瑞芬太尼用于婴幼儿快通道心脏手术麻醉

目的 评价瑞芬太尼复合麻醉用于婴幼儿心脏手术安全性和有效性.方法 选择30例患儿,ASA Ⅰ～Ⅱ级,择期行房间隔缺损(ASD)或单纯室间隔缺损(VSD)修补术.随机分为2组,Ⅰ组芬太尼0.0 5～1 μg/(kg·min)持续泵入,Ⅱ组瑞芬太尼0.05～1.00 μg/(kg·min)持续泵入.分别于不同时间记录血流动力学参数,并采集动脉血标本测量应激激素浓度,观察术后机械通气时间和拔管时间.结果 与Ⅰ组比较,Ⅱ组在术中各时点血流动力学参数和应激激素浓度差异均无统计学意义,但术后通气时间和拔管时间均显著缩短(P＜0.01).结论 瑞芬太尼复合麻醉维持术中血流动力学稳定,有效抑制应激激素释放,术后能早期拔管,适用于婴幼儿心脏手术快通道麻醉.     

新生儿缺氧缺血性脑病早期干预的效果

目的探讨通过早期干预对新生儿缺氧缺血性脑病(HIE)发育状况的疗效。方法将96例观察对象随机分到两组,早期干预组在新生儿期即开始接受系统的干预;晚期干预在4个月以后开始治疗,1岁时测量他们的的行为发育商(DQ)和发育年龄(DA),并进行比较。结果晚期干预组发育异常率为27.7%,高于早期干预组的10.45%(χ2=4.597,P=0.032),干预疗效与开始接受治疗的年龄(H=23.92,P<0.001)、治疗疗程(H=0.990,P<0.001)有关。结论对新生儿缺氧缺血性脑病患者早期干预治疗能有效改善智力及运动发育。     

微生态制剂预防和治疗小儿肺炎继发腹泻的临床疗效

目的探讨预防性应用微生态制剂(贝飞达)对小儿肺炎继发腹泻的防治效果。方法2000年1月～2007年12月住院治疗的肺炎患儿360例随机分为预防组和对照组。预防组在入院后即开始应用微生态制剂;对照组入院后始终未用或住院时间72h后因出现继发腹泻才开始应用微生态制剂。对肺炎继发腹泻的发生率和治疗效果进行统计分析。结果预防组186例住院治疗期间继发腹泻病发病率为20.97%(39/186);对照组174例住院治疗期间继发腹泻病的发病率40.80%(71/174),两组间差异具有统计学意义(χ2=16.672,P<0.01),而腹泻的治疗疗效,预防组也明显优于对照组。结论预防性应用微生态制剂(贝飞达)能减低肺炎患儿继发腹泻的发生率,并对腹泻有较好的治疗效果。     

婴幼儿后颅凹肿瘤43例临床分析

目的 探讨婴幼儿后颅凹肿瘤的临床特点及治疗方法.方法 回顾性分析43例婴幼儿后颅凹肿瘤的临床资料.结果 婴幼儿后颅凹肿瘤的常见症状为呕吐和共济失调.43例中,肿瘤全切除32例(74.4%),近全切除8例(18.6%),大部切除3例(7.0%),本组无手术死亡.33例随访13个月～7年,其中术后放疗13例,12例存活,1例术后2年死亡;术后未放疗的20例患儿中,8例存活,12例于术后2个月～2年死亡.结论 显微镜下肿瘤全切除是良好预后的关键.恶性肿瘤单纯手术预后不好,术后分子病理学指导下的放化疗是今后治疗的方向.     

Plasma lipids and blood glucose in infants of toxemic mothers

Maternal and cord blood of 34 toxemic and 27 non-toxemic mothers and their infants were studied for lipids and glucose. All the lipid fractions in cord blood were significantly lower (P < .001) than that of the mother in all groups due to relative impermeability of the placenta. AFD infants of toxemic mothers had significantly higher (P < .001) value of FFA and triglyceride as compared with AFD infants of non-toxemic mothers. However SFD infants of toxemic mothers had higher FFA only when compared with that of non-toxemic mother. This is possibly due to sympathetic stimulation related to placental insufficiency with hypoxia and hypoglycemia that lead to mobilisation of adipose tissue into FFA and glycerol in fetus. Plasma phospholipid, cholesterol, HDLC, LDLC of infants of toxemic mothers were significantly lower (P < .001), more so in SFD infants, possibly due to impaired liver function, 53% of infants of toxemic mothers also had hyperbilirubinemia. Cord blood glucose in toxemic group was significantly lower (P < .05) than AFD infants of non-toxemic group.     

赛加羚羊羔羊的人工哺育初试

少数雌性赛加羚羊产羔后不给其羊羔哺乳,故进行人工哺育。所用人工乳配方为新鲜山羊奶100毫升、鲜鸡蛋10毫升、鱼肝油5毫升、白糖10克和食盐1克,经40日龄断奶后羚羊羔可正常存活并能繁衍后代。     

Demonstration of perivascular echogenicities in congenital cytomegalovirus infection by colour Doppler imaging

Two children with congenital cytomegalovirus infection and intracerebral echogenicities were investigated by computer sonography and colour Doppler imaging (CDI). By simultaneous imaging of brain tissue and CDI, blood flow within the stripe-like echogenicities of the basal ganglia was demonstrated. Using CDI the echogenicities were identified as the walls of thalamostriate vessels.     

耳蜗电图在婴幼儿听力障碍诊断中的应用

报道６０例临床疑有听力障碍的小儿耳蜗电图（ＥＣｏｃｈＧ）和脑干听觉诱发电位（ＢＡＥＰ）检测结果：正常１６例，异常４４例；其中周围性耳聋３９例，中枢性耳聋２例，混合性耳聋３例。证明ＥＣｏｃｈＧ在小儿听力检测中占有重要地位，它可以提高ＢＡＥＰＩ波检出率，能够判断耳蜗损害性质，与ＢＡＥＰ相结合还可以判断周围性或中枢性耳聋。因此，有必要将ＥＣｏｃｈＧ广泛用于婴幼儿听力检测。     

Recurrent ventricular tachycardia in asymptomatic young children with an apparently normal heart

Abstract Ventricular tachycardia without underlying heart disease is rare in infancy and childhood. Four young children (median age 8 months at initial presentation) with frequently recurrent episodes of asymptomatic and self-limiting ventricular tachycardia are reported. By noninvasive investigation no apparent heart disease has been found in all patients. Initially three of the four children had been treated with an anti-arrhythmic drug. Treatment was soon stopped in two patients for lack of symptoms and for lack of efficacy of therapy; one patient remained on beta-blocker therapy. One child did not receive anti-arrhythmic therapy. After a mean follow up of 32 months all patients continued to be asymptomatic despite frequently recurrent episodes of self-limiting ventricular tachycardia.Conclusion Ventricular tachycardia in asymptomatic children with an otherwise normal heart carries a good prognosis. Invasive investigation (cardiac catheterization with electrophysiological study and right ventricular biopsy) can be with-hold, as long as there are no symptoms. For lack of efficiency of antiarrhythmic drugs in suppressing ventricular tachycardia in asymptomatic children with apparently normal hearts, these patients may be left without therapy but have to be followed closely.     

Left ventricular thrombosis during infancy: Report of two cases

Two patients with left ventricular thrombosis diagnosed by echocardiography are presented. The first patient was a 6-week-old girl with supraventricular tachycardia. Cross-sectional echocardiography showed a rounded and mobile structure protruding from the left ventricular wall. The girl was in heart failure and had signs of peripheral embolization. After sinus rhythm had been restored the thrombus diminished gradually and the girl recovered. The second patient was a newborn boy with severe aortic stenosis and a large massive thrombus along the left side of the interventricular septum. The boy died after valvotomy, the postmortem examination confirmed the diagnosis of a large thrombus. Left ventricular thrombosis is uncommon in neonates and infants but may appear secondary to abnormal hemodynamics.