七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

Objective To observe the anesthetic effect of sevoflurane combined with propofol total general anaesthesia in children undergoing tracheal foreign body removal. Methods Sixty patients aged from 1 to 4 years admitted for tracheal foreign body removal were randomly divided into two groups : sevoflurane group (n = 30) and ketamine group (n = 30). In the sevoflurane group, anaesthesia was induced and maintained with inhalation of sevoflurane and propofol [1.5 mg/(kg · h)] was administered continuously for anesthesia maintenance by micro-pump during operation. The ketamine group were pre-medicated with ketamine 6 mg/kg i. m for sedation, then an-aesthesia was induced with midazolam 0.1 mg/kg and ketamine 1.5 mg/kg i. v and was maintained with intravenous bolus of ketamine. Systolic blood pressure(SBP), Diastolic blood pressure(DBP) ,heart rate(HR) and saturation of percutaneous oxygen(SPO2) were monitored in both groups before anaesthesia inducation (T0) , after anaesthesia inducation and before operation (T1), at the time point of bronchial endoscopy(T2) ,endoscope remoral (T3) ,con-sciousness recovery(T4). The operation condition was evaluated by surgeons, and the incidence of bronchial spasm, glossal drop, nausea and vomiting were recorded both during operation and after operation. Results The SBP and HR increased at the time point of bronchial endoscopy in two groups and decreased after anaesthesia inducation in aevoflurane group. The SPO2 increased in two group after anaesthesia inducation. Compared with ketamine group, the time of consciousness recovery was shorter markedly in sevoflurane group. The occurrence of postoperative glossal drop was higher in ketamine group. Conclusion Sevoflurane combined with propofol is safe and effective during general anaesthesia of children undergoing tracheal foreign body removal.     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

Objective To observe the anesthetic effect of sevoflurane combined with propofol total general anaesthesia in children undergoing tracheal foreign body removal. Methods Sixty patients aged from 1 to 4 years admitted for tracheal foreign body removal were randomly divided into two groups : sevoflurane group (n = 30) and ketamine group (n = 30). In the sevoflurane group, anaesthesia was induced and maintained with inhalation of sevoflurane and propofol [1.5 mg/(kg · h)] was administered continuously for anesthesia maintenance by micro-pump during operation. The ketamine group were pre-medicated with ketamine 6 mg/kg i. m for sedation, then an-aesthesia was induced with midazolam 0.1 mg/kg and ketamine 1.5 mg/kg i. v and was maintained with intravenous bolus of ketamine. Systolic blood pressure(SBP), Diastolic blood pressure(DBP) ,heart rate(HR) and saturation of percutaneous oxygen(SPO2) were monitored in both groups before anaesthesia inducation (T0) , after anaesthesia inducation and before operation (T1), at the time point of bronchial endoscopy(T2) ,endoscope remoral (T3) ,con-sciousness recovery(T4). The operation condition was evaluated by surgeons, and the incidence of bronchial spasm, glossal drop, nausea and vomiting were recorded both during operation and after operation. Results The SBP and HR increased at the time point of bronchial endoscopy in two groups and decreased after anaesthesia inducation in aevoflurane group. The SPO2 increased in two group after anaesthesia inducation. Compared with ketamine group, the time of consciousness recovery was shorter markedly in sevoflurane group. The occurrence of postoperative glossal drop was higher in ketamine group. Conclusion Sevoflurane combined with propofol is safe and effective during general anaesthesia of children undergoing tracheal foreign body removal.     

七氟醚复合丙泊酚在小儿气道异物取出术中的麻醉效果

Objective To observe the anesthetic effect of sevoflurane combined with propofol total general anaesthesia in children undergoing tracheal foreign body removal. Methods Sixty patients aged from 1 to 4 years admitted for tracheal foreign body removal were randomly divided into two groups : sevoflurane group (n = 30) and ketamine group (n = 30). In the sevoflurane group, anaesthesia was induced and maintained with inhalation of sevoflurane and propofol [1.5 mg/(kg · h)] was administered continuously for anesthesia maintenance by micro-pump during operation. The ketamine group were pre-medicated with ketamine 6 mg/kg i. m for sedation, then an-aesthesia was induced with midazolam 0.1 mg/kg and ketamine 1.5 mg/kg i. v and was maintained with intravenous bolus of ketamine. Systolic blood pressure(SBP), Diastolic blood pressure(DBP) ,heart rate(HR) and saturation of percutaneous oxygen(SPO2) were monitored in both groups before anaesthesia inducation (T0) , after anaesthesia inducation and before operation (T1), at the time point of bronchial endoscopy(T2) ,endoscope remoral (T3) ,con-sciousness recovery(T4). The operation condition was evaluated by surgeons, and the incidence of bronchial spasm, glossal drop, nausea and vomiting were recorded both during operation and after operation. Results The SBP and HR increased at the time point of bronchial endoscopy in two groups and decreased after anaesthesia inducation in aevoflurane group. The SPO2 increased in two group after anaesthesia inducation. Compared with ketamine group, the time of consciousness recovery was shorter markedly in sevoflurane group. The occurrence of postoperative glossal drop was higher in ketamine group. Conclusion Sevoflurane combined with propofol is safe and effective during general anaesthesia of children undergoing tracheal foreign body removal.     

脑电双频指数在未插管全身麻醉患者靶控输注丙泊酚麻醉中的应用价值

Objective To investigate the utility of anesthesia depth monitoring of BIS during general anesthesia without tracheal intubation.Methods Sixty patients underwent surgery with local anesthesia were randomly divided into three groups of Ⅰ ,Ⅱand Ⅲ,who were sedated with propofol by TCI propofol 1.0,1.5,2.0μg/ml,respectively.HR,MAP,SpO2 BIS and MOAA/S score were recorded at l0min before operation(T0) .during local anesthesia ( T1) , at 30min after incision (T2) , at 60min after incision (T3) , and the end of operation (T4).Results BIS values declined with the decrease of MOAA/S.MOAA/S score was lower in group Ⅲ than that in group Ⅰ (all P < 0.05).Respiratory depression was seen in 3 cases in group Ⅲ.The difference of MAP had statistical significance between level 3 and level 2 of MOAA/S in group Ⅱ and group Ⅲ (P < 0.05).Conclusion Propofol 1.0 ～ 1.5 μg/ml given by TCI could produce optimal depth of sedation with less side effects in surgery during local anesthesia.     

丙泊酚靶控输注在全麻拔管期的应用

Objective To study the effectiveness and feasibility of the propofol target-controlled infusion (TCI) in the extubating period of general anesthesia to prevent cardiovascular response.Methods 60 patients who were in the ASA Ⅰ～Ⅱclass and seleetived abdominal surgery were randomly divided into the Propefol group (A) and the control group (B).Extubating in the same eircumstanees and conditions, A group were given with propofol TCI, Marsh model, keep the target plasma concentration as 1μ g/ml. and the drug withdrawal was 5rain after extubating; B group was not given the Propofol TCI,they were extubated after the sputum aspiration.The breathing rate, heart rate, MAP and SpO2 were continuous monitoring in the intraoperative, before using the TCI,during the extubating, 5min and 10min after extubatiug.And the time to recover the breathing, the time for extubating, the conscious level, the adverse effect and so on were also monitoring.Results during the extuhating, 5rain and 10min after the extubating, the breathing rate, the heart rate, MAP were declined slightly than that before using the TCI.And there was significantly lower in the A group than the B group (P < 0.05), B group, The value of SpO2 was significantly lower than the basis of value during extubating and the sputum aspiration(P < 0.05).Conclusions Propofol target-controlled infusion using in the extubating period of general anesthesia, the stress reaction of the body was small,and the vital signs were stable in the process of extubating.     

腹腔镜下手术治疗老年胆石症临床分析

Objective To explore the clinical effect of laparoscopy in treatment of elderly patients with cholelithiasis. Method The clinical data of 120 elderly patients with cholelithiasis were retrospectively analyzed,which were divided into observation group and control group. Result The operation time, hemorrhage amount of operations,length of stay and recurrence rate after operation of the observation group were lower than that of the control group, and the stone clearance rate in the observation group had significantly higher than that of the control group ,the difference was statistical significance( all P ＜ 0. 05). Conclusion The clinical curative effect of laparoscopy in treatment of elderly patients with cholelithiasis was good.     

布地奈德联合沙丁胺醇治疗小儿支气管哮喘疗效分析

Objective To investigate the effect of Budesonide combined with Salbutamol in treatment of chil-dren with bronchial asthma.Methods 100 cases of children with asthma were randomly divided into conventional therapy group(Group A)50 cases and combined treatment group(Group B)50 cases;Conventional therapy was given to group B and Group A Was givend the conventional therapy puls Budesonide combined with salbutamol treatment,2 times a day.The course of treatment was 10d;The effect of clinical symptom score、clinical recovery and adverse reac-tions in two groups were observed.Results The total efficiency of 47 cases(94.O%) in group A were significantly higher than the B group 36 cases(72.0%)(P<0.05);The index of breathing diffculties、coushing、wheezing、wheezing sustain and sleep satisfaction after treatment were significantly decreased compared with before treatment in two groups(all P<0.01);The time of recovery of breath shortness、cough、asthma、wheezing and therapy hys in group A were less than group B(all P<0.05).Condusion Atomizing inhalation treatment of Bedesonide combined with Sallbutamol was effective to treat children with bronchial asthma.     

布地奈德联合沙丁胺醇治疗小儿支气管哮喘疗效分析

Objective To investigate the effect of Budesonide combined with Salbutamol in treatment of chil-dren with bronchial asthma.Methods 100 cases of children with asthma were randomly divided into conventional therapy group(Group A)50 cases and combined treatment group(Group B)50 cases;Conventional therapy was given to group B and Group A Was givend the conventional therapy puls Budesonide combined with salbutamol treatment,2 times a day.The course of treatment was 10d;The effect of clinical symptom score、clinical recovery and adverse reac-tions in two groups were observed.Results The total efficiency of 47 cases(94.O%) in group A were significantly higher than the B group 36 cases(72.0%)(P<0.05);The index of breathing diffculties、coushing、wheezing、wheezing sustain and sleep satisfaction after treatment were significantly decreased compared with before treatment in two groups(all P<0.01);The time of recovery of breath shortness、cough、asthma、wheezing and therapy hys in group A were less than group B(all P<0.05).Condusion Atomizing inhalation treatment of Bedesonide combined with Sallbutamol was effective to treat children with bronchial asthma.     

围术期不同时间应用曲马多对术后镇痛和恶心呕吐的影响

Objective To investigate the analgesic effect and the influence on nausea and vomiting of tramadol during the different periods of perioperation. Methods Fifty-four patients undergoing gynecologic surgery under general anesthesia were randomly divided into three groups according to the time of using tramadol: after operation instantly group, before the end of surgery group and before induction of anesthesia group. All the patients received intravenous patient controlled analgesia(PCA) pump. The vital signs, pain scores and postoperative nausea and vomiting were observed 24 hours after operation. Results There was no significant difference of the vital signs and visual analogue scale (VAS) scores among the three groups( P ＞ 0.05 ). At 8 h after PCA, the number of PCA in before induction of anesthesia group was obviously reduced(P ＜0.05). At 1 h after PCA, the patients in before the end of surgery group experienced the severest nausea and vomiting( P ＜0. 05 ). At 4 h, 8 h and 12 h after PCIA, the patients in after operation instantly group experienced the severest nausea and vomiting ( P ＜ 0.05 ).Conclusion Using tramadol before induction of anesthesia not only has a good analgesic effect, but also decreases the incidence of nausea and vomiting after postoperative analgesia.     

冠心病患者介入治疗前后焦虑抑郁障碍的心理干预与评价

Objective To discuss the effect of psychological intervention of depression in coronary heart disease after percutaneous coronary intervention (PCI). Methods The depression of 105 cases of coronary heart disease after PCI treatment was investigated. One hundred and five patients were randomly divided into intervention group and control group. The patientsin intervention group were treated with psychological intervention before and after PCI. The patients in control group were treated with normal treatment. Results There was not significant difference of incidence of depression an self-rating depression scale score between two groups. The depression in intervention group was less severe than that in control group ( P ＜ 0.01 ). Multivariate analysis showed: education level, the recent negative life events, household income, length of stay and sequelae of catheter intervention had significantly correlated with depression in coronary heart disease. Conclusion Psychological intervention can reduce the ratio of depression in coronary heart disease after PCI.