盐酸昂丹司琼体外抑菌作用的实验研究

目的观察盐酸昂丹司琼在体外对大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌抑菌作用的影响。。方法将盐酸昂丹司琼注射液用无菌生理盐水稀释至终浓度分别为0.5、0.25、0.125和0.0625 mg/mL,与大肠埃希杆菌、金黄色葡萄球菌、和铜绿假单胞菌培养,每个实验重复三遍,所有菌株的稀释的系列测定均进行两次。结果昂丹司琼对大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌均有明显的抑菌作用,昂丹司琼对大肠埃希菌的抑菌作用随着昂丹司琼浓度的增加而增加,至0.0625 mg/mL时仍有明显的抑菌作用(P<0.05)。昂丹司琼对金黄色葡萄球菌和铜绿假单胞菌的抑菌作用在昂丹司琼浓度为0.125 mg/mL时消失。结论昂丹司琼在体外可以抑制大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌的生长,对于预防麻醉相关的感染可能有一定的临床意义。     

盐酸格拉司琼在术后硬膜外镇痛(PCEA)中的应用

目的:观察盐酸格拉司琼在术后硬膜外镇痛中的应用。方法:选择32例ASAⅠ～Ⅱ级硬膜外阻滞下腹部手术病人,随机分为盐酸格拉司琼组(n=16)和对照组(n=16)。术毕全部病人均采用硬膜外镇痛,镇痛液配方为:盐酸格拉司琼组芬太尼0.4mg+0.75％罗哌卡因10ml+地塞米松5mg+盐酸格拉司琼3mg+生理盐水稀释至10ml。对照组芬太尼0.4mg+0.75％罗哌卡因10ml+地塞米松5mg+生理盐水稀释至100ml。均以2ml/h匀速给药。连续观察24h记录恶心、呕吐发生率、疼痛评分。疼痛评定采用视觉模拟标尺评分(VAS)。结果:盐酸格拉司琼组恶心呕吐发生率(6.25％)低于对照组(68.75)。两组病例均未发现有明显的呼吸抑制及下肢麻木、运动受影响的情况。结论:盐酸格拉司琼对术后硬膜外镇痛所引起的恶心呕吐有一定的预防作用。     

格拉司琼对腹腔镜胆囊切除术后恶心、呕吐的预防作用--随机双盲对照研究

目的探讨格拉司琼对腹腔镜胆囊切除手术（laparoscopic cholecystectomy，LC）后恶心、呕吐（postoperative nausea and vomiting，PONV）的预防作用。方法选择120例ASAⅠ-Ⅱ级LC，随机分为A、B、C组，双盲法于手术结束后分别静脉注射格拉司琼3mg（A组）、6mg（B组）和生理盐水6ml（C组），观察3组病入手术结束后0～4h、4～8h、8-24h、24～48h恶心、呕吐、头痛、头昏情况。结果A、B组术后各时段恶心、呕吐发生率比C组明显减少（Y=4．021，P=0．045；x^2=4．267，P=0．039），A、B2组之间比较差异无显著性；头痛、头昏发生率B组显著高于A组（x^2=4．021，P=0．045；x^2=4．267，P=0．039），B组头痛发生率与C组比较差异无显著性（x^2=2．813，P=0．094），B组头昏发生率高于C组（x^2=4．267，P=0．039）。结论静注3mg或6mg格拉司琼能明显减少LC术后恶心、呕吐的发生率，但剂量增大会增加副作用。     

氟哌利多、阿扎司琼和格拉司琼对患者校正QT间期影响的比较

目的比较氟哌利多、阿扎司琼、格拉司琼对患者校正QT(QTc)间期的影响。方法择期手术患者80例,随机均分为四组,于麻醉前30min分别静注氟哌利多2.5mg(A组)、阿扎司琼10mg(B组)、格拉司琼3mg(C组)和生理盐水5ml(D组)。记录用药前后ECG,分析QTc间期的变化。结果与用药前比较,A组患者用药后5、10minQTc间期明显延长(P<0.05),且明显长于D组(P<0.05)。其它三组用药后QTc间期无显著变化。结论预防性应用止吐剂量的氟哌利多可引起QTc间期显著延长。     

格拉司琼预防术后病人自控镇痛治疗中恶心呕吐的观察

病人自控镇痛 (ｐａｔｉｅｎｔ ｃｏｎｔｒｏｌｌｅｄａｎａｌｇｅｓｉａ ,ＰＣＡ)过程中 ,恶心呕吐是常见的并发症之一。本研究旨在观察格拉司琼对术后ＰＣＡ恶心呕吐的预防作用。资料与方法一般资料　 80例ＡＳＡⅠ～Ⅱ级行择期手术的病人 ,男41例 ,女 39例 ,年龄 15～ 71岁 ,均在全身麻醉加硬膜外麻醉下施行腹部、胸部及脊椎、四肢手术。术前用药 :苯巴比妥钠 0 1ｇ和阿托品 0 5ｍｇ肌肉注射。全身麻醉 :麻醉诱导均依次静注咪唑安定 0 1ｍｇ/ｋｇ、芬太尼 1～ 2 μｇ/ｋｇ、维库溴铵0 15ｍｇ/ｋｇ、丙泊酚 1 5ｍｇ/ｋｇ诱导插管。术…     

格拉司琼治疗乳腺癌患者化疗后胃肠道反应27例疗效分析

胃肠道反应如恶心、呕吐是乳腺癌患者化疗后常见的不良反应之一。为减轻患者的痛苦,人们一直在探索防治化疗后严重胃肠道反应的有效方法。本研究探讨应用高选择性5-HT,受体拮抗剂格拉司琼治疗乳腺癌化疗后的严重胃肠道反应,获得较好的效果。现报告如下。     

中药及组方对常见厌氧菌的体外抑菌作用

为了探讨中药对厌氧菌的作用，我们采用具有清热解毒、活血化瘀、通里攻下功用的五十种常用中草药及１２株临床常见厌氧菌，进行了体外抗菌实验。在体外中药抑菌作用的初步筛选实验基础之上，我们选用了有较强抗厌氧菌作用的黄连、黄岑、木通、大黄、加上活血化瘀药物丹参，组成方剂，并暂定名为“厌氧灵”。本实验研究采用琼脂稀释法，对厌氧灵及组成的五种单味药物分别进行了抑菌实验，并测定了最小抑菌浓度。实验结果表明，五十种中草药中，黄连、黄岑、大黄、五味子、木通对六种以上的脆弱类杆菌的抑菌环直径分别为１８ｍｍ、２２ｍｍ。厌氧灵对包括脆弱类杆菌在内的六种厌氧菌有良好的抑菌作用，对金黄色葡萄球菌在内的三种需氧菌亦有较好的抑菌作用。黄连、黄芩、木通、大黄、丹参和厌氧灵对脆弱类杆菌的最小抑菌浓度分别为０．０６２ｇ／ｍｌ、０．５００ｇ／ｍｌ、０．０３１ｇ／ｍｌ、０．１２５ｇ／ｍｌ、０．５００ｇ／ｍｌ、０．０３１ｇ／ｍｌ。说明厌氧灵在体外可同时抑制某些厌氧菌和需氧菌的生长。     

地塞米松和格拉司琼预防腹腔镜胆囊切除术后恶心呕吐比较的研究

目的：研究地塞米松和格拉司琼预防腹腔镜胆囊切除术后恶心呕吐的临床效果及两者有无交互作用。方法：80例ASAⅠ～Ⅱ级择期全身麻醉下行腹腔镜胆囊切除术的患者，随机分为4组：地塞米松组、格拉司琼组、地塞米松＋格拉司琼组和对照组，每组20人。各组患者均于麻醉诱导前经静脉给予止吐药，记录术后24h内恶心呕吐评分及刀口愈合情况。结果：各实验组术后恶心呕吐评分均低于对照组（P〈0．05）；地塞米松组和格拉司琼组相比差异无统计学意义（P〉0．05）；地塞米松＋格拉司琼组与格拉司琼组、地塞米松组相比均矧氏（P〈0．05）；析因分析认为地塞米松和格拉司琼两药联合应用对预防术后恶心呕吐具有协同作用；各组术后刀口愈合均良好。结论：地塞米松和格拉司琼均能较好预防术后恶心呕吐，两者效果无明显差异，两药联合应用具有协同作用。     

格拉司琼用于预防术后恶心呕吐

目的观察妇科子宫切除术患者术后恶心、呕吐情况，通过新型5-羟色胺，(5-HT3)受体拮抗剂格拉司琼预防术后恶心、呕吐的效果，并与氟沛利多相比较。方法6ID例妇科择期子宫切除术患者，ASAⅠ～Ⅱ级。术前无恶心、呕吐，随机分为3组：A组为格拉司琼组20例；B组为氟沛利多组加例；C组为对照组20例，并分别于术中同时使用镇痛药一格拉司琼组静注格拉司琼3mg加入5％GS20ml，氟沛利多组静注氟沛利多2．5mg。对照组度冷丁50mg于摩菲氏滴管滴入．观察3组患者白手术结束至手术后48h的恶心、呕吐程度并予评估。结果3组患者用药后监测血压、呼吸、心率、血氧饱和度、心电图情况与给药前相比无明显差异，手术后恶心、呕吐情况，氟沛利多组和对照组发生例数明显多于格拉司琼组，程度亦较后者重。结论麻醉性镇痛药最多引起术后恶心、呕吐，而新型止吐剂格拉司琼是一种高选择性的5-HT3受体拮抗剂，通过拮抗中枢化学感受区及外周迷走神经末梢的5-HT3受体，从而抑制恶心、呕吐的发生。注药后无锥体外系症状发生，无血压偏低、无烦躁、无过度镇静等副作用…。对手术后引起的恶心、呕吐具有良好的预防和治疗作用。     

格拉司琼与氟哌利多预防胃癌根治中后恶心呕吐的比较

在硬膜外麻醉下行胃癌根治术 ,术中常见恶心呕吐。传统的做法是在切皮前静注半量的杜氟合剂[1] 或芬氟合剂等辅助药物 ,使患者入睡不感牵拉内脏之不适 ,效果常不理想。而格拉司琼的应用却收到了理想的效果。1　资料与方法1 .1　一般资料 :6 9例ASAⅠ～Ⅱ级择期胃癌手术患者 ,年     

Efficacy of prophylactic intravenous granisetron in postoperative emesis in adults

Purpose This randomized, double-blind, placebo-controlled trial evaluated the efficacy, safety, and optimal dose of granisetron in the prophylactic control of postoperative nausea and vomiting in patients undergoing gynecologic surgery or cholecystectomy.Methods Three-hundred and fifteen patients (age, 20–65 years) received intravenous granisetron (1mg or 3mg) or placebo immediately before the end of anesthesia. After treatment, patients were observed for 24h, and the occurrence of nausea and vomiting was recorded and safety was assessed. The no-vomiting rate, time-to-first vomiting episode, and severity of nausea were recorded.Results The no-vomiting rates in patients receiving granisetron 1mg and 3mg were significantly higher than that in the placebo group (83.7%, 78.8%, and 57.9%, respectively; P = 0.0004 for 1mg vs placebo, P = 0.001 for 3mg). Time-to-first vomiting episode was longer in the granisetron 1-mg and 3-mg groups than in the placebo group (time-to-event analysis, Kaplan-Meier, log-rank test; 83.2%, 80.1%, and 59.1%, respectively; P = 0.0002 and P = 0.0010). The severity of nausea was also less in granisetron-treated patients (25.2%, 11.5%, and 15.4% severe nausea incidence for placebo, granisetron 1mg, and granisetron 3mg, respectively; P = 0.00003 and P = 0.002). Fewer rescue medications were required in the two granisetron-treated groups compared with those receiving placebo. Adverse events were similar in all groups. No differences in efficacy or safety were observed between granisetron doses.Conclusion Granisetron is well-tolerated and more effective than placebo in the prophylactic control of nausea and vomiting after surgery. This study suggests that the optimum dose of granisetron is 1mg.*See Appendix.     

去甲万古霉素载药涤纶血管材料体外抗菌活性测定

目的：评价去甲万古霉素（NV）载药涤纶血管材料体外抗菌活性。方法：血管材料剪成直径6mm圆形。分别制成空白涤纶材料和载药（NV）涤纶材料，分别于0，7，14，28d取样观察体外缓释性能。选用耐甲氧西林表皮葡萄球菌（MRSE）和耐甲氧西林金黄色葡萄球菌（MRSA）作为试验菌，分别观察空白和载药涤纶血管材料0．7，14，28d和快慢相的抗菌效果。结果：两种细菌0，7，14，28d载药涤纶材料-细菌混合培养液的菌落数显著少于空白涤纶材料-细菌混合培养液（P均〈0．001）。结论：体外试验证实载NV涤纶材料MRSE和MRSA具有抗菌作用，且可持续维持28d。提示该载药材料具有持久抗菌活性，可用于制备抗感染血管移植物。     

真皮下血管网岛状皮瓣抗菌力的实验研究

为研究真皮下血管网薄皮瓣用于感染创面的可行性,在家猪臀部两侧分别形成以旋髂深血管主干分支为蒂的传统岛状皮瓣和远侧50%修薄的真皮下血管网岛状皮瓣。用细菌计数、吖啶橙荧光染色测定白细胞吞噬指数和白细胞内杀菌率,应用激光多普勒、墨汁灌注、透明标本等方法,对两种皮瓣的抗菌力作自身对照研究。结果表明,真皮下血管网岛状皮瓣的抗菌力明显降低,可能与皮瓣修薄后血供减少,白细胞功能相应降低有关。     

真皮下血管网岛状皮瓣抗菌力的实验研究

为研究真皮下血管网薄皮瓣用于感染创面的可行性，在家猪臀部两侧分别形成以旋髂深血管主干分支为蒂的传统岛状皮瓣和远侧５０％修薄的真皮下血管网岛状皮瓣。用细菌计数、吖啶橙荧光染色测定白细胞吞噬指数和白细胞内杀菌率，应用激光多普勒、墨汁灌注、透明标本等方法，对两种皮瓣的抗菌力作自身对照研究。结果表明，真皮下血管网岛状皮瓣的抗菌力明显降低，可能与皮瓣修薄后血供减少，白细胞功能相应降低有关。     

Effects of intravenous ondansetron and granisetron on hemodynamic changes and motor and sensory blockade induced by spinal anesthesia in parturients undergoing cesarean section

BackgroundSpinal anesthesia has many advantages for cesarean section parturients, but hypotension is considered the most frequent complication and can be managed by different interventions. One of these interventions is to give a serotonin receptor antagonist prior to spinal anesthesia.ObjectivesTo compare between two serotonin receptor antagonists on the hemodynamics, sensory, and motor blockade induced by intrathecal bupivacaine in parturients undergoing cesarean section.Patients and methodsSixty patients undergoing elective cesarean section under spinal anesthesia by intrathecal bupivacaine were randomly divided into three groups (20 pregnant females of ASA I–II physical status in each group). Group O received intravenous 4 mg ondansetron diluted in 10 ml normal saline and injected over 1 min, 5 min before spinal anesthesia, group G given intravenous 1 mg granisetron by the same route and group S given 10 ml normal saline. Mean arterial blood pressure, heart rate, vasopressor use, sensory, and motor blockade were assessed.ResultsDecreases in mean arterial pressure were significantly lower in group O than groups G and S with lower vasopressor use (P < 0.05), while there was significant faster sensory recovery in group G than groups O and S (P < 0.05). Actually, there were significant decrease in the incidence of nausea in groups O and G than group S (P = 0.008).ConclusionIn parturient females undergoing elective cesarean section, intravenous 4 mg ondansetron before subarachnoid block significantly decreased both the hypotension and the doses of vasopressor used, while intravenous 1 mg granisetron prior to subarachnoid block induced faster sensory recovery compared to both the ondansetron and the saline groups, with no significant differences between the later two groups.     

Albumin reduces the antibacterial activity of polyhexanide-biguanide-based antiseptics against Staphylococcus aureus and MRSA

Background

Wound infection is one of the major complications in acute and chronic wound healing. Antiseptic solutions and wound irrigating agents are routinely used for therapy and prevention in healthcare today. Even if wound exudate contains total protein concentrations up to 9.3% and albumin concentrations up to 2.7% its influence to the antibacterial efficacy of these agents is barely investigated.

Materials and methods

This study analyzed the antibacterial effect of polyhexanide biguanide (PHMB) agents (PHMB-concentration 0.005–0.1%) against Staphylococcus aureus and methicillin-resistant-S. aureus (MRSA) after 2 min incubation in presents of albumin in different concentrations (0–3%) in a standardized quantitative suspension assay.

Results

A significant decrease of the antibacterial activity against S. aureus was shown for a PHMB-concentration of 0.005% from 0.3% albumin (p < 0.05), respectively highly significant from 0.75% (p < 0.01) on. Thereby the loss of antimicrobial effect was presented as a linear correlation to the rising concentration of albumin. Furthermore a reduction of the antibacterial activity against MRSA in comparison to S. aureus was presented, for albumin concentrations from 3% on highly significant (p < 0.01).

Conclusion

The study showed that albumin causes a significant decrease of the antibacterial potency of PHMB-based antiseptics. Furthermore a diminished potency of the investigated substances for MRSA-contaminated wounds must be taken in consideration. If in vitro experiments show a significant decrease of antibacterial efficacy in the presence of albumin a sufficient activity of PHMB-based agents in clinical practice, especially in cases of exuding wounds or dried-up exudates, cannot be expected.     

Ondansetron, granisetron, and dexamethasone compared for the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy

BACKGROUND: Laparoscopic cholecystectomies are associated with an appreciably high rate of postoperative nausea and vomiting (PONV). This study was designed to compare the effectiveness of ondansetron, granisetron, and dexamethasone for the prevention of PONV in patients after laparoscopic cholecystectomy. METHODS: A total of 80 American Society of Anesthesiologists (ASA) physical class I-II patients scheduled for laparoscopic cholecystectomy were included in this randomized, double blind, placebo-controlled study. All patients received a similar standardized anesthesia and operative treatment. Patients were randomly divided into four groups (n = 20 each). Group 1, consisting of control patients, received 0.9% NaCl; group 2 patients received ondansetron 4 mg i.v.; group 3 patients received granisetron 3 mg i.v.; and group 4 patients received dexamethasone 8 mg i.v., all before the induction of anesthesia. Both nausea and vomiting were assessed during the first 24 h after the procedure. RESULTS: The total incidence of PONV was 75% with placebo, 35% with ondansetron, 30% with granisetron, and 25% with dexamethasone. The incidence of PONV was significantly less frequent in groups receiving antiemetics (p < 0.05). The differences between dexamethasone, granisetron, and ondansetron were not significant. CONCLUSIONS: Prophylactic dexamethasone 8 mg i.v. significantly reduced the incidence of PONV in patients undergoing laparoscopic cholecystectomy. Dexamethasone 8 mg was as effective as ondansetron 4 mg and granisetron 3 mg, and it was more effective than placebo.