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31.
目的 研究功能性消化不良的钡餐诊断方法和标准。方法 设计观察胃功能改变五项指标:胃潴留液量;胃形态类型;幽门功能不全(返流现象);蠕动功能;胃排空功能。对2718例患者进行钡餐观察和评价。结果 符合功能性消化不良临床诊断标准的1208例中,胃潴留液量多191例,占15.81%,无力型胃225例,占18.63%,幽门功能不全(返流)332例,占27.48%,胃蠕动乏力138例,占11.42%,胃排空延缓422例,占34.93%。上述5项指标,可单独出现,也可合并出现,且大多合并出现。结论 观察胃功能改变的5项指标中,胃排空延缓是评价胃功能障碍的主要依据,并提出功能性消化不良的钡餐诊断标准:①本组设计的五项观察胃功能改变的指标中符合三项或胃排空延缓加其它四项中的任何一项,无器质性病变;②上腹痛、腹胀、早饱、暖气、反酸、烧心、恶心、呕吐等上腹症状超过4周;③排除肝、胆、胰及肠道等其它系统病变。达到上述三项标准者基本可以确定诊断。 相似文献
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目前纤维胃镜已广泛用于临床,在行胃镜检查前,一般常规肌肉注射阿托品、安定等药物,但在胃镜导入时,仍有部分病人频繁出现恶心,镜下胃蠕动快,有的病人出现贲门或幽门痉挛,而且有部分病人于注射阿托品后感到心悸,个别病人对药物过敏,在检查后多数病人感到头晕。为探索一种有效的方法,消除药物引起的不良反应,我们试用针刺行纤维胃镜检查7.0例,取得满意的效果,现报告如下。方法和穴位本组应用针刺行纤维胃镜检查70例;另设60例为对照组,采用常规肌肉注射阿托品和 相似文献
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《临床军医杂志》2018,(3)
目的比较右美托咪定联合瑞芬太尼和丙泊酚联合瑞芬太尼这两种麻醉方案应用于内镜黏膜下肿物剥离术(ESD)的有效性、安全性和舒适性。方法选取自2016年7—12月收治的拟行ESD术的80例患者为研究对象。将所有患者随机分为右美托咪定联合瑞芬太尼组(DR组)和丙泊酚联合瑞芬太尼组(PR组),每组各40例。DR组输注右美托咪定,PR组输注丙泊酚,维持脑电双频指数(BIS)值在65~75的范围内。两组均以6μg/(kg·h)的速率持续输注瑞芬太尼。评估两组内窥镜入喉的松弛度、胃蠕动度、医师及患者的满意度等。记录两组呼吸频率(RR)、呼气末二氧化碳浓度(PETCO_2)、心率(HR)、脉搏氧饱和度(SpO_2)、平均动脉压(MAP)、术中肢体躁动情况及不良反应发生情况。结果在PR组内窥镜入喉更容易("非常好进镜",25.0%比57.5%,P<0.05),DR组的胃活动度更多的被抑制("蠕动轻微",97.5%比72.5%,P<0.05)。内镜医师对DR组的手术过程更满意(100.0%比85.0%,P<0.05);两组患者的满意度比较,差异无统计学意义(P>0.05)。PR组的MAP在标记肿瘤边缘(T_3)、黏膜下切除胃肿瘤(T_4)时明显低于DR组,HR在T_3、T_4、手术结束(T_5)时明显高于DR组,差异均有统计学意义(P<0.05)。PR组肢体躁动2例(5.0%),明显低于DR组的9例(22.5%),两组间比较,差异有统计学意义(P<0.05);PR组呼吸抑制9例(22.5%),明显高于DR组的1例(2.5%),两组间比较,差异有统计学意义(P<0.05);两组患者均未发生呼吸道梗阻、恶心呕吐及反流误吸。结论瑞芬太尼联合丙泊酚或右美托咪定均可安全、有效的应用于ESD手术。右美托咪定联合瑞芬太尼对患者呼吸抑制少,胃蠕动度更低,内镜医师更满意;而丙泊酚联合瑞芬太尼使患者进镜耐受好、体动少,但需要严密监测,以避免呼吸相关并发症的发生。 相似文献
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患者女,22岁,4年前开始无明显诱因出现上腹部疼痛,与进食无关,未治疗,自行好转,后偶有类似症状发作.近日又出现上腹部疼痛,并伴恶心,呕吐3次来诊,超声检查:饮水约500 ml后,胃充盈可,胃壁各层次尚清晰,胃蠕动正常,胃内见多个大小不等的不均质中等回声团块,自胃壁黏膜层向胃腔内突出,边界清楚,呈弥漫性分布,形态各异,不规则,有柱状、桑椹状、分叶状、乳头状等多种形态,还有的呈偏平突起,基底较宽,部分团块间基底部发生融合(图1),最大者约11 mm×15 mm,小的约4mm×3 mm,胃蠕动时见较大团块略有活动,但与胃壁不分离,CDFI:团块内无明显血流信号显示. 相似文献
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AIM: To observe the effect of acupuncture at Foot- Yangming Meridian on gastric mucosal blood flow (GMBF), gastric motility and brain-gut peptide.
METHODS: Sixty SD rats were randomly divided into 6 groups: normal control group, model group (group with gastric mucosal damage, GMD), Sibai group (with acupuncture at Sibai point + GMD), Tianshu group (with acupuncture at Tianshu point + GMD), Zusanli group (with acupuncture at Zusanli point + GMD) and non-acupoint group (with acupuncture at non-acupoint + GMD). The GMD model group was induced by infusing pure alcohol into gastric cavity. H2 Gas Clearance Test (HGCT) was used to measure GMBF, the frequency and amplitude of gastric motility were measured by the method of aerocyst, the content of brain-gut peptide in sinus ventriculi and bulbus medullae were detected by radioimmunoassay.
RESULTS: Inhibitory effect of the frequency and amplitude of gastric motility were shown in model group, and the rates of frequency and amplitude changes were remarkably different from the normal control group (-19.41 ± 17.21 vs-4.71 ± 10.32, P 〈 0.05; -51.61 ± 29.02 vs 1.81 ± 14.12, P 〈 0.01). In comparison with control group, the GMBF was 0.52 ± 0.161 mL vs 1.03 ± 0.255 mL per 100g tissue/min, P 〈 0.01, the content of motilin in sinus ventriculi and bulbus medullae was 63.04 ± 7.77 pg/mL vs 72.91 ± 8.42 pg/mL, P 〈 0.05 and 50.96 ± 8.77 pg/mL vs 60.76 ± 8.05 pg/mL, P 〈 0.05, but the content of somatostatin in sinus ventriculi and bulbus medullae was 179.85 ± 43.13 ng/g vs 90.54 ± 40.42 ng/g, P 〈 0.01 and 532.86 ± 122.58 ng/g vs 370.91 ± 76.29 ng/g, P 〈 0.05,respectively. In comparison with model group, the amplitude of gastric motility was 1.52 ± 20.13, -6.52 ± 23.31, 6.92 ± 25.21 vs -51.61 ± 29.02, P 〈 0.01 and GMBF was 0.694 ± 0.160 mL vs 0.893 ± 0.210 mL, 1.038 ± 0.301 mL vs 0.52 ± 0.161 mL per 100g tissue/rain, P 〈 0.01, respectively in Tianshu, Sibai and Zusanli groups, the content of moti 相似文献
METHODS: Sixty SD rats were randomly divided into 6 groups: normal control group, model group (group with gastric mucosal damage, GMD), Sibai group (with acupuncture at Sibai point + GMD), Tianshu group (with acupuncture at Tianshu point + GMD), Zusanli group (with acupuncture at Zusanli point + GMD) and non-acupoint group (with acupuncture at non-acupoint + GMD). The GMD model group was induced by infusing pure alcohol into gastric cavity. H2 Gas Clearance Test (HGCT) was used to measure GMBF, the frequency and amplitude of gastric motility were measured by the method of aerocyst, the content of brain-gut peptide in sinus ventriculi and bulbus medullae were detected by radioimmunoassay.
RESULTS: Inhibitory effect of the frequency and amplitude of gastric motility were shown in model group, and the rates of frequency and amplitude changes were remarkably different from the normal control group (-19.41 ± 17.21 vs-4.71 ± 10.32, P 〈 0.05; -51.61 ± 29.02 vs 1.81 ± 14.12, P 〈 0.01). In comparison with control group, the GMBF was 0.52 ± 0.161 mL vs 1.03 ± 0.255 mL per 100g tissue/min, P 〈 0.01, the content of motilin in sinus ventriculi and bulbus medullae was 63.04 ± 7.77 pg/mL vs 72.91 ± 8.42 pg/mL, P 〈 0.05 and 50.96 ± 8.77 pg/mL vs 60.76 ± 8.05 pg/mL, P 〈 0.05, but the content of somatostatin in sinus ventriculi and bulbus medullae was 179.85 ± 43.13 ng/g vs 90.54 ± 40.42 ng/g, P 〈 0.01 and 532.86 ± 122.58 ng/g vs 370.91 ± 76.29 ng/g, P 〈 0.05,respectively. In comparison with model group, the amplitude of gastric motility was 1.52 ± 20.13, -6.52 ± 23.31, 6.92 ± 25.21 vs -51.61 ± 29.02, P 〈 0.01 and GMBF was 0.694 ± 0.160 mL vs 0.893 ± 0.210 mL, 1.038 ± 0.301 mL vs 0.52 ± 0.161 mL per 100g tissue/rain, P 〈 0.01, respectively in Tianshu, Sibai and Zusanli groups, the content of moti 相似文献
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针刺四白及内庭穴对胃蠕动功能的影响 总被引:5,自引:0,他引:5
目的:观察针刺足阳明经上下对应的四白、内庭穴对胃蠕动功能的影响,进一步探讨足阳明经与胃的相关规律。方法:选择12例正常人及3例胃疾病患者为观察对象,对其四白、内庭及左右旁开对照点进行针刺,并以B超显像观察针刺前后胃蠕动波频率、电子标尺测蠕动波幅,同时摄片记录。结果:针刺足阳明经的四白、内庭穴对胃蠕动功能有特异性影响。结论:足四明经四白、内庭穴对其相应的内脏有特异性,为临床调整消化系统功能的有效穴。 相似文献
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