly more rapidly over the preceding 72 h (p = 0.004) then those who proposed to halt their ascent. With regard to symptoms of HAPE/HACE, 12 (9 per cent) indicated they would not descend, demonstrating no association with AMS (p = 0.07) or ascent in preceding 72 h (p = 0.7). CONCLUSION: Trekkers who indicated that they would act safely in the event of developing moderate to severe AMS were significantly less likely to be suffering from AMS when interviewed and had ascended significantly less altitude in the preceding 72 h being more likely to adhere to recommended ascent guidelines.     

海拔5000米高原急性高山病的发病率及影响因素和伴随症状

本文对进入海拔5000m高原的62例健康人的急性高山病(AMS)的发病率,影响因素及伴随症状进行了现场调查.总AMS发病率为48.4%,发生高原肺水肿1例(1.6%),上山后4天出现外周水肿18例(29%),一周后水肿逐渐消退.72%水肿患者同时合并AMS,提示外周水肿可能和AMS有某种内在联系.年龄及原居住地海拔高度与AMS发病率无明显关系.有居住3500m以上高原史组AMS发病率明显低于无居住高原史组.本文还对AMS一系列伴随症状进行了讨论.     

Acute mountain sickness, two cases and their treatment in the field

Objective

The number of lowland dwellers traveling at high altitudes has greatly increased in recent decades. Business travelers flying to La Paz or Lhasa are at risk of altitude illnesses, similarly to miners and soldiers transported to high altitudes. Traveling to high altitude requires adaptation and if this process fails due to too rapid an ascent rate or susceptibility of the climber, acute mountain sickness (AMS) may result. Doctors and nurses in travel clinics, health centers and occupational health care clinics may face patients asking advice on how to plan their trips or manage AMS, or the health care personnel may take part in a travel to high altitude environment.

Methods

Two patients, aged 29 and 47 years, who fulfilled the criteria for AMS were studied. The clinical findings and treatment in the field are described including the review of the current recommendations for prevention and treatment of AMS.

Results

Both patients developed a severe AMS due to too rapid ascent and their denial of the symptoms.

Conclusions

Prevention is the safest and the most efficient method in the care concerning AMS. Realizing the risk of mountain sickness, active inquiry about the symptoms and correctly timed reaction to them, in other words interrupting the ascent or descending, help to reduce and even to prevent the development of serious problems.     

How can acute mountain sickness be quantified at moderate altitude?

Reports of acute mountain sickness (AMS) at moderate altitude show a wide variability, possibly because of different investigation methods. The aim of our study was to investigate the impact of investigation methods on AMS incidence. Hackett's established AMS score (a structured interview and physical examination), the new Lake Louise AMS score (a self-reported questionnaire) and oxygen saturation were determined in 99 alpinists after ascent to 2.94 km altitude. AMS incidence was 8% in Hackett's AMS score and 25% in the Lake Louise AMS score. Oxygen saturation correlated inversely with Hackett's AMS score with no significant correlation with the Lake Louise AMS score. At moderate altitude, the new Lake Louise AMS score overestimates AMS incidence considerably. Hackett's AMS score remains the gold standard for evaluating AMS incidence.     

高原病的发病机制及防治研究进展

海拔在3 000 m以上的地区,称为高原地区.其特点为气压和氧分压均低,易导致人体缺氧.如未能习服,可引起高原病.高原病的发病机制主要由于高原低氧血能导致脑和肺微循环的过分充盈,而发生高原脑水肿和高原肺水肿.治疗主要是尽速转移至低地或用轻便加压舱以及采用药物(乙酰唑胺和地塞米松),充分给氧.预防采用逐渐登高习服、锻炼、多食碳水化合物,给予高量抗氧化营养素或食用中等量抗氧化物质,如维生素C、E、硒等.     

Disturbed eating at high altitude: influence of food preferences, acute mountain sickness and satiation hormones

Purpose

Hypoxia has been shown to reduce energy intake and lead to weight loss, but the underlying mechanisms are unclear. The aim was therefore to assess changes in eating after rapid ascent to 4,559 m and to investigate to what extent hypoxia, acute mountain sickness (AMS), food preferences and satiation hormones influence eating behavior.

Methods

Participants (n = 23) were studied at near sea level (Zurich (ZH), 446 m) and on two days after rapid ascent to Capanna Margherita (MG) at 4,559 m (MG2 and MG4). Changes in appetite, food preferences and energy intake in an ad libitum meal were assessed. Plasma concentrations of cholecystokinin, peptide tyrosine–tyrosine, gastrin, glucagon and amylin were measured. Peripheral oxygen saturation (SpO₂) was monitored, and AMS assessed using the Lake Louis score.

Results

Energy intake from the ad libitum meal was reduced on MG2 compared to ZH (643 ± 308 vs. 952 ± 458 kcal, p = 0.001), but was similar to ZH on MG4 (890 ± 298 kcal). Energy intake on all test days was correlated with hunger/satiety scores prior to the meal and AMS scores on MG2 but not with SpO₂ on any of the 3 days. Liking for high-fat foods before a meal predicted subsequent energy intake on all days. None of the satiation hormones showed significant differences between the 3 days.

Conclusion

Reduced energy intake after rapid ascent to high altitude is associated with AMS severity. This effect was not directly associated with hypoxia or changes in gastrointestinal hormones. Other peripheral and central factors appear to reduce food intake at high altitude.     

在青藏铁路施工中阶梯式习服对急性重型高原病预防的作用

目的了解阶梯式习服在急性重型高原病(即高原肺水肿及高原脑水肿)预防中的作用。方法通过对2003年3—10月中旬进入青藏铁路西藏段(唐古拉山口至西藏拉萨段)施工的22200名施工人员重型急性高原病的发病情况调查,并对采用不同方式进入高原的发病情况进行比较,对采用阶梯式方式进入高原的发病情况进行分析。结果2003年7个月中,共计进入青藏铁路西藏段施工人员22200名,发生高原肺水肿184例(男180例,女4例,年龄20～45岁)及高原脑水肿155例(均为男性,年龄22～44岁),发病率分别为0.83%和0.70%。位于同海拔高度的阶梯式者与未习服者比较,未习服者的发病率明显高于阶梯式习服者。结论急性重型高原病的发病率随着海拔的升高而增高。平原大规模人群进入高原地区,采用阶梯式习服方式进入高原能有效降低急性重型高原病的发病率,而对于大规模人群急进高原,在海拔2500m左右建立习服站不失为一种较好的办法。     

高原HBO治疗方案的制定与注意事项的探讨

高原病是发生在高原这个特殊环境的一类疾病,主要是人体对低氧适应发生了障碍,出现头痛、头晕、心慌、胸闷、食欲不振、腹胀、恶心呕吐、失眠、精神紧张、血压改变等症状,甚至发生高原性脑水肿,肺水肿。利用高压氧舱在高气压下吸纯氧、对高原病的治疗是其他任何方法所不能代替的。本文介绍了高原高压氧（HBO）治疗的方案的制定,以及在治疗过程中的注意事项。     

Phase III evaluation of the insecticidal efficacy and durability of a deltamethrin-treated polypropylene long-lasting net LifeNet®, in comparison with long-lasting nets made from polyester and polyethylene: study protocol

Background

Traveling to Tibet implies a risk for developing acute mountain sickness (AMS), and the size of this problem is likely increasing due to the rising number of tourists. No previous study on AMS has been conducted among the general tourist population in Tibet. Thus, the aim of this study was to estimate the prevalence and determinants of AMS in a large tourist population visiting Lhasa.

Methods

A sample of 2385 tourists was recruited from seven randomly selected hotels in Lhasa between June and October 2010. Within three days of their first arrival, the participants filled in a questionnaire based on the Lake Louise Scoring System (LLSS) about AMS-related symptoms and potential contributing factors. AMS was defined as the presence of headache and a cumulative Lake Louise Score ≥4. After estimating the prevalence of AMS, a Log-Binomial Model was applied to analyse the relationship between AMS and selected risk factors.

Results

The prevalence of AMS was 36.7 % (95 % CI: 34.6–38.7 %) and was not dependent on tourists’ country of origin. Among the participants who developed AMS, 47.6 % reported that they experienced symptoms within the first 12 h after arriving in Lhasa, and 79.0 % reported that they had to reduce their activity level. A poor or average health condition (adjusted PR 1.63, 95 % CI 1.38–1.93), an age below 55 years (adjusted PR 1.29, 95 % CI 1.04–1.60), a rapid ascent to Lhasa (adjusted PR 1.17, 95 % CI 1.02–1.34) were independent AMS risk factors, while smoking (adjusted PR 0.75, 95 % CI 0.59–0.96) and pre-exposure to high altitude (adjusted PR 0.71, 95 % CI 0.60–0.84) reduced the risk of AMS.

Conclusions

AMS is commonly experienced by tourists visiting Lhasa Tibet, and often affects their activities. The tourists’ country of origin did not seem to affect their risk of AMS, and their age was inversely related to AMS. Subjects planning to visit a high-altitude area should be prepared for experiencing AMS-related problems, and consider preventive measures such as pre-exposure or a gradual ascent to high altitudes.

     

急性高原反应及高原肺水肿发病机理和诊断标准的探讨

本文观察了急性高原反应，高原肺水肿患者及同海拔健康者各２０名的血气，心肺功能及体液平衡的变化。结果表明二者均有低氧血症，心功能不全，体液代射异常以及脑水肿表现。本文还讨论了稳性高原反应，高原肺水肿的综合定量诊断标准。