小剂量硫酸镁治疗多沙普仑所致躁动18例

小剂量硫酸镁治疗多沙普仑所致躁动１８例刘文东⒇赵兵赵颖崔骥陈金良朱喜春关键词硫酸镁多沙普仑催醒中图法分类号Ｒ９７１多沙普仑广泛应用于全麻后催醒，但其引起苏醒期躁动应注意。我院自１９９３－０６～１９９６－０８对１８例应用多沙普仑全麻催醒患者的剧烈躁动以...     

纳洛酮加氨茶碱用于酒醉后催醒效果观察

纳洛酮普遍用于吗啡类麻醉药的催醒[1] 也可试用于原因不明的昏迷和呼吸深度抑制[2 ] 。氨茶碱为常用平喘药 ,由于具有兴奋中枢作用 ,有人曾用于地西泮、吗啡过量的催醒[3] 。我们将两药合用于酒醉后催醒 ,经对比观察 ,疗效较好。1　对象和方法1 1　对象　酒醉者 73例 ,均为男性 ,年龄 1 854岁。酒醉时间 :1 2 5ｈ ,随机分成 4组 :纳洛酮氨茶碱合剂(Ａ)组 2 0例 ,纳洛酮 (Ｂ)组 1 8例 ,氨茶碱 (Ｃ)组 1 5例 ,对照 (Ｄ)组 2 0例 ,各组间年龄、饮酒量、酒醉时间均无显著差异。1 2　方法　在保持呼吸道通畅的情况下 ,以葡萄糖、胰岛素治疗的…     

多沙普仑对新斯的明拮抗泮库溴铵神经阻滞的影响28例

多沙普仑对新斯的明拮抗泮库溴铵神经阻滞的影响２８例第四军医大学西京医院麻醉科韩曙君①，熊利泽，曾祥龙（西安７１００３２）关键词多沙普仑，泮库溴铵多沙普仑作为全麻后催醒药已广泛应用于临＊床，人们对其副作用亦进行了系列探讨，例如：＊催醒会出现烦躁、恶心呕...     

纳洛酮联合复方丹参治疗急性高原脑水肿的临床观察

目的：总结采用纳洛酮联合复方丹参治疗急性高原脑水肿的疗效和经验。方法：将68例急性高原脑水肿的患者随机分成两组,治疗组36例,对照组32例,治疗组在综合治疗基础上加用纳洛酮与常规用药治疗组进行比较对照。结果：纳洛酮联合复丹参治疗组（总有效率86．1％）,明显高于对照组（总有效率65．6％）,无不良反应。结论：纳洛酮联合复方丹参治疗急性高原脑水肿疗效可靠,作用迅速,使用方便,具有明显的催醒效果,能显著提高抢救成功率,降低病死率。     

2 016例高原肺水肿现场救治体会

目的：寻找现场有效救治高原肺水肿的方法和措施；方法：采用系统回顾性方法，分析我院自1956年-2002年收治的高原肺水肿住院病例；结果：氨茶碱组、速尿组、硝苯吡啶组、酚妥拉明组、654-2组、高压氧组及NO组患者症状、体征、X线平片肺部阴影消失时间与基础治疗组比较，差异有显著性；地塞米松组同基础治疗组相比无统计学意义；各治疗组相比，氨茶碱组、NO组及速尿组的临床疗效明显优于其它治疗组；结论：综合比较各种药物、措施。现场救治HAPE临床疗效的优劣依次为：氨茶碱、NO、速尿、硝苯吡啶、酚妥拉明、高压氧等。     

静脉滴注氨茶碱对慢性阻塞性肺病、肺心病患者通气功能及左心功能的影响

对慢性阻塞性肺病(COPD)与肺心病12例患者及无肺胸疾患的5名志愿者进行氨茶碱负荷剂量(6mg/kg)快速静滴,以放射性核素~(113)In观察其用药前后的LVEF,LVER及FEV_(1.0)、FVC、动脉血气分析。同时测血清氨茶碱浓度。GOPD,肺心病12例,临床上无冠心病诊断依据,但10/12例(85％)显示LVEF异常,且下降程度与病情一致,提示该类患者左心受累。结果表明:(1)静滴氨茶碱后可以改善该类患者的左心功能及通气功能。(2)静滴氨茶碱负荷剂量可以使血清茶碱浓度达治疗中水平。认为氨茶碱可以成为该类患者缓解期治疗的方法。     

过氧化碳酰氨治疗高原肺水肿的临床观察

高原肺水肿是人体快速进入高原或由高原进入更高海拔地区时的常见病,目前多采用抗泡沫吸氧 静推速尿、氨茶碱等治疗,消化道不良反应多。本文探讨过氧化碳酰氨治疗高原肺水肿的疗效。作者选取100例高原肺水肿病人,其中男67例,女33例,初次进入高原者68例,2次以上发病者14例,汉族89例,藏族7例,年龄(17~46)岁,平均24岁。随机分为两组,治疗组采用抗泡沫吸氧 静滴过氧化碳酰氨治疗。对照组采用抗泡沫吸氧 静推速尿氨茶碱治疗,观察临床疗效。结果治疗组与对照组在病人症状的缓解、体征、胸部透视的变化等方面差别无显著性(P>0.05)。这一结果表明:…     

超短波治疗对高原肺水肿患者肺部罗音的影响

目的:探讨超短波治疗对高原肺水肿肺部罗音影响。方法:将中度病情的高原肺水肿随机分为常规治疗组(对照组)和常规治疗加超短波治疗组(实验组),对照组使用吸氧(2L/min)、速尿、地塞米松、氨茶碱静脉注射治疗,实验组在如前常规治疗的基础上加用超短波治疗,观察两组患者肺部罗音消失时间。结果:实验组肺部罗音消失时间明显缩短,t检验,P<0.01,两组比较具有非常显著性差别。结论:超短波治疗高原肺水肿可缩短病程,具有较好疗效。     

催醒宁缩瞳与催醒安降低眼压临床应用的初步探讨

催醒宁、催醒安系军事医学科学院药理毒理研究所自行设计合成的新药,通过动物试验和志愿正常人的检测,证明两药不仅有缩瞳作用而且有降眼压作用。本文分别对催醒宁的缩瞳作用,催醒安的降压作用进行了临床观察。(1)选不同强度的敌瞳剂散瞳后的患者,应用不同浓度的催醒宁缩瞳,并与匹罗卡品、依色林作对照。缩瞳作用与依色林相似,强于匹罗卡品,无毒性反应。(2)选用确诊的开角青光眼患者,一组为1滴药组与匹罗卡品对照,另一组为多次点药组,观察时间最短1周,最长28周。结果表明催醒安与匹罗卡品降压作用相似,而且不引起调节痉挛,易被患者接受。     

格-拉段进藏列车急性高原病现场治疗体会

目的:总结进藏列车急性高原病现场治疗的体会.方法:79例急性高原病来自2010年3月-2010年10月我们随车格一拉段48趟进藏列车旅客,79例患者通过持续吸氧、给予安乃近片、复方丹参滴丸、50％葡萄糖注射液、胃复安片、氨茶碱、甘露醇、速尿、地塞米松、能量合剂等治疗.结果:79例均治愈(其中高原肺水肿2人、高原脑水肿1...     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.