小儿腭裂修复术268例麻醉处理

报告小儿腭裂手术268例麻醉处理。麻醉以静吸复合全麻为主。氯胺酮5mg/kg肌注或羟基丁酸钠80-100mg/kg静注加琥珀胆碱1-1.5mg/kg插管142例，较大儿童用硫喷妥钠4-6mg/kg或丙泊酚2-2.5mg/kg加琥珀胆碱插管126例，75例辅用芬太尼2-3μg/kg。麻醉效果满意，发生导管滑出2例，喉水肿3例，心律失常3例，术后死亡1例。对腭裂手术麻醉药物及方法选择、气管插管途径、可能出现麻醉意外及并发症的原因和处理等加以分析。     

青霉素皮试速发性过敏性休克抢救前后1例报告

1典型病例 患儿，女，12岁，发热，咽痛伴全身乏力3天入院治疗。既往无药物过敏史。查体：T38．9℃．P90次／分，BP100／60mmHg，发育正常，营养不良，神清，皮肤粘膜无黄染，浅表淋巴结无肿大，无鼻翼扇动，口唇无紫绀，咽部充血，双侧扁桃体1度肿大。颈软，心肺无异常，腹平软，腹部皮下脂肪明显减少，无压痛反跳痛，肝脾肋下未及，神经系统未见异常。     

肠套叠患儿的临床护理观察

一段肠管套入相邻的肠内称为肠套叠，是婴幼儿急腹症之一，也是最常见的急性肠梗阻疾患，4～10个月的小儿发病率最高。据统计，山东省肠套叠发病率在急腹症中占第3位。我科2001-2004年收治28例肠套叠患儿，均为10个月内的婴幼儿。经临床护理观察，采用非手术治疗的17例中14例空气灌肠整腹，3例钡剂灌肠整腹；手术复位的11例中8例行肠套叠手术松解，3例行肠管坏死切除。住院时间最长15d，最短1d。现将护理观察介绍如下。     

呼吸功法与播音练声

播音气息训练，其实就是改变呼吸习惯的训练。对于练习者来说，始终是一个破与立的过程，养生功练气为益寿，而播音练气为发声。二者适当相融有百利而无一害。对健康大有益处。[编者按]     

脊柱矫形术中唤醒试验的麻醉体会

<正>脊髓损伤是脊柱外科矫形手术中最严重的并发症,迄今为止仍未能完全避免,当患者手术结束完全清醒后发现脊髓损伤,虽然立即去除器械,采取各种措施,但脊髓功能仍不能完全恢复。     

Changes in T .lymphocyte subsets after severe traumatic brain inJury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.     

电子束全身照射的实施和剂量学研究

自行设计了全身电子线照射(TSEI)的患者固定用标准体位架,以及可以人工360度旋转的特制旋转盘。分别应用剂量仪、仿真石蜡固体体模、固体水,柯达慢感光胶片,胶片分析仪等多种剂量测试工具,对开展该技术所需的临床剂量学参数进行系统的数据采集,并加以分析。总结出一套对临床行之有效的照射剂量参数,并已应用于临床,为逐步开展此项工作的临床机构提供参考。     

训练Wistar大鼠急进高原并运动力竭后血气变化与肺损伤的干预防护研究

本文通过训练大鼠急进高原模型从血气分析与肺的损害,研究干预对训练大鼠肺组织和呼吸功能的损伤与防护。作者在1520m环境设实验组(EG)使用中药抗疲Ⅰ号加入常规饲料中喂养;对照组(CG)常规饲料喂养。EG、CG各40只游泳训练4周后,各选30只3h急进3850m静息1.5h,从中各选10只作为静息对照采集标本,其余EG、CG各20只游泳至力竭后,1h、24h雌雄不分采集股动脉血分析血气。结果:EG与CG相比,血气变化均有显著性差别(P<0.05,P<0.01),肺组织HE染色CG肺泡壁结构不清晰,有红细胞和液体渗出;EG肺泡结构清晰,肺泡内无渗出。这一结果表明:没有防护…