卡前列素氨丁三醇注射液联合缩宫素治疗高危妊娠产后出血的临床研究

目的:探究卡前列素氨丁三醇注射液与缩宫素联合用药治疗高危妊娠产后出血的临床效果.方法:选取我院产科收治的高危妊娠产妇110例,按照用药方式不同均分为实验组和参照组,每组55例,实验组给予卡前列素氨丁三醇注射液联合缩宫素治疗;参照组给予缩宫素治疗,对比两组产后出血状况、出血量、不良反应以及治疗效果.结果:实验组术后2h出血量明显低于参照组,差异具有统计学意义(P<0.05),实验组产后出血产生率、输血率明显低于参照组,差异具有统计学意义(P<0.05).结论:卡前列素氨丁三醇注射液与缩宫素联合用药治疗降低高危产妇妊娠出血产生率的效果显著.     

缩宫素联合卡前列素氨丁三醇对高危产妇剖宫产产后出血的影响

目的 观察缩宫素联合卡前列素氨丁三醇对高危产妇剖宫产产后出血的影响.方法 选取我院就诊的94例剖宫产高危产妇,随机分为观察组(缩宫素+卡前列素氨丁三醇)和对照组(缩宫素)各47例.对比两组临床疗效.结果 观察组产后2h和24h出血量、产后出血发生率及产后24h血红蛋白下降值均显著少于对照组(P<0.05).观察组术后24h尿量显著多于对照组(P<0.05).观察组不良反应发生率6.38%与对照组不良反应发生率10.64%比较,差异无统计学意义(P>0.05).结论 高危产妇剖宫产应用缩宫素联合卡前列素氨丁三醇可显著减少产妇产后出血,安全性良好,值得临床推广.     

卡前列素氨丁三醇注射液联合缩宫素注射液治疗高危妊娠产后出血的效果

目的 观察卡前列素氨丁三醇注射液联合缩宫素注射液治疗高危妊娠产后出血的效果。方法 择取2019年5月—2020年5月于广东省阳江市妇幼保健院就诊的高危妊娠产妇110例,采取奇偶数的方式随机分为观察组和对照组,每组55例。观察组产妇给予卡前列素氨丁三醇注射液联合缩宫素治疗,对照组产妇给予缩宫素注射液治疗,比较2组产妇产后出血率、附加止血措施发生率、输血率、产后出血量及治疗前后凝血功能指标。结果 观察组产妇产后出血率、附加止血措施发生率、输血率均低于对照组,差异均有统计学意义(P<0.05或P<0.01);观察组产妇产后2 h、24 h出血量均明显少于对照组,差异均有统计学意义(P<0.01);治疗后,2组产妇凝血功能指标均有所改善,且观察组改善程度优于对照组,差异均有统计学意义(P<0.01)。结论 卡前列素氨丁三醇注射液联合缩宫素注射液治疗高危妊娠产后出血的效果显著,可有效减少产后出血量,降低输血率,改善凝血功能,值得临床广泛采纳。     

卡前列素氨丁三醇注射液联合缩宫素预防高危妊娠产后出血临床研究

目的:观察卡前列素氨丁三醇注射液(商品名:安列克)预防产后出血的应用效果。方法:将365例孕产妇随机分为两组,对照组183例在胎儿娩出后立即给予缩宫素10μ静脉滴注,应用缩宫素;观察组182例在胎儿娩出后除立即给予缩宫素注射液10 U静脉滴注外,臀部注射卡前列素氨丁三醇注射液250μg,观察出血量及不良反应发生等指标,比较两组产妇的药物应用效果。结果:观察组应用药物后24 h出血量比对照组明显减少,两组比较差异有统计学意义(P﹤0.05)。结论:卡前列素氨丁三醇注射液与缩宫素注射液联合应用,可有效预防产后出血。     

卡前列素氨丁三醇联合米索前列醇治疗产后出血的临床疗效及对临床相关指标的影响研究

目的:探讨卡前列素氨丁三醇联合米索前列醇在产后出血的应用效果。方法:收集我院收治的产妇50例,其中25例产妇常规使用缩宫素进行产后出血干预,作为对照组,25例产妇在常规治疗的基础上使用卡前列素氨丁三醇联合米索前列醇进行产后出血干预,作为观察组。结果:观察组产妇术中、产后出血量均明显少于对照组,P0.05;观察组出血时间、住院时间也明显少于对照组,P0.05;观察组和对照组产妇不良反应发生率无显著性差异,P0.05。结论:卡前列素氨丁三醇联合米索前列醇可有效降低产妇产时和产后出血量,对于提高产妇产后身体恢复效果具有积极作用,且临床应用产妇无其他不良反应,安全性良好,值得推广应用。     

卡前列素氨丁三醇注射液联合缩宫素预防产后出血的疗效观察

目的观察卡前列素氨丁三醇注射液联合缩宫素预防产后出血的临床效果。方法将50例宫缩乏力性产后出血高危因素产妇随机分为观察组和对照组各25例。观察组胎儿娩出后予缩宫素20U宫体注射,卡前列素氨丁三醇注射液0．25mg肌内注射。对照组予缩宫素20U宫体注射,缩宫素20U静脉滴注。应用称重法计算2组产后2h及24h出血量、出血率和不良反应。结果观察组产后2h及24h出血量明显少于对照组,差异均有统计学意义（P〈0．05）。观察组产后出血率为16．0％（4／25）低于对照组的56．0％（14／25）,差异均有统计学意义（P〈0．05）。结论卡前列素氨丁三醇注射液联合缩宫素治疗宫缩乏力性产后出血较单独使用缩宫素疗效显著,具有临床意义。     

卡前列素氨丁三醇、米索前列醇和缩宫素联合应用治疗产后出血的疗效分析

目的:探讨应用药物卡前列素氨丁三醇和米索前列醇与缩宫素联合应用对于产后出血患者的临床治疗效果。方法:对照组产妇以缩宫素进行治疗,观察组产妇在此治疗基础之上联合应用卡前列素氨丁三醇和索前列醇进行治疗。结果:观察组产妇的总体治疗有效率是97.67%,对照组产妇的总体治疗有效率是81.40%(P0.05);观察组产妇的术中出血量、术后2h、24h出血量以及住院时间等一般指标均少于或短于对照组(P0.05)。结论:卡前列素氨丁三醇和米索前列醇联用缩宫素对于产后出血的疗效比较显著,能够有效改善产妇产后出血症状并缩短产妇住院时间,该联合用药治疗方案的临床应用价值较高。     

卡前列素氨丁三醇预防高危妊娠产妇产后出血的临床疗效

目的探讨卡前列素氨丁三醇预防高危妊娠产妇产后出血的临床疗效。方法选取2013年3月—2015年5月台安县妇幼保健院收治的73例高危妊娠产妇,随机分为研究组37例和对照组36例。两组产妇均行剖宫产,对照组给予米索前列醇和缩宫素预防产后出血,研究组给予卡前列素氨丁三醇和缩宫素预防产后出血,比较两组产妇产后2、24h出血量及输血、产后出血、子宫切除发生率。结果研究组产妇产后2、24h出血量少于对照组,产妇输血、产后出血发生率均低于对照组,差异有统计学意义(P<0.05)。结论卡前列素氨丁三醇预防高危妊娠产妇产后出血的疗效显著,可有效减少产后出血量,降低产后出血发生率,保障母婴生命安全。     

剖宫产术中联合用药预防高危产妇产后出血的疗效观察

目的 探讨卡前列素氨丁三醇联合缩宫素预防高危因素剖宫产产后出血的临床效果.方法 选择120例有出血倾向的高危孕妇,随机分为观察组和对照组各60例.两组孕妇全部采取剖官产手术方法,观察组手术后给予卡前列素氨丁三醇并缩宫素治疗;对照组在手术后采用缩宫素治疗.比较两组孕产妇剖宫产术后2 h及产后24 h的出血量,同时观察卡前列素氨丁三醇使用前后血压变化情况.结果 剖宫产术后2 h及产后24 h的出血量观察组明显少于对照组(P<0.05);卡前列素氨丁三醇使用前后血压无明显变化(P>0.05).结论 卡前列素氨丁三醇能有效预防高危妊娠剖宫产产后出血,且用药安全、方便,易掌握,副反应小,值得临床推广.     

卡前列素氨丁三醇联合缩宫素预防产后出血的临床效果

目的观察卡前列素氨丁三醇联合缩宫素预防产后出血的临床效果。方法选择2018年6月-2019年8月广东省信宜市人民医院妇产科收治的产妇200例,采用随机数字表法分成研究组和对照组,每组100例。对照组采用缩宫素预防产后出血,研究组采用卡前列素氨丁三醇联合缩宫素预防产后出血。对比2组产妇产时、产后2 h、产后24 h出血量,产后出血率及不良反应。结果研究组产妇产时、产后2 h、产后24 h出血量均显著少于对照组(P <0.01);研究组不良反应总发生率及产后出血率均显著低于对照组(P <0.01)。结论卡前列素氨丁三醇联合缩宫素预防产后出血可有效降低产后出血发生率,减少产后出血量,还可降低用药不良反应发生率,保障产妇分娩的安全。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.