全麻复合硬膜外阻滞用于老年开胸手术的探讨

老年人体质相对较差，对麻醉药耐受性较差。为保证手术顺利平稳，术后患者能及时苏醒，我们采用全麻复合硬膜外阻滞用于老年开胸手术，效果满意。现报告如下。     

YCP—ⅡA型心脏起搏器使用寿命超过12年一例

报道用重庆华伟电子设备厂生产的YCP—ⅡA型心脏起搏器治疗完全性房室阻滞伴阿斯氏综合症一例。起搏器使用 13年零2月后才出现症状复发。经置换起搏器后症状消失。本例提示 ,我们有能力生产全部用国产件制造的、性能可靠、长寿命的VVI型心脏起搏器。     

拉贝洛尔防治颈丛神经阻滞后心血管副反应疗效观察

颈部手术作颈丛神经阻滞后病人多发生平均动脉压(MAP)升高和心率(HR)增快,且程度较重,发生心脑血管意外的可能性也增加[1].我院使用拉贝洛尔预防性治疗颈丛神经阻滞后的心血管副反应,取得较好的疗效,现报道如下.     

星状神经节阻滞治疗交感型颈椎病12例分析

交感型颈椎病临床主要表现为疼痛、感觉异常和植物神经功能紊乱,目前以非手术治疗为主,方法较多[1～3],各具特色.我科自2002年10月以来采用星状神经节阻滞治疗交感型颈椎病12例,取得满意的效果,总结如下.     

下肢手术患者罗哌卡因硬膜外麻醉运动阻滞的半数有效浓度

硬膜外麻醉产生镇痛以及运动阻滞的效果,取决于局麻药的容量,浓度以及剂量,手术要求阻滞区域镇痛完善,肌肉松弛,而术后镇痛则要求在完善的镇痛基础上尽量保留阻滞区域的运动功能,即通常所说的感觉-运动分离阻滞。由于罗哌卡因在较低浓度范围内就能产生良好的感觉-运动分     

硬膜外阻滞复合异丙酚全麻在老年消化系统肿瘤手术中的应用

目的：研究硬膜外阻滞复合异丙酚全麻在老年消化系统肿瘤手术中的应用。方法：ASAⅡ～Ⅲ级、40例老年上腹部手术病人，年龄65～82岁．随机分为2组，Ⅰ组采用硬膜外阻滞复合异丙酚全麻；Ⅱ组采用静吸复合麻醉．观察麻醉、苏醒期间心率、血压、脉搏、血氧饱和度的变化和苏醒期苏醒质量及相关时间。结果：Ⅰ组围麻醉期血流动力学明显较Ⅱ组平稳，苏醒及清醒快，术后并发症少。结论：硬膜外阻滞复合异丙酚全麻可安全有效地用于老年上腹部手术的麻醉。     

星状神经节阻滞用于治疗糖尿病初探

探讨星状神经节阻滞治疗糖尿病( 1 ) ,结果 :使患者的血糖、血脂接近正常。结论 :星状神经节阻滞治疗糖尿病是一种快捷有效的新途径     

Effect comparison between sacral blocking and massage combined with traction on protrusion of lumbar intervertebral disc

Background:Epidural injection is an important method in treatment of protrusion of lumbar intervertebral disc.Especially in the recent decade sacral injection is adopted more and more often.Objective:To compare the clinical effects of sacral blocking and massage combined with traction.Unit:Yinhe Hospital of Beijing.Subjects:290 outpatients with grade Ⅱ of ASAI were selected from May,1994 to July,2000.Patients were randomly divided into observation group(n=145)and control group(n=145).Sacral blocking was adopted in observation group and 80 males and 65 females aged 20-78(mean:46.4)years old were included with disease course 3 days to 30 years.Massage combined with treaction was adopted in control group and 74 males and 71 females aged 22-74(mean:44.9)years oled were inmcluded with disease course 2 days to 10 years.Interention:Sacral blocking:Operation was according to sacral blocking and druge(dexamethasone injection,2 mg;0.75% bupivavaine hydrochloride,5 ml;saline,50ml) were injected slowly after success of puncture.Patient rested for 0.5h after injection and left treatment room if no adverse effects occurred.Massage combined with traction:Massage was adopted after traction to every patients.(1)Massage:Patient was seated at square stool and lower limbs separated naturally with same width of shoulders.Doctors sit behind patient.First,thubs of both hands were pressed on projecting part near spinous process(pressing points were selected according to different projecting part).Flexing and extending forward and backward were taken at the same time and extent was ddecided addording to patients‘ maximal endurable degree,5-10 timmes.Upper part of body was turned 45 degrees to left and right.Massage was still taken to affected part,3-t times.(2)Traction:Pelvis was extracted with general physical therapy and massage table.Supine position,chest and treaction bandage were fixed,tractiron wheel was turned slowly until patient felt comfortable with maximal endurance as limit(traction force,20-40kg),After extracting for 5 minutes,massagee switch was turned on to take rolling massage to bck and both lower libmbs.Traction force was increased every5 minutes and limit was still according to patient‘s maximal endurance,30 minutes for every time,once a day and ten times as a therapeutic course.Cohclusion:Effect of sacral blocking on protrusion of lumbar intervertebral disc was positive and fewer therapeutic time were needed.Massage combined with traction was also effective,safe and no adverse effects wer observed,but more therapeutic times were neeeded and inconveinient.