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61.
Gregory P. Hetter M.D. 《Aesthetic plastic surgery》1984,8(1):23-26
The author presents a method to test the adequacy of any suction machine pump used in lipolysis surgery, regardless of the altitude and/or sea level of the operating room physical conditions. Surgeons can, therefore, subject any vacuum pump to a vaporization test and thereby ensure its adequacy for lipolysis techniques. 相似文献
62.
Summary Background. Blood clot evacuation through an osteoplastic craniotomy, a procedure requiring neurosurgical expertise and modern medical
facilities, is the accepted method for treatment of a pure traumatic epidural haematoma following closed head injury. In certain
emergency situations and/or in less sophisticated settings, however, use of this procedure may not be feasible. The present
study was undertaken to ascertain whether placement of a burr hole and drainage under negative pressure constituted a rapid,
effective and safe approach to manage patients with simple epidural haematomas.
Methods. Thirteen patients suffering from a traumatic epidural haematoma were treated from January, 1999 to October, 2002. Twelve
patients presented with skull fracture but no fracture was depressed. Placement of flexible tubes through a burr hole, followed
by continuous suction under negative pressure, enabled aspiration of the clot and drainage of the cavity. In 8 cases, the
procedure was performed under local anaesthesia with 2% Xylocaine™ and with intravenous sedation with propofol as needed.
The operative procedure was accomplished within 30 min, and the drainage tube was left in place for 3–5 days. CT scans were
performed daily from days 1 to 5.
Results. In 11 of 13 cases, clots were evacuated successfully and patients regained consciousness within 2 hours. Recoveries occurred
without significant sequelae. In the remaining 2 cases, the drainage tube was found to be obstructed by a blood clot such
that the haematoma was unaffected. A traditional craniotomy was performed within 8–12 hours, and these 2 patients recovered
consciousness within the subsequent 6 hours.
Conclusion. Burr hole evacuation followed by drainage under negative pressure is a safe and effective method for emergency management
of a pure traumatic epidural haematoma. To assure safety patients given this procedure should be monitored by daily CT scans.
Decompressive craniotomy should be performed if consciousness does not improve within several hours. 相似文献
63.
J. Dudel 《Pflügers Archiv : European journal of physiology》1973,338(3):187-199
Summary A capillary suction electrode was developed which contains in its tip a sucrose-gap. The nerve fiber is pulled by negative pressure through the closely fitting openings of an outer and an inner capillary. The space between these openings is o.1 mm wide and can be perfused with sucrose solution. Because of the small physical size of the electrode tip the electrode can be used to record from single unmyelinated nerve fibers in small preparations in combination with other electrodes or transducers.Action potentials were recorded from branches of the motor axon of the opener muscle of the crayfish claw. The amplitude of the recorded action potentials was 7–22 mV, and all records were monophasic positive. The action potential showed depolarizing but not hyperpolarizing afterpotentials.Hyperpolarization of the nerve fiber by –0.05 to –0.2 A current injected through the recording electrode led to about 50% increase in the amplitude of the recorded action potentials and to a marked prolongation of the depolarizing afterpotentials. Depolarization of the fiber decreased the amplitude of the action potential.This work was supported by the Deutsche Forschungsgemeinschaft. 相似文献
64.
目的探讨不同强度的周期性眼外负压吸引对兔视网膜超微结构的影响。方法以新西兰大白兔为实验动物分为对照组和实验组,对实验组分别应用改良准分子激光原位角膜磨镶术负压吸引环置于兔角巩膜缘,以眼球外负压每3s100mmHg(1mmHg=0.133kPa)的速度升高至负压(200±20)mmHg(实验组Ⅰ)、(300±20)mmHg(实验组Ⅱ)、(400±20)mmHg(实验组Ⅲ)、(500±20)mmHg(实验组Ⅳ)。即时眼压分别为35、45、55及75mmHg,维持约5s后释放压力至0,间隔1min后重复上述操作共10个循环,隔日实验1次。2周后电镜观察不同部位兔视网膜超微结构,并比较实验组和对照组的差异。结果实验组Ⅰ与对照组相比未见到明显变化,实验组Ⅱ视网膜超微结构与对照组相比发现细胞器略有增多,提示细胞代谢增强。Ⅲ、Ⅳ组视网膜超微结构有一定变化,其中Ⅳ组超微结构破坏,细胞有坏死征象。结论不同终点眼压的周期性眼外负压吸引对视网膜超微结构影响不同,小于45mmHg基本无影响,55mmHg左右有一定影响,大于75mmHg有明显的破坏作用。 相似文献
65.
目的探讨鼻内镜下吸切器治疗小儿腺样体肥大的疗效和安全性。方法对63例4~12岁腺样体肥大的患儿行鼻内镜下吸切器吸切治疗,所有病例鼻咽侧位片示腺样体厚度/鼻咽腔前后径≥0.71,纤维鼻咽镜检查腺样体阻塞后鼻孔的程度Ⅲ°52例;Ⅳ°11例。其中以鼻塞、流涕首诊15例,睡眠打鼾、憋气、张口呼吸39例,听力下降9例。11例并发扁桃体Ⅲ°,肥大者予以切除,3例鼓室积液同期行鼓膜置管术。结果 9例伴分泌性中耳炎复查声导抗鼓室功能曲线均呈A型,语频听力恢复到发病前水平,12例鼻腔通气正常,3例明显改善,37例睡眠打鼾和张口呼吸症状消失,2例好转。全部患儿术后无大出血、无鼻咽粘连和损伤等症状。结论手术是治疗临床症状明显的腺样体肥大的较好手段,鼻内镜下吸切器行腺样体切除与传统方法相比具有视野清晰、创伤小、出血少、不易残留、治疗效果好等优点,可以推广。 相似文献
66.
Limited preload sensitivity of rotary left ventricular assist devices (LVADs) renders patients susceptible to harmful atrial or ventricular suction events. Active control systems may be used to rectify this problem; however, they usually depend on unreliable sensors or potentially inaccurate inferred data from, for example, motor current. This study aimed to characterize the performance of a collapsible inflow cannula reservoir as a passive control system to eliminate suction events in extracorporeal, rotary LVAD support. The reservoir was evaluated in a mock circulation loop against a rigid cannula under conditions of reduced preload and increased LVAD speed in both atrial and ventricular cannulation scenarios. Both cases demonstrated the ease with which chamber suction events can occur with a rigid cannula and confirm that the addition of the reservoir maintained positive chamber volumes with reduced preload and high LVAD speeds. Reservoir performance was dependent on height with respect to the cannulated chamber, with lower placement required in atrial cannulation due to reduced filling pressures. This study concluded that a collapsible inflow cannula is capable of minimizing suction events in extracorporeal, rotary LVAD support. 相似文献
67.
吸痰对人工气道套囊内压力的影响 总被引:2,自引:0,他引:2
目的 通过观察吸痰时及吸疾后30min人工气道套囊压力的变化,探讨吸痰对人工气道套囊压力的影响.方法 吸痰前用测压表调整人工气道套囊压力为30CMH2O,持续监测吸痰时的套囊最高压力、患者有无咳嗽,以及吸痰后5min、10min、15min、30min的压力,并记录吸痰后套囊压力降至25cmH2O时所需时间.结果 在吸痰过程中81.25%(78/96)患者发生咳嗽.本组套囊内压力平均明显升高至(89.42±31.37)cmH20,咳嗽者套囊内平均压力为(96.00±25.99)cmH2O,高于无咳嗽者套囊内平均压力(60.89±37.14)cmH2O,差异有统计学意义(P<0.01).吸痰时套囊内压力升高者较保持者更易下降至正常低限(25cmH2O),差异有统计学意义(P<0.01).结论 患者吸痰过程中容易发生咳嗽,人工气道套囊内压力波动明显,建议临床上在吸痰后30min内调整套囊内压力,必要时应立即调整,避免囊内压力过低或过高对患者的伤害. 相似文献
68.
目的 探讨阶梯性吸痰法对机械通气患者氧合及血流动力学的影响.方法 将60例患者随机分为试验组和对照组,每组30例.试验组采用阶梯吸痰法,第1阶梯应用最佳呼气末正压(PEEP);第2阶梯为体外振动排痰;第3阶梯为开放吸痰;第4阶梯为持续气道正压(CPAP)肺复张.对照组采用常规开放吸痰加人工气囊肺复张.试验组和对照组均在60min后进行下一次吸痰,同时监测各时间点血流动力学参数、氧代谢指标、肺机械参数的变化.结果 试验组和对照组吸痰后2h血流动力学指标变化不大,试验组氧合指数、肺机械参数较前明显改善并保持2h以上.结论 阶梯性吸痰法可以明显改善氧合,对正常心功能状态下的血流动力学的影响并不显著. 相似文献
69.
70.
目的评价急性ST段抬高心肌梗死(STEMI)患者急诊冠状动脉介入治疗(PCI)中应用血栓抽吸装置的效果与安全性。方法入选50例患者,将Diver CE血栓抽吸导管送至闭塞病变血栓前,将其尾端的注射器抽成负压状态,前后移动抽吸导管,从近端至远端尽可能深地进行抽吸。结果冠脉造影均提示大量血栓征象,抽吸后梗死相关血管血栓负荷明显降低,36例可见红色血栓,42例即刻恢复TIMIⅢ级血流,8例恢复TIMIⅡ级血流。均行支架治疗,术后前向血流均达到TIMIⅢ级,血管开通率100%。结论 PCI中应用Diver CE血栓抽吸装置在血栓负荷较重的AMI患者中能有效地减少梗死相关血管内的血栓负荷及远端栓塞,显著改善患者术后即刻的远端心肌血流灌注,应用Diver CE血栓抽吸导管安全可行。 相似文献