兔肺原位灌注在缺氧性肺血管收缩反应研究中的应用(摘要)

参考国外有关资料 ,结合我室实际 ,建立了兔肺原位自体血灌注方法 ,用于缺氧性肺血管收缩反应的研究 .( 1)模型的建立 :实验用家兔 1 5～ 2 5ｋｇ,雌雄不拘 ,2 5%乌拉坦 ( 1ｇ/ｋｇ)耳缘静脉麻醉 ,气管插管进行人工通气 ,潮气量 15～ 2 5ｍＬ ,频率 30次/ｍｉｎ.耳缘静脉注射肝素 ( 10 0 0～12 0 0Ｕ/ｋｇ) ,1ｍｉｎ后 ,于左颈总动脉插管放血 ,将所放的血倒入血容器内 ,在放血的同时 ,剪开胸骨 ,暴露心脏 ,结扎主动脉 ,防止灌流液流入体循环 ,先进行肺动脉插管 ,再从左心室将另一导管插入左心房 ,以收集从肺静脉回流的血液 .导管结扎固定后…     

丙泊酚对兔肺动脉压和缺氧性肺血管收缩的影响

目的观察丙泊酚对肺动脉压和缺氧性肺血管收缩反应的影响。方法60足家兔分为六组，每组10只，采用兔自身血液原位肺灌流模型。同步记录肺动脉压和左房压。应用回归分析和P／Q曲线以及跨血管压（TVPQ100）反映丙泊酚对肺血管的效应。结果（1）1、2、3组在给不同剂量丙泊酚后，TVPQ100降低，但无显著性差异（P〉0．05）；（2）4、5、6组在给不同剂量丙泊酚后，TVPQ100均降低，有极显著性差异（P〈0．01）；（3）1、2、3组在低氧后TVPQ100均上升，与低氧前比较，有显著性差异（P〈0．05）；三组TVPQ100上升幅度组间比较有极显著性差异（P〈0．01）；（4）4、5、6组在低氧后TVPQ100均上升，与低氧前比较，有显著性差异（P〈0．05）；三组上升幅度组间比较无显著性差异（P〉0．05）。结论（1）丙泊酚对正常肺动脉压影响较小，但可抑制肺动脉对低氧的反应性，且呈剂量依赖性；（2）丙泊酚对缺氧性肺血管收缩反应有抑制作用，其效应呈剂量依赖性。     

268例急性胆囊炎腹腔镜手术治疗体会

我科于2002年4月至2008年6月共收治急性胆囊炎268例(择期胆囊手术不在统计范围内).现对急性胆囊炎行腹腔镜手术治疗的指征、时机及术中技巧予以探讨.     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

Objective To assess the effects of concentration of sevoflurane on the electrocorticogram (ECoG) of intractable epileptic patients or non-epileptic patients undergoing surgery and investigate the suitable concentration of sevoflurane for epilepsy surgery. Methods Of 24 patients with intractable epilepsy and 15 patients with non-epilepsy but brain diseases, ECoG were recorded under sevoflurane anesthesia with 0.7 minimum alveolar anesthetic concentration (MAC), 1.0 MAC, 1.3 MAC, and 1.5 MAC, respectively, under similar ventilatory conditions. Spike activity and other frequency brain waves were evaluated. Results The frequencies and leads of spike waves (or spike-form waves) were similar with 0.7-1.3 MAC sevoflurane anesthesia in epileptic patients, whereas the spike waves were significantly increased at 1.5 MAC in epileptic patients and 5 of 15 non-epileptic patients (P<0.05). The change of other frequencies brain waves was similar in both group: the frequency of α and β waves decreased, δ waves increased and θ waves changed a little. Conclusion The maintenance of anesthesia with 0.7-1.3 MAC sevoflurane is safe and suitable for the craniotomy surgery of epileptic patients with ECoG monitoring. Careful attention should be paid to the higher concentration of sevoflurane (>1.5 MAC) used when intraperative ECoG is used in both epileptic patients and non-epilepsy patients.     

端粒酶检测在膀胱癌诊断中的应用

端粒酶(Telomerase，TLMA)是一种依赖RNA的DNA聚合酶，能以自身的RNA为模板，逆转录合成染色末端的DNA，从而维持端粒长度的稳定性。大量研究结果表明，正常体细胞和组织TLMA均为阴性，TLMA的激活与细胞的无限增殖有关，它不仅参与正常细胞的调控，也参与恶性肿瘤的形成。TLMA活化是许多肿瘤发生的必经之路，肿瘤的发生发展需要TLMA的参与。本文就端粒酶检测在膀胱癌诊断中的应用概述如下。     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

Objective To assess the effects of concentration of sevoflurane on the electrocorticogram (ECoG) of intractable epileptic patients or non-epileptic patients undergoing surgery and investigate the suitable concentration of sevoflurane for epilepsy surgery. Methods Of 24 patients with intractable epilepsy and 15 patients with non-epilepsy but brain diseases, ECoG were recorded under sevoflurane anesthesia with 0.7 minimum alveolar anesthetic concentration (MAC), 1.0 MAC, 1.3 MAC, and 1.5 MAC, respectively, under similar ventilatory conditions. Spike activity and other frequency brain waves were evaluated. Results The frequencies and leads of spike waves (or spike-form waves) were similar with 0.7-1.3 MAC sevoflurane anesthesia in epileptic patients, whereas the spike waves were significantly increased at 1.5 MAC in epileptic patients and 5 of 15 non-epileptic patients (P<0.05). The change of other frequencies brain waves was similar in both group: the frequency of α and β waves decreased, δ waves increased and θ waves changed a little. Conclusion The maintenance of anesthesia with 0.7-1.3 MAC sevoflurane is safe and suitable for the craniotomy surgery of epileptic patients with ECoG monitoring. Careful attention should be paid to the higher concentration of sevoflurane (>1.5 MAC) used when intraperative ECoG is used in both epileptic patients and non-epilepsy patients.     

先天性距骨嘴1例

先天性距骨嘴１例冯宝龄①李荣文①吉勇①李月萱①患者，女，６０岁，农民。因双踝关节肿痛１０年，加重半月。于１９９５年２月１７日就诊。１０年前患者无意中发现双足背豆大肿块，时有隐痛不适，当地医院拟诊为足背腱鞘囊肿，拟行手术治疗，因患者不同意手术，而对症处...     

抗惊厥药对持续泵注维库溴铵肌松作用的影响

目的　观察抗惊厥药对持续泵注维库溴铵的临床用量及肌松时效的影响。方法　择期神经外科手术 4 0例 ,ASAⅠ -Ⅱ级。A组 19例 ,无抗惊厥药服用史 ;B组 2 1例 ,抗惊厥药服用史 9- 12年。均吸入异氟醚 ,当肌松开始恢复至TOF =8%时 ,静脉泵注维库溴铵 0 .0 3mg/ (kg·h) ,调节泵速 ,维持 8%≤FOF≤ 12 % ,用肌松监测仪监测TOF(四个成串刺激 )。结果　A组和B组维库溴铵总用药量分别是 1.90± 0 .10mg/h和 2 .90± 0 .2 0mg/h ,两组维库溴铵总用药量有显著差异 (P <0 .0 5 )。停药后TOF恢复至 2 5 %、75 %的时间及恢复指数 ,A组分别为7.30± 1.5 0、4 5 .75± 3.5 1、38.4 5± 2 .0 1,B组分别为 5 .0 6± 2 .12、31.0 5± 3.90、2 5 .6 6± 1.78,两组间恢复时效有显著差异 (P <0 .0 5 )。结论　术前长期服用抗惊厥药降低维库溴铵的肌松作用 ,缩短肌松恢复时间     

血液透析致骨筋膜室综合征1例

血液透析致骨筋膜室综合征１例王颖，吉勇（淄博市中心医院，２５５０３６）关键词血液透析；骨筋膜室；尿毒症；骨筋膜综合征患者，男，３９岁，因发作性头痛伴呕吐７个月人院。７个月前病人无明诱因出现头痛，伴恶心、呕吐，吐后头痛减轻。ＢＰ２８～３０／１３～１４ｋ...