氯胺酮麻醉复合眶下神经阻滞在小儿唇裂修补术中的应用

目的:观察氯胺酮麻醉复合眶下神经阻滞在小儿唇裂修补术中应用的麻醉效果并探讨其安全性。方法:50例行唇裂修补术患儿,随机分为对照组和实验组,每组各25例。对照组采用氯胺酮麻醉,实验组采用氯胺酮麻醉复合眶下神经阻滞,同时观察两组患儿麻醉过程中循环和呼吸参数的变化以及麻醉效果。结果:实验组麻醉效果优良率为96％,对照组为48％,实验组的优良率明显高于对照组,P<0.05。结论:在小儿唇裂修补术中,氯胺酮麻醉复合眶下神经阻滞,操作简便安全且麻醉效果好,临床上值得推广应用。     

关于办好麻风康复骨干学习班的经验和体会

我省曾是全国麻风病重点流行省份之一 ,截至 1994年基本消灭达标验收合格为止 ,全省累计发现病人 5 330 5例 ,治愈 396 5 4例 ,患病率降至 1/ 10万以下 ,近5年平均发病率降至 0 .5 / 10万以下 ,在全国高中流行区率先实现了基本消灭麻风病的目标[1] 。目前全省治愈存活者约180 0 0人 ,其中ＩＩ级以上畸残者约 5 2 % ,即 930 0余人 ,新发病人每年平均在 6 0例 ,ＩＩ级以上畸残者占 2 0 % ,即 12例 ,因此迄今全省需要进行康复的人数近万例 ,康复工作任重而道远 ,对麻风康复的新理论、新知识、新技术和新方法 ,通过对麻防人员的继续医学教育 ,培…     

穴位注射加威麝骨刺散外敷治疗骨关节炎500例疗效观察

骨关节炎是一种老年慢性疾病，又称退性、增生性关节炎、骨刺等，目前仍缺乏特别有效的治疗方法。临床采用辨证穴位注射药物，中药威麝骨刺散外敷治疗骨关节炎５００例，取得了较为满意的疗效，穴位注射加中药外敷有利于经络的疏通，炎性的吸收和骨质增生的软化萎缩，现总结如下。１ 临床资料 ５００例骨关节炎患者全部经ｘ线拍片确诊，其中男性２３８例，女性２６２例；年龄最大者８２岁，年龄最小者２２岁，平均年龄６０岁，以老年为多见；病程最长者２０余载，病程最短者半年余；治疗次数最少６次，最多１０次。２ 治疗方法２．１ 穴位注…     

兔肢体爆炸伤合并海水浸泡后在不同复温速率及维持浅低体温下机体炎症反应的特征

Objective To investigate effects of different rewarming rates and maintenance of light hypothermia on inflammatory response in rabbits after limb blast injury, coupled with seawater immersion. Methods First, the model of limb blast injury coupled with seawater immersion was reproduced [the animals were immersed to low body temperature of (31.0±0.5℃)]. Then, 24 adult rabbits were randomly divided into group Ⅰ [the rapid rewarming group, n=6, rewarmed to (38±0.5)℃ at a rate of (8.94±0.93)℃/h], group Ⅱ [the slow rewarming group, n=6, rewarmed to (38±0.5)℃ at a rate of (3.88±0.22)℃/h], group Ⅲ [another slow rewarming group, n=6, rewarmed to (38±0.5)℃ at a rate of (2.18±0.12)℃/h], and the H group [the hypothermia group, n =6, rewarmed to (34 - 35)℃ at a rate of (4.49±0.66)℃/h and kept at that temperature till termination of the experiment]. Regulation of ambient temperature and warm transfusion were used to restore body temperature to target levels and maintained there for 6 hours. Blood samples were taken at 5 different times, I.e. Pre-injury time(T0), post-immersion time (T1), the time when rewarming started (T2), 3 h after rewarming (T3), and 6 h after rewarming (T4). Tissue samples from heart, liver, intestinum, lung and kidney were also collected. Levels of TNF-α (tumor necrosis factor-α), IL-1β (interleukin-1β) and IL-6 (interleukin-6) in plasma and MPO (myeloperoxidase) in homogenate were detected. Results Following rewarming, TNF-α, IL-1β, IL-6 concentrations in the plasma of the animals in group Ⅰ and group H were significantly higher when compared with those of the animals in group Ⅱ and group Ⅲ (P<0.05, P<0.01), and MPO activity in homogenate was significantly higher when compared with that of the animals in group Ⅱ and group Ⅲ(P<0.01, P<0.05), and no statistical difference could be seen between group Ⅱ and Ⅲ (P>0.05). Conclusions Rapid rewarming and maintenance of light hypothermia could obviously elevate TNF-α, IL-1β, IL-6 concentrations in plasma and MPO activity in homogenate, following limb blast injury coupled with hypothermia induced by seawater immersion, while slow rewarming (with a rewarming rate of 2-4℃/h) could significantly inhibit TNF-α, IL-1β, IL-6 levels and PMN activity.     

住院精神分裂症患者亲属焦虑情绪多因素分析

目的：探讨住院精神分裂症患者亲属的焦虑情绪及其影响因素。方法：以随机抽样的原则调查2002年3月-2002年6月住院精神分裂症患者亲属130名，使用Zung焦虑自评量表（SAS）及自制问卷进行逐人评定。结果：130人家属中有63名出现焦虑症状，其发生率为48.46％，多元逐步回归分析筛选出影响其焦虑情绪的5项因素。按作用大小依次是：家属健康状况、家属性格、家属年龄、与病人感情、与病人关系。结论：患者亲属的焦虑情绪发生率较高，且受多种因素影响。     

极小剂量氨酰心安致首剂综合征1例

１　临床资料患者男,６９岁,汉族,风心病联合瓣膜病有房颤、心衰,行综合治疗,病情尚稳定,但多汗、房颤、心室率快难以控制,地高辛稍加量即出现室早。在慎重考虑和严密观察下给予氨酰心安６．２５ｍｇ,口服后４ｈ出现大汗淋漓,血压由原来的１６／１０ｋＰａ（１２０／７５ｍｍＨｇ）降为９．３／６．６ｋＰａ（７０／５０ｍｍＨｇ）,心率由原来的８０次／ｍｉｎ降为４４次／ｍｉｎ,处于休克状态,即用静点多巴胺和山莨菪碱（６５４－２）等,抢救４ｄ病情才逐渐平稳,１个月后步行出院,而此患者既往从无类似发作史。２　讨论国外…     

经尺骨鹰嘴截骨入路双钢板治疗C型肱骨远端骨折

目的探讨经尺骨鹰嘴截骨入路,利用内、外侧双钢板治疗C型肱骨远端骨折的方法及疗效。方法2002年3月～2007年12月共采用经尺骨鹰嘴“V”型截骨入路,内、外侧双重建钢板治疗C型肱骨远端骨折29例,男17例,女12例,左18例右11例。年龄23～61岁,平均37．5岁,按AO／ASIF分型,C1型7例,C2型12例,C3型10例。其中开放性骨折3例,尺神经损伤2例,桡神经损伤1例。术后48小时开始功能锻炼。结果随访12～36个月,平均15．4个月。骨折及鹰嘴截骨处全部愈合。皮下感染3例,经换药3周后愈合,神经损伤在3月内均恢复。骨化性肌炎2例。按Cassebaum评分系统评价肘关节功能,优9例,良15例,可3例,差2例,优良率82．8％。结论经尺骨鹰嘴截骨入路可以充分显露肱骨远端,有利于解剖复位粉碎的关节面,内、外侧双钢板固定骨折块,牢固可靠,可满足肘关节早期功能锻炼。