中药润目灵雾化熏蒸治疗对眼压影响的临床观察

目的:观察中药雾化熏蒸治疗对于患者眼压的影响。方法:序贯选取患者28例56只眼,对所有患者进行中药雾化熏蒸治疗前、治疗后分别进行眼压测定,比较患者治疗前后眼压变化情况。结果:患者治疗前后眼压有显著性差异(t=-2.895,P=0.005),治疗后眼压值升高0.74 mmHg(1 mmHg=0.133 kPa),眼压变化值与治疗前眼压无显著性相关(F=1.514,P=0.224),回归方程为y=-0.0622x+1.7079,确定系数R2=0.0273。结论:中药雾化熏蒸治疗前后眼压值变化虽然差异有显著意义,但并无实际临床意义,仍然是一种安全的治疗途径。     

氧驱雾化吸入布地奈德联合沐舒坦治疗咳嗽变异性哮喘的临床观察

目的 观察氧气驱动雾化吸入布地奈德联合沐舒坦治疗咳嗽变异性哮喘的临床效果.方法 将2007年1月至2009年1月在我院住院治疗的64例咳嗽变异性哮喘患儿分为观察组(34例)和对照组(30例),两组均常规控制感染、支持、对症治疗,观察组采用布地奈德联合沐舒坦氧气驱动雾化治疗,对照组采用沐舒坦氧气驱动雾化治疗加地塞米松0....     

利咽化痰通络法结合超声雾化治疗慢性咽炎的临床观察

目的观察利咽化痰通络法结合超声雾化治疗慢性咽炎的临床疗效。方法180例慢性咽炎患者依照区组随机化法分为安慰剂组、实验组、对照组各60例。安慰剂组用生理盐水20 mL进行超声雾化喷喉,实验组用生理盐水15 mL＋中药天竺雾化剂5 mL行超声雾化喷喉,对照组用庆大霉素8万单位＋地塞米松注射液10 mg＋生理盐水配成20 mL溶液行超声雾化喷喉。每次治疗时间均为10 min,每日1次,持续2周。治疗前、治疗2周后分别观察记录患者临床症状及咽部体征评分。结果治疗后三组的临床症状及咽部体征评分均较治疗前有所下降,差异均有统计学意义（P〈0.05）;但实验组的临床症状及咽部体征评分降低程度及临床疗效均明显优于安慰剂组及对照组,差异均有统计学意义（P〈0.05）。结论利咽化痰通络法结合超声雾化治疗慢性咽炎有良好的临床疗效。     

西维来司钠对脑损伤继发吸入性肺损伤大鼠的影响研究

目的:探讨西维来司钠(Sivelestat sodiom)雾化吸入对脑损伤继发肺损伤大鼠的影响,从炎性反应角度探讨其作用机制.方法:SD大鼠60只,随机分为6组,正常组(A),误吸组(B),脑损伤误吸组(C),生理盐水雾化吸入组(D),地塞米松雾化吸入组(E),西维来司钠雾化吸入组(F),每组10只,用酶联免疫吸附(Enzyme-linked immunosorbent assay,ELISA)法测定支气管肺泡灌洗液(Bronchoalveolar lavage fluid,BALF)的中性粒细胞弹性蛋白酶(Neutrophil elastase,NE)和白介素-8(Interleukin-8,IL-8)含量,免疫透射比浊法测定BALF中白蛋白浓度;光镜观察肺组织病理改变.结果:F组肺组织形态学改善最明显,其次为E组;E、F组大鼠BALF中NE低于B、C、D组(P＜0.05),F组最明显;E、F组大鼠BALF中IL-8含量均低于C、D组(P＜0.05),但E、F2组间差异无统计学意义(P＞0.05).结论:西维来司钠雾化吸入对脑损伤继发吸入性肺损伤大鼠肺组织的改善作用优于地塞米松,其作用机制可能与抑制NE的产生和活性,减轻NE对肺组织的直接损伤作用和抑制肺内炎性网络循环反应导致的肺组织损伤有关.     

Anesthesia and ventilation options for flex robotic assisted laryngopharyngeal surgery

BackgroundTransoral treatment of benign and malignant lesions of laryngopharynx has limitations in exposure and access, partially due to the endotracheal tube (ETT). With a proper airway control to tailor ventilation and maximize exposure, transoral Flex robotic surgery (FLEX), using its 3D camera and instruments, can expand its ability. Choosing the right ETT, including a novel concept of using jet ventilation (JV) in FLEX, and placement technique can allow augmentation of the advantages that robotic surgery offers.MethodsChart review of FLEX assisted procedures was performed. Attention was given to demographics, all events of airway manipulation and ventilation type, procedures performed and outcomes including adverse effects.ResultsFifty-two patients underwent eighty procedures. The airway was manipulated sixty-four times to include 8 JV. All possible FLEX instruments including CO2 laser were used. Three novel possible indications for trans-oral robotic surgery including the feasibility of JV in FLEX procedures were shown.ConclusionsLesions of the tongue base, hypopharynx, larynx and trachea have the possibility to be managed with adequate exposure with minimal obstruction from ETT. Robotic HD camera permits both the surgeon and anesthesiologist to observe surgery and safely monitor the airway. An algorithm was developed for selecting ideal ventilation method for different procedures. The FLEX and the utilization of JV allows flexibility of two instruments without obstruction.     

医院中心医用压缩空气雾化治疗系统的建立

目的探讨建立医院中心医用压缩空气雾化治疗系统的效果。方法2012年之前我院使用雾化机进行雾化治疗,2012年之后我院使用中心医用压缩空气雾化治疗系统进行雾化治疗,选取40台雾化机(雾化机组)和150套中心雾化终端(中心雾化组),比较两组的使用效果、一次性成本投入、使用成本。结果中心雾化组的使用效果优于雾化机组(P<0.05)。中心雾化组的一次性成本投入低于与雾化机组(P<0.01)。中心雾化组单个雾化终端使用成本低于雾化机组(P<0.05)。结论基层医院在新院建设时,如建立中央压缩空气系统,建议选用医用压缩机组,在此基础上建立中心医用压缩空气雾化治疗系统。     

氧驱动雾化吸入与空气压缩泵雾化吸入治疗小儿哮喘临床效果

目的:分析氧驱动雾化吸入与空气压缩泵雾化吸入治疗小儿哮喘的临床效果。方法:选取2018年1月~2019年1月本院接诊的60例小儿哮喘患儿作为研究对象,平分为观察组和对照组,每组各30例。对照组选择空气压缩泵雾化吸入,观察组采取氧驱动雾化吸入,比较2组患儿的治疗效果、临床指标、FeNO值。结果:观察组患儿的治疗总有效率为96.67%,明显优于对照组76.67%;观察组患儿咳嗽胸闷、喘息等各项指标均优于对照组;此外,患者的FeNO值低于对照组(P<0.05)。结论:在小儿哮喘的治疗中,氧驱动雾化吸入可以提升患儿的治疗效果,缩短患儿咳嗽胸闷、喘息、呼吸困难的时间。     

支撑喉镜引导下喷射通气在气道介入治疗中的应用

目的观察支撑喉镜引导下喷射通气在气道介入治疗中对患者肺交换功能及呼吸道并发症的影响。方法选择行纤维支气管镜介入治疗患者13例,常规全麻诱导后采用支撑喉镜引导下喷射通气。分别记录麻醉诱导前5 min、放置即时、放置后5 min平均动脉压、心率,术前、术中SpO₂、PO₂、PCO₂,术中SpO₂是否下降,术中及术后相关并发症,术后咽喉部疼痛评分,手术者及麻醉医生满意度评分。结果患者支撑喉镜放置即时MAP、HR较放置前明显升高(P<0.05),放置后5 min MAP、HR明显降低(P<0.05)。支撑喉镜引导通气后10 min,SpO₂、PO₂明显升高(P<0.05),PCO₂与术前比较差异无统计学意义。1例患者上唇损伤,1例撤出喉镜时松动牙齿脱落。结论支撑喉镜引导下喷射通气用于气道介入治疗,氧合良好,手术操作视野开阔,并发症少,安全有效。     

家庭雾化吸入治疗毛细支气管炎85例可行性分析

目的:探讨家庭雾化吸入治疗毛细支气管炎的可行性,为临床治疗方式提供参考。方法:选取我院2015年1月至2016年1月在门诊诊断为轻/中度毛细支气管炎的患儿177例,按随机分组设计方案分为家庭组85例和医院组92例。两组患儿均采用压缩空气驱动的射流雾化器雾化吸入布地奈德混悬液及0.5%沙丁胺醇雾化溶液,家庭组由经过培训的家长在家中进行,医院组在医院门诊雾化室进行,两组患儿分别于治疗第3天、第5天及第7天监测其喘息缓解时间、喘鸣音消失时间、咳嗽消失时间、疗程、不良反应及家长满意度。结果:医院组总有效率为92.4%,高于家庭组的81.2%(P<0.05);医院组的喘息缓解时间及喘鸣音消失时间为(3.39±1.28)d、(4.01±1.29)d,家庭组喘息缓解时间及喘鸣音消失时间为(3.71±1.26)d、(4.35±1.37)d,两组比较差异有统计学意义(P<0.05);家长满意度中的方便性、依从性家庭组明显高于医院组(P<0.05),而可操作性、安全性、给药规律性三项指标及总满意度家庭组明显低于医院组(P<0.01)。结论:家庭雾化吸入治疗毛细支气管炎暂不可行,有待进一步观察。     

Unilateral examination of olfactory threshold using the Jet Stream Olfactometer

Objective: The Jet Stream Olfactometer, a modification by the T&T olfactometer, has been recently developed and is now commercially available. This Jet Stream Olfactometer can routinely measure the unilateral sense of smell. Clinical usefulness of the Jet Stream Olfactometer was evaluated. Methods: Twenty-three patients with sinus-related symptoms were examined. Unilateral olfactory acuity was examined using the Jet Stream Olfactometer and compared it with the anatomy of the olfactory cleft by computed tomographic (CT) scans. Results: In 13 of the 23 patients examined the right olfactory threshold was similar to that of the left. Of these 13, in seven patients there was transport damage of the odorants and in the other six there was sensorineural damage. Ten patients showed an apparent difference between the right and left smell thresholds. Anosmia in seven of these ten patients was due to a conductive olfactory disturbance resulting from rhinosinusitis, whereas sensorineural damage was recognized in the other three patients. The difference in the detection threshold between the right and left nasal cavities was well correlated to that of the opacity between the right and left olfactory clefts. Conclusion: Jet Stream Olfactometer provides a convenient and reliable means for assessing the ability of unilateral smell.