婴儿氧舱治疗重度新生儿缺氧缺血性脑病近期头颅CT观察(附51例分析)

目的：探讨足月、重度新生儿缺氧缺血性脑病（HIE）在常规治疗基础上用婴儿氧舱近期治疗效果。方法：将51例足月、重度HIE随机分为治疗组28例，即在常规治疗同时加用婴儿氧舱治疗；对照组23例仅给予常规治疗。对头颅CT进行观察。结果：HIE高压氧治疗组较对照组疗效显著。结论：高压氧治疗重度HIE近期疗效显著，值得尽早应用。     

复方丹参治疗新生儿缺氧缺血性脑病23例疗效观察

目的：观察复方丹参治疗新生儿缺氧缺血性脑病的疗效。方法：46例新生儿缺氧缺血性脑病患儿随机分为治疗组和对照组各23例,治疗组在对照组常规治疗的基础上加用复方丹参注射液2 mL/kg静脉滴注,1次/f,对照组仅予常规治疗。两组均10 d为一个疗程。结果：复方丹参治疗组合对照组,总有效率分别为87.4%和73.5%,两组比较差异有统计学意义（χ2=10.45,P〈0.05）。结论：复方丹参注射液佐治新生儿缺氧缺血性脑病疗效好,相对安全。     

西宁地区新生儿缺氧缺血性脑病的CT表现分析

目的：研究高海拔地区新生儿缺氧缺血性脑病(HIE)的CT表现并进行分析,以提高CT早期诊断价值,达到对该病的早期及时治疗和预后恢复的观察。方法：对西宁地区(海拔2260m)298例临床有缺氧缺血性脑病症状的新生儿患者进行头颅CT扫描检查并对其CT表现进行分析。结果：高海拔地区HIE头颅CT表现为脑水肿和颅内出血,脑水肿可分为轻度、中度、重度三型,颅内出血可见到蛛网膜下腔出血、脑室出血、脑实质出血。结论：高海拔地区HIE发病率明显偏高,早期行头颅CT扫描检查对高海拔地区HIE早期诊断、分型、预后的判断、治疗起着重要决定作用。     

高压氧治疗新生儿缺氧缺血性脑病

目的：探讨高压氧治疗新生儿缺氧缺血性脑病的疗效。方法：将40例确诊为新生儿缺氧缺血性脑病的患儿随机分为两组,对照组采用常规治疗方法（包括吸氧、止痉、脱水降颅压及使用脑细胞代谢激活剂等治疗）。治疗组在常规治疗的基础上行高压氧治疗。结果：治疗组病情迅速恢复,疗效明显优于对照组。结论：高压氧治疗新生儿缺氧缺血性脑病疗效肯定,安全可靠。     

神经节苷酯加高压氧治疗新生儿缺氧缺血性脑病的临床研究

目的观察单唾液酸四己糖神经节苷酯钠(商品名,翔通)加高压氧治疗新生儿缺氧缺血性脑病的临床疗效。方法98例新生儿缺氧缺血性脑病患儿随机分为治疗组(常规治疗上加翔通和高压氧治疗)51例及对照组(常规治疗)47例进行治疗,观察近期疗效、行为神经评分及长期随访结果。结果治疗组患儿的近期疗效及长期随访结果均明显优于对照组(P<0.01,P<0.01)。结论翔通加高压氧治疗新生儿缺氧缺血性脑病能起到积极的治疗作用,并能明显改善预后。     

高海拔地区250例新生儿缺氧缺血性脑病B型超声影像诊断分析

通过对国内外高海拔地区２５０例新生儿颅脑Ｂ型超声影像检查，阐明缺氧缺血性脑病的发病率。以不正常的出生的新生儿及早产儿为主要对象。     

42d龄婴儿脑外间隙与新生儿缺氧缺血性脑病关系的CT分析

目的 研究42d龄婴儿脑外间隙与新生儿期缺氧缺血性脑病的关系,回顾性评价新生儿期缺氧缺血性脑病的诊断并及时指导临床给予适当治疗改善预后.方法 将38例新生儿期患轻度缺氧缺血性脑病的42 d龄婴儿作为一组,将28例因呼吸道引起发热、惊厥以及外伤而行CT头颅检查,并且结果 为阴性的同龄婴儿作为对照组,分别测量2组婴儿的脑外间隙宽度并进行统计学分析.结果 缺氧缺血性脑病组婴儿的额前间隙及前纵裂间隙宽度明显大于对照组,有显著性差异(P＜0.01),而外侧裂间隙宽度的比较无统计学意义(P＞0.05).结论 通过对42 d龄婴儿额前间隙及前纵裂间隙宽度的测量分析有助于新生儿期缺氧缺血性脑病的诊断.     

纳络酮治疗新生儿缺氧缺血性脑病疗效分析

新生儿缺氧缺血性脑病 (ＨＩＥ)为儿科常见的一种疾病 ,将纳络酮早期应用于ＨＩＥ ,在快速缓解临床症状方面获得满意效果。1　对象和方法1.1　对象　选择 1998元月～ 2 0 0 1年 6月住院中、重度新生儿缺氧缺血性脑病的足月新生儿 6 8例 ,并头颅ＣＴ证实为ＨＩＥ ,诊断标准按 1997年杭州会议标准。1.2　方法　根据治疗方法不同分为两组 :Ａ组 :常规组 33例 ;Ｂ组 :治疗组 35例。Ａ组予三项支持治疗基础上 ,于生后第 1～ 3天尽早加用纳络酮 ,剂量 :0 .8ｍｇ、0 .4ｍｇ、0 .4ｍｇ。两组病例胎龄、出生体重、疾病分度经统计学处理无显著性差异。…     

高压氧治疗新生儿缺氧,缺血性脑病疗效观察

1998年1～6月,我们在常规治疗的基础上,应用高压氧(HBO)治疗新生儿缺氧、缺血性脑病(HIE)35例,并与常规治疗方法进行比较,高压氧效果较好。1　对象和方法1.1　对象　HBO组35例,男30例,女5例;年龄7～20d,均为足月第1胎。分娩方式:顺产25例,臀位2例,胎吸助娩3例,剖宫产5例。诊断标准依据中华医学会儿科学会1996年10月修订的新生儿缺氧、缺血性脑病诊断依据和临床分度[1]。轻度10例,中度20例,重度5例。其中伴肺炎5例,湿肺2例,硬肿症2例,消化道出血1例。经CT检查均有蛛网膜下腔出血,表现为脑池内高密度影,并伴脑水肿。常规治疗组32例,男22…     

高海拔地区新生儿缺氧缺血性脑病的临床病理与CT分析

 目的探讨高海拔地区新生儿缺氧缺血性脑病(Hypoxic-ischemic encephalopathy,HIE)的CT表现与临床特点,以进一步提高对该地区HIE的认识.方法对我院7年来所做的598例西宁及其附近高海拔地区新生儿的头颅CT结合临床表现及病理特点进行回顾性分析.结果高海拔地区患儿在寒冷或有轻度窒息时,即可失代偿而诱发HIE.病理主要表现为脑水肿、脑组织坏死及出血3种形式.结论主要病因与文献一致,为宫内窘迫.患儿均出现神经症状,结合病史及CT表现临床可早期做出诊断,以赢得早期治疗.     

高海拔地区尿激酶静脉内溶栓治疗急性心肌梗塞疗效观察

为了了解在高海拔地区使用尿激酶静脉内溶栓治疗急性心肌梗塞的效果。呃生分析了１９８９￣１９９６年６月间在我院心内科和急诊科接受尿激酶静脉内溶栓治疗的７３例，ＡＭＩ者的临床资料。治疗结果显示：溶栓后再灌注率为４９．３％，再灌注患者并发症的发生率及住院病死率明显低于血管未再通者，说明ＵＫ对高原地区的ＡＭＩ也有较好疗效。     

低压舱内大鼠游泳运动模型的建立

目的：大鼠在低压舱内进行游泳时,皮毛上会附着大量气泡,严重影响对大鼠运动能力的判断。本实验旨在建立低压舱内稳定可靠的大鼠游泳运动模型。方法：SD大鼠分平原组和高原组,每组大鼠又分为A、B、C、D四组。A组大鼠为对照组;B组大鼠在游泳用水中加入去污剂;C组大鼠实验前1天用脱毛剂脱去头部以下被毛;D组大鼠用实验前1天沸腾后自然冷却的水游泳。大鼠分别置于平原和5 000m低压舱内饲养,24h后各组在其饲养环境下进行负重2.5%体重的游泳运动。观察大鼠游泳运动情况,并记录游泳力竭时间。结果：在平原,往游泳用水中加入吐温20（B组）或去除大鼠被毛（C组）可减轻大鼠身上附着的气泡,而在低压舱中使用这两种方法无效。无论是在舱内还是在舱外,使用实验前1天沸腾后自然冷却的水（D组）可完全消除大鼠游泳时皮毛上附着的气泡。D组大鼠在平原力竭时间为（56±11）min,显著长于高原力竭时间（25±17）min。结论：通过实验前煮沸游泳用水,可消除大鼠在低压舱中游泳时皮毛上附着的气泡,建立稳定可靠的低压舱内大鼠游泳运动模型。     

The risk of altitude decompression sickness at 12,000 m and the effect of ascent rate

INTRODUCTION: Loss of aircraft cabin pressurization can result in very rapid decompression rates. The literature contains reports of increased or unchanged levels of altitude decompression sickness (DCS) resulting from increasing the rate of decompression. We conducted two prospective exposure profiles to quantify the DCS risk at 12,192 m (40,000 ft), and to determine if there was a greater DCS hazard associated with a much higher rate of decompression than typically used during past DCS studies. METHODS: The 63 human subjects participated in 80 altitude chamber decompression exposures to a simulated altitude of 12,192 m (2.72 psia; 18.75 kPa) for 90 min, following preoxygenation with 100% oxygen for 90 min. Half of the subject-exposures involved an 8-min decompression (1,524 mpm; 5,000 fpm) and the other half experienced a 30-s decompression (mean of 24,384 mpm; 80,000 fpm). Throughout each ascent and exposure, subjects were seated at rest and breathed 100% oxygen. At altitude, they were monitored for precordial venous gas emboli (VGE) and DCS symptoms. RESULTS: The higher decompression rate yielded 55.0% DCS and 72.5% VGE and the lower rate produced 47.5% DCS and 65.0% VGE. Chi square and log rank tests based on the Kaplan-Meier analyses indicated no difference in the incidence or onset rate of DCS or VGE observed during the two profiles. CONCLUSION: Decompression rate to altitude up to 24,384 mpm was found not to have an effect on DCS risk at altitude. However, research is needed to define the DCS risk with decompression rates greater than 24,384 mpm. It was also found that the onset time to DCS symptoms decreases as altitude increases.     

4种药物防治高原脱适应的对比观察

目的筛选防治高原脱适应的药物品种。方法对驻守海拔5170m一年的57名某部官兵,在返回平原(海拔1400m)前5天随机分为5组,分别口服银杏叶片(12人)、复方红景天胶囊(12人)、刺五加片(11人)、复方党参胶囊(11人)、炒面胶囊(对照组,11人),至返回平原第7天停药,共服药12天。采用高原脱适应症状调查表调查部队返回平原第2天、4天、6天的高原脱适应情况,并计算出每天的总得分。采用二级定量负荷踏阶运动实验评价受试者返回平原第7天的PWC170和台阶指数。结果与对照组比较,复方党参组和复方红景天组高原脱适应症状显著减轻(P<0.01或P<0.05),且复方党参组明显优于银杏叶片组和刺五加组(P<0.05)。与对照组比较,复方党参组和复方红景天组PWC170和台阶指数均显著提高(P<0.05)。结论复方党参胶囊和复方红景天胶囊防治高原脱适应效果较好。     

高海拔地区重度妊高征并发严重视网膜病变的综合治疗

目的：探讨高海拔地区（2260m）缺氧因素对重度妊高征患者眼底视网膜影响的程度，并寻求综合救治的措施;方法;对重度长高征常规行检眼镜及裂隙灯显微镜检查眼底，根据视网膜病变程度分视网膜血管病变、视乳头高度水肿及网膜出血渗出、视网膜脱离等。并以积极地非手术综合措施进行治疗;结果：对高度妊高征205例检查后发现198例存在眼底小动脉痉挛及动静脉比例失调，严重视网膜病变102例，其中视乳头高度水肿混浊52例，视网膜出血和渗出38例，视网膜脱离12例，经积极综合治疗，101例患者视力逐渐恢复，眼底病变逐渐消失，治愈率为99.0％;结论：高海拔地区因缺氧因素对重度妊高征视网膜影响大于平原地区，视网膜病变发病率高、程度重，应引起高度重视并行常规检查，早期治断和积极的非手术综合治疗对减轻和减少视力永久性损害有重要意义。     

便携式制氧机的工作原理及性能分析

为检测自主研发的便携式制氧机的工作性能,本文通过高原就地试验和低压舱试验测试了便携式制氧机的氧气浓度、氧气流量和使用者的生理效应。试验结果表明：自主研究的便携式制氧机在高原环境下氧气浓度能维持在90%左右,在5 000m以下使用者的血氧饱和度超过90%,能有效解决高原缺氧问题;使用脉宽调制（PWM）技术,有效地节省了能耗,延长了便携式制氧机在户外的使用时间。     

Air transport of patients with intracranial air: computer model of pressure effects

INTRODUCTION: Air is commonly trapped within the skull in patients who have been treated for trauma or intracranial hemorrhage. In Sweden, when such a patient is transported by air ambulance it is standard procedure to maintain sea-level pressure in the cabin to prevent increased intracranial pressure (ICP). However, this type of flight operation is more difficult and expensive. Maintenance of sea-level cabin pressure is not common practice all over the world, and the criteria supporting the choice of pressurization during transport are inadequate and in need of evaluation. The purpose of this study was to develop and evaluate a model to simulate the influence of intracranial air on ICP during air transport. METHODS: We identified an existing nonlinear model of the cerebral spinal fluid and intracranial pressure dynamics, then added intracranial air as a new component and evaluated the model through simulations. RESULTS: The model behaved as expected, and the simulations indicated that under normal flying conditions with decreased cabin pressure the initial intracranial air volume will increase by approximately 30% at normal maximum cabin altitude, 8000 ft. The increase in ICP depends upon both the initial air volume and the rate of change in cabin altitude. For an intracranial air volume of 30 ml the estimated worst-case increments of ICP from sea level to maximum altitude would be from 10 mm Hg to 21.0 mm Hg, or from 20 mm Hg to 31.8 mm Hg. DISCUSSION: Our results support the need for maintenance of sea-level pressure during air transport of patients with suspected intracranial air, since an ICP increment could potentially impair the patient's clinical condition.     

急性坏死性胰腺炎外科治疗分析

目的：探讨急性坏死性胰腺炎合理的外科治疗方法。方法：１９９７年１月至１９９９年６月共治疗急性坏死性胰腺炎４９例，其中非手术治疗３５例。手术治疗１４例。结果：总治愈率为９１．８４％。其中非手术治愈率为９４．２９％，手术治愈率为８５．７２％。非手术组并发症为０，手术组为１４．２８％。两组死亡率均为０。结论：急性坏死性胰腺炎应采取非手术与手术并重的综合治疗体系。手术应简化，以适度的坏死组织清除和引流较为合理。     

青海高原178例呼吸系统疾病猝死尸检的临床病理分析

目的：分析高原地区178例呼吸系统疾病猝死的病因、病理及临床特点,提高诊疗水平,尊多妻避免呼吸系统猝死的发生;方法：对本院1959年11月—2004年7月1158例尸检进行总譬分析;结果：青海高原呼吸系统疾病明显高于平原（x^2=28．6,P〈0．01）;结论：青海高原猝死的病因呼吸系统占首位且明显高于平原。     

Gastric emptying effects of dietary fiber during 8 hours at two simulated cabin altitudes

BACKGROUND: In a questionnaire survey, long-distance flying staff of a charter airline reported significantly more dyspeptic symptoms than did short-haul crewmember and ground personnel (belching: 57% vs. 37%, bloating: 51% vs. 36%). To elucidate the reason for increased frequency of gastrointestinal symptoms during long-distance flights, we investigated the effects of altitude and diet on gastric emptying, cardiovascular function, and bodily complaints. METHODS: In a 2 x 2 repeated measurement design we simulated an 8-h flight in a hypobaric chamber in 16 healthy men subjected to 2 meal conditions (high fiber vs. low fiber) on separate days, and assigned to either a flight altitude of 2500 m (8200 ft) or 1000 m (3280 ft). The subjects were blinded toward altitude. Heart rate and gastrointestinal symptoms were taken every hour, and gastric emptying was assessed by 13C-octanoic acid breath-test. In a separate experiment, we examined the effect of the two test meals (2 g vs. 20 g of fiber) in 30 healthy men under conventional laboratory conditions and found no significant differences. RESULTS: At an altitude of 2500 m, heart rate was significantly increased independent of the dietary condition. Gastric emptying (T1/2) was significantly delayed at 2500 m (8200 ft) when a high-fiber meal was given (146.3 +/- 58.4 min low fiber vs. 193.9 +/- 54.3 min high fiber). The symptom score for gastric distension (mean: 1.33 +/- 0.3 vs. mean: 1.07 +/- 0.15) and bloating (mean: 1.82 +/- 0.47 vs. mean: 1.34 +/- 0.35) were also significantly increased at 2500 m for the high-fiber meal compared with the low-fiber meal. CONCLUSIONS: Flight altitude is a physiological load. In combination with a high-fiber diet, this induces significant delays in gastric emptying that may explain symptoms of cabin and cockpit crew and passengers on long-distance flights.