改良型锁骨上臂丛神经阻滞的临床观察

臂丛神经阻滞麻醉是上肢手术最常用的麻醉方法，在基层医院被广泛应用。臂丛神经阻滞的入路很多，临床上采用的传统方法有三种：肌间沟法、锁骨上法和腋路法。肌间沟法和腋路法易出现阻滞不全，锁骨上法虽阻滞完善但易出现气胸等并发症。自1998年以来，我们采用改良型锁骨上臂丛神经阻滞，即经中斜角肌下端外缘入路行臂丛神经阻滞，效果良好。１资料与方法１．１一般资料选择ASAI-II级，年龄18～45岁，上肢手术病人150例，随机分成改良组，肌间沟组和锁骨上组，每组50例。三组病人均术前30min肌注苯巴比妥钠0.1克、阿托品0.5毫克。臂丛神…     

SR治疗腰椎滑脱的疗效观察

对12例腰椎滑脱采用SR对峡部崩裂腰椎复位固定、植骨融合、椎管减压手术。结果：复位满意。症状改善明显，优良率为91．6％，融合率为100％。结果表明，运用SR治疗腰椎滑脱疗效满意。     

ARDS机械呼吸治疗时最佳PEEP的选择

呼气末正压通气(PEEP)已证实对急性呼吸困难综合征(ARDS)有效,由于其病因和严重程度不同,选择PEEP 的压力因人而异,而且随病情变化,每个病人最佳PEEP 也在发生变化,应随时进行监测和调整。本文对两例 ARDS 病人施行机械通气时选择最佳 PEEP 的指标进行探讨。     

应用完全酶解法构建杂交瘤2F_7DNA基因文库

人-鼠嵌合抗体。在人体内应用时,将消除或大大减低由鼠的Ig在人体中引起的异种蛋白反应,这对单克隆抗体的临床应用,将开辟更为广扩的前景。本实验室研制的鼠型杂交瘤单克隆抗体2F_7,在体外已显示对人体小细胞肺癌有良好的反应性,与正常组织极少有交叉反应。抗体与小细胞肺癌抗原,有较好的结合常数、在带人体小细胞肺癌的裸鼠体内,也显     

隆乳术后乳癌1例

1999年10月我科收治1例隆乳术后6年发生乳腺癌的患者,现报告如下。一、临床资料某女,33岁。6年前因原发性乳腺发育不良在外院行“乳房下皱襞切口隆乳术”。所用材料为国产硅凝胶假体,术后乳房柔软,外形良好,无明显不适。2年前在迪厅跳舞时右侧乳房不慎被他人肘部撞击,当时,自觉右侧乳房疼痛,局部无红肿,外形无明显变化,未予处理。半年后,渐觉右侧乳房柔软度不如从前。1年前打保龄球时因用力过猛,突觉右侧乳房撕裂样疼痛,并向右臂放散,在外院检查:右侧乳房较左侧偏大,触诊较硬,未扪及包块,怀疑“假体破裂”。因拒绝取出假体未果。入院前半年…     

异丙酚用于小儿臂丛麻醉辅助用药的临床观察

小儿手及前臂手术的麻醉常规选择臂丛神经阻滞加静脉辅助麻醉完成。以往多用氯胺酮、ｒ ＯＨ丁酸钠、杜冷丁 异丙嗪合剂作为辅助麻醉用药 ,这些药物并发症及不良反应较多 ,而异丙酚是一种新型短效的静脉麻醉药 ,本文将其作为小儿臂丛麻醉的辅助用药收到了满意效果。1　材料与方法选择 30例ＡＳＡＩ级 ,年龄在 3～ 7岁 ,拟行手或前臂择期手术的小儿 ,手术时限少于两小时。术前 30分钟肌注阿托品 0 0 1ｍｇ·ｋｇ-1,在抢救设施完备的手术室内 ,用 (ＨｅｗｌｅｔｔＰａｃｋａｒｄ)监护仪连续监测ＥＣＧⅡ导、ＨＲ、ＢＰ、ＳＰＯ2 ,开放静脉以 …     

窒息新生儿血浆神经肽Y测定及临床意义

目的：研究窒息新生儿血浆神经肽Y(NPY)及β内啡肽(βEP)的含量,探讨它们与新生儿窒息及窒息后脑损伤的关系。方法：采用放射免疫分析法测定37例窒息新生儿及12例健康新生儿(对照组)血浆NPY及β－EP的含量,同时行头颅CT检查,并测定脑实质CT值。结果：重度窒息组血浆NPY及β EP明显高于对照组［(1.85±1.10) μg/L vs (0.04±0.03) μg/L,(2.0 3±1.45)μg/L vs (0.06±0.04) μg/L］,差异有显著性(P<0.01);轻度窒息组NPY及β EP［(0.47±0.38) μg/L,(0.34±0.33)μg /L］低于重度窒息组(P<0.01),但高于对照组(P<0.01)。轻、重度窒息组脑CT值水平分别为(15.60±2.20) Hu和(13.08±2.18) Hu,均低于正常对照组［(20.16±2.66) Hu］(P<0.01);其中重度窒息组脑CT值低于轻度窒息组(P<0.01)。重度窒息组NPY和β EP呈正相关(r=0.4220,P<0.05)。结论：血浆NPY,β-EP含量及脑CT值与窒息程度密切相关。窒息越重,血浆NPY和β-EP含量越高,CT值越低。NPY,β-EP可作为观察新生儿窒息程度和窒息后脑损伤的指标。     

AF内固定系统治疗胸腰椎爆裂性骨折76例疗效分析

我们2000—06／2008—09采用AF内固定系统手术治疗胸腰椎爆裂性骨折76例,效果良好,分析如下。1临床资料1．1一般资料本组男53例,女23例,年龄20～74岁。受伤原因：高处坠落伤28例,交通伤34例,砸伤14例。损伤节段：T12 2例,T12 15例,L1 41例,L2 11例,L3 4例,L4 3例,其中合并四肢骨折6例,23例有不同程度脊髓损伤。椎管侵犯按Wolter分型：Ⅰ度38例,侵犯椎管1／3;Ⅱ度35例,侵犯椎管2／3;Ⅲ度3例.     

急性心血管事件院前急救的应急策略及流程探讨

Objective To study the strategy and process of out-hospital emergency care of acute cardiovascular events. Methods One hundred and eighty-three patients in the Second Affiliated Hospital of Baotou Medical College were prospectively studied. The patients were divided into two groups according to the different ways of out-hospital care, one group consisted of patients who received first-aid care after calling " 120" (94 cases), another was self-aid group consisting of patients sent to hospital by relatives (89 cases). The proportion of persons with higher than high school education and better knowledge for emergency care of patients with heart disease in first-aid group was higher than self-aid group (50. 0% vs. 29. 2%, 83.0% vs. 60. 7%, both P<0. 05). When the patients were brought to the emergency room, they were all treated according to our standard procedure and then registered. All patients were followed up at the end of first and third month after illness. Results Cardiovascular events were mainly myocardial infarction (61.7%) among 183 patients. There were statistically significant differences between two groups in self-aid response time, first disposal time and out-hospital rescuing time [(32.3 ± 5.6) minutes vs. (89.6±8.4) minutes, (47.3±7.3) minutes vs. (149.8±13.5) minutes, (61.7±8.3) minutes vs. [(149.8±13.5) minutes, all P<0. 01], but no difference was found in in-hospital rescuing time [(29. 9±5.3) minutes vs. (31.1±4.5) minutes, P>0. 05]. Morbidity rate was lower in first-aid group than self-aid group in 1st and 3rd month, respectively (2.1% vs. 9. 0%, 4. 2% vs. 12.4%, both P<0. 05). Conclusion Excellent emergency system and procedure can shorten initial disposal time and out-hospital rescuing time, thus improve patients' prognosis. The education level and health knowledge of patients and their raletives directly affect their mode of arriving hospital and prognosis.     

小鼠抗人小细胞肺癌单抗可变区基因的体外扩增,克隆及核苷酸序列分析

近年来越来越多的实验数据表明抗体介导的导向治疗在肿瘤治疗上有着很好的应用前景。但就目前而言,由于人源性单克隆抗体制备的技术尚不完善,绝大多数用于导向的单抗都是鼠源性的,因而在人体内容易引起排斥反应。近几年来世界上许多著名的实验室及公司纷纷应用基因工程技术研制即能保持小鼠抗体原有特异性,同时在人体内又能尽可能