喉罩和气管插管用于妇科腹腔镜手术麻醉的效果比较

目的 探讨喉罩用于妇科腹腔镜手术麻醉的安全性及优点.方法 选择行妇科腹腔镜手术的患者60例,随机分为喉罩组(观察组)30例和气管插管组(对照组)30例,均采用静吸复合全身麻醉.分别观察两组麻醉前(T0)、诱导插管或放置喉罩后(T1)、气腹后30 min (T2)、拔管后(T.)的MAP、HR和SpO2的变化；以及气腹前和T2时气道峰压(PAW)和PET CO2的变化；观察插管或置人喉罩时,拔除前及术中是否出现呛咳、体动、反流、呕吐、误吸等；术后有无咽喉不适、声音嘶哑等并发症.结果 观察组在T1、T2、T3时平均动脉压、心率均升高,但与T0相比,差别无统计学意义(P＞0.05),对照组在T1、T2、T3时平均动脉压更高,心率更快,差异有统计学意义(P＜0.05),两组间比较差异有统计学意义(P＜0.05)；两组T2时PAW和PET CO2均显著高于气腹前(P＜0.05),但组间无差异(P＞0.05)；麻醉期间两组患者Sp()2波动不明显,组内及组间比较,差异均无统计学意义(P＞0.05)；两组患者均未见呛咳、体动等；术后观察组出现咽喉不适2例,对照组出现8例,组间比较,差异有统计学意义(P＜0.05).结论 喉罩用于妇科腹腔镜手术具有安全性好,血流动力学平稳,并发症少等优点.     

口腔矫正器治疗阻塞性睡眠呼吸暂停综合征的疗效分析

阻塞性睡眠呼吸暂停综合征(Obstructivesleepapneasyndrome,OSAS)是一高发而有潜在危险性的疾病,北京地区患病率3.1%,欧美1.3%～4.2%,是为人们进一步认识的一种中老年疾病[1]。由于睡眠时反复发作的上气道狭窄或阻塞,引起睡眠打鼾,鼾声和呼吸暂停交替发生,部分患者反复憋醒使睡眠结构紊乱,白天困倦、嗜睡、健忘;并因缺氧,使一些患者血氧饱和度下降,形成心、脑、肺、肾、内分泌等一系列并发症,被认为是导致高血压、心绞痛及心脑血管栓塞的危险因素之一,目前也被认为是夜间猝死的诱因之一。OSAS的治疗包括手术和保守治疗,夜间多导睡眠仪监…     

基因重组卡介苗的研究现状

卡介苗已成为可同时表达多种外源抗原的新型疫苗载体，通过基因工程技术构建重组卡介苗是改造和提高传统卡介苗的有效途径。本文就重组卡介苗的重要作用、分泌细胞因子的重组卡介苗在免疫应答中的作用特点及应用现状，重组卡介苗的培养与生产条件、存在的问题及应用前景进行简要概述。     

说明文教学中的困惑与解决方法

课程改革教学实践中,说明文的教学在＂淡化文体＂的呐喊声中备受冷落。说明文知识不适应新课程提出的新要求;教材编写对＂知识体系＂和＂主题单元＂的两难兼顾;说明文教学和说明文阅读与写作考查的实际脱离。给教学工作者带来不少困惑,必须寻求新的解决方法。     

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??Comparative study of elastosonography and molybdenum X-ray photography in the diagnosis of breast diseases WANG Han-feng??HUAI Qi-liang??SHANG Yan-kun??et al??Department of Breast Surgery??Zouping Family Planning Maternal and Child Health Service of Binzhou??Binzhou 256200??China
Corresponding author??WANG Han-feng??E-mail??Hansinwang@163.com
Abstract Objective To investigate the value of elastosonography and molybdenum X-ray photography in the diagnosis of breast diseases. Methods From March 2009 to August 2010, 65 female patients with 72 lesions in breast were examined with elastosonography and molybdenum X-ray photography in Zouping Family Planning Maternal and Child Health Service of Binzhou City of Shandong Province.Pathology was used as the golden diagnosing criterion. The accuracy of elastosonography and molybdenum X-ray photography for diagnosing breast diseases was compared. Results Pathological examination showed 53 nodules were benign and 19 nodules were malignant.The sensitivity, specificity and Youden index of elastosonography were 84.2%,96.2% and 0.804 respectively.Those of molybdenum X-ray photography were 68.4%,92.4% and 0.608 respectively. Conclusion The accuracy of elastosonography is much higher than that of molybdenum X-ray photography.The combinative use of elastosonography and molybdenum X-ray photography can elevate the accuracy for differentiating the benign from malignant breast tumours.