肺表面活性物质对早产儿持续肺动脉高压的作用探讨

目的探讨肺表面活性物质(PS)对早产儿持续肺动脉高压(PPHN)的疗效和作用。方法治疗组16例给予PS及机械通气联合治疗,对照组15例,仅给予机械通气治疗,并比较两组患儿治疗前后氧合及肺功能指标。结果治疗组肺动脉压力下降较快,PS治疗后6h氧合及肺功能指标氧合指数(OI)、氧浓度(FiO2)、吸气峰压(PIP)显著改善,明显缩短高PIP、高FiO2时间及机械通气时间,与对照组比较,差异有统计学意义,P<0.05。结论PS能迅速改善早产儿PPHN的肺动脉压力,显著改善机械通气的治疗条件及预后。     

肺表面活性物质联合机械通气治疗高原地区新生儿肺透明膜病的临床观察

目的:观察肺表面活性物质(PS)治疗新生儿肺透明膜病(HMD)的效果。方法:17例患儿应用外源性PS(固尔苏,curosurf)治疗,观察治疗后临床症状、血气分析及机械通气参数的变化。结果:应用固尔苏后患儿呼吸困难、呻吟、三凹征、紫绀症状减轻或消失,用药后2、6、12 h动脉血气分析示PaO2升高、pH值升高、PaCO2下降,与用药前比较差异有统计学意义(P<0.05);辅助机械通气治疗患儿用药后30 min均下调呼吸机参数;FiO2、PIP、PEEP、RR在用药后2、6、12 h均显著下降,与用药前比较差异有统计学意义(P<0.05)。结论:PS治疗HMD疗效确切,可有效改善患儿的肺氧合功能,降低机械通气参数,缩短机械通气治疗时间,减少住院天数、降低病死率。     

肺表面活性物质西地那非联合常频机械通气治疗新生儿胎粪吸入综合征并发持续肺动脉高压的疗效观察

目的 观察肺表面活性物质(PS)、西地那非联合常频机械通气治疗新生儿胎粪吸入综合征(MAS)并发持续肺动脉高压(PPHN)的疗效.方法 选取2017年1月-2018年12月丽水市人民医院新生儿科重症监护室收治的因MAS并发PPHN的40例患儿为研究对象,随机分为观察组(20例)和对照组(20例).两组患儿均常规接受常频...     

肺表面活性物质与鼻塞持续气道正压通气联合治疗肺透明膜病疗效观察

目的观察肺表面活性物质(PS)与鼻塞持续气道正压通气(NCPAP)联合治疗早产儿肺透明膜病(HMD)对呼吸机使用和近期、远期并发症发生的影响。方法对30例临床诊断HMD的早产儿给予PS加NCPAP治疗,与同期用呼吸机同步间歇指令通气(SIMV)治疗的30例HMD作对照,观察两组患儿的吸入氧浓度(FiO2)、上机时间,近期、远期并发症发生率。结果PS加NCPAP治疗组的FiO2较对照组减少,上机时间较对照组缩短,近期并发症(肺炎)的发生较对照组减少,治愈率高,差异均有显著意义。结论PS加NCPAP治疗HMD疗效肯定,并发症少。     

肺表面活性物质及鼻塞式CPAP早产儿肺透明膜病的治疗探讨

[目的]评价鼻塞式持续气道正压(continuouspositiveairwaypressure,CPAP)加肺表面活性物质(curosurf)对早产儿肺透明膜病的治疗作用,并与常规的机械通气做比较。[方法]CPAP组27例患肺透明膜病的早产儿经气管内滴入curosurf100mg/(kg·dose),然后拔管予鼻塞式CPAP呼吸支持治疗,并与25例常规的机械通气患儿进行比较,指标包括患儿的临床症状、体征及血气变化、并发症、住院时间以及住院费用。[结果]治疗后1h,患儿症状体征明显好转,6、12及24h,两组患儿的血气较治疗前显著改善,两组比较差异无显著性。而CPAP组肺部感染及慢性肺疾病的发生率明显低于机械通气组,CPAP组的氧疗及住院时间明显少于机械通气组,而且住院费用也较低。[结论]鼻塞式CPAP及肺表面活性物质能有效地治疗早产儿肺透明膜病,与常规机械通气比较,具有治疗效果好、并发症少、住院时间短、住院费用少等特点。     

肺表面活性物质及鼻塞CPAP治疗早产儿呼吸窘迫综合征

目的本研究的目的是评价鼻塞式CPAP加肺表面活性物质对早产儿呼吸窘迫综合征的治疗作用,并与常规的机械通气做比较.方法17例患呼吸窘迫综合征的早产儿经气管内滴入肺表面活性物质(Exosurf)67.5 mg/kg/dose,然后拔管予鼻塞CPAP呼吸支持治疗,与25例常规的机械通气病例比较两者的病情及血气变化、肺部感染及慢性肺疾病的发生率,氧疗和住院时间以及治愈率.结果治疗后6、12及24小时,两组患儿的血气较治疗前显著改善,两组比较,无明显差异,而CPAP组肺部感染及慢性肺疾病的发生率明显低于机械通气组,CPAP组的氧疗时间也少于机械通气组,但两者的住院时间无明显差异.结论鼻塞式CPAP及肺表面活性物质能有效地治疗早产儿肺透明膜病,与常规机械通气比较,具有肺部感染及慢性肺疾病的发生率低,氧疗时间短等优点.     

肺表面活性物质联合经鼻持续气道正压通气治疗早产儿肺透明膜病临床疗效观察

目的:探讨肺表面活性物质(PS)联合经鼻持续气道正压通气(NCPAP)治疗早产儿肺透明膜病(HMD)临床疗效。方法:收集于该院2009年8月~2014年4月出生的早产儿并患有典型HMD患者96例,随机分为两组,观察组给予PS同时给予NCPAP治疗,对照组只给予PS治疗。观察两组患儿治疗前后呼吸症状、血气分析、氧疗时间及早产儿视网膜病变(ROP)发生率。结果:两组患儿治疗后呼吸症状、血气分析等均有明显好转,但观察组患儿较对照组患儿在呼吸症状、血气分析改善更明显,氧疗时间更短,ROP发生率明显降低,差异有统计学意义(P<0.01)。结论:PS联合NCPAP治疗早产儿HMD疗效更好。     

机械通气对新生儿气道灌洗液中肺表面活性物质蛋白A的影响

目的:观察机械通气对新生儿气道灌洗液中肺表面活性物质蛋白A(SP-A)的影响,探讨其在机械通气肺损伤中的作用及其临床意义。方法:将36例使用机械通气新生儿设为机械通气组,31例未使用机械通气新生儿设为非机械通气组,动态观察机械通气组患儿在机械通气后1 h、24 h、48 h、72 h气道灌洗液中SP-A在各时段的变化,非机械通气组也以同样时段气道灌洗液,用W estern dot b lot免疫印迹法检测气道灌洗液中SP-A水平。应用SPSS 10.0统计学软件进行统计学处理,所有数值以均数±标准差(x±s)表示;相关性分析应用直线相关公式计算关联系数r值。结果:机械通气组患儿气道灌洗液中SP-A水平显著降低,与非机械通气组比较差异有显著性(P<0.05,P<0.01),且SP-A水平与使用机械通气天数相关。机械通气后48 h气道灌洗液中SP-A水平出现明显变化,提示机械通气后48 h患儿可能开始出现肺损伤。结论:动态观察新生儿机械通气时气道灌洗液中SP-A水平可能有助于监测机械通气肺损伤的发生,对临床的诊断和治疗具有重要指导意义。     

肺表面活性物质及鼻塞式CPAP早产儿肺透明膜病的治疗探讨

目的：评价鼻塞式CRAP加肺表面活性物质（Curosurf）对早产儿肺透明膜病的治疗作用，并与常规的机械通气做比较。方法：CPAP组27例患肺透明膜病的早产儿经气管内滴入Curosurf（100mg／kg／dose），然后拔管予鼻塞式CPAP呼吸支持治疗，并与25例常规的机械通气患儿进行比较，指标包括患儿的临床症状、体征及血气变化、并发症、住院时间以及住院费用。结果：治疗后1h，患儿症状体征明显好转，6、12及24h，两组患儿的血气较治疗前显著改善，两组比较，无明显差异。而CPAP组肺部感染及慢性肺疾病的发生率明显低于机械通气组，CPAP组的氧疗及住院时间明显少于机械通气组，而且住院费用也较低。结论：鼻塞式CPAP及肺表面活性物质能有效地治疗早产儿肺透明膜病，与常规机械通气比较，具有治疗效果好，并发症少、住院时间短，住院费用少等特点。     

NCPAP联合肺表面活性物质治疗早产儿呼吸窘迫综合征的疗效观察

目的探讨经鼻持续气道正压通气(NCPAP)联合肺表面活性物质(PS)治疗早产儿呼吸窘迫综合征(RDS)的疗效。方法对20例有RDS临床表现的早产儿气管内给予PS并加用NCPAP辅助治疗;选择同期单纯采用NCPAP治疗的15例早产儿RDS作为对照组,比较治疗前、后的临床表现、胸片及呼吸机参数的变化,同时进行其他综合治疗。结果治疗后观察组的症状、体征、胸片及呼吸机参数变化均较对照组明显改善。结论NCPAP联合PS治疗早产儿呼吸窘迫综合征疗效显著,安全,但应尽早使用,同时加强护理。     

The effect of different intravenous nutritional regimens on renal function during acute renal failure in the rat

Acute renal failure in the surgical patient is accompanied by a state of hypermetabolism and increased catabolism. Nutritional therapy is therefore directed at the preservation of body cell mass and protein synthesis for repair of wounds and damaged renal tubuli and for maintenance of host defense mechanisms. We examined the effect of two levels of protein intake (18.4 +/- 1.4 and 30.8 +/- 2.4 mg N/100 g BW/day) and three different amino acid formulations (Freamine III, Nephramine, and a made-up mixture of Nephramine + Freamine HBC) on renal function following mercury chloride-induced acute renal failure in the rat. All animals suffered severe renal failure manifested by increased plasma urea and creatinine levels, decreased creatinine clearance, and increased fractional excretion of sodium. On day 4 of acute renal failure, rats receiving low dose amino acids had better-preserved renal function than those receiving high dose amino acids. However, the type of solution infused did not affect recovery of renal function.     

The effect of different intravenous nutritional regimens on renal regeneration during acute renal failure in the rat

Acute renal failure in the surgical patient is accompanied by a state of hypermetabolism and increased catabolism. Nutritional therapy is therefore directed at the preservation of body cell mass and protein synthesis for repair of wounds, repair of the damaged renal tubuli and maintenance of host defense mechanisms. We examined the effect of two levels of protein intake (18.4 ± 1.4 and 30.8 ± 2.4 mg N/100 g BW/day) and three different amino-acid formulations (Freamine III^®, Nephramine^® and a made-up mixture of Nephramine^® ± Freamine^® HBC) on renal regeneration following mercury chloride-induced acute renal failure in the rat. All animals suffered severe renal failure manifested by increased plasma urea and creatinine levels, decreased creatinine clearance and increased fractional excretion of sodium. Incorporation of ³H-thymidine into renal DNA on day 4 of acute renal failure was similar in all six groups studied, irrespective of the amount or composition of amino-acids infused. Renal regeneration during acute renal failure in the rat seems not to be affected either by the quantity or quality of amino-acids infused. However, although not reaching statistical significance, increased amounts of a standard TPN formulation may depress renal regeneration.     

不同胰岛素治疗方案对糖尿病家兔大脑顶叶锥体细胞的影响

目的 以大脑顶叶锥体细胞的变化为判断标准,探讨家兔糖尿病模型胰岛素(Ins)用药治疗的适宜方案.方法 40只雄性家兔随机分成5组[对照组(N组)、模型组(D组)、多次Ins治疗组(A组)、50R预混Ins治疗组(B组)、30R预混Ins治疗组(C组)],其中4组用四氧嘧啶制作成家兔糖尿病模型.治疗组用Ins 30 d后处死动物,同时处死其他组动物;记录各治疗组血糖达标时间及达标时Ins用量.观察比较各组血糖、脑重、大脑顶叶的锥体细胞凋亡率及病理学变化.结果 B组的达标Ins用量较A、C组少,C组达标时Ins用量最多,差异有统计学意义(P<0 01).A组达标时间最短(7.00±1.31)d、C组血糖达标时间最长(19.63±1.41)d,各组间差异有统计学意义(P<0.01).结束时的体重与血糖呈负相关(r=-0.559,P<0.01),脑重量与血糖亦呈负相关(r=-0.656,P<0.01).模型组绝大多数神经元变性凋亡,与其他各组比较差异有统计学意义(P<0.01).各治疗组大脑顶叶皮质锥体细胞组织水肿及病变受损严重程度A>B>C.结论 30R预混胰岛素治疗方案最佳.提供一个较高的基础胰岛素浓度加少量餐时胰岛素峰值量治疗糖尿病,血糖平稳缓降,对糖尿病神经组织有治疗和保护作用.多次胰岛素3短加1中或长的强化治疗及太短时间达标的方法不可首选.     

The effects of different recess timing regimens on preschoolers' classroom attention

This study examined the effects of different recess timing regimens on preschoolers’ classroom attention. Using cognitive immaturity theory, we predicted that attention to a classroom task would be greater after a recess break. We also examined the extent to which different recess timing regimens related to post‐recess attention. Participants were 27 European American children (18 girls and nine boys; mean = 55.56 months, standard deviation = 4.01) from a northeastern US preschool. Observations were made in the classroom before and after recess and outdoors on the playground during recess. Findings revealed that post‐recess attention was greater following sustained outdoor play periods. Gender differences emerged. Girls were more attentive to classroom tasks than boys were. Our findings support and parallel empirical findings with primary school children on the role of recess in children’s cognitive performance. It seems reasonable that outdoor recess breaks rejuvenate young children and help them attend to classroom tasks.     

The effects of different recess timing regimens on preschoolers' classroom attention

This study examined the effects of different recess timing regimens on preschoolers' classroom attention. Using cognitive immaturity theory, we predicted that attention to a classroom task would be greater after a recess break. We also examined the extent to which different recess timing regimens related to post-recess attention. Participants were 27 European American children (18 girls and nine boys; mean = 55.56 months, standard deviation = 4.01) from a northeastern US preschool. Observations were made in the classroom before and after recess and outdoors on the playground during recess. Findings revealed that post-recess attention was greater following sustained outdoor play periods. Gender differences emerged. Girls were more attentive to classroom tasks than boys were. Our findings support and parallel empirical findings with primary school children on the role of recess in children's cognitive performance. It seems reasonable that outdoor recess breaks rejuvenate young children and help them attend to classroom tasks.     

不同抗栓治疗对急性桥脑梗死患者预后影响

目的 探讨急性桥脑梗死患者不同治疗方法对预后的影响.方法 对2008年10月～2010年10月期间某科连续收治的急性桥脑梗死患者进行回顾性分析,根据治疗方法不同分为肝素抗凝治疗组和抗血小板治疗组,记录患者入院时NIHSS评分、mRS评分、BI评分,记录患者既往病史、脑梗死危险因素,患者头颅CT和MRI结果,对所有患者于治疗后6个月时进行随诊并评分,所得结果进行统计学分析.结果 两组患者年龄、性别、既往史、引起脑梗死的危险因素等基本情况方面差异无统计学意义,具有可比性.治疗前抗凝组NIHSS评分、mRS评分、BI评分分别为(3.36±3.26)、(1.82±1.04)和(75.45±25.99)分,抗血小板组分别为(2.71±3.09)、(1.67±1.02)和(81.28±24.90)分,两组比较差异无统计学意义；治疗后6个月两组患者NIHSS评分、mRS评分、BI指数分别为(1.64±2.32)、(1.15±0.83)分、(87.58±16.59)和(1.69±2.81)、(0.94±0.79)分、(89.6±18.20),与治疗前相比,两组患者治疗前后得分差异有统计学意义,对两种治疗方法6个月后的得分进行比较,差异无统计学意义.结论 抗凝治疗与抗血小板治疗对急性桥脑梗死疗效可靠.