A retrospective study of fluid therapy for 100 patients of liver transplantation

Objective: To review the evolution of fluid therapy (IOFT) during liver transplantation (LTX) based on clinical experience in our institute over 7 years. Methods: All patient records (n = 130) of LTX from 1996 to 2003 were examined. After excluding patients with co-morbidities 100 cases were found suitable for IOFT analysis. All patients had undergone LTX and follow-up under the same surgical team. Based on IOFT records we tried to identify distinct patterns of practice evolving over 7 years. Intraoperalive hemodynamics (IOHD) and long-term outcome records were examined. Results: Retrospectively, 3 types of IOFT were found. Group A (n= 18, period 1996-1997) received high amounts of crystalloids; group B (n= 24, period 1998-2000) received high amounts of plasma and albumin; and group C (n = 58, period 2001-2003) received lower amounts of albumin and plasma and recommended amounts of 6% hy-droxyethyl starch 200/0. 5 (HES) and high amounts of vasoprcssors. Intraoperatively, group A exhibited the highest levels of central venous and pulmonary artery pressures in the neo-hepatic stage (P<0. 05). Postoperatively, the patients in group C had the shortest time to extubation; the values for group A,B,C were (15.8±11), (17. 3±10. 2) and (7. 98±3. 2) h respectively( P<0. 05). At the end of one-year follow-up, the patients in group C had the lowest mortality (group A, B, C were 27. 78%, 29. 17% and 6. 25% respectively; P<0. 05). Conclusion: In our institute over the years the use of crystalloids, albumin and plasma during IOFT of LTX is gradually replaced to a large extent by HES. The improvements in IOHD and long term outcomes are likely to be related to improved surgical experience of our team. Nevertheless, the shift in IOFT practices might be associated with an beneficial effect on IOHD or long term outcome. Treatment with proper amount of liquid and vasoactive drugs may be a better method of fluid therapy.     

医学激光设备的应用及选购

激光在医学中的应用非常广泛,根据医用激光仪的特点,介绍了在采购医用激光设备时应考虑的几个问题.     

生物安全三级实验室负压控制系统探究

生物安全三级实验室负压控制必须解决气流组织问题、实验室内各房间的压力梯度问题以及压力稳定性问题.本文从问题入手,提出科学合理的解决方法,为生物安全三级实验室负压控制的设计提供了理论依据;从节能的角度,建议在生物安全实验室内使用全热交换器来更好的节能.     

探讨医疗设备引资(合资)风险管理体系建设

从现代风险管理角度，结合医院医疗设备引资（合资）管理实际，发现存在4类风险。探讨了建立医疗设备引资（合资）风险管理体系。包括风险管理流程、风险管理机制、风险规避措施和风险分析方法等方面，以便度时识别、降低和化解存在的风险。     

难治性癫(癎)持续状态

由于小儿大脑发育不成熟,对异常刺激的分析、鉴别和抑制能力较弱,易出现癫(癎)样发作,甚至导致癫(癎)持续状态(status epilepticus,SE)和难治性癫(癎)持续状态(refractory status epilepticus).难治性SE是临床危重症,死亡率高,存活者也可因长时程发作产生脑损伤而遗留严重后遗症.以下就难治性SE的一些问题进行简要介绍.     

电子文献数据库收录期刊的质量瑕疵及对策

以限题检索为手段，以收录期刊所裁论文为指标，比较分析了国内常用的4种医学电子文献数据库收录医学期刊的质量。结果表明4种医学电子文献数据库均存在收录“非法医学期刊”之瑕疵，但各数据库的收录量有差异。提示广大读者和电子文献数据库使用者注意，并针对此问题提出了相应的对策和建议。     

纳洛酮治疗急性酒精中毒46例疗效观察

目的:总结纳洛酮(naloxone)治疗急性酒精中毒的疗效和经验。方法:对用纳洛酮治疗的46急性酒精中毒患者的临床资料进行分析。结果:纳洛酮治疗轻、中度患者症状消失时间为(0.6±0.1)小时,重度中毒患者神志清醒时间为(3.0±0.3)小时,与传统的治疗相比有明显的优势。结论:纳洛酮是治疗急性酒精中毒的有效药物,使用简单,疗效快速可靠。