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1.
目的 观察并比较在靶控输注相同丙泊酚效应室浓度下,置入SLIPA 喉罩和第一代LMA喉罩所需的瑞芬太尼半数有效量.方法 将择期行输尿管镜碎石术的40 例患者分成L 组和S 组;L 组置入LMA 喉罩,S 组置入SLIPA 喉罩.两组均采用Marsh 药代动力学模型以4.0μg/ml 的半数有效量靶控输注丙泊酚5min后,应用改良的Dixon 上下序贯法,采用Minto 药代动力学模型靶控输注瑞芬太尼,5min 后置入喉罩.采用probit 法计算出L组和S组所需瑞芬太尼的半数有效量(ECe50).结果 L组患者瑞芬太尼的EC50值为2.97 ng/ml(95%CI 2.82~3.22ng/ml),S 组患者瑞芬太尼的EC50为3.25 ng/ml(95%CI 2.86~3.43ng/ml).结论 在不使用肌松剂的情况下,相同丙泊酚半数有效量下置入SLIPA 喉罩和LMA喉罩,SLIPA 喉罩所需的瑞芬太尼半数有效量要高于第一代LMA喉罩.  相似文献   

2.
目的:探讨小剂量舒芬太尼复合丙泊酚对小儿喉罩插入条件及应激反应的影响。方法:选取全麻喉罩插入下行骨科手术治疗患儿90例,随机分为A组,B组和C组,每组各30例,分别给予0.1ug/kg,0.2ug/kg及0.3ug/kg舒芬太尼复合丙泊酚进行麻醉诱导,比较三组患儿喉罩一次插入成功率,喉罩插入时间及不同时间点血流动力学指标水平等。结果:三组患儿喉罩一次插入成功率和喉罩插入时间比较差异无统计学意义(P0.05);B、C组患儿呼吸暂停时间显著长于A组(P0.05);A组患儿T2时MAP和HR水平均显著高于B、C组(P0.05)。结论:0.2ug/kg舒芬太尼复合丙泊酚可为提供小儿喉罩插入条件,并有助于降低应激反应水平。  相似文献   

3.
目的通过对丙泊酚联合瑞芬太尼喉罩麻醉与氯胺酮复合丙泊酚麻醉在小儿眼科手术中的比较,探讨丙泊酚联合瑞芬太尼喉罩麻醉方法在小儿眼科手术中的可行性与安全性。方法选择该院66例择期眼科手术患儿,年龄1~8岁,ASAⅠ~Ⅱ级,随机分为二组:瑞芬太尼组(A组)和氯胺酮组(B组)。A组患儿缓慢静脉注射丙泊酚3 mg/kg和瑞芬太尼2μg/kg,待患儿体动消失、下颌松弛后置入喉罩,给予机械通气,以瑞芬太尼0.25~0.3μg/(kg·min)和丙泊酚8~10mg/(kg·min)静滴维持。B组肌肉注射氯胺酮6~8mg/kg和静脉注射丙泊酚2~3 mg/kg,保留患儿自主呼吸,面罩吸氧2L/min,以丙泊酚8~10μg/(kg·min)静滴维持,根据手术需要间断静脉注射氯胺酮0.5~1mg/kg。记录并分析二组患儿麻醉前(T1),麻醉后5min(T2),手术开始时(T3),手术开始后10min(T4)以及手术结束时(T5)患儿的HR、MAP、SpO2、手术时间、患儿Aldrete评分达9分时间、麻醉恢复室(PACU)停留时间和围术期不良反应。结果 ①A组患儿在手术过程中HR和MAP的波动变化显著优于B组患儿(P〈0.05);②二组患儿在手术时间上差异无统计学意义(P〉0.05);③A组患儿在Aldrete评分达9分时间、离开PACU时间明显优于B组患儿(P〈0.05);在术后躁动、恶心呕吐的发生率上,A组患儿显著低于B组患儿(P〈0.05)。结论小儿眼科手术中使用丙泊酚联合瑞芬太尼喉罩麻醉较使用氯胺酮麻醉效果好,可控性强,术后苏醒快,不良反应少,能够保证患儿围术期安全,是小儿眼科手术的新选择。  相似文献   

4.
目的探讨瑞芬太尼联合丙泊酚联合靶控输注在小儿喉罩麻醉中应用的安全性和可行性。方法选择择期全麻下行腹部手术患儿116例,随机分为瑞芬太尼联合丙泊酚组(A组)和单纯丙泊酚组(B组),每组58例。两组患儿分别静脉输注瑞芬太尼1μg/kg和等容量生理盐水30 s后静注丙泊酚,按照序贯法给予患儿相应的丙泊酚剂量,丙泊酚靶浓度为2.5 mg/kg,后行喉罩插入。观察并记录麻醉诱导前(T0)、瑞芬太尼给药后2 min(T1)、喉罩成功插入即刻(T2)、切皮即刻(T3)、切皮后5 min(T4)和喉罩拔出即刻(T5)患儿的血压(HR)、平均动脉压(MAP)、呼气末二氧化碳分压(PETCO2)和脑电双频谱指数(BIS)以及记录喉罩重新置入的人数、置入时间、术中不良反应。结果与T0时刻比较,B组患儿的HR、MAP在T2、T3、T5时刻均升高(P〈0.01),而A组患儿在各时点HR、MAP差异无统计学意义(P〉0.05)。与B组患儿比较,A组患儿的HR、MAP在T2、T3、T5时刻降低(P〈0.01)。两组患儿PETCO2在T1、T2、T3、T4时刻均高于T0(P〈0.01)。与A组患儿比较,B组患儿BIS在T1~T5时刻均升高(P〈0.01),两组患儿在T1-T5时刻BIS均低于T0(P〈0.01)。A组的患儿喉罩插入后出现咳嗽/作呕、肢体动的例数少于B组(P〈0.05)。结论瑞芬太尼联合丙泊酚靶控输注的麻醉诱导方法能够为患儿喉罩插入提供较好的麻醉条件和较低的不良反应发生率。  相似文献   

5.
目的 序贯法测定丙泊酚靶控输注(TCI)麻醉诱导喉罩置入时丙泊酚效应室浓度的半数有效剂量(ED50).方法 选择30例择期行膝关节镜检查的患者,按序贯法设置丙泊酚TCI靶浓度,观察喉罩置入是否顺利.入选病例从顺利置入喉罩病例的前一个无效病例开始计算.结果 在复合1.5μg/kg芬太尼的情况下,顺利进行喉罩置入时丙泊酚效应室浓度的ED50为2.99 μg/ml(95%CI 2.85 ~3.12μg/ml).结论 在复合1.5 μg/kg芬太尼的情况下,顺利进行喉罩置入时丙泊酚的ED50为2.99μg/ml(95% CI为2.85 ~3.12μg/ml),可以作为临床参考.  相似文献   

6.
目的 探讨我国不同年龄男性小儿喉罩置入时七氟烷和丙泊酚的适宜浓度.方法 择期美国麻醉医师协会(ASA)Ⅰ级、体重7~53 kg男性小儿腹股沟手术200例,按年龄分为7个月~1岁(A组)、1~3岁(B组)、4~6岁(C组)、7~11岁(D组)4组,n=50.不用术前用药,常规禁食禁饮.喉罩置入采用七氟烷+50%N2O吸入麻醉(As、Bs、Cs、Ds,n=25)或丙泊酚效应室浓度TCI静脉麻醉(Ap、Bp、Cp、Dp,n=25).8组均根据Dixon序贯法来确定喉罩置人时的适宜浓度,在患儿下颌松弛、睫毛反射及咽喉反射消失时用翻转法置入喉罩.结果 As、Bs、Cs、Ds组喉罩置入时呼末七氟烷浓度的ED50各为2.96%(95%CI 2.58%~3.44%)、2.62%(95%C/2.31%~2.90%)、2.16%(95%CI 1.97%~2.33%)及1.89%(95%CI 1.66%~2.24%);Ap、Bp、Cp、Dp组喉罩置人时丙泊酚效应室浓度的ED50各为4.74μg/ml(95%CI 4.49~5.13μg/ml)、4.33 μg/ml(95%CI 4.07~4.62μg/ml)、4.10 μg/ml(95%CI 3.90~4.31 μg/ml)及3.65μg/ml(95%CI 3.24~3.98 μg/ml).结论 喉罩置入时呼末七氟烷浓度及丙泊酚效应室浓度的ED50随着男性小儿年龄增加而逐步减少.  相似文献   

7.
目的观察瑞芬太尼复合丙泊酚或七氟烷无肌松喉罩通气在小儿腹腔镜疝囊高位结扎术中的应用。方法选择2016年2月至2017年7月行小儿腹腔镜疝囊高位结扎术患儿80例,分为丙泊酚组(Prop组)和七氟烷组(Sev组)各40例,丙泊酚组瑞芬太尼3μg/kg+丙泊酚3mg/kg诱导置入喉罩,术中瑞芬太尼0. 3μg/kg·min+丙泊酚8mg/kg·h维持;七氟烷组8%七氟烷入睡后改4%吸入同时加瑞芬太尼3μg/kg诱导置入喉罩,术中瑞芬太尼0. 3μg/(kg·min)+七氟烷3%维持;记录诱导前(T0)、诱导后(T1)、置入喉罩后(T2)、手术开始(T3)、手术结束(T4)、拔出喉罩即刻(T5)各期的HR、MBP、BIS,并记录恢复自主呼吸时间、拔出喉罩时间、复苏时间和腹腔空间的评价情况(好、差);统计手术并发症的情况指标包括胃胀气、反流误吸、喉痉挛、低氧血症、咽痛、肌僵、呛咳、术后躁动情况。结果两组中丙泊酚组在诱导后MAP、BIS下降明显,差异有统计学意义(P<0. 05);两组恢复自主呼吸时间、拔出喉罩时间、复苏时间差异无统计学意义(P>0. 05),腹腔空间七氟烷组优于丙泊酚组,差异有统计学意义(P<0. 05),七氟烷组术后躁动多于丙泊酚组,差异有统计学意义(P<0. 05)。结论瑞芬太尼复合丙泊酚或七氟烷无肌松喉罩通气都适合小儿腹腔镜疝囊高位结扎术。  相似文献   

8.
李克寒  杨惠敏  郭丹 《蚌埠医学院学报》2016,41(10):1299-1301,1305
目的:探讨瑞芬太尼或不同剂量地佐辛全麻诱导期喉罩置入对丙泊酚半数有效血浆靶浓度(Cp50)的影响。方法:择期手术全身麻醉患者160例,随机分为A、B、C、D组各40例。A组患者初始靶控输注丙泊酚5 μg/mL,B、C和D组患者初始靶控输注丙泊酚3 μg/mL,同时,B组患者靶控输注瑞芬太尼2 ng/mL,C组患者予地佐辛0.1 mg/kg,D组患者地佐辛0.15 mg/kg,A组患者给予与B组等量0.9%氯化钠注射液。20 min后置入喉罩。记录麻醉诱导前、喉罩置入前、喉罩置入时4组患者的心率(HR)、平均动脉压(MAP)和脑电双频谱指数值(BIS)。并采取上下交叉法对丙泊酚Cp50进行观察。结果:喉罩置入前,A、C和D组患者HR均显著高于B组(P<0.01),而C组患者HR也明显高于A和D组(P<0.01);B、C和D组患者的MAP显著高于A组(P<0.01)。喉罩置入时,B和D组患者HR均显著低于A和C组(P<0.01)。喉罩置入前与麻醉诱导前比较,A、B和D组患者HR均显著下降(P<0.01),4组患者的MAP及BIS均显著降低(P<0.01)。喉罩置入时与喉罩置入前比较,A和B组患者的HR、MAP及BIS值均上升(P<0.05~P<0.01)。C组患者MAP和BIS值亦均上升(P<0.05)。B、C和D组丙泊酚Cp50均显著低于A组(P<0.01)。且B和D组也显著低于C组(P<0.01)。结论:瑞芬太尼或地佐辛0.15 mg/kg能有效地降低丙泊酚Cp50,但地佐辛在麻醉诱导及喉罩置入过程中,血流动力学较瑞芬太尼更加稳定。  相似文献   

9.
目的:观察丙泊酚、丙泊酚复合芬太尼、丙泊酚复合瑞芬太尼用于人工流产手术麻醉效果,探寻理想麻醉方式。方法:ASAⅠ~Ⅱ级自愿接受无痛人流术的早孕妇女150例,随机分为丙泊酚组(A组)、丙泊酚复合芬太尼组(B组)、丙泊酚复合瑞芬太尼组(C组)各50例,分别静脉推注丙泊酚2.0 mg/kg、丙泊酚1.5 mg/kg+枸橼酸芬太尼1.0μg/kg、丙泊酚1.5 mg/kg+瑞芬太尼0.5μg/kg。记录每组术前、术中、术后的血压、心率、呼吸频率和脉搏血氧饱和度、苏醒时间、镇痛效果、不良反应和丙泊酚用量。结果:A组术中收缩压下降最多(P<0.05);C组心率下降最多(P<0.05);C组麻醉效果最好,苏醒最快,嗜睡、恶心、呕吐等发生例数最少,丙泊酚用量最小。结论:丙泊酚复合瑞芬太尼用于无痛人流麻醉效果好、安全可行。  相似文献   

10.
目的观察抑制视可尼喉镜气管插管反应,靶控输注不同浓度瑞芬太尼对丙泊酚半数有效浓度(EC50)的影响。方法择期全麻耳鼻喉科手术患者68例,ASA Ⅰ~Ⅱ级。依据瑞芬太尼靶浓度不同随机分为4组:RF1.5组,1.5ng/ml;RF2.0组,2.0ng/ml;RF2.5组,2.5ng/ml;RF3.0组,3.0ng/ml。同时靶控输注丙泊酚,以序贯法确定丙泊酚EC50,并计算95%可信区间。结果 RF1.5、RF2.0、RF2.5、RF3.0组视可尼喉镜插管无反应的丙泊酚EC50分别为3.62、3.38、2.90、2.69μg/ml。结论视可尼喉镜插管刺激强度小于传统喉镜,瑞芬太尼靶控浓度为2.0~2.5ng/ml时,丙泊酚EC50为3.38~2.90μg/ml,是较适宜的插管浓度。  相似文献   

11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

12.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

13.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

14.
Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P<0.01);the MAP decreased(P<0.01)and the HR increased drastically(P<0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.  相似文献   

15.
Objective:To investigate the gene expression of osteoprotegerin(OPG) and osteoclast differentiation factor(ODF) in the bone tissue of patients with hip fracture due to osteoporosis. Methods:OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers(over 50 years old) with hip fracture(Observer Group) and 30 cases of hip facture sufferers with no osteoporosis(Control group) were analyzed with the Semi-Quantitative RT-PCR method. Results:The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion:Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.  相似文献   

16.
Objective:To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas(SPTP). Methods:Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin(HE) staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results:Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin(9/9 cases), AAT(9/9 cases), NSE(9/9 cases), ACT(7/9 cases), CK20(2/9 cases), CgA(1/9 cases), S-100(3/gcases), PR(4/gcases), Syn(3/9 cases) and CD56(5/9cases), negative in CEA and ER. Conclusion:SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.  相似文献   

17.
In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.  相似文献   

18.
Objective: To explore the role of matrix metalloproteinase-1,2 (MMP-1, MMP-2) and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in endometriosis. Methods: The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects (excluding endometriosis) were collected and examined by in situ hybridization technology and western blot assay. Results: Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant (P 〈 0.01 ). Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion: The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.  相似文献   

19.
Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.  相似文献   

20.
《中国结合医学杂志》2008,14(2):159-159
The 6th National General Congress of Chinese Association of Integrative Medicine (CALM) was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.  相似文献   

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