老年肺部感染的病原学及传统抗生素的抗菌活性评价

肺部细菌感染是老年人死亡的一个重要原因.近年来,由于病原菌的变迁及对传统抗生素耐药性的产生,老年肺部感染的传统抗生素治疗受到限制.我们对此进行了调查和分析.     

压力—容量曲线对急性肺损伤家兔实行个体化保护性通气？…

OBJECTIVE: To explore the lung-protective effect of ventilation with tidal volume and PEEP determined on pressure-volume curve in oleic acid rabbit models of acute lung injury. METHODS: 24 New Zealand rabbits were randomly divided into 4 groups (V1P1, V1P2, V2P1, V2P2). After inducing lung injury, the P-V curves were measured and drawn. The low and upper inflection point pressure (Pinf and Pdef respectively) were manually determined. Two levels of tidal volume (V1 = 15 ml/kg, V2 reduced for Pplat < Pdef) and two levels of PEEP (P1 = Pinf, P2 = Pinf - 3 cm H2O) were selected. The peak airway pressure (PIP), plateau pressure (Pplat), mean pressure (PAW), static compliance (Cst), heart rate, arterial blood pressure and blood-gas analysis were measured. The lung tissues were pathologically analyzed with light microscope. RESULTS: The oxygenation was not significantly different among 4 groups. The reduced VT significantly raised PaCO2 and lowered pH. Larger VT reduced arterial blood pressure. VT and PEEP synergetically raised airway pressure. Larger PEEP improved Cst, which was counteracted by larger VT. Reduced VT significantly lessened alveolar barotrauma. Larger PEEP lightened alveolar hyaline membrane formation and hemorrhage. CONCLUSION: The ventilation with VT and PEEP determined on P-V curve has significant protective effect on the acutely injured lung.     

纤支镜检查术麻醉方法改进

纤支镜检查术呼吸道麻醉方法很多。近来,我们对麻醉方法进行了改进,临床试用60例,效果尚好。一、方法: 1.术前4～6小时禁食。2.术前10分钟肌注阿托品0.5～1毫克。3.用手捏式喉头喷雾器将2%赛路卡因1～2毫升,在病人吸气时喷入咽喉部,每隔1～2分钟喷1次,共4次,然后嘱被检查者头稍后仰。用此喷雾器将麻药分别喷入病人两鼻腔内,在喷入鼻腔麻药的同时,令其快速用力吸气,在喷药吸气后     

四环素胸内注射治疗反复发作性及顽固性气胸

我们用四环素胸内注射封闭法治疗反复发作性气胸(RPT)和顽固性气胸(OPT)18例,取得较满意疗效。一、临床资料本组RPT15例,OPT3例;患者年龄17～50岁,其中右侧气胸11例,左侧7例;肺压缩程度为40～100%。     

抗生素诱发内毒素释放

尽管临床上进行了有效、敏感的抗生素治疗，革兰阴性（Ｇ－）杆菌败血症患者病死率仍较高。即使生存的患者，在抗生素治疗初期也有疾病恶化的情况，可能的原因是抗生素导致细菌破坏，内毒素（ＬＰＳ）释放，使原已受损的组织进一步受到损害，甚至导致多脏器功能衰竭［１，...     

家兔急性肺损伤油酸模型的制备

为探讨制备稳定的家兔急性肺损伤油酸模型的方法和所需剂型 ,将新西兰家兔 1 5只随机分为 99%油酸组、97%油酸组和分析纯组三组 ,用油酸经颈静脉分次注射复制急性肺损伤模型 ,观察三组造成急性肺损伤模型需要油酸的剂量和模型的稳定性。结果 ,三组在油酸用量小于 0 .0 8ml/kg体重时均不能达到模型要求 ,0 .0 8ml可达到要求 ,并于注射后 1h稳定 ,但分析纯组有 3只出现中到大量气道渗液 ,于 1h内死亡。结果提示 ,制造油酸模型时 ,油酸纯度越高越好 ,但每次用量以不超过 0 .0 8ml/kg为宜 ;分析纯杂质多 ,模型不稳定。