急性胃粘膜病变的诊治

急性胃粘膜病变的诊治华西医科大学附属一院普外科（６１００４１）郑吉祥，彭德恕急性胃粘膜病变（ａｃｕｔｇａｓｉｔｒｉｅｍｕｃｏｓａｌｌｅｓｉｏｎ，ＡＧＭＬ）系指主要与应激有关的，以胃粘膜损害为病理特征的急性胃粘膜出血性病变。其别称繁多，如出血性胃炎、急...     

急性胃粘膜损害与创伤后腹部多内脏缺血

急性胃粘膜损害与创伤后腹部多内脏缺血朱立杨宗城急性胃粘膜损害（Ａｃｕｔｅｇａｓｔｒｉｃｍｕｃｏｓａｌｌｅｓｉｏｎ，ＡＧＭＬ）是机体在严重创伤、烧伤、休克、感染以及内脏功能严重受损等多种危重情况下发生的，以胃粘膜的糜烂、溃疡、出血为主要特征的急性应激性...     

急性胃粘膜病变

急性胃粘膜病变(Acute gastric mucosal Lesions)又称应激性溃疡(Stress ulceration)或出血性胃炎(Haemorrhagic gastritis)、急性糜烂性胃炎(Acute erosive gastritis)，是指机体在严重创伤、大面积烧伤、严重感染和休克等严重应激状态下，胃粘膜的完整性受到损害，胃近端发生急性多发性浅表性胃粘膜糜烂和溃疡。但严格地说，应激性溃疡并非就是急性胃粘膜病变。而是急性胃粘膜病变的其中一种类型。     

急性胃粘膜病变

急性胃粘膜病变(Acute gastric mucosal Lesions)又称应激性溃疡(Stress ulceration)或出血性胃炎(Haem-orrhagic gastritis)、急性糜烂性胃炎(Acute erosive gastri-tis),是指机体在严重创伤、大面积烧伤、严重感染和休克等严重应激状态下,胃粘膜的完整性受到损害,胃近端发生急性多发性浅表性胃粘膜糜烂和溃疡。但严格地说,应激性溃疡并非就是急性胃粘膜病变。     

前列腺切除术后并发急性胃粘膜病变九例报告

前列腺切除术后并发急性胃粘膜病变九例报告王世杰，邹道庆，高海良，肖汉文，尤卫军急性胃粘膜病变（ＡＧＭＬ）也称应激性溃疡。在泌尿外科手术后发生的ＡＧＭＬ，由于其发生率低，很少有人统计及报道。我们自１９８７年７月至１９９３年１１月共施行前列腺切除术，３３...     

多器官功能障碍与应激性溃疡

1932年Cushing发现颅脑损伤可并发急性胃溃疡出血及穿孔。1936年Selye首先采用应激性溃疡的命名,并提出应激三联证（肾上腺肿大,淋巴腺、胸腺、脾脏萎缩,胃肠道急性溃疡或糜烂）。40年代后又出现不少其它名称,如出血性胃炎、急性胃粘膜损害、急性胃粘膜糜烂等。 应激性溃疡（SU）泛指休克、严重创伤、大手术、重度全身性感染等危重病人发生急性胃粘膜损害,是一种严重的应激反应,故以应激性溃疡的命名较为合适,如称之为应激性胃粘膜损害也无不可。     

胃去动脉术治疗急性胃粘膜病变大出血

作者采用胃去动脉术治疗各种原因引起的急性胃粘膜病变（ＡＧＭＬ）大出血１３例，１１例即刻止血，２例无效，１例再出血，３例死亡。临床分析提示，低血压、肝功能损害、严重感染、酸中毒、尿毒症等是ＡＧＭＬ的危险因素；对门静脉高压性ＡＧＭＬ，本手术疗效较差，应慎重选用。作者还就ＡＧＭＬ的病因和发病机理、胃去动脉术的解剖学和生理学依据以及ＡＧＭＬ的术式选择等问题进行了讨论     

胃应激性溃疡的近况

胃应激性溃疡(Stress ulcer)是指各种原因所致的休克、烧伤、感染以及某些药物等因素引起的急性胃粘膜糜烂或溃疡。为了正确地解释该病的病因和病理变化,文献多称此类病变为急性胃粘膜糜烂(Acute erosive gastritis),或急性胃粘膜病变(Arute gastric mucosal lesion),包括应激性溃疡(Stress ulcer),出血性胃炎,硷性反流性胃炎,药物性胃炎,Cushing溃疡以及Curling溃疡。     

急性胃粘膜出血(文献综述)

急性胃粘膜出血是胃粘膜急性糜烂,常併发于严重外伤,败血症,大手术,呼吸衰竭,尿毒症,黄疸和某些药物作用之后,在临床上往往伴有频发出血及很高死亡率,近年来发病率亦有增加,故这一严重疾患已日益受到重视,现将有关进展综合如下。急性胃粘膜出血的命名由胃粘膜急性表浅糜烂和溃疡及其所致之上消化道出血在文献中命名甚多,有出血性胃炎,急性胃粘膜糜烂,急性表浅性溃疡。糜烂性胃炎等又常与应激性溃疡相提并论或明确这些病名都是同义词。也有根据发病机理、病理改变而命名为急性胃血管收缩综合征,急性胃肠道局灶性坏死综合征或应激性溃疡综合征,各种报道中虽命名不一,但更多以应     

溃疡病大出血急诊胃大部切除术后的急性胃粘膜病变

作者报告６例溃疡病急性大出血行远端胃大部切除术后再发上消化道出血，经胃镜证实为急性胃粘膜病变（ＡＧＭＬ），着重对术后ＡＧＭＬ的发病机理、诱发因素、好发部位及治疗方法等资料进行了分析讨论。认为在低血压状况下行急诊胃大部切除术易导致术后ＡＧＭＬ，诊断上应注意与胃术后吻合口出血相鉴别。治疗本病以综合性保守治疗为主，提出洛赛克（Ｌｏｓｅｃ）是治疗本病疗效可靠的药物之一。     

VALIDITY AND RELIABILITY OF MEASURES OF OCCUPATIONAL AND ROLE STRESS USING SAMPLES OF AUSTRALIAN MANAGERS AND PROFESSIONALS

Reviews of the literature show that there is inadequate attention to the development of appropriate measures for the impact of stress on women's health. The present study sought to (1) construct a new measure of occupational role stress which sourced categories of stress in the broad range of experienced female roles; (2) assess the validity and reliability of the new measure; (3) obtain discriminant validity with reference to another measure of occupational stress (the Occupational Stress Indicator); and (4) report on demographic differences in occupational stress. Two hundred and forty working managerial and professional women from different industries, educational backgrounds and marital and parental status took part in the study. Results of analyses revealed that the new role stress measure had good validity and internal consistency (reliability) and that it could be discriminated from other measures of occupational stress. Four scales were derived in exploratory factor analyses: organizational and task grievances, role conflict and self-misgivings, role excess and overload, responsibilities and commitments. Analyses of these factors by demographic variables such as marital status, education and number of children suggest that marriage and family were not a major stressor and in some cases were actually a positive feature of job satisfaction. The most significant factors in women's stress were those which appeared to come from their own desires and wants—to be promoted.     

眼部整形美容的现状和前景

眼部整形美容是整形美容外科医疗范围内最为常见的手术,就发展而言,眼部整形美容还是整形美容外科最具有研究和发展前景的领域之一.同时,眼部整形美容又是整形美容外科发生并发症最多的手术,也是常见的用虚假名词做广告的一类手术.因此,每位整形美容外科医师应坚持正确方向,应十分重视眼部的整形美容的研究工作和临床实践.     

COMPARISON OF THE ANAESTHETIC AND HAEMODYNAMIC EFFECTS OF CHLORMETHIAZOLE AND THIOPENTONE

Two groups of eight women (60 – 85 yr) undergoing gynaecologicaloperations of 50 to 130 min duration were compared. Anaesthesiawas induced with either thiopentone (mean 4.5mg kg^–) orchlormethiazole(mean 6.0 ing kg^–1) and maintained withnitrous oxide and pethidine in combination with the drug usedfor the induction. The hourly maintenance dose and the plasmaconcentration determined at equilibrium were greater for chlormethiazole(means 4.7mg kg^–1 h^–1 and 27(µmol litre^–1)compared with 1.3 mgkg ^–1h ^–1 (P< 0.01) and 16µmollitre^–1 respectively for thiopentone (P< 0.02). Impedancecardiography showed that cardiac output was decreased by 30–40%in the thiopentone group (P < 0.01), whereas ho significantchange was observed in the chlormethiazole group. Chlormethiazoleanaesthesia was followed by a significant increase (P<0.02)in stroke volume. No correlations were found between the plasmaconcentrations and changes in the haemodynamic indices for eitherof the drugs.     

低温性血管收缩的机制及防治措施的研究

目的 探讨低温性血管收缩的机制和防治措施。方法 采用内皮细胞培养,扫描电镜,离体血管舒缩功能实验技术,观察血管低温性收空与内皮细胞释放血管舒缩因子的关系。结果 低温使内皮完整或去内皮血管环均明显收缩,务砭张力随着温度的下降而增高,去内皮后血管低温性收缩减弱。低温组牛主动脉内皮细胞茶件培养液能使离体大鼠颈总动脉环产生明显收缩反应,提示牛主动脉内皮细胞向培养液向释放了血管收缩因子。３７℃复温或血管舒张     

骨膜成骨细胞的分离培养及其成骨作用的放射自显影研究

取４只家兔胫前骨膜进行成骨细胞分离培养，用３Ｈ－ＴｄＲ标记，然后回植于同一供体的皮下、耳软骨缺损处及挠骨缺损处。分别在２周和４周后处死动物，原位取材，用放射自显影方法观察种植细胞的转归。结果表明，种植的细胞在皮下转化为类骨组织；在软骨缺损处转化为软骨组织；而在骨缺损处则转化为典型的骨组织。提示用骨膜分离培养成骨细胞，回植体内，有可能用于骨缺损和软骨缺损的修复。     

COMPARISON OF THE SEDATIVE AND AMNESIC EFFECTS OF MIDAZOLAM AND PROPOFOL

We have compared the sedative and amnesic effects of midazolamand propofol in 35 volunteers. Sedation was measured by simplereaction time immediately before and after a bolus injectionand 1 h after the commencement of a subsequent continuous infusion.Memory was measured three times using two memory tests: perceptualfacilitation provided an implicit memory measure and recognitionprovided an explicit memory measure. Propofol and midazolamhad similar sedative effects both immediately after bolus dosesand after 1 -h continuous infusions of the drugs. In contrast,midazolam had a more profound amnesic effect than propofol onthe recognition memory test. The drugs had little effect onperformance with the implicit memory test. Performance on thememory tests was unrelated to sedation. (Br. J. Anaesth. 1993;70: 612–616)