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对32例大肠损伤在一期切除端端吻合或修补的同时,于肛门处置支撑吻合管,具有减压、引流、冲洗等作用,使损伤的结肠一期愈合,避免了预防性、分流性结肠造瘘,免除了二次手术的痛苦,缩短了住院时间,节省了住院费用。  相似文献
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Objective: Since dimethicone may be employed to improve gastrointestinal tolerability of non steroidal anti-inflammatory drugs (NSAIDs), we studied its influence on the pharmacokinetics of ketoprofen in subjects receiving a single oral dose of racemic ketoprofen. Patients and methods: In a cross-over experimental design, 12 healthy fasting volunteers were given a single oral dose (100 mg) of racemic ketoprofen, administered with or without dimethicone. The kinetic parameters measured were area under the concentration (AUC), maximum peak plasma concentration (Cmax), time to reach peak concentration (tmax), elimination half-life (t1/2), mean residence time (MRT) and urinary excretion for R and S enantiomers. Results: Dimethicone reduced the peak concentration of both R and S ketoprofen by about 10% (P < 0.05) and also induced a slight but non-significant increase in the mean time to achieve peak concentration. However, this treatment had no significant effect on the bioavailability and the elimination of R and S enantiomers, as shown by AUC, t1/2 and MRT values. The absorption patterns were equivalent for both ketoprofen isomers, since plasma pharmacokinetic parameters were similar. Nevertheless, the urinary recovery was significantly lower for R ketoprofen than for its antipode. The administration of dimethicone did not alter this stereoselectivity. Conclusion: The administration of dimethicone to alleviate the epigastralgic effects related to NSAIDs does not affect the efficacy of the treatment. Dimethicone did not significantly alter the bioavailability of ketoprofen, chosen as an example of an NSAID, especially that of the pharmacologically active S enantiomer. Received: 5 August 1997 / Accepted in revised form: 7 March 1998  相似文献
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目的:讨己酮可可碱对重症急性胰腺炎(Severe Acute Pancreatitis,SAP)大鼠肠黏膜微循环的影响及意义。方法 SD大鼠96只随机分为假手术(SO)组、胰腺炎(SAP)组、己酮可可碱(PTX)治疗组。建立大鼠SAP模型。3组于2、6、12、24 h 4个时相观察腹水量及胰腺病理变化、肠黏膜微血管管径、流速。检测3组血浆内毒素( LPS)和血清淀粉酶( AMY)、脂肪酶( LIP)水平。结果腹水量、胰腺病理评分各时相SAP组与SO组差异有统计学意义( P<0.05);PTX组与SAP组相比各指标变化程度较小( P <0.05)。 SAP组、PTX组与SO组比较,肠黏膜微血管管径减小、血流速度减慢( P <0.05)。 SAP组、PTX组LPS、AMY、LIP水平明显高于SO组( P <0.05);PTX组血液指标均低于SAP组( P <0.05)。结论己酮可可碱可有效改善SAP时肠黏膜的微循环。  相似文献
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Gastrointestinal injury is a major cause of death following exposure to high levels of radiation, and no effective treatments are currently available. In this study, we examined the capacity of granulocyte colony-stimulating factor (G-CSF) to mitigate intestinal injury in, and improve survival of, C3H/HeN mice given a lethal dose (12 Gy) of radiation to the abdomen. G-CSF (100 μg/kg body weight) was injected subcutaneously daily for 3 days after irradiation and shown to improve survival and intestinal morphology at 3.5 days compared with saline-injected controls. The morphological features improved by G-CSF included crypt number and depth, villous length, and the length of basal lamina of 10 enterocytes. G-CSF also normalized the levels of circulating tumor necrosis factor alpha and attenuated the loss of peripheral neutrophils, caused by radiation-induced myelosuppression. In conclusion, our results suggest that G-CSF enhanced the survival of irradiated mice and minimized the effects of radiation on gastrointestinal injury.  相似文献
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摘 要质子泵抑制药(PPIs)可有效治疗胃和十二指肠的损伤出血,但对非甾体抗炎药(NSAIDs)所致小肠损伤效果不佳,甚至加重损伤的程度。PPIs通过改变肠道菌群和增加胆汁酸的细胞毒性等机制加重NSAIDs药物引起的小肠损伤,联合用药前应充分评估患者的获益及风险,治疗时需兼顾上下消化道,可选用具消化道黏膜保护功能的特殊组胺H2受体拮抗药如拉呋替丁;尽可能选用对消化道影响较小的NSAIDs药物如选择性COX 2抑制药;补充肠道益生菌,纠正肠道微生态;使用消化道黏膜保护药物;必要时使用肠道的局部抗菌药。考虑到COX 2抑制药和PPIs的心血管风险,对于患有心脑血管疾病和存在心脑血管疾病风险的患者,应慎用此两类药物。  相似文献
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张鑫 《中国医药指南》2011,9(35):270-271
目的探究因实施计划生育手术导致的子宫穿孔及肠损伤的临床特点及其诊断和治疗方法。方法 2006年1月至2011年6月间因接受计划生育手术而出现子宫穿孔、肠损伤而就诊于我院的患者共8例,收集患者的临床资料并进行回顾性分析,重点研究患者的临床表现、诊断及治疗方法。结果经诊断发8例患者中2例患者的损伤部位为结肠系膜,2例的损伤部位为结肠浆肌层,4例小肠受到破损。根据肠的损伤部位及损伤程度,为患者选择相应的肠修补手术方式。结论对于计划生育手术失败者应高度警惕要严格检查患者是否存在子宫穿孔及肠损伤的存在,以便及时采取积极的治疗措施,将该损伤为患者带来的不良影响降至最低。  相似文献
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非甾体抗炎药(NSAIDs)是目前临床应用最广泛、处方中最常见的药物之一,但此类药物治疗作用与不良反应并存,不恰当的应用或滥用,会给患者造成严重危害。大量研究表明NSAIDs不仅可以引起胃的损伤,也可以引起肠道的损伤,甚至比上消化道更为严重,应引起临床医师警惕。  相似文献
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观察注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白 (rhu TNFR: Fc) 对脂多糖 (LPS) 诱导的休克大鼠肠损伤的保护作用及其可能机制。SD大鼠随机分为对照组、rhu TNFR: Fc组、LPS组和rhu TNFR: Fc + LPS组, 监测各组大鼠平均动脉压 (MAP) 计算其死亡率, 检测血清中肿瘤坏死因子-α (TNF-α) 含量和活性; 观察小肠病理形态变化。结果表明, 对照组和rhu TNFR: Fc组大鼠全部存活, MAP无变化, TNF-α含量和活性均维持较低水平; LPS组大鼠死亡率为83%, TNF-α含量和活性明显高于对照组; rhu TNFR: Fc + LPS组大鼠死亡率33%, TNF-α含量升高, 其活性较LPS组明显降低, rhu TNFR: Fc还能降低LPS所致的MDA含量和MPO活性的升高并减轻LPS所致的肠病理性损伤。因此rhu TNFR: Fc对LPS诱导的休克大鼠的肠损伤有保护作用, 其机制可能主要是竞争性结合TNF-α, 减低TNF-α活性以及抗氧化作用。  相似文献
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目的 构建放射性肠损伤大鼠模型,观察丁酸钠对肠损伤的保护作用。方法 SPF级成年SD大鼠90只,分为对照组、模型组和丁酸钠组,每组各30只。除对照组外,造模大鼠暴露腹部上至胸骨剑突下至耻骨联合,VarianClinic600直线加速器6MV高能X射线定位照射,其余部位用5 cm厚铅砖屏蔽,单次照射,总吸收剂量10 Gy。造模前3 d,丁酸钠组SD大鼠ig 40 mg/kg丁酸钠,1次/d,照射后继续给药3 d,对照组和模型组ig生理盐水。多普勒血流仪检测肠黏膜血流量;FITC荧光标记的葡聚糖检测肠黏膜血管通透性;ELISA法检测外周血浆二胺氧化酶(DAO)活性和肠组织一氧化氮(NO)水平;肠黏膜组织切片HE染色,显微镜下测量肠黏膜绒毛高度、黏膜厚度。结果 丁酸钠组造模成功率为83.3%,显著低于模型组的100%(P<0.05)。模型组和丁酸钠组肠黏膜血流量、黏膜绒毛高度和黏膜厚度显著低于对照组(P<0.05、0.01),丁酸钠组肠黏膜血流量、黏膜绒毛高度和黏膜厚度显著高于模型组(P<0.05)。模型组和丁酸钠组肠黏膜葡聚糖、DAO和NO显著高于对照组(P<0.05),丁酸钠组肠黏膜葡聚糖、DAO和NO显著低于模型组(P<0.05)。结论 丁酸钠可以增加放射性肠损伤大鼠肠黏膜血流量,降低NO表达,发挥肠黏膜保护作用。  相似文献
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