氧气雾化吸入器面罩吸氧在食管、贲门癌术后的临床应用

目的：证明氧气雾化吸入器面罩吸氧的有效性,以便更好的向病人进行宣教,提高其利用效能。方法：与传统鼻塞吸氧方法进行对比,并利用t检验、x2检验和秩和检验。结果：氧气雾化吸入器面罩吸氧与传统鼻塞吸氧相比,虽然对患者血氧饱和度、脉搏、呼吸等方面均没有明显差异（P〉O．05）,但对患者减低痰液粘稠度、滋润咽部等有显著效果（两组比较P〈0．05）。结论：氧气雾化吸入器面罩吸氧是有效降低食管、贲门癌各术式开胸术后咽干、咽痛、痰液粘稠等呼吸道不适症状、减少术后心肺并发症发生的重要途径。     

墙式氧气雾化吸入治疗快速接头的制作与应用

目前很多医院利用墙式浮标式氧气吸入器进行氧气雾化吸入治疗由于湿化瓶耐压不够，在使用过程中存在湿化瓶爆破的安全隐患。上海市食品药品监督管理局在2006年下发了《关于正确使用浮标式氧气吸入器的紧急通知》，禁止利用浮标式氧气吸入器进行氧气雾化吸入治疗。为了安全，我们研制了墙式氧气雾化吸入治疗快速接头，     

多功能吸氧面罩在Ⅰ型呼吸衰竭患者雾化吸入时的应用效果

目的探讨空气压缩泵雾化器与多功能吸氧面罩两种雾化方式对Ⅰ型呼吸衰竭患者雾化吸入过程中生命体征的影响。方法对照组采用普通吸氧面罩配合空气压缩泵雾化吸入器进行雾化治疗,实验组应用多功能吸氧面罩在患者高流量吸氧的同时进行雾化吸入。在两组患者雾化开始和结束时分别记录患者的生命体征。结果对照组与实验组患者在雾化开始前各生命体征比较没有明显差异(均P0.05);在雾化吸入结束后,对照组患者生命体征波动大于实验组患者(均P0.01);实验组患者在应用面罩吸氧的同时进行雾化吸入治疗试验前与试验后生命体征比较波动无明显差异(均P0.05)。结论应用多功能吸氧面罩可以更好地减少I型呼吸衰竭患者在雾化吸入时的生命体征波动,减少患者因雾化产生的血压升高、心率增快和血氧降低等常见问题。     

浅谈浮标式氧气吸入器的检定方法

氧气吸入器广泛应用于临床，属高风险的医疗器械，被列为国家强检项目。医院依据检定规程，在做好检测环境和辅助设备准备的基础上，对XY-90A型浮标式氧气吸入器进行了检定，并解决了安全阀排气压力无法检定的问题，保证了氧气吸入器检定质量。     

自制光电控制智能化吸氧计时器

介绍一种自行研制的光电控制智能化吸氧累积计时器。将光电控制的探头固定在未通气状态下氧气流量表的浮标处．打开氧气流量开关．浮标上升即开始供氧计时：停止吸氧．     

医用氧气流量计的计量检定与质量分析

目的：对本军区部分在用的医用氧气流量计进行检定和摸底。方法：依据JJG 917—1996浮标式氧气吸入器检定规程对全区部队的930只氧气流量计进行检定。结果：发现医用流量计不合格的原因主要有：潮化瓶耐压性能下降；接口密封不住；工作压力超差；流量示值超差。结论：改善医用氧气流量计质量状况需技术监督部门、医院和生产厂家的共同努力。     

自制小儿面罩加温器

面罩给氧是儿科临床常用的氧气疗法之一。其优点是吸入氧浓度高，临床使用简便，患儿舒适易耐受等，尤适于新生儿和婴幼儿等应用。面罩给氧时，氧流量较大，氧气需经加湿、加温处理，否则，易致小儿气道干燥损伤和体温降低。目前，医用氧气表上均备有湿化瓶，但无加温装置，为此，我们自制面罩给氧加温器。1材料小儿开放式面罩1个．手电筒的反光罩1个，铝管直径Icm、长7cml根，鞋烘干器中的电热板2块，电线若干，塑料瓶1个。2制作方法首先，取出鞋烘干器中的两块电热板，把它们固定在铝管上，再与电源线相连。然后．把开放式面罩的橡皮环套…     

可调空混Bain式气动呼吸机的研制与应用

总结分析临床应用的国内外气动急救呼吸机及Bain回路，根据现有战备器材的不足及临床需要，改进国外高档呼吸机气动气控技术，研制成可调空混Bain式气动呼吸机（DH－1多功能呼吸机），使可调空混单向射流泵应用于上升内压折叠风箱式气动气控制呼吸中，可直观监测患者潮气量。用英国电子潮量计测试，氧气工作压力为0．36MPa，射流氧气混合空气效果为：氧流量用2L／min可空混至10．2L／min，吸氧浓度39．7％；氧流量用2．5L／min可空混至17．1L／min，吸氧浓度38．3％；关闭进气孔，吸入纯氧。经临床多参数呼气末二氧化碳（EtCO2）监测…     

病员吸氧用氧气用量计的研制

本文介了自行研制的单个病员吸氧用氧气用量计的原理 ,即不改变原氧气减压湿化器的结构和原吸氧管路 ,利用氧气减压湿化器上原有的珠式流量计 ,加装光电检测电路 ,由单片机对流量与时间进行积算等数据处理 ,数字显示吸氧时间、氧气用量等参数。     

车载重症患者转运高流量吸氧装置的研制与应用

目的：研究危重症患者急救车转运时对高流量氧气吸入的要求,提供一种转运装置,用于转运中和重症病房使用。方法：研制一种车载重症患者转运高流量吸氧装置,包括储氧瓶、氧气压力流量监测端、高压氧气连接管以及高压氧气终端,所有装置依次连接。结果：高压氧气终端型号与重症病房型号相同,既可以在转运过程中与呼吸机连接提供氧气给急救患者,也可以在重症病房中作为通常意义上的氧气供应。结论：该装置使用范围大、效率高,可取代价格昂贵的专用设备,有效地在医院进行推广使用。     

氧气吸入器检定中存在的问题及常见故障的解决

针对氧气吸入器检定过程中存在的主要问题,指出了计量器具检定的必要性、重要性.重点介绍了氧气吸入器的工作原理及检修实践中常见故障的分析和解决方法.     

脉冲吸氧与脉冲吸氧仪

本文介绍了“脉冲吸氧”的机理和脉冲吸氧仪的电原理及优越性。增加吸氧效果，减少感染，大大地降低氧损耗量。该仪器的广泛应用将使病人更加安全舒适。     

新型高流量湿化氧疗系统探讨

目的：根据氧疗特点和临床实际情况,设计提供一种实用湿化氧疗系统,可以实现最佳氧疗。方法：由文丘里空氧混合阀,加温湿化器和湿化氧疗加热丝管路组成高流量湿化氧疗系统。结果：系统各部分可以发挥良好效果,实现最优化组合,输出效果达到了设计预期。结论：该高流量湿化氧疗系统简单实用,操作方便,兼容配套性好,能提供符合最佳氧疗条件的输出,可以广泛使用于医院临床治疗。     

无创通气与高流量氧疗在急性呼吸衰竭中的应用比较

目的观察比较无创通气与高流量氧疗在急性呼吸衰竭患者中的应用效果。方法选取2017年7月-2019年6月期间我院重症医学科收治的52例急性呼吸衰竭患者,按抽签法分为A组(n=26)与B组(n=26)。A组给予无创通气(non-invasive ventilation,NIV),B组给予高流量氧疗(high flow oxygen therapy,HFNC),比较两组治疗前、治疗后2 h时呼吸情况[心率(heart rate,HR)、呼吸频率(respiratory rate,RR)、平均动脉压(mean arterial pressure,MAP)]、血气指标[动脉血氧分压(arterial blood oxygen partial pressure,PaO2)、血氧饱和度(blood oxygen saturation,SpO2)]、舒适度以及呼吸困难程度。结果治疗后2 h时,两组患者HR、RR、MAP均下降,PaO2、SpO2均上升(P <0.05),其中A组PaO2高于B组(P <0.05),其余指标两组间差异均无统计学意义(P> 0.05);治疗后2 h时,B组Borg评分、舒适度评分明显低于A组,差异有统计学意义(P <0.05)。结论 NIV与HFNC于短期内均可改善急性呼吸衰竭患者的呼吸状态,而相比之下,患者对于HFNC的耐受性与舒适度更好。     

经鼻高流量氧疗治疗老年重症肺炎的临床疗效和安全性研究

目的:研究经鼻高流量氧疗治疗老年重症肺炎的临床疗效和安全性。方法:选取在医院就诊的90例重症肺炎老年患者,按照数表法随机将其分为对照组和观察组,每组45例。对照组采用无创机械通气治疗方法,观察组采用经鼻高流量氧疗治疗方法,观察并比较两组临床疗效、痰液粘稠度、血气分析及并发症情况。结果:观察组临床治疗总有效率为80.00%,显著高于对照组的60.00%,其差异有统计学意义(x^2=4.286,P<0.05);治疗后7 d观察组和对照组痰液粘稠度Ⅱ级人数显著增加,Ⅲ级、Ⅳ级人数显著减少,两组患者痰液粘稠度分级比较差异有统计学意义(Z=6.547,P<0.05);两组患者治疗后的血气分析比较中观察组呼吸频率(RR)、二氧化碳分压(PCO2)值与治疗前相比显著降低,差异有统计学意义(t=5.331,t=2.283;P<0.05);两组氢离子浓度(pH)值及氧合指数(OI)值治疗前后无明显改变;治疗后观察组氧分压(PO2)值显著高于治疗前,差异有统计学意义(t=2.325,P<0.05)。观察组术后并发症发生率为17.78%,对照组为22.22%,两组比较差异无统计学意义。结论:老年重症肺炎经鼻高流量氧疗治疗后临床疗效显著,呼吸困难症状明显缓解,且并发症发生率较低,安全性较高。     

Practical limitations of the Deltatrac indirect calorimeter

Indirect calorimetry is used to assess energy requirements. The Deltatrac Metabolic Monitor is a relatively inexpensive indirect calorimeter which uses a 'fixed' flow of ambient air to collect expired air. Only oxygen and carbon dioxide concentrations are measured and the 'fixed flow' is assumed in the calculation of oxygen consumption ((.)VO(2)) and carbon dioxide production ((.)VCO(2)). Using inert gas dilution we have studied the effect on (.)VO(2), and on the variability in (.)VO(2), of changing and lengthening the 1.77 m length of 35 mm tubing supplied with the instrument to collect expired air, and of using a mask to collect expired air instead of the manufacturer's hood. One would anticipate that changing the tubing could cause a change in resistance to gas flow and thus affect the true flow rate. This would alter the gas concentrations seen by the analysers, but the 'fixed flow' would still be assumed so the results would be in error. Adding extra lengths of manufacturers tubing caused an apparent rise in (.)VO(2) of 0.36%/m of tubing added, and using 22 mm tubing instead of the manufacturer's 35 mm tubing increased (.)VO(2) by 0.42% for each 10 cm of tubing added. Using the mask to collect expired air instead of the canopy (.)VO(2) was higher, possibly due to the energy cost of holding the mask, and was more variable, probably because of poorer mixing of the expired air. To measure (.)VO(2) using a mask with the same precision as a 10 min measurement made with the hood would entail measuring (.)VO(2) for 14.5 min. The methods used to collect expired air (mask or canopy, length and type of tubing) when measuring metabolic rate with the Deltatrac do affect the results obtained but these effects are small and predictable.     

Respiration in High Flying: (United Services Section)

Atmospheric pressure falls, as height increases, to about one-ninth of its sea-level value at 50,000 feet. The intake of oxygen into the blood depends on the partial pressure of oxygen in the inspired air, which is about one-fifth of the atmospheric pressure. But since the gaseous content of the lungs is saturated with water vapour at body temperature, 47 mm. Hg. of the atmospheric pressure in the lungs is due to water vapour and is therefore not available for oxygen or other gases, while the alveolar air contains also an almost constant pressure of 40 mm. CO₂.Mental and physical output demand an adequate partial pressure of O₂; they begin to be limited as soon as this falls, and at heights above 18,000 feet are seriously reduced. Consequently in order to fly higher than about 15,000 feet it is necessary to increase the partial pressure of oxygen in the inspired air. Up to about 44,000 feet this can be done by merely raising the percentage of oxygen, usually by allowing a regulated stream of oxygen to enter a small naso-buccal mask, but preferably by a closed system in which the negative pressure of inspiration opens a valve and allows oxygen to enter a bag from which it is inspired.Beyond 44,000 feet as a limit (and a lesser height for safety) it is necessary to create a local atmospheric pressure around the pilot higher than that of the surrounding air, by enclosing him in an airtight sit or cabin in which a relatively increased pressure with a maximum value of about 2½ lb. per square inch is maintained, while he breathes pure oxygen. This device was used in the recent British world record high flight, when a height of 50,000 feet was attained. The pressure-suit used by the pilot on this occasion and the decompression chamber recently built at Farnborough are described in detail.     

液体推进剂双罐大眼窗防护面具的研制

目的：为了解决高浓度毒气环境下防护面具所存在的问题，研制了MFT-2S型双罐大眼窗防护面具，进一步完善三级防护装具体系。方法：以MFT-2型面具为基础，整合其优势．在面罩下方双侧加装2套圆螺纹接头座组件及不锈钢卡箍（均为FMJ05面具组件），有效保证了固定强度。在通话器上装封口组件，将双罐分装两侧．并改装防雾镜片、适当增加滤毒罐高度。结果：测试结果表明，与MFT—1型面具相比，MFT-2S型面具吸气阻力减小一半．总质量减轻约50％，漏气系数0．005％，保明性能明显提升，防护性能比MFT-2型面具提高1倍以上。结论：根据换算的防护参数指标，说明MFT-2S型面具可以代替MFT-1型面具．实现面具的轻型化、简单化、标准化。     

Comparison of fibre types and size distributions in lung tissues of paraoccupational and occupational cases of malignant mesothelioma

The results of analysis of mineral fibres in lung tissues from 10 paraoccupational cases of malignant mesothelioma were compared with analysis obtained from seven cases of malignant mesotheliomas that had developed in gas mask workers. Nine of the paraoccupational cases were considered to have developed their tumours because of exposure to asbestos on their husbands' working clothes and one cancer developed in the daughter of a man who had died of asbestosis. The gas mask workers had direct exposure to asbestos while working in a factory that produced military gas masks. The results of mineral fibre analysis in the paraoccupational cases were variable; six showed high crocidolite concentrations, seven raised amosite concentrations and two normal concentrations of all types of asbestos fibre measured. Chrysotile was raised in one case but crocidolite and amosite were also increased. The gas mask workers showed a consistent pattern with high crocidolite concentrations and normal or low concentrations of chrysotile and amosite. Fibre lengths for chrysotile were similar in both groups and predominantly less than 5 microns. Crocidolite fibres tended to be longer in the gas mask workers than in the paraoccupational group and longer than chrysotile in both groups. Amosite fibres tended to be more variable in width than those of chrysotile or crocidolite.     

Comparison of fibre types and size distributions in lung tissues of paraoccupational and occupational cases of malignant mesothelioma.

The results of analysis of mineral fibres in lung tissues from 10 paraoccupational cases of malignant mesothelioma were compared with analysis obtained from seven cases of malignant mesotheliomas that had developed in gas mask workers. Nine of the paraoccupational cases were considered to have developed their tumours because of exposure to asbestos on their husbands' working clothes and one cancer developed in the daughter of a man who had died of asbestosis. The gas mask workers had direct exposure to asbestos while working in a factory that produced military gas masks. The results of mineral fibre analysis in the paraoccupational cases were variable; six showed high crocidolite concentrations, seven raised amosite concentrations and two normal concentrations of all types of asbestos fibre measured. Chrysotile was raised in one case but crocidolite and amosite were also increased. The gas mask workers showed a consistent pattern with high crocidolite concentrations and normal or low concentrations of chrysotile and amosite. Fibre lengths for chrysotile were similar in both groups and predominantly less than 5 microns. Crocidolite fibres tended to be longer in the gas mask workers than in the paraoccupational group and longer than chrysotile in both groups. Amosite fibres tended to be more variable in width than those of chrysotile or crocidolite.