小儿法乐四联症术后低心排综合征的防护

报告28例法乐四联症根治术后病人防护低心排综合症护理体会,采用减少氧消耗量;适当应用心肌正性肌力药物;注意补充足够的血容量;合理使用血管扩张剂;纠正严重的心律紊乱等措施,28例术后发生低心排血量综合征仅3例,及时发现及时处理,防止并发症的发生.     

小儿法乐四联症术后心排综合征的防护

报告28例法乐四联症根治术后病人防护低心排综合症护理体会，采用减少氧消耗量；适当应用心肌正性肌力药物；注意补充足够的血容量；合理使用血管扩张剂；纠正严重的心律紊乱等措施。28例术后发生低心排血量综合征仅3例，及时发现及时处理，防止并发症的发生。     

阻抗微分法测量小鼠心排血量的实验研究

探讨一种测量２０ｇ以内小鼠心排血量的可行方法，以应用于研究。方法：应用 ＲＭ－０６３００型八道生理仪及针式电极行阻抗微分法测量，根据相应公式计算每搏心输出量，结果：测得正常小鼠的每分钟心输出量为１．６７±０．０９ｍｌ／分，病毒性心肌炎小鼠模型每分钟心输出量为１．１６±０．０５ｍｌ／分。     

应用二氧化碳重复呼吸法测定正常人心排血量的初步观察

二氧化碳重复呼吸法测定心排血量是无创测定心脏功能的一种方法，它既可以用于静态测定，更适合于运动状态下的监测。我们应用此方法初步观察了４１个正常人在静态及运动状态下的心排血量，结果表明，大多数受试者的态心排血量和每搏血量均正常，随着负荷的增加，ＣＯ、ＳＶ和ＨＲ也相应增加，但当负荷达一定水平时，ＣＯ的增加则主要靠心率的增加来完成。     

新活素在心衰病人的药效观察

目的 观察冻干重组人脑利钠肽(新活素)治疗急性心力衰竭(AHF)的临床疗效.方法 AHF患者随机分为新活素组与硝酸甘油组各50例,2组均给予常规治疗,新活素组在常规治疗基础上加用新活素,硝酸甘油组加用硝酸甘油,观察2组疗效及肺毛细血管楔嵌压(PCWP)、肺动脉压(PAP)的变化.结果 新活素组总有效率为96%高于对照组的64%,差异有统计学意义(P<0.05).新活素组给药后第1、3、6小时的PCWP、PAP降低值高于硝酸甘油组,差异均有统计学意义(P<0.05).结论 新活素治疗AHF临床疗效确切,值得临床推广应用.     

脉搏轮廓心排血量监测技术在严重烧伤治疗中应用的全国专家共识(2018版)

脉搏轮廓心排血量(PiCCO)监测技术作为一种新型血流动力学监测技术,在指导休克复苏、液体管理等方面体现出重要价值。PiCCO监测技术在烧伤患者中的应用日趋增多,但如何在烧伤患者中实施PiCCO监测,正确理解PiCCO监测参数的临床意义,以及基于PiCCO监测参数指导严重烧伤救治,尚缺乏统一认识。中国老年医学学会烧创伤分会组织国内烧创伤领域著名专家学者,以文献进展为主要依据,结合临床经验,撰写制订《PiCCO监测技术在严重烧伤治疗中应用的全国专家共识(2018版)》,为该技术的临床应用提供参考。     

欧瑞血活素治疗慢性重症病毒性肝炎疗效观察

目的　探讨血活素治疗慢性重症病毒性肝炎 (CSH)的疗法。方法　治疗组 5 0例 ,在常规治疗基础上加用血活素 15ml于 10 %葡萄糖注射液 2 5 0ml中静滴 ,qd× 4wk。对照组 5 0例 ,仅用护肝、退黄、支持、抗感染及利尿等常规治疗。结果　治疗组SB和ALT较治疗前明显下降 (P <0 .0 1) ,显效率为 5 2 % ,总有效率为 86 % ,均优于对照组。结论　血活素是安全有效的慢性重症肝炎辅助治疗药物。     

脉波指示剂连续心排血量(PiCCO)中的胸内血容量(ITBV)测定

在新近推向临床的脉波指示剂连续心排血量(PiCCO)监测中,用单一温度稀释法所测定的胸内血容量(IT-BV),已被许多学者证明是一项可重复、又敏感,而且比肺动脉阻塞压(PAOP)、右心室舒张末期压(RVEDP)、中心静脉压(CVP)更能准确反映心脏前负荷变化的实用指标.本文从心脏生理学、病理生理学及临床应用等方面,系统阐述了前负荷的定义及其影响因素,列举了上述压力监测数据不能准确反映心脏前负荷的机理及临床报道.详细讲述了单一温度稀释法测定ITBV的原理、计算方法、修正公式、测定中注意事项、正常范围值.列举了ITBV作为心脏前负荷的具有代表性的实验与临床统计分析资料.有鉴于左心功能减退伴有中度容量不足病人.恒速补液过程中显示充盈压比ITBV更敏感的报道,笔者建议:临床工作者在应用PiCCO新技术、确认ITBV作为前负荷指标的同时,仍然不应该忽略相关心血管腔的传统压力监测.     

和肽素水平对大鼠心肾综合征的早期预测价值

目的:研究和肽素(CPP)水平对部分肾切除术(SNX)合并心肌梗死(MI)大鼠心肾综合征(CRS)的预测价值。方法:60只雄性SD大鼠采用SNX+MI建立CRS模型,随机分成空白对照(Con)组、SNX组、MI组和CRS组,造模后1~5周检测大鼠血清与尿液中CPP浓度的变化及血液动力学、血压与肾功能的水平。采用受试者工作特征(ROC)曲线评价CPP对大鼠发生CRS的预测价值。结果:与Con组比,CRS组大鼠在造模后9 d的左心室收缩压(LVSP)显著降低(P0.05),左心室舒张末压(LVEDP)显著升高(P0.05),而血压在各时点的差异无统计学显著性;CRS组大鼠的血尿素氮(BUN)和尿肌酐(UCr)在1周和3周均显著升高(P0.05)。与Con组比,CRS组在造模后1、3和5周血清中的CPP显著升高(P0.05),造模后3周尿液中的CPP显著升高(P0.05);在造模后1和3周血清中脑钠肽(BNP)显著升高(P0.05),造模后5周尿液中BNP显著升高(P0.05);CRS组在造模后1周血清和尿液中CPP与BNP和BUN无相关性。ROC曲线分析显示,血清CPP在1周时预测CRS的曲线下面积(AUC)为0.908(95%CI为0.789~1.028),以56.59 ng/L为阈值,其诊断敏感度为87.5%,特异性为80.0%。结论:SNX+MI合并术式能建立心肾共损的CRS大鼠模型,血清CPP可以作为CRS早期预测较为敏感和特异的生物标志物。     

纳洛酮、脑活素治疗新生儿缺氧缺血性脑病96例疗效观察

目的观察纳洛酮、脑活素治疗新生儿缺氧缺血性脑病（HIE）的疗效。方法将96例HIE患儿随机分为两组，治疗组50例，对照组46例，全部病例均给予相同供氧、脱水降颅压、止痉、纠酸等对症治疗，治疗组在此基础上纳洛酮、脑活素治疗。对比疗效并定期随访比较两组疗效。结果治疗组显效率（76％）、总有效率（92％）较对照组显效率（43.5％）、总有效率（78.3％）有显著性差异（P〈0.05）；随访结果比较，治疗组治愈率显著高于对照组，致残率、死亡率显著低于对照组（P〈0，05）。结论早期联合应用纳洛酮、脑活素治疗HIE能有效改善HIE患儿的临床神经症状，缩短病程提高治愈率，降低致残率．     

Observations on Cardiac Output in Animal Experiments and Clinical Application of Jiuling Bileaflet Mechanical Valve Prosthesis

Objective:To observe the cardiac output(CO)in animals and patients undergone valve replacement with Jiuling bileaflet mechanical valve prosthesis.Methods: 1.Animal experiments:6 sheep that subjected to mitral replacement with a 21-mm-valve prosthesis were measured by open cardiac catheterization intraoperatively. Echocardiographic and open cardiac catheterization under dobutamine stress were performed on 2 sheep survival for 30 months post-operation.2.Patient measurements:CO of 14 cases of aortic valve and 10 cases of mitral valve was measured by open cardiac catheterization,and after 12 months,it was measured by echocardiography.Results:1. Animal experiments:The mean CO of 6 sheep was 2.5 L/min intraoperatively by catheterization,and that of 2 sheep survival for 30 months post-implant was 3.0 L/min by echocardiography and 2.9 L/min by catheterization,respectively.2.Patient measurements: The mean cardiac index of 4 patients with 21 mm valve replacement was(2.55±0.27) L/min/m2by catheterization,and was(2.84±0.13)L/min/m2 by echocardiography after 12 months.Conclusion:This study demonstrates that cardiac function on animals and patients return to normal activity after undergone the valve replacement,and the newly valve prosthesis shows excellent hemodynamic performance.     

Measurement of Neonatal Blood Pressure: A New Method

Psychophysiological research on the neonatal cardiac system has focused almost exclusively on heart rate. Other cardiovascular parameters such as blood pressure (BP) have been difficult, if not impossible, to examine in the newborn due to the difficulty involved in measurement. This study tested a new, non-invasive device that simultaneously measured systolic, diastolic, and mean arterial BP and heart rate in the newborn. Eighty healthy babies’ BP and heart rate were measured for the first 3 days of life and the findings were compared with previous reports in the literature. BP was found to increase on each of the first 3 days of life while mean heart rate did not change during this period. State of alertness significantly affected BP and heart rate, with sucking leading to the greatest rise in BP, while crying elicited the highest heart rates. The results indicated that this new non-invasive technology provides an important advance that has considerable bearing on future studies of neonatal psychophysiology.     

肺表面活性物质联合CPAP治疗NRDS的疗效

目的 观察肺表面活性物质（PS）联合持续气道正压通气（CPAP）治疗新生儿呼吸窘迫综合征（NRDS）的疗效。方法 选择2016年6月~2019年5月我院收治的62例NRDS患儿,按随机数字表法分为对照组和观察组,各31例。对照组接受CPAP治疗,观察组在对照组基础上联合PS治疗。比较两组临床疗效、pH、动脉二氧化碳分压（PaCO2）、动脉血氧分压（PaO2）、氧合指数（OI）、住院时间及并发症发生情况。结果 观察组总有效率为93.55%,高于对照组的74.19%,差异有统计学意义（P＜0.05）;观察组pH、PaO2、OI均高于对照组,PaCO2低于对照组,差异均有统计学意义（P＜0.05）;观察组支气管肺发育不良发生率低于对照组,差异有统计学意义（P＜0.05）;两组肺不张、气胸及腹胀发生率比较,差异无统计学意义（P＞0.05）;观察组住院时间短于对照组,差异有统计学意义（P＜0.05）。结论 NRDS患儿接受PS联合CPAP治疗有利于改善动脉血气指标,提升呼吸功能,缩短住院时间,降低相关并发症发生率。     

Response Inhibition Initiates Cardiac Deceleration: Evidence from a Sensory-Motor Compatibility Paradigm

Two experiments tested the hypothesis that response selection processes alter the timing of the shift between anticipatory cardiac deceleration and acceleratory recovery. Experiment 1 compared changes in cardiac interbeat interval induced by the manipulation of sensory-motor compatibility in a four choice reaction time task. A direct spatial mapping between a linear array of light-emitting diodes (LEDs) was compared to randomly assigned, indirect (non-compatible) mappings. Experiment 2 repeated these two tasks and added a two choice condition with direct spatial mapping, a task frequently employed to examine heart rate deceleration. Fifteen college aged males participated in Experiment 1; 18 college aged males participated in Experiment 2. In both experiments anticipatory cardiac deceleration either reached a plateau or shifted to acceleration by the interbeat interval in which the stimulus occurred. In contrast to previous reports, a secondary deceleration, rather than cardiac acceleration, often followed the stimulus. The secondary deceleration was greater with non-compatible mapping, slow response speeds, and short intertrial intervals. The findings suggested that the motoric inhibition required during response selection induces a phasic cardiac deceleration.     

肺表面活性物质在重症新生儿呼吸窘迫综合征中的应用

肺表面活性物质作为新生儿呼吸窘迫综合征的针对病因的特效医治措施,已成为其标准治疗手段之一,有效降低了新生儿呼吸窘迫综合征的并发症发生率及死亡率,但重症新生儿呼吸窘迫综合征仍是引起新生儿残疾和死亡最常见的疾病,因而应重视新生儿呼吸窘迫综合征严重度的评价,并制订出适用于重症新生儿呼吸窘迫综合征的治疗方案。     

Cardiac responses to maximal anisotonic isometric contractions during handgrip and leg extension

A group of 14-healthy men performed anisotonic isometric contractions (AIC), for 60 s, at an intensity of 100% maximal voluntary contraction force (MVC) during handgrip (HG) and leg extension (LE). Heart rate (f _c), stroke volume index (SVI) and cardiac output index (Q_cI) were measured during the last 10 s of both AIC by an impedance reography method. Force (F) exerted by the subjects was recorded continuously and reported as a relative force (F _r) (% MVC). The F generated during MVC was greater for LE than for HG (502.I N compared to 374.6 N, P < 0.001). The rate of decrease in F _r was significantly slower for LE than HG for the first 25 s of the exercise (phase 1 of AIC). The F _r developed by the subjects at the end of AIC was 40% MVC for both LE and HG. The increase in f _c was greater for LE (63 beats · min^–1) than for HG (52 beats · min^–1), P < 0.01. The SVI decreased significantly from the resting level by 17.0 ml · m^–2 and by 18.2 ml · m^–2 for LE and HG, respectively. The Q_cI increased insignificantly for HG by 0.091 · min^–1 · m^–2 andsignificantly forLE by 0.561 · min^–1 · m^–2 (P < 0.001). It was concluded that although both AIC caused a significant decrease in SVI, greater increases in f _c and Q_c were observed for LE than for HG. The greater f _c and Q_c reported during LE was probably related to the greater relative force exerted by LE during phase 1 of AIC. It seems, therefore that central command might have dominated for phase 1 of AIC but that the muscle reflex also contributed significantly to the control of the cardiac response to the high intensity AIC.     

In Vitro Study of Hydrodynam ics at DifferentSimulated Cardiac Output for a Newly JiulingBileaflet Heart Valve Prostheses

INTRODUCTION　　 The Jiuling bileafletprosthetic heartvalve is a newly China-made cardiac valvesubstitute.The hydrodynamic performance at different pulsatile frequency and thepreliminary clinical study of the Jiuling bileaflet prosthetic valve have beenre…     

联合应用PS及机械通气治疗新生儿呼吸窘迫综合征

目的：探讨肺表面活性物质联合机械通气治疗新生儿呼吸窘迫综合征的疗效。方法：联合应用肺表面活性物质和机械通气治疗25例新生儿呼吸窘迫综合征患儿，对治疗前后临床表现、动脉血气、呼吸机参数、胸部X线变化等进行观察。结果：用药后患儿临床症状明显好转，胸部X线透亮度明显改善、颗粒网状阴影消失，血气分析及机械通气参数如FiO2、PIP、PEEP值明显降低（P〈0．01）。结论：肺表面活性物质联合机械通气能迅速有效地治疗新生儿呼吸窘迫综合征。     

新生儿无创呼吸机防治新生儿呼吸窘迫综合征的效果

目的 探讨无创呼吸机治疗新生儿呼吸窘迫综合征的效果。方法 选取2016年5月~2019年5月我院新生儿科收治的60例呼吸窘迫综合征新生儿作为研究对象,按照随机数字表法分为对照组和观察组,每组30例。对照组实施机械通气治疗,观察组实施无创呼吸机治疗,比较两组动脉血气指标（pH、PaO2、PaCO2）及并发症发生率。结果 观察组pH,PaO2和PaCO2低于对照组[（7.06±0.31）vs（8.14±0.65）]、[（75.63±5.84）mmHg vs（86.12±6.31）mmHg]、[（30.58±3.95）mmHg vs（42.52±5.14）mmHg],差异有统计学意义（P＜0.05）。观察组并发症发生率为3.33%,低于对照组的23.33%,差异有统计学意义（P＜0.05）。结论 实施无创呼吸机治疗新生儿呼吸窘迫综合征,可改善患儿动脉血气指标,降低并发症发生率。