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1.
目的探讨异丙酚复合小剂量芬太尼、麻黄碱、利多卡因静脉麻醉在人工流产术中应用的优越性和安全性。方法从2003年9月至2004年3月随机选择ASAⅠ~Ⅱ级接受人工流产术的门诊病人246例,随机分为3组,即单纯应用异丙酚组82例(Ⅰ组),异丙酚复合小剂量芬太尼组82例(Ⅱ组),异丙酚复合小剂量芬太尼、麻黄碱、利多卡因组82例(Ⅲ组);并记录HR、BP、RR、SpO2及镇痛效果、用药总量、苏醒时间、不良反应。结果单纯应用异丙酚组和异丙酚复合小剂量芬太尼组病人HR、BP均有不同程度下降,注药局部疼痛例数明显高于异丙酚复合小剂量芬太尼、麻黄碱及利多卡因组,具有显著意义(P<0.05);3组病人的苏醒时间和麻醉效果无显著性差异(P<0.01)。结论异丙酚复合小剂量芬太尼、麻黄碱、利多卡因静脉麻醉行无痛人工流产术安全性大,不良反应少,值得临床推广。  相似文献   

2.
目的探讨芬太尼联合异丙酚在人工流产术中的镇痛作用及护理。方法将1650例早孕妇女随机分为2组。实验组为人工流产术孕妇,缓慢静脉注入芬太尼0.1mg及异丙酚2mg/kg,必要时追加异丙酚,剂量掌握在0.5mg/kg以内;对照组施行传统人工流产术(不用任何镇痛药),观察比较两组镇痛、宫口松弛、满意度、遗忘的程度、术中情况及血压(MAP)、心率(HR)、血氧饱和度(SpO2)。结果实验组100%孕妇镇痛、人工流产综合征发生、宫口松弛、满意度、遗忘程度明显优于对照组(P<0.01)。实验组在术中术后MAP、SPO2明显下降(P<0.01)。呼吸抑制(SpO2<90%)发生率占1.05%,对照组术中术后MAP、HR明显上升(P<0.01)。实验组阴道流血量和手术时间与对照组比较差异无统计学意义。结论芬太尼联合异丙酚用于人工流产术中,可显著改善孕妇的耐受性,镇痛效果确切,操作简便,副反应少,安全有效,且护理支持中必经加强呼吸、循环监护及镇痛观察。  相似文献   

3.
丙泊酚复合麻醉用于无痛人流的临床研究   总被引:1,自引:1,他引:0  
目的 观察丙泊酚与小剂量芬太尼、氯胺酮联合应用于人工流产手术麻醉无痛人流术的麻醉效果.方法 选择门诊自愿要求人工流产健康妊娠妇女180例,随机分成A、B、C三组,每组60例,A组静脉注射丙泊酚2.5mg/kg;B组静脉注射丙泊酚1.5mg/kg+芬太尼1μg/kg;C组静脉注射丙泊酚1.5mg/kg+氯胺酮0.1mg/kg.分别记录术前和术中的血压(MAP)、心率(HR)、呼吸(RR)及血氧饱和度(SPO2),各组丙泊酚总用量、苏醒时间、术后头晕发生率,并评判术中镇痛效果.结果 (1)MAP、HR、SPO2术前和术中比较:A组明显F降(P<0.05);B、C两组比较则无显著性差异.(2)A组丙泊酚总用量明显高于B、C两组,镇痛效果B、C两组明显优于A组,术后头晕发生率B、C两组较A组有明显降低(P均<0.05),但B、C两组比较其差异无统计学意义.苏醒时间三组比较无显著性差异.结论 芬太尼、氯胺酮对丙泊酚的药效学有加强作用,丙泊酚复合小剂量芬太尼、氯胺酮进行静脉麻醉用于门诊无痛人工流产手术是一种较为合理、安全可行的麻醉方法 ,其麻醉效果更佳、更安全、更经济,值得在临床中推广.  相似文献   

4.
丙泊酚复合芬太尼麻醉用于无痛人工流产手术的疗效观察   总被引:1,自引:4,他引:1  
目的:探讨丙泊酚复合芬太尼在无痛人工流产手术中的临床效果及安全性。方法:选取临床病例分为丙泊酚复合芬太尼组、利多卡因组和不采用任何干预措施的对照组,观察3组的镇痛效果、人工流产综合反应(PAAS)发生率、宫颈口松弛情况、出血量及手术时间,并观察丙泊酚复合芬太尼组MAP、SPO2、HR、RR变化及副反应。结果:丙泊酚复合芬太尼组镇痛效果明显,人工流产综合反应发生率低,与利多卡因组、对照组比较差异有显著性(P<0.05);出血量及手术时间与利多卡因组、对照组比较差异无显著性(P>0.05)。术后血压、心率、呼吸无明显变化。结论:丙泊酚复合芬太尼麻醉效果可靠,符合门诊无痛人工流产麻醉的要求。  相似文献   

5.
目的:比较咪唑安定复合小剂量芬太尼与度氟合剂用于妇科手术中患者的镇静效果.方法:选择ASA 1~2级硬膜外麻醉下行妇科手术患者60例,随机分成两组,每组30例.A组:咪唑安定0.04 mg/kg 芬太尼1.0 μg/kg;B组:哌替啶1.0 mg/kg 氟哌利多0.05 mg/kg.观察两组患者生命体征的改变、术中镇静程度以及术后24 h调查遗忘情况.结果:两组患者术中心率(HR)、呼吸(RR)、血氧饱和度(SPO2)和平均动脉压(MAP)同术前相比差异无统计学意义(P>0.05),用药后5、15、30、60 min的OAA/S评分B组高于A组,差异有统计学意义(P<0.05);A组遗忘程度优于B组,差异有统计学意义(P<0.05).结论:咪唑安定复合小剂量芬太尼用于硬膜外麻醉镇静遗忘效果好.  相似文献   

6.
目的探讨瑞芬太尼复合异丙酚在人工流产中的有效性和安全性。方法将210例早孕妇女随机分成3组,每组70例,2组人工流产中分别应用瑞芬太尼复合异丙酚、利多卡因,另一组为对照组,不采用任何干预措施。观察3组的镇痛效果、人工流产综合征(PAAS)发生率、宫口松弛度、阴道流血量及手术时间,并观察瑞芬太尼复合异丙酚组的血压(BP)、血氧饱和度(SPO2)、心率(HR)、呼吸(RR)变化、苏醒时间、麻醉效果、定向恢复及副作用等。结果瑞芬太尼复合异丙酚组镇痛效果明显,镇痛率为100%,人工流产综合征发生率为0,与利多卡因组比较有差异有统计学意义(P<0.05),且苏醒早,术中BP、HR、RR较平稳,手术时间和出血量与其他两组比较差异无统计学意义(P>0.05)。结论瑞芬太尼复合异丙酚麻醉效果可靠,适合门诊无痛人工流产的要求,但术中须与麻醉科医师密切配合,以增加无痛人流术的安全性。  相似文献   

7.
目的:比较异丙酚复合芬太尼静脉麻醉与异丙酚静脉麻醉用于人工流产术的临床效果。方法:选择门诊人工流产患者100例,随机分为异丙酚复合芬太尼组(Ⅰ组)和异丙酚组(Ⅱ组),记录给药前后各时间点两组的MAP、HR及SPO2的变化;术中异丙酚的用量及术中体动情况;患者的苏醒时间及苏醒质量。结果:给药后两组的MAP、HR及SPO2均有不同程度的下降,与给药前相比差异有统计学意义(P<0.05);异丙酚用量Ⅱ组明显大于Ⅰ组(P<0.01);术中患者体动Ⅱ组明显多于Ⅰ组(P<0.01);两组苏醒时间及苏醒质量差异无统计学意义(P>0.05)。结论:异丙酚复合芬太尼麻醉效果确切,异丙酚用量小,生命体征平稳,是一种较理想的无痛人工流产术的麻醉方法。  相似文献   

8.
丙泊酚并小剂量芬太尼或舒芬太尼用于人工流产效果   总被引:1,自引:0,他引:1  
目的 比较丙泊酚复合小剂量芬太尼、舒芬太尼用于人工流产的麻醉效果.方法 选择门诊ASA Ⅰ~Ⅱ级、自愿接受无痛人工流产手术的病人40例,随机分成丙泊酚复合芬太尼组(A组,n=20)和丙泊酚复合舒芬太尼组(B组,n=20).A组于丙泊酚给药前缓慢静脉注射芬太尼0.6 μg/kg,B组于丙泊酚给药前缓慢静脉注射舒芬太尼0.1 μg/kg.比较两组病人用药前、后平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、脉搏氧饱和度(SpO2),术中丙泊酚用量、病人意识消失和定向力恢复(用药结束至完全清醒)时间,术中呼吸抑制和术后发生宫缩痛的例数.结果 B组用药后MAP、HR、RR高于A组,丙泊酚用量少于 A组,差异均有显著性(t=2.043~7.430,P<0.05). A组5例病人术后发生宫缩痛,B组0例.两组病人SpO2和意识消失时间比较差异无统计学意义(P>0.05).B组定向力恢复时间明显短于A组(t=2.626,P<0.05).两组病人术中均无呼吸抑制.结论 丙泊酚复合小剂量芬太尼或舒芬太尼用于无痛人工流产术都是安全有效的,舒芬太尼的镇痛效果优于芬太尼.  相似文献   

9.
宋正亮  王璇  陈源源 《中外医疗》2010,29(28):114-115
目的观察芬太尼、异丙酚伍用麻黄碱在宫腔镜手术中的麻醉效果与生命体征变化。方法选择80例宫腔镜手术患者,随机分为实验组(M组)和对照组(D组),每组40例,用芬太尼、异丙酚行静脉复合麻醉。实验组在诱导液中加入麻黄碱0.08mg/kg,监测MAP、HR、RR、SPO2,比较2组麻醉效果的差异和生命体征变化。结果实验组MAP、HR、RR、SPO2稳定,苏醒快;对照组MAP、HR、RR、SPO2下降明显。结论芬太尼、异丙酚伍用麻黄碱可以减轻镇静深度和伤害反应,减少异丙酚的副作用,使苏醒更加迅速。  相似文献   

10.
目的观察依托咪酯和异丙酚复合芬太尼应用于无痛人流术的麻醉效果。方法要求行人工流产术妇女180例,随机分为三组,C组不用任何麻醉药及镇痛药;A组静脉推注芬太尼1μɡ/kg后静脉推注依托咪酯0.3mg/kg;B组静脉推注芬太尼1μɡ/kg后静脉推注异丙酚2.0mg/kg。监测人流术前、术中以及术后的平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、脉搏氧饱和度(SpO2)变化;进行镇痛效果评价并观察术中出血量、人流综合征的发生情况以及术后恶心呕吐情况;记录患者苏醒时间和离院时间。结果A组患者MAP在给药后无明显变化;B组患者MAP在给药后1-3分钟有轻微下降(p<0.05)。A、B两组患者心率在给药后均有所降低(p<0.05)。给药后,A、B两组患者自主呼吸频率明显减缓,10分钟后恢复到给药前水平;两组血氧饱和度有所下降,但不明显(p>0.05)。A、B两组镇痛效果明显优于C组(p<0.05);A、B两组镇痛效果差别无显著性(p>0.05)。A组离院时间较B组有所延长(p<0.05)。A、B两组人流综合症发生情况和恶心呕吐发生率明显低于C组(p<0.05)。结论采用依托咪酯或异丙酚复合小剂量芬太尼应用于无痛人流术中,均可产生良好的麻醉与镇痛效果。  相似文献   

11.
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   

12.
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   

13.
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   

14.
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   

15.
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   

16.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

17.
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   

18.
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   

19.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

20.
ANTI-PROLIFERATION EFFECT OF ORIDONIN ON HL-60 CELLS AND ITS MECHANISM   总被引:4,自引:0,他引:4  
Objcetive To investigate the anti-proliferation effect of oridonin on leukemic HL-60 cells and its mechanism. Methods HL-60 cells in vitro in culture medium were given different concentrations of oridonin. The inhibitory rate of cells were measured by microculture tetrazolium (MTT) assay, cell apoptotic rate was detected by flow cytometry (FCM), morphology of cell apoptosis was observed by hoechst 33258 fluorescence staining, and the activity of telomerase was detected using telomere repeat amplification protocol (TRAP) PCR-ELISA before and after apoptosis occurred. Results Oridonin could decrease telomerase activity, inhibit growth of HL-60 cells, and cause apoptosis significantly. The suppression was both in time- and dose-dependent manner. Marked morphological changes of cell apoptosis including condensation of chromatin and nuclear fragmentation were observed clearly by hoechst 33258 fluorescence staining especially after cells were treated 48-60 hours by oridonin. Conclusions Oridonin has apparent anti-proliferation and apoptotic effects on HL-60 cells in vitro, decreasing telomerase activity of HL-60 cells may be one of its most important mechanisms. These results will provide strong laboratory evidence of oridonin for clinical treatment of acute leukemia.  相似文献   

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