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1.
唐红海  严国章  丁力 《中国药业》2012,21(23):99-100
目的探讨6%中分子羟乙基淀粉130/0.4预输液预防剖宫产术仰卧位低血压综合征的临床效果。方法将剖宫产手术的孕产妇380例作为研究对象,按照入院时间分为观察组和对照组,各190例。术前开放静脉通路,观察组输注6%中分子羟乙基淀粉130/0.4500mL,对照组输注乳酸钠林格注射液500mL,然后实施腰麻联合硬膜外麻醉。结果两组孕产妇平均动脉压与扩容前、扩容后比较,均无统计学差异(P〉0.05);观察组麻醉过程中平均动脉压(93.59±9.67)mmHg高于对照组的(87.45±9.45)mmHg,低血压发生率5.79%和麻黄素剂量(3.12±1.08)nag均低于对照组的16.84%和(8.89±2.45)mg(P〈0.05)。结论在腰硬联合麻醉下施行剖宫产中,麻醉前输注6%中分子羟乙基淀粉130/0.4能很好地预防麻醉后血流动力学的变化。  相似文献   

2.
目的探讨琥珀酰明胶注射液、羟乙基淀粉130/0.4注射液及复方乳酸钠液对围术期T淋巴细胞亚群及自然杀伤细胞的影响。方法选择甲状腺瘤患者45例,ASAI或Ⅱ级,分为3组,每组15例:琥珀酰明胶注射液组(Ⅰ组),羟乙基淀粉130/0.4氯化钠注射液组(Ⅱ组),复方乳酸钠液(Ⅲ组)。每组输液10ml/kg。分别于术前、术后第3d、术后第7d抽取静脉血10ml,用三色流式细胞仪检测T细胞亚群和NK细胞。结果与术前相比,术后第2d三组CD3+均下降,CD8+升高(P〈0.05);Ⅰ,Ⅲ组CD4+/CD8+降低(P〈0.05);术后第7dⅡ,Ⅲ组CD3+降低(P〈0.05),Ⅰ组CD3+恢复术前水平;与术前相比,各组NK细胞差异无统计学意义。结论羟乙基淀粉130/0.4氯化钠注射液和复方乳酸钠注射液相比,琥珀酰明胶注射液利于甲状腺瘤患者围术期细胞免疫功能的恢复。  相似文献   

3.
羟乙基淀粉行急性高容量血液稀释对围术期肾功能的影响   总被引:1,自引:1,他引:0  
目的探讨术前用6%羟乙基淀粉130/0.4(6%HES130/0.4)行急性高容量血液稀释(AHHD)对胃肠择期手术患者肾功能的影响。方法选择60例ASAⅠ-Ⅱ级的择期胃肠手术患者,随机分成两组:H组(万汶组)和R组(晶体组)。H组用万汶术前扩容;R组输注乳酸林格氏液作为对照。监测AHHD前(T0)、术毕(T1)、术后24h(T2)、术后72h(T3)血尿素氮(BUN)、血肌酐(BCr)、尿α1-微球蛋白(α1-MG)和尿比重。结果两组血尿素氮、血肌酐、尿量、尿比重等肾功能常用指标基本在正常范围内;两组尿α1-MG在T1、T2、T3均较T0增高(P〈0.001)。各指标组间比较差异均无统计学意义。结论用6%HES130/0.4行AHHD对肾功能正常患者的肾功能无明显影响。  相似文献   

4.
目的:观察麻醉前预输注6%中分子羟乙基淀粉130/0.4(万汶,Voluven)时ERCP患者循环系统的影响。方法:ASAI~Ⅱ级行ERCP十二指肠支架置入术病人60例随机分为两组,每组30例。L组麻醉前30min内静脉输注乳酸钠林格液500mL;V组麻醉前30min内静脉输注万汶500mL。两组麻醉诱导及维持相同,芬太尼0.05mg复合丙泊酚1.5mg/kg麻醉诱导;丙泊酚250~450mg/h静脉麻醉维持。观察麻醉前(即基础值)、手术即刻、手术后5min、术毕各时点平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO2)变化。结果:两组患者基础MAP、HR、SpO2无显著差异性。L组患者手术即刻、手术后5min、术毕各时点MAP较术前下降(P〈0.01);V组患者手术即刻MAP也较术前下降(P〈0.05),但术毕时MAP与术前比较差异无显著性(P〉0.05)。组间比较V组手术即刻、手术后5min、术毕各时MAP较L组显著增高(P〈0.05)。两组患者手术后5min.HR均较术前增加,但L组较V组显著增高(P〈0.05);SpO2与术前比较差异无显著性,组间也无差异性。结论:ERCP十二指肠支架置入术前静脉预注6%中分子羟乙基淀130/0.4可有效预防低血压。  相似文献   

5.
目的观察小剂量去氧肾上腺素联合羟乙基淀粉扩容对腰硬联合麻醉患者血压及心率的影响。方法120例腰硬联合麻醉患者随机分为三组:去氧肾上腺素联合羟乙基淀粉(A组)。羟乙基淀粉(B组)和单纯乳酸林格氏液(C组)。每组40例。全部患者均先给予乳酸林格氏液10ml/kg,补充生理需要量。A组给予羟乙基淀粉(HES)以25ml/min的速度,15ml/kg的用量输入。于腰穿前2~3s给予50mg去氧肾上腺素。B组给予羟乙基淀粉,输入速度及用量A组,C组单纯给予乳酸林格氏液以25ml/min,15ml/kg输入。监测患者入室(T0)、预处理后(T1),腰麻注药后5min(T2)、8min(T3)、15min(T4),BP及HR变化。结果A组患者在T2、T3和T4时点与T0相比BP及HR无明显变化(P〉0.05)。B组患者BP及HR在T2、T3和T4时点下降明显,与T0同时点A组相比差异有统计学意义(P〈0.05)。C组患者L、T3及L时点与T0相比及与同时点A组相比BP和HR变化明显,差异有统计学意义(P〈0.05或P〈0.01)。结论在腰硬联合麻醉下,对无严重心肺疾患患者给予去氧肾上腺素联合羟乙基淀粉预处理,可以明显减少腰硬联合麻醉后BP下降的发生率。  相似文献   

6.
目的评价应用不同液体行急性高容量血液稀释(AHH)对老年食管癌根治术患者血流动力学、凝血功能的影响。方法择期全身麻醉复合硬膜外食管癌手术患者90例,完全随机分为3组:每组30例,麻醉诱导前30min,A组按15~20ml/kg,以20ml/min速率静脉滴注6%羟乙基淀粉(200/0.5);B组以同样的剂量、速率静脉滴注6%羟乙基淀粉(130/0.4);C组静脉滴注乳酸钠林格液。分别记录AHH前(t.)、插管即刻(t2)、插管后10min(t3)、AHH后10min(t4)、手术3h(t5)、手术结束(t6)的MAP、CVP、HR和各时间点的Hb、Hct、Pit、PT、APTT及FIB的变化。结果血流动力学:组内与AHH前(t1)比较,A、B组在t4、t5时点CVP、MAP显著升高,差异均有统计学意义;Hct显著下降;A、B组在t4、t5与c组比较,CVP、MAP升高,Hct下降,差异均有统计学意义(P〈0.05)。凝血功能变化:组内与t。相比,A、B组P1t在t3、t4、t5时点显著下降;C组无明显变化;PT、APTT明显延长,FIB亦明显下降,而C组仅在t5时点延长或下降,差异均有统计学意义(均P〈0.05);A、B组在t4、t5与C组比较差异均有统计学意义(均P〈0.05)。而A、B组之间血流动力学与凝血功能差异均无统计学意义。C组术中输液、输血量显著高于A、B组(t分别为2.99、24.63、3.58、24.20,均P〈0.01)。结论6%羟乙基淀粉(200/0.5)和6%羟乙基淀粉(130/0.4),AHH对老年食管癌手术循环稳定、凝血功能抑制轻,减少输血量,节约血源。  相似文献   

7.
吴建浓  雷澍  方强 《江西医药》2006,41(8):535-538
目的观察中分子羟乙基淀粉(130/0.4)对脓毒性休克病人胃粘膜灌注的影响。方法收集20例脓毒性休克病人.按照2004年脓毒性休克治疗指南中的复苏目标,用中分子羟乙基淀粉(130,0.4)进行液体复苏。观察复苏前、后血流动力学指标、动脉乳酸浓度(ABL)和局部二氧化碳压力差(Pg-aCO2),即胃粘膜和动脉血二氧化碳压力差。结果中分子羟乙基淀粉(130/0.4)复苏后,Pg-aCO2从15.49mmHg降至11.72mmHg(P〈0.01),PAWP、CI、SVRI、DO2及ABL等指标升高(P〈0.01);Pg-aCO2与ABL呈显著正相关性(r=0.546,P〈0.05),而与CI、DO2、VO2无显著相关性;中分子羟乙基淀粉(130/0.4)复苏前后。血清肌酐、PT、APTT和血小板无明显变化(P〉0.05)。结论中分子羟乙基淀粉(130/0.4)能改善脓毒性休克病人胃粘膜的灌注,对肾功能和凝血功能无明显影响。  相似文献   

8.
李峰  游春枝 《中国基层医药》2011,18(15):2102-2103
目的观察不同方法输注羟乙基淀粉对麻醉患者的血流动力学影响。方法选择下腹部手术患者100例,均行腰硬联合麻醉,麻醉平面控制在T6~S,之间,观察组麻醉前预输羟乙基淀粉(200/0.5)8ml/kg,20min内输注完毕后输注乳酸林格氏液500ml。对照组麻醉前预输乳酸林格氏液500ml,输注完毕后输注羟乙基淀粉(200/0.5)8ml/kg,20min。观察两组输液前、预输液后、麻醉后的红细胞比积(Hct)、凝血功能((PT,APTT)、SBP、DBP、HR、SpO2变化。结果观察组血压波动在5%之间,对照组在20%以上。两组的Hct、PT、APTT无显著变化,且组内均与术前无明显变化。结论羟乙基淀粉(200/0.5)用于麻醉前预输液对维持患者的血流动力学平稳效果是确切有效的,且无凝血功能及血液的携氧能力改变。  相似文献   

9.
目的探讨开颅血肿清除术中早期快速输注羟乙基淀粉对去颅骨瓣后反射性低血压的预防作用。方法将40例开颅血肿清除术患者随机分为两组,均使用气管内全身麻醉。A组(对照组)在入室后到去颅骨瓣前单纯输注乳酸钠林格注射液750 ml;B组(实验组)在入室后到去颅骨瓣前输入羟乙基淀粉500 ml、乳酸钠林格注射液250 ml。去颅骨瓣减压后根据患者情况输入羟乙基淀粉或浓缩红细胞及晶体液。观察两组患者诱导前、去颅骨瓣前和去颅骨瓣后5 min、15 min的收缩压(SBP)、舒张压(DBP)、中心静脉压(CVP)、HR及手术后存活率。结果麻醉诱导前A组SBP、DBP、CVP、HR与B组无明显差异,去颅骨瓣前两组SBP、DBP均有下降,但两组之间无明显差异,CVP值B组高于A组。去颅骨瓣后5 min两组SBP、DBP均明显下降,但B组较A组平缓(P<0.05),两组HR无明显差异。去颅骨瓣后15 min,A组和B组SBP、DBP均有回升.B组SBP回升明显比A组高(P<0.01)。CVP值在去颅骨瓣后5 min、15 min B组明显高于A组(P<0.05)。手术后存活率A组68%,B组90%。结论去颅骨瓣前用羟乙基淀粉联合乳酸钠林格注射液快速扩容可以有效预防去颅骨瓣后血压反射性骤降,防止脑组织的进一步缺血、缺氧。  相似文献   

10.
张骐  崔雯  方明星 《安徽医药》2008,12(12):1219-1220
目的探讨6%羟乙基淀粉130/0.4预输注对联合脊麻-硬膜外麻醉下剖宫产术血流动力学的影响。方法剖宫产80例,ASAⅠ-Ⅱ级,年龄21-35岁,体重62-88kg,随机分为羟乙基淀粉组(H组)及对照组(D组),每组40例。H组病人麻醉前先输注6%羟乙基淀粉500 ml,再行联合脊麻-硬膜外麻醉后行手术,D组病人麻醉前先输注乳酸钠林格注射液500 ml,再行联合脊麻-硬膜外麻醉后行手术。分别记录麻醉前(T0)、麻醉后1 min(T1)、2min(T2)、5 min(T3)、10 min(T4)的心率(HR)、收缩压(SP)、舒张压(DP)及麻醉后恶心呕吐的发生率。结果H组病人的麻醉后心率、血压较平稳,D组病人血压下降明显,心率明显增快,两组比较有明显差异(P〈0.01)且H组病人的恶心呕吐发生率明显低于D组。结论剖宫产术行联合脊麻-硬膜外麻醉前预输注6%羟乙基淀粉可以明显稳定术中的血流动力学。  相似文献   

11.
目的研究甲基黄酮醇胺盐对大鼠学习记忆的影响,分析该药影响学习记忆与其影响脑内自由基反应的关系。方法ip甲基黄酮醇胺盐5,10mg·kg-1共7d后,采用Mor-ris水迷宫测试大鼠的学习记忆能力,同时测定训练d5和休息30d后大鼠脑内过氧化脂质(LPO)含量和超氧化歧化酶(SOD)活性。结果甲基黄酮醇胺盐两种剂量均可提高大鼠获取空间定位信息能力和信息贮存能力并增强记忆保持和再现过程。用药大鼠脑内LPO含量明显低于对照组,与其记忆成绩呈正相关性。而脑内SOD活性则高于对照组,与其记忆成绩呈负相关性。结论甲基黄酮醇胺盐对大鼠的学习记忆机能具有促进作用,而它的抗氧化作用可能为其促进学习记忆的作用机制。  相似文献   

12.
目的研究舒芬太尼+咪达唑仑在乳腺癌手术麻醉复苏中的应用,术后麻醉苏醒情况及拔管时血流动力学变化。方法选取ASAⅠ级,临床诊断为乳腺癌,拟行乳腺癌改良根治术患者60例,随机分为三组,每组20例,三组均采用气管内插管全身麻醉方式,以维库溴铵诱导插管,1组(F)以芬太尼+异丙酚+咪达唑仑维持麻醉,2组(S)以舒芬太尼+丙泊酚+咪达唑仑维持麻醉,3组(T)以舒芬太尼+丙泊酚+咪达唑仑维持麻醉,于术毕前10min停止丙泊酚输注,追加舒芬太尼+咪达唑仑,观察记录手术结束,取吸痰时,拔管时及拔管后MAP,HR,与基础值进行比较,记录呼患者睁眼时间,拔除气管导管时间和OAA/S评分。结果与术毕时比,F组和S组的MAP和HR在吸痰、拔管时均明显增高(P<0.05)。在睁眼时间、拔管时间两项观察指标中,各组之间差异有统计学意义,T组患者睁眼时间及拔管时间最短,S组次之,F组最慢,OAA/S评分T组评分较F组和S组明显升高(P<0.05)。结论舒芬太尼联合咪达唑仑用于乳腺癌手术患者,能保证很好的麻醉深度,术毕前10min追加舒芬太尼+咪达唑仑,拔管时心血管反应轻,术毕苏醒时间快,清醒状况良好,值得临床推广。  相似文献   

13.
The airway surface epithelium is frequently injured by microorganisms and viruses due to its permanent contact with the external medium. Following injury, the epithelium is able to repair itself and regenerate through several mechanisms including spreading and migration of basal cells, cell proliferation and differentiation. The cellular and molecular factors involved in wound repair and epithelial regeneration interact closely, implying the participation of cytoskeleton proteins and integrins receptors, matrix metalloproteinases and their inhibitors as well as cytokines and growth factors secreted by airway epithelial and mesenchymal cells. The spatio-temporal modulation of the pro-inflammatory cytokines such as IL-8, and MMPs (MMP-9 and -7) during the different steps of regeneration suggests that the matrix and secretory environment are markedly involved in these mechanisms and that their dysregulation may induce remodeling of the airway mucosa. A better knowledge of the mechanisms involved in airway epithelium regeneration may pave the way to regenerative therapeutics allowing the reconstitution of a functional airway mucosa in numerous respiratory diseases such as cystic fibrosis, chronic obstructive pulmonary diseases and bronchiolitis.  相似文献   

14.
目的 探讨微小核糖核酸-15b(miR-15b)基因干扰对脑缺血再灌注损伤的影响及其作用机制。方法 取新生24 h内Wistar乳鼠的大脑皮层星形胶质细胞传代培养并鉴定,氧糖剥夺/再恢复法处理模拟体内脑缺血再灌注损伤(模型组);无特殊处理的大脑皮层星形胶质细胞为对照组。构建miR-15b干扰腺病毒载体及阴性对照载体,分别转染上述模型组细胞,记为过表达组、沉默组、过表达对照组、沉默对照组,另设置空白组。24 h后,倒置相差显微镜观察各组细胞形态学改变;氮兰四唑盐(MTS)法检测细胞存活率,乳酸脱氢酶(LDH)漏出率实验检测细胞活力;流式细胞术检测细胞凋亡率;实时荧光定量聚合酶链反应检测各组细胞miR-15b以及B淋巴细胞瘤-2(Bcl-2)、胱天蛋白酶-3(Caspase-3)、Caspase-9 mRNA表达;Western blot检测各组细胞Bcl-2、Caspase-3、Caspase-9蛋白表达;荧光素酶报告基因实验验证miR-15b是否靶向调控Bcl-2。结果 与对照组比,空白组、过表达对照组和沉默对照组贴壁细胞减少,细胞缩小变圆,分布松散,细胞存活率和Bcl-2 mRNA及...  相似文献   

15.
Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.  相似文献   

16.
With the continuing development of clinical drug resistance among bacteria and the advent of resistance to the recently released agents quinupristin-dalfopristin and linezolid, the need for new, effective agents to treat multi-drug-resistant Gram-positive infections remains important. This review focuses on agents presently in clinical development for the treatment of serious multidrug-resistant staphylococcal, enterococcal and pneumococcal infections, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci and penicillin-resistant Streptococcus pneumoniae. Agents to be discussed that affect the prokaryotic cell wall include the antimethicillin-resistant S. aureus cephalosporins BAL9141 and RWJ-54428, the glycopeptides oritavancin and dalbavancin and the lipopeptide daptomycin. Topoisomerase inhibitors include the fluoroquinolones gemifloxacin, sitafloxacin and garenoxacin. Protein synthesis inhibitors are represented by the ketolides telithromycin and cethromycin, the oxazolidinones and the glycylcycline tigecycline. Although each of these compounds has demonstrated antibacterial activity against antibiotic-resistant pathogens, their final regulatory approval will depend on an acceptable clinical safety profile.  相似文献   

17.
Summary Six normal young and six normal elderly volunteers and six elderly hypertensive patients took part in an acute and chronic dose study of a combination capsule containing atenolol (50 mg), hydrochlorothiazide (25 mg) and amiloride (2.5 mg) designed for the treatment of hypertension. No difference in any of the drug pharmacokinetic parameters could be detected between the hypertensives and the normal elderly subjects. The bio-availability and the 24-h blood concentrations of all three drugs, half-life of atenolol and amiloride and the peak concentration of hydrochlorothiazide was significantly greater in the elderly. The 24-h blood concentrations of atenolol and hydrochlorothiazide did not alter with chronic dosing, but amiloride concentrations were significantly higher at this time in all groups. A significant fall in the blood pressure was observed in the hypertensive group. Heart rate fell more in the normal and hypertensive elderly subjects than in the young. The combination has shown to be an effective and well tolerated antihypertensive in the elderly patient with a 24-h duration of action.  相似文献   

18.
19.
目的:通过总结《儿科阿奇霉素注射使用的快速建议指南》临床问题与结局指标的前期调查结果,与指南专家评估结果进行对比,探讨开展该工作的意义。方法:通过电子问卷,对临床一线医务人员进行调查,调查内容主要包括参与者的基本信息、对指南拟纳入的临床问题(5分制)和结局指标(9分制)进行重要程度评分以及补充。计算各题平均分,采用变异系数表示一致性,采用Wilcoxon秩和检验,对比参与者和专家评估结果,对补充的内容进行描述性分析。结果:共纳入155位参与者的调查结果,各年龄段、文化程度和职称等均有分布。结果显示,注射用阿奇霉素的用法用量(4.56分)和有效性指标(7.28分)最受关注,特殊人群用药(42.71%)和安全性(34.52%)的一致性较差;与专家评估对比分析显示,对于大部分问题和指标,前期调研和专家评估的评分差异无显著性,专家评估的变异系数更低;共收集有效补充15条,最终将新生儿的使用问题纳入。结论:在指南制订前期,有必要对临床问题和结局指标进行广泛调查,收集并分析评估和补充意见,这对指南专家组的评估具有一定的参考意义。  相似文献   

20.
目的观察辛伐他汀对野百合碱(MCT)诱导的肺动脉高压大鼠炎症细胞因子IL-6和IL-8表达的影响,探讨辛伐他汀作用于肺动脉高压的机制。方法将30只健康雄性SD大鼠随机平均分为正常对照组、MCT诱导的肺动脉高压组(模型对照组)、辛伐他汀干预治疗组(治疗组)。模型对照组和治疗组注射野百合碱造模。治疗21 d后,采用右心导管法检测大鼠平均肺动脉压(mPAP);称量RV和LV+S,计算右心肥大指数(RVHI)。采用RT-PCR检测大鼠肺组织中IL-6和IL-8 mRNA的表达,采用ELISA法检测大鼠血清中IL-6和IL-8水平。结果模型对照组mPAP和RVHI值显著高于治疗组和正常对照组,治疗组和正常对照组mPAP和RVHI值比较无显著性差异。模型对照组大鼠肺组织中IL-6和IL-8 mRNA的表达和血清中IL-6和IL-8水平显著高于正常对照组和治疗组,而治疗组大鼠肺组织中IL-6和IL-8 mRNA的表达和血清中IL-6水平与正常对照组比较无显著性差异,但治疗组大鼠血清IL-8水平高于正常对照组(P〈0.05)。结论辛伐他汀可通过抑制MCT诱导大鼠肺动脉高压模型大鼠肺组织中炎性细胞因子的表达、下调大鼠炎性细胞因子的分泌,达到对肺动脉高压的治疗作用。  相似文献   

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