共查询到20条相似文献,搜索用时 78 毫秒
1.
异丙酚及咪唑安定诱导对心脏瓣膜轩换术患者血液动力学的影响 总被引:8,自引:2,他引:6
目的:比较异丙酚和咪唑安定对心脏瓣膜置换术患者在诱导前后对血液动力学的影响。方法:20例ASAⅡ-Ⅲ级,成年患者随机分成2组,分别静注异丙酚2mg/kg(P组)或咪唑安定0.2mg/kg(M组)诱导。局麻下插Swan-Ganz导管到肺动脉,分别在诱导前,注药后2、5、10分钟时测血液动力学变化。结果,P组SP、DP、MAP、CO在诱导后2分钟即显著下降(P〈0.05),M组SP、DP、MAP和CO 相似文献
2.
咪唑安定和异丙酚麻醉诱导对心脏瓣膜病人血液动力学的影响 总被引:6,自引:0,他引:6
本研究采用Swan-Ganz导管和热稀释测定方法,观察心脏瓣膜手术在咪唑安定和异丙酚麻醉诱导和气管插管时的血液动力学变化。资料和方法择期心瓣膜手术病人26例。麻醉前随机分成咪唑安定组(M组)和异丙酚组(P组)。M组男4例、女9例,平均年龄39.9岁、身高159.5cm、体重49.4kg;P组男5例、女8例,平均年龄37.5岁、身高160.8cm、体重52.8kg。麻醉前半小时肌注哌替啶1mg/kg、安定7.5~10mg及东莨菪碱0.3mg。麻醉诱导:M组用Roche公司产咪唑安定0.5mg/kg… 相似文献
3.
4.
5.
异丙酚麻醉和腹腔镜胆囊切除术对血流动力学的影响 总被引:13,自引:0,他引:13
目的;了解异丙酚麻醉和腹腔镜胆囊切除术(LC)对血流动力学的影响。方法;在8例非肥胖ASAⅠ-Ⅱ级患者使用异丙酚2mg/kg,静脉诱导前,后5和10分名目气腹(腹内压0.67,1.33和2kPa),反向屈氏卧位后5,20和35分钟。放气后2,15和30分钟,分别测录MAP,肺动脉压,肺毛细血管楔压,CVP,心输出量(热稀释法)。 相似文献
6.
川芎嗪对大鼠在体缺氧性肺血管收缩反应的影响 总被引:1,自引:0,他引:1
以大鼠在体(in vivo)全血恒流灌注模型观察川穹嗪对缺氧性肺血管收缩(HPV)反应的影响。血液恒流灌入肺动脉的速度为14ml/min,平均肺动脉压(MPAP)为2.44±0.42kPa,吸入3%O2+4%CO2+93%N2混合气后,MPAP明显升高至3.69±0.55hPa,产生HPV反应。当注入川芎嗪4mg/kg和 8mg/kg后, MPAP分别下降至 2. 90± 0. 30kPa和 2. 48± 0. 33kPa,抑制升压反应分别为 63%和96%。结果表明,川芎嗪可明显抑制HPV且与剂量有关。 相似文献
7.
乌拉地尔预防气管插管时心血管反应的观察 总被引:17,自引:0,他引:17
46例(ASAI ̄Ⅱ)全麻择期手术患者随机分为A(n=23)、B(n=23)两组。麻醉用安定0.2mg/kg、2.5%硫喷妥钠5mg/kg、琥珀胆碱1.5mg/kg快速诱导气管插管。组A在琥珀胆碱后即静注乌拉地尔0.5mg/kg。结果:组A插管后心血管反应较稳定,SBP、DBP、MAP、HR和RPP分别升高6%、12%、15%、24%和28%;组B插管后上述参数分别升高30%、37%、33%、48 相似文献
8.
患者.女,26岁,体重46kg。先天性心脏病、房间隔缺损(ASD),拟行ASD修补术。术前心电图诊断为三度房室传导阻滞(ⅢA-VB)、结性逸搏心率。超声心动:ASDⅡ孔型33.5mm,三尖瓣中度返流;胸部正位片:肺血多、右房及右室大。术前30分钟肌肉注射阿托品0.5mg、哌替啶50mg。入手术室监护仪连接后HR72次/分,心电图仍为典型皿Ⅲ1-VB(交界部),桡动脉穿刺直接测压(ABP)18.67/10.67kPa。麻醉诱导以静脉注射安定5mg、2.5%硫喷妥钠(SP)10ml、氯胺酮70mg、… 相似文献
9.
10.
11.
Manecke GR Wilson WC Auger WR Jamieson SW 《Seminars in cardiothoracic and vascular anesthesia》2005,9(3):189-204
Chronic thromboembolic pulmonary hypertension results from incomplete resolution of a pulmonary embolus or from recurrent pulmonary emboli. Its incidence is underappreciated, and it is currently an undertreated phenomenon. Pulmonary thromboendarterectomy is currently the safest and most effective treatment for this condition. The surgery involves midline sternotomy, profound hypothermic circulatory arrest, and complete endarterectomy of the pulmonary vascular tree. Success depends on effective coordination of multiple medical teams, including pulmonary medicine, anesthesiology, and surgery. This review, based on the past 30 years of experience at University of California San Diego Medical Center, includes information about the clinical history, diagnostic workup, anesthesia, surgical approach, and postoperative care. Outcome data are discussed, as are avenues for future research. 相似文献
12.
Three patients suffering from acquired pulmonary stenosis are described resulting from compression of the main pulmonary artery by anterior mediastinal teratoma, Hodgkin's disease, and aneurysm of the ascending aorta, respectively; also four others who had compression of the right or left primary branch of the pulmonary artery. The pulmonary artery compression was demonstrated angiographically in every case, and in the patient with right and left pulmonary artery compression the main pulmonary artery pressure tracing was characteristic of bilateral pulmonary artery stenosis. Cardiac catheterization and selective angiography are indicated in patients who have evidence of right ventricular outflow obstruction to determine the site and severity of the obstruction and to differentiate between extrinsic compression and intrinsic stenosis. 相似文献
13.
14.
15.
A comparative analysis of the radiographic features in a group of patients dying with pulmonary embolism and/or pulmonary infarction, and a group without but suspected of having the conditions before death, showed that two radiologists could diagnose pulmonary infarction correctly in 70% of cases. The most useful radiographic sign was elevation of the diaphragm often with slight atelectasis and a small unilateral effusion. The plain chest radiograph was of little value in diagnosing pulmonary embolism without infarction. 相似文献
16.
STUDY DESIGN: Case report. OBJECTIVE: To describe an unusual case of progressive pulmonary hypertension due to recurrent pulmonary embolism in a chronically paralyzed spinal cord injury patient. SETTING: Veterans Administration Hospital, West Roxbury, MA, USA. SUBJECT: A 57-year-old man, tetraplegic, sensory incomplete and motor complete for 30 years due to a diving accident, complained of lightheadedness and shortness of breath intermittently for 7 years. Examination during the latest episode revealed anxiety, confusion, respirations 28 per min, blood pressure 80/60 mmHg, and arterial pH 7.41, P(CO2) 28 mmHg, P(O2) 95 mmHg on 2 l of oxygen. A chest film 2 weeks earlier had revealed a right-sided cutoff of pulmonary vasculature; the current film showed right-sided pleural effusion. Review of EKGs showed a trend of increasing right axis deviation with recovery and recurrences during the previous 9 years and a current incomplete right bundle branch block with clockwise rotation and inverted T waves in V1-4. Computerized tomography with contrast material revealed small pulmonary emboli, but only in retrospect. The patient died shortly after scanning. AUTOPSY: The pulmonary arteries were free of thromboemboli on gross examination but medium and small-sized arteries were constricted or obliterated with thrombotic material microscopically. The estimated ages of the thromboemboli ranged from days to years. The right ventricle was hypertrophied; the coronary arteries were patent. CONCLUSION: Recurrent pulmonary emboli resulted in chronic pulmonary hypertension and eventual death in a patient with chronic tetraplegia. 相似文献
17.
18.
19.
20.
目的 探讨肺动脉高压(PH)时肺动脉压力(PAP)与结构的关系。方法 实验幼犬15条,分2组:分流组(n=12),正常对照组(n=3)。分流术后90d两组行血流动力学检测后,放血处死,肺组织切片行病理学检测。结果 (1)分流组左下肺动脉压(PLLPA)由1.36kPa(1kPa=0.75mmHg)升至11.13kPa,左下肺血管阻力(LLPVR)由5.65Wood’s单位升至14.31Wood’s 相似文献